Chapter 7 - The Sick Role

patient-physician role

- involves a basic mutuality - that is, each participant in the social situation is expected to be familiar with both his or her own and others expectations of behavior and the probable sequence of social acts to be followed - the sick role evokes a set of patterned expectations that define the norms and values appropriate to being sick, both for the individual and for others who interact with the person

medicalization

- is the name for the process by which medical definitions and practices are applied to behaviors, psychological phenomena, and somatic experiences not previously within the conceptual or therapeutic scope of medicine - occurs when previously non-medical problems are defined and treated as medical problems, usually in terms of illness or disorder

chronic illness

- is usually slow in developing, long in duration, and typically incurable - are not usually communicable

functionalism

- perceives social systems as composed of various closely interconnected parts - model of deviance that stresses societal-level processes, systems, equilibrium, and interrelationships, represents a homeostatic approach to deviance

unconditional legitimacy

- the deviants are exempted permanently from normal obligations and are granted privileges in view of the hopeless nature of their deviance - EXAMPLE: terminal cancer

conditional legitimacy

- the deviants are temporarily exempted from normal obligations and gain some extra privileged on the proviso that they seek help in order to rid themselves of their deviance - EXAMPLE: a cold

labeling theory

- theory that is based on the concept that what is regarded as deviant behavior by one person or social group may not be so regarded by other persons or social groups - while disease may be a biological state existing independently of human knowledge, sickness is a social state created and formed by human perception

functionalist theory

- theory that states that sickness is dysfunctional because it also threatens to interfere with the stability of the social system - the medical profession functions to offset the dysfunctional aspects of sickness by curing, controlling, or preventing disease and by establishing technology by which handicapped persons can assist in self-maintenance

acute illness

- typically refers to the sudden onset or sharp increase in pain, discomfort, or inflammation - symptoms only last a short while and either disappear after a few days or are cured by medical treatment

Why is Parson sick-role-theory criticized?

1. Behavioral Variation (Not everyone is going to act the same with being sick) 2. Type of diseases 3. The patient-physician relationship 4. The sick role's middle class orientation

The physician exercises leverage through which three basic techniques?

1. Professional Prestige (Top of class) 2. Situational authority (They have what you need) 3. Situational dependency of the patient.

The Identifying criteria for disease:

1. The patients experience of subjective feeling of sickness. 2. The finding by the physician that the patient has a disordered function of the body. 3. The patient's symptoms conforming to a recognizable clinical pattern.

Parson's concept of the sick role

1. The sick person is exempt from normal social roles 2. The sick person is not responsible for his or her condition 3. The sick person should try to get well 4. The sick person should seek technically competent help and cooperate with the physician.

What does the sick role only apply to?

Acute diseases

How is sickness viewed by sociologists?

As a form of deviance.

In later reconsideration, what did Becker later agree on?

Becker agreed that labeling theory cannot possibly be considered as the sole explanation of what alleged deviants actually do.

What does the poor blame sickness?

Being sick and the sick role to excuse one's circumstances in life appear frequently among the lower class.

What category would a person with STDs fall into?

Blemishes of character or abomination of the body.

What is the dysfunctional nature of illness?

Deviance

How is deviance defined ?

Deviance is not a quality of the act a person commits, but instead is a consequence of the definition applied to that act by other people.

criticisms of the sick role

Does not account for type of disease - applies only to acute diseases which are generally temporary and overcome with a physician's help - chronic diseases do not fit model well, since they are incurable and exemption from social roles is not feasible Does not account for variations in the patient-physician relationship - relationship changes depending on setting: doctor's private office versus team-approach in hospitals - preventive care requires different approach

The third thing the labeling theory does not do?

Does not explain why certain people commit deviance acts and others in the came circumstances do not.

gatekeepers

Friedson argues that physicians are ___________ to most professional health resources, since these resources (drugs and hospitals) cannot be used without their permission - the behavior of the physician and others in the health field constitutes the embodiment of certain dominant values in society

What was Parson the first to do?

He was the first to demonstrate the function of medicine as a form of social control and did so with the parameters of classical sociological theory.

What is the second thing the labeling theory not do?

If deviant acts and actors share common characteristics other than societal reaction, theses common characteristics are not defined or explained.

Where does the physician has maximum control?

In the physician office.

What is the clinical pattern?

Is a representation of a model or theory of diseases held by the diagnostician.

What is the full meaning of acting like a physician?

It depends on the patient's conception of what a physician is in terms of the social role.

Where did the 'impaired role' Come from?

It emerged from Gordon's data, which required normal role responsibilities and rejected role exemptions despite sickness.

What has labeling theory failed to do?

It has failed to develop theory of illness behavior comparable to parson's model.

How is sickness of special interest?

It involves analysis of factors that are distinctly sociological namely the expectations and normative behaviors that the wider society has for people who are defined as sick.

What is Freidson's model useful/fails to do?

It is useful in categorizing illness behavior but it fails to explain differences in the way people define themselves as being sick and in need of professional medical care.

Labeling approach stresses what?

It stresses judgement of what is deviance are relative, depending upon the perceptions of others.

How is the label theory/sickness applicable?

Labeling theory is explaining illness behavior is that while disease may be a biological state existing independently of human knowledge, sickness is a social state created and formed by human perception.

What is the contemporary medical practice concerned with?

Maintaining and improving public health.

Medicalization according to Parson?

Medicine is an institution for the social control of deviant behavior so medicine's task to control abnormal behavior by medical means on behalf of society.

What kind of behavior is Parson's sick role?

Middle class

What are the two type of illness conditions?

One is acute illness which typically refers to the sudden onset or sharp increase in pain, discomfort, or inflammation. The other is chronic illness which is usually slow in developing, long in duration, and typically incurable.

cage

Parsons viewed the sick role as a fixed, mechanical kind of ______ that would produce similarities of behavior among sick people, regardless of variant cultural backgrounds and different personal learning experiences

What is the poor's behavior concerning being sick?

People living in a poverty environment might work, regardless of how sick they might be, as long as they feel able to perform some of their work activities.

What do people experience with chronic illnesses?

Persons with chronic disorders, particularly those who are physically handicapped, are faced with additional problems of altered mobility, a negative body image, and stigma.

What has research shown?

Research on patients with chronic diseases has shown that they perceive the sick role differently from patients with acute diseases.

According to the functionalist theory what is sickness seen as?

Sickness is seen as dysfunctional and threatens to interfere with the stability of the social system.

sick role

Talcott Parsons formulated this concept describing the normative behavior a person typically adopts when feeling sick - being sick is not a deliberate and knowing choice of the sick person, though illness may occur as a result of motivated exposure to infection or injury

What is Becker's position on deviance?

That deviance is created by social groups who makes rules or norms.

What did Peter Freund and Meredith explain?

That illness is upsetting because it is experienced as a threat to the order and meanings by which people make sense of their lives.

What category do handicapped people usually fall in?

The first category of abomination of the body.

What does the labeling theory not do?

The labeling theory does not explain what causes deviance, other than the reaction of other people to it.

What is the role of the physician?

The physician is invested with the function of social control and is intended to control deviance.

What happens to the patient-physician relationship if it involves a group?

The physician or health practitioner must be usually be persuasive rather than authoritative, since he or she lacks the leverage to control the client group.

What happens to the patient-physician relationship if it takes place at the patient's home?

The relationship may vary because the patient and his or her family can much more clearly influence the interaction.

What is the sick person motivated to do?

The sick person is motivated to recover as a result of socialization and the influence of the superego and yet may perhaps also be motivated either consciously or unconsciously, to desire the secondary gain of privileges and exemptions from daily tasks that accompany the sick role.

What does the sick role evoke?

The sick role evokes a set of patterned expectations that define the norms and values appropriate to being sick, both for the individual and for others who interact with the person.

What is the physician's role?

To return the sick person to his or her normal state of functioning.

Jews

Twaddle found that the sick role, as defined by Parsons, was much more applicable to _____ than to either Protestants or Italian Catholics

Jews, Italians

Zborowski found that ______ and ________ tended to be more sensitive to pain and more prone to exaggerate the experience of pain than Old Americans - setting (hospital vs. home) mattered for expression of pain - attitudes toward pain (acceptable levels and concern with meaning of pain) varied across groups

social judgement

a pronouncement of deviant behavior involves making a ________ _________ about what is right and proper behavior according to a social norm

stigma

an attribute that is deeply discrediting and is used to describe: (1) abominations of the body - physical deformities (2) blemishes of individual character - STDs (3) race, nationality, or religion

deviance

any act or behavior that violates the social norms within a given social system

ideal type

by definition, these don't really exist, but they describe selected aspects of behavior typical in certain contexts, and they serve as bases for comparing and differentiating concrete behavior occurring in similar situations in different sociocultural circumstances

biomedicalization

consists of the capability of computer information and new technologies to extend medical surveillance and treatment interventions well beyond past boundaries, by the use of genetics, bioengineering, chemoprevention, individualized drugs, multiple sources of information, patient data banks, digitized patient records, and other innovations

medical view of illness

defined as the deviance from a biological norm of health and feelings of well-being

Becker's position

deviance is created by social groups who make rules or norms

Pharmaceuticalization

growth of drug markets internationally through large scale advertising campaigns directed to both physicians and public at large, including drugs for non-medical enhancements

sickness

has been characterized as a social state, signifying an impaired social ole for those who are ill

illness

has been characterized as a subjective state, pertaining to an individual's psychological awareness of having a disease and usually causing that person to modify his or her behavior

disease

has been characterized as an adverse physical state, consisting of physiological dysfunction within an individual

sanction

includes the use of jails, prisons, and mental hospitals to remove the deviant from society to ensure social order and cohesion

medicine

is an institution for the social control of deviant behavior - it has the task to control abnormal behavior by medical means on behalf of society

sickness as deviance

is regarded as an undesirable circumstance for both the sick person and society

Biomedicalization

major technological and scientific advances in biomedicine are taking capability to treat any problem even further

chronic patients

patients that are faced with he impossibility of resuming normal roles and the are shown the necessity of adjusting their activities to a permanent health disorder

norms

reflect expectations or appropriate behavior shared by people in specific social settings

agrarian society

society where illness occurred largely in small-group contexts such as the family

industrialized society

society where the decline of large families, changing theories in the treatment of disease, the development of an extensive menu of disease-fighting drugs, and the evolution of complex medical techniques that often require hospitalization have drawn out disease from these societies

illegitimacy

the deviants are exempted from some normal obligations by virtue of their deviance, for which they are technically not responsible, but gain few if any privileges and take on handicaps such as stigma - EXAMPLE: having a stammer, or epilepsy

1st category of the sick role

the sick person is exempt from "normal" social roles

2nd category of the sick role

the sick person is not responsible for his or her condition

4th category of the sick role

the sick person should seek technically competent help and cooperate with the physician

3rd category of the sick role

the sick person should try to get well