Complete samenvatting verplichte literatuur Sociology of Health and Ilness
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Course
Sociology of Health and ilness
Institution
Universiteit Gent (UGent)
This is a summary of all mandatory texts for the course Sociology of health and illness for the English Master in Sociology at Ghent University. These texts must be thoroughly known before the oral exam. Here you will find the mandatory texts summarized for all 9 modules. The majority is handwritte...
o Stigma is defined as a convergence of interrelated components: labeling,
stereotyping, separation, status loss, and discrimination, all occurring within a power
dynamic.
o Goffman: stigma is relationship between attribute and stereotype
According to Link and Phelan, the key components that define stigma are:
1. Labeling: Because human differences are socially selected for salience → In this paper we
use label instead of attribute or condition → label is more open
2. Stereotyping: Dominant cultural beliefs link labeled individuals to undesirable
characteristics, leading to negative stereotypes about them.
3. Separation: Labeled individuals are placed into distinct categories, which facilitates a
separation between "us" (the non-stigmatized) and "them" (the stigmatized).
4. Status Loss: Individuals who are labeled experience a loss of status, which results in unequal
outcomes in various aspects of life.
5. Discrimination: The culmination of the previous components leads to discrimination, where
labeled individuals face unfair treatment and exclusion.
6. Power Dynamics: Stigmatization is contingent upon access to social, economic, and political
power, which allows for the identification of differences, the construction of stereotypes, and
the execution of discriminatory practices.
Powerful groups can discriminate stigmatized ppl subtly or by force.
2 challenges of researching stigma → scientists often don’t belong to stigmatized groups + very
individualistic focus
1. Consequences of Stigma:
a. Stigma leads to status loss, resulting in negative outcomes for stigmatized
individuals, such as impacts on social relationships and longevity.
2. Stigma as a Persistent Predicament:
a. 3 forms of discrimination (individual, structural, and through the beliefs of
stigmatized individuals) contribute to the ongoing nature of stigma.
3. Need for Multifaceted and Multilevel Approaches:
a. Fundamental changes in the attitudes and beliefs of powerful groups are necessary
to combat stigma effectively, or alternatively, the power dynamics that allow such
beliefs to dominate must be altered.
4. Understanding Stigma's Impact on Life Chances:
a. Stigma processes significantly influence the distribution of life chances across various
domains, including careers, earnings, and health.
5. Misinterpretation of Stigma's Effects:
, a. A comprehensive exploration of stigma must consider its broad effects on multiple
life chances rather than focusing on isolated instances.
6. Challenges of Targeted Interventions:
a. The focus on singular behaviors can result in temporary successes that diminish over
time due to the underlying mechanisms of stigma remaining intact.
7. Persistence of Discrimination Mechanisms:
a. There are numerous ways to discriminate, and if one mechanism is blocked, others
can easily replace it, contributing to the persistence of stigma.
, Clark
The article discusses the evolution of palliative care, emphasizing its expansion beyond terminal care
to include earlier stages of disease and a broader range of conditions beyond cancer. It highlights the
tension between modern medical practices and the holistic ideals of palliative care, which aims to
address not just physical symptoms but also psychosocial and spiritual concerns.
Key Concepts
• Palliative Care: A specialized area of healthcare focused on providing relief from the
symptoms and stress of serious illness, aiming to improve quality of life for patients and
their families.
• Medicalisation of Dying: The increasing tendency to treat dying as a medical problem to be
solved, often leading to an emphasis on physical symptoms over holistic care.
• Quality of Life vs. Good Death: The shift in focus from achieving a "good death" to managing
quality of life, which may overlook the broader existential aspects of dying.
The integration of palliative care into mainstream medicine is essential for addressing suffering, but
this risks compromising the original ideals of the specialty.
Shift from anecdotal (learning from peers, without scientific methods being applied, thus patients
could experience a wide variance in quality of care) practices to evidence-based approaches
(interventions and treatments are now increasingly guided by scientific studies, clinical trials; this
shift aims to improve patient outcomes by ensuring that care is based on the best available evidence
rather than solely on tradition or anecdote).
There is concern that the focus on symptom management may lead to a reduction in attention to
the psychosocial and spiritual dimensions of care.
The societal expectation to resist and delay death perpetuates futile treatments, raising ethical and
economic concerns.
Key Findings
• There is a growing recognition of the need for palliative care across various diseases, not just
cancer.
• It highlights the tension between the medicalization of dying and the holistic approach that
palliative care advocates. (physical symptoms vs whole person care; aggressive interventions
vs comfort and dignity; patient autonomy vs medical authority; focus on specific disease vs
understanding complexities of suffereing and emotional/spiritual needs; evidence based
medicine 1 size fits all vs. individualised care which considers beliefs and preferences).
• Evidence suggests that while palliative care has made significant strides in symptom
management, it may inadvertently contribute to a more clinical and less compassionate
approach to dying. (focus on protocals and standardised methods, in contrast to
personalised care; training may pritorise technical skill over relational abilities; impact upon
cultural towards dying, seeing it as somehting indicating a failure, rather than a natural
process to be accepted).
While the integration of palliative care into broader medical practice is necessary to alleviate
suffering, it is essential to remain vigilant against the risks of medicalisation that could undermine
, the core values of compassion and holistic care. The future of palliative care should strive to honor
its foundational ideals while adapting to the complexities of modern healthcare.
The emergence of palliative care has significantly influenced the perception of death in modern
medicine:
1. Shift from Medicalization to Acceptance: Palliative care has encouraged a more humane
approach to dying, promoting the acceptance of death as a natural part of life rather than
something to be aggressively fought against. This contrasts with the traditional medical view
that often sought to postpone or resist death at all costs, leading to a more compassionate
understanding of the dying process .
2. Focus on Quality of Life: Palliative care emphasizes improving the quality of life for patients
facing terminal illnesses. This shift has led to a broader recognition that managing symptoms
and providing emotional and spiritual support are as important as extending life. The focus
on quality of life has changed how healthcare providers and society view the end of life,
moving away from solely curative measures to a more holistic approach .
3. Recognition of Dignity and Meaning: The principles of palliative care advocate for dignity
and meaning in the dying process. This has fostered a cultural shift towards acknowledging
the importance of personal preferences, family involvement, and the resolution of personal
conflicts before death. Such recognition has made the process of dying more personal and
individualized, rather than a purely clinical event , .
4. Integration into Mainstream Medicine: As palliative care has become more integrated into
mainstream medical practice, it has brought attention to the needs of dying patients within
acute care settings. This integration has led to a greater awareness among healthcare
professionals about the complexities of dying and the importance of addressing both
physical and psychosocial aspects of care , .
5. Challenging the Dualism of Body and Mind: Palliative care has challenged the traditional
body-mind dualism prevalent in medical practice by recognizing the interdependency of
physical and emotional suffering. This holistic view has influenced how healthcare providers
approach end-of-life care, encouraging them to consider the whole person rather than just
their medical condition , .
The concept of "total pain," as introduced by Cicely Saunders, the founder of the modern hospice
movement, refers to a comprehensive understanding of the suffering experienced by patients at the
end of life. It encompasses not just physical pain but also emotional, psychological, social, and
spiritual dimensions of suffering. It highlights the interconnectedness of these dimensions—
addressing only one aspect may leave others unresolved, perpetuating overall suffering.
Illich
The five distinct stages of the evolving image of death mentioned are:
1. The fifteenth-century "dance of the dead."
2. The Renaissance dance at the bidding of the skeleton man, known as the "Dance of Death."
3. The bedroom scene of the aging lecher under the Ancien Régime.
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