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Sociology of health presentation on the sick role

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  1. 1. The Doctor and Patient Sociology of Health Lesson 2
  2. 2. Functionalist Perspective <ul><li>Parsons and the sick role (1951) </li></ul><ul><li>The medical profession has power in society </li></ul><ul><li>They have a role to diagnose sickness and to try to cure it through treatment </li></ul><ul><li>They also have other powers which function to regulate the amount of sickness in society </li></ul>
  3. 3. The ‘Sick Role’ <ul><li>Just like any other role in society the sick role has certain expectations or norms associated with it </li></ul><ul><li>Therefore being sick is not merely a condition but it is a set of expectations that form a pattern </li></ul><ul><li>The sick role comprises of rights and obligations in Western society </li></ul>
  4. 4. Rights <ul><li>When we are defined as sick we are exempt from some of our normal responsibilities </li></ul><ul><li>Think of the child complaining of a tummy bug – they (if they can prove it) get to have the day off school and stay at home. </li></ul><ul><li>The more serious the complaint the more exemption the person has – more than one day off school, not having to complete chores, not having to attend work for a prolonged period of time if illness is more serious </li></ul><ul><li>Generally the sick person is not blamed for their condition (although there are some conditions for which the sick person is blamed) </li></ul><ul><li>The sick person needs to be ‘looked after’ in some way – a cup of tea brought to bed, chicken soup etc </li></ul>
  5. 5. Responsibilities <ul><li>The sick person is not expected to desire to be sick and take on the sick role </li></ul><ul><li>They are expected to see it as something to avoid </li></ul><ul><li>They are expected to take steps to recover as quickly as possible – take a course of drugs, not put oneself in danger of prolonging the sickness </li></ul><ul><li>The sick person will only have the right to be exempt from their responsibilities if they take these steps to ‘get better’ </li></ul><ul><li>If the person does not take these steps then there will be sanctions on them to do so – think of the moral aspect – the accusation of ‘malingering’ or ‘pretending’ to be ill in order to continue to receive the benefits of being ill </li></ul><ul><li>The sick person must seek medical diagnosis and help if their illness persists – think of responsibilities at work; usually possible to ‘self-certify’ sickness for the 1 st week of absence but requirement of a ‘sick note’ from the doctor for sickness lasting longer. A sanction for not seeking diagnosis/help can result in non-payment of wages or some other sanction </li></ul>
  6. 6. Vulnerability <ul><li>The patient or ‘sick role’ is seen as being vulnerable – that is, they are more passive and weaker than members of society not defined as sick </li></ul><ul><li>In this sense they need to be ‘looked after’ and protected </li></ul><ul><li>When we are sick we have to trust other people to help us and to help make us better </li></ul><ul><li>The patient has to enter into an often intimate relationship with a doctor or member of the health profession </li></ul><ul><li>This level of intimacy is very unusual compared to contact with other roles – think of an internal examination like the ‘smear test’ </li></ul><ul><li>Again, the medical professional has more power which adds more to the vulnerability of the patient/’sick’ person </li></ul><ul><li>This all makes the sick more vulnerable to exploitation </li></ul><ul><li>Therefore medical professions must be highly valued and trust if of paramount importance </li></ul>
  7. 7. Deviance <ul><li>Sick people can also be a threat to society and social order </li></ul><ul><li>The benefits of being sick – exemption from day to day responsibilities are, on their own, attractive to many – many people would prefer the day off work! </li></ul><ul><li>Therefore to ensure that the sick role is less attractive and to avoid the disruption so many sick days could cause, the sick role must also have a negative side </li></ul><ul><li>Being exempt from normal responsibilities is seen as being deviant – that is, not part of mainstream society </li></ul><ul><li>The medical profession is needed to safeguard the rest of society from fraudulent sickness </li></ul><ul><li>In this sense the doctor can be seen as a ‘gate keeper’ filtering those who are genuinely ill from those that are faking! </li></ul><ul><li>They are a form of social control to ensure the smooth running of society and maintain social order </li></ul>
  8. 8. The Interactionist Perspective <ul><li>Some key terminology you need to understand before looking at the Interactionist perspective on the ‘sick role’ </li></ul><ul><li>Interactionists are often termed ‘micro-sociologists’ </li></ul><ul><li>They see the Marxist and functionalist perspectives as having a ‘dehumanising effect’ on the people in society </li></ul><ul><li>It seeks to explain HOW people understand each other and the social world they inhabit </li></ul><ul><li>People construct meaning into their lives – we don’t just passively follow, we make sense of the world </li></ul><ul><li>We interpret society and the actions of others </li></ul><ul><li>Our worlds are fragile and subject to change through reinterpretation </li></ul><ul><li>Interactions with others will shape how we see and understand our social world </li></ul>
  9. 9. More terms to understand <ul><li>Interactionists talk about labels </li></ul><ul><ul><li>Labels identify things or people as distinct from other things or people </li></ul></ul><ul><ul><li>Often, in interactionism, these labels can be negative; assigning negative characteristics to people </li></ul></ul><ul><ul><ul><li>Such as deviant (different from others in some way) </li></ul></ul></ul><ul><ul><li>Labels form part of how we see ourselves and other people (criminal label might cause us to attribute certain undesirable characteristics such as; untrustworthy etc) </li></ul></ul><ul><ul><li>Being given a particular label can make others treat us differently (avoidance, for example, upon discovering someone is a criminal) </li></ul></ul><ul><ul><li>Labels often have a moral aspect </li></ul></ul><ul><ul><li>Labels can alter how we see ourselves and form a significant part of our identity </li></ul></ul>
  10. 10. Interactionists and Health <ul><li>Sickness as a negative label </li></ul><ul><li>Sickness as a negative trait in society – think of ideas about beauty, fitness, competence </li></ul><ul><li>SOCIETAL REACTION </li></ul><ul><ul><li>Negative label can lead others to view the person assigned with the sick label in a negative way </li></ul></ul><ul><ul><ul><li>Can result in the sick person being treated in a negative way </li></ul></ul></ul><ul><ul><ul><ul><li>Such as being treated like a child (having to be taken care of) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Being ignored (speaking to the person with the wheel chair user rather than the wheel chair user) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Treated as being deficient in some way </li></ul></ul></ul></ul><ul><li>This has an impact on the way the person labelled as sick sees themselves </li></ul><ul><ul><ul><li>Negative self-concept (how a person sees themselves) </li></ul></ul></ul><ul><ul><ul><li>Being different from ‘normal people’ </li></ul></ul></ul>
  11. 11. Criticisms of Parsons <ul><li>People often reject the ‘sick role’ – soldiering on regardless </li></ul><ul><ul><li>Avoiding because of negative label </li></ul></ul><ul><ul><li>The sick are not merely passive </li></ul></ul><ul><ul><ul><li>They negotiate with the doctor </li></ul></ul></ul><ul><li>The sick ARE often blamed for their sickness </li></ul><ul><ul><li>Think of obesity, lung cancer, HIV/AIDS etc </li></ul></ul><ul><ul><ul><li>Many illnesses are seen to be the fault of the sick </li></ul></ul></ul><ul><ul><ul><li>Chalfont and Kurtz (1971) </li></ul></ul></ul><ul><ul><ul><ul><li>Alcoholism seen as an illegitimate illness as the ‘sufferer’ has ‘brought it on themselves’ </li></ul></ul></ul></ul><ul><li>Chronic illness </li></ul><ul><ul><li>Parsons’ analysis fits with temporary illness (acute) rather than with long term illness (chronic) </li></ul></ul><ul><ul><ul><li>Person with diabetes is not exempt from everyday responsibilities but is expected to do what they can </li></ul></ul></ul>