The theory of approaches will be discussed in this essay with regards to health and medicine. There exist four main approaches in regards to health and medicine. These include: Social action theory, Functionalism, Marxism and Feminism. However, the two main approaches that will be discussed in this essay are Functionalism and Marxism. The key points of each theory will be examined and a key study for each theory will looked at including its strengths and its weaknesses. This essay will highlight the main issue of the health care profession being a source of social control.
There is no singular definition of the terms health or illness which makes health and medicine a rather complex area of sociological study. The terms health and illness are subjective in nature. They are interpretations of how you feel and are therefore social products. They are also relative in nature that is, they change over time and place. The question of what it is to be healthy is therefore open to a wide range of individual, social and cultural interpretations.
However, health can generally be defined as a physiological, psychological and social state. Since health is difficult to define, it is inevitable that the measurement of health is difficult to define also. However, there are generally three main ways to measure health. These are: calculating life expectancy, studying the potential years of life loss and looking at standardised mortality rates.
Functionalism in relation to health and medicine views health as a functional need for every individual member of society. It views health as a functional prerequisite in other words. According to this view point, illness is dysfunctional for the social system as it disrupts the smooth running of society.The functionalist theory links health and medicine to structures and takes a macro level approach. Through a consensus analysis this theory looks at functions in the interests of society as a whole.
However, it does not question the status quo and virtually ignores inequality.A key study in relation to functionalism is that by Parsons (1951) 'The social system' where Parsons carries out an analysis of the sick role. According to Parsons good health is a functional need for society and illness poses a threat to society since it can lead people to withdraw from their normal roles and responsibilities. He argues that the role of the doctor is to play a social control function to ensure the adoption of the sick role is justified. Doctors must attempt to pick out those who seek to misuse the sick role. Parsons identifies four aspects of the sick role in which patients have certain rights and certain obligations.
The certain rights are: illness suspends routine responsibilities and a person's illness is not their fault and so they have a right to be taken care of. The certain duties are that a sick person must want to get better and a sick person must seek competent help.This theory is useful as it highlights the role of the doctor as a gatekeeper regulating access to the sick role. The notion of the sick role is also useful in that it highlights how society accommodates illness and non-illness.
However, this theory can be criticized for being too deterministic as it creates the impression that everyone slips into the sick role mode. In addition, the sick role is concerned with temporary exemptions from social roles and therefore its utility is limited in terms of chronic illness.Marxism in relation to health and medicine recognizes that the capitalist system creates a contradiction between health and profit, where the profit motive is underlying in topic. The financial interests of the doctor's decision to perform surgery reflect the financial interests of the hospitals.
Marxists believe health care specialists are agents of social control, as where sickness is seen as an inability to work, the doctor is seen as a gatekeeper who allows us limited time off work. According to this viewpoint, the healthcare system performs two key functions of the capitalist system. These are a labor function and an ideological function. Health is linked to social inequality. For example, there is the access issue where there is good health care for the rich however, not so good provision for the rest of the population. This reflects dominant ideology within capitalism.
.The Marxist theory links health and medicine to structures and takes a macro level approach. Through a conflict analysis this theory looks at functions in the interests of the ruling class. The Marxist theory questions the status quo and looks at inequality particularly in relation to class.A key study in relation to Marxism is that by Navarro (1978) 'Class struggle, the state and Medicine'. Navarro sees institutions as preserving the interests of the dominant class.
He portrays the doctor as a gatekeeper controlling his workforce and describes medicine as serving the interests of capitalism thus helping to increase productivity and profit. According to Navarro, the medical profession acts as a consumer of the products of capitalism. The values of biomedicine are close to those of capitalism.The Marxist view offers another explanation of the relationship between health, medicine and society.
It also encourages us to question the extent to which and ways in which doctors are serving the interests of the powerful in society. However, this theory can be criticized in that it tends to minimize the overall improvement in health through the years and medicines contribution to the high standard of living in the west today.To conclude, the definitions of health and illness are clearly problematical. Functionalism offers a reasonable explanation with regards to health and medicine. However, it ignores factors which the Marxist theory provides and vice versa.
However, both functionalism and Marxism contribute to understanding the health care profession as a source of social control. Both theories highlight the power and control doctors have and portray the doctor as a gatekeeper. Functionalists view the doctor as having the power to restrict access to the sick role. Marxists view the doctor as having the power to restrict time taken off work. Doctors therefore have almost complete control over medical care.
They have the right to define health, to treat illness and the authority to officially state whether people are sick or well.
