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Soc 238 > Chapter 12 > Flashcards

Chapter 12 Flashcards

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1
Q

Origins of Scientific or Western Medicine

A
  • While medicine is the dominant health profession in contemporary society, scientific or Western modern medicine only dates back to the late 19th century
  • However, efforts to care for the sick & explain disease have been common for thousands of years
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2
Q

Hippocrates

A

*Considered the Father of Medicine because he connected disease to natural causes, rather than spirits or magic

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3
Q

Humoral theory of disease

A

Illness due to humor imbalance

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4
Q

17th Century

A

Disease was still viewed in spiritual terms during early Christian times & until early 17th century
- during this time, medical practice was based in monasteries & controlled by religious organizations, but secular healers also existed

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5
Q

Renaissance Period

A

Brought scientific approach to medical knowledge & practice

  • Experimentation, observation & dissection of the human body, emergence of medical schools
  • Mostly benefitted wealthy; rural residents relied on traditional methods
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6
Q

Scientific Revolution

A

Of 17th century changed thinking about much of world

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7
Q

Age of Enlightenment

A

Scientific method became prevalent approach to study of many aspects of life
-medical discoveries included: the circulation of blood by the heart, early vaccination for small pox & anatomical model of disease

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8
Q

19th Century

A

Discovery of stethoscope, improvements in X-ray & microscope, discovery of the cell & the germ theory of disease

  • concern for social medicine, as links were made between poor living & working conditions & infectious diseases
  • Hospital became site of treatment for disease
  • surgery became safer & less painful because of anesthesia & antiseptics
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9
Q

Germ theory of disease

A

Bacteria as the cause of diseases among the most important discoveries

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10
Q

20th Century

A

Scientific medicine & the biomedical approach to illness had established legitimacy
- Many important developments in last century

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11
Q

Allopathic medicine

A

Conventional medicine that relies on the scientific approach by treating disease & illness, based on the biomedical model

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12
Q

Allopathic medicine (Underlying Principles)

A
  1. The determinants of illness are primary biological
  2. Based on engineering model of the body
  3. Health care is focused on curing illness or disability
  4. Medicine is scientific
  5. The Doctor is the authority & expert
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13
Q

Consequences of the determinants of health being viewed as biological

A

Focus on diagnostic tests & prescriptions, therefore Drs. do not need to ask about social factors
*If no observable evidence, complaint may be dismissed by Dr.

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14
Q

Based on Engineering model of the body

A
  • Medical specialization
  • Body as machine= focus on certain body parts
  • Fee-for-service payment
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15
Q

Health care is focused on curing illness or disability

A
  • Acute care

* Focus is impersonal, rather than patient specific

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16
Q

Acute Care

A

Aimed at treatment rather than prevention/addressing social determinants

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17
Q

Medicine is Scientific

A
  • Presumption that all treatments are based in scientific research (randomized control trials) projects air of superiority
  • Assumes neutrality of medicine
  • Proposes universal presentation of disease & response to treatment
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18
Q

The Doctor is the authority & expert

A
  • Have jurisdiction to define & label some as ill= ability to determine what is illness & what is not
  • Drs as always right; patients’ views typically dismissed
  • Neglects social & political processes related to medicalization, pursuit of profit etc.
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19
Q

Medical Dominance

A

The power that medical profession has to control their own work & work of others as well as influence health policy & organization of health care

  • Medicine was & mostly continues to be, the most powerful profession in the health care system
  • Reinforced by scientific advances- as more discoveries were made, more authority was accumulated
  • Drs. restricted activities of other health care occupations
  • Connections to elite members of society & the state allowed this dominance to occur
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20
Q

% of Medical Professionals (2011)

A

10.3%- Doctors
42.7%- Nurses
47%- Others

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21
Q

Freidson (1970)

A

Professional dominance & medical power enforced by Drs.’ clinical role in diagnosis & treatment, in which they possess control over knowledge & supervision of other health professions
*Drs. control diagnosis & treatment which determines work of other health professionals, such as pharmacists, as many therapies require referral from a doctor

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22
Q

Wolpe (1985)

Study These Flashcards
A

Medical dominance lies in social capital
- Institutionalized in Drs. control over licensing, education & self-regulation, which is not subject to formal direction or evaluation by others

23
Q

Marxist analysis (Conflict Theory)

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A
  • In US, medical dominance serves interests of dominant (Capitalist) class
  • Drs can establish & maintain power because of other forms of power that enable control over production of knowledge, practice & institutions of medicine
24
Q

Confederation (1867)

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A
  • Few Dr.s at time of confederation & no med schools or associations (but soon after)
  • most people did not consult Drs. when sick, but natural or spiritual healers
  • Drs. often served wealthy only, & did have same level of respect because of post-operative infection
25
First Canadian Hospital
Established in 17th century, but not until 20th century that hospitals became centre of medical & surgical procedures - prior, hospitals viewed as unhygenic & place for poor & dying
26
19th Century in Canada
No medical profession- struggle between regular & irregule healers - however, physicians have tried to regulate medical practice since late 18th century - took until 20th century to achieve control over medicine - Formal education necessary to assert dominance
27
Canada Medical Act (1912)
Formed the Medical Council of Canada to regulate medical licensing & exams - Establishment of medical dominance rooted in political means
28
Challenges to medical dominance
a) welfare state b) The professionalization of Other Occupations c) Conflicts within medicine d) The demystification of Medicine
29
Welfare State
Emerged in 1930s & 40s - government presumes primary responsibility for the welfare of its citizens - Saskatchewan first to elect social-democratic government that promised to implement government hospital insurance plans (1947) - 1962, SK government implemented provincial medical-care plan & Drs. went on strike= Gov't defeated Drs. which marked a decline in medical dominance because Gov't established power over health care
30
Medical Care Act (1966)
Federal act that laid foundation for Medicare in Canada - diminished power of medical profession to set wages & work conditions by giving government more control - State administered health plans allowed government to regulate physicians work & income - Hospitals became jurisdiction of universities, which brought in other administrators & constrained Drs. autonomy - Shift in focus to social determinants of heath in 1970s & 1980s
31
The Professionalization of Other Occupations
Other health occupations also want control/greater autonomy *Nurses comprise a large number of health care providers in Canada & have more recently increased their scope of practice & independence
32
Nursing
* Historically, nurses have offered compassion & comfort for the sick & dying & approached health as holistic * A subordinate occupation with nurses as victims of medical power * often lacking power in the hierarchical structure of the health care system, which can result in tension with Drs. other nurses etc. * Nursing has become more critical of medicine- research shows that nurses negotiation, disagree, subvert & engage in open conflict with doctors
33
Conflicts within Medicine
Those involved in research often differ from GPs & specialists - specialists focused on acute care & individual treatment, while others advocate for different model of care
34
The Demystification of Medicine
Growing skepticism of medical authority as scientific & indisputable - Individuals are better informed than in the past - Some have accused medicine as being self-serving rather than working to benefit patients - Close ties of medical profession with pharmaceutical companies has raised criticisms
35
Complementary & Alternative Medicine (CAM)
The diagnosis, treatment &/or prevention that complements the mainstream medicine & satisfies a demand not met by conventional approaches - There has been shifts towards de-medicalization, different forms of medicine, & natural or holistic healing approaches
36
Conventional or modern medicine
Medical practices & developed in Europe during the 19th and 20th centuries that are legally recognized by the government
37
Features of CAM
1. Holistic focus 2. Healing as innate to the human body 3. The active role of the patient in his or her healing 4. Often includes a focus is on prevention & well-being 5. Complementary
38
Examples of CAM
- Comprehensive systems: homeopathy - Spiritual & Mental: meditation - Energy work: acupuncture - Dietary therapies: macrobiotics - Manipulation: chiropractic
39
Natural Health Products
* Increasing in use * 75% of Canadians regularly use * Highest in BC
40
CAM Most likely used by:
- Women - Ages 25-64 yrs - Those with more education & disposable income to spend on uninsured services - Western Canada
41
Medicine Works if it Produces
* Changes so that individuals feel more comfortable * Clinical observable changes * Changes that are scientifically attributable to the intervention (treatment)
42
The placebo effect
Despite no clinical effect, there is therapeutic benefit/change
43
Social Support
May relieve health issues/promote well-being
44
The 4 humours
1. Blood 2. Phlegm 3. Yellow Bile 4. Black Bile
45
Barber Surgeons
Surgery was practiced mostly by barbers and had lower status. They learned their skills in apprenticeship in many cases on the battlefield, performed surgeries, managed open wounds and repaired broken bones
46
Apothecaries
Early pharmacists, dispensed herbs and spices, and in the countryside sometimes acted as physicians
47
William Harvey
proved that blood is conserved and then circulated through the body by the heart
48
Giovanni Morgagni
Specific diseases could be traced to specific pathology in individual organs, and hence developed the anatomical concept of disease
49
Josef Leopold Auenbrugger
Discovered that he could detect fluid in the lungs by tapping on the chest
50
Edward Jenner
Paved the way for modern immunology with the discovery that persons inoculated with cowpox developed immunity to smallpox
51
Rene Laennec
Invented the stethoscope
52
iatrogenesis
A concept popularized by Ivan Illich that refers to any adverse outcome or harm as a result of medical treatment
53
Ottawa Charter for Health Promotion
a 1986 document produced by the WHO. It was launched at the first international conference for health promotion, held in Ottawa, Canada
54
Victim Blaming
The process whereby social inequality is explained in terms of individuals being solely responsible for what happens to them in relation to the choices they make and their assumed psychological, cultural and/or biological inferiority

Soc 238 (14 decks)

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