ERS34 Sickness As A Form Of Deviance Flashcards
Health and Illness
Health:
- Absence of disease —> Objective (via diagnosis)
- state of harmony with nature / environment
- complete state of well-being
- functional adequacy (to live everyday life)
- WHO: complete physical, mental, socially well-being and not merely absence of disease / infirmity
Disease: Medically defined pathology
- may exist without subjectively experienced symptoms e.g. cancer in remission
Illness: Subjective interpretation of problems
- involves suffering
- but not require complaint
Sick-role: Rights and Obligations associated with being ill, Social performance between doctor / patient
- can be ill but not adopt sick role
Flow:
Illness —> Visit doctor —> Diagnosis —> Treatment + Legitimise Illness (i.e. sick-role)
- Functionalism perspective (功能主義)
Based on Functionalism:
- Social consensus + Stable social systems
- Sickness: Deviance from this stability
- Responsibilities of doctor and patient (Sick-role)
Goffman:
- Sickness —> Spoiled identity —> interfere with ability to present the self
- Deviance —> Behaviour which fails to fulfil the institutionally defined expectations of person’s role
- Sick role —> modified to include continuing to function socially
Parson:
- Institutions in society (e.g. Economic system) —> perform particular functions —> to keep society stable
- System of medicine:
—> Doctors: Provide medical advice, Policing **Access + **Exit from sick role, determines whether someone is sick
—> Patients: Comply with medical advice
—> Overall: Stabilise society by Controlling sickness + Reducing disruptive effects on social systems resulting from deviance
- Conflict perspective (Marxism, Feminism)
- Social divisions and Conflict among institutions
- Social institutions: serve interests of powerful groups who have a interest in maintaining the social status
—> fighting each other to achieve status - Social disparities in sickness —> Product of Capitalism
- Sickness has **social / economic / political causes (i.e. Capitalism / Gender oppression) —> lead to **Inequalities in health outcomes
簡單而言: Capitalism —> Social disparities in Sickness —> Inequalities in health outcomes
- Constructionist perspective (建構主義)
建構主義: 任何一個社會人的行為都被約定俗成的社會傳統、社會習慣和個人身份來制約或改變。
Deviance: Socially constructed (based on cultural norms)
- Social institutions (e.g. Hospitals) + Social norms + Attitudes + Values + Beliefs
—> Structurally produced rather than Naturally given - Patients and Doctors —> Socialised into certain specific patterns of thinking / behaving
- Social processes —> create systems of medical practices —> vary in different contexts and at different times
- Sickness could be socially and historically re-defined —> Not an objective outcome caused by only biological factors
—> Subjective: affected by social historical conditions, culture etc.
Constructionist perspective: Interactionalism (互動論)
Interactionalism:
- Medical diagnosis / Treatment:
—> process of Negotiation / Adjustment
—> reach Consensus / restore Harmony - Construct understandings of themselves / others
—> based on experiences
—> subjective
—> consequences in the way people act / others react (e.g. Doctor-Patient interaction)
- Interpretivism perspective (解釋主義)
In order to understand sickness as deviance:
- How patients experience / understand sickness
- Biographical / Cultural contexts important when defining sickness
- Medical practices: Processes of interpretation + Experiences of social aspects of sickness
- Subjective
- Postmodernism (後現代主義)
- Interest in discourses, Crisis of legitimation, Sickness: fragmented world
- Medicine —> Surveillance system
- New understanding of body (i.e. new biological understandings of Human)
- Reflexive response to health risk
Example:
“The Medical gaze” by Foucault
- define human body / mind as an object of study
- emphasise on abstracted “facts”
- marginalise human being / biological factors to whose those “facts” relate
- establish relationship of power (Doctor > Patient)
- differ from Interactionalism
Changing social context: Sickness
- Defined differently based on time, historical / social conditions
- Differ in Doctor-Patient relationship
- Changes in patterns of illness
- Technological development
- Growing emphasis on health as distinct from treatment of disease
- Rising costs of sickness - emphasis on effectiveness
Sickness behaviour
The ways in which symptoms are perceived, evaluated, acted upon by a person who recognises pain, discomfort, other signal organic malfunction
—> i.e. how patients decide whether to consult
Factors influencing Illness behaviour
Personal / Environmental factors
- Age, Sex, Social class, Ethnic origin, Marital status, Family size
- Nature of symptoms (Mechanic’s variables —> how do they influence our decision to see a doctor)
- Individual’s personal / social circumstances
- e.g. death of family member from cancer
- people around you force you to see doctor - Perceptions of costs and benefits (whether we believe it is worthwhile)
- Interference with social activities (i.e. with your normal role in society e.g. not able to work)
- Interference with physical activities e.g. sport
Sick-role of patient
Right:
- Allowed to give up some activities depending on nature / severity of condition
- Deserve care
Obligation:
- Get well asap
- Seek professional health
Professional role of doctor
Right:
- Examination and Insight to intimate area physically / personally
- Autonomy
- Authority
Obligation:
- High degree of skills, knowledge
- Act in interest of patient
- Objective and follow professional practice
Summary: Sickness as Deviance
Sickness:
- Deviance from normal social roles
- Undesirable form of deviance
Deviance conditions:
- varies according to culture norms
- depends on how other perceive
- socially constructed (Constructionist perspective)
- relative (based on expectations of norm)
- involves power (norms and applying them are linked to social position)
- conditions that set their conditions apart from normal people —> sick role / sick behaviour
—> can results in marking these patients as socially unacceptable, inferior (mental illness, severe burns, deafness, AIDS etc.)
- medicalisation: defining certain kinds of previously deviant identities as illnesses
