1 SO2003 Lecture 11: Experiencing Health and Illness 29 October, 2007.
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Transcript of 1 SO2003 Lecture 11: Experiencing Health and Illness 29 October, 2007.
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SO2003 Lecture 11:Experiencing Health and Illness
29 October, 2007
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Lecture Outline
Sociology’s relationship to medicine
Structural-functionalism Parsons’ view of the doctor-patient
relationship
The ‘biomedical model’ Obesity as epidemic?
Sociological criticism of biomedicine
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Sociology and medicine
Theoretical impetus US and UK
Medicine’s influence on sociology Inherited medicine’s value judgements Topics reflected an implicit medical template ‘Older’ science dominant Research reifies the authority of the
profession – e.g., The Student Physician: Studies in the Sociology of Medical Education (Merton 1957)
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Structural-functionalism
Sees society as a harmonious set of interrelated institutions Each serves its own function
Parsons’ The Social System (1951): Harmony maintained via social roles Illness is a form of deviance The ‘sick role’ ensures social order
Specific rights/obligations for the patientMirrored in the ‘physician role’
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The ‘sick role’
Criticisms include: ‘Motivatedness’ Entry into the sick role not straightforward Certain forms of illness are stigmatising Pertains only to acute conditions
(Gallagher 1976) Conflict is common (Friedson 1988)
But concept is valuable as a challenge to the biomedical model
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The biomedical model
Focuses on the body of the sick person (i.e., a reductionist model)
Based in the ‘doctrine of specific aetiology’ (Dubos 1960)
Sees disease as culturally universal Claims scientific neutrality Rising prestige of medical specialists Hospital represents pinnacle of medical
practice
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The sociological critique
Causes of illness are often partly social Biomedical model defines them in
individualistic terms Patients are deemed responsible for
‘failed’ treatment
Doctrine of specific aetiology rarely provides a complete explanation
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The sociological critique
‘Disease’ is far from universal Changes over time: medicalisation
Definitions, descriptions, understandings, and interventions become medical
Numerous examples: e.g., childbirthVarious factors: e.g., emergence of medical
specialty, patient demands, politics, trends Current concerns about the ‘obesity
epidemic’Contradictory evidence is problematicCultural imagery is relevant
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Fat Imagery
Disgust involves fear and moral judgement (Miller 1998)
People may react to corresponding panic via humour
‘Fat drag’ now fills the cultural role of ‘black face’
Both ‘race’ and ‘obesity’ are social constructs (Campos 2004)
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The sociological critique
Medical practice is less than value-free May aim to be unbiased, but still normative
in practice Factors like class influence consulting
behaviours (Cartwright and O’Brien 1976) Normative judgements also affect treatment
(Jeffrey 1979)
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The sociological critique
Medicine conceptualised as a form of social control
Foucault (1973; 1977): Power operates through surveillance/self-
surveillance and individuation (New) medical knowledge establishes norms
against which all can be judged
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Tomorrow…
Some implications for inequalities in health Patterns associated with gender, age and
class
Variations in people’s understandings of ‘healthiness’, and Beliefs about how to become/stay
healthy