Chapter 5 The Social Meanings of Illness

Chapter Overview Explaining Illness Across History Models of Illness Medicine as Social Control

Competing Models of Illness Medical Model: Sociological Model: Illness is an objective label Illness is a subjective category Illness is a non-moral label Illness is a moral category Illness is an apolitical label. Illness is a political label.

Competing Models of Illness: Medical Model: Sociological Model: Illness is concrete, unchanging reality recognized by all informed observers agree Illness is a social construction Each illness has specific, universally recognizable, features, so diagnosis is objective and consistent Illness is neither specific nor universally recognized, so diagnosis is subjective and culturally bound Each illness is caused by unique biological forces Each illness is caused by social, psychological, and biological factors

Medicine as an Institution The world and culture of doctors The economic, social, and political underpinnings of that world

Medicine as an Institution of Social Control Three examples: Medicalization The Human Genome Project The Sick Role

Medicalization and Social Control Process of identifying a condition as medical problem requiring a medical solution and Process of broadening the definition of an illness

Medicalization can gain support from: Doctors Consumer groups Pharmaceutical companies Managed care organizations

Consequences of Medicalization Promotes social awareness of a problem Unintended negative consequences Increases power of doctors Decreases power of other social authorities Medical treatment deemed only logical solution Depoliticalization Used to justify voluntary and involuntary treatment Counter-pressures toward demedicalization

The Human Genome Project and Social Control Benefits Understand one’s own risks Prevent future disease Reduce anxieties Problems Increases anxieties, especially since offers only partial information Potential for discrimination Potential for genetic/eugenic control

The Sick Role and Social Control Talcott Parsons: Functionalist analysis: Illness as deviance The sick role summarizes social expectations regarding: How society should view the sick How the sick should behave

The Sick Role According to Parsons, society assumes that: Illness is a legitimate reason for not fulfilling normal role Illness is beyond person’s control Sick person must work to get well Sick person must follow medical advice These four expectations = The Sick Role

Critique of the Sick Role Model According to conflict theorists: Deviance is necessary for social change Studying social control agents important Sick role model Doesn’t fit chronic or stigmatized conditions Ignores class, age, gender, race Confuses illness with patienthood