Theoretical co-constitution proposes a shift from unilateral causality to a mutual ontological emergence, wherein entities such as individuals and institutions, technologies and health systems, or norms and marginal actors, are not merely influenced by one another but actively sculpt one another’s formation in synchrony. In contrast to linear causation—where A precedes and produces B—co-constitution theorises an entangled dynamism where boundaries between cause and effect dissolve, revealing a continuous interplay that configures both structure and subject. In the realm of International Relations, this lens illuminates how so-called "weak actors"—minor states, civil society organisations, even individuals—can subtly or radically influence global normative architectures, thereby contesting the notion of norms as merely imposed top-down from hegemonic powers; norms and agents emerge together, neither ontologically prior to the other. A compelling illustration lies in technology and healthcare, where the introduction of diagnostic AI tools or decentralised platforms for health records doesn’t merely ‘impact’ the system but rather reconfigures roles, expectations, and ethical frameworks in tandem with institutional responses. The health system, conversely, shapes the uptake, design and meaning of these tools, dismantling the myth of technology as neutral or external. Within organisational settings, particularly in the adoption of CRISPR gene-editing technologies, we observe how legal frameworks, bioethical discourses, market mechanisms and lab practices co-emerge with the tool itself, blurring the line between innovation and institution. Hence, co-constitution articulates a world not of isolated variables acting upon each other, but of symbiotic emergence, where agency is diffuse, contingent, and always relational.
