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Power within healthcare organizations
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Medicine as a Form of Social Control This critique will examine the view that medicine is a form of social control. There are many theorists that have different opinions on this view. This critique will discuss each one and their different views. We live in a society where there is a complex division of labour and where enormous varieties of specialist healing roles are recognised. We attribute to our modern healers a great deal of power, and trust that they will use it for our benefits rather than to harm us. Professional codes of ethics are promises that doctors will use their knowledge to benefit patients. The sociologist Talcott Parsons (1951) described what he considered the essential point of this contract. These rights, obligations and privileges are standards of behaviour, which Parsons felt people in American society believed desirable in the 1940s. The sociological term for such a standard of behaviour is a norm. People in modern Britain acts in a certain way that is seen as appropriate for ill people. In the 1950s, Parsons (1951) outlined the norms that govern illness behaviour and professional responses to it, in modern society. He also saw the patient - doctor relationship as a social system, governed by norms about appropriate behaviour. Also, Parsons (1951) claimed illness as disruptive, a kind of deviance and is therefore potentially disruptive to the social order. Parsons saw society as a functioning whole, and was concerned with how the social order was maintained, and how various institutions in society in the case health care institution function... ... middle of paper ... ...power, which extend throughout the whole of society. He described what he called the clinical gaze as having moved beyond the hospital and the clinic into many and diverse sites such as our schools, workplaces, and homes. For Foucault (1973) the clinical gaze was a facet of a new kind of power, which relied on surveillance and inspection. In conclusion, this critique has critically examined the view that medicine is a form of social control. Discussing the views of theorists such as Talcott Parsons, Ivan Illich, Narvarro, Irving Zola and Foucault. These theorists have views about how dominating medicine can be in society, the power of the professionals and medicalisation how it refers social problems into medical problems. Throughout this critique, it has been made clear that medicine is a form of social control.
In the realm of medical ethics, there are many topics that are debated and discussed, but there is not necessarily one clear, correct answer. One of these topics is paternalism. Many questions are bandied back and forth: is it beneficial, should it be disallowed entirely, are there instances when paternalism is good and beneficial, and the list goes on. For each of these questions there have been authors who have provided their comments. One such author is Alan Goldman. He draws a very firm line on paternalism, simply put: medical paternalism is deleterious to a patient because it intrudes on their primary rights of liberty and autonomy. This paper is going to expound upon Goldman’s viewpoint in detail, going through point by point how he presents his argument. There will then be a critique of Goldman’s viewpoint that will counter his main points. The counterpoints will show Goldman’s views on paternalism are incorrect and should not be considered valid.
Patient autonomy was the predominant concern during the time of publication of both Ezekiel and Linda Emanuel, and Edmund D. Pellegrino and David C. Thomasma's texts. During that time, the paternalistic model, in which a doctor uses their skills to understand the disease and choose a best course of action for the patient to take, had been replaced by the informative model, one which centered around patient autonomy. The latter model featured a relationship where the control over medical decisions was solely given to the patient and the doctor was reduced to a technical expert. Pellegrino and Thomasma and the Emanuel’s found that the shift from one extreme, the paternalistic model, to the other, the informative model, did not adequately move towards an ideal model. The problem with the informative model, according to the Emanuel’s, is that the autonomy described is simple, which means the model “presupposes that p...
The patient should have confident and trust in their doctor, but the doctor must also recognize that the patient is entitled to have an attitude to illness and his preferred way of tackling this (Turner-Warwick, 1994). Buchanan infers that paternalism eliminates an individual’s power of making their own choices and thus pressed into making decisions. To achieve public health goals, greater considerations must be directed toward promoting a mutual understanding of a just society (Buchanan, 2008). So, if people are given the choice to make certain decision over another, then they are still granted freedom of choice. Buchanan identifies 3 arguments in justifying paternalistic actions: informed consent, weak paternalism, and utilitarianism. To support his argument of informed consent, Buchanan admits there is no significant ethical concern because an individual may reach out to the professional for help, but it is problematic when an intervention is targeting the entire population (Buchanan, 2008). This point of view from Buchanan is flawed and completely limits what public health is all about. The Institute of Medicine (IOM) defines public health as “what we, as a society, do collectively to assure the conditions for people to be healthy.” With its use of the phrase “we, as a society,” the IOM emphasizes cooperative and mutually shared obligation and it also reinforces the notion that collective
Drugs have been influencing the ideas, culture, and music of America for ages. Illicit narcotics have left the Union in a state of immense debt. Anti-drug policies have been dumping billions upon billions of dollars in prevention, punishment, and rehabilitation. From the roaring twenties, to the prohibition, drugs have always been fought (Bailey). Most times, the drugs start off as medicines and end up being harmful (Morris). Perhaps, the most prominent and influential eras of drug use in America are the two decades of the 60’s and twenty years later, the 80’s. It may very well be that these two decades molded America into what it is now.
Alan Goldman argues that medical paternalism is unjustified except in very rare cases. He states that disregarding patient autonomy, forcing patients to undergo procedures, and withholding important information regarding diagnoses and medical procedures is morally wrong. Goldman argues that it is more important to allow patients to have the ability to make autonomous decisions with their health and what treatment options if any they want to pursue. He argues that medical professionals must respect patient autonomy regardless of the results that may or may not be beneficial to a patient’s health. I will both offer an objection and support Goldman’s argument. I will
In, Body Work by Sara Paretsky, the Guaman family’s homophobia damages their family by causing both Allie’s rape and death, and the covering up of them. Homophobia manages to cause all of this damage because it is a powerful social control mechanism, meaning it leads individuals towards conformity, and shames and or ostracizes those who don’t conform to the societal norm. In this case, the societal norm is heterosexuality, and homosexuals are shamed and ostracized for deviating from that norm. Allie is ashamed of being a lesbian and decides to serve in Iraq in the hope that she can repent for her “sins,” and her family is so ashamed of her homosexuality that they must deny it, which allows Tintrey to cover up the truth behind Allie’s death.
Public health practice in the nineteenth century mainly focused on sanitary reforms such as clean water, efficient sewage system, garbage collection and disposal, fumigation practices and clean housing facilities. This was mainly attributed to the filth theory which was widely accepted during that time. These sanitary measures were necessary to keep the infectious diseases such as smallpox, cholera and typhoid under control so as to prevent their epidemic outbreaks. However, in the early twentieth century, the advent of germ theory shifted the focus of public health from sanitary reforms to the laboratory. This changed the outlook of public health officials leading to alterations in the treatment procedures of the disease which were now concentrated mainly on the elimination of bacteria causing the disease. (Rosen, G.,1993)
Doctors have to go through many years of studying and many more hours of practicing on people. These qualities make any doctor seem god-like to the eyes of everyday people. Doctors are trusted blindly and people are led to believe that doctors are always honest. In the story, The Use of Force by William Carlos Williams, the parents of Matilda question the tactics the doctor is using to properly diagnose the girl but trust that the doctor knows what he is doing and lets him use force anyway. These cases are seen all over the world as well. There have been many reported cases of doctors using force to allow patients to get treated. Some patients however, do not wish to be treated because of things like religion or preference or other reasons but doctors still treat them in order to save them from themselves. The power struggle creates anger and resentment from both parties and blurs the line between personal rights and saving lives. In an article written by Jessica Grose, doctors force a woman to have a C-Section because they believe it was in the baby’s best interest. However, the woman did not want to have the surgery performed. This led to the doctors threatening to sue the woman for possible child endangerment. The woman, in fear of possibly killing her child, sided with the health care providers even though personally she did not want to have the surgery performed. This
The biomedical model of health has been criticised because it fails to include the psychological and social causes relating to an individual’s medical illness or health, looking only at the biological causes (Giddens and Sutton, 2013). Therefore, sociologists being aware of the impacts of social structure and lifestyle on health have put in various efforts to place the study of ‘the social’ at the core of health and healthcare examination.
In his essay, “The Refutation of Medical Paternalism,” Alan Goldman discusses his argument against differentiation in the roles between physicians and patients. He says the physician may act against a patient’s will in order treat the patient in their best interest. Goldman makes his whole argument around the assumption that a person’s right to decide his or her future is the most important and fundamental right, saying, “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.” His claim is that most people agree that they are the best judges of their own self-interest and there is an innate value in the freedom to determine their own future. On these principles, Goldman starts by discussing conditions under which paternalism may be justified.
Jecker, N. (1990). Integrating medical ethics with normative theory: Patient advocacy and social responsibility. 11(2), 125-139.
Health as a Social Construction In my essay, I aim to find out why social construction affects the health of our society. Ill health may be defined as 'a bodily or mental state that is deemed undesirable'. This means that health is the condition of the body both physically and mentally. Social construction of health refers to the way health varies from one society to another.
Professionalism is an adherence to a set of values comprising both a formally agreed-upon code of conduct and the informal expectations of colleagues, clients and society. The key values include acting in a patient's interest, responsiveness to the health needs of society, maintaining the highest standards of excellence in the practice of medicine and in the generation and dissemination of knowledge. In addition to medical knowledge and skills, medical professionals should present psychosocial and humanistic qualities such as caring, empathy, humility and compassion, as well as social responsibility and sensitivity to people's culture and beliefs. All these qualities are expected of members of highly trained professions.
Morality plays a huge role in the health care field. This principle of right and wrong behavior is significant to every doctor when evaluating the merits and difficulties of many medical procedures. One may find the advancement of medical technologies hard to endure, however, this increase in medical technology serves as a solution to our human imperfections. For example, using in-vitro fertilization to pick and choose embryos regarding an ideal genetic baby or human cloning. If we screen an embryo for a tissue type, we can then allow certain physical traits for the baby. We can choose their eye color, type of intelligence, athleticism, and talent that could suggest our babies nonetheless, perfect
Many individuals are in denial about their health as a result they do not take responsibility for their health. These individuals rather have a doctor tell them that their condition is hereditary opposed to blatantly honest responses such as “Stop smoking.” or “Change your eating habits.” which imply that the individual is at fault. An article on the blog ‘Medical Malprocess’, outlines the responsibility of doctor and patient by stating that: “The providers should be held responsible for their advice and actions only. We patients should be responsible for the consequences of our decisions and actions.” This shows that while doctors may be responsible in a patient’s health that patient is also considered responsible for their actions or decisions that may have caused or worsened their condition. The blog farthest outlines and illustrates these responsibilities by giving examples such as; a regularly smoker should be responsible for getting lung cancer as this increasing their chances. However a non-smoker’s actions should not be accused if they got lung cancer.