Week 6_1 Medicalization and The Sick Role Flashcards
(27 cards)
Medicalization
Def.
Barker 2008
“processes by which an ever wider
range of human experiences come to be defined, experienced, and treated as medical conditions”
Medicalization
Def.
Conrad 2007
“process of defining a problem in medical terms, using medical language to describe a problem, or using a medical intervention to treat it”
medicalization, when?
the term is emplyoed when there’s a deviant starting point, when something is seen as abnormal and not as medical problem in the sense of the biomedical paradigm
Examples of medicalization
THEN and NOW
Hyperactivity in
child –> Attention Deficit
Hyperactivity Disorder
Hysteria –> Mental Illness
Transexualism –> Gender Dysphoria
Senility –> Alzheimer’s Disease
Body size –> Obesity
Drug Abuse –> Addiction
Examples of demedicalization?
THEN and NOW
Homosexuality
(as illness) –> Homosexuality (as
orientation)
Medical
treatment of
Disability –> Independent living
support for PLWD
Masturbatory
insanity –> Normal pubescent
behavior
Degrees of Medicalization
Minimal
Medicalization
(e.g., domestic
violence, sex
addiction)
«<
Partial Medicalization
(e.g., opioid addiction,
menopause)
> > >
Full
Medicalization
(e.g., death,
childbirth)
What socio-cultural changes
have led to increases in
medicalization?
- Secularization
and the rise of
science - Expansion of
professional
domain - Social
movements and
interest groups - Creation of
medical
markets
At what levels does medicalization occur?
see scheme as well
conceptional
institutional
interactional
medicalization at the conceptional level
- Medical vocabulary or model used to
define problem - May-may not involve medical
professionals or treatments
medicalization at the institutional level
- Medical treatment approach
conceptually incorporated - Physicians as gatekeepers
medicalization at the interactional level
- Medicalization through doctor-patient
interactions - Physician defines problem as
medical/needing medical treatment
Therapeutic Social Control
meaning
Control as definitional
* “The greatest social control power comes from having the
authority to define certain behaviours, persons and things”
What does Therapeutic Social Control entail?
1) Medical Ideology
- Imposed medical model
because of accrued social
and ideological benefits
2) Medical Technology
- Social control through
technology (drugs, surgery,
genetic/other screening)
3) Medical Collaboration
- Physician as information
provider, gatekeeper, inst.
agents and technician
4) Medical Surveillance
- Imposition of a medical gaze;
disease and medical process
monitoring
Impacts of Medicalization
THE GOOD
- “Humanization” of
social problems - Focus on helping
afflicted individuals,
lessening suffering,
etc. - Validation and route
to addressing issue
Impacts of Medicalization
THE BAD AND THE UGLY
- Misplaced assumption of neutrality
- Control by “experts”
- Individualizing of social problems
- Prevents seeing social/structural
causes, dislocation of responsibility - Therapeutic control may subvert
prevention or reform - Dominance of technology
Parsons (1975) - The Sick Role
- Functionalist theory
-Concerned with consensus and equilibrium - Every part of society has a purpose that fits together to allow societies to endure
- Sickness is not solely a biological state
of a human, but an institutionalized role
with an assigned set of norms and
values (pg. 261)
Parsons (1975) – Sickness as Deviance
- Illness as deviance– the breakdown of the general
‘capacity for the effective performance of valued
tasks’ (Parsons, 1964: 262) - Losing this capacity disrupts ‘loyalty’ to
commitments, such as the workplace and the family - Cause of disloyalties is not disregard of norms but
inability to conform to them - (Key distinction between illness and immorality or crime)
- For the effect on the social system, however, it does not
matter. In any case, it is dysfunctional
Sick Role: Two Rights
- A sick person is exempt from performing ‘normal social roles (exemption)
- A sick person can seek help and be looked after, because they are not curable by simple willpower or motivation (responsibility/motivatedness)
Sick Role: Two Obligations
- A sick person must see being sick as
undesirable, and to try and recover as quickly as possible - A sick person must seek “technically competent”
help and follow all the advice of the doctor
Therapeutic Agents
- Asymmetry in role relations between sick person
and doctor - Doctors must be competent and able, and do so with
moral authority (sickness = bad), which exerts social
control - Must reinforce patients desire to get better
Therapeutic Agents
RIGHTS
*to high status and prestige
*to autonomy in their professional practice
*to authority over the patient (gatekeeper of the social role of being sick)
*to examine the patient physically
Therapeutic Agents
OBLIGATIONS
*to be highly trained and knowledgeable
*to be motivated for a concern
*to be objective and emotionally detached
*to be bound by the rules of professional
conduct
Therapeutic Agents + Sick Persons
“For the inherent functions of effective care and for the amelioration of
conditions of illness, there must be a built-in institutionalized superiority of
the professional roles [over the sick person], grounded in responsibility,
competence, and occupational concern.” Parsons 1975, 271
- Despite asymmetry, relationship between TA + SP is
reciprocal. Both have rights and obligations. - Reciprocity and consensus, despite hierarchy, in a healthcare system of shared values (i.e., get better)
- Type of “medical paternalism”
Feminist Critique of Sick Role Theory
- Rights of the sick role are not afforded to women as for men.
- When a woman is ill, she is rarely excused from the ‘normal social
role’ of being the housekeeper / mother
