The ‘sick role’ revisited Understanding and misunderstanding Parsons’ contribution

Talcott Parsons 1902-1979 Topics: social action / social system Fields: economics, politics, culture, health system Publications: Structure of social action (1938) Social system (1951) Toward a general theory of action (1951) Social structure and personality (1964) Harvard professor: 1939-1972 ESHHS - August 2006

ESHHS - August 2006

Health, illness and the social system Achievement: health and motivation Illness as incapacity  sick role as deviance  passive withdrawal as a psychosomatic issue Social system doctor and patiënt as a collectivity checks and balances unconscious psychotherapy ESHHS - August 2006

The sick role Exemption from duties Unwilful deviance Intention to get well Seek professional help Temporary regression Fears and irrational beliefs ESHHS - August 2006

The doctor’s role Welfare-oriented Maintain professional standards Right to enter privacy Exclusiveness of care Regulation motivational balances Secondary gain and countertransference ESHHS - August 2006

Critical reception Parsons: Idealizes medical practice and profession Overemphasizes normalization Underestimates conflict Parsons: a ‘reactionary functionalist’? ESHHS - August 2006

Parsons revisited The limits of medical technology The role of the social and behavioural sciences Evidence versus experience based interventions The optimistic bias The rise and decline of medical power The medicalization of almost everything, yet: Withering of trust in the consulting room Decline of professional autonomy The power of theory ESHHS - August 2006