This entry is focused on social, economic, and cultural aspects of (physical and mental) health, diseases and illnesses, and medicine. Bryan Turner, in Medical Power and Social Knowledge (1995), shows how all societies have developed specific roles related to diseases. These roles prescribe specific patterns of behavior in cases of illness, but these roles and patterns differ significantly between different societies. In Western societies, there are individualized patient roles; for example, one stays in hospitals only when it is really necessary, one stays as short as possible, and the possibilities of visits are very limited. In Japan, on the other hand, disease-related roles are more community-oriented. Patients in Japan stay longer in hospitals, and visits from family and friends are more frequent and longer.

Anselm Strauss contributed to the development of medical sociology by studying: psychiatric institutions; value systems that emerge in medical institutions; attitudes of medical staff and other people towards terminally ill patients in hospitals, as well as towards chronically ill people who are treated at home; the relationship between the physical body of the individual and his personal identity. In the book Awareness of Dying (1965), Strauss and Barney Glaser introduced the concept of „awareness context“, which pertains to awareness of dying patients, who are in hospital care, of their impending deaths.  Glaser and Strauss distinguished four types of awareness contexts: closed awareness, suspicion awareness, mutual pretense awareness, and open awareness. Closed awareness context relates to patients who are unaware of their health status, while the staff of the hospital know patients' prospects. In the suspicion awareness context, the patient suspects that the staff thinks that they are about to die, but the staff doesn’t reveal that to the patient. Mutual pretense awareness context exists in situations when both patients and staff know that the patients are dying but are pretending otherwise. Open awareness context pertains to situations when both staff and patients know and acknowledge that the patient is dying.

                        Critique of the Medical Industry

In the book The American Health Empire (1970), Barbara Ehrenreich introduces the term "medical-industrial complex". This complex represents an industry worth hundreds of billions of dollars and consists of doctors, hospitals, nursing homes, insurance companies, pharmaceutical companies, companies that produce equipment for hospitals, the construction industry, health insurance systems, and banks. The essence of the medical-industrial complex is to make a profit, while research and education are secondary goals. Ehrenreich later turned her attention to the history of women in medicine and found that in the nineteenth and early twentieth centuries, women were systematically excluded from the medical profession. This was achieved by banning women from enrollment in medical schools, as well as formal bans on unlicensed persons to practice medicine. Medical teachings have also been used as a justification for subordinating the role of women.

In the book Medical Nemesis (1975), Ivan Illich argues that the medical profession poisons patients with harmful drugs, butchers them during bad operations, and makes patients increasingly dependent on doctors. Doctors claim the exclusive right to treat diseases, but they treat individuals and do not change external factors - diet, working conditions (fatigue and stress), quality of housing, and hygiene - which have the greatest impact on the development of the disease. He believes that the medical profession is beginning to affect more and more people's lives. 

For his book Asylums (1961), Goffman did an empirical study on life within a mental hospital and how the interactional order develops within it. Mental hospitals are part of „total institutions“. Total institutions are those in which a person spends all their time, such as prisons, monasteries, boarding schools, etc. Goffman divided the so-called "moral career" of the patient into three phases: before, during, and after the hospital stay. The period before going to the hospital was marked by a "betrayal funnel" by people close to the patient who reported his behavior. After entering the institution, the patient experiences a "civil death" because he loses most of his human and civil liberties. In addition, patients experience "mortification of self" through the standardization of clothing, as well as many other inconveniences. Patients who do not cooperate with the hospital staff are punished, and those who cooperate, which is perceived as a sign of improving mental health, receive certain benefits. Patients are constantly forced to choose between a reduced sense of self, if they follow all the instructions, or, otherwise, to create strategies to restore self-autonomy; however, such strategies carry with them the risk of causing punishment or being interpreted as a worsening of the mental state. Goffman came to the controversial conclusion that psychiatrists lack real knowledge about mental illness and that they instead apply common-sense criteria when interpreting patient behavior.

In The Birth of the Clinic (1973, in French 1963), Michel Foucault documents how the French Revolution and the ideas of rationality and enlightenment transformed medicine into a precise and empirical science. After the Revolution, the body was anatomically mapped, and diseases were classified. All these changes have affected our understanding of health, disease, life, and death. Foucault believes that the structure of medical knowledge continues to be regulated in a similar, arbitrary way.

References:

Allen. The Expirience of Unemployment (1986);

Ehrenreich. The American Health Empire (1971);

     -     Witches, Midwives, and Nurses: A History of Women Healers (1972);

Eisenstein. Manmade Breast Cancers (2001);

Foucault. Madness and Civilization: A History of Insanity in the Age of Reason (1988, in French 1961);

     -     The Birth of the Clinic: An Archaeology of Medical Perception (1973, in French 1963);

Fromm. The Sane Society (1955);

     -     The Art of Loving (1956);

Goffman. Asylums (1961);

Illich. Medical Nemesis: The Expropriation of Health (1975);

Lorde. The Cancer Journals (1980);

McIntosh. "The Homosexual Role", in Social Problems (1968);  

Oakley. The Captured Womb: A History of the Medical Care of Pregnant Women (1984);

Skocpol. Boomerang: Clinton’s Health Security Effort and the Turn Against Government in U.S. Politics (1996);

Strauss. Psychiatric Ideologies and Institutions (1964);

     -     Awareness of Dying (1965);

     -     Unending Work and Care: Managing Chronic Illness at Home (1988);

Thomas W. The Relation of the Medicine-man to the Origin of the Professional Occupations (1903);

Titmus. The Cost of the National Health Insurance (1956);

Turner B. Medical Power and Social Knowledge (1995);

     -     The New Medical Sociology (2004);

Walby. Medicine and Nursing: Professions in a Changing Health Service (1994);

Wilensky. The Welfare State and Equality: Structural and Ideological Roots of Public Expenditures (1975);

Zerubavel. Patterns of Time in Hospital Life (1979).