Rosalie Aroni; Week 1 MED1011; Health, Knowledge and Society
Ontology: what we believe about what kinds of things exist; epistemology: the study of theories of knowledge or ways of knowing; methodology: principles and practices that determine or underpin how research is conducted in the field
Macro sociological theories: consensus theories (structural functionalism) versus conflict theories (Marxian/Weberian theories)
Micro sociological theories: interpretive theories (symbolic interactionism)
Feminist theories: span structural and interpretive domains
Post-structuralism and post-modernism: dispite the existence of universal truths, argue all knowledge is socially constructed and not neutral
Social structure is how society is structured including norms, beliefs and values; social agency is ability of individual to act independently and with purpose
Structural functionalism (consensus theory) is that society is a biological organism that maintains equilibrium, has basic needs that must be fulfilled for survival, various parts of society carry out their function in harmony, certain structures must exist for societal equilibrium and survival
Emile Durkheim put forward social integration, conscience collective, his suicide theories are about social integration and social regulation in society (altruistic suicide/kamikaze pilots, egoistic suicide/migrant suicides; anomic suicide, fatalic suicide (love pact))
Talcott Parsons argued society needs mechanisms for sickness to avoid straining the social order, has hierachy of control of individual behaviour: values, norms, personality, behaviour
His sick role has 4 parts: sick person is not morally culpable for illness, is excused from performing everyday roles, is incapable of overcoming it alone, must seek expert help and try and get well
- Criticisms: only apples to acute conditions, chronic conditions may be permenant, may have person drop into lower SES, cannot resume normal role performance at previous level; there can also be stigma towards disease; variability leads to lack of uniformity in sick role behaviour (gender, ethnicity); there has been a change in doctor patient relationship where patients are more powerful; middle class values want to work hard
Eric Friedson discussed differences between medical knowledge of specialists and public, gives authority to decide who is ill
Conflict perspective is that medicine is inequally distributed, partly due to unequal access, competition for resources shapes health system (Marx, Weber, Zola); Marx talks about the impact of living and working conditions on illness and how doctors have links to upper class interests; Weber talks about how people shape society and society shapes people back, talks about wealth, prestige and power (class, status and party), does not view class as overriding division in society unlike Marx; Zola talks about how life is medicalised by expansion of medicine into private lives, public lives, extension of governmental control over prescription/surgery, gaining dominance over taboo areas (child abuse, addiction, alcoholism).
Micro sociological theories (interpretive theories) focus on human action, its meaning, can be used to understand the difference in patient to health professional concerns- what is percieved to be real will result in real consequences. Cooley examined looking glass self where individual's view of themself is how they percieve others to view them, can cause patients to clamp up if they feel doctor is dismissive. Talks about the impact of self worth on social interaction. Interpretive theories are to do with personal perception of medical behaviour such as stigma and discrimination, cultural sensitivity
Symbolic interactionism is through the exchange of symbols, reality is constantly changing through these, social identity is fluid and built through social interaction.
Ethnomethodology is examination of the methods people use on a daily basis to carry out lives; commonsense knowledge and the range of procedures societies make sense of and act on circumstances in which they find themselves.
Phenomethodology is examination of intersubjectivity (how is understanding and communication possible, self-interpretation