Unit 2 Reading 1

UNIT 2, READING 1
MEDICINE AS CULTURE
BY LUPTON, DEBORAH
INTRODUCTION
In the past two decades, the lines between subjects like humanities and social
sciences have become less clear. People are paying more attention to language
and how it shapes our social lives. The way we study health and illness has
changed too, partly because some folks are not as trusting of traditional medicine
anymore. New theories, like social constructionism, are helping us understand
how society and culture influence medicine. This chapter explores these shifts,
especially in sociology, highlighting the growing importance of looking at things
from different perspectives.
THE SOCIOLOGY OF HEALTH AND ILLNESS
Originally called medical sociology in the United States and sociology of health
and illness in Britain and Australia, this field initially focused on measurable data
and adopted positivist values. It aligned with scientific medicine, often being seen
as a branch of social medicine rather than critical sociology. For a long time, it
accepted a traditional biological view of the body. Three dominant theoretical
perspectives: Functionalism, Political economy approach and Social
constructionism. However, in the 1980s, social constructionism gained
prominence, challenging these perspectives. Today, functionalism and political
economy views have declined, while social constructionism remains a thriving
approach in studying health and illness.
FUNCTIONALISM
Functionalism in medical sociology says that in a society where people mostly

agree on things, the roles and functions in healthcare help maintain order. It looks
at how healthcare workers do their jobs and how people handle being sick.
According to this idea, getting sick is like going against what society expects, and it
can make people feel ashamed. Functionalists think that doctors and the medical
system help control this by deciding what's normal and what's not, keeping things
in order.
Talcott Parsons, a big name in applying functionalist ideas to medicine, talked

about the 'sick role.' When someone is seriously ill, according to him, they go
against what society expects. The sick role means being excused from normal
duties, not blamed for being sick, wanting to get better, and seeking help from
doctors. Parsons thought patients see doctors as helpful figures. Even though the
doctor-patient relationship has a power difference, it's seen as working well,
helping patients move from dependence to getting better.
While Talcott Parsons' work shed light on the social aspect of medical
interactions, criticism arises for neglecting potential conflicts in the doctor-patient
relationship. Critics argue that Parsons' view portrays patients as passive and
grateful, doctors as universally benevolent. However, conflicts of interest
between them, involving power struggles, negotiations, and external factors, are
overlooked. Although the functionalist perspective is now less popular due to
these critiques, it still offers insights into the emotional dynamics between
doctors and patients
THE POLITICAL ECONOMY PERSPECTIVE

The political economy approach, responding to functionalism, emerged in the
1970s influenced by Marxist ideas. Also known as critical structuralism, it's
still impactful in health sociology. This view defines good health not just as
well-being but having control over resources for a satisfying life. People who
can't contribute to production and consumption, like the ill or disabled, are
marginalized. Medicine, from this perspective, aims to keep people healthy
for economic reasons but doesn't invest much in those who can't return to
work. This perpetuates social inequalities, favoring the privileged over the
underprivileged.
Critics in political economy talk about the 'cultural crisis of modern

medicine' under capitalism, calling it not very effective, too expensive, and
unfair. They say that because doctors are highly respected, various social
problems are wrongly labeled as illnesses. This idea, called 'medicalization,'
suggests that medicine has become a big tool for social control, even more
than religion or law. Some critics argue that modern medicine, controlled by
professionals, can harm by making people too dependent, hiding the real
reasons for illness, and taking away people's control over their health.
Political economists, unlike functionalists, think medicine is used to define

normal and punish those seen as different. However, they see this power as
harmful and abused by doctors. They question the values of biomedicine,
focusing on politics, money, and history influencing health. They argue
capitalism turns healthcare into a money-making business, causing conflicts
between doctors and patients. Instead of preventing illness, they say
biomedicine often just treats symptoms, ignoring broader factors like
processed foods, pollution, stress, and work dangers that affect health.
Some people who study society and health, called political economists, criticize the
government for not stopping harmful things like pollution and unhealthy products.
They say our system of making money, called capitalism, creates health problems
without admitting it. They suggest a healthcare system where everyone gets free
care and using other ways besides just medicine. Some people criticize them for not
paying enough attention to personal relationships with doctors and for being too
negative about medicine. But these discussions are important for understanding
how money and politics affect health and why some groups of people may have
more health problems.
SOCIAL CONSTRUCTIONISM
In the 1980s and 1990s, a perspective called social constructionism became important in
understanding health and illness. It questions the idea of absolute truths and believes that what
we consider true is influenced by power and is not neutral. Social constructionism says that all
knowledge comes from social relationships and can change over time. It sees knowledge not as
something universal but as part of creating our understanding of reality. This approach looks at
how common-sense knowledge in society is created and sustained, with a focus on power
relations.
Social constructionists study how society influences biomedical knowledge and
practices. They don't deny diseases but emphasize that how we understand them is
shaped by society. Medical knowledge is seen as socially constructed, not a
straightforward progression. Social constructionists, influenced by feminism,
critique how medical knowledge can favor certain groups. Scholars have different
views on whether medical knowledge is neutral or serves social control. While
popular, this perspective faces criticism for generalizing medical discourse, lacking
micro-level examination, and overlooking human agency and resistance.
Critics argue that social constructionism can lead to relativism, questioning the
validity of its own insights. They also say it overlooks the material reality of the
body. However, defenders argue that the purpose is to highlight these challenges,
not define 'truth.' Researchers must be aware of their analysis's assumptions. Social
constructionists rarely claim experiences are solely social constructs; they
recognize biological realities. Social constructionism isn't nihilistic; exposing the
social bases of health care allows for change, negotiation, and resistance.
MEDICAL ANTHROPOLOGY
Medical anthropology and sociology of health have blended in the last two decades.
Anthropology looks at health across cultures, emphasizing how culture influences
illness experiences. Originally focused on small societies, it now explores Western
health beliefs. However, close ties to biomedicine sometimes limit social criticism,
and medical anthropologists may act more as cultural translators than critics. The
challenge is balancing the exploration of cultural views on illness with maintaining a
critical perspective in health care settings
Medical anthropology has changed a lot. At first, it focused on

decoding what patients meant. It thought folk illness was less
important than medical understanding. But since the 1960s, it has
become more critical. Now, it looks at how society makes medical
knowledge and controls people. It also sees diseases as contested. It
looks at the body as both biological and cultural, using different
perspectives.
THE HISTORICAL DIMENSION
A while back, the history of medicine only praised scientific progress. Now,
we look at it more critically, realizing that Western medicine isn't better than
others. Understanding history helps us see how people reacted to health
issues in the past. This insight is vital for understanding why certain
diseases are stigmatized and feared today. It also explains how media and
health policies are influenced by past beliefs and behaviors.
Looking at the history of medicine helps us understand how people and
relationships work during times of illness. Foucault, a key figure, questioned
historical "truths" and showed how power influences medical knowledge. In
psychiatry, he said labeling behaviors as normal or abnormal creates mental
illnesses. This idea influenced those critical of modern mental health approaches.
Foucault's ideas changed how we see medicine, emphasizing the language that
shapes our thoughts and the power dynamics in medical experiences—important for
this book's focus.
CULTURAL STUDIES
Cultural studies and sociology of culture study how people create and share
meaning in everyday things like food and fashion, challenging the idea that culture
is just "natural." Bryan Turner and others explore how our bodies, appearance, and
manners are shaped by social norms. Cultural studies, rooted in sociology, looks at
mass media and products, criticizing how they support powerful interests in society.
Many social scientists treated medicine as separate from culture, thinking it's purely
scientific. Yet, people shape their views of medicine from cultural sources and
experiences. The mass media plays a big role, showing medicine in certain ways.
Sociologists and cultural scholars find it crucial to study how medical practices are
portrayed in media and how people interpret these representations to understand
cultural aspects of medicine and health.
DISCOURSE AND THE LINGUISTIC TURN
In recent decades, cultural studies and other social sciences have paid more
attention to language and discourse. Semiotics, the study of signs, and Barthes'
work in the 1960s influenced this change. Discourse, a poststructuralist idea, looks
at language structure in a social context. It involves using words and symbols to
describe and categorize the social world. Discourses are expressed in texts,
interconnected, and influenced by historical, political, and cultural contexts.
The way we talk about things (discourses) is connected to our actions (practices).
For instance, describing the maternal body and fetus can create a separation
between them. Practices and discourses influence each other. Analyzing texts, like
medical books and TV shows, helps understand these discourses. It shows how
biology and culture work together in shaping our view of disease in society. Looking
at debates on abortion, accusations against pregnant women, medical training, and
ultrasound use reveals how language and practices reinforce societal views on
health and define social boundaries.
CONCLUSION
In looking at medicine as a cultural phenomenon, various disciplines share the
understanding that in modern western societies, medicine plays a crucial role in
social control and shaping human behavior, bodies, and subjectivity. While different
perspectives exist, scholars in the humanities and interpretive social sciences find
medicine worthy of study. Encouraging an eclectic approach, combining diverse
theoretical and methodological angles, can enhance our understanding of medical
phenomena by incorporating elements from various disciplines, potentially bridging
artificial boundaries between them.

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UNIT 2, READING 1

THE SOCIOLOGY OF HEALTH AND ILLNESS

Functionalism in medical sociology says that in a society where people mostly

Talcott Parsons, a big name in applying functionalist ideas to medicine, talked

THE POLITICAL ECONOMY PERSPECTIVE

Critics in political economy talk about the 'cultural crisis of modern

Political economists, unlike functionalists, think medicine is used to define

Medical anthropology has changed a lot. At first, it focused on

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