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Regula Burri (2012) proposed a sociology of images based on a 'visual logic' that consists of three dimensions: visual value, visual performance and visual persuasiveness. She drew on ethnographic study in medical settings, using medical images to explore her visual logic.
What she suggested, in offering her proposal, is that images, even those that have a status of 'objective', such as medical images, are constructions and, further, are constructions that have to be interpreted and communicated.
The ethnographic fieldwork was conducted in radiology departments and magnetic resonance imaging (MRI) units in the United States and in Europe.
Burri (2012, p. 49) explained that in medical settings images, such as X-rays and scans can convey more information faster than words.
In the daily hectic environment of the hospital or clinic, images simplify work processes because they allow one to grasp information in a very short time. Otherwise, physicians would be forced to write long reports and plan extended discussions to communicate a diagnosis to their colleagues.
Thus, visual value, the first of Burri 's (2012, pp. 49–50) dimensions,
is the surplus value of images; it makes images different from auditory, olfactory, flavourful, or tactile signs. The visual value is constructed in social practice; it serves as a phenomenological criterion to distinguish images (as visual signs) from other signs, such as numerical or textual signs. It also underlines that images cannot entirely be transformed into textual or numerical signs without losing some of their advantages.
She further elaborated her choice of the term visual value:
Scientific images, for example, cannot be used in the same way when they are represented in digital numbers instead of showing a visual representation. Art historians have called the non-reducibility of images an 'iconic difference' (Boehm, 1994), by which they emphasize that images are more than texts. However, this notion serves to determine an ontological status of images. Such a definition is problematic because it defines the characteristics of images independently from social practice. The term 'visual value', in contrast, aims to emphasize that image characteristics are never independent from the epistemic practices and social contexts of actors…. (Burri, 2012, p. 50)
For a sociology of images:
The visual value becomes important in social practice because it allows a simultaneous perception of visual information. A sociology of images has to explore the role of the simultaneity of visual information in social practice and understand in what ways it shapes epistemic practices, social interactions and the use of images. (Burri, 2012, p. 53)
Burri stated that it became evident, in the ethnographic fieldwork, that the aesthetic appeal of images is an important issue in medical practice. At first instance this might seem surprising as they aren't normally considered as art works or images of beauty. However, the aesthetic quality valued by practitioners is clarity of image, detail and evidential persuasiveness when making a case to colleagues, patients and their families.
For example, a technologist referred to the beauty of the image when it is 'rich in contrast and detail' and, this requires action during the production process, such as, enhancing body scan images:
This knee here, I've smoothed it once. Why? So that it looks better. For family doctors the first impression of an image is important. For us too, of course. No one likes looking at a completely blurred image.
What can be seen in an image is thus the result of specific aesthetic decisions made during the production of the image. Such aesthetic criteria are incorporated and learned in social practice. (Burri, 2012, p. 50)
In medical practice, Burri (2012, p. 51) contended, the 'visual performance' is also 'shaped by local sociotechnical arrangements and institutional contexts. Different imaging apparatuses, social norms and local routines to fabricate images are all inscribed into medical images'.
Importantly, the image is not self-explanatory and needs interpreting. Visual skills to interpret a medical image are learned in medical school and become habit through routine practice. Interpretive practices are shaped by both professional skills of reading images and by cultural traditions of seeing.
As a consequence, Burri (2012, p. 51) suggested, differences can be observed between older and younger physicians depending on how they perceive and use information technology and the training they received.
The social order in which the actors are embedded is incorporated into their practical sense and shapes image interpretation. Such examples show that what is depicted in the image—the visual performance—is always a social and cultural achievement. The visual performance is not purely objective but contingent and situational, thus affecting medical practices in a contingent way.
The use of images andthe ways realities are represented in an image are thus 'inherently social'. (Burri, 2012, p. 53)
Images are used in medical practice to communicate information and knowledge and to illustrate written reports, this is their visual persuasiveness. Even more importantly, Burri (2012, p. 52) pointed out:
images are used in talks with patients or colleagues to underline an argument and convince others of a diagnosis or research finding….
It is because of their authoritative power that images are deployed to convince patients of a certain therapy. Gynaecologist Bettina Matter explained how she tried to convince a patient to undergo a necessary surgery. The patient did first resist the operation but then agreed after having seen her body scans. In talks with patients, it is mostly the authoritative power of images that becomes relevant. Medical images are scientific images and thus viewed as 'objective facts' with authoritative power.
Burri contrasts the implicit objectivity of medical images in patient conversations with the use within the scientific community; where aesthetic appeal and seductive power are more prized and effective.
The visual persuasiveness in such professional contexts is quite dependent on the aesthetics of images—the more beautiful an image, the more attention it may get. Researchers use images in the scientific community to gain attention and to find support for their own arguments (Latour, 1986, 1990). Scientists and physicians strategically deploy images in conference presentations and in publications. Because medical images are both authoritative and seductive, such images are very persuasive in social communication. (Burri, 2012, p. 53)
For Burri, a sociology of images would explore how social actors use the persuasive power of images and deploy them in communication.
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