There are criticisms of the biomedical model of health (McKeown 1979) argues that ‘the improvement of health during the past three centuries was due essentially to provisions of food, protection from hazards, and limitations of numbers’. He does not dispute the role of medicine overall but argues that ‘it is often sometimes extremely effective; but often it is ineffective and only tides the patient over a short illness, leaving the underlying disease, condition and prognosis essentially unchanged. (Haralambos, 2008)
The social model of health looks at how society and our environment affect our everyday health and well-being, and includes factors such as social class, occupation, education, income and poverty, housing, and diet. The gap between rich and poor, or the connections between social class and other factors such as health have been of sociological concern since Marx’s work on capitalism. ‘Those people who belong to higher social classes tend to have better life chances, be more healthy, and live longer than those lower down the social scale. The better off people are, the more inclined they are to eat well and healthily’ (Giddens, 2009). As the biomedical model focus on acute illness of ill individuals, the social medical model incorporates the wider environment, living and working conditions that affect health.
Complementary medicines belief is that the “biomedical models perception of the person as a form of biological machine which can be repaired through surgical or pharmaceutical intervention is mistaken. Complementary medicines see each person as unique and that both the mind and the body must be taken into consideration when seeking a cure” (Haralambos, 2008) Alternative medicines are widely used in the UK and in(2000) Ernst and White conducted a national survey that showed that over 20% of the population used alternative medicine in some shape or form. They also calculated that over £1.6 billion is spent on alternative medicines as a whole. (Haralambos, 2008). They do not suggest that people are rejecting the biomedical approach to medicine just that they are more likely to use both models together and they concluded that over 80% saw a combination of both the biomedical and alternative approaches to be the most effective treatment strategy. In 1988 Andrew Wakefield a Doctor published an academic journal which suggested that there might be a link between autism and the MMR vaccination, the medical profession quickly sought to discredit his work, but the resulting fall almost 10% in ten years in the number of vaccinations instead of the expected increase showed a lack of trust for the biomedical model and as such the BMA has had to reconsider its approach to alternative medicine and where it had previously been successful in ensuring that only those forms of alternative medicine that conformed to requirements of “positivistic models of scientific endeavour” (Haralambos, 2008) could be considered for treatment it is now instead of trying to exclude them from practice it has now had to accept more forms of alternative medicine but while still trying to subordinate them.
Although the biomedical model still dominates healthcare there is a steady re-emergence of alternative medicine due to a more savvy consumerist approach to health, Cant and Sharma describe the current health care system as one of ‘medical pluralism’, by which they mean that there are different health providers and people will not simply choose between them, but use more than one at the same time. (Haralambos, 2008)
The functionalist’s perspective of health derives from the work of Parsons .In the 50’s when Parsons started writing on health and illness most sociologists had paid little attention to the idea of illness, but Parsons wanted to show that even the biological aspects of social life could be explained through the lens of sociology. (Haralambos, 2008) In the social system (1951) Parsons put forward the concept of the ‘sick role’. The concept of the ‘sick role’ is that instead of accepting the idea of sickness as a biological concept, Parsons suggests it is a social concept, that being ill is acting differently form the norm, being sick is deviant. There are two main elements of the ‘sick role’ one being ‘The rights of the sick role’ and the other being ‘The obligations of the sick role’. (Giddens, 2009)
The rights of the sick role state that a person has the right to be exempt from the normal social obligations such as work or the normal interactions with the family depending on the seriousness of the illness, a person can do nothing about being on the ‘sick role’ and they should not be blamed for being on the ‘sick role’ but they do have obligations when they are on it, they should accept the situation they are in is not acceptable to society and must do as much as possible to get well as soon as possible, and they must seek professional medical help to get better. Parsons states that these rights are dependent on the sick person undertaking their obligations and if they do not do this they are seen as unfairly appropriating the ‘sick role’ (Haralambos, 2008)
There are however criticism of the ‘sick role’ the first being that it only applies to acute illness it has no use when looking at chronic illness, the obligation to get well as soon as possible cannot apply with chronic illness, Parsons argued that although they cannot get better they can manage chronic illness to return to the norm as much as possible. The second criticism is that Parsons assumes the ‘sick role’ only occurs when a doctor or medical professional legitimises the illness, but according to Eliot Freidson (1970) before a person sees a doctor they will have seen others close to them, and only after this will the consult a doctor. Freidson argues that others are important in deciding whether a person will be put on the ‘sick role, the third criticism is when an illness has a social stigma attached to it, such as with sexually transmitted disease, society may assume that this is the fault of the individual and if this is the case then the patient may be seen as being on the ‘sick role’ illegitimately. (Haralambos, 2008)
The Interactionists perspective of health
“Symbolic interactionism has probably been the most influential theoretical approach in the sociology of health” (Haralambos, 2008). They study how individuals who are ill or disabled negotiate their daily lives, social interactions and sense of self and identity this involves three areas of ‘work’: illness work, everyday work and biographical work. (Giddens, 2011)
Illich (1975) suggested that modern medicine has done more harm than good because of iatrogenesis, or ‘self-caused ‘disease. Illich argued that there are three types: clinical, social and cultural iatrogenesis. Clinical iatrogenesis is where medical treatment makes the patient worse or may even create new conditions. Social iatrogenesis is where medicine expands into more and more areas, creating an artificial demand for its services. Social iatrogenesis, Illich argued, leads to cultural iatrogenesis, where the ability to cope with the challenges of everyday life is progressively reduced by medical explanations and alternatives. (Polity, 2012)
Brown and Harris (1978, 1989) conducted studies on women with depression from different social classes in London; they concluded that two major factors “life events” had the greatest effect on their mental health, (short term) divorce or (long term) poverty and protection and vulnerability were major factors Brown and Harris concluded that working class women were more likely to suffer from these “life events” than middle class women, as they were less likely to have the supportive networks around them to help them to cope, therefore they were more likely to suffer from a mental illness such as depression. (Haralambos, 2008)
Word count 1640
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