It's more than a case study

I’m a medical sociologist – which is to say that I am interested in the knowledge, practices, and social relations that underpin medicine as a social institution; and in health care as the matrix in which it is set, and the ways that it is linked to other social institutions. I’m also interested in the history and sociology of technology – hence my focus on the development of explanatory models of socio-technical change, discussed in other posts. My small contribution to this field has been to lead a programme of work that has led to the development of Normalization Process Theory.

From my perspective, one of the interesting features of sociological research around health and illness over the past decade has been the growing significance of the broad field of Science and Technology Studies, or STS. A number of commentaries – of which a paper in Health Care Analysis by Casper Jensen is the most recent – have argued that a shift to the theories and methodological perspectives of STS is necessary to secure the intellectual future of ‘medical’ sociology. My research and writing has certainly been influenced by STS although – it seems – not enough for Jensen. In some ways, STS seems to have a good fit with the ways that Sociologists of Health and Illness construe their own field of research. In the UK, at least, the boundaries between the two fields are getting a bit blurred.

Now, STS is constructionist in its theoretical approach; privileges contingent and relational aspects of social life; focuses on specific incidents or cases of general problems; and is largely conducted through the application of qualitative research techniques – often ethnographies, and increasingly also interview-based research. But, as John Law has argued in a recent position paper in Sociological Review, there is a strong argument within the communities of practice that make up STS that it ought to concern itself primarily with case studies, description and classification, and that it should seek neither causal explanations nor should it attempt quantitative generalisation. Actually Law may go further than this. He seems to say that this is the way that we should think about sociology as a whole discipline. I think this is a counsel of despair; a recipe for empirical fragmentation; and a prescription for the loss of analytic power. The multiplication of small-scale, qualitative, case studies of contingencies and relational processes restricts the development of Sociology as a holistic science of social and material relations. If everything is a case, then nothing is a whole.

As a brief aside, the BiomedCentral papers describing Normalization Process Theory passed 18,000 on-line accesses today.