Chapter 1 Textbook Notes
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HLTB03 Midterm Notes: Health, Illness, and Health Care in Canada
Chapter 1: Sociology, Medicine, Health, and Illness: An Overview
Evolution and the Dominant Paradigm of Scientific Medicine
¾ The germ theory of disease, which gained prominence in the late 19th century, had a profound impact on the practice
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therapies has its roots in the germ theory of disease developed by Pasteur and Koch.
¾ While the germ theory helped to develop the prevention of infectious diseases and improved medical practice, the
paradigm of specific etiology and specific therapies gave rise to the thought that people can be made healthy by
medical technologies and technological fixes.
¾ dZ]]Pu]ooÇ}^uZv]]u}o_}(ZZµman body.
functioning of the human machine. This approach basically ignores social causes of much ill health.
¾ This mechanistic conception brought about a shift from the consideration of illness as a breakdown of the total
system to the notion that ill health could be caused by the malfunctioning of one particular part of the body
machinery t in other words, localized pathology. This idea lead, to the medical fragmentation of the delivery of health
¾ It is argued that the major decline in mortality and morbidity was due to better nutrition and sanitation and other
environmental improvements, and that the decline in mortality and morbidity patterns, rather than following
significant diagnostic and therapeutic discoveries, in fact preceded them.
¾ The ascendancy of scientific laboratory-based medicine and the dominant position of allopathic medicine in North
America at the beginning of this century were aided by the publication of the Flexner Report.
¾ The costs of delivering premedical education, as well as the necessity for expensive laboratory facilities, led to high
tuition fees in medical schools, making medical education all but inaccessible to working-class students. In addition to
the changes in the class composition of the medical profession, these changes also led to reduced competition and
higher incomes for the doctors.
¾ The Flexner Report, supported by the medical profession and by philanthropic foundations, helped to consolidate the
dominance of the allopathic practitioners and to establish laboratory-based scientific medicine as the norm for
medical education and practice.
Health and Illness
¾ The Dorland Medical Dictionary (]vZoZ^v}uo}v]]}v}(}Çvu]vU]XXUÁ]ZooZ
(µv]}v]vPv}uooÇ_Vv]](]v^(]v]u}]}ZÀ]vPZ]] strain of symptoms
t it may affect the whole body or any of its parts, and its etiology, pathology, and prognosis may be known or
¾ If workers are hard to replace or reproduction costs are high, employers are greatly concerned about the health of
the workers and are interested in prolonging their productive life span.
¾ Conversely, if workers are easily replaceable, employers are less concerned about their health. Workers are kept
healthy so long as the cost of health care is less than the cost of replacing them.
Reduction in Medicine
latter the solution lies primarily in the changing individual behaviours and patterns of consumption.
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