Sociological Perspectives on Health and Medicine
Functionalist. conflict. symbolic interactionist, and postmodernist perspectives focus on different aspects of health and medicine; each provides us with significant
insights on the problems associated with these pressing social concerns.
A Functionalist Perspective: The Sick Role
According to the functionalist approach, if society is to function as a stable system, it is important torpeople to be healthy and to contribute to their society. Consequently. sickness is viewed as a form of deviant behavior that must he controlled by society. "his view was initially set forth by the sociologist Talcott Parsons (1951) in his concept of the sick role-the set of patterned expectations that defines the norms and values appropriate for individuals who are sick and for those who interact with them. According to Parsons. the sick role has four primary characteristics:
1. People who are sick are not responsible for their condition. It is assumed that being sick is 1I0t a deliberate and knowing choice of the sick 1't'r5011.
2. People who assume the sick roll" arc temporarily exerupt from their normal roles and obligations. For example. people with illnesses arc typically not expected
to go to school or work.
3. People who are sick must want to get well. TIle sick role is considered to be a temporary role that people must relinquish as soon as their condition Improves sufficiently. Those who do not return to their regular activities in a timely fashion may be labeled as hypochondriacs or malingerers.
4. People who are sick must seck competent help from a medical professional to hasten their recovery. As these cbaracteristics show. Parsons believed that illness is dysfunctional for both individuals and the larger society. Those who assume the sick role are unable to fulfill their necessary social roles. such as being parents or employees. Similarly. people who are ill lose days from their productive roles in society. thus weakening the ability of groups and organizations to fulfill their functions.
According to Parsons. it is important for the to maintain social control over people who enter the sick role. Physicians are empowered to determine - who may enter this role and when patients are read)' to exit it. Because physicians spend many years in training and have specialized knowledge about illness and its treatment. they are certified by the society to he "gatekeepers' of the sick role. When patients seek the advice of a physician. they enter into the patientphysician relationship. which docs not contain equal power for both parties. The patient is expected to follow the "doctor's orders' by adhering to a treatment regime. recovering from the malady. and returning to a normal routine as soon as possible. What arc the major stren ths and weaknesses of Parsons's model and. more generally, of the functionalist view of health and illness? Parsons's analysis of the sick role was pathbreaking when it was introduced. Some social analysts believe that Parsons made a major contribution to our knowledge of how society cxplai ns illness-related behavior and hO\'1 physicians have attained their gatekeeper status. In contrast. other analysts believe that the sick-role model docs not take into account racial-ethnic. class, and gender variations in the ways that people view illness and interpret this role. For example, this model does not take into account the fact that many individuals in the working class may choose:' not to accept the sick role unless they are seriously ill-because they cannot afford to miss time from work and lose a portion of their earnings.
Moreover, people without health insurance may not
have the option of assuming the sick role.
