British Sociological Association, Annual conference / PAPER Presentation / Oracles of truth in medical work: AI and Bureaucratic cybernetics, from Noise to Message.

Max will be presenting a paper at the British Sociological Association Annual Conference 2026.

TITLE

Oracles of truth in medical work: AI and Bureaucratic cybernetics, from Noise to Message.

ABSTRACT

This paper will outline the ways in which 'artificial intelligence' technologies in healthcare can be understood as logics of bureaucratic rationalisation. An account will be developed that places ‘artificial intelligences’ as distinct tools of cognitive automation with a longer history in healthcare, one that includes 'decision-support', audit, numericalisation and standardisation. Each of these techniques look to reduce zones of uncertainty. Making use of Linsey McGoey’s notion of ‘oracular power’, the paper argues that the primary locus of power in the UK’s bureaucratic system of medicine has been shifted away from clinicians, creating new techniques of pathologisation.

To automate cognitive practices in medicine, decision making processes needs to be rendered legible to binary/Boolean logics. This has a long history in bureaucratic medicine but is subject to renewed vigour through the deployment of automated technologies reliant upon ‘deep learning’ & ’machine learning’. Through these technologies, automations are performed within a realm of ‘negative-metaphysics’ in which questions regarding the nature-of-things are reduced to engineering problems to be ‘resolved’ at the database level.  In medicine, as in other domains of contemporary life, computer science concepts such as 'knowledge representation and reasoning' and ‘database ontologies’ are vital to such activities and increasingly abstract and centralise knowledge production.

Ultimately, this paper makes a historical & sociological argument regarding the contours of oracular power in medicine. We trace the rise of certain bureaucratic technologies and their problematisation within 'artificial intelligence', and describe the ways they divest power from ‘the clinic' through cybernetic techniques and cognitive 'automations'.