1. Concepts of Ill Health (P4)
How do you view ill health?
There are different ideas as to what ill health is.
The following are concepts of ill health which look at how individuals and society view ill health.
Illness, Disease & Disability
Iatrogenesis
The sick role
The clinical iceberg

2. What Are Illness, Disease & Disability?

3. Are Illness, Disease & Disability Indicators of Ill Health?
What do you consider to be ill health?
Does someone with a prosthetic leg and who can do all the things that an able bodied person do, have a disability?
Do all people with disabilities have ill health?
Do all illnesses and diseases cause ill health?
Different people have different concepts of what illness, disease and disability are.

4. What is Illness? Illness is subjective.
“I feel ill” can mean different things to different people.
Both these boys have the same symptoms, one feels ‘ill’ and one doesn’t.

5. What is Disease? Disease is Objective.
Symptoms have been diagnosed and have been given a specific name, eg Chickenpox or Cancer or Depression or Multiple Sclerosis etc
Either you have a disease or you don’t.
This child has measles

6. The Clinical Iceberg
This theory says that because only 1/3 of patients present their symptoms to a health professional we are never really sure how many people have ill health.
It gives an indication that peoples’ concept of ill health are different.
Why do you think only 1/3 of people visit the doctor?

7. The Clinical Iceberg What is mental ill health?
Why might people not see health professionals about having mental ill health?

8. Imagine the surgeon slipped – what might happen to the patient?
Iatrogenesis
Ivan Illich (1976) identified that some medical interventions could cause ill health. He called this ‘Iatrogenic Ill health’
Imagine the surgeon slipped – what might happen to the patient?

9. Clinical Iatrogenesis
Ill health caused by medical intervention such as an unwanted reaction to a prescribed drug or an infection acquired while under medical care, eg MRSA
Research a prescription drug and list ALL the side- effects caused.
Prescribed drugs often cause side-effects like:
dizziness
tiredness
headache
nausea                                                                                                                                       

10. Social Iatrogenesis: The loss of the ability to COPE
This maybe linked to:
the medicalisation of everyday life (can’t cope with life without medication)
the instititutionalisation of individuals in medical settings such as psychiatric hospitals.
‘One Flew Over The Cuckoos Nest’. The majority of patients were ‘voluntary’ and felt unable to live life by themselves because they relied on the institution.

11. Cultural Iatrogenesis
The loss people experience from the unrealistic expectations raised by modern medicine.
We expect to be treated for EVERYTHING that is wrong with us by medical professionals, and so we do not expect to suffer at all.
Illich says we are unable to cope with normal pains or suffering because we expect a ‘magic wand’.
Therefore, cultural Iatrogenesis is where we experience a feeling of loss because we can’t be made better. The doctors have not ‘made’ us ill, but our belief in them means that we expect to be perfectly healthy all the time, and so the doctors have given us unrealistic expectations of health, which means that when we suffer we feel it much more than generations before us because they did not have those expectations.

12. Talcott Parsons’ Theory: The Sick Role
Parsons said that society applies ‘rules’ to people who are ill.
The sick person AND the society have obligations:
Sick Person: To seek appropriate medical help AND to want to get better.
Society: To excuse the sick person from normal social roles (eg worker, mother etc) AND to not hold the patient responsible for their condition.
These obligations must be fulfilled for the person to be allowed to be in the ‘sick role’.
Do people always have someone to care for them? No
Does society always hold the person not responsible for their condtion? No, alcholoism, aids, etc.
Do people always seek medical help? No, clinical ice-berg shows us this.
Do patients always want to get better? No, they aresometimes naughty!! Hahaha

13. Talcott Parsons’ Theory: The Sick Role
The sick role is a functionalist theory
If this person is sick then they cannot put into society in the way they usually do.
Society
But they can receive from society in the same way.
It is a functionalist theory because he believed that society sees people as having a function and so if they don’t perform that function they are going to stop society functioning properly.
The sick role is therefore seen as a deviant role.
A functionalist would want the sick person to get better so they can start contributing to society again.

14. Talcott Parsons’ Theory: The Sick Role
If you were the person in the sick role, what roles would YOU be exempt from?
What would you be excused from having to do?
Society
List all the roles you have in life, and describe how you would be excused from doing them. Eg if you are a student you are excused from going to college or doing essays. If you are a worker, you are excused from going to work (sick pay – sometimes). If you are a friend you are excused from social arrangements without fear of losing your friends (hopefully)! If you are a wife/partner you are excused from giving attention to your partner.

15. Analysing The Sick Role
Lets go back to the obligations of the sick person: To seek appropriate medical help AND to want to get better.
How many people don’t seek medical help? What reasons do they have?
Do people always seek medical help? No, clinical ice-berg shows us this.
Do patients always want to get better? No, they are sometimes naughty!! Hahaha. Interferes with their benefits. Institutionalised. Can’t cope without the medical help. Addicted to the medication (pain killers, no condition then no medication!)
Do sick people always want to get better? Describe situations when they don’t.

16. Analysing The Sick Role
Lets go back to the obligations of the society: To excuse the sick person from normal social roles AND to not hold the sick person responsible for their condition.
Are people always excused from their normal social roles? List situations when they are not.
Do people always have someone to care for them? No. mum with kids – has to look after them. Some people feel they have to go to work.
Does society always hold the person not responsible for their condition? No, alcoholism, AIDS, etc. STIs. Lung cancer after smoking
Does society always not hold the person responsible for their condition? List situations when they are.