Module Overview: Aims, Objectives and Learning Outcomes

UNIVERSITY OF WARWICK

DEPARTMENT OF SOCIOLOGY

SOCIOLOGY OF HEALTH AND ILLNESS

2006-2007

Second & Third Year Module

Professor Simon J. Williams

MODULE OVERVIEW: AIMS, OBJECTIVES AND LEARNING OUTCOMES

The aims of the module are to provide students with a thorough grounding in the sociology of health and illness, including key debates on the biomedical model and the social construction of medical power/knowledge; the relationship between social structure and health (principally by class, gender and ethnicity); lay concepts, images and experiences of health and illness; the nature and status of professional power and dominance; and the challenges and uncertainties, dilemmas and contradiction of medicine and health care in the twenty-first century. Throughout the module, the relationship between theory and evidence is stressed, alongside newly emerging issues surrounding the body and risk in late/postmodernity. In these and other ways, a balanced assessment is provided of the sociology of health and illness, and the place and function of sociological critiques in the `academic encirclement’ of medicine.

Learning objectives for the Sociology of Health and Illness Module:

By the end of the module students should:

1) Have an advanced knowledge and understanding of key concepts and theoretical approaches within the sociology of health and illness as a developing field of inquiry, with specific reference to: a) The nature and status of medical power/knowledge and professional dominance in contemporary western societies b) Social diversity and inequalities in health within contemporary western societies c) Concepts and experiences of health and illness, and the social nature of relations between medical and lay worlds. d) Processes of social transformation and change in health, medicine and society.

2) With reference to these substantive areas of study, be able to: a) Assess a range of perspectives b) Evaluate sociological arguments and evidence

1 c) Draw upon, summarise and synthesise a variety of source materials in constructing their own sociological arguments; d) Identify and select sociological work relevant to given social, public or policy debates e) Recognise sociologically informed questions and the distinctive character of sociology in relation to other forms of understanding and everyday explanations f) Undertake and present scholarly work g) Participate in group discussion and work h) Make appropriate use of library and IT resources

Learning and teaching methods (which enable students to achieve these learning outcomes):

1. A course of 20 lectures is delivered

2. Weekly seminars are conducted (Term 1, week 2 to Term 2, week 10) in which small group work is incorporated and for which students are expected to prepare

3. Two non-examined class essays

4. A non-examined, small group, internet based project on the medicine, (bio)technology and the body (the equivalent of a third class essay)

5. Inclusion of learning materials and key website addresses/hypertext links, on the module website

6. A revision course in Term 3, weeks 1-4

Assessment methods (which will measure the achievement of these learning outcomes):

1. EITHER a Two OR Three hour examination in which students must show ability to: a) Assess perspectives b) Evaluate sociological arguments and evidence c) Draw upon, summarise and synthesise a variety of source material in constructing their own sociological arguments d) Recognise sociologically informed questions and the distinctive character of sociology in relation to other forms of understanding and everyday explanations e) Describe and analyse at least ONE of the following: i) The nature and status of medical power/knowledge and professional dominance in contemporary western societies

2 ii) Social diversity and inequalities in health within contemporary western societies iii) Concepts and experiences of health and illness, and the social nature of relations between medical and lay worlds. iv) Processes of social transformation and change in health, medicine and society. v) Sociological work relevant to given social, public or policy debates

2. AND/OR One OR Two, 3,000 assessed essays in which students must show ability to: a) Assess perspectives b) Evaluate sociological arguments and evidence c) Draw upon, summarise and synthesise a variety of source material in constructing their own sociological arguments d) Recognise sociologically informed questions and the distinctive character of sociology in relation to other forms of understanding and everyday explanations e) Undertake and present scholarly work f) Describe and analyse at least ONE of the following: i) The nature and status of medical power/knowledge and professional dominance in contemporary western societies ii) Social diversity and inequalities in health within contemporary western societies iii) Concepts and experiences of health and illness, and the social nature of relations between medical and lay worlds. iv) Processes of social transformation and change in health, medicine and society. v) Sociological work relevant to given social, public or policy debates

3) Students’ performance in the following (transferable) skills is assessed (via standardised criteria) as part of the Departments review of student progress: a) Time management b) Participation in discussion c) Group work d) Use of library and IT resources

LECTURES/SEMINARS AND CLASS WORK

3 Lectures times and seminar groups for the module, including room details, are posted on the Dept. notice board. Please do not attempt to swap the seminar group to which you have been allocated unless absolutely necessary. Class essay questions are provided for each lecture topic covered on the module. Seminars will be theme or issue based, drawing together two or more topics covered in the lectures. As such they provide a useful basis for assessed essay work: assessed essay questions, in other words, will be based on these broader seminar questions. Many of the seminars involve small group work as well as more open debates and discussions concerning particular themes and issues relating to the topic in question: the emphasis here is very much on learning through active participation and involvement in seminar groups. Remember, these are YOUR seminars. Students are, therefore, expected to prepare adequately for, and attend, each and every seminar.

TWO class essays (2,000 words each), one for each term, are required: the first by END OF WEEK 8 (TERM 1), the second by the END OF WEEK 8 (TERM 2). You will also be required to work in groups of 3-4 on a small-scale project of your choice bearing on the topic of `medical/health technologies and the body'. This will involve a short group presentation (10-15 minutes) in Term 2, week 7, concerning your findings, which can then be written up individually (if you wish) as `another agreed title' on the assessed essay list. See below for further details.

Revision sessions, for those sitting the summer exam will be held at the beginning of Term 3: in line with Departmental Good Practice Guidelines. These will cover all aspects of the module, structured around model answers to past exam paper questions. Details of these revision sessions will be circulated/posted at the end of Term 2.

MODULE WEBSITE

The SHI home page, including reading lists and powerpoints, can be accessed via the following website address: http://www2.warwick.ac.uk/fac/sociology/staff/academic/williamss/williamss_index/teaching/shi/

You can also access details of the module via the undergraduate module website: http:/www2.warwick.ac.uk/fac/sociology/undergrad/modules/shi/

IT/PROJECT BASED WORK AND PRESS CLIPPINGS FILE

The aim of this small-scale, group based, project is to provide you with a `hands on’ exercise, using your IT skills, in order to research a topic of your choice pertaining (in some shape, sense or form) to ‘medical/health technologies and the body’. You may, for example, decide to study something to do with plastic surgery, organ transplants, the new genetics, e-health or virtual medicine.

Your project should comprise information drawn from a range of sources, including the Internet.

Whatever you chose, you will need to work in groups of 3-4, and will be expected to give a short 10- 15 minute presentations of your group projects in the seminar slot scheduled for week 7 in Term 2.

Further details will be provided early in Term 2.

This is NOT a formal assessment. You can, however, if you wish, write your projects up individually as `another agreed title’ on the assessed essay list.

4 Any further questions, please ask. Hopefully it will prove an exercise in independent learning which you all enjoy and benefit from, adding a further dimension to the module whilst honing your IT and presentation skills to boot!

Press Clippings File: You may also like to keep a press clippings folder, throughout the module, concerning the reportage of various issues concerning medicine and health care in the media. This could also be turned into an assessed piece of work through a case-study of a particular issue regarding medicine and the media. See, for example, Seale, C. (2003) Media and Health. London: Sage.

5 READING

In the reading lists that follow, I have attempted to provide you with a fairly detailed/comprehensive list of references bearing on each particular topic covered within the module (in part to increase choice and to offset heavy use of limited library resources). Obviously you are not expected to read each and every reference on the reading list! Rather, core/essential readings for each lecture are indicated first, followed by a series of further readings, key ones indicated by an asterisk. Students are expected to read the core/essential reading(s) and at least one of the other key further (asterisked) readings each week in order to prepare adequately for class and seminar work. For essay/exam preparation, however, students should read more widely within and across topic areas.

As you can see, I have tried, wherever possible, to rely upon articles in journals which are permanently available in the library or online. Copies of certain books in heavy usage can also be found in the Student Reserve Collection (SRC).

(i) Module Textbooks

There are no set textbooks for this module as such: instead a variety of texts will be used and referred to throughout the module. However, I strongly recommend students to buy or borrow one of the following books:

* Annandale, E. (1998) The Sociology of Health and Medicine: a Critical Introduction. Cambridge: Polity Press. An accessible text that covers a series of key contemporary theoretical, substantive and policy relevant concerns; organised around the guiding theme of social inequalities in health and medicine.

* EITHER: Bury M. (1997) Health and Illness in a Changing Society. London: Routledge. (A lively and critical account of the impact of social change on the experience of health and illness, including useful chapters on health beliefs and illness behaviour, inequalities in health, doctor-patient relations, chronic illness and disability, death and dying, the body, health and risk). OR: Bury, M. (2005) Health and Illness. Cambridge: Polity (a new short introductory text).

Gerhardt. U. (1989) Ideas about Illness: An Intellectual and Political History of Medical Sociology. London: Macmillan. (A detailed and comprehensive account of the main theoretical paradigms and perspectives within medical sociology: not an easy text, but one which is well worth the effort and will pay dividens for those who seek to master it!). NB. This is now OUT OF PRINT, but copies are available in library.

Lupton D. (2003) Medicine as Culture: Illness, Disease and the Body in Western Societies (2nd Edition). London: Sage. (An accessible, yet quite sophisticated text, covering theoretical perspectives on medicine and society, the body in medicine, representations of medicine and disease in elite and popular culture, lay perspectives on illness and disease, power relations in the medical encounter, and feminsms and medicine).

Scambler (2002) Health and Social Change: A Critical Theory. Buckingham: Open University Press. (A theoretically sophisticated book which critically examines the social changes that have affected capitalist societies and the implications for health (care). Particularly good on the postmodern turn, issues of disorganised capitalism, neo-liberalism and the 'Third Way', and inequalities in health)

Stacey M. (1988) Sociology of Health and Healing. London: Routledge (A broad ranging historical and contemporary sociological analysis of health and healing with a particular emphasis upon feminist

6 analyses of the division of labour in health care).

* Turner B.S. (1995) Medical Power and Social Knowledge (2nd Edition). London: Sage. (A good introduction to the sociological analysis of disease, sickness and the social organisation of medical power, particularly from a Foucauldian perspective. The second edition also includes some useful new chapters on medicine and psychiatry, the body and 'risk').

* Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/Lonon: Norton & Co. A good new book taking a more global look at the body, health, inequality and citizenship.

White, K. (2002) An Introduction to the Sociology of Health and Illness. London: Sage. (An accessible introduction, which nonetheless covers some sophisticated theoretical debates and current developments in the field, including topics such as inequalities and the new genetics).

* Williams, S.J. (2003) Medicine and the Body. London: Sage. (A critical re-reading of medical sociology in and through sociological debates on the body; covers many topics and issues on the module, including biomedicine, health, childhood, ageing, inequalities, medical technologies and complementary therapies).

(ii) Other (Recent) Edited Volumes/Readers:

The following texts/readers are also useful for the module – I particularly recommend buying or borrowing the Bury and Gabe Reader below in conjunction with one of the textbooks listed above:

Albrecht, G., Fitzpatrick, R. and Scrimshaw, S. (eds.) (2000) The Handbook of Social Studies in Health and Medicine. A number of useful chapters/essays, thematically organised under the following key headings: I: Social and cultural frameworks of analysis; II: The experience of health and illness; III: Health care systems and practices. Copies available on reference in the library.

* Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge (A really useful reader, with many key essays covered in the module, including sections on health beliefs, inequalities, professional/patient interaction, chronic illness and disability, and the evalutation and politics of health care).

Bendelow, G., Carpenter, M., Vautier, C. and Williams, S.J. (eds.) Gender, Health and Healing: The Public/Private Divide. London: Routledge. (Covers a range of key issues regarding gender, health and healing across the public/private divide, including human reproduction, the emotional division of labour and health care in transition).

Davey B., Gray A. and Seale C. (eds.) (2001) Health and Disease: a Reader (Third Edition). Milton Keynes: OUP. (Many useful readings including new material on genetics and globalization).

* Gabe, J., Kelleher, D. and Williams, G.H. (eds.) (2005) Challenging Medicine (2nd Edition). London: Routldge.

Gabe, J., Bury, M. and Elston, M.A. (2004) Key Concepts in Medical Sociology. London: Sage. (Covers all key concepts, in an accessible/digestible format, from embodiment to stigma….).

7 Scambler, G. and Higgs, P. (eds.) (1998) Modernity, Medicine and Health: Medical Sociology Toward 2000. London: Routledge. A number of useful chapters on the modernity/postmodernity interface in relation to health and medicine at the turn of the century.

Scambler G. (ed.) (1987) Sociological Theory and Medical Sociology. London: Tavistock. (Contains a number of important chapters on the relevance of theorists such as Parsons, Goffman and Foucault for medical sociology).

Scambler, G. (ed.) (2001) Habermas, Critical Theory and Health. London: Routledge. (A useful series of chapters exploring the implications of the Habermasian project for health, including lay health knowledge, doctor-patient interaction, health inequalities and new social movements).

Williams, S.J., Gabe, J. and Calnan, M. (eds.) (2000) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge. Many useful current essays, organised around key themes of social structure and health, the body, consumption and risk, and emotions and health (care).

(iii) Journal Reading

The following specialist journals (all in the University library), are of particular relevance to the module (most are now available online, (via library, e-resources, journals) so this makes life much easier for us all in terms of access):

Sociology of Health and Illness. (published six times per year, one of which forms a special issue/monograph on a current topic).

Social Science and Medicine. (published bi-weekly).

Health. (a new interdisciplinary journal, published twice in (July and October) in 1997 and quarterly from 1998 (January, April, July and October)).

Critical Public Health (published quarterly)

Ethnicity and Health (published quarterly)

International Journal of Health Services. (published quarterly).

Journal of Epidemiology and Community Health.

Journal of Health and Social Behavior. (US: published quarterly, mainly quantitative articles).

British Medical Journal (published weekly).

Medical Sociology News (published three times per year).

In addition, the more general/mainstream sociology journals such as Sociology, American Journal of Sociology, Social Problems, Journal of Social Issues, the British Journal of Sociology and Body & Society often carry useful articles pertaining to medicine, health and illness.

Many of these journals are now available online through the library, including Sociological Research Online [http://www.socresonline.org.uk/socresonline].

8 (iv) (Key) Website Addresses

These are given at various points throughout the reading list, under key topic headings. You will also need to find further website addresses for your internet health project, which can then be shared amongst students and incorporated in future reading lists.

(v) (Classic) Novels/Plays/Essays:

A. Daudet (2001/) In the Land of Pain. London: Jonathan Cape.

A.H. Huxley (1994/1932) Brave New World. London: Flamingo.

C.S. Lewis (1977/1940) Pain. London: Fount.

T. Mann (1960/1924) The Magic Mountain. Harmondsworth: Penguin.

G.B. Shaw (1911) The Doctor's Dilemma. Harmondsworth: Penguin.

S. Sontag (1978) Illness as Metaphor. Harmondsworth: Penguin.

9 MODULE OUTLINE: TERMS 1 AND 2

LECTURE AND SEMINAR PROGRAMME

Term 1:

Introduction: Theoretical perspectives and critical debates on medicine, health and disease

1. Introduction: the origins, nature and status of medical sociology.

2. Critical perspectives on biomedicine: medicalization and beyond.

Seminar 1 (week 2): The Doctor’s Dilemma

3. Illness as social 'deviance': the Parsonian and interactionist paradigms.

Lay and medical worlds: a meeting of ‘experts’?

4. Lay concepts of health, risk and the body

Seminar 2 (week 4): The shifting engines of medicalisation/disease mongering

5. Patient/professional relations: consensus, conflict or negotiation?

Health across the life course

6. Children, health and the social order.

Seminar 3 (week 6): The lay expert: a contradiction in terms?

7. Ageing and health: decline and disadvantage?

8. Disrupted bodies/biographical disruption? the meaning and experience of chronic illness.

Seminar 4 (week 8): Growing up and growing old

9. Sleep, health and society: the ‘dormant/drowsy’ body.

10. `Mortal' bodies: Death and dying in (late/post) modernity.

Seminar 5 (week 10): Bodily dys-order: illness, death and dying

/Cont…

10 Term 2:

Social structure and the `social patterning' of health and illness

11. Social class and health: a widening gap?

12. Gender and health: the morbidity/mortality paradox.

13. `Race', ethnicity and health.

Seminar 6 (week 13): Inequalities in health: from material to psychosocial pathways?

Medical power/professional dominance: autonomy, resistance and control

14. Medicine, gender and the health care division of labour.

15. Health professions in transition: Medical power under threat?

Seminar 7 (week 15): Challenging medicine?

16. Reading week.

Medicine and health care in the twenty-first century: ferment and change

17. Medical technology and the `uncertain' body: from corporeality to hyperreality?

Seminar 8 (week 17): Medical technologies of the body: Group work presentations

18. The sociology of health promotion and the `new' Public Health (NPH): surveillance, consumption and risk in late/post modernity.

19. `Alternative' and `complementary' therapies: a challenge to biomedical hegemony?

Seminar 9 (week 19): A ‘new’ medical pluralism? The future of biomedicine

20. Conclusions and module evaluation.

Term 3:

Revision sessions for those taking the exam will be held at the beginning of Term 3. Details will be given at the end of Term 2.

11 TERM 1:

1. INTRODUCTION: THE ORIGINS, NATURE AND STATUS OF MEDICAL SOCIOLOGY.

This first preliminary session will provide a general introduction to the module, and a brief overview of the origins, nature and status of medical sociology. In doing so, it will serve as a backdrop to the following weeks lectures on theoretical perspectives in the sociology of health and illness. There will be NO seminar this first week: SEMINARS START IN WEEK 2;

Class Essay Question:

Is it time for a ‘new’ medical sociology, as Turner (2004) suggests?

1. Core/Essential Readings:

1. Annandale, E. (1998) The Sociology of Health and Medicine: a Critical Introduction. Cambridge: Polity Press (Chpt. 1 `The theoretical origins and development of the sociology of health and illness'). OR: Turner B.S. (1995) Medical Power and Social Knowledge (2nd Edition). Sage (Chpt. 1: 'Medical sociology'. See also new Part IV Chpts. 11-13)).

2. Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/London: Norton & Co. (Introduction and Chpt. 8).

3. G.B. Shaw (1911) The Doctor's Dilemma. Harmondsworth: Penguin. (A highly entertaining read which raises many issues covered on the module)

2. Further (Key *) Readings:

Alderson, P. (1998) The importance of theories in health care. British Medical Journal. 317: 1007-1010 (follow up leads here to other articles in the series).

(*) Claus L.M. (1983) The development of medical sociology in Europe. Social Science and Medicine 17: 1591-97.

Gerhardt U. (1989) Ideas about Illness: An Intellectual and Political History of Medical Sociology. London: Macmillan ('Introduction: the origin of medical sociology'. This is not an easy text, but it provides the theoretical backdrop and underpinnings of the module as a whole so try and master it; it is well worth the effort!).

Gold M. (1977) A crisis of identity: the case of medical sociology. Journal of Health and Social Behavior. 18 (June): 160-168.

Scambler (2002) Health and Social Change: A Critical Theory. Buckingham: Open University Press. (Chapter 7, from critical theory to critical sociology).

Stacey M. and Homans H. (1978) The sociology of health and illness: its present state, future prospects and potential for health research. Sociology. 12 (2): 281-307. See also: Stacey M. (1988) The Sociology of Health and Healing. London: Routledge (Introduction: some theoretical and methodological thoughts: pp. 1-14).

Straus R. (1957) The nature and status of medical sociology. American Sociological Review. 22: 200-

12 204.

(*) Williams, S.J., Annandale, E. and Tritter, J. (1998) The sociology of health and illness at the turn of the century: back to the future? Sociological Research Online. 3, 4. [see p. 7 above for full online address].

13 2. CRITICAL PERSPECTIVES ON BIOMEDICINE: MEDICALIZATION AND BEYOND

In this lecture we look at the nature and status of biomedicine, from a variety of sociological perspectives, with particular reference to the medicalization debate, both past and present.

Class Essay Questions:

‘Medicine is not merely neutral…As a moral enterprise it is an instrument of social control’ (Freidson 1970). Discuss.

Are sociological critiques of medicine self-serving?

To what extent have women’s bodies and (reproductive) lives been medicalised? Have there been gains as well as losses here for women in the process?

1. Conrad. P. (1992) Medicalization and social control. Annual Review of Sociology. 18: 209-32.

2. Conrad, P. (2005) The Shifting engines of medicalization. Journal of Health and Social Behavior. 46 (March): 3-14. SEE ALSO: (a) Conrad, P. and Leiter, V (2004) Medicalisation, markets and consumers. Journal of Health and Social Behavior. 45 (extra issue): 158-76; (b) Clarke, A., Mamo, L., Fishman J., Shim, J K and Fosket J.F (2003) Biomedicalization: technoscientific transformations of health, illness and US biomedicine. American Sociological Review. 68 (April): 161-94; (c) Nettleton, S. (2004) The emergence of E-scaped medicine? Sociology. 38, 4: 661-679.

3. Moynihan, R., Heath, I and Henry, D. (2002) Selling sickness: the pharmaceutical industry and disease mongering. British Medical Journal. 324: (13 April): 886-91.

4. Lupton D. (1997) Foucault and the medicalisation critique. In Petersen A. and Bunton R. (eds.) Foucault and Health. London: Routledge.

5. Strong P. (1979) Sociological imperialism and the medical profession: a critical examination of the thesis of medical imperialism. Social Science and Medicine. 13A, (2): 199-216. See also: Conrad P. and Schneider J. (1980) Looking at levels of medicalization: a comment on Strong's critique of the thesis of medical imperialism. Social Science and Medicine 14A: 75-79. For an unpdate on these ‘imperialist’ debates, see: EITHER: Williams, S.J. (2001) Sociological imperialism and the medical profession: where are we now? Sociology of Health and Illness. 23, 2: 135-58 OR: Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt. 1).

The ‘efficacy’ debate and the ‘orthodox’ medicalisation critique;

Conrad P. and Schneider J.W. (1985) Deviance and Medicalization: From Badness to Sickness. London: Merrill (esp. Chpts. 1,2,9 and 10).

Davey, B., Gray, A. and Seale, C. (eds.) (1995) Health and Disease: a Reader (2nd Edition). Buckingham: Open University Press. (Chapters by McKeown (30), Szreter (31), Cochrane (32), lllich (36), Navarro (37)).

14 Doyal L. (1979) The Political Economy of Health. London: Pluto (Chpt. 1).

Dubos R. (1960) The Mirage of Health. London: Allen and Unwin (Chpts. 1 and 6) (An extract of this book (1. Mishler E.G. (1989) Critical perspectives on the biomedical model. (Chpt. 10), in: Brown P. (ed.) Perspectives in Medical Sociology. Belmont Calif.: Wadsworth. 1) is reproduced in Davey et al. (eds.) (1995) Health and Disease: A Reader above (chpt. 1)).

Freidson E. (1988) Profession of Medicine: A Study of the Sociology of Applied Knowledge (2nd Edition). London/Chicago: University of Chicago Press (Chpts. 10 & 12).

(*) Harrison, S. (2004) The politics of evidence-based medicine in the United Kingdom, in M. Bury and J. Gabe (eds.) The Sociology of Health and Illness: A Reader. London: Routledge.

(*) Illich I. (1976) Limits to Medicine - Medical Nemesis: The Expropriation of Health. Harmondsworth: Penguin (Chpts. 1 and 2). See also Navarro's critique of Illich: Navarro V. (1978) The industrialisation of fetishism or the fetishism of industrialisation: a critique of Ivan Illich. Social Science and Medicine. 9: 351-63. Also in Navarro V. (1976) Medicine Under Capitalism. New York: Prodist.

(*) Jewson N.D. (1976) The disappearance of the sick-man from medical cosmologies: 1770-1870. Sociology. 10: 225-244.

(*) Kelly M and Field, D. (1994) Comments on the rejection of the biomedical model in sociological discourse. Medical Sociology News. 19, 2: 34-7.

McKeown T. (1979) The Role of Medicine (2nd Edition). Oxford: Basil Blackwell. (Passim, esp. Chpts. 6, 8 and 13). See also: McKinlay J. and McKinlay S. (1990) Medical measures and the decline of mortality. (Chpt. 1), in: Conrad P., and Kern R. (eds.) Op cit., and; Gray A. (ed.) (1993) World Health and Disease Buckingham: Open Univeristy Press. (Chpt. 6 'The decline of infectious diseases: the case of England).

McKinlay J. (1990) A case for refocussing upstream: the political economy of illness. (Chpt. 42), in: Conrad P. and Kern R. (eds.) (1990) The Sociology of Health and Illness: Critical Perspectives (3rd edition). St Martin's Press.

(*) Mishler E.G. (1989) Critical perspectives on the biomedical model. (Chpt. 10), in: Brown P. (ed.) Perspectives in Medical Sociology. Belmont Calif.: Wadsworth.

(*) Navarro V. (1980) Work, ideology and science: the case of medicine. Social Science and Medicine. 14: 191-205. See also any of the following: Navarro V. (1976) Social class, political power and the state and their implications in medicine. Social Science and Medicine. 10: 437-457; Navarro V. (1984) Navarro V. (1976) Medicine Under Capitalism. New York: Prodist.

(*) Taussig M. (1980) Reification and the consciousness of the patient. Social Science and Medicine. 14B: 3-13.

Waitzkin H. (1979) Medicine, superstructure and micropolitics. Social Science and Medicine. 13: 601- 609. See also: Waitzkin H. (1989) Social structures of medical oppression: a Marxist view. (Chpt. 11), in: Brown P. (ed.) Perspectives in Medical Sociology. Wadsworth.

(*) Williams S.J. and Calnan M. (1996) The limits of medicalisation: modern medicine and the lay populace in late modernity. Social Science and Medicine. 42, 12, 1609-20.

15 (*) Zola I.K. (1972) Medicine as an institution of social control. Sociological Review. 20, (4): 487-504. Also reprinted in Tuckett D. and Kaufert J. (1978) (eds.) Basic Readings in Medical Sociology. London: Tavistock; Cox C. and Mead A. (1975) (eds.) A Sociology of Medical Practice. London: Collier Macmillan and; Ehrenreich J. (ed.) (1978) The Cultural Crisis of Modern Medicine. (Introduction). New York/London: Monthly Review Press.

Zola I.K. (1975) In the name of health and illness: on some socio-political consequences of medical influence. Social Science and Medicine 9: 83-87.

Women and medicalization

Akirch, M., and Pasveer, B. (2004) Embodiment and disembodiment in childbirth. Body & Society. 10 (2-3): 63-84.

Arney W.R. and Neill J. (1983) The location of pain in childbirth. Sociology of Health and Illness. 7: 109-17.

Bell S. (1987) Changing ideas: the medicalisation of menopause. Social Science and Medicine. 24: 535- 542.

Bransen E. (1992) Has menstruation been medicalised? Or will it ever happen? Sociology of Health and Illness. 14, (1): 98-110.

(*) Dixon-Woods, M., Williams, S.J., Akkad, A, Kenyon, S. and Habiba, M. (2006) Why do women consent to surgery, even when they do not want to? An interactionist and Bourdieusian analysis. Social Science and Medicine. 62: 2742-53.

Ehrenreich B. and English D. (1979) For Her Own Good: 150 Years of the Expert's Advice to Women. London: Pluto Press. See also: Ehrenreich B. and English D. (1990) The sexual politics of sickness. (Chpt. 23) in: Conrad P. and Kern R. (eds.) Op cit.

Lawrence C. and Benedixen K. (1992) His and hers: male and female anatomy in anatomy texts for US medical students 1890-1989. Social Science and Medicine. 35 (7): 925-934; See also: Petersen, A. (1998) Sexing the body: representations of sex differences in Gray's Anatomy, 1858 to the present. Body & Society. 4, 1: 1-15; Scully D. and Bart P. (1978) 'A funny thing happened on the way to the orifice: women in gynaecological textbooks', in Ehrenreich J. (1978) The Cultural Crisis of Modern Medicine. New York/London: Medical Review Publications.

(*) Lupton, D. (2003) Medicine as Culture: Illness, Disease and the Body in Western Societies. London: Sage (Chpt. 6: 'Feminisms and medicine').

(*) Martin E. (1987) The Woman in the Body. Milton Keynes: OUP (esp Chpts. 3, 4 and 8) AND/OR any of the following: Martin E. (1990) Science and women's bodies (Chpt. 4) in: Jacobus M., Fox Keller E. and Shuttleworth S. (eds) Body/Politics: Women and the Discourse of Science. London: Routledge; Martin E. (1991) The egg and the sperm: how science has constructed a romance based on stereotypical male-female roles. Signs: Journal of Women in Culture and Soceity 16, (3): 485-501.

(*) Reissman C.K. (1989) Women and medicalization: a new perspective. (Chpt. 13) in: Brown P. (ed.) Critical Perspectives in Medical Sociology. Belmont CA: Wadsworth.

Graham H., and Oakley A. (1981) Competing ideologies of reproduction: medical and maternal

16 perspectives on pregnancy. In: Roberts H. (ed.) Women, Health and Reproduction. London: RKP. Also reprinted in Currer C. and Stacey M. (eds.) (1986) Op cit (week 8).

Griffiths, F. (1999) Women’s control and choice regarding HRT. Social Science and Medicine. 49: 469- 81.

Jacobus M., Fox Keller E. and Shuttleworth S. (eds) (1990) Body/Politics: Women and the Discourse of Science. London: Routledge.

Laqueur T. (1990) Making Sex: Body and Gender from the Greeks to Freud. Harvard. See also: Gallagher C. and Lacquer T. (eds.) (1987) The Making of the Modern Body: Sexuality and Society in the Nineteenth Century. Berkeley: University of California Press.

(*) Oakley A. (1980) Women Confined: Towards a Sociology of Childbirth. Oxford: Martin Robertson. And/or: Oakley A. (1984) The Captured Womb. Blackwell (Chpts. 6, 11 and 12).

(*) Todd A.D. (1989) Intimate Adversaries: Cultural Conflict Between Doctors and Women Patients. University of Pennsylvania Press.

Ussher, J. (1991) Women’s Madness: Misogyny or Mental Illness?. London: Harvester Wheatsheaf.

Foucauldian critiques and postmodern debates; the social construction of medical knowledge and the body

Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 2 `Shattering the orthodoxy: Foucault, postmodernism and the social theory of the body').

Armstrong D. (1984) The patient's view. Social Science and Medicine 18: 737-44. SEE ALSO ANY OF THE FOLLOWING Armstrong, D. (1983) Political Anatomy of the Body: Medical Knowledge in Britain in the Twentieth Century. Cambridge: Cambridge University Press (esp. preface and Chpt. 1); Armstrong D. (1979) The emancipation of biographical medicine. Social Science and Medicine. 13A: 1- 8; Armstrong D. (1985) The subject and the social in medicine: an appreciation of Michel Foucault. Sociology of Health and Illness 7, (1): 108-117; Armstrong D. (1987) Bodies of knowledge: Foucault and the problem of human anatomy. (Chpt. 3) in: Scambler G. (ed.) Sociological Theory and Medical Sociology. London: Tavistock, and; Armstrong D. (1994) Bodies of knowledge/knowledge of bodies (Chpt 2) in: Jones C. and Porter R. (eds.) Reassessing Foucault: Power, Medicine and the Body. London: Routledge; Armstrong D. (1995) The rise of surveillance medicine. Sociology of Health and Illness 17, (3): 393-404; Armstrong, D. (1997) Foucault and the sociology of health and illness: a prismatic reading. In Petersen A. and Bunton R. (eds.) Foucault and Health. London: Routledge.

(*) Bury M. (1986) Social constructionism and the development of sociology. Sociology of Health and Illness. 8 (2): 137-169. (See also debate between Bury, Nicolson and McLaughlin: Nicolson M and McLaughlin C. (1987) Social constructionism and medicial sociology: a reply to M.R. Bury. Sociology of Health and Illness 9, 2: 107-126. And: Bury M. (1987) Social constructionism and medical sociology: a rejoinder to Nicolson and McLaughlin. Sociology of Health and Illness 9, 4: 439-441).

(*) Foucault M. (1973) The Birth of the Clinic. London: Tavistock. 1

Fox, N.J. (2000) The ethics and politics of caring: postmodern reflections, in Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge. OR: the chapter by Fox in Scambler, G. and Higgs, P. (eds.) (1998) Modernity, Medicine and Health. London: Routledge.

17 Jacobus M., Fox Keller E. and Shuttleworth S. (eds) (1990) Body/Politics: Women and the Discourse of Science. London: Routledge.

Morris, D. (1998) Illness and Culture in the Postmodern Age. Berkeley CA: University of California Press.

(*) Scambler, G. and Higgs, P. (eds.) (1998) Modernity, Medicine and Health. London: Routledge (Chapters by M. Bury and A. Scambler).

(*) Wright P. and Treacher A. (eds.) (1982) The Problem of Medical Knowledge: Examining the Social Construction of Medicine. Edinburgh: Edinburgh University Press (esp. Introduction, and Chpts. by K. Figlio, and J. Gabbay).

1 NB. For useful introductory accounts of Foucault see: (i) Smart B. (1985) Michel Foucault. London: Tavistock; (ii) Williams S.J. and Bendelow (1998) The Lived Body. London: Routledge (Chpt. 2).

Disease-Mongering/Selling Sickness:

Moynihan, R. (2002) Disease-mongering: how doctors, drug companies, and insurers are making you feel sick. British Medical Journal. 324 (April 13th): 923.

Special issue of Public Library of Science – Medicine (2006), volume 3, issue 4 (April): a series of papers on disease-mongering, select any you are particularly interested in.

18 SEMINAR 1 (WEEK 2): The Doctor’s Dilemma

As a gentle way of easing you into the module and themes and issues covered therein we will be reading extracts from George Bernard Shaw’s classic play The Doctor’s Dilemma.

Seminar Questions:

What sociological issues does Shaw’s play The Doctor’s Dilemma raise?

Is this play as relevant today as it ever was?

Key reading(s): Shaw, G.B. (1911) The Doctor's Dilemma. Harmondsworth: Penguin.

19 3. ILLNESS AS SOCIAL `DEVIANCE'? THE PARSONIAN AND INTERACTIONIST PARADIGMS

In this lecture we take a closer look at another key point of departure for medical sociology: the notion of illness as social deviance. Two main approaches to this issue are examined here. First Parsons' approach to the sick role and various criticisms/extensions to which it has given rise. Second, alternative interactionist approaches to the question of deviance, encompassing both `crisis' and `negotiation' models of illness.

Class essay questions:

Assess Parsons’ views of illness as social deviance and the contribution of the sick role to the stability of society

What light does Parsons shed on the psychodynamics of illness and the therapeutic relationship?

Can we recover a Parsonian ‘health’ role?

1. Parsons T. (1951) Social structure and dynamic processes: the case of modern medical practice. (Chpt. X), in: The Social System. London: Collier-Macmillan.

2. Gerhardt U. (1979) The Parsonian paradigm and the identity of medical sociology. Sociological Review. 27, (2): 229-251, Or Chpt. 5 by Uta Gerhardt in: Scambler G. (ed.) (1987) Sociological Theory and Medical Sociology. London: Routledge, Or: Gerhardt U. (1989) Ideas About Illness: An Intellectual and Political History of Medical Sociology. London: Macmillan (Part I on the Parsonian paradigm).

3. Lupton, D. (1997) Psychoanalytic sociology and the medical encounter: Parsons and beyond. Sociology of Health and Illness. 19, 5: 561-79. See also: Pilgrim, D. (1998) Medical sociology and psychoanalysis: a rejoinder to Lupton. Sociology of Health and Illness. 20, 4: 537-44, and; Lupton, D. (1998) Psychoanalytic sociology and the medical encounter: a reply to Pilgrim. Sociology of Health and Illness. 20, 4: 545-7.

4. Pflanz M. and Rhode J.J. (1970) Illness: deviant behaviour or conformity. Social Science and Medicine. 4, 645-53.

5. Shilling, C. (2002) Culture, the ‘sick role’ and the consumption of health. British Journal of Sociology. 53. 4: 621-38 AND/OR: Williams, S.J. (2005) Parsons revisited: from sick role to…? Health. 9 (2): 123-144.

Parsons and the sick/health role:

(*) Frank A.W. (1991) From sick role to health role: deconstructing Parsons. In Robertson R. and Turner B.S. (eds.) Parsons: Theorist of Modernity. London: Sage.

20 Freidson E. (1988) Profession of Medicine: A Study of the Sociology of Applied Knowledge (2nd Edition). London/Chicago: University of Chicago Press. (Chpts. 10 and 11.).

Gallagher E. (1976) Lines of reconstruction and extension in the Parsonian sociology of illness. Social Science and Medicine. 10: 207-218.

McKinlay J.B. (1972) Sick role - illness and pregnancy. Social Science and Medicine. 6: 561-572.

(*) Parsons T. (1975) The sick role and the role of the physician reconsidered. Milbank Memorial Fund Quarterly. 53, (3): 257-279.

Waitzkin H.B. (1971) Latent functions of the sick role in various institutional settings. Social Science and Medicine 5: 45-75. Waitzkin H.B. and Waterman B. (1974) The Exploitation of Illness in Capitalist Society. Indianapolis: Bobbs Merrill (Chpts 2, 3).

(*) West C. (1989) Talcott Parsons 'sick role' and its critiques. (Chpt 9) in: Brown, P. (ed.) Perspectives in Medical Sociology. Belmon, Calif.: Wadsworth.

(*) Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt 9 first part on ‘the psychodynamics of the sick role’).

Williams, S.J. (1998) Health as moral performance: ritual, transgression and taboo. Health. 2, 4: 435-57.

Interactionist & phenomenological perspectives/studies;

(*) Gerhardt U. (1989) Ideas About Illness: An Intellectual and Political History of Medical Sociology. London: Macmillan (Part II on the interactionist paradigm).

(*) Goffman E. (1961) Asylums: Essays on the Social Situation of Patients and Other Inmates. Harmondsworth: Penguin. (esp. 'The moral career of the mental patient'). See also: Goffman E. (1995) The insanity of place (Chpt. 11) in: Davey et al. (eds.) Health and Disease: A Reader. OUP.

Goffman E. (1963) Stigma: Notes on the Management of Spoiled Identity. Harmondsworth: Penguin.

Jeffrey R. (1995) 'Normal rubbish': deviant patients in casualty departments. (Chpt. 50) in Davey et al. (eds.) Health and Disease: A Reader OUP.

(*) Scheff T. (1966) Being Mentally Ill. Chicago Ill: Aldine. See also: Gove W. (1970) Societal reaction as an explanation of mental illness: an evaluation. Amercian Sociological Review. 35: 873-884. Or: Gove W. (1980) The Labelling of Deviance: Evaluating a Perspective (2nd Edition). London: Sage.

(*) Williams S. (1987) Goffman, interactionism and the management of stigma in everyday life. (Chpt. 6) in: Scambler G. (ed.) Sociological Theory and Medical Sociology. London: Tavistock.

NB. The theoretical perspectives covered in lectures 1-3 will be drawn upon and illustrated throughout the module in relation to the subsequent topics and issues covered. You will be expected to make these connections in your class and assessed work.

21 4. LAY CONCEPTS OF HEALTH, RISK AND THE BODY.

Grounded in people's ways of life and their common sense understandings of body, self and society, lay concepts of health and illness are subtle and sophisticated, encompassing a complex mixture of traditional, popular and scientific ideas, beliefs and image. In this lecture, therefore, we critically explore these issues through a focus on lay concepts, images and metaphors of health, risk and the body, their influence on health related actions and behaviours, and their importance across the lay/professional divide.

How ‘lay’ are lay concepts of health and illness?

How important is risk to lay thinking on health and illness?

1. EITHER: Bury M. (1997) Health and Illness in a Changing Society. London: Routledge (Chpt. 1 `From illness behaviour to health beliefs and knowledge). OR: Bury, M. (2005) Health and Illness. Cambridge: Polity Press (Chpt. 1 ‘What is health’?)

2. Crawford R. (1985) A cultural account of 'health': control, release and the social body. In McKinlay (ed.) Issues in the Political Economy of Health Care. London: Tavistock.

3. Davison C., Davey Smith., G., and Frankel S. (1991) Lay epidemiology and the prevention paradox. Sociology of Health and Illness 13: 1-19. AND/OR any of the following: Davison C., Frankel S. and Davey Smith G. (1992) The limits of lifestyle: reassessing 'fatalism' in the popular culture of illness. Social Science and Medicine. 34 (6): 675-85. See also: Lupton D. and Chapman S. (1995) A healthy lifestyle might be the death of you: discourses on diet, cholesterol and heart disease in the press and among the lay public. Sociology of Health and Illness. 17 (4): 477-494.

4. Shaw, I. (2002) How lay are lay beliefs? Health. 6, 3: 287-99. AND: Prior, L. (2003) Belief, knowledge and expertise. Sociology of Health and Illness. 25 (Silver Anniversary Issue): 41-57.

5. Hardey, M. (1999) Doctor in the house: the internet as a source of lay health knowledge and the challenge to expertise. Sociology of Health and Illness. 21, 6: 820-35. AND/OR: Nettleton, S., Burrows, R., O’Malley, L. and Watt, I. (2004) Healthy E-Types? An analysis of the everyday use of Internet for health. Information, Communication & Society. 7, 4: 531-53.

(NB. Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge, contains the Davison et al article, plus other key essays by Hezlich and Blaxter)

(*) Blaxter M. (1984) The causes of disease: women talking. Social Science and Medicine. 17, (2): 59- 69. Also in Black N. et al. (eds.) (1984) Health and Disease: A Reader. OUP (Chpt. 1.5). See also: Blaxter M. (1990) Health and Lifestyles. London: Routledge. (Chpts. 3 and 4), an extract of which is

22 reproduced as (Chpt. 4) 'What is health?' in Davey et al. (eds.) (1995) Health and Disease: a Reader. OUP.

(*) Calnan M. (1987) Health and Illness: The Lay Perspective. London: Tavistock. (Passim).

Calnan M. and Williams S. (1991) Style of life and the salience of health: a study of health-related practices in middle-class and working-class households. Sociology of Health and Illness 13, (4); 506- 529.

(*) Cornwell J. (1995) Chapt 19 (an extract of Hard Earned Lives) in Davey, B. et al. (eds.) (1995) Health and Disease: a Reader. OUP. AND/OR: Cornwell J. (1984) Hard Earned Lives: Accounts of Health and Illness from East London. London: Tavistock. (esp. Chpts. 5, 6 and 8). See also Radley and Billig (1996) listed as a further key reading below for a critique of Cornwell.

(*) Currer C. and Stacey M. (eds.) (1986) Concepts of Health, Illness and Disease: A Comparative Perspective. Berg. (esp. Chpts 2,4,11,12 and 13). d'Houtaud A. and Field M.G. (1984) The image of health: variations in perceptions by social class in a French population. Sociology of Health and Illness. 6, (1): 30-60.

Freidson E. (1989) Profession of Medicine (2nd Edition). Chicago Press. (Part III, esp. chpt. 13).

Gadamer, H. (1996) The Enigma of Health. Cambridge: Polity Press.

(*) Helman C. (1984) 'Feed a cold, starve a fever': folk models of infection in an English suburban community and their relation to medical treatment. (Chpt. 1.2) in: Black N. et al. (eds.) Health and Disease: A Reader. Milton Keynes: OUP. Also reprinted in: Currer C., and Stacey M. (eds.) (1986) Concepts of Health, Illness and Disease: A Comparative Perspective. Leamington Spa: Berg). And: Helman C. (1990) Culture, Health and Illness (2nd edtion). Bristol: John Wright (pp: 86-113).

(*) Herzlich C. (1973) Health and Illness: A Social Psychological Analysis. Academic Press (esp. Part I and Chpts. 4, 7 & 8). And: Herzlich C. and Pierret J. (1987) Illness and Self in Society (Translation Foster E.). Baltimore/London: John Hopkins University Press (esp. Chpts. 1, 2, 4, 5 and 6).

(*) Martin E. (2000) Flexible bodies: science and the new culture of health in the US., in Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge. For a fuller account, see: Martin, E. (1994) Flexible Bodies. Boston: Beacon Press.

(*)Monaghan, L. (2001) Looking good, feeling great: the embodied pleasures of vibrant physicality. Health. 23, 3: 330-56.

Nettleton S. and Watson J. (eds.) (1998) The Body in Everyday Life. London: Routledge.

Parsons T. (1964) Definitions of health and illness in the light of American values ans social structure. (pp: 258-291) in: Parsons T. Social Structure and Personality. New York: Free Press.

Pill R., and Stott N. (1982) Concepts of illness causation and responsibility: some preliminary data from a sample of working class mothers. Social Science and Medicine. 16: 43-52. See also: Pill R. and Stott N. (1985) Choice or chance: further evidence on ideas of illness and responsibility for health. Social Science and Medicine. 20, (10): 981-91.

(*) Radley A. and Billig M. (1996) Accounts of health and illness: dilemmas and representations.

23 Sociology of Health and Illness. 18, (2) 220-41.

(*) Saltonstall R. (1993) Healthy bodies, social bodies: men's and women's concepts and practices of health in everyday life. Social Science and Medicine 36, (1): 7-14.

(*) Sontag S. (1978) Illness as Metaphor. Harmondsworth: Penguin. See also: Sontag S. (1989) AIDS and its Metaphors. London: Allen Lane. An extract is reprinted as Chpt. 5 in Davey et al. (eds) (1995) Health and Disease: a Reader. OUP.

Stacey M. (1989) The Sociology of Health and Healing. London: Routledge. (Chpts. 10 and 11).

Stainton Rogers W. (1991) Explaining Health and Illness: An Exploration of Diversity. London: Harvester Wheatsheaf (esp. Chpts. 4 & 8).

(*) Williams, G.H. and Popay, J. (2001) Lay knowledge and the concept of the lifeworld, in G. Scambler, (ed.) Habermas, Critical Theory and Health. London: Routledge.

(*) Williams R. (1983) Concepts of health: an analysis of lay logic. Sociology. 17: 185-204.

Williams, S.J. and Calnan M (eds.) (1996) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press.

(*) Williams, S.J. (1998) Health as moral performance: ritual, transgression and taboo. Health. 2, 4: 435- 57.

The Internet and health

Delmouzou, E. (2002) Women’s health on the internet. Sociology of Health and Illness. 24, 6; 879-880.

Fox, N.J., Ward, K. and O’Rourke, A. (2005) Pro-anorexia, weight-loss drugs and the internet: an ‘anti- recovery’ explanatory model of anorexia. Sociology of Health and Illness. 27, 7: 944-71.

* Henwood, F., Wyatt, S, Hart, A, and Smith, J. (2003) ‘Ignorance is bliss sometimes’: constraints on the emergence of the ‘informed patient’ in the changing landscapes of health information’. Sociology of Health and Illness. 25, 6: 589-607.

* Nettleton, S., Burrows, R. and O’Malley, L. (2005) The mundane realities of the everyday use of the internet for health, and their consequences for media convergence. Sociology of Health and Illness. 27: 7: 972-992.

Plus Hardey (1999) AND Nettleton et al. (2004) in core/essential readings (No. 5) above.

24 SEMINAR 2: (week 4): The Shifting Engines of Medicalization/Disease-Mongering

Seminar Question(s):

To what extent have the engines or drivers of medicalization (Conrad 2005) shifted over time?

How prevalent is disease-mongering? Who is responsible, why, and what should be done about it?

Key Seminar Readings:

Conrad, P (2005) The shifting engines of medicalization. Journal of Health and Social Behavior.

Readings on disease-mongering/selling sickness, from week 2.

25 5. PATIENT/PROFESSIONAL RELATIONS: CONSENSUS, CONFLICT OR NEGOTIATION?

One of the cornerstones of medical sociology has been the theoretical and empirical study of the medical encounter (traditionally between doctor and patient, but now increasingly focused on other professional- client relations). The sick role has already been considered in this connection, but in this lecture we look at a variety of other work on the stuggle beween the 'voice of medicine and the voice of the lifeworld' (Mishler 1990). The emotional dynamics of these relations are also considered, alongside issues of trust and risk, which have come to the fore in recent literature in the era of reflexive modernity and the rise of 'consumerism' in health care.

To what extent can the medical encounter be portrayed as a 'struggle between the voice of medicine and the voice of the lay world'?

What roles does consumerism play in the contemporary medical encounter?

1. Bury (1997) Health and Illness in a Changing Society. London: Routledge (Chpt. 3 `Doctors, patients and interaction in health care) OR: Lupton D. (2003) Medicine as Culture: Illness, Disease and the Body in Western Societies. London: Sage (Chpt. 5 'Power relations and the medical encounter').

2. Mishler E. (1990) The struggle between the voice of medicine and the voice of the lifeworld. (Chpt. 25) in: Conrad P. and Kern R. (eds.) The Sociology of Health and Illness: Critical Perspectives. St Martin’s Press.

3. Lupton D. (1997) Consumerism, reflexivity and the medical encounter. Social Science and Medicine. 45, 3: 373-81. See also Lupton D. (1996) `Your life in their hands': trust in the medical encounter, in V. James and J. Gabe (eds.) Health and the Sociology of Emotions. Oxford: Blackwell.

4. Stokes, T, Dixon-Woods, M and Williams, S.J. (2006) Breaking the ceremonial order: patients’ and doctors’ accounts of removal from a general practitioner’s list. Sociology of Health and Illness. 28, 5: 611-36.

5. May, C., Allison, G, Chappel, A, Chew-Graham, C, Dixon, C., Gask, L., Graham, R., Rogers, A., Roland, M. (2004) Framing the doctor-patient relationship in chronic illness: a comparative study of General Practitioners’ accounts. Sociology of Health and Illness. 26, 2: 135-158.

(NB. Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge, contains the Lupton article, plus other key essays in Part 3 on ‘Professional and patient interaction)

Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 9).

26 Armstrong D. (1982) The doctor-patient relationship: 1930-80. (Chpt. 5) In: Wright P. and Treacher A. (eds.) The Problem of Medical Knowledge: Examining the Social Construction of Medicine. Edindburgh: Edinburgh University Press.

Atkinson P. (1995) Medical Talk and Medical Work. London: Sage.

(*) Bloor M. (1976) Professional autonomy and client exclusion: a study of ENT clinics. In: Wadsworth M., and Robinson D. (eds.) Studies in Everyday Medical Life. Martin Robertson. And: Bloor M.J., and Horobin G.W. (1975) Conflict and conflict resolution in doctor-patient interactions. In: Cox C., and Mead A. (eds.) A Sociology of Medical Practice. London: Collier Macmillan.

(*) Freidson E. (1970) The Profession of Medicine. New York: Dodd Mead. (Chpt 14, esp. 313-322). Also reprinted in Brown P. (ed.) (1989) Perpsectives in Medical Sociology. California: Wadworth (Chpt. 35). And: Freidson E. (1975) Dilemmas in the doctor-patient relationship. In: Cox C., and Mead A. (eds.) A Sociology of Medical Practice. London: Collier Macmillan.

(*) Gothill, M. and Armstrong, D. (1999) Dr. No-body: the construction of the doctor as an embodied subject in British general practice 1955-97. Sociology of Health and Illness. 21, 1: 1-12.

Hendersen, S. and Petersen, A. (eds.) (2002) Consumerism in Health Care. London: Routledge.

Parsons T. (1951) The Social System. London: Collier-Macmillan (Chpt. X).

Lupton, D. (1997) Doctors on the medical profession. Sociology of Health and Illness. 19, 4: 480-497.

(*) Scambler, G. and Britten, N. (2001) System, lifeworld and doctor-patient interaction, in G. Scambler (ed.) Habermas, Critical Theory and Health. London: Routledge AND/OR Scambler, G. (2002) Health and Social Change. Buckingham: Open University Press (Chpt. 6 'Lifeworld, narratives and expert cultures').

Scheff T.J. (1968) Negotiating reality: notes on power in the assessment of responsibility. Social Problems. 16, (1): 3-17.

Silverman D. (1987) Communication and Medical Practice. London: Sage.

(*) Strong P. (1979) The Ceremonial Order of the Clinic. London: Routledge.

Szasz T., and Hollender M. (1956) A contribution to the philosophy of medicine: the basic models of the doctor-patient relationship. Archives of Internal Medicine. 97: 585-592.

(*) Waitzkin H. (1979) Medicine, superstructure and micropolitics. Social Science and Medicine. 13: 601-609. See also any of the following: Waitzkin H. (1984) The micropolitics of medicine: a contextual analysis. International Journal of Health Services. 14, (3): 339-377, and; Waitzkin H. (1991) The Politics of Medical Encounters: How Patients and Doctors Deal with Social Problems. London: Yale University Press (esp Part I: 'The micro-politics of medicine').

(*) West P. (1976) The physician and the mangement of childhood epilepsy. In: Wadsworth M., and Robinson D. (eds.) Studies in Everyday Medical Life. Martin Robertson.

Empirical studies of doctor-patient interaction: the case of general practice;

27 (*) Boulton M. et al. (1986) Social class and the General Practice consultation. Sociology of Health and Illness. 8: 325-350.

Broom D.H. and Woodward R.V. (1996). Medicalisation reconsidered: toward a collaborative approach. Sociology of Health and Illness. 18, (3): 357-78.

Comaroff J. (1976) Communicating information about non-fatal illness: the strategies of a group of general practitioners Sociological Review. 42, (2): 269-290.

(*) May, C., Dowrick, C and Richardson, M (1996) The confidential patient: the social construction of therapeutic relationships in general practice. The Sociological Review. 44, 2: 187-203.

(*) Stimson G. and Webb B. (1978) Face-to-face interaction and after the consultaton. (Chpt. 16), in: Tuckett D. and Kaufert J. (eds.) Basic Readings in Medical Sociology. London: Tavistock. Also in: Brown P. (ed.) Perspectives in Medical Sociology. Belmont CA: Wadsworth.(Chpt. 36: an abstact from Stimson G. and Webb B. (1975) Going to see the Doctor: The Consultation Process in General Practice London: RKP). See also: Webb B. and Stimson G. (1976) 'People's accounts of medical encounters' (Chpt. 7) in: Wadsworth M. and Robinson D. (eds.) Studies in Everyday Medical Life. London: Martin Robertson.

Stimson G. (1974) Obeying Doctor's orders: a view from the other side. Social Science and Medicine. 8: 97-104.

Stimson G. (1976) General practitioners 'trouble' and types of patients. In: Stacey M. (ed.) The Sociology of the NHS. Keele: University of Keele.

Tuckett D., Boulton M.G. and Williams A. (1985) Meetings Between Experts: An Approach to Sharing Ideas in Medical Consultations. London: Tavistock.

Problems of uncertainty in medicine:

Calnan M. (1984) Clinical uncertainty: is it a problem in the doctor-patient relationship. Sociology of Health and Illness. 6, (1): 74-85.

Davis F. (1960) Uncertainty in medical prognosis: clinical and functional. American Journal of Sociology. 66: 41-47, and in: Tuckett D., and Kaufert J. (eds.) Basic Readings in Medical Sociology. London: Tavistock. See also Davis F. (1963) Passage Through Crisis. Bobbs Merill (esp. pp: 68-80).

(*) Fox, R. (2000) Medical uncertainty revisisted. In Albrecht, G., Fitzpatrick, R. and Scrimshaw S. (eds.) The Handbook of Social Studies in Health and Medicine. London: Sage. Also reprinted in Bendelow, G. et al. (eds.) (2001) Gender, Health and Healing: Reflections Across the Public/Private Divide. London: Routledge.

McIntosh J. (1978) The routine management of uncertainty in communication with cancer patients. In: Davis A. Relationships Between Doctors and Patients. See also McIntosh J. Communication and Awareness in a Cancer Ward. London: Croom Helm (esp. Chpts 2,3 and 4).

NB. Regarding doctor-patient relationships, you should refer back to/make connections with the readings on Parsons and his critics (lecture 3), the contrast between the biomedical model of disease

28 (lecture 2) and lay concepts of health and illness (lecture 4), and also make connections with lecture 13 and 14 on professional power and dominance.

29 6. CHILDREN, HEALTH AND THE SOCIAL ORDER

It is only relatively recently that sociologists have turned their attention to children and childhood, health-related or otherwise. This lecture examines these issues more closely, with particular reference to the notion of children as active constructors and negotiators of health and risk across the public/private divide.

Class essay question:

To what extent are children active constructors and negotiators of health, risk and identity across the public/private divide?

1. Williams, S.J. (2003) The Body, Health and Medicine. London: Sage (Chpt. 4 `Childhood, ageing and health: bodies across the lifecourse’; first half on children).

2. Mayall, B. (1994) Keeping healthy at home and at school. Sociology of Health and Illness 15: 464- 88. AND/OR: James, A. (1998) Children and health, in D. Field and S. Taylor (eds.) Sociological Perspectives on Health, Illness and Health Care. Oxford: Blackwell Science

3. Oakley A., Bendelow, G. Barnes, J. Buchanan, M. and Hussain, O. 1995: Health and cancer prevention: knowledge and beliefs of children and young people. British Medical Journal. 310: 1029-33. AND/OR: Williams S.J. and Bendelow G. (1998) `Malignant bodies': Children's beliefs about health, cancer and risk. In Nettleton S. and Watson J. (eds.) Lay Perceptions of the Body. London: Routledge. And/Or: Williams S.J. and Bendelow, G. (1999) `Recalcitrant bodies?': Children, cancer and the transgression of corporeal boundaries. Health. 4, 1: 51-71.

4. Green J. (1997) Risk and the construction of social identity: children's talk about accidents. Sociology of Health and Illness. 19, 4: 457-479. See also: Risk and Misfortune: the Social Construction of Accidents. London: UCL Press.

Aries, P. (1979[1960]) Centuries of Childhood Harmondsworth: Peregrine.

(*) Bendelow, G. and Brady, G. (2002) Experiences of ADHD: Children, health research and emotion work, in G. Bendelow et al. (eds.) Gender, Health and Healing. London: Routledge. AND/OR Place, B. (2000) Constructing the bodies of ill children in the intensive care unit in Prout, A. (ed.) The Body, Childhood and Society. London: Macmillan.

(*) Brannen, J. Dodd, K. Oakley, A. and Storey, P. (1994) Young People, Health and Family Life. Buckingham: Open University Press.

(*) Hill, M. and Tidsall K. (1997) Children and Society. London: Longman.

30 James, A. (1993) Childhood Identities: Social Relationships and the Self in Children's Experiences. Edinburgh: Edinburgh University Press.

James A. and Prout A. (eds.) (1990) Constructing and Reconstructing Childhood: Contemporary Issues in the Sociology of Childhood. London: Falmer Press.

(*) James, A., Jenks, C. and Prout, A. (1998) Theorising Childhood. Cambridge: Polity Press.

Kalins, I. McQueen D.V., Backett, K.C., Curtice, L. and Currie, C.E. (1992) Children, empowerment and health promotion: some new directions in research and practice. Health Promotion International. 7: 53-9.

(*) Kirk, D. and Tinning, R. (1994) Embodied self-identity, healthy lifestyles and school physical education. Sociology of Health and Illness. 16, 5: 600-25.

Lauritzen S.O. (1997) Notions of child health: mothers accounts of health in their young babies. Sociology of Health and Illness. 19, 4: 436-56.

Lee, N. (2001) Childhood and Society. Buckingham: Open University Press.

Mayall, B. (2002) Towards a Sociology For Childhood. Buckingham: Open University Press.

(*) Mayall, B. (1996) Children, Health and the Social Order. Buckingham: Open University Press.

Mayall, B. (1994) Negotiating Health: Children at Home and Primary School. London: Cassell.

Mayall, B. Bendelow, G., Barker, S. Storey, P. and Veltman, M. (1996) Health in Primary Schools. London: Falmer Press.

Prout, A. (2000) Childhood bodies: social construction and translation. In Williams S.J. et al. (eds). Health, Medicine and Society: Key Theories, Future Agendas. London: Routlege.

(*) Prout, A. (ed.) (2000) The Body, Childhood and Society. London: Macmillan (many useful chapters).

Prout, A. (1992) Work, time and sickness in the lives of schoolchildren. In Frankenberg R. (ed.) Time, Health and Medicine. London: Sage.

Prout, A. (1986) `Wet children' and `little actresses': going sick in primary school. Sociology of Health and Illness. 8, 2: 111-36.

(*) Roberts, H. Smith, S.J. and Bryce, C. (1994) Prevention is better...Sociology of Health and Illness. 15, 4: 447-64.

Shilling C. (1991) Educating the body: physical capital and the production of social inequalities. Sociology. 25: 653-72.

(*) Tyler D. (1997) At risk of maladjustment: the problem of child mental health. In Petersen A. and Bunton R. (eds.) Foucault and Health. London: Routledge.

(*) Wearing B., Wearing, S. and Kelly, K. (1994) Adolescent women, identity and smoking: leisure experience as resistance. Sociology of Health and Illness. 16, 5: 626-44.

31 SEMINAR 3 (week 6): The ‘Lay expert’: A contradiction in terms?

Seminar Questions:

Is the notion of lay expertise a contradiction in terms?

What role do the media and the Internet play in reconfiguring relations between ‘lay’ and medical worlds?

Key Seminar Readings:

Hardey, M. (1999) Doctor in the house: the internet as a source of lay health knowledge and the challenge to expertise. Sociology of Health and Illness. 21, 6: 820-35. AND/OR: Nettleton, S., Burrows, R., O’Malley, L. and Watt, I. (2004) Healthy E-Types? An analysis of the everyday use of Internet for health. Information, Communication & Society. 7, 4: 531-53.

Henwood, F., Wyatt, S, Hart, A, and Smith, J. (2003) ‘Ignorance is bliss sometimes’: constraints on the emergence of the ‘informed patient’ in the changing landscapes of health information’. Sociology of Health and Illness. 25, 6: 589-607.

Shaw, I. (2002) How lay are lay beliefs? Health. 6, 3: 287-99. AND: Prior, L. (2003) Belief, knowledge and expertise. Sociology of Health and Illness. 25 (Silver Anniversary Issue): 41-57.

Plus other readings for Lecture 4, in the sub-section on the Internet and Health.

32 7. AGEING AND HEALTH: DECLINE AND DISADVANTAGE?

In this lecture we focus on recent debates concerning ageing, health and the body, with particular reference to what may be termed ‘positive’ and ‘negative’ perspectives on these matters in late/postmodernity.

What is meant by the `mask of ageing’ (cf. Featherstone and Hepworth), and what light does it shed on the body, health and identity in later life?

1. Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt 5 ‘Children, ageing and health’; latter half on ageing).

2. Bury, M. (2000) Health, ageing and the lifecourse. In Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

3. Gilleard, C. and Higgs, P. (1998) Ageing and the limiting conditions of the body. Sociological Research Online. 3, (4).

4. Featherstone, M. and Hepworth M. (1991) The mask of ageing and the postmodern life course. In M. Featherstone, M. Hepworth and B.S. Turner (eds.), The Body: Social Process and Cultural Theory. London: Sage. OR: Hepworth, M. (1998) Ageing and the emotions, in Bendelow G. and Williams S.J. (eds.) Emotions in Social Life. London: Routledge.

Further (Key*) Readings:

(*) Arber, S. and Ginn, J. (1998) Health and illness in later life, in D. Field and S. Taylor (eds.) Sociological Perspectives on Health, Illness and Health Care. Oxford: Blackwell Science.

Arber, S. and Ginn, J. (eds.) (1995) Connecting Gender and Ageing: a Sociological Approach. Buckingham: Open University Press.

Arber, S. and Ginn, J. (1991) Gender and Later Life: a Sociological Analysis of Resources and Constraints. London: Sage.

Bury, M. and Holme, A. (1991) Life After Ninety. London: Routledge.

Biggs, S. (1999) The Mature Imagination. Buckingham: Open University Press.

Bytheway, B. and Johnson J. (1998) The sight of age, in S. Nettleton and J. Watson (eds.) The Body in Everyday Life. London: Routledge.

33 Fairhurst, E. (1998) `Growing old gracefully' as opposed to `mutton dressed as lamb': the social construction of recognising older women, in S. Nettleton and J. Watson (eds.) The Body in Everyday Life. London: Routledge.

(*) Featherstone, M. (1995) Post-bodies, aging and virtual reality. In M. Featherstone and A. Wernick (eds.), Images of Aging: Cultural Representations of Later Life. London: Routledge.

Featherstone M and Wernick A. (eds.) (1995) Images of Aging: Cultural Representations of Later Life. London: Routledge.

(*) Gilleard, C. and Higgs, P. (2001) Cultures of Ageing; Self, Citizen and the Body. London: Prentice Hall.

(*) Hockey, J. and James, A. (1993) Growing Up and Growing Old: Ageing, Dependency and the Lifecourse. London: Sage.

(*) Katz, S. (1996) Disciplining Old Age: The Formation of Gerontological Knowledge. Charlottesville and London: Univeristy Press of Virginia.

(*) Phillipson C. (1998) Reconstructing Old Age: New Agendas in Social Theory and Practice. London: Sage.

(*) Phoenix, C and Sparks, A.C. (2006) Young athletic bodies and narrative maps of ageing. Journal of Ageing Studies. 20, 2 (April): 107-121.

34 8. DISRUPTED BODIES/BIOGRAPHIES? THE MEANING AND EXPERIENCE OF CHRONIC ILLNESS

Shifting demography and changing patterns of disease, echoing last weeks lecture, have resulted in a `greying' of the Western population and a consequent increase in chronic disabling illness. In this week's lecture, therefore, the meaning and experience of chronic illness will be our prime concern, spanning a variety of sociological themes and issues, including notions of `biographical disruption', `narrative reconstruction', and `coping', `strategy' and `style' in chronic illness. In doing so, questions of body and society are again thrown into critical relief, embracing themes of pain, suffering and emotions. The politics of `disabled' bodies will also be considered here, as a point of comparison and critique.

Seminar questions:

What light does Bury’s (1982) notion of ‘biographical disruption’ shed on the meaning and experience of chronic illness?

1. Bury M. (1982) Chronic illness as biographical disruption. Sociology of Health and Illness. 4, (2): 167-182. AND/OR: Bury M. (1991) The sociology of chronic illness: a review. Sociology of Health and Illness. 13. OR: Bury M. 1997, Health and Illness in a Changing Society. London: Routledge (Chpt. 4 `Chronic illness and disability') OR: Bury, M. (2005) Health and Illness. Cambridge: Polity Press (Chpt. 4 ‘The Body, health and society’).

2.Williams G.H. (1984) The genesis of chronic illness: narrative reconstruction. Sociology of Health and Illness. 6: 175-200. Also reproduced in: Brown P. (ed.) (1989) Perspectives in Medical Sociology (Chpt. 18), Belmont CA: Wadsworth.

3. EITHER: Williams S.J. (2000) Chronic illness as biographical disruption or biographical disruption as chronic illness? Reflections on a core concept. Sociology of Health and Illness. 22, 1: 40-67. OR: Williams, S.J. (2003) Medicine and the Body. London: Sage (Chapt. 5 ‘Bodily Dys-Order).

4. ANY/ALL OF THE FOLLOWING: Carricaburu, D,. and Pierett, J. (1995) From biographical disruption to biographical reinforcement.: the case of HIV-positive men. Sociology of Health and Illness. 17: 65-88; Faircloth, C.A., Boylstein, C, Rittman, M., Young, ME, Gubrium, J. (2004) Sudden illness and biographical flow in narratives of stroke recovery. Sociology of Health and Illness. 26. 2: 242-61; Pound, P. , Gompertz, P, and Embrahim, S. (1998) Illness in the context of older age: the case of stroke. Soiciology of Health and Illness. 20, 4: 489-506.

5. Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/London: Norton & Co (Chpt 4 ‘Time, self, disruption’ and Chpt. 5 ‘Reshaping health and illness’).

(NB. Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge, contains many of these articles, plus other useful papers in Part 4 on ‘chronic illness and disability).

35 Chronic illness;

(*) Anderson R., and Bury M. (eds.) (1988) Living With Chronic Illness: The Experience of Patients and Their Families. London: Hyman Unwin. (Extracts from Kelleher's Chpt. on diabetes are reproduced as Chpt. 15 in Davey et al. (eds.) (1995) Health and Disease: a Reader. OUP).

(*) Bendelow G. and Williams S.J. (1995) Transcending the dualisms? Towards a sociology of pain. Sociology of Health and Illness. 17 (2): 139-165. And/or: Bendelow G. and Williams S.J. (1995) Pain and the mind-body dualism. Body & Society 1 (2): 83-103. See also Bendelow, G. (2000) Gender and Pain. Harlow, Essex: Pearson Education Ltd.

Bury, M. (2001) Illness narratives: fact or fiction? Sociology of Health and Illness. 23, 3: 263-85.

Charmaz K. (1983) Loss of self: a fundamental form of suffering in the chronically ill. Sociology of Health and Illness. 5: 168-195. See also: Charmaz K. (1994) Identity dilemmas of chronically ill men. The Sociological Quarterly. 35 (2): 269-288.

Comaroff J. and Maguire P. (1981) Ambiguity and the search for meaning: childhood leukaemia in the modern clinical context. Social Science and Medicine. 15B, (2): 115-124.

Corbin J., and Strauss A. (1990) Managing chronic illness at home: three lines of work. (Chpt. 11) in: Conrad P., and Kern R. (eds.) The Sociology of Health and Illness: Critical Persepctives (3rd Edition). St Martin’s Press.

(*) Frank A.W. (1997): Reconciliatory alchemy: bodies, narrative and power. Body & Society. 2, 3: 53- 71 and/or: Frank A.W. (1995) The Wounded Storyteller. Chicago: University of Chicago Press. See also: Frank A.W. (1997) Blurred inscriptions of health and illness. Body & Society 3, 2: 103-13.

Garro L. (1994) Narrative representations of chronic illness experience: cultural models, mind, and body in stories concerning the temporomandibular joint (TMJ). Social Science and Medicine. 38, (6): 775-88.

Goffman E. (1963) Stigma: Notes on the Management of Spoiled Identity. Harmondsworth: Penguin.

Greco, M. (2001) Inconspicuous anomalies: alexithymia and ethical relations to the self. Health. 5, (4): 471-92.

(*) Hyden, L.C. (1997) Illness and narrative. Sociology of Health and Illness. 19, 1: 48-69. OR: Jacoby A. (1994) Felt versus enacted stigma: a concept revisited. Evidence from a study of people with epilepsy in remission. Social Science and Medicine. 38, (2): 269-274.

(*) Kleinman A. (1988) The Illness Narratives: Suffering, Healing and the Human Condition. Basic Books.

(*) Kelly M. (1991) Coping with an ileostomy. Social Science and Medicine. 33 (2): 115-125. See also: Kelly M. (1992) Self, identity and radical surgery. Sociology of Health and Illness. 14, (3): 390-415.

(*) Kelly M. and Field. D. (1995) Medical sociology, chronic illness and the body. Sociology of Health and Illness. 18, (2): 241-57. See also: Kelly M.P. and Field, D. (1998) Conceptualising chronic illness, in D. Field and S. Taylor (eds.) Sociological Perspectives on Health, Illness and Health Care. Oxford: Blackwell Science.

36 Löyttniemi, V. (2005) Doctors as wounded storytellers: embodying the physician and gendering the body. Body & Society. 11 (1): 87-110.

(*) Mol, A. and Law, J. (2004) Embodied action, enacted bodies: the example of hypoglycaemia. Body & Society. 10 (2-3): 63-84.

Morris, D. (1991) The Culture of Pain. Berkeley: University of California Press.

(*) Morris, D. (1998) Illness and Culture in the Postmodern Age. Berkeley: University of California Press.

Pinder R. (1992) Coherence and incoherence: doctors' and patients' perspectives on the diagnosis of Parkinson's disease. Sociology of Health and Illness 14, 1: 1-22.

(*) Radley A. and Green R. (1987) Chronic illness as adjustment: a methodology and conceptual framework. Sociology of Health and Illness. 9 (2): 179-207. And: Radley A. (1989) Style, discourse and constraint in adjusting to chronic illness. Sociology of Health and Illness. 11, (3): 230-252. See also any of the following: Radley A. (1993) 'The role of metaphor in adjustment to chronic illness' (Chpt. 6) in: Radley A. (ed.) (1993) World's of Illness: Biographical and Cultural Perspectives on Health and Disease. London: Routledge; Radley, A. (1999) The aesthetics of illness: narrative, horror and the sublime. Sociology of Health and Illness, 21, 6: 778-96.

Riessman C.K (1990) Strategic use of narrative in the presentation of self and illness. Social Science and Medicine. 30, (11): 1195-1200.

(*) Scambler G., and Hopkins A. (1986) Being epileptic: coming to terms with stigma. Sociology of Health and Illness. 8 (1): 26-43.

Skultans, V. (1999) Narratives of the body: illness in judgement on the Soviety past. Sociology of Health and Illness. 21, 3: 310-28.

Strauss A. et al (1984) Chronic Illness and the Quality of Life. St Louis: C.V. Mosby Co.

Williams G.H. (1993) 'Chronic illness and the pursuit of virtue in everyday life' (Chpt. 5) in: Radley A. (ed.) (1993) World's of Illness: Biographical and Cultural Perspectives on Health and Disease. London: Routledge.

(*) Williams S.J. (1987) Goffman, interactionism and the management of stigma in everyday life. (Chpt. 6) in, G. Scambler (ed.) Sociological Theory and Medical Sociology. London: Tavistock.

Williams S.J. (1993) Chronic Respiratory Illness. London: Routledge (esp. Chpts 2 and 6). See also other books in the: Experience of Illness series by: Kelleher D. (1988) Diabetes; Kelly M. (1990) Colitis; Robinson I. (1989) Multiple Sclerosis; Scambler G. (1989) Epilepsy. London: Routledge.

(*) Williams S.J. (1996) The vicissitudes of embodiment across the chronic illness trajectory. Body & Society. 2, 2: 23-47.

(*) Williams S.J. and Calnan M. (eds.) (1996) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press (Part III `Chronic illness and modern medicine').

Yoshida K.K. (1993) Reshaping of self: a pendular reconstruction of self and identity among adults with

37 traumatic spinal cord injury. Sociology of Health and Illness 15, (2): 217-245.

NB. Some of the references in the lay concepts lecture (week 8) on the metaphorical aspects of illness are also relevant here: (e.g. Sontag (1991)). See also novels such as T. Mann (1988 [1924]) The Magic Mountain. Harmondsworth: Penguin; and O. Sacks. (1985) The Man Who Mistook his Wife for a Hat. London: Picador, and; O. Sacks (1986) A Leg To Stand On. London: Pan.); Frank A.W. (1993) At the Will of the Body: Reflections on Illness. Boston: Houghton Mifflin, and; Murphy R.F. (1987) The Silent Body. New York: Henry Holt.

Disability/politics of disablement;

(*) Albrecht, G., Seelman, K.D. and Bury, M. (eds.) (2003) Handbook of Disability Studies. London: Sage.

(*) Barnes C. and Mercer G. (eds.) (1996) Exploring the Divide: Illness and Disability. Leeds: The Disability Press.

Barnes, C., Mercer, G. and Shakespeare T. (1999) Understanding Disability: a Sociological Approach. Cambridge: Polity Press.

(*) Freund, P.E.S. (2001) Bodies, disability and spaces: the social model of disability and disabling spatial organisations. Disability and Society.16, 5: 689-706.

(*) Hughes B. and K. Patersen (1997) The social model of disability and the disappearing body: towards a sociology of impairment. Disability & Society. 12, 3: 325-40.

Office of Population Censuses and Surveys (1988a) OPCS Surveys of Disability in Great Britain: The Prevalence of Disability Among Adults. London: HMSO. And: OPCS (1988b) The Financial Circumstances of Disabled Adults Living in Private Households. London: HMSO.

(*) Oliver M. (1990) The Politics of Disablement. London: Macmillan.

Oliver, M. (1996) Understanding Disability: From Theory to Practice. London: Macmillan.

(*) Seymour, W. (1998) Remaking the Body: Rehabilitation and Change. London: Routledge.

(*) Shakespeare, T. and Erickson, (2000) Different strokes: beyond biological determinism and social constructionism, in Rose, H. and Rose, S. (eds.) Alas Poor Darwin: Arguments Against Evolutionary Psychology. London: Jonathan Cape.

(*) Swain J., French, S., Barnes, C. and Thomas, C. (eds.) (2004) Disabling Barriers - Enabling Environments. (2nd Edition) London: Sage.

(*) Williams G.H. and Busby, H. (2000) The politics of `disabled' bodies. In Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Williams, S.J. (1999) Is anybody there? Critical realism and the disability debate. Sociology of Health and Illness. 21, 6: 797-819.

38 SEMINAR 4 (week 8): Growing up and growing old.

Seminar questions:

Can the sociology of childhood and the sociology of health be profitably reconciled?

Is ageing all about decline and disadvantage?

Key Readings:

Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt 5 ‘Children, ageing and health’; latter half on ageing).

Mayall, B. (1994) Keeping healthy at home and at school. Sociology of Health and Illness 15: 464-88. AND/OR: James, A. (1998) Children and health, in D. Field and S. Taylor (eds.) Sociological Perspectives on Health, Illness and Health Care. Oxford: Blackwell Science

Bury, M. (2000) Health, ageing and the lifecourse. In Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Plus other examples of empirical studies of children, childhood and ageing in lectures 6 and 7 above.

39 9. MORTAL BODIES: DEATH AND DYING IN LATE/POSTMODERNITY

Traditionally accused, rightly or wrongly, of immersing itself in matters of life rather than death, sociological studies of death and dying now abound. In this lecture, we take a closer look at these issues, and the dilemmas of the `mortal body' they raise, through debates as to whether or not we are a ‘death- denying society’.

Are we a ‘death-denying’ society?

Is a ‘revival’ of death (Walter, 1995) currently underway?

1. Kellehear A. (1984) Are we a `death denying' society? A sociological view. Social Science and Medicine. 18, 9: 713-

2. Mellor P. and Shilling C. (1993) Modernity, self-identity and the sequestration of death. Sociology. 27, (3).

3. Lawton, J. (1998) Contemporary hospice care: the sequestration of the unbounded body and `dirty dying’. Sociology of Health and Illness. 20, 2: 121-143. See also Lawton, J. (2000) The Dying Process: Patients’ Experiences of Palliative Care. London: Routledge. (NB. This is not for the faint hearted, given some of the descriptions of dying contained in Lawton’s work).

4. Armstrong D. (1987) Silence and truth in death and dying. Social Science and Medicine 24, (8): 651- 658.

Western attitudes towards death, the mortal dilemmas of identity, and the medicalisation of death and dying;

(*) Aries P. (1976) Western Attitudes Towards Death: From the Middle Ages to the Present. London: Marion Boyers. And: Aries P. (1983) The Hour of Death. London: Penguine. (esp Chpt. 12 and Conclusion).

(*) Bauman, Z. (1998) Postmodern adventures in life and death, in G. Scambler and P. Higgs (eds.) Modernity, Medicine and Health. London: Routledge. OR: Bauman Z. (1992) Survival as a social construct. Theory, Culture and Society. 9: 1-36. See also: Bauman Z. (1992) Mortality, Immortality and Other Life Strategies. Cambridge: Polity Press.

Bury M. (1997) Health and Illness in a Changing Society. London: Routledge (Chpt. 5).

(*) Clark D. (1993) The Sociology of Death. Oxford: Blackwell (esp. Chpts. by Mellor and Walter).

40 (*) Elias N. (1985) The Loneliness of Dying. Oxford: Basil Blackwell.

Giddens A. (1991) Modernity and Self Identity. Oxford: Polity (Chpt. 5, esp pp: 144-169).

(*) Haddow, G. (2005) The phenomenology of death, embodiment and organ transplantation. Sociology of Health and Illness. 27, 1: 92-113.

(*) Hockey, J. and Draper, J. (2005) Beyond the womb and the tomb: (dis) embodiment and the life course. Body & Society. 11 (2): 41-57.

(*) Illich I. (1975) Death against death. (Chpt. 8) in: Illich I. Medical Nemesis. London: Calder and Boyars; and (Chpt. 5) in: Illich I. (1977) Limits to Medicine. Harmondsworth Penguin.

Kearl M.C. (1989) Endings: A Sociology of Death and Dying.

Lock, M. (2004) Living cadavers and the calculation of death. Body & Society. 10 (2-3) 135-52.

(*) Mestrovic, S.G. (1997) Postemotional Society. London: Sage (Chpt. 6: 'Death and the end of innocence')

Prior L. (1989) The Social Organisation of Death London: Macmillan.

(*) Prior, L. (2000) Reflections on the `mortal' body in late modernity. In Williams, S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

(*) Seale C. Heroic death. Sociology. 29, (4): 597-613. See also: Seale, C. (1999) The Social Construction of Death and Dying. Cambridge: Cambridge University Press.

Walter T. (1989) Modern death: taboo or not taboo? Sociology 25, (2): 293-301. Also reprinted in Donaldson D and Johnson M. (eds.) (1993) Op cit.

(*) Walter T. (1995) The Revival of Death. London: Routledge.

(*) Walter T. Littlewood J. and Pickering M. (1995) Death in the news: the public invigilation of private emotion. Sociology. 29, (4): 579-96. See also: Walter, T. (ed.) (1999) The Mourning of Diana. Oxford: Berg Publishers.

Williams R. (1989) Awareness and control of dying: some paradoxical trends in public opinion. Sociology of Health and Illness 11, (3): 200-12.

'Dying trajectories', death as a 'status passage', and the social organisation of death and dying in the hospital/hospice;

Clark, D., Hockley J. and Ahmedzai, S. (1997) New Trends in Palliative Care. Buckingham: Open University Press.

Clark, D. (1993) The Future of Palliative Care. Buckingham: Open University Press.

Glaser B. and Strauss A.L. (1965) Temporal aspects of dying as a non-scheduled status passage. Amercian Journal of Sociology. 71: 48-59.

41 (*) Glasser B., and Strauss A. (1965) Awareness of Dying. Chicago: Aldine. See also: Glaser B.G. and Strauss A.L. (1967) Awareness contexts and social interaction. (Chpt. 40) in: Manis J.G. and Meltzer B.N. (eds.) Symbolic Interaction. Allyn and Bacon. And: Glaser B. and Strauss A.L. (1968) Time for Dying Chicago: Aldine. See also: Timmermans S. (1994) Dying of awareness: the theory of awareness contexts revisited. Sociology of Health and Illness 16, (3): 322-339.

Kubler-Ross E. (1970) On Death and Dying. London: Tavistock.

(*) Lawton, J. (2000) The Dying Process: Patients’ Experiences of Palliative Care. London: Routledge.

McIntosh J. (1978) The routine management of uncertainty in communication with cancer patients. In: Davis A. Relationships Between Doctors and Patients. See also McIntosh J. Communication and Awareness in a Cancer Ward. London: Croom Helm (esp. Chpts 2,3 and 4).

Seale C. (1990) A comparison of hospice and conventional care. Social Science and Medicine 32, (2)?: 147-152. See also: Seale C. (1990) Caring for people who die: the experience of family and friends. Ageing and Society. 10: 413-428. And: Seale C. (1991) Communication and awareness about death: a study of a random sample of dying people. Social Science and Medicine. 32, (8): 943-952.

Strauss A.L. and Glaser B.G. (1975) Patterns of dying. (Chpt. 15) in: Cox C. and Mead A. (eds.) A A Sociology of Medical Practice. London: Collier Macmillan.

(*) Sudnow D. (1965) Passing On: The Social Organization of Dying. Prentice Hall. (esp Chpts. 3 and 4).

Taylor K. (1988) 'Telling bad news': physicians and the disclosure of undesirable information. Sociology of Health and Illness 10: 109-132. c) Death and dying in the community/ problems of bereavement, grief and mourning;

Eisenbrugh M. (1984) Cross cultural aspects of bereavement: a conceptual framework for comparative analysis. Culture, Medicine and Psychiatry. 8, (3): 283-

Field D., Hockey J. and Small N. (eds.) (1997) Death, Gender and Ethnicity. London: Routledge.

(*) Kear, A and Steinberg, D.L. (eds.) (1999) Mourning Diana: Nation, Culture and the Performance of Grief. London: Routledge.

Gorer G. (1965) Death, Grief and Mourning in Contemporary Britain. London: Cresset Press.

Parkes C.M. (1975) Bereavement: Studies of Grief in Adult Life. Harmondsworth: Penguin. (esp. Chpts. 2 and 11).

Walker K.N. (1977) Social support networks and the crisis of bereavement. Social Science and Medicine. 11: 35-41.

(*) Walter, T. (1999) The Mourning for Diana. Oxford: Berg.

(*) Young M. and Cullen L. (1996) A Good Death: Conversations with East Londoners. London: Routledge.

42 10. DORMANT/DROWSY BODIES: SLEEP, HEALTH AND SOCIETY.

Sleep is crucial to society and the health, well-being, productivity, performance and quality of life of each and every one of us. Sleep indeed is a basic human right and resource, recognised or not. How we sleep, when we sleep, where we sleep, let alone what we make of it and who we do it with, are all important social issues. It is only relatively recently, however, that sociologists have begun to turn their attention to this dormant matter. In this lecture we take a critical look at this recent upsurge of sociological interest in sleep, with particular reference to issues of health and medicalization.

To what extent has sleep become medicalised?

1. Williams, S.J. (2005) Sleep and Society: Sociological Ventures into the (Un)known. London: Routledge (Chapter 5: ‘Colonising sleep? Medicalisation and beyond…’). SEE ALSO: Williams, S.J. (2002) Sleep and health: sociological reflections on the dormant society. Health. 6, 2: 173-200 OR: Williams, S.J. (2003) Medicine and the Body. London: Sage (Chapt. 6 ‘Dormant/mortal bodies; first half on sleep).

2. ANY OF THE FOLLOWING: Hislop, J. and Arber, S. (2003a) Sleepers wake! The gendered nature of sleep disruption among mid-life women. Sociology. 37, 4: 695-711; Hislop, J. and Arber, S. (2003b) Sleep as a social act: a window on gender roles and relationships, in S.Arber, K. Davidson and J. Ginn (eds.) Gender and Ageing: Changing Roles and Relationships. Maidenhead and Philadelphia: Open University Press; Hislop, J. and Arber, S. (2003c) Understanding women’s sleep management: beyond medicalization- healthicization? Sociology of Health and Illness. 25, 7: 815-37.

3. Brown, M. (2004) Taking care of business: self-help and sleep medicine in American corporate culture. Journal of Medical Humanities. 25, 3 (Fall): 173-187.

4. Kroll-Smith, S. (2003) Popular media and ‘excessive daytime sleepiness’: a study of rhetorical authority in medical sociology. Sociology of Health and Illness. 25, 6: 625-43.

5. Weisgerber, C. (2004) Turning to the internet for help on sensitive medical problems: A qualitative study of the construction of a sleep disorder through online interaction. Information, Communication & Society. 7, 4: 554-74.

[NB See also the Williams – Hislop and Arber debate: Williams, S.J. (2004) Beyond medicalization-healthicization? A rejoinder to Hislop and Aber. Sociology of Health and Illness. 26, 4: 453-59 and Hislop and Arber, S. (2004) Understanding women’s sleep management: beyond medicalization-healthicization: A response to Simon Williams. Sociology of Health and Illness. 26, 4: 460-63.]

2. Further (* Key) Readings:

Aubert, V. and White, H. (1959a) Sleep: a sociological interpretation I. Acta Sociologica. 4, 2: 46-54.

43 Aubert, V. and White, H. (1959b) Sleep: a sociological interpretation II. Acta Sociologica. 4, 3: 1-16.

(*) Dement, W. (1999/2000) The Promise of Sleep: The Scientific Connection Between Health, Happiness and a Good Nights Sleep. New York/London: Delacourt Press/Macmillan.

Dement, W.C. (1972) Some Must Watch, Whilst Some Must Sleep: Exploring the World of Sleep. New York: W.W. Norton & Co.

Flanagan, O. (2000) Dreaming Souls. Oxford: Oxford University Press.

(*) Martin, P. (2003) Counting Sheep: The Science and Pleasure of Sleep and Dreams. London: Flamingo.

(*) Meadows, R. (2005) The ‘negotiated night’: an embodied conceptual framework for the sociological study of sleep. The Sociological Review. pp 240--254.

(*) Schwartz, B. (1970) Notes on the sociology of sleep. Sociological Quarterly. 11, (Fall): 485- 99.

(*) Steger, B. and Brunt, L. (2003) Night-time and Sleep in Asia and the West: Exploring the Dark Side of Life. London: Routledge Curzon.

Taylor, B. (1993) Unconsciousness and society: the sociology of sleep. International Journal of Politics, Culture and Society. 6, 3: 463-71.

(*) Williams, S.J. (2001d) Dormant issues? Towards a sociology of sleep, in Cunningham-Burley S. and Backett-Milburn, K. (eds.) Exploring the Body. Basingstoke: Palgrave. OR Williams S.J. and Bendelow, G. (1998) The Lived Body: Sociological Themes, Embodied Issues. London: Routledge (Chpt. 9 on the `Dormant body: sleep night-time and dreams).

Useful Websites: www.sleepnet.com

www.sleepfoundation.org; www.warwick.ac.uk/go/sleepandsociety

44 SEMINAR 5 (week 10): Bodily dys-order/(un)bounded bodies: Illness, disability and death

Seminar Questions:

What light does chronic illness shed on the relationship between the body, biography and self- identity?

To what extent can narratives or stories of sickness and suffering ‘heal’?

Is it only certain types of ‘dirty’dying (cf. Lawton) that are sequestrated in late/postmodernity?

Is dying with ‘dignity’ possible within the hospice?

45 TERM 2:

11. SOCIAL CLASS AND HEALTH: A WIDENING GAP?

Inequalities in health provide an important index of the power and force of social structure in shaping our lives, for better or worse, richer or poorer. From the nineteenth century Reports of Chadwick and Engels to the present day gap, the gap in health as well as wealth has been documented and debated: a gap it appears, despite absolute improvements in health and living standards, which is widening. In this lecture, we concentrate less upon a battery of evidence and statistics in support of these claims, than the explanation proposed, their relative merits, and the most promising lines of current and future research. In particular, we shall focus on issues of income distribution, debates over `social capital' and the `psychosocial' pathways to disease, and the resurgence of neo-materialist explanations.

Critically evaluate Wilkinson’s recent work on income inequality, social cohesion and health.

1. Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 4 `Class structure, inequalities and health'). AND/OR Scambler, G. (2002) Health and Social Change: A Critical Theory. Buckingham: Open University Press. (Chapter 5 'The new inequality and health').

2.Wilkinson, R.G. (1997) [Handout] Perspective: Hale and place The Times Higher, May 9: 19. AND/OR ANY OF THE FOLLOWING: Wilkinson, R.G. (1990) Income distribution and mortality: a `natural’ experiment. Sociology of Health and Illness. 12, (4): 391-412;Wilkinson, R.G. (1992) Income distribution and life expectancy. British Medical Journal. 304: 165-68; Wilkinson, R.G. (1994) Divided we fall: the poor pay the price for increased social inequality with their health. British Medical Journal. 308: 1113-1114; Wilkinson, R.G. (1998) Mortality, the social environment and crime. Sociology of Health and Illness. 20, (5): 578-97. For the most comprehensive coverage of these issues, see Wilkinson, R.G. (1996) Unhealthy Societies: the Afflications of Inequality. London: Routledge (esp. Intro, Parts II, IV and V); Wilkinson, R. (2000) Mind the Gap: Hierarchies, Health and Human Evolution. London: Weidenfeld and Nicoloson. (a very short 70 page book); PLUS his most recent book: Wilkinson, R.G. (2005) The Impact of Inequality: How to Make Sick Societies Healthier. London: Routledge. NB. For a useful summary of Wilkinson's work and contribution, see J. Ivor Elstad (1998) Sociology of Health and Illness (special issue on: The Sociololgy of health inequalities Bartley, M. et al. (eds.) (1998). Also reproduced as an edited book: M. Bartley et al. (eds.) (1998) The Sociology of health inequalities. Oxford: Blackwell).

3. ANY OF THE FOLLOWING: Coburn, D. (2004) Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities. Social Science and Medicine. 58: 41-56, OR: Coburn, D. (2000) income inequality, social cohesion and the health status of populations: the role of neo-liberalism. Social Science and Medicine 51: 135-46 PLUS the debate which follows, including Wilkinson's (2000) reply in SSM, 51: 997-1000, and Coburn's brief response in SSM 51: 1009-10; (ii) Lynch, J.W, Davey Smith, G., Kaplan, G.A. and House, J.S. (2000) Income inequality and mortality: importance to health of income, psychosocial environment or material conditions. BMJ. 320: 1200- 1204; (iii) Muntaner, C. and Lynch, J. (1999) Income inequality, social cohesion and class relations: a

46 critique of Wilkinson's neo-Durkheimian research programme. International Journal of Health Services. 29: 59-81, AND Wilkinson's (1999) reply, IJHS. 29: 525-43.

4. Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/Lonon: Norton & Co. (Introduction, , Chpts. 1, 7&8).

(NB. Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge, has a chapter by Wilkinson, plus other useful essays for this and the subsequent two sessions on gender and ethnicity in Part 2 ‘Inequalities and the patterning of health and illness’)

Bartley M., Carpenter L, Dunnell K. and Fitzpatrick R. (1996) Measuring inequalities in health: an analysis of mortality patterns using two social classification. Sociology of Health and Illness. 18 (4): 455-474.

(*) Bartley, M., Blane, D. and Smith, G. Davey (eds.) (1998) The Sociology of Health Inequalities. Oxford: Blackwell (esp. intro., and articles by Wilkinson et al., Ivor Elstad, Popay et al., Shaw et al. Nettleton and Burrows, Dike van de Mheen et al.) This volume can also be accessed as a `Special Issue' of Sociology of Health and Illness. 20, 5.

(*) Blane D., Davey Smith G. and Bartley M. (1993) Social selection: what does it contribute to social class inequalities in health? Sociology of Health and Illness. 15, (1): 1-15.

Blane D., Bartley M., Davey Smith G. et al. (1994) Social patterning of medical mortality in youth and early adulthood. Social Science and Medicine 39 (3): 361-366.

(*) Blane, D. Brunner E. and Wilkinson R. (eds.) (1996) Health and Social Organization: Towards a Health Policy for the 21st Century. London: Routledge.

(*) Blaxter M. (2000) Class, time and biography. In Williams S.J., Gabe J. and Calnan M. (eds.). Theorising Health, Medicine and Society. London: Routledge. See also Blaxter M. (1994) Why do victims blame themselves? In: Radley A. (ed.) (1993) World's of Illness: Biographical and Cultural Perspectives on Health and Disease. London: Routledge; Blaxter, M. (1990) Health and Lifestyles. London: Routledge. For an update on the health and lifestyles survey (HLS) see: Cox B., Huppert F.A. and Whichelow M.J. (eds.) (1993) The Health and Lifestyle Survey: Seven Years On. Aldershot: Dartmouth Publishing Co.

(*) Bloor M., Samphier M. and Prior L. (1987) Artefact explanations of inequalities in health: an analysis of evidence. Sociology of Health and Illness. 9, (3): 321-364.

Engels F. (1995) Health 1844. (Chpt. 21) in Davey et al. (eds.) Health and Disease: a Reader. Buckingham: Open University Press.

(*) Graham, H. (eds.) (2000) Understanding Inequalities in Health. Buckingham: Open University Press.

(*) Higgs, P. and Scambler, G. (1998) Explaining health inequalities: how useful are concepts of class?, in G. Scambler and P. Higgs (eds.) Modernity, Medicine and Health. London: Routledge.

(*) Illsley R. (1986) Occupational class, selection and the production of inequalities in health. Quarterly Journal of Social Affairs. 2 (4): 415-422. See also: Wilkinson R. (1986) Occupational class, selection

47 and the production of inequalties; a reply to Raymond Illsley. Quarterly Journal of Social Affairs. 2, (4): 415-422.

(*) Lynch, J., Due, P., C. Muntaner C. and Davey Smith, G. (2000) Social capital: is it a good investment for public health? Journal of Epidemiology and Community Health. 54: 404-08. Follow up subsequent articles by Baum, F. (pp. 409-10) and Wilkinson's reply (pp. 411-13).

(*) Macintyre, S. (1997) The Black Report and beyond: what are the issues? Social Science and Medicine. 44: 723-45.

Marmot M. et al (1978) Employment grade and coronary heart disease in British civil servants. Journal of Epidemiology and Community Health. 32, (4): 244-249. See also: Marmot M.G., Davey Smith G., Stansfield S., Patel C., North F., Head J., White I., Brunner E., and Feeney A. (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337 (June 8th): 1387-1393.

(*) Muntaner, C., Lynch, J. and Oates, G. (1999) The social class determinant of income inequality and social cohesion. International Journal of Health Services. 29: 699-732.

(*) Navarro, V. (ed.) (2002) The Political Economy of Social Inequalities: Consequences for Health and Quality of Life. New York: Baywood Publishing Co. Inc.

(*) Shaw, M., Dorling, D., Gordon, D. and Davey Smith, G. (1999) The Widening Gap: Inequalities in Health in Britain. Bristol: the Policy Press.

(*) Townsend P., Davidson N., and Whitehead M. (1988) Inequalities in Health: The Black Report and the Health Divide. Harmondsworth: Penguin. (Chpts. 2 and 6 of the Black Report, and Chpts. 2 and 6 of The Health Divide). See also Graham, H (2000) and Shaw et al (1999) above.

Tudor Hart J. (1971) The inverse care law. Lancet (1): 405-412. (Also reprinted in Cox C. and Mead A. (eds.) (1975) A Sociology of Medical Practice. London: Collier Macmillan).

West P (1988) Inequalities? Social class differentials in health in British youth. Social Science and Medicine 27: 291-296.

(*) West P. (1991) Rethinking the health selection explanation for health inequalities. Social Science and Medicine. 32, (4): 373-384.

(*) Williams S.J. (1998) `Capitalising' on emotions: rethinking the inequalities debate. Sociology. 32, (1): 121-39. See also Williams S.J. (1995) Theorising class, health and lifestyles: can Bourdieu help us? Sociology of Health and Illness. 17 (5): 577-604.

Key (recent) Government Reports;

Acheson, D.(1998) Independent Inquiry into Inequalities in Health. London: The Stationary Office.

Secretary of State for Health (1999) Saving Lives: Our Healthier Nation (Cm 4386). London: The Stationary Office.

Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London: DoH. (http://www.dh.gov.uk)

48 49 12. GENDER DIFFERENCES IN HEALTH: THE MORTALITY/MORBIDITY PARADOX.

Following on from last weeks lecture, this session examines issues of gender and health, including both conceptual and methodological problems of research in this area to date, and evidence and explanations for the gendering of mortality and morbidity.

Is the relationship between gender and health as simple as it seems?

Core/Essential Readings:

1. Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity (Chpt. 5 `Gender inqualities and health status'). OR: Annandale, E. (1998) Health, illness and the politics of gender, in D. Field and S. Taylor (eds.) Sociological Perspectives on Health, Illness and Health Care. Oxford: Blackwell Science.

3. Macintyre, S., Hunt, K., and Sweeting, H. (1996) Gender differences in health: are things as simple as they seem? Social Science and Medicine. 42: 617-24. Also reproduced in Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge)

3. Cameron, E. and Bernardes, J. (1998) Gender and disadvantage: men's health for a change. Sociology of Health and Illness 20, 5: 673-93.

4. Doyal, L. (2002) Gender equity in health: debates and dilemmas, in G. Bendelow et al. (eds.) Gender, Health and Healing. London: Routledge.

(*) Annandale, E. and Hunt, K. (eds.) (1999) Gender Inequalities in Health. Buckingham: Open University Press (esp. Chapters by Annandale and Hunt, and Carpenter).

(*) Annandale E., and Hunt K. (1990) Masculinity, femininity and sex: an exploration of their relative contribution to explaining gender differences in health. Sociology of Health and Illness. 12 (1) 24-46.

Annandale E. and Clark J. (1996) What is gender? Feminist theory and the sociology of human reproduction. Sociology of Health and Illness. 18, (1): 17-44.

(*) Arber S., Gilbert N. and Dale A. (1985) Paid employment and women's health: a benefit or a source of role strain? Sociology of Health and Illness. 7, (3): 375-400. See also: Arber S. (1990) Opening the 'Black' box: inequalities in women's health. (pp. 37-56) in: Abbott P., and Payne G. (eds.) New Directions in the Sociology of Health. London: Falmer Press, and; Arber (1997) Comparing women and men's health: Britain in the 1990s. Social Science and Medicine. 44, 6: 773-88.

(*) Banks, I. (2001) No man's land: men, illness, and the NHS. British Medical Journal. 323: 1058-60. NB This is part of a special BMJ issue on men's health, follow up other articles.

(*) Bendelow G. (1993) Pain perceptions, emotions and gender. Sociology of Health and Illness. 15, 3: 273-294. See also Bendelow, G. (2000) Gender and Pain. Harlow, Essex: Pearson Education Ltd.

50 Brown G. (1995) Depression: a sociological view. (Chpt. 23) in: Davey et al (eds.) Health and Disease: a Reader. OUP. Also reprinted in: Tuckett D., and Kaufert J (eds.) Readings in Medical Sociology. London: Tavistock. (See also Chpt. 8 in Tucket D. and Kaufert J., by Brown G. et al. on schizophrenia). The chapter on depression is an edited extract from: Brown G.W. and Harris T.O. (1978) The Social Origins of Depression. London: Tavistock. (Chpt. 1 and Section 5).

Brown G.W. (1987) Social factors and the development and course of depressive disorders in women: a review of a research programme. British Journal of Social Work. 17: 615-634.

Busfield J. (1988). Mental illness as social product or social construct: a contradiction in feminists' arguments? Sociology of Health and Illness 10, (4): 521-542. See also Busfield, J. (1996) Men, Women and Madness: Understanding Gender and Mental Disorder. London: Macmillan.

(*) Clarke J. (1983) Sexism, feminism and medicalism: a decade review of literature on gender and illness. Sociology of Health and Illness. 5 (1): 62-81.

Doyal L. (1995) What Makes Women Sick? Gender and the Political Economy of Health London: Macmillan (esp. Chpts. 1,2 and 6).

Gove W. (1973) Sex, marital status and mortality. American Journal of Sociology. 79: 45-67.

Gove W. (1978) Sex differences in mental illness among adult men and women: an evaluation of four questions raised regarding the evidence of the higher rates of women. Social Science and Medicine. 12 (B): 187-198. And: Gove W. (1984) Gender differences in mental and physical illness illness: the effects of fixed roles and nurturant roles. Social Science and Medicine. 19, (2): 77.

(*) Graham, H. (ed) (2000) Understanding Inequalities. Buckingham: Open University Press.

Graham H. (1993). Hardship and Health in Women's Lives. London: Harvester Wheatsheaf, and; Graham H. (1994) Gender and class as dimensions of smoking behaviour in Britain: insights from a survey of mothers. Social Science and Medicine. 38, (5): 691-98.

(*) Hibbard J., and Pope D. (1983) Gender roles, illness orientation and the use of medical services. Social Science and Medicine. 17 (3): 129-137.

Kaplan M.S. and Marks G. (1995) Appraisals of health risks: the roles of masculinity, femininity and sex. Sociology of Health and Illness. 17, (2): 206-221.

Martikainen P. (1995) Women's employment, marriage, motherhood and mortality: a test of the multiple role and role accumulation hypotheses. Social Science and Medicine. 40 (2): 199-212.

Oakley A. and Oakley R. (1981) Sexism and official statistics. In: Irvine J., Miles I. and Evans D. (eds.) Demystifying Social Statistics. London: Pluto Press.

(*) Roberts H. (ed.) (1990) Women's Health Counts. London: Routledge. (Chpts. 1,2,3,4,8, (esp. MacFarlane's Chpt.)). Roberts H. (1992) Women's Health Matters. London: Routledge (esp. Chpt. by J. Popay).

(*) Sabo, D. and Gordon, D. (1995) Men's Health and Illness: Gender, Power and the Body. London: Sage.

51 (*) Saltonstall, R. (1993) Healthy bodies, social bodies: Men’s and women’s concepts and practices of health in everyday life. Social Science and Medicine 36, 1: 7-14.

Stacey M. and Oleson V. (1993) Women, Men and Health. Social Science and Medicine (Special issue) 36, (1): 1>.

Verbrugge L. (1985) Gender and health: an update on hypotheses and evidence. Journal of Health and Social Behavior. 26 (3): 156-182. See also: Verbrugge L. (1989) The twain shall meet: empirical explanations of sex differences in health and mortality. Journal of Health and Social Behavior. 30: 282- 304.

Walters V. et al. (1997) The effect of paid and unpaid work on nurses' well-being: the case of gender. Sociology of Health and Illness. 19, 2: 328-347.

(*) Watson, J. (2000) Male Bodies: Health, Culture and Identity. Buckingham: Open University Press.

52 13. `RACE', ETHNICITY AND HEALTH.

In this lecture, which completes the section on social structure and health, we explore issues of `race', ethnicity and health, both physical and mental. In particular, we shall examine current evidence and explanations for the ethnic patterning of health and illness, the limits of research in this area to date, and the key policy and future research agendas this signals.

‘Methodological and definitional problems beset the study of inequalities in health by ethnic group’. Discuss.

Can inequalities by social class and ethnic group be considered simultaneously?

Critically explore the relationship between ethnicity and mental illness.

1. Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 6 `Race' ethnicity and health status')

2. EITHER Bradby, H. (2003) Describing ethnicity in health research. Ethnicity and Health. 8, (1): 5-13; OR: Bradbury H. (1995) Ethnicity: not a black and white issue. A research note. Sociology of Health and Illness 17 (3): 405-417.

3. Nazroo, J. (1998) Genetic, cultural and socio-economic vulnerability? Explaining ethinic inequalities in health. Sociology of Health and Illness. 20 (special issue) -- Also reproduced in: Bartley, M., Blane, D. and Smith, G. Davey (eds.) (1998) The Sociology of Health Inequalities. Oxford: Blackwell and in Bury, M. and Gabe, J. (eds.) (2004) The Sociology of Health and Illness: A Reader. London: Routledge) -- AND/OR: OR Davey-Smith, G. et al. (2000) Ethnic inequalities in health – a review of UK epidemiological evidence. Criticial Public Health. 10, 4: 375-407; Cooper, H. (2002) Investigating socio-economic explanations for gender and ethnic inequalities in health Social Science and Medicine 54: 693-706.

4. Pilgrim D. and Rogers A. (1999) A Sociology of Mental Health and Illness. Milton Keynes: OUP. (Chpt. 4 'Race and ethnicity'.).

Airhihenbuwa, C. (1995) Health and Culture: Beyond the Western Paradigm. London: Sage.

Ahmad W. (1989) Policies, pills and political will: a critique of policies to improve the health status of ethnic minorities. Lancet. (Jan 21st): 148-150. See also any of the following: Ahmad W. (1998) Ethnicity, Health and Health Care in Britain. In Petersen, A. and Waddell, C. (eds.) Health Matters . Buckingham: Open University Press; Ahmad, W. (ed.) (1993) 'Race' and Health in Contemporary Britain. Milton Keynes: OUP (Covers a broad range of issues).

(*) Andrews A. and Jewson N. (1993) Ethnicity and infant deaths: the implications of recent statistical evidence for materialist explanations. Sociology of Health and Illness 15, (2): 137-156,

53 Berthoud, R. and Nazroo, J. (1997) The mental health of ethnic minorities. New Community. 23, 3: 309- 24.

Bowler I. (1993) 'They're not the same as us': midwives' stereotypes of South Asian descent maternity patients. Sociology of Health and Illness. 15, (2): 157-178.

Donovan J. (1987) We Don't Buy Sickness, it Just Comes. Gower.

Fenton, S. (2003) Ethnicity. Cambridge: Polity Press.

(*) Health Survey for England (1999) Health of Minority Ethnic Groups. London: HMSO/Office for National Statistics.

(*) Kelleher D. and Hillier S. (eds.) (1996) Researching Cultural Differences in Health. London: Routledge.

Marmot M.G. et al. (1984) Lessons from the study of immigrant mortality. Lancet. i: 1455-1457.

Mason, D. (1995) Race and Ethnicity in Modern Britain. Oxford: Oxford University Press (Chpt. On ‘Health). See also 2nd Edition.

Mason, D. (ed.) (2003) Explaining Ethnic Differences. Bristol: Policy Press.

(*) Morgan, M. and Watkins, C. Managing hypertension: beliefs and responses to medication among cultural groups. Sociology of Health and Illness. 10: 561-78. See also Morgan, M. (1996) Perceptions and use of anti-hypertensive medication drugs among cultural groups (Chpt. 5) in Williams, S.J. and Calnan, M. (eds.) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press.

Navarro, V. (1989) Race or class or race and class. International Journal of Health Services. 19, 2: 311- 314.

(*) Nazroo, J. (2001) Ethnicity, Class and Health. London: Policy Studies Institute.

(*) Nazroo, J. (1997) The Health of Britain's Ethnic Minorities: Findings from a National Study. London: Policy Studies Institute.

(*) Office for National Statistics (2001) Focus on Ethnicity and Idenitity (http://www.statistics.gov.uk/ethnicity)

Rattansi, A. and Westwood, S. (eds) (1994) Racism, Modernity and Identity. Cambridge: Polity Press.

(*) Smaje C. (1995) Health, 'Race' and Ethnicity: Making Sense of the Evidence. London: King's Fund: See also any of the following: Smaje C. (1996) The ethnic patterning of health: new directions for theory and research. Sociology of Health and Illness. 18, (2): 139-171.; Smaje C. (1995) Researching health and ethnicity. Medical Sociology News. 20 (3): 28-30, Smaje C. (1997) Not just a social construct: theorising race and ethnicity. Sociology. 31, 2: 307-28; Smaje, C. (2000) A place for race: medical sociology and the critique of racial ideology, in Williams, S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Thorogood N. (1990) Carribean home remedies and their importance for Black women's health care in Britain. (pp: 140-152), in: Abbott P., and Payne G. (eds.) New Directions in the Sociology of Health.

54 London: Falmer Press.

Thorogood N. (1989) Afro-Caribbean women's experiences of the health service. New Community. 15, (3): 319-334.

Ethnicity and mental illness;

Cochrane R. (1983) Migration, culture and mental health. (Chpt. 5) in: Cochrane R. The Social Creation of Mental Illness. London: Longman. And: Cochrane R., and Bal S. (1987) Migration and schizophrenia: an examination of five hypotheses. Social Psychiatry. 22: 181-191.

(*) Fernando, S (1995) Mental Health in a Multi-Ethnic Society. London: Routledge.

Harrison G., et al. (1988) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine. 18: 643-657. (See also BMJ leading article referring to the paper: Psychiatric illness among British Afro-Caribbeans. British Medical Journal. 296: 950-951; and Tilby A. (1989) Race and mental illness. The Listener. 122, No 3105 (March 16th): 10-11).

Helman C. (1990) Culture, Health and Illness (2nd Edition). London: Wright (Chpt. 10 on 'Cross- cultural psychiatry').

(*) Ineichen B. (1989) Afro-Caribbeans and the incidence of schizophrenia: a review. New Community. 13, (3): 335-341.

(*) Knowles C. (1991) Afro-Caribbeans and Schizophrenia: How does psychiatry deal with issues of race, culture and ethnicity? Journal of Social Policy. 20, (2): 173-190.

King M., Coker E., Leavey G., Hoare A. and Johnson-Sabine E. (1994) Incidence of psychotic illness in London: comparison of ethnic groups. British Medical Journal 309 (29 October): 1115-1119.

(*) Littlewood R. and Lipsedge R. (1982) Aliens and Alienists: Ethnic Minorities and Psychiatry. Harmondsworth: Penguin. See also an extract (Chpt. 8) in: Davey et al. (eds.) (1995) Health and Disease: a Reader. OUP.

Littlewood R. and Lipsedge M. (1988) Psychiatric illness among British Afro-Caribbeans (Leading article) British Medical Journal. 296: 950-951.

(*) Nazroo, J. (1997) Ethnicity and Mental Health: Findings from a National Community Survey. London: Policy Studies Institute.

Rack P. (1982) Race, Culture and Mental Disorder. London: Tavistock. (Passim, esp. Chpts. 9, 10, 12, 17 and 18).

(*) Westwood, S. (1994) Racism, mental illness and the politics of identity, in A. Rattansi and S. Westood (eds.) Racism, Modernity and Identity. Cambridge: Polity Press.

NB. See also literature on `race', ethnicity and health promotion (Week 18).

55 SEMINAR 6 (week 13): Inequalities in health: from material to psychosocial pathways?

Seminar questions:

Are psychosocial factors now the primary determinant of health inequalities in advanced Western societies?

Is there a need to address the wider global dimensions and drivers of health inequalities, such as the role of neo-Liberalism?

What conceptual, theoretical and methodological problems remain for those researching inequalities in health and how can they be addressed/overcome?

Should we be moving toward more integrated forms of research on the crosscutting axes of inequality and their implications for health?

Key Readings:

Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpts. 4, 5, and 6 on class, gender and ethnicity respectively)

Any of Wilkinson’s work listed in core/essential reading for Lecture 11, particularly his new book: Wilkinson, R.G. (2005) The Impact of Inequality: How to Make Sick Societies Healthier (esp. the Chapt. On ‘Gender, race and inequality’)…OR: Elstad, J.I. (1998)…

Coburn, D. (2004) Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities. Social Science and Medicine. 58: 41-56, OR: Coburn, D. (2000) income inequality, social cohesion and the health status of popultions: the role of neo-liberalism. Social Science and Medicine 51: 135-46 PLUS the debate which follows, including Wilkinson's (2000) reply in SSM, 51: 997-1000, and Coburn's brief response in SSM 51: 1009-10.

Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/Lonon: Norton & Co. (Introduction, plus Chpts. 1, 7&8).

56 14. MEDICINE, GENDER AND THE HEALTH CARE DIVISION OF LABOUR.

The rise of the medical profession to its current position of power and dominance within the health care division of labour was not simply the outcome or triumph of scientific rationality, devoid of political struggle or ideological manoeuvrings. In this lecture we examine these issues more closely, focusing on the sociology of professions, with particular reference to the gendered division of labour in health care and salience of 'emotion work', both formal and informal, paid and unpaid.

‘The contemporary position of the medical profession is a product of professional power and dominance’. Discuss.

What light does the sociological notion of emotion work shed on the (gendered) health care division of labour?

1. Turner B.S. (1995) Medical Power and Social Knowledge (2 nd Edition). London: Sage (Chpt. 7).

2. Bendelow, G. et al. (eds.) (2002) Gender Health and Healing: The Public/Private Divide. London: Routledge (esp. Chpt. 5 by Davies). AND/OR: Davies, C. (1996) The sociology of professions and the profession of gender. Sociology 30, (4): 661-78; Witz A. (1992) Professions and Patriachy. London: Routledge. London: Routledge OR: Stacey M. (1988) The Sociology of Health and Healing. London: Routledge (Chpts. 3-6)

3. Bolton, S.C. (2001) Changing faces: nurses as emotional jugglers. Sociology of Health and Illness. 23, 1:85-100. AND/OR: James N. (1992) Care = organisation + physical labour + emotional labour. Sociology of Health and Illness. 14 (4): 488-509. OR: James N. (1989) Emotional labour: skill and work in the social regulation of feelings. Sociological Review. 37 (1): 15-42.

4. Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt. 9 ‘Caring bodies/embodied ethics).

Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 8, covers material for this lecture and next lecture the medical power under threat).

Arney W.R. (1982) Power and the Profession of Obstetrics. Chicago Ill: University of Chicago Press.

Doyal, L. (1994) Changing medicine? Gender and the politics of health care, in J. Gabe et al. (eds.) Challenging Medicine. London: Routledge.

(*) Doyal, L. (1995) What Makes Women Sick: Gender and the Political Economy of Health. London: Macmillan (Chpt. 6 `Waged work and well-being').

57 Elston, M.A. (1994) The anti-vivisectionist movement and the science of medicine, in J. Gabe et al. Challenging Medicine. London: Routledge.

Fox, N. (1991) Postmodernism, rationality and the evaluation of health care. Sociological Review. 39: 709-44. See also Fox, N. (1992) The Social Meaning of Surgery. Buckingham: Open University Press.

(*) Freidson E. (1970) Profession of Medicine. New York: Dodds Mead (Parts I and II).

Freidson E. (1970) Professional Dominance. Chicago: Aldine.

(*) Freidson, E. (1995) Professionalism Reborn. Cambridge: Polity Press.

(*) Jewson N. (1974) Medical knowledge and the patronage system in 18th century Britain. Sociology. 8: 369-385. And: Jewson N. (1976) The disappearance of the 'sick-man' from medical cosmology 1770- 1870. Sociology. 10: 225-244.

Johnson T., Larkin G. and Saks M. (eds.) (1995) Health Professions and the State in Europe. London: Routledge (esp. Chpts 1 and 3).

Macdonald, K.M. (1995) The Sociology of Professions. London: Sage.

(*) Navarro V. (1976) Social class, political power and the state and their implications in medicine. Social Science and Medicine. 10: 437-457. See also Navarro V. (1984) The mode of state intervention in the health sector. (Chpt. 37), in: Davey et al. (eds.) (1995) Health and Disease: A Reader. Buckingham: OUP; Navarro V. (1976) Medicine Under Capitalism. New York: Prodist; Navarro V. (1986) Crisis, Health and Medicine. London: Tavistock.

Parry N., and Parry J. (1976) The Rise of the Medical Profession. London: Croom Helm (Chpt. 6-8).

(*) Saks M. (1983) Removing the blinkers? A critique of recent contributions to the sociology of professions. Sociological Review. 31, (1): 1-21.

(*) Stacey, M. (1992) Regulating British Medicine: The GMC. Chichester, Sussex: John Wiley.

Starr P. (1982) The Social Transformation of American Medicine. Basic Books (esp Introduction pp: 3- 17). And/or: Starr P. (1989) The growth of medical authority. (Chpt. 29) in: Brown P. (ed.) Op cit.

Strauss, A.L. et al. (1985) The Social Organization of Medical Work. Chicago: University of Chicago Press.

Waddington I. (1973) The role of the hospital in the development of modern medicine. Sociology. 7, (2): 211-224.

Nursing, gender and the `emotional' division of labour in health care:

Allen D. (1997) The nursing-medical boundary: a negotiated order. Sociology of Health and Illness. 19, 4: 498-520.

(*) Bendelow, G., Carpenter, M,. Vautier, C. and Williams S.J. (eds). (2001) Gender, Health and Healing: Reflections Across the Public/Private Divide. London: Routledge.

58 Davies C. (ed.) (1980) Rewriting Nursing History. Lonodon: Croom Helm.

(*) Gamarnikow E. (1978) Sexual divisions of labour: the case of nursing. In: Kuhn A. and Wolpe A.M. (eds.) Feminism and Materialism. London: Routledge and Kegan Paul.

(*) Lawler J. (1991) Behind the Screens: Nursing, Somology and the Problem of the Body. Melbourne/Edinburgh: Churchill Livingstone.

Lee-Treweek, G. (1997) Women, resistance and care: an ethnographic study of nursing work. Work, Employment and Society. 11 (1): 47-63.

Mackay K. (1990) Nursing just another job, in P. Abbott and C. Wallace (eds.) The Sociology of the Caring Professions. London: Falmer Press.

May, C. (1991) Nursing work, nurses' knowledge and the subjectification of the patient. Sociology of Health and Illness. 14: 472-87.

(*) Olesen, V. and Bone, D. (1998) Emotions in rationalising organisation, in G. Bendelow and S.J. Williams (eds.) Emotions in Social Life. London: Routledge. See also: Olesen, V, (2000) (Chpt. 16) in Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Porter, S. (1995) Nursing's Relationship with Medicine. Aldershot: Averbury.

Reverby S. (1990) A caring dilemma: womanhood and nursing in historical perspecctive. (Chpt. 16) in: Conrad P., and Kern R. (eds.) Op cit.

(*) Riska E. and Wegar K. (eds.) (1993) Gender, Work and Medicine: Women and the Medical Division of Labour. London: Sage.

(*) Smith P. (1992) The Emotional Labour of Nursing. Basingstoke: Macmillan Educational Books.

Strauss A., Fagerhaugh S., Suczek B., Weiner C. (1982) Sentimental work in the technological hospital. Sociology of Health and Illness. 4: 254-278.

Svensson, R. (1996) The interplay between doctors and nurses: a negotiated order perspective. Sociology of Health and Illness 18, 3: 379-98.

Wertz R. and Wertz D. (1990) Notes on the decline of midwives and the rise of medical obsetetricians. (Chpt. 14) in: Conrad P. and Kern R. (eds.) The Sociology of Health and Illness (3 rd Edition) St Martins Press.

(*) Witz A. (1994) The challenge of nursing. In: Gabe J., Kelleher D. and Williams G.H. (eds), Challenging Medicine.

NB. Some of the readings for week 2 on biomedicine and medicalization are also revelevant here.

59 15. PROFESSIONS IN TRANSITION: MEDICAL POWER UNDER THREAT?

Whilst professional dominance has been the order of the day, a series of trends, both inside and outside the academy, suggest that things may indeed be changing. Is medical power and autonomy under threat? In this lecture we examine this very question, and trends to which it speaks, through a range of recent literature, including debates over the deprofessionalisation or proleterianisation of medicine, and the response of medicine to these and other supposed `challenges' to its hegemonic position within the health care division of labour and society more broadly. The lecture should be set, therefore, against the backdrop of the previous session on professional power and dominance, and the subsequent block of lectures on medicine and health care in the twenty-first century: ferment and change.

Critically assess the deprofessionalisation and proletarianisation theses on modern medicine. How applicable are these in theses to the British context?

1. EITHER: Annandale, E. (1998) The Sociology of Health and Medicine. Cambridge: Polity Press (Chpt. 8 `Professional power: the formal health care division of labour in transition'. See also Chpt. 7 `Health care in the 1990s and beyond' for background/context) AND/OR Elston M.A. (1991) The politics of professional power: medicine in a changing health service. In: Gabe J., Calnan M. and Bury M. (eds.) The Sociology of the Health Service. London: Routledge (pp: 58-88).

2. Haug M. (1988) A re-examination of the hypothesis of physician de-professionalization. Milbank Memorial Fund Quarterly. 66, supplement 2: 48-56. This article is in a special issue of the journal (edited by McKinlay J.) devoted to The Changing Character of the Medical Profession. See also Haug’s original article: Haug M. (1973) Deprofessionalization: an alternative hypothesis of the future. Sociological Review Monograph (No: 20) (pp: 195-211). University of Keele.

3. McKinlay J and Arches J. (1985) Towards the proletarianization of physicians. International Journal of Health Services. 15: 161-195. See also International Journal of Health Services. (1986) 16: 469-471, and; (1986) 16: 473-477.

4. Any of the the following: (i) Freidson E. (1985) The reorganization of the medical profession. Medical Care Review. 42, (1): 11-35; (ii) Freidson E. (1986) The medical profession in transition. In Aitken L. and Mechanic D. (eds.) Applications of Social Science to Clinical Medicine and Health Policy. Rutgers University Press (pp: 63-79); (iii) Freidson E. (1994) Chpt. in Hafferty F.W. and McKinlay J.B. (eds.) The Changing Character of the Medical Profession. Oxford: Oxford University Press; (iv) Freidson E. (1994) Professionalism Reborn. Cambridge: Polity Press.

5. Harrison, S., and Dowswell, G. (2002) Sociology of Health and Illness. 24, 2: 208-26.

6. Gabe J., Kelleher D. and Williams G.H. (eds.) (2005) Challenging Medicine (Second Edition). London: Routledge. (Esp. 'Understanding medical dominance', Chpts 1, 3 and 'Epilogue: the last days of doctor power').

(*) Allsop, J. (2003) Regulating the Health Professions. London: Sage.

60 Allsop, J., Jones, K and Baggott, R. (2004) Health consumer groups in the UK: a new social movement? 26, 6: 737-56.

Annandale E. (1989) Proletarianization or restratification of the medical profession? The case of obstetrics. International Health Services Journal. 19: (4): 611-634.

Armstrong D. (1976) The decline of medical hegemony. Social Science and Medicine. 10: 157-163.

(*) Calnan M. and Williams S.J. (1995) Challenges to professional autonomy in the UK. The perspective of GPs.International Journal of Health Services 25 (2): 219-241.

Weiss M. and Fitzpatrick R. (1997) Challenges to medicine: the case of prescribing. Sociology of Health and Illness. 19, 3: 297-327.

General Medical Council (1993) Tommorows Doctors. London: GMC.

(*) General Medical Council (2001) Protecting Patients: a Summary Consultative Document. London: GMC. www.gmc-uk.org/consultation/default.htm

(*) Hafferty F.W. and McKinlay J.B. (ed.) (1994) The Changing Character of the Medical Profession. Oxford: Oxford University Press (esp. Chpts 1,4,5,6 and Part III 'Discussion').

(*) Hunter D. (1992) Doctors as managers: poachers turned gamekeepers? Social Science and Medicine. 35, (4): 557-566. (NB. This article is also relevant to the lecture on the NHS reforms).

(*) Irvine, D. (1997a) The performance of doctors. I: professionalism and self regulation in a changing world. British Medical Journal. 314 1540-2. AND Irvine, D. (1997b) The performance of doctors. II: maintaining tood practice, protecting patients from poor performance British Medical Journal. 314: 1613- 5.

(*) Lupton D. (1997) Doctors on the medical profession. Sociology of Health and Illness. 19, 4: 48--97.

(*) Navarro V. (1982) Professional dominance or proletarianization? Neither! Milbank Memorial Fund Quarterly. 66, (2): 57-75.

(*) Nettleton, S., Burrows, R., O’Malley, L and I, Watt (2004) Healthy E-Types? An analysis of the everyday use of the Internet for health. Information, Communication & Society. 7, 4: 531-53.

Strong P.M. (1985) The academic encirclement of medicine. Sociology of Health and Illness. 6, (3): 339-359.

(*) West, L (ed.) (2000) Doctors on the Edge. London: Free Association Books.

Useful Website address: http://www.NetDoctorm

61 SEMINAR 7 (week 15): Professional power/dominance under threat?

Seminar questions:

Is professional power and dominance currently under threat?

What types of challenges can be identified?

How has medicine responded?

Key readings:

Core/essential readings for lecture 15, esp. readings 5 (Harrison and Dowswell, 2002) and 6 (Gabe et al., 2005), PLUS:

Calnan M. and Williams S.J. (1995) Challenges to professional autonomy in the UK. The perspective of GPs.International Journal of Health Services 25 (2): 219-241.

Lupton D. (1997) Doctors on the medical profession. Sociology of Health and Illness. 19, 4: 48--97.

GMC website: www.gmc-uk.org

62 16. READING WEEK

This week has been kept clear, in line with Departmental requirements, as a student reading week. No lectures or seminars, therefore, will take place this week. You may like to use this time to finalise/rehearse your ‘medical/health technologies of the body’ group presentations ready for next week.

63 17. MEDICAL TECHNOLOGY AND THE `UNCERTAIN' BODY: FROM CORPOREALITY TO HYPERREALITY?

The pace of (bio)technological change as we enter the new millennium is truly breathtaking, from plastic surgery and organ transplants to the possibilities of 'virtual' medicine and the implications of the new genetics. In this lecture therefore, we examine these and other cutting edge developments, through a focus on the corporeal dilemmas of high technology medicine: a situation, it is claimed, in which increasing control over the body leads, paradoxically, to a crisis of meaning as to its very nature and boundaries. With all this, as we shall see, the 'leaky' (postmodern) cyborg provides an emblematic figure and paradigmatic expression of these debates, and the (real/virtual) landscapes upon which they are fashioned.

This lecture slot, and the subsequent seminars for this week, will be devoted to student presentations of their `medical/health technologies of the body’ projects.

Is (post)modern medicine turning us all into ‘cyborgs’?

Is the new genetics a ‘backdoor’ to eugenics?

1. Williams, S.J. (2003) The Body, Health and Medicine. London: Sage (Chpt. 8 Hi-tech bodies).

2. Brown, N. and Webster, A. (2004) Innovative Medical Technologies and the Body. Cambridge: Polity Press. AND/OR: Miller, P. and Wilsdon, J. (eds.) (2006) Better Humans? The Politics of Human Enhancement and Life Extension. London: Demos (http://www.demos.co.uk/publications/betterhumanscollection)

3. Turner, B.S. (2004) The New Medical Sociology: Social Forms of Health and Illness. New York/London: Norton & Co. (Chpts. 6 & 7).

4. Conrad, P. and Gabe, J. (eds.) (1999) Introduction: Sociological perspectives on the new genetics. Sociology of Health and Illness 21, 5 (Special issue: follow up any other papers you find interesting here). NB. Also published as an edited vol. (same editors/title) by Blackwells; AND/OR: Kerr, A. and Cunningham-Burley, S. (2000) On ambivalence and risk: reflexive modernity and the new human genetics. Sociology. 34, 2: 283-304. SEE ALSO: Kerr A., Cunningham-Burley S. and Amos A. (1997) The new genetics: professionals' discursive boundaries. The Sociological Review. 279-303.

5. Nettleton, S. (2004) The emergence of E-scaped medicine? Sociology. 38, 4: 661-679.

Medical/Bio-technology:

Balsamo, A. (1992) On the cutting edge: cosmetic surgery and the technologicl production of the gendered body. Camera Obscura, 28: 207-37.

64 Balsamo, A. (1995a) Forms of technological embodiment: reading the body in contemporary culture. Body and Society (Cyberspace, Cyberbodies, Cyberpunk), 1, 3-4: 215-238.

Balsamo, A. (1995b) Technologies of the Gendered Body: Cyborg Women. Durham, NC: Duke University Press.

(*) Birke, L. (1999) Feminism and the Biological Body. Edinburgh: Edinburgh University Press.

Bryan, J. and Clare, J. (2001) Organ Farm. Pig to Human Transplants: Medical Miracle or Genetic Time Bomb. London: Carlton Books.

Calnan M. and Williams S. (1992) Images of scientific medicine. Sociology of Health and Illness. 14, (2): 233-54.

(*) Clarke, A., Mamo, L., Fishman J., Shim, J K and Fosket J.F (2003) Biomedicalization: technoscientific transformations of health, illness and US biomedicine. American Sociological Review. 68 (April): 161-94.

Davey, B., Halliday, T. and Hirst, M. (eds.) (2001) Human Biology and Health: An Evolutionary Approach.. Buckingham: Open University Press. (Chpt. 9 `Tinkering with nature').

(*) Davis, K. (1994): Reshaping the Female Body: the Dilemmas of Cosmetic Surgery. London: Routledge. See also: Davis, K. (1997) Pygmalions in plastic surgery. Health 1, 2: 227-43.

(*) Frank, A.W. (1992): Twin nightmares of the medical simulacrum: Jean Baudrillard and David Cronenberg. In W. Stearns and W. Chalouplea (eds.). Jean Baudrillard: The Disappearance of Art and Politics. London: Macmillan.

(*) Fukuyama, F. (2002) Our Posthuman Future. London: Profile Books.

(*) Gilman, S. (1999) Making the Body Beautiful: A Cultural History of Aesthetic Surgery. Princeton NJ: Princeton University Press.

McGovern K. (1994) Application of virtual reality to surgery. British Medical Journal. 308: 1054-5. And: McGovern K. and McGovern L. (1994) Virtual clinic. The future is now. Virtual Reality World. March/April: 41-44.

(*) Scheper-Hughes, N. (2001a) Bodies for sale – whole or in parts. Body & Society. 7. 2-3: 1-8. AND: Scheper-Hughes, N. (2001b) Commodity fetishism in organs trafficking. Body & Society. 7, 2-3: 31-62. NB. This is part of a special issue on the commodified body, follow up other interesting articles.

Wickham, J. (1994) Future developments. British Medical Journal 308: 193-6.

(*) Williams S.J. and Calnan M. (eds.) (1996) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press. (Esp. Chpt. 2 and sections III and IV).

New Reproductive Technologies and the New Genetics:

Arditti R., Klein R.D. and Minden S. (eds.) (1984) Test-tube Women: What Future for Motherhood?

65 London: Pandora.

Cohen C.B. (ed.) (1996) New Ways of Making Babies: the Case of Egg Donation. Bloomington and Indianapolis: Indianna University Press.

Davey, B., Gray, A. and Seale C. (eds.) (2001) Health and Disease a Reader (Third Edition).. Buckingham: Open Univeristy Press. (Includes chapters on the new genetics).

(*) Denny E. (1994) Liberation or oppression? radical feminism and in vitro fertilisation. Sociology of Health and Illness. 16 (1): 62-80. OR: Denny E. (1996) The new reproductive technologies: the views of women undergoing treatment. (Chpt. 10) in: Williams S.J. and Calnan M. (eds.) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press.

Farquhar, D. (1996) The Other Machine: Discourse and Reproductive Technologies. London: Routledge.

(*) Franklin, S. (2001) Culturing biology: stems cells for the new millenium. Health 5, 3: 535-354 (Part of a special issue on medical innovation and public knowledge edited by Margaret Lock).

Franklin, S. (1997) Embodied Progress: A Cultural Account of Assisted Conception. London: Routledge.

(*) Kerr, A. and Shakespeare, T (2002) Genetic Politics: From Eugenics to Genome.Cheltenham: Clarion Press.

Kitcher, P. (1996) The Lives to Come: The Genetic Revolution and Human Possibilities. Harmondsworth: Penguin.

(*) Le Breton, D. (2004) Genetic fundamentalism or the cult of the gene. Body & Society. 10 (4): 1-20.

McNeill M., Varcoe I. and Yearly S. (eds.) (1990) The New Reproductive Technologies. New York: St. Martin's Press.

Macer D.R.J. (1994) Perceptions of risk and benefits in in vitro fertilization, genetic engineering and biotechnology. Social Science and Medicine. 38 (1): 23-33.

(*) Petersen, A. and Bunton, R. (2002) The New Genetics and the Public’s Health. London: Routledge.

Rowland R. (1992) Living Laboratories: Women and Reproductive Technologies. London: Pan Macmillan.

(*) Stacey M. (1993) Changing Human Reproduction: Social Science Perspectives. London: Sage.

Stanworth M. (eds.) (1987) Reproductive Technologies: Gender, Motherhood and Medicine. Cambridge: Polity.

(*) Steinberg, D.L. (2000) Recombinant bodies: narrative, metaphor and the gene. In Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge. See also Steinberg, D.L. (1997) Bodies in Glass: Genetics, Eugenics, Embryo Ethics. Manchester: Manchester University Press.

66 Strickler J. (1992) The new reproductive technologies: problem or solution? Sociology of Health and Illness. 14, (1): 111-32.

(*) Throsby, K. (2002) Negotiating ‘normality’ when IVF fails. Narrative Inquiry. 12 (1): 43-65.

(*) Van Der Ploeg, I (2004) ‘Only angels can do without skin’: on reproductive technology’s hybrids and the politics of body boundaries. Body & Society. 10 (2-3): 153-81.

Zimmerman, R, Emery, J. and Richards, T. (2001) Putting genetics in perspective. British Medical Journal. 322: 1005-6. NB. Part of a special BMJ issue, follow up other interesting articles.

Cyber/digital bodies/virtual medicine/e-health:

Benedikt M. (ed.) (1991) Cyberspace: First Steps. Cambridge, MA: MIT Press (Esp. Chpt 6. by Stone A.R., Chpt. 5 by Heim M. and Chpt. 4 by Stenger N.).

Cartwright, L. (2000) Reach out and health someone: telemedicine and the globalization of health care. Health. 4, 3: 347-77.

(*) Cyberspace/Cyberbodies/Cyberpunk. Body & Society, 1, 3-4. (esp. articles by Featherstone M. and Burrows R., Tomas D., Balsamo A. and Wilson R.R. (This is also published as an edited book by Featherstone M. and Burrows R. (1996) Cyberspace, Cyberbodies, Cyberunk: Cultures of Technological Embodiment. London: Sage).

(*) Featherstone M. and Wernick A. (eds.) (1995) Images of Aging: Cultural Representations of Later Life. London: Routledge. (Part V: The body, aging and technology).

Fox, N.J. (1999) Beyond Health: Postmodernism and Embodiment. London: Free Association Books.

(*) Gray C.H. (ed.) The Cyborg Handbook. London: Routledge. (Esp. Foreward by D. Haraway, Introduction by C.H. Gray and Part 3: `Medicine'). AND/OR: Kirkup, G., Janes, L, Woodward, K and Hovenden, F. (2000) The Gendered Cyborg: A Reader. London: Routledge, OR: Bell, D. and Kennedy, B.M. (eds.) (2000) The Cybercultures Reader. London/New York: Routledge (many useful reprints).

Haraway, D. (1991) Simians, Cyborgs and Women. London: Free Association Books.

Kroker, A. and Kroker, M. (1988) Body Invaders: Sexuality and the Postmodern Condition. Basingstoke: Macmillan. See also: Kroker A., Kroker M. and Cook D. (1990) Panic USA: Hypermodernism as America's postmodernism. Social Problems. 37, (4): 443-59.

(*) Lupton D. (1994) Panic computing: the viral metaphor and computer technology. Cultural Studies. 8, 3, 556-68. See also Lupton D. and Noble G. (1997) Just a machine? Dehumanising strategies in personal computer use. Body & Society. 3, 2: 83-101.

(*) Thacker, E. (1999) Performing the technoscientific body: RealVideo surgery and the anatomy theatre. Body & Society. 5, 2-3: 317-36. NB. This is part of a special issue of Body & Society (edited by Mike Featherstone, on `Body Modification').

(*) Waldby, C. (1997) The body and the digital archive: the Visible Human Project and the

67 computerization of medicine. Health. 1, 2: 227-43. See also: Waldby, C. (2000) The Visible Human Project: Informatic Bodies and Posthuman Medicine. London: Routledge.

(Bio)ethics:

(*) Corrigan, O. (2003) Empty ethics: the problem with informed consent. Sociology of Health and Illness. 25, 3: 768-92.

Frank. A.W. (2003) The bioethics of biotechnology: alternative claims of posthuman futures, in S.J.Williams, L. Birke and G. Bendelow (eds.) Debating Biology: Sociological Reflections on Health, Medicine and Society. London: Routledge. See also: Frank, A.W. (2000) Social bioethics and the critique of autonomy. Health 4 (3): 378-94.

Fox, R.C. (2001) Medical uncertainty revisited. In G. Bendelow, et al. (eds.) Gender, Health and Healing: The Public/Privated Divide. London: Routledge.

(*) Lopez, J. (2004) How sociology can save bioethics…maybe. Sociology of Health and Illness. 26, 7: 875-96.

Morris, D. (1998) Illness and Culture in the Postmodern Age. Berkeley: University of California Press.

Shildrick, M. (1997) Leaky Bodies and Boundaries: Feminism, Postmodernism and (Bio)Ethics. London: Routledge.

(*) Williams, S.J. (2003) Medicine and the Body. London: Sage (Chpt. 9 ‘Caring bodies/embodied Ethics).

68 SEMINAR 8 (week 17): Medical technologies of the body: Student Presentations

The lecture and seminars for this week will be devoted to student presentations of their group work projects on medical technologies of the body.

69 18. THE SOCIOLOGY OF HEALTH PROMOTION AND THE `NEW' PUBLIC HEALTH (NPH): SURVEILLANCE, CONSUMPTION AND RISK IN (LATE/POST) MODERNITY.

One of the key paradigm shifts, in recent years, has been the increasing emphasis on issues of prevention, health promotion and the `new' public health vis-a-vis `curative' medicine. What role should sociology play in these developments and debates, and what issues does this raise at the level of theory, policy and practice? These are some these issues which will be discussed and debated in this lecture which should, in turn, be located in the context of previous issues covered on module such as the inequalities debate and the role of medicine.

What issues are raised by sociological critiques of health promotion and the ‘new’ public health?

Assess the sociological implications of the new genetics for public health.

1. Bunton R., Nettleton S. and Burrows R. (eds.) (1995) The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk. London: Routledge (Chpt. 4). [This book contains some other key chapters, esp. Chpts. 1, 5,6 and 16].

2. Petersen, A. and Bunton, R. (2002) The New Genetics and the Public's Health. London: Routledge.

3. Armstrong D. (1993) Public health spaces and the fabrication of identity. Sociology. 27: (3): 393-410.

4. Lupton D. (1993) Risk as moral danger: the social and political functions of risk discourse in public health. International Journal of Health Services 23 (3): 425-35. AND/OR: Lupton D. (1995) The Imperative of Health: Public Health and the Regulated Body. London: Sage.

5. Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London: DoH. (http://www.dh.gov.uk)

6. Hunter, D. (2005) Choosing or losing health? Journal of Epidemiology and Community Health. 1010- 1013.

Ashton J., and Seymour H. (1988) The New Public Health. Open University Press.

(*) Bambra, C., Fox, D. and Scott-Samuels, A. (2005) Towards a politics of health. Health Promotion International. 20, 2: 187-193.

(*) Beattie A. (1991) Knowledge and control in health promotion. (Chpt. 7) in: Gabe J., Calnan M., and Bury M. (eds.) The Sociology of the Health Service. London: Routledge.

Becker M. (1986) The tyranny of health promotion. Public Health Review 14: 15-25.

70 Bloor M. (1995) The Sociology of HIV Transmission. London: Sage.

Brown J, and Minichiello V. (1994) The condom: why more people don't put it on. Sociology of Health and Illness. 16, (2): 229-251.

Bunton R. and Macdonald G. (eds.) (1992) Health Promotion: Disciplines and Diversity. London: Routledge (esp. Chpt. 1 by Macdonald G. and Bunton R. 'Health promotion: discipline or disciplines', and; Chpt 3. by Thorogood N: 'What is the relevance of sociology for health promotion?').

Crawford R. (1977) You are dangerous to your health: the ideology and politics of victim blaming. Interantional Journal of Health Services. 7: 663-680. See also: Crawford R. (1980) Healthism and the medicalization of everyday life'. International Journal of Health Services 10: 365-388.

(*) Crawford R. (1994) The boundaries of self and the unhealthy other: reflections on health, culture and AIDS. Social Sicence and Medicine. 38 (10): 1347-66.

Crawford, R. (2000) The ritual of health promotion, in Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Featherstone M. (1991) The body in consumer culture. In: Featherstone M. Hepworth M. and Turner B.S. (eds.) The Body: Social Process and Cultural Theory. London: Sage.

Fenton, L. (2004) Preventing HIV/AIDS through poverty reduction: the only sustainable solution? Lancet (Sept. 25th): 364 (9440): 1186-7.

Glassner B. (1989) Fitness and the postmodern self. Journal of Health and Social Behaviour. 30: 180-91.

(*) Hart, G. and Chapman, S. (2000) Drugs and risk: developing a sociology of HIV risk behaviour, in Williams S.J. et al. (eds.) Health, Medicine and Society: Key Theories, Future Agendas. London: Routledge.

Gabe J. (ed.) Medicine, Health and Risk: Sociological Approaches. (Sociology of Health and Illness Monograph No. 1). Oxford: Blackwell. (esp. Chpts. 5, 6, and 8)

Hendersen, S. and Petersen, A. (eds.) (2002) Consumerism in Health Care. London: Routledge.

Holland J. et al. (1990) AIDS: from panic stations to power relations: sociological perspectives and problems. Sociology. 24: 499-518. See also: Holland J. et al. (1990) Sex, gender and power: young women's sexuality in the shadow of AIDS. Sociology of Health and Illness 12: 336-350; and the publications stemming from the Women/Men Risk and AIDS Project, Tufnell Press, many of which have Holland J. as their first author...).

(*) Lupton D., McCarthy S and Chapman S. (1995) `Panic bodies': discourses on risk and HIV antibody testing. Sociology of Health and Illness 17 (1): 89-108.

(*) McKinlay J. (1979) Epidemiological and political determinants of social policies regarding public health. Social Science and Medicine. 13A: 541-. And/or: McKinlay J. (1990) A case for refocussing upstream: the political economy of illness. (Chpt. 42), in: Conrad P., and Kern R. (eds.) The Sociology of Health and Illness: Critical Perspectives (3 rd Edition). St. Martins Press.

Nettleton S. and Burrows R. (1997) If health promotion is everybody's business what is the fate of the health promotion specialist? Sociology of Health and Illness. 19, 1: 23-47.

71 (*) Petersen A. and Bunton R. (eds.) (1997) Foucault and Health. London: Routledge (Chpts. by Gastaldo, Petersen, Nettleton, and Bunton).

Pietroni P. (1995) The greening of medicine. (Chpt. 56) in: Davey B. et al. (eds.) Health and Disease: a Reader (2nd Edition). Buckingham: OUP.

Rhodes T. and Hartnoll R. (eds.) (1996) AIDS, Drugs and Prevention. London: Routledge.

(*) Waldby, C. (1996) AIDS and the Body Politic: Biomedicine and Sexual Difference. London: Routledge.

Williams G. and Popay J. (1994) Lay knowledge and the privilege of experience. In: Gabe J., Kelleher D., and Williams G. (eds), Challenging Medicine. London: Routledge.

Williams S.J. (1995) Theorising class, health and lifestyles: can Bourdieu help us? Sociology of Health and Illness. 17 (5): 577-604. See also: Williams, S.J. (1998) Health as moral performance: ritual, transgression and taboo. Health. 2, (4): 435-57.

(*) Williams S.J. and Calnan M. (1994) Perspectives on prevention: the views of general practitioners. Sociology of Health and Illness. 16, (3): 372-93.

Recent Government Reports;

Acheson, D (1998) Independent Inquiry into Inequalities in Health. London: The Stationary Office.

Secretary of State for Health (1999) Saving Lives: Our Healthier Nation (Cm 4386). London: The Stationary Office.

(*) Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London: DoH. (http://www.dh.gov.uk)

NB. Students should keep abreast of newly emerging policy initiatives, given the fast past of change in this arena.

72 19. `COMPLEMENTARY' AND `ALTERNATIVE' THERAPIES: A CHALLENGE TO BIOMEDICAL HEGEMONY?

In this final lecture, we pick up on a theme running through much of the module to date: namely, that biomedicine is simply one, albeit dominant, approach given a plurality of healing modalities, themselves enjoying a `reversal of fortunes' in the current era. In particular, we shall look at the `eclipse' of these other healing modalities with the rise of biomedicine, and reasons for their resurgence in contemporary Western society. Who, therefore, is `challenging' who, or are these very terms of debate themselves inadequate or inappropriate, given these changing relations and the broader societal currents or trends to which they speak?

‘The contemporary growth of “alternative and complementary medicines” (CAMs), represents a failure of, and a challenge to, orthodox biomedicine’. Discuss.

1. Cant S. and Sharma U. (2000) Alternative health practices and systems, in Albrecht, G. et al. (eds.) The Handbook of Social Studies in Health and Medicine. London: Sage. SEE ALSO ANY OF THE FOLLOWING: (i) Sharma U. (1995) Complementary therapies: a challenge to orthodox medicine? (Chpt. 11) in: Williams S.J. and Calnan M. (eds.) Modern Medicine: Lay Perspectives and Experiences. London: UCL Press: (ii) Sharma, U. (2002) Integrated medicine: an examination of GP-complementary practitioner collaboration, in Bendelow, G., Carpenter, M., Vautier, C. and Williams, S. (eds.) Gender, Health and Healing: the Public/Private Divide. London: Routledge.

2. ANY/ALL OF THE FOLLOWING: (i) Nissim, M., Shuval, J. and Sky, G. (2005) Boundary at work: alternative medicine in biomedical settings. Sociology of Health and Illness. 27, 1: 20-43; (ii) Welsh, S, Kelner, M., Wellman, B. and Boon, H. (2004) Moving forward? Complementary and alternative practitioners seeking self-regulation. Sociology of Health and Illness. 26, 2: 216-241; (iii) Goldner, M. (2004) The dynamic interplay between Western medicine and the complementary and alternative medicine movements: how activists perceive a range of responses from physicians and hospitals. Sociology of Health and Illness. 26, 6: 710-36.

3. Gabe, J., Kelleher, D. and Williams, G.H. (eds.) (2005) Challenging Medicine. London: Routledge. (Chpt. by Mike Saks).

4. Armstrong D. (1986) The problem of the whole-person in holistic medicine. Holistic Medicine 1: 27- 36. Also reprinted as Chpt. 7 in: Davey B. et al. (eds.) (1995) Health and Disease: a Reader (2nd Edition). Buckingham: OUP.

5. Bakx K. (1991) The `eclipse' of folk medicine in western society. Sociology of Health and Illness. 13: 20-38.

(*) Aakster C.W. (1986) Concepts in alternative medicine. Social Science and Medicine 22 (2): 265- 273.

73 Berliner H.S. and Salmon J.W. (1980) The holistic alternative to scientific medicine: history and analysis. International Journal of Health Services. 10, (1): 133-147.

British Medical Association Board of Science and Education (1986) Alternative Therapies. London: BMA.

(*) British Medical Association (1993) Complementary Medicine: New Approaches to Good Practice. Oxford: Oxford University Press.

(*) Cant S.L. and Calnan M. (1991) On the margins of the medical marketplace? An exploratory study of alternative practitioners' perceptions. Sociology of Health and Illness. 13: 39-57.

(*) Cant, S. and Sharma, U. (1998) A New Medical Pluralism? Alternative Medicine, Doctors, Patients and the State. London: UCL Press.

(*) Coward R. (1989) The Whole Truth: The Myth of Alternative Health. London: Faber and Faber.

Fulder S.J. and Munroe R.E. (1985) Complementary medicine in the United Kingdom: patients, practitioners and consultations. Lancet. 11: 542-546.

(*) House of Lords (2000) Complementary and Alternative Medicine. London: Sationary Office.

Pietroni P. (1995) The greening of medicine. (Chpt. 56) in: Davey B. et al. (eds.) Health and Disease: a Reader (2nd Edition). Buckingham: OUP.

(*) Rees L. and Weil, A. (2001) Integrated medicine: imbues orthodox medicine with the values of complementary medicine.. British Medical Journal. 322 (20 January): 119-20. NB. This is part of a special issue of the BMJ on integrated medicine: follow up other interesting articles.

(*) Saks M. (1994) The alternatives to medicine. In: Gabe J., Kelleher D. and Williams G.H. (eds), Challenging Medicine. London: Routledge. See also any of the following: Saks M. (1995) The changing response of the medical profession to alternative medicine in Britain: a case of altruism or self-interest? (Chpt. 7) in: Johnson T., Larkin G. and Saks M. (eds.) Health Professions and the State in Europe. London: Routledge; Saks M. (1995) Professions and the Public Interest: Medical Power, Altruism and Alternative Medicine. London: Routledge (esp. Part II: `An empirical application: the response of the medical profession acupuncture in Britain').

Sharma (1990) Using alternative therapies: marginal medicine and central concerns. In: Abbott P. and Payne G. (eds.) New Directions in the Sociology of Health. Falmer Press (pp: 127-152) (An extract of this is reprinted as Chpt. 6) in Davey et al (eds.) (1995) Health and Disease: a Reader (2nd Edition). OUP).

(*) Sharma U. (1991) Complementary Medicine Today. London: Routledge. See also: Sharma U. (1994) The equation of responsibility: complementary practitioners and their patients' (Chpt. 4) in: Budd S. and Sharma U. (eds.) The Healing Bond: The Patient-Practitioner Relationship and Therapeutic Responsibility. London: Routledge.

Stacey M. (1988) The Sociology of Health and Healing. London: Routledge (Chpt. 11).

(*) Taylor R. (1984) Alternative medicine and the medical encounter in Britain and the United States. In: Salmon J.W. (ed.) Alternative Medicines: Popular and Policy Perspectives. London: Tavistock (pp: 191-228).

74 Thomas K., Carr J., Westlake L. and Williams B. (1991) Use of non-orthodox and conventional health care in Great Britain. British Medical Journal. 302: 207-210.

Wardell W.I. (1994) Alternative medicine in the United States. Social Science and Medicine 38, (8): 1061-68.

Yates P.M. et al. (1993) Patients with terminal cancer who use alternative therapies: their beliefs and practices. Sociology of Health and Illness. 15, (2): 199-216.

75 SEMINAR 9 (week 19): The future of biomedicine: a ‘new’ medical pluralism?

Seminar questions:

Why are CAMs becoming so popular?

Is a ‘new’ medical pluralism emerging?

What does this tell us about the future of biomedicine?

Key readings:

Core/essential readings for lecture 19, especially those listed in 2 above.

76 20. CONCLUSIONS AND MODULE EVALUATION.

This session will offer some brief conclusions concerning the importance of sociology to contemporary issues surrounding health, illness, medicine and the body, together with some speculations regarding possible lines of future development in the sociology of health and illness. There are no specific readings for this session.

Revision sessions for those taking the exam will be held at the beginning of Term 3. Details will be given in class and posted on the requisite notice boards.

S.J. Williams. June 2006.

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