Sick role
The "sick role" is a foundational concept in medical sociology. It offers a lens through which the interplay between sickness, societal norms, and the roles individuals adopt can be understood. The term originated from American sociologist Talcott Parsons in 1951 and has since been used to elucidate the rights and obligations of individuals when they fall ill.
Historical Background
Talcott Parsons, a prominent figure in functionalist sociology, first conceptualized the "sick role" in 1951. According to Parsons, illness entails more than just physiological symptoms; it ushers an individual into a distinct social role defined by societal expectations and norms.
Parsons' Perspective
Functionalist theories view societies as systems in equilibrium, with each component serving a purpose. Within this framework, sickness is seen as a form of "sanctioned deviance". A sick individual is temporarily unable to fulfill their conventional societal roles, which necessitates adjustments within the societal framework. Consequently, the medical profession emerges as a guardian, ensuring that the deviation is temporary and is managed appropriately.
Conceptual Framework
For Parsons, illness doesn't solely reflect a biological malfunction. It constitutes a well-defined social role with ingrained rights and responsibilities, molded by prevailing societal conventions.
Rights of the Sick Person:
- The sick person is exempt from normal social roles.
- The sick person is not held accountable for their condition.
Obligations of the Sick Person:
- The sick person has an imperative to recuperate.
- The sick person should actively seek proficient medical aid and collaborate with healthcare professionals.
Furthermore, the "sick role" can be classified into three distinct categories:
- Conditional Role: Temporary and universally acknowledged.
- Unconditionally Legitimate Role: Recognized without contention.
- Illegitimate Role: Conditions that face societal stigma.
Criticism of the Sick Role Model
While Parsons' model has been foundational, it has not been without its critics.
Rejection of the Role
The model assumes that individuals willingly accept the sick role, which might not always be the case. Some individuals might resist relinquishing their societal obligations or shun dependency. In cases of stigmatized illnesses, individuals might evade the public sick role to avoid societal judgment. Not all patients are inclined to adopt a 'passive patient' role.
Doctor-Patient Dynamics
A visit to a doctor often culminates a longer journey of seeking assistance. Freidson (1970) emphasized the significance of the 'lay referral system', where a person seeks guidance from their social circle before consulting a medical professional. The model presupposes ideal roles for both doctors and patients, which may not always manifest in reality. For further reading on this topic, refer to works by Murcott (1981), Sacks (1967), and Bloor & Horobin (1975). Patient experiences can vary significantly based on factors such as social class, gender, and ethnicity. Notable studies in this area include those by MacIntyre & Oldman (1984), Buchan & Richardson (1973), and Sudnow (1967).
Attribution of Blame
The granted 'rights' are not universally applicable. At times, individuals might be deemed responsible for their ailments, particularly if their lifestyle is considered a contributing factor. An examination of this can be found in Chalfont & Kurtz's 1971 study on alcoholism. Illnesses that carry societal stigma might not always be recognized as valid, further alienating the afflicted.
Relevance to Chronic Illness
The "sick role" model is aptly suited for acute conditions, such as measles or appendicitis. However, its application becomes problematic when considering chronic or long-term conditions like blindness or diabetes. For these conditions:
The expectation of recovery is often non-existent. Continuously embodying the sick role may not be practical or beneficial for the individual or society. There's a notable emphasis on promoting independence and self-management among chronically ill patients.
Conclusion
While the "sick role" provides a valuable framework for understanding illness within a societal context, its applicability has limitations. Nevertheless, it remains a seminal concept in medical sociology, prompting continued discourse on the sociocultural aspects of illness.
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Contributors: Prab R. Tumpati, MD