Sickness and meaning Flashcards
List the categories of meanings attributed to symptoms
- personal
- social
- cultural
Describe personal meaning
In this case, we use the lens of someone’s personal lives to understand how they experience their symptoms.
The symptom carries a meaning and is connected with the experience of the patient.
Describe social meaning
In this case, we use the lens of what is accepted by society to understand how someone’s symptoms may be attributed meaning by their society. Examples could include which symptoms may enable you to obtain a sickness certificate, and which may not. For example, I can write you out a sickness certificate for having a cough or a cold for a few days. In fact, you may take a day off work without a certificate for these symptoms. Our society has no structure that would allow a woman to take a day off work a month for menstruation, even if the intensity of the illness experience was similar.
Illnesses can have social meaning as they allow the person to opt out temporarily from everyday obligations, using the sick role. The concept of sick role does not work well for chronic disorders, or if the patient cannot seek out effective treatment.
Describe cultural meaning
In this case, we may use the lens of culture to explore how we understand who gets sick, and why we pay attention to some symptoms for some people, and not to symptoms expressed by other groups of people.
The cultural lens could be age, race, social class, disability. In this lesson, we have used gender as the cultural lens. Illnesses can be distributed along gender lines for both biological and social reasons.
Describe the role of the doctor and patient in the sick role
What should doctors do?
Doctors are responsible for authorising someone’ sick role, by endorsing the illness. In this, the doctor:patient relationship is held to be syllogistically similar to the parent:child relationship.
What should sick people do?
Just as doctors have responsibilities to authorise whether or not someone can undertake a sick role, patients have a responsibility to seek treatment and to get well as soon as possible.
List some critiques of the sick role
The sick role has suffered in use because
(a) doctors tend to authorise “legitimate” conditions rather than ones that are less “legitimate”, leading to people with medically unexplained symptoms having the fact of their sickness contested
(b) negative politicisation - the sick role itself has become in some popular readings a synonym for malingering
(c) it doesn’t work well with chronic illnesses and disabilities. The National Disability Insurance Scheme, for example, is explicitly designed so that people with illnesses are encouraged to shuck off the sick role.
See notes on legitimacy gap and focus on biology as the sole arbiter of legitimacy
Define and distinguish between sex and gender
- Sex refers to the biology of being male and female, generally through reproductive organs and secondary sex characteristics
- Gender refers to the cultural patterns and expectations that we recognise as masculine or feminine (or other genders)
according to WHO:
“Sex” refers to the biological and physiological characteristics that define men and women.
“Gender” refers to the socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women
Define gender identity
Gender identity refers to one’s personal experience of one’s gender
Define gender role
Gender role refers to a set of norms that describe the ways one’s behaviour should fit with their gender
Define what it means to be transgender and what it means to be intersex
- Transgender refers to one’s gender identity being different to the sex assigned at birth, or gender one has been raised with
- Intersex refers to a range of states in which biological sex does not match typical notions of male and female
Why do illnesses present differently in different genders?
Men and women can have different sicknesses because:
- there are genuine biological (sex) differences between men and women. It is now recognised that epidemiological studies in the past have obscured some of these differences because they have not included sufficient women, or did not differentially analyse by gender.
- there are genuine differences in health seeking patterns. For example, women attend GPs more frequently than men do. This can lead to higher rates of diagnosis of some conditions - for example, depression - because they have come on contact with a doctor.
- cultural differences can result sicknesses being distributed along gender lines. For example, our expectations that men do not discuss psychological distress may have resulted in higher suicide completion rates among men.
Define the sick role
As described by Parsons, a temporary, permissible disengagement from roles and responsibilities e.g. not working, isolating etc.
DOES NOT INCLUDE WORKING FROM HOME
