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HS 3630 > 1: Overview & Key Concepts > Flashcards

1: Overview & Key Concepts Flashcards

1
Q

Biomedicine is consider THE TRUTH because it’s rooted in “_____” and “______” via the ______ or ______

A

rooted in facts and observation via the Scientific Method or Positivism

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2
Q

Knowledge

A
  • certain kinds are more valuable than others (scientific vs naturopathic)
  • privileging of the present (ahistorical)
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3
Q

Power

A
  • medicine has the power to define illness, to fix it, not to be questioned
  • issue of commodification (especially in the US/private health care settings)
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4
Q

All of these “facts” are ________, which means they cannot be ….

A
  • culturally constructed
  • means they cannot be stable, neutral, and somehow always right or the best way to create knowledge and understand our world
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5
Q

medical sociology

A
  • tool to improve social conditions and health status of people post WWII (small pox, measles, childbirth)
  • Significant because of the ‘new’ link between social conditions and health ( vs former ideas about only biology, physical body)
  • Also new links between health and technology
    (Ultrasound scans)
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6
Q

MS had to prove itself as a ‘scientific’ discipline against the idea of _______

A

Positivism: the only ‘real’ knowledge is that which is ascertained through directly observable science

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7
Q

3 dominant theoretical perspectives within medical sociology

A
  1. Functionalism
  2. the political economy approach
  3. Social constructionism
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8
Q

Functionalism

A
  • maintenance of social order
  • Health is produced and maintained through normative interactions between individuals and society
  • Illness = social deviance, causing biological or physical impairment & social dis-equilibrium (UNNATURAL!!!!)
  • medical profession’s job/duty to control this dangerous element
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9
Q

4 components of Talcott Parsons SICK ROLE theory

A
  1. people are exempted from social obligations which they are normally expected to fulfill
  2. They are not blamed for their condition and don’t need to feel guilty when they don’t fulfill normal obligations
  3. people must want to try and get well = can be accused of malingering if not
  4. Being sick = in need of medical help to return to ‘normality’
    - must put themselves in hands of practitioners to help get well again
    - Places patient in role of socially vulnerable, seeking verification from Dr that they are not malingering
    - Dr is socially beneficent, and Dr-patient relationship is harmonious despite unequal power dynamic
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10
Q

the political economy approach

A

Marxist views on capitalist system: labour, inequitable distribution of resources/capital, resulting inequalities for health/human rights,

Health = political phenomenon related to one’s relationship to class, socio-economic power & access to/control over basic resources

Product of struggle
- Ill/aging/physically disabled people are marginalized by society for not contributing to the production and consumption of commodities
(marginalized = women, ESL, poor)
(distributed unequally)
- Medical systems can exacerbate these inequalities

Clash of interests between Dr-patient
- Medical care is oriented around treatment of acute symptoms using drugs/technology vs prevention/maintenance of good health

State’s failure to acknowledge:
- role of environmental toxins resulting from industry in causing illness
- steps to control production/marketing of unhealthy commodities (tobacco, alcohol)

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11
Q

Medicalization Thesis - political economy approach

A

See medicine as a major institution of social control (above religion/law)

believes this power is harmful and abused by medical professionals
- leading to dependence upon medicine
- removing autonomy to control their health

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12
Q

Post-modernism
( ‘30s-60s)

A

Ideas and practices related to art, literature, global politics, fashion

Instability, change, doing things differently

Linked with the rise of social constructionism and global feminism

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13
Q

Social constructionism

A

Examines certain ‘truths’ and how they are produced & reconfigured
- Who benefits? Who is left out? How can we resist or reconfigure truths?
- Knowledge is fluid and depends on social relations/ social position
- never neutral, always in someone’s interest

Examines the development of medico-scientific and lay knowledge and practices

Power isn’t only in institutions or hospitals, it is embodied, constructed, and used by people as well as medical systems

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14
Q

Social constructionism vs Political Economy

A

Political economy = micro level (capitalism)
Social construction = macro level

  • PE views power as shaped entirely from capitalist forces
  • SC recognizing a multiplicity of interests and sites of power

Both: medicine as an institution of social control
- PE = medicine as oppressive
- SC = medicine producing knowledge that changes in time and space

SC: Medical power is deployed by every individual by socialization to accept values and norms of behaviour
- in addition to institutions and powerful individuals

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15
Q

how does the feminist movement relate to SC

A
  • feminist movement has shown how medical and scientific knowledge is used to privilege the position of powerful groups over others
  • Critiques biology as destiny = used to deny women full participation in public sphere
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16
Q

Medical anthropology

A
  • emerged after diseases post WWII
  • Focus on non-Western cultural models, beliefs, and practices
  • Explores how to blend dominant medical technologies and products (ex. vaccines) in a way that they will be locally adopted

focus on interpretation and lived experience of illness
- Culture influences illness experience
- nature/society/culture speak simulatenously

17
Q

Critical vs applied nature of medical anthropology

A

Critical =
how political/economic/gendered/racialized/class-related factors influence behaviour & risk factors

Applied =
application of research findings to address social problems

18
Q

History of medicine

A

Medical knowledge has been created over time
- Many changes in knowledge in historical periods

Social, political, cultural, and economic influences in the production of medicine/health/disease .etc

Shows that western biomedicine are no more ‘scientific’ or ‘objective’ than medicine in other cultures

Important insights into human responses to illnesses, plagues
- stigmatizing HIV/AIDs
- response to COVID

19
Q

Foucalt: history & modern sexuality

A

Questions ‘truths’ of historical interpretations, shows how power produces medical knowledge and experiences
-psychiatry: mental illness was socially constructed by labelling some behaviours as normal and others as abnormal, requiring treatment

Question the “repressive” hypothesis in relation to modern sexuality
- regulations related to sex didn’t lead to
1. suppression
2. explosion of sexual discourses (people were obsessed with taboo)

  • Modern power structures (church, medicine) created new forms of sexuality by talking about it = unintended outcome

**Power is a 2-way street = it’s exerted and to also be found in resistance

20
Q

Cultural studies

A

Examining ways mass media supports positions of power/social groups under capitalism

Media about health, the body, sexuality, and medicine = cultural ‘texts’ through which we can ‘read’ different kinds of messages

21
Q

Discourse & the “linguistic turn”


A

signs + language = discourse
- Pattern of words, figures of speech, concept, values, symbols to describe something
- language is embedded in social and political settings used for certain purposes
- Not WHAT is being said but HOW it is said

linguistic turn = attention paid to language in maintenance of social life and subjectivity

22
Q

Medical gaze

(Davenport -= Campaign on Homelessness in clinic for medical students)

A

= seeing a case/condition instead of a human being
= transforms subjects/people into objects/bodies

Part of objectification process that occurs in medical encounters

Focus on locating bodily pathology, exclusion of socio-cultural factors

Linked with larger constructs of power that are responsible for how life is administered = “bio-power”

transition from “what is the matter” to “where does it hurt”

23
Q

Bio-power

A

A form of control and power over bodies
- State-run systems through which populations are controlled, regulated, and made to conform to certain political ideals

Individual level
= medical norms that define a healthy individual, which have a political angle to them (Covid-19 regulations)

Societal level
= the focus on population health as a resource for the state, which must be managed in particular ways (take care of yourself to not strain the health care system…)

24
Q

Surveillance

A

Used to monitor and police HIGH RISK people and behaviours
- Policing, public health, government

25
Q

Foucault’s (self) surveillance via the panopticon

A

Prisoners don’t know if the guards are in the tower or not

Primary outcome = people surveilled themselves = self-surveillance

Powerful and hidden form of control

Reproduce institutional forms of bio-power and administer our lives to reflect state policies and ideals
- can resist these

26
Q

witnessing

A

= acknowledging whole lives of populations they served, not just ailment

= Treating each person as an individual, not a representation of class

27
Q

“medical gaze” vs. witnessing”

A

Struggle to maintain balance in the encounter between patient and Dr.

*Traditionally these studies focus on the flow of power from Dr.- patient
*Davenport argues that this isn’t necessarily so
- Drs. don’t just blindly reproduce the ‘gaze’ and other techniques of control

Social reflexivity (self-awareness) = key to inversion of normative medical training, mainly through the vehicle of ‘witnessing’

28
Q

Witnessing: multiple meanings

A
  • Attentive listening to ppl attending clinic
  • More active engagement with people and the totality of their lives

The Campaign aims to change the ways medicine constructs its objects

In order to counter the symbolic violence of the medical gaze
- power of every-day habits and practices to govern our lives
- often not conscious of these insidious processes
- Individuals instead of the system is often blamed if problems arise

29
Q

quality, not quantity

A

taking time to gather full history on each patient, not simply the medical aspects of patient’s complaint but social and psychological environment

30
Q

5 Micro-Practices

A
  1. history taking
  2. patient presentations
  3. physical exam
  4. charting
  5. post-clinic meetings
31
Q

History Taking

A

history taking = good way to practice witnessing

  • Gentle, thorough probing of patient’s history beginning with what brought them to the clinic
    -“sounds like ….” … summarizing or rephrasing things that patient said in a way to bring out more information
  • Allowing patient to ramble = powerful technique
  • What is medically important will be revealed in witnessing process
  • struggle between gazing and witnessing
32
Q

Patient Presentations

A

Tensions between knowing clients as “people” and need to accomplish a medical task/root of the problem

Clinic policy = presentation to occur in examination room with patient

Students often receive more messages from gazing than witness
= Observed patient was mostly ‘talked over’ despite attempt to participate
= drug use became secondary to the objective of clinic visit - irregular periods

33
Q

The Physical Exam

A

Clinic = teaching environment = technical communications between student & preceptor excluding patient is to be expected

Balance teaching by conducting exam by talking to patient while explaining to student process of exam
- simplifying complicated problems uncovered by student into something you could see
- “this is you examine a thyroid gland - sir I will just …”
- Engages patient as well

34
Q

Charting

A

Selecting what gets written down and what does not

Social conditions and narratives often lost in favour of the ‘real’, physical evidence
- Told to put the definite and specific on forms, what they felt confident about/ was treatable

Gazing prevailed in charting

35
Q

Post-Clinic Meetings

A
  • each patient seen was presented to group (rounds)
  • Discussion of of day’s most interesting case often predominated
  • Witnessing easily switching into objectified analysis of patient

HS 3630 (8 decks)

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