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Chapter 1

Chapter 1 and Chapters 12-22 Book Notes


Department
Health Studies
Course Code
HLTA02H3
Professor
Anna Walsh
Chapter
1

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Part 1: The Canadian Health Care System and the Health Status of Canadians
-Sociological studies of health, illness, and health care cover a wide range of issues, such
as the structure and organization of the health care sector, medical institutions,
inequalities in health status, and social, political, and economic determinants of the nature
and composition of the health care delivery system
-The perspectives have profound influence on these areas, such as definition and etiology
of health and illness, funding, organization and delivery of health services, research
directions, and health policies and reforms
-Bolaria examines the evolution and prevalence of the dominant paradigms in medicine
and their implications with regard to etiology as well as treatment of health and illness
-Bolaria notes that the mechanistic-individualistic clinical approach remains the dominant
paradigm in medicine which attributes disease to the “malfunctioning” of the human
body and the treatment focuses on surgical or chemical interventions to restore normal
functioning
-Individuals receive treatment outside of and abstracted from theirnormal social and
material contexts
-Similar reductionist approachblames illness on individual lifestyles, behaviour, and
consumption patterns
-Both approaches, bolaria notes, obscure the social nature of disease; that is, human health
and illness are embedded in social, economic, political, and cultural contexts and these
factors produce social variability in the health and illness status of individuals
-Goal of health policy and health reforms is to improve the health status of the population
Chapter 1: Sociology, Medicine, Health, and Illness: An Overview
Introduction
-Medical sociology covers a wide range of substantive areas and encompasses a diversity
of issues pertaining to health and illness, medical institutions, the structure and
organization of the health care sector, and the political, economic, and social
determinants of the nature and composition of the health care delivery systems
Evolution and the Dominant Paradigm of Scientific Medicine
-Knowledge of modern scientific medicine is founded on the work of Koch, Pasteur, and
other bacteriologists
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-The germ theory of disease, which gained prominence in the late 19th century, had a
profound impact on the practice of medicine
oCurrent medical paradigm of the “specific etiology” of diseases and specific
therapies has its roots in the germ theory of disease developed by Pasteur and
Koch
oHelped to develop the prevention of infectious diseases and improved medical
practice, the paradigm of specific etiology and specific therapies gave rise to the
essentially curative orientation of medicine and medical practice; that is, that ppl
can b made healthy by medical technologies and technological fixes
this paradigm adopted a “mechanistic model of the human body
-illness cud b caused by the malfunctioning of one particular part of the body machinery—
in other words, localized pathology
-specialization in medical knowledge and practice tends to focus on specific parts of the
body machine, such as the nervous system, the cardiovascular system, the gastro-
intestinal system, and so forth
-work of bacteriologists and other scientists undeniably had a positive impact on the
control of infectious diseases and led to improvements in medical practice
-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
patters, rather than following significant diagnostic and therapeutic discoveries, in fact
preceded them
-the form n nature of medicine is determined by class n power relations in the society n
not by scientific imperatives
-allopathic medicine:
-Flexner Report was critical of the medical schools that did not have the facilities to teach
laboratory-based scientific medicine
-in Canada, the rise n social legitimacy of scientific medicine was also bolstered by the
Flexner report
-The Flexner Report, supported by the medical profession and by philanthropic
foundations, helped to consolidate the dominance of the allopathic practitioners and to
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establish laboratory-based scientific medicine as the norm for medical education and
practice
-This mechanistic-individualistic conception is currently pervasive in medical practice and
research
-Rodberg and Stevenson pointed out:Modern medicine operates according to an
individualistic, scientific, machine model. Humans receive medical treatment outside of,
and abstracted from, their normal social and environmental context.”
Health and Illness
-Dorland Medical Dictionary defines health asa normal condition of body and mind, i.e.,
with all the parts functioning normally.”
oDisease is defined asa definite morbid process having a characteristic strain of
symptoms- it may affect the whole body or any of its parts, and its etiology,
pathology, and prognosis may be known or unknown”
-In functional terms, health meansthe state of optimum capacity of an individual for the
effective performance of the roles and tasks for which he has been socialized
Reductionism in Medicine
-Lifestyle also one of the foci of another health policy,achieving Health for All: A
Framework for Health Promotion”
-Mechanistic-individualistic conception of disease, which attributes disease to a
malfunctioning” of the human body, absolves the economic and political environment
from responsibility for disease
-New reductionism introduces the idea that the causes of disease lie in individual
lifestyles and behaviours
Social Production of Illness
-Health and illness cannot be understood by referring only to biological phenomena and
medical knowledge
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