Module 3 Notes
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Date Created: 08/04/16
Illness and Identity Monday, March 21, 2016 11:03 AM 1. How do people experience illness? How do those experiences vary based on our position in US society and global economy? 2. How are new technologies shifting ideas about health and illness, life and death, and the boundaries of the body? 3. How does illness shape our identities? How can we better understand emerging identities? Medicalization suffix- standardized ending to word, "-Ization" denotes an authority and rules expanding medical authority over new domain, process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness or disorder things previously considered every day life now governed by medicine examples: male aging, adult ADHD, HGH for shorter individuals demedicalization: homosexuality, used to be included in DSM as an illness -what's being medicalized? -menstruation, aging and wrinkles, sleep, drug addiction, depression, child birth, obesity, menopause, stress, death Article Distinction between emergencies and complications, Emergencies lead to C sections, more surgeries Epidurals to stop pain, intervention that leads to further interventions (c sections) Professions: midwives lead to lower rates of c sections, expertise Medical malpractice- have been lead to believe that death is rare and not normal, fear of getting sued is leading to greater medicalization and more interventions, if doctor shows they did everything they could=better defense in court Choices of delivering women deferred to medical authority, whose expertise and knowledge matters more, authority and hierarchy at play Suggests that society accept that birth is a natural part of life, remove routine birth from medical authority Social factor that drives c section rates Concept of medicalization is often used to critique the expansion of medical authority Therapeutic care as a form of social control (???) Making what was previously normal into a pathology Labeling many more people as "sick" that may have no symptoms, genetic disorder that hasn’t shown yet? Driven by profit motives or availability of new technology Devaluing of knowledge, people's own experience Positive Effects of Medicalization Parity- mental illnesses not recognized by health insurance Obesity- leads to other diseases, incorporated into prevention strategies, reduces stigma (moral failing, social) May increase access to treatment May validate people's real experiences of suffering Pharmaceuticalization Wednesday, March 23, 2016 11:01 AM Dumit- grammatical analysis of Pharmaceutical marketing 5 steps in marketing Pharmaceuticals 1. Awareness through Education a. Raise awareness of disease itself b. Lower reading level for ads, applicable to more people, limited vocabulary c. Ad needs to promote action, person must pursue medication for company to make profit 2. Personalization of risk 3. Motivation to self-diagnose a. Makes viewers comfortable to self-diagnose, symptoms are common, questions asked are general and hard to answer "no" to 4. Seeing and convincing a doctor a. Restate symptoms from commercial, patient reproduces vocabulary from commercial b. Doctor doesn't ask further questions 5. Branded compliance Personalization of risk- form relationship with facts and accept that there are risks, ads make it seem like even people with no symptoms are at risk, story telling helps to push mindset that even normality can be at risk, testing never hurts, invoke fear that issues are asymptomatic and tests are needed, medication may not even be relevant to person but they still continue to think about risk, successful ad causes person to believe they are already sick and are ignorant to condition and have moral obligation to seek treatment Sick Role Monday, March 28, 2016 11:24 AM Sick people have different rights right to medical care exemption from roles child-like dependency people who are sick are presumed innocent and not faking it Obligated to isolate themselves Where concept comes from Introduced by Talcott Parsons Mid 20th century US, advanced industrial capitalism Looked for way to explain how illness allows someone to retreat from being a productive member of society Have economy in which large number of people are paid hourly and do not have paid sick days o Cannot avoid getting others sick if sick person comes to work o Parents Limits to Sick Role Concept Many illnesses are chronic, stigmatized illness(patient blamed), or unrecognized, chronic health(perpetually occupy a sick role) Stigma and the Experience of Illness Wednesday, March 30, 2016 11:01 AM The concept of stigma Negative attitudes toward people who have 1. Visible illnesses- deformities, burns, obesity 2. Illnesses associated with behaviors a. Lung cancer b. Liver disease c. HIV/AIDS d. Diabetes 3. Illnesses related ethnic/group identity a. HIV in Haiti What causes stigma? People are uncomfortable with difference, "I can't bear to look" Fear that diseases are or might be communicable Inaccurate information about actual modes of transmission Fear of being seen with person with stigmatized condition Moral judgments on sick person's character, based on inferences about behavior Living with HIV: Stigma Strong stigma because of ignorance Patient's own shame Values and beliefs that people have had for years Stigma always negatively affects person Fear-based prevention messages creates stigma Condom use: some religions don't allow for contraceptives Stima harms people living with HIV, and hinders prevention of other diseases Stigma has spiraling set of affects Consequences of Stigma People become isolated People may delay diagnosis and treatment People experience depression Internalized stigma: shame and guilt Murphy Article "I cannot remember ever before thinking about physical disability, except as something that happened to other, less fortunate people. It certainly had no relevance to me." "one of 'them'" as if sick or impaired people are separate then those who appear normal Marked vs unmarked How van we reduce stigma? Educate those who don't know Interact more with those with disabilities Expand access to treatment and care Support groups to reduce isolations Practice humility and kindness Biological Citizenship Wednesday, April 13, 2016 11:01 AM As a project of belonging or identity information o Biological, physical, material Biosociality- Halverson o Social relationships and identities grounded in the genetic and biological realm o Ex. Patient met other patient online, felt closer to patient across the globe than to own family Information disclosure, having a right to know about genetic factors in our bodies o Health insurance and access o Potential for new markets and new products o Genetic information becomes easily disclosed after test Parenting and genetic testing o Important to know genes before hand o Autosomal recessive disorders- both parents are carriers leads to 25% chance of having affected child Destigmatizing diseases by means of not medicalizing o Advocate groups for stopping prenatal screening of disabled children, leads to elective abortions o Neuro-diversity People with autism and related conditions are not abnormal, humans are neurodiverse Angelina Jolie- Previvor o Had double mastectomy and hysterectomy Against Health Wednesday, April 27, 2016 11:00 AM Why on earth would anyone be against health? -religion, culture causes conflict of interest -stigmas related to health, smoking is bad for your health or smoking makes you a bad person -health is neglected, person is too busy -health status and self worth -health is well-being, rather than being defined in biological terms (too reductionist) Case- Pg. 3 Consequences for understanding Using kids to make adults feel guilty, smoking in a car with a child is like the child smoking themselves, "Moralism," smoking is morally wrong about children, children used as "health" in this situation, points fingers and accuses smokers of being negligent and irresponsible parents, goes back to notion of "smoking makes you a bad person," makes smoking characteristic of whole person, creates form a judgment, means we don't understand parents as complex individuals
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