Sociology of Health and Illness: SOC 325 Medicine and the body

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Sociology of Health and Illness SOC 325Medicine
and the body

• What do we mean by the Sociology of the Body?
• Previously overlooked everywhere and nowhere
  (Williams 2003)
• Theoretical impact on established and new areas
  of study within sociological study of health
  illness.
• Advances in medical technology and bodily
  boundaries.
• Identity the body as object and project.

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Sociology of the Body

• Dualism of mind and body (Descartes)
• Rejection in favour of the body as site of lived
  experiences social action (phenomenologists -
  e.g. Merleau-Ponty 1962)
• Classified through social norms (Douglas 1963)
• Constructed through discourses -
  source/reflection of knowledge as power (Foucault
  1976 Armstrong 1983)
• Expressive (dramaturgical) resource (Goffman
  1959 Freund 1998)
• Project of identity (Shilling 1993)

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• Within these different approaches, the focus may
  be on....
• ...how the body is produced and regulated by
  society (Turner 1984 feminist critiques)
• ...how society is experienced through and shaped
  by the body (Frank 1998 disability theorists)
• ...bodies as shapers of and shaped by society
  (Gabe et al 2004)
• ...an embodied sociology body as object of
  analysis analysis of embodiment place of
  emotions in social life practice of sociology
  (Williams Bendelow 1998)

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Applications within the sociology of health and
illness (1)

• Maintaining distinctiveness from the bio-medical
  model.
• Integrating the biological, physical and social.
• Body as an absent presence until
  illness/disability.
• Effects of illness/impairment on identity and
  potential for social action.
• Understanding pain.
• The ageing / dying body.
• Living with impairment experiencing disability.

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Applications within the sociology of health and
illness (2)

• Positive understandings of health (e.g. Monaghan
  2001).
• Health as a moral category.
• Gendered bodies.
• Pregnancy and reproduction blurred boundaries.
• Refashioned bodies.
• The work of health care gendered division of
  labour emotional labour.
• The receipt of personal care.

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The Body and Society(Bryan Turner 1984 1992)

• Somatic society the body as central field of
  political and cultural activity.
• Societal preoccupations with sexual health,
  abortion, infertility, eating disorders, obesity
  etc.
• Social order built on reproduction, regulation
  of bodies internal restraint of desire physical
  presentation and representation.
• Bodies regulated through the law, religion and
  medicine to meet needs of capitalism.
• Secularisation accompanied by medicalisation.
• Medicine has a moral as well as clinical purpose.

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Foucault and the Body

• Sovereign power ? disciplinary power invested in
  the bodies of the population.
• Social institutions (e.g. prisons, hospitals,
  schools, clinics) produce knowledge of bodies.
• Individual bodies are trained and observed
  populations are monitored.
• Clinical gaze hierarchical objectification
  standards of the normal examination to assess
  / correct.
• Knowledge informs social policies which control
  and alter bodies e.g. health clinics.
• Extended by Armstrong (1995) to notion of
  surveillance medicine.

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Chronic Illness and the Body(Kelly and Field
1996)

• Illness make the body problematic.
• Limits social action and impacts on identity/
  identity reconstruction.
• Pain poses questions about our body and the power
  of medicine. (Williams Bendelow 1998)
• Emotions as an embodied state of feeling
  empowered or disempowered.
• Illness narratives as stories of embodiment
  tragedy, heroism, styles of adjustment.
• Issues of unbounded bodies, hygiene, dirty
  dying (Lawton 2000)

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Disciplined bodies (Monaghan 2001)

• Its all to do with looks, and I would rather
  look good on the outside. Thats what
  bodybuilding is. Its not for fitness reasons,
  its all visual.
• Bodybuilding careers can go on indefinitely. I
  know guys in their 60s and 70s whove got a hell
  of a physique. .. a friend of mine whos 68 and
  he hasnt got the genetics to have a nice
  physique, but his body is so toned and so fit and
  so healthy-looking, given that hes got bad
  genetics.
• You walk in and you get noticed. Even though
  youre getting older you still get noticed.
• I enjoy pushing myself through that threshold of
  pain. I find it gives me maybe it strengthens
  the character. .. Enables you to take on other
  problems.

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Starved bodies (Fox et al 2005)

• Table showing different theoretical perspectives

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Reproductive technologies

• Used to regulate population size.
• Effect may be to control or empower women.
• Main methods
• control of fertility
• managing pregnancy and childbirth
• screening techniques finding abnormalities
• conceptive technologies (New Reproductive
  Technologies).
• Changed meanings (Stanworth 1987)
• human, male, female, parent, child, foetus,
  family, race.
• Potential for designer babies / cloning.
• Problematic technology or problematic contexts?

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Hi-Tech Bodies(Williams 2003)

• Rendering our bodies uncertain ? crisis of
  meaning (Shilling 1993)
• Imagery of the cyborg
• ...a leaky figure born of the interface
  between automaton and autonomy,
  nature/culture, masculinity/femininity,
  Self/Other (Haraway 1991)
• Opportunities and risks of new technologies
• Moral judgements and ethical dilemmas

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Moulded Bodies

• Spare-part surgery
• 1967 first heart transplant (Christian
  Barnard, South Africa)
• 1980s new techniques increased success rates
• 2006 single organ transplants now routine
• Reconstructive / corrective surgery
• Plastic surgery to achieve normality
• Cosmetic surgery in search of perfection
• Non-surgical means e.g. hair dye, botox,
  body-building, anabolic steroids.

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Criticisms of spare-part surgery

• Reductionist a human being is a collection of
  body parts
• Objectification a heart is a pump
• Commodification the value of a body part
• Marketing the gift of life
• Harvesting / trafficking / coercion / social
  injustices
• Storage presentation of organs
  preservation of organs.

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Cosmetic Surgery

• Number of operations estimated (?22,000 in 2005
  ?29,000 / ?90,000 in 2006) but increasing.
• Around 92 of procedures are carried out on women
  although gradual increase in men since 1990s.
• Most popular breast augmentation eyelid
  surgery liposuction face/neck lift breast
  reduction tummy tuck rhinoplasty ear
  correction brow lifts.
• Normalised through botox, celebrities, media.
• Faulty identity remediable through physical
  change blending in / being yourself.
• Looking young / not tired.
• Botched procedures.

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• These figures reflect the growing acceptance of
  aesthetic surgery, particularly in the areas of
  body contouring and anti-ageing. I am sure the
  continued media coverage has had an impact on the
  amount of people considering it because by being
  out there, it is losing its stigma. The media
  coverage also provides the public with an idea
  of what surgical procedures can achieve, as well
  as technological advances that improve safety and
  reduce costs.
• (President of the British Assoc of Aesthetic
  Plastic Surgeons, The Guardian, 29 Jan 2007)
• Not only does plastic surgery throw into
  critical relief the commodified nature of the
  body in consumer culture, it also indicates the
  extreme lengths to which individuals will go in
  order to mould and shape their bodies in line
  with prevailing cultural mandates of beauty.
  
• (Simon Williams (2003) Medicine and the Body)

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• I always looked in the mirror and thought, I
  want that bump out. Ive thought, oh I feel
  hideously ugly. But Ive always thought, its
  like you have a car that has a dent in it. If you
  got it fixed it would be quite a nice car. So I
  thought, apply the same thing to your nose.
  Notice how her nose is both her and not her,
  something that makes her feel hideously ugly at
  the same time that its as materially distinct as
  a car. This is what happens to your body when you
  start changing it surgically.
• From Virginia Blums Flesh Wounds,
• quoted in The Guardian 14th Sept 2005

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• Distinguishing between....
• ... the body as regulated and policed by society
• ... the body as a commodity
• ... the body as a site of (political) struggle
• ... the body as a project of identity.