Chapter 13: Chapter 13: MedicineMedicine

An Anatomy of Health and An Anatomy of Health and IllnessIllness

Soc 100 Dr. Santos

Introduction- EuthanasiaIntroduction- Euthanasia

Medical futility- treatment fails to Medical futility- treatment fails to end total dependence on medical careend total dependence on medical care

Active euthanasia- aiding the dying Active euthanasia- aiding the dying individual by prescribing or individual by prescribing or administering a lethal dose of drugs administering a lethal dose of drugs to patients who request it, usually to patients who request it, usually under legally-controlled conditionsunder legally-controlled conditions

Arguments in favor of euthanasiaArguments in favor of euthanasia Arguments against euthanasiaArguments against euthanasia

What is health?What is health?

Health- a state of Health- a state of physical, mental, physical, mental, and social well and social well being or the being or the absence of diseaseabsence of disease

Illness- the lack of Illness- the lack of healthhealth

Why is health a social Why is health a social issue?issue?

Micro- Health impacts our abilities to Micro- Health impacts our abilities to carry out other responsibilitiescarry out other responsibilities

Meso- The institution of medicine Meso- The institution of medicine impacts and is impacted by other impacts and is impacted by other institutionsinstitutions

Macro- Beliefs about illness are Macro- Beliefs about illness are culturally determinedculturally determined

Global- Pandemics, bio-terrorism, the Global- Pandemics, bio-terrorism, the distribution of immunizations and drugsdistribution of immunizations and drugs

Theoretical perspectives on Theoretical perspectives on healthhealth

Symbolic interactionism and labeling Symbolic interactionism and labeling theorytheory

Illness is whatever the powerful (doctors) Illness is whatever the powerful (doctors) define and label it asdefine and label it as

The labels applied can impact policies and The labels applied can impact policies and treatments surrounding diseasestreatments surrounding diseases

Medicalization- the shift from handling Medicalization- the shift from handling some forms of deviance and normal human some forms of deviance and normal human functions at home or in the legal or functions at home or in the legal or religions arenas to the health care systemreligions arenas to the health care system

Theoretical perspectives on Theoretical perspectives on healthhealth

Functionalist PerspectiveFunctionalist Perspective Social norms define what counts as Social norms define what counts as

illness and how to treat itillness and how to treat it The health care system maintains the The health care system maintains the

social structure and a balance between social structure and a balance between individuals and institutionsindividuals and institutions

Illness is not functional for societyIllness is not functional for society The sick role is seen as deviant since it The sick role is seen as deviant since it

“robs” society of normal role “robs” society of normal role functioningfunctioning

Theoretical perspectives on Theoretical perspectives on healthhealth

Conflict PerspectiveConflict Perspective People’s economic and social positions People’s economic and social positions

in society affect their access to health in society affect their access to health care and the types of illnesses from care and the types of illnesses from which they sufferwhich they suffer

Global inequalityGlobal inequality Is health care a right or a commodity?Is health care a right or a commodity?

Theoretical perspectives on Theoretical perspectives on healthhealth

Feminist theoryFeminist theory The patriarchal control of women carries The patriarchal control of women carries

over to health care systems and reinforces over to health care systems and reinforces dependence, submission, and definitions of dependence, submission, and definitions of what is “illness” for womenwhat is “illness” for women

Western women are seen more often and Western women are seen more often and their procedures are more expensive than their procedures are more expensive than men’smen’s

Women’s bodies and normal life cycles Women’s bodies and normal life cycles have been used historically to “prove” have been used historically to “prove” their inferiority and keep them out of their inferiority and keep them out of some social positionssome social positions

Micro-level analysis: The Micro-level analysis: The sick rolesick role

Parson’s sick role- the rights and Parson’s sick role- the rights and responsibilities expected of ill people responsibilities expected of ill people in order to be accepted as in order to be accepted as legitimately illlegitimately ill

The sick person is excused from normal The sick person is excused from normal social responsibility in order to get wellsocial responsibility in order to get well

The illness is not the sick person’s faultThe illness is not the sick person’s fault The sick person should not enjoy being The sick person should not enjoy being

sick and not malingersick and not malinger The sick person is expected to seek The sick person is expected to seek

competent medical help in getting wellcompetent medical help in getting well

Social factors in health Social factors in health and illnessand illness

Illnesses and treatments are culturally Illnesses and treatments are culturally determineddetermined

Group factors matter in health careGroup factors matter in health care Age- older people need more preventative and acute Age- older people need more preventative and acute

carecare Gender- Western women report more health problems Gender- Western women report more health problems

than men, receive more preventative care, and take than men, receive more preventative care, and take more medications; men use emergency services moremore medications; men use emergency services more

Ethnic groups- African Americans are less likely to be Ethnic groups- African Americans are less likely to be able to access health care and are less likely to use able to access health care and are less likely to use hospitals and clinics; infant mortality is much higher hospitals and clinics; infant mortality is much higher among minoritiesamong minorities

Social status- wealthier individuals are more likely to Social status- wealthier individuals are more likely to seek health care, in part because they can afford seek health care, in part because they can afford treatment, especially preventative treatmenttreatment, especially preventative treatment

Meso-level analysis:Meso-level analysis: Modern health care Modern health care

systemssystems Types of national health care systemsTypes of national health care systems

Socialized medicine- government-Socialized medicine- government-sponsored consumer service with equal sponsored consumer service with equal access to all citizens; private care is access to all citizens; private care is available for an extra feeavailable for an extra fee

Decentralized national health programs- Decentralized national health programs- the government regulates health care but the government regulates health care but does not operate itdoes not operate it

Developing countries often cannot provide Developing countries often cannot provide health insurance or security and rely on a health insurance or security and rely on a combination of Western and indigenous combination of Western and indigenous medicinemedicine

Hospitals as complex Hospitals as complex organizationsorganizations

Urbanization and industrialization led Urbanization and industrialization led to new health problems which required to new health problems which required systematized, rational health caresystematized, rational health care

Hospitals share many of the same Hospitals share many of the same characteristics as other bureaucraciescharacteristics as other bureaucracies

Health care systems are major Health care systems are major employers in developed nationsemployers in developed nations

Clear divisions exist between Clear divisions exist between physicians and administratorsphysicians and administrators

Changing professional Changing professional status of health care status of health care

employeesemployees Hospitals differ from other formal Hospitals differ from other formal

organizationsorganizations Divisions of labor more extensive and Divisions of labor more extensive and

specializedspecialized Hierarchical system of stratification is Hierarchical system of stratification is

well established and visiblewell established and visible Physicians are facing new challenges as Physicians are facing new challenges as

the health care system changesthe health care system changes

Macro-level analysis: Macro-level analysis: Health care and policy Health care and policy

issues issues The U.S. health care The U.S. health care

system is one of the system is one of the best and worst in the best and worst in the worldworld

Achievements Achievements include increases in include increases in medical research and medical research and public health (e.g., public health (e.g., motor vehicle safety, motor vehicle safety, safer workplaces, safer workplaces, clean drinking water)clean drinking water)

Problems in the U.S. Problems in the U.S. healthcare systemhealthcare system

Access to healthcareAccess to healthcare Maldistribution of servicesMaldistribution of services Lack of family practice physiciansLack of family practice physicians

Healthcare costs and fundingHealthcare costs and funding Costs continue to escalateCosts continue to escalate Managed care attempts to be efficient Managed care attempts to be efficient

and offer high quality careand offer high quality care CorporatizationCorporatization

Problems in the U.S. Problems in the U.S. healthcare systemhealthcare system

Lack of health care securityLack of health care security 46 million Americans (and climbing!) 46 million Americans (and climbing!)

remain uninsuredremain uninsured Insurance companies deny claimsInsurance companies deny claims Pre-existing conditions can lead to Pre-existing conditions can lead to

denial of insurance or higher premiumsdenial of insurance or higher premiums Racial and ethnic differences in Racial and ethnic differences in

coveragecoverage

Policy issues and social Policy issues and social reforms in the U.S. health reforms in the U.S. health

care systemcare system Is health care a human right or a market-Is health care a human right or a market-

driven system?driven system? Current proposals for health care reform Current proposals for health care reform

include:include: Revise the partly public, partly private systemRevise the partly public, partly private system Vote in reforms one at a timeVote in reforms one at a time Pass a comprehensive reform package to Pass a comprehensive reform package to

provide national health insurance and provide national health insurance and government oversight and administrationgovernment oversight and administration

The high cost of prescription drugsThe high cost of prescription drugs

Main challenges for Main challenges for the U.S. health care systemthe U.S. health care system

What to do about the rising What to do about the rising uninsured population?uninsured population?

How to control costs in a managed How to control costs in a managed care system?care system?

What will be the physician-patient What will be the physician-patient relationship under new structures relationship under new structures of health care?of health care?

Health care around the Health care around the worldworld

Each society organizes its health Each society organizes its health care around its culture and the care around its culture and the demographic needs of its demographic needs of its populationpopulation

Great Britain- socialized medicineGreat Britain- socialized medicine China- medicine in a Communist China- medicine in a Communist

statestate Nicaragua- revolutionary changesNicaragua- revolutionary changes

Global medical problemsGlobal medical problems

International sale of body parts on International sale of body parts on the black marketthe black market

How to increase life spans and How to increase life spans and decrease infant mortality?decrease infant mortality?

The mobility of diseases with more The mobility of diseases with more people traveling globallypeople traveling globally

Growing prevalence of tobacco useGrowing prevalence of tobacco use

Indigenous medicineIndigenous medicine

Medical practices spread with Medical practices spread with migration migration

Various medical traditions can offer Various medical traditions can offer wisdom and compliment one wisdom and compliment one anotheranother

Allopathy- medicine practiced by Allopathy- medicine practiced by the dominant groups of physicians the dominant groups of physicians in Western societiesin Western societies