Social Construction of Health and Illness

Social Constructivism (Constructionism) Functionalism declined in the 1970s and social control re-emerged in Medical Sociology in the form of Social Constructivism It is influenced by: – the labelling theory and Goffman’s critique of psychiatry as a total institution. –Zola (1972) argued that medicine should be understood as an institution of social control, ‘nudging aside’ the traditional institutions of law and religion. –Illich & McKneown’s Role of medicine Medical social control advances through medicalisation

Social Construction of Illness & Medical Knowledge Sociological history of diseases Medicalisation Mediation of Medicine (social meaning of illness) e.g. eating disorders –Process of discovering and characterising illnesses –Attribution of new medical knowledge –Medicine may be based on objective science but application of medical knowledge is not!

Debates within Social Constructivism 1.Problemisation of reality –Interpretation varies between time and place 2.Social creation of ‘facts’ –Products of scientific communities that are realised within discursive contexts 3.Medical knowledge mediates social relations 4.Application of technical knowledge 5.Medicalisation

Medicalisation Thesis Originated with Illich (1976): Clinical iatrogenesis – many medical treatments are ineffective/harmful Social iatrogenesis –create passive consumers dependent on drugs/medicine Structural iatrogenesis –individuals lose ability to cope with pain, sickness and death in a meaningful way

Four steps of Medicalisation (Conrad, 2000) 1.Define a problem in medical terms 2.Use medical language to describe a problem 3.Adopt a medical framework to understand a problem 4.Use a medical intervention to treat it

‘ Illegitimate’ extensions of medicine’s power and influence Making claims upon medical achievements that can then be scientifically justified Illegitimate extension of professional power - patient reliant on doctor Shifts focus of a problem away from the social to the individual

Criticism of Social Constructivism It denies existence of truth and possibility of finding a single valid account of disease and body It takes issue with traditional histories of medicine & undermines possibility of progress Social constructivism has implications of relationships between so-called ‘experts’ and ‘lay people’. Expertise can and is questioned and all types of knowledge are viewed as being valid whether it be experimental knowledge or rational science.