Sociology Flashcards
1
Q
Changes to means to death
Describe the historical and social changes that have occurred in the meanings associated with death (session)
A
- in the past death was sudden, now rising standards of living and health technologies, live longer. Death practices lose their power.
- Death now comes after prolonged deterioration
- Pre-emptive grief, Loss of ‘social’ person grief etc
- Society seperates those who are ‘dying’ n hospitals and care homes before their biological death.
- Therefore the biological death loses meaning as the ‘sheltering canopy’ of cultural customs are lost.
- Lack of social script for dying results in ‘disorderly deaths; is made more painful
- Death occurs in the temple of hope- HOSPITAL
- Loss of the public space and now there is the ‘privatisation of death;
2
Q
Medicalisation of death
Describe and discuss the social and organisational processes that are associated with the ‘medicalisation of death’ construct (session)
A
- People are dying hygienically and yet in solitude
- Who struggles with death? The doctor more than the patient.
- More of the biomedical terms are encorporated into life. The move to using language such as ‘HAVE DIED’ rather than ‘passed, gone to forever sleep’
- Normal physiological processes are now biomedical
- OVER TREATMENT
- HEROIC MEDICINE
- Cultural Iatrogenesis
- Biomedical accoutns undermine ability to manage own death, pain, suffering and autonomy. Rely on medicine
3
Q
What is a good death
Outline the meaning of the notion of a ‘good death’ (session)
A
- Not about creating ideal type
- Awareness of Dying: A personal and social process of greater openness about the prognosis of an illness where it known that there is a high probability of death.
- Personal preparations and social adjustments: An enablement of the settling of‘emotional accounts’.
- Public preparations: sorting out wills, putting practical affairs in order.
- The relinquishing, where appropriate of formal work roles. Too often it is automatically assumed that dying individuals are beyond the age of retirement. This is not the case with AIDS and forms of CHD and Cancer.
- A Good death involves formal and informal farewells.
- Requires a social support of friends family and professionals
- SHIFTS BACK TO A COLLECTIVE SPHERE not induvidualist
- HOSPICE MOVEMENT and the development of Palliative care.
4
Q
Social vs biological death
Outline the distinction that is drawn between ‘social’ and ‘biological’ death (session)
A
- Social death precedes biological death
- and dying associated with the ‘epidemiological transition’ (death occurring predominantly in later life and from chronic disease).
- Social:
- ontologically deficient – meaning that they are not seen as being ‘fully human.’
- loss of agency and identity
- treating people as if they are already dead
- rituals and bereavement.
- USE THEIR NAME not ‘loved one, or deceased’
- Biological
- A final event.
- An absolute state (being dead).
- Part of the dying process.
5
Q
What happens after someone dies
Describe what happens after someone dies (paperwork and processes from the families point of view)
A
- A ‘trained healthcare professional’ must verify the de
- ath, this could be
- MCCD is the certificate that explains the cause of death. It allows the family to register the death which in turn allows the funeral to go ahead
- any medical practitioner as long as they are able to knowledgeably state the cause of death
- the patient has been seen (in person or remotely) within 28 days of death, or after death.
- If no doctor attended the patient, then the certificate is usually completed by their registered GP
- Families must register death within 5 days with the local register office
- hospital administrator, someone present at the death or someone arranging the funeral can also register the death if there is not family or the family are unable to for any reason
- Deaths must be reported to the coroner if…
- the cause of death is unknown
- the deceased was not seen by the certifying doctor either after death or within 28 days before
- death (pre-covid was 14 days)
- the death was violent or suspicious or unnatural
- the death may be due to an accident (whenever it occurred)
- the death may be due to self-neglect or neglect by others
- the death may be due to an industrial disease or related to the deceased’s employment
- the death may be due to an abortion
- the death occurred during an operation or before recovery from the effects of an anaesthetic
- the death may be a suicide
- the death occurred during or shortly after detention in police or prison custody or while the
- deceased was subject to compulsory detention under the Mental Health Act
- for any other concerning feature
- Post mortem
- consent must be sought from the patient before death or the patient’s family after death
- If requested by the coroner it is obligatory that the post-mortem takes place
6
Q
Identify some common myths that surround death and funerals
Identify some common myths that surround death and funerals
A
- Talking about death brings it closer – A common superstition that discourages open discussion.
- Funerals must be expensive to be respectful – Many believe cost equals honor.
- Embalming is always required – Not legally necessary in many places.
- Viewing the body is essential for closure – Helpful for some, not all.
- Only religious ceremonies are proper – Secular or personalized services are equally valid.
- Cremation means no funeral – You can still have a full service with cremation.
- Children shouldn’t attend funerals – Depends on the child and how it’s explained.
7
Q
Faith and death
Reflect on the different views that different faiths and cultures have on good death care
A
- Christianity
- Funeral service in a church or chapel with prayers and hymns.
- Burial or cremation based on denomination and personal/family preference.
- Eulogy and remembrance to honor the life of the deceased.
- Hinduism
- Cremation is the preferred method, usually performed within 24 hours.
- Antyesti (last rites) performed by the eldest son or close male relative.
- Shraddha rituals and offerings to honor ancestors, often on the 10th or 13th day.
- Islam
- Body washed (ghusl), shrouded (kafan), and buried as soon as possible, facing Mecca.
- No embalming or cremation – burial is required.
- Janazah (funeral prayer) held in congregation, typically at a mosque or outdoor space.
- Sikhism
- Cremation preferred, with prayers (Kirtan Sohila) and recitation from Guru Granth Sahib.
- Antim Sanskar (last rites) include remembrance of God and community support.
- Bhog ceremony held at the end, where scriptures are read to conclude mourning.
- Buddhism
- Meditation and chanting before and during the funeral to aid rebirth.
- Cremation or burial depending on tradition and regional customs.
- Offerings and rituals made over 49 days (e.g., in Tibetan Buddhism) to support the soul’s journey.
- Judaism
- Burial as soon as possible, usually within 24 hours, no cremation.
- Shiva (7-day mourning period) observed at home with family and community support.
- Simple wooden coffin and plain shroud to emphasize equality in death.
- Non-Religious / Humanist
- Personalized ceremonies focused on the life and values of the deceased.
- No religious rituals, often led by a celebrant or family member.
- Cremation or burial, based on personal choice or environmental preference
8
Q
A
9
Q
What type of support does Macmillan Cancer Support provide?
A
Emotional, practical, and financial support
Also includes support for families affected by cancer.
10
Q
What services do Maggie’s Centres offer?
A
Drop-in cancer support and counseling
Designed to provide a welcoming environment for patients and families.
11
Q
What is the role of local hospices and palliative care teams?
A
End-of-life care and respite services
Focus on comfort and quality of life for patients and families.
12
Q
How do support groups benefit patients with cancer?
A
Peer connection and mental health support
Can be in-person or online.
13
Q
What assistance do social services provide to cancer patients?
A
Help with housing, benefits, and care coordination
Aims to ease the burden of navigating healthcare and support systems.
14
Q
What are some examples of charities that support cancer patients?
A
Cancer Research UK, Teenage Cancer Trust
Focus on education, advocacy, and family support.
15
Q
What emotional impact does acute illness have on a child?
A
Fear, confusion, or trauma for the child and anxiety for parents
Emotional distress can affect the entire family.
16
Q
What disruption does acute illness cause in a child’s life?
A
Disruption to routines such as school, play, and development
Important for social and emotional growth.
17
Q
What strain do parents experience when a child is acutely ill?
A
Balancing work, caregiving, and emotional support
Parental role strain can lead to burnout.
18
Q
How are siblings affected by a child’s acute illness?
A
May feel neglected or worried
Sibling dynamics can change significantly.
19
Q
What financial pressures do families face during a child’s acute illness?
A
Time off work, travel, and healthcare costs
Financial strain adds to emotional burden.
20
Q
How does acute illness impact parent-child bonding?
A
Especially in hospital or high-dependency settings
May hinder normal interactions and closeness.
21
Q
What are some physical symptoms of end stage renal failure (ESRF)?
A
Fatigue, dietary restrictions, fluid limitations
These symptoms significantly affect daily living.
22
Q
What psychosocial burdens are associated with ESRF?
A
Depression, isolation, loss of independence
These can severely affect quality of life.
23
Q
How does frequent dialysis affect daily living?
A
Time-consuming treatment affects daily living and work
Impacts social interactions and routine activities.
24
Q
What financial strain do ESRF patients experience?
A
Travel costs, employment disruption
Financial challenges can exacerbate stress.
25
How does ESRF impact family relationships?
Stress on family dynamics and intimacy
## Footnote
The illness can create tension and emotional distance.
26
What does healthcare dependency in ESRF entail?
Reliance on ongoing care and regular monitoring
## Footnote
Patients must navigate complex healthcare systems.
27
How does treatment burden in ESRF differ from general quality of life?
Heavily shaped by the demands of dialysis, limiting autonomy and routine functioning
## Footnote
ESRF-specific QoL considers the impact of treatment.
28
What dietary and fluid restrictions are pertinent to ESRF?
Constant vigilance required around what to eat/drink
## Footnote
Affects social life and enjoyment of meals.
29
What psychological toll does ESRF introduce?
Chronic dependence on healthcare systems and transplant uncertainty
## Footnote
This goes beyond general quality of life concerns.
30
Homeless
## Footnote
Outline health and social care for the single homeless person in the community (session)
- Emotional Needs
- Twice level of Gen Pop
- 9 times suicide risk
- Psychosis 4-15 times prevalent
- Psychological
- Anger
- Communication/ communicate needs
- Patient priorities
- Social needs
- Where they sleep,
- who is their community/ relationships
- Physical
- Diagnosis and referral criteria
- Medical needs
- Management of withdrawal symptom
- Infestation
- Teams involved
- Patient-what are strengths and weaknesses
- Drug and Alcohol Liason Team
- Homeless Persons Unit
- GP/Clinics/Dual diagnosis workers
- Patients street community
- Streetlink 0300-500-0914,
- St Mungos- 0203-856-6000
- Hostel or day centre
- Social Services
31
How is social dependency constructed?
## Footnote
Identify the ways in which the concept of social dependency in older age is socially constructed (session)
- Social structural factors that serve to exacerbate the consequences of the demographic shift towards a more elderly population.
- The role of social constructions that through various cultural representations of older people, reinforce the association of dependency with later life. incl self-fulfilling prophecies
- Inequalities accumulate over the life course and are often more pronounced in later life.
- Women’s lower pension rates increase poverty risk and contribute to higher rates of morbidity in older age.
- Cultural ideas, such as:
- Older people are less productive, which informs retirement policies.
- Older age brings inevitable health decline, reducing labour market participation
- Independence is judged by ability to perform daily activities
- Enforced retirement and reliance on state pensions
- Active ageing is essential; reduced social participation correlates with poorer health outcomes.
32
- Guiding Principles of Social Care
## Footnote
Outline the key principles underpinning the current social care system in England and Wales (session
- Promoting Well-being: Ensuring dignity, physical and mental health, emotional well-being, protection from abuse, and personal control over daily decisions.
- Prevention: Identifying services to prevent or delay increased care needs, helping individuals stay independent longer.
- Assessment of Needs: Assessing the needs of individuals and their carers for support.
- Integration of Care: Promoting the integration of social care with NHS services for a seamless experience
33
- Summary of the England and Wales social care system
## Footnote
- Summary of the England and Wales social care system
- Social care supports individuals with daily living, independence, social connection, and protection from vulnerability. It is distinct from the NHS, focusing on non-medical needs.
- Community Care Act 1990 – Introduced needs assessments and community-based care.
- Care Act 2014 – Major reform establishing a single legal framework, clearer eligibility criteria, and a duty on local authorities to assess and meet care needs.
- Local authorities must assess, provide, and commission care services, often through voluntary and private providers.
- Types of Social Care Provision
- Support at home by local authorities.
- Institutional care (e.g., residential/nursing homes).
- Informal care from family or friends.
- Means-Testing & Inequity
- Social care is means-tested – only those with assets below £23,250 receive publicly funded care.
- This leads to unmet needs, especially for those whose needs fall below eligibility thresholds.
- In contrast, NHS care is free at point of use, creating disparity.
- Eligibility Criteria Evolution
- FACS (2003–2014) classified needs, but restricted support to only those with ‘critical’ needs due to limited funding.
- Care Act 2014 replaced FACS, introducing focus on key activities (e.g., nutrition, hygiene, relationships, safety).
- Prevention & Early Intervention
- Shift towards preventative care to delay decline, e.g., home adaptations, exercise, support with daily tasks.
- Early support can prolong independence and reduce long-term costs.
- Current Challenges & Policy Directions
- System under pressure from ageing population, limited funding, and public concern.
- Proposals include:
- Paying family carers (e.g., Netherlands model).
- Encouraging private savings/insurance for old age.
- Dedicated tax for social care (e.g., King’s Fund suggestion).
- Redistribution of resources from lower to higher-need individuals.
34
psychological, social and cultural factors that are associated with the development of psychotic disorders
## Footnote
Describe the interrelationship between psychological, social and cultural factors that are associated with the development of psychotic disorders and may precipitate their relapse (PBL 1 + 2 + session)
- In premodern cultures, what is now viewed as mental illness was often interpreted through a spiritual or moral lens
- Social stressors—such as deprivation, isolation, and inequality—are shown to increase the risk of mental illness:
- Cultural frameworks shape perceptions of “madness” and determine responses:
- Lack of social support and high stress environments are key contributors to both the development and relapse of disorders
- Employment status is a strong indicator of common mental disorders, as shown in epidemiological data
- Mental health problems disproportionately affect people living in poverty, those who are unemployed and who already face discrimination.”
35
Aetiology of MH
## Footnote
Demonstrate an understanding of the social aetiology of mental illness in Britain today (session)
- The social causation model emphasizes that mental illness arises largely from social conditions rather than internal pathology:
- Core assumptions include:
- Mental illness is an “objective, measurable social fact.”
- Social class and inequalities are primary correlates of mental distress.
- Prevention requires cross-government intervention in housing, employment, and social inclusion.
- Disproportionate detention of ethnic minorities under the Mental Health Act points to a structurally unequal mental health system
- Psychiatry's traditional alignment with medicine has contributed to an individualised view of mental illness, often excluding social context.
- The DSM’s rigid classification system risks medicalising normal emotional states:
- “DSM criteria do not account for social context... failing to distinguish between ‘normal’ responses to stress... and pathological conditions.”
- Neuroscience has advanced understanding but does not offer a complete solution:
- “Mental disorders are problems of persons, not of brains.”
- “Molecular-based treatments alone are insufficient.”
- Environmental and random factors—beyond just genetics—play a substantial role in mental health, challenging reductionist models.
- Increasing medicalisation and the dominance of brain-based explanations can obscure the real-world, social causes of distress.
36
sociological perspectives in the conceptualisation of mental health
## Footnote
Critically examine the contribution of sociological perspectives in the conceptualisation of mental health and illness within modern societies (session)
- Social constructionism understands everyday knowledge as actively created through social interactions and processes.”
- what counts as mental illness is culturally and socially defined.
- Foucault critiques psychiatry as a power structure, not an objective science:
- “Madness as psychiatric illness was ‘not a discovery of an objective truth but a result of the convergence of internment and medicine.’”
- Psychiatric diagnosis can alienate the individual:
- “The victim of mental illness is entirely alienated in the real person of his doctor... the doctor dissipates the reality of the mental illness.”
- The rise of the “Moral Treatment” and the psychiatrist’s authority reframed institutional confinement as therapeutic, reflecting changing societal discourses.
- Sociological approaches highlight the moral, political, and economic underpinnings of how madness is categorized and treated.
37
lived experience of disability from the perspective of the family
## Footnote
Develop understanding about the lived experience of disability from the perspective of the family (session)
- Emotional and Mental Well-being of Parents:
- The process of receiving information about a child's disability can significantly impact the parents’ emotional health.
- For example, healthcare professionals’ approach to delivering difficult news is critical in shaping parents' mental states
- how parents experience guilt, shame, and personal blame after genetic testing results.
- Parental Relationships:
- Disability can also affect family dynamics, especially the relationship between parents.
- Mugweni (2021) found that stressful healthcare interactions could disrupt familial bonds, as parents navigate the emotional impact of the diagnosis together:
- The way healthcare professionals engage with families significantly affects their relationship with parents, influencing their trust and emotional response:
- Siblings
- Research on siblings shows mixed outcomes, but it is clear that those who take on caregiving roles may experience higher levels of mental distress
- Risk factors, such as socio-economic deprivation and a psychologically distressed primary carer, amplify these challenges.
- Interestingly, middle-class siblings seem to experience worse mental health impacts, perhaps due to different expectations in family roles.
- The Role of Community:
- For working-class families, the community may offer a more protective role, helping mitigate the emotional and psychological strain
38
the impact of disability through the family life cycle
## Footnote
Develop understanding about the impact of disability through the family life cycle (session)
- Schooling & Educational Challenges:
- Parents face stress when deciding between mainstream and special education.
- The decision impacts the child's social development, integration, and life skills development, and raises concerns about bullying.
- Mainstream schools offer social integration but may not provide specialized medical care, while special schools focus on life skills but may have a more protected environment.
- Transition to Adulthood:
- The shift from child to adult services is challenging for both parents and children.
- The lack of normal markers for independence (work, financial independence, marriage) complicates this transition for those with disabilities.
- Parents often express the need for more guidance, support, and involvement in the process.
- Adulthood:
- As individuals with disabilities age, the caregiving burden increases, and new challenges emerge in terms of who will care for them as their parents grow older.
- There is anxiety about outliving the child or being unable to provide care.
- The transition to adult services can be difficult, and respite care remains a pressing need. "Caring complexity increases... Finding adequate support."
- Social and Legal Considerations:
- The UK Care Act 2014 mandates local authorities to assess and meet the needs of people with disabilities and their carers, but challenges persist in accessing the appropriate services.
- Additionally, parents often experience social isolation and guilt due to the ongoing caregiving demands. "Loss of freedom for parents as do not have the independence of other peers."
39
Health inequalities are unfair and avoidable differences
## Footnote
OTHER: Health inequalities are unfair and avoidable differences in health status between different groups in society (NHS England).
- They arise from social determinants of health, including the conditions in which people are born, grow, live, work, and age (WHO).
- Key Risk Factors:
- Health status (e.g., disease incidence, life expectancy).
- Access to healthcare (e.g., service availability).
- Quality & experience of care (e.g., patient satisfaction).
- High-risk behaviors (e.g., smoking, alcohol consumption).
- Wider determinants (e.g., housing quality, employment, income).
40
Health Inequalities in Clinical Practice & Interventions
## Footnote
Health Inequalities in Clinical Practice & Interventions
* Case Studies Demonstrating Health Inequalities:
* Antenatal Care: A pregnant woman struggling financially, unable to afford folic acid, highlights income-related inequalities.
* Interventions: Prescription exemptions, Healthy Start vouchers, social prescribing, family support referrals.
* Neonatal Care: A newborn from an immigrant family with a language barrier, born underweight and at social disadvantage.
* Interventions: Translator, breastfeeding support, social prescribing, housing support.
* Childhood Asthma: Two children with asthma, one from a well-off family with good health literacy, the other in poor housing with language barriers.
* Interventions: Health literacy support, translation services, housing intervention, smoking cessation for the family.
* Women's Health: A Black Caribbean woman with undiagnosed endometriosis, dismissed by previous doctors.
* Interventions: Proactive investigation, specialist referrals, acknowledging biases in women's healthcare.
* Broader Strategies for Addressing Inequalities:
* Early identification of inequalities in clinical settings.
* Advocacy for patients, especially in under-resourced settings.
* National policies & programs, such as the Women's Health Strategy 2022.
* Community and social interventions, like Sure Start Children's Centres.
41
THe marmot review
Health Equity in England: The Marmot Review 10 Years On (2020) - Five Policy Objectives:
A. Giving every child the best start in life
B. Enabling all people to maximise their capabilities and have control over their lives
C. Creating fair employment and good work for all
D. Ensuring a healthy standard of living for all
E. Creating and developing healthy and sustainable places and communities.
42
Main issues in health inequality
## Footnote
Describe the main issues related to the inequalities in health as described by the major UK reports, including the marmot reports (session)
- The Marmot Review (2010) – "Fair Society, Healthy Lives": Commissioned to address health inequalities in England.
- Give every child the best start in life.
- Enable all to maximize their capabilities and have control over their lives.
- Create fair employment and good work for all.
- Ensure a healthy standard of living for all.
- Develop healthy and sustainable communities.
- Strengthen the role and impact of ill-health prevention.
- Key Themes:
- Health inequalities are a matter of fairness and social justice.
- Requires proportionate universalism (actions targeting all but with greater intensity for those in need).
- Action should address all social determinants.
- Economic impact: Health inequalities cost £31-33bn in productivity losses and £20-32bn in tax losses and increased welfare payment
43
Health policy over time
## Footnote
To assess the health policy responses of successive uk governments to the evidence of persistent and widening social inequalities in health (sociology lecture)
- Post war
- Beveridge Report (1942)Highlighted key social issues (disease, poverty, etc.) and laid the foundation for universal healthcare.
- NHS Creation (1948): Ensured free healthcare at the point of use, aiming to reduce health inequalities across all social classes.
- Health Inequalities Rise (1970s-1980s)
- The Black Report (1980): Highlighted growing health inequalities, particularly among lower socioeconomic groups.
- Policy Response: Report recommended addressing social determinants of health but was largely ignored due to political resistance (especially under Thatcher’s government).
- Neoliberalism & NHS under Conservatives (1980s-1990s)
- Internal Market Reforms: Focused on market-driven solutions, reducing NHS's ability to address health inequalities.
- Increase in Inequalities: Austerity and privatization exacerbated social and health inequalities.
- New Labour (1997-2010)
- Health Inequality Focus: Recognized health inequalities as a key issue but mainly focused on NHS modernisation.
- Health Inequalities National Support Team (HINST): Initiated policies targeting poverty and housing as social determinants of health.
- Acheson Report (1998): Suggested measures to reduce inequalities, such as improving early childhood development, education, and housing, but with limited policy implementation.
- Coalition Government (2010-2015)
- Austerity Measures: Cuts to public spending, welfare, and services worsened health inequalities.
- Health and Social Care Act (2012): Introduced reforms with a focus on market solutions, potentially exacerbating inequalities in healthcare access.
- Current Government (2015-Present)
- Health Inequalities Strategy: Focused on social determinants of health, but austerity and underinvestment limited effectiveness.
- COVID-19 Impact: Pandemic revealed and worsened existing health inequalities, particularly among ethnic minorities and lower-income groups.
- Key Factors Influencing Policy
- Social Determinants of Health: Policies often focus on healthcare access but neglect broader factors like income, education, and employment.
- Political Ideology: Health inequality responses are influenced by the governing party’s ideology—Labour tends to focus on addressing inequalities, while Conservatives favour market-based solutions.
- Public Health Research: Reports like the Black Report, Acheson Report, and Marmot Review have influenced policy but have not always been fully implemented.
44
Marmot and life course.
