A Brief History of Institutions The Sick Role Concept

What is a Social Institution? Definition: group of persons banded together for common purposes and having rights, privileges, responsibilities, etc., that are independent from those of individual members. Community Service Organizations Educational Institutions Health Care Institutions 11/9/2018 JCD/REC

Why Do They Exist? Historically, to help maintain the status quo. Public Schools Prisons Hospitals/clinics Today? Some maintain society; some challenge society 11/9/2018 JCD/REC

What Purpose Do They Serve What do you think? What purpose do the following organizations serve? What are they supposed to do? Public education Prisons Health care facilities 11/9/2018 JCD/REC

Structural-Functionalist Theory A group of researchers, many of whom were sociologists, whose understanding of American society focused on how society maintains the status quo of the society. 11/9/2018 JCD/REC

Talcott Parsons (1950s) Looked at illness as a social phenomenon Illness is a deviation from expected behavior and prevents individuals from fulfilling their normal role responsibilities What are role responsibilities? Therefore, illness is a different role that we play. 11/9/2018 JCD/REC

The Sick Role The Sick Role is a temporary role we take on when we are ill. We are not held responsible for the fact that we are ill and/or unable to do what we normally do. Characterized by Rights and Responsibilities: Rights: things you are allowed to do because you are ill and can’t do what you normally do. Responsibilities: things you must do because you are ill and, therefore, deviant. (Obligations) 11/9/2018 JCD/REC

Rights Exempt from “normal” social roles Depends on the nature and the severity of the illness. TEMPORARY Not held responsible for his or her condition Illness is beyond your control. Malfunction that needs to be fixed 11/9/2018 JCD/REC

Obligations/Responsibilities Must try to get well. Must view being sick as undesirable Must seek competent medical help and cooperate with treatment regimen. To Parsons, this meant going to a physician, and only a physician. 11/9/2018 JCD/REC

Problems with the Sick Role Are all illnesses temporary? Doesn’t apply very well to chronic illnesses or emotional health issues. Are all illnesses completely not the individual’s fault? What about addictions? What about exercise, alcohol, smoking, diet, etc. choices? Grounded in middle class values Does everyone have the same values? Bottom line: patient is passive and just follows the physician’s instructions. No accountability. 11/9/2018 JCD/REC

Freidson’s Sociological Types of Illness Adds labeling theory to the mix 3 key variables: Responsibility of the person for their illness Seriousness of the illness How much does it interfere with your life? Legitimacy How does society view your illness? Do you deserve a break today? 11/9/2018 JCD/REC

Perceived Legitimacy Conditional legitimacy: Yes, you deserve a break, but it is time-limited. Unconditional legitimacy: Yes, you get a permanent break, because your condition isn’t going away. Illegitimate: No breaks. Your condition doesn’t merit any breaks STIGMA: treated badly by society. Not a full citizen? 11/9/2018 JCD/REC

Exemptions, Privileges & Obligations Exemptions: things you don’t have to do because you are sick Privileges: Things you get to do because you are sick that you wouldn’t normally be allowed to do. Obligations: responsibilities you have because you are sick 11/9/2018 JCD/REC

Conditionally Legitimate Unconditionally Legitimate Legitimacy Seriousness Illegitimate Conditionally Legitimate Unconditionally Legitimate Minor Deviation Exemptions: none Privileges: none Obligations: to protect others from your condition Example: scars Exemptions: temporary Privileges: temporary Obligations: get better and resume normal activities Example: a cold or flu Exemptions: Permanent Privileges: permanent Obligations: possible, as relevant to the condition Example: amputation. Permanent disability Major Deviation Example: seizure disorder Obligations: seek appropriate care, get better, and resume normal activities. Example: Pneumonia Exemptions: permanent Privileges: Permanent Obligations: few, all centered around the condition. Example: cancer. 11/9/2018 JCD/REC