Question

A. The sick role concept, developed by Talcott Parsons in the 1950s, can be thought of as a marker for how much our social institution of health care has changed. Give examples from the story of Lia Lee in The Spirit Catches you and you Fall Down to discuss one aspect of the sick role and physician-patient relationship that has a) changed greatly from when Parsons wrote, and one that has b) remained much the same. Identify and discuss two aspects of health and the health care system in the US that have driven the change you named in a).

Answer 1

Based on the criticism changes were made in the sick role concept :-

#.Rejecting the sick role.

This model assumes that the individual voluntarily accepts the sick role.

Individual may not comply with expectations of the sick role, may not give up social obligations, may resist dependency, may avoid public sick role if their illness is stigmatised.

Individual may not accept 'passive patient' role.

#. Doctor Patient relationship.

Going to see doctor may be the end of a process of help seeking behaviour, Freidson (1970) discusses importance of 'lay referral system'- lay person consults significant lay groups first.

This model assumes 'ideal' patient and 'ideal' doctor roles See- Murcott (1981), Sacks (1967), Bloor & Horobin (1975).

Differential treatment of patient, and differential doctor patient relationship- variations depend on social class, gender and ethnicity. See- MacIntyre & Oldman (1984), Buchan & Richardson (1973), Sudnow (1967).

#. Blaming the sick.

'Rights' do not always apply.

Sometimes individuals are held responsible for their illness, i.e. illness associated with sufferers lifestyle. (See Chalfont & Kurtz: 1971, on alcoholism).

In stigmatised illness sufferer is often not accepted as legitimately sick.

#. Chronic Illness.

Model fits acute illness (measles, appendicitis, relatively short term conditions).

Does not fit chronic/long-term/permanent illness as easily, getting well not an expectation with chronic conditions such as blindness, diabetes.

In chronic illness acting the sick role is less appropriate and less functional for both individual and social system.

Chronically ill patients are often encouraged to be independent.