Medical Sociology - Introduction

1
Medical Sociology - Introduction

• Health and illness are socially defined using
• Science religious experience, insanity,
  witchcraft, evil
• Associated with stigma or sin
• Vary by culture (takes on different meanings) and
  across time.
• Dis-ease and dis-ability and dys-function
  implying lack of productivity, activity
• Some diseases are obvious (e.g., cancer)
• Others, not
• Health levels and health behavior are linked
• Per capital wealth, economic development,
  industrialization
• Age, sex
• Education and income, social class
• Form of government
• Payment system form of health care
• Race, ethnicity, religion (culturally defined)

2
Medical Sociology - Physicians and their world

• Physicians were healers of spiritual ills.
• Shamans, priests, priestesses, wise women,
  midwives.
• Several developments changed that.
• Sanitation
• Germs, vaccines and antibiotics
• Painkillers
• Quackery arose and the need for some oversight
  and overhaul needed
• 2 yrs of biology and physical sciences,
• School affiliated with university
• Rigorous licensing
• Result better quality but also a trade guild.
• Exclusion of Jews, blacks, women.
• Pecking order of medical providers
• Physician-patient status hierarchy.
• Since the 70s, more physicians are women and
  minorities, patients are better educated and
  better informed (Internet!), HMOs are the boss,
  so theres less hierarchy.

3
Medical Sociology Health differentials

• Reasons
• Biological gender, race, age.
• Social and cultural lifestyle, dietary
  behaviors
• Economic access to medical care, nutrition,
  exercise, safe environments, safe occupations.
• Differences
• Gender men have brute strength but women are
  healthier.
• Age age-related diseases for childhood through
  old age from genetics or exposure
• Race some genetic (e.g., sickle cell,
  Tay-Sachs).
• Social smoking, diets, meaning of fitness
  health, alcoholic consumption, interaction of
  gender and social behavior.
• Economic Adequate food, health care insurance
• Theorists
• Weber Health and healthy lifestyles are status
  symbols
• Marx unhealthy working and living conditions
  signify exploitation.
• Consumerism wealthy consumers as patients
  negotiate better deals.

4
Medical Sociology Forms of Medical Deviance

• Physician-level (white collar)
• Negligent behavior, assault while patient is
  sedated.
• Unsafe staffing practices at hospitals
• Using lower paid assistants instead of RNs.
• Treating health issues as criminality
• Criminalizing unhealthy behavior (e.g., drug
  addiction)
• Focusing on individual aspects of illness rather
  than the environmentally or socially constructed
  or configured causes.
• Infertility as a womens problem and their
  decisions to delay childbearing
• Fetal health and women
• Harmful experiments
• CIA conducted experiments with LSD in the 1950s
  on unsuspecting agents and civilians.
• Using inmates in prisons and mental hospitals.

5
Medical Sociology Forms of Social Control

• Medicalization seeks to eliminate, modify,
  isolate, or regulate socially defined behavior as
  deviant, with medical means, in the name of
  health. (p. 564).
• Phrases like disease-management or pain
  management treating symptoms instead of
  disease, lent itself to treating social behavior
  as symptoms to be managed and controlled.
• Medical information can be used to deny health
  insurance, employment, marriages
• Medical conditions can be used to excuse behavior
• Medicalization confers status to physicians,
• Gives patients a role and an excuse.

6
Medical Sociology - Medicalization

• Pluses
• Removes stigma
• Offers sick role as a way to reconcile
  problematic self-image.
• Optimistic outcome a disease to be treated and
  maybe cured.
• Expands authority of medicine (debatable plus)
• More flexible than judicial control
• Minuses
• Absolves person of responsibility
• Allows moral neutrality of medicine to run
  unchecked.
• Conferred social control (power) to medical world
  without due process
• Excuses evil instead of confronting it for what
  it is.

7
Medical Sociology

• Discussion Questions for Bad Blood
• In the Tuskegee experiment, the research question
  itself had much to do with the outcome of the
  research process. Discuss how this is so, and
  think of how similar problems might occur with
  other research (not just medical).
• It seems that the medical establishment in
  general had few or no problems with the Tuskegee
  experiment. Why would this be so? To what extent
  is this because medical professionals bear the
  same social values as others in the society? To
  what extent is it the result of something
  specific to medical power relationships?
• Many people and organizations concerned with AIDS
  and with public health in general believe that
  the federal (and now internationally in Africa,
  many governments) acted slowly on research and
  prevention. These critics argue that such
  inaction or slow action was due to a belief that
  AIDS victims were somehow unworthy or at fault.
  How do you evaluate this criticism? Do you have
  an alternative explanation(s)?
• How could Nurse Rivers have continued to
  participate the way she did? Explain this
  behavior based on race, class, gender. Then
  GOOGLE Nurse Rivers Tuskegee obituary and see
  what explanations you find.