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Paper short abstract

This paper argues that sociology’s value in health research lies not in amplifying lived experience but in analysing the social structures that shape it. Drawing on Luhmann, it shows how incongruence between engagement and sociology enables critical, generative dialogue.

Paper long abstract

This paper explores the distinctive contribution of sociology in the evolving landscape of participatory and experience-centred health research. It argues that sociology’s value lies not in amplifying experiential accounts, but in analysing the social structures and norms that shape them—a contribution that can be obscured by the assumed alignment between qualitative research and engaged health agendas.

Drawing on a recently published article (Engagement and qualitative sociology in health research: proximal, but incongruent, Montenegro & Green, 2025), the paper challenges the notion that qualitative social science and experiential knowledge are naturally allied. While both respond to the limitations of biomedical reductionism, they occupy distinct epistemic positions. Using Niklas Luhmann’s concept of second-order observation, the paper situates this misalignment as a space for generative tension rather than an impase.

The analysis highlights how alignment narratives are shaped by three developments: user-led struggles for recognition, the social sciences’ critique of biomedical dominance, and the institutionalisation of patient engagement in research. Rather than erasing this incongruence, the paper argues for recognising its productive potential. Through sociological analysis, experiential accounts are placed within wider systems of meaning, power, and institutional change.

In a context where lived experience is increasingly mobilised across polarised and unequal settings, the paper calls for a reflexive sociology that does not simply participate in engagement efforts, but interrogates the conditions under which certain voices become visible, legitimate, or useful. This opens space for collaboration without mimicry, and for critique without detachment.