Actor-network theory, technology and medical sociology : an illustrative analysis of the metered dose inhaler

Actor-network theory is a form of relational materialism that codifies a body of ideas developed in the sociology and history of technology. At its centre is a non-dualistic account of the relation between ‘society’ and ‘technology’. In this view society is produced through the mutually constituting interaction of a wide range of human and non-human entities (including machines and technologies). This paper outlines some of the key ideas of actor-network theory and suggests that they might be usefully incorporated into medical sociology (and/or anthropology). An illustrative example is given which demonstrates some aspects of the application of such a non-dualist approach to a particular medical device, the metered dose inhaler (MDI), widely used in the treatment and management of asthma. Within a shifting network of socio-technical relations the MDI and various human actors are seen to have mutually constituted each other. Competencies were created and distributed and linked to panoptical practices of surveillance, control and modification. These included attempts to change both the technologies and the human actors who came into relationship with it. The intricate and mutually constitutive character of the human and the technological in the processes and relationships of sickness and healing is thus demonstrated.