Health and Illness in Market Society

Master 2020/2021

Category 'Best Course for Broadening Horizons and Diversity of Knowledge and Skills'

Category 'Best Course for New Knowledge and Skills'

Type: Elective course (Applied Social Psychology)

Area of studies: Psychology

Delivered by: School of Psychology

Where: Faculty of Social Sciences

When: 2 year, 1, 2 module

Mode of studies: offline

Instructors: Elena Berdysheva

Master’s programme: Applied Social Psychology

Language: English

ECTS credits: 4

Contact hours: 48

Full Syllabus

Abstract

The course seeks to critically evaluate the role of medicine and psychiatry in controlling greater forms of human experiences in contemporary Western society dominated by consumer markets. Health and illness as well as life and death are in the center of all human experience. From sociological point of view, they are not just biological events of intimate and private life. Social distinctions between health and illness refer to the cultural conceptions of normal and pathological. Cultural connotations of diseases often hide politics of behavioral risk factors, communicate interests of resourceful social groups, being used as devices of social control and power struggles. In contemporary society the social processes around health and illness get complicated due to marketization. Market economy has produced market society with control, money efficiency, self-maximization and individual happiness as key cultural values. Having replaced religion and church, medical professionals have obtained new authority over individuals. However, professional logic of medicine today competes with the state logic and the managerial logic of markets. Social definitions of human problems and ways to solve them get formulated at the crossroads of public health needs and profitability. Organizing principles of contemporary medicine serve not only to heal but to accumulate capital. Sociological concepts given in the course highlight alternatives to medicalized and marketized ways of thinking about health, illness, body, pain and suffering, risk behavior, care, and death.

Learning Objectives

By the end of the course students are expected to 1. Use sociological concepts to explain social issues related to health and illness as political, social and cultural, not simply biological personal events 2. Recognize the historical, economic and cultural embeddedness of medical power in society, identify current social and political processes that produce and support medical authority, notice their seeking-for-power nature, understand their dynamics 3. Critically analyze current social attitudes to different diseases and health-related behavioral patterns in different social groups. 4. Identify peculiarities of medical markets and explain changes in doctor-patients that have taken place with development of consumerism and markets in healthcare. 5. Explain the connections between economic and political settings of contemporary Western society with the design of healthcare and death care infrastructure.

Expected Learning Outcomes

Give original empirical examples to illustrate the distinction between illness as an experience of dysfunction and disease as a social experience configurable by cultural ideas about what a dysfunction is about, what are its causes, what behavior has led to it, and what to do now
Critically examine the modes of biomedicine as a device of social control used to reduce social deviance and to support dominated social order
Critically evaluate the role of medicine and psychiatry in controlling greater forms of human experiences
Identify cultural and economic reasons due to which medical profession has obtained its social and political authority
Clarify a tension between two ideal types of the medical profession: as a source of medical knowledge, ethics and care and as an expert with the monopoly over certain goods/services
Demonstrate the implications of the concept of sick role for sociological reflection on mental and physical disfunctions
Prompt various modes of medical colonization of the human body
Describe projects of social eugenics through the medicine in contemporary Western societies
Demonstrate a critical understanding of sociological approaches on suffering
Prompts current ability of social science to see the burden of social world, experienced by individuals
Make distinctions between cultural interpretations of suffering in different historical periods and explain social, political and economic reasoning of their dynamic
Relying on sociological concepts clarify the social nature of pain and cultural patterns of pain experience
Relate the issues of healthy lifestyle with sociological implications on social agency and structure
Basing on sociological concepts explain why does biomedicine possess a unique degree of status and power in contemporary society?
Identify key socio-economic peculiarities of medical markets as socially entangled institutions for distribution of vital services
Explain paradoxes of consumer choice, pricing, doctor-patient trust and complience on medical markets
Describe the competition between state, professional and managerial institutional logics in healthcare on empirical examples
Critically asses power configurations and conflicts of interests behind the hype over drugs in contemporary pharmaceuticalised culture
Explain the rise of social demand for psychological help as a consequence of emotional capitalism
Explain why death can never be understood merely as a biological event, without its cultural, medical, legal, and political dimensions
Identify economic peculiarities of funeral markets and related social restrictions
Describe the connection between socio-economic dynamics in contemporary society and the evolution of death criteria in culture, societies, communities

Course Contents

Health, Well-Being, Illness and Disease in Market Society. Between Norm and Pathology for Social Order.
Market Economy and Market Society. Purity and Danger in Risk Society. Negative Definitions of Health. Shifting Conceptions of Public Health. Health Beliefs and Multiculturalism. Professional and Popular Ideas of Sickness. Illness as Moral Occasion. Between Badness and Sickness. Stigmatization of Sickness. Healthism Culture - a Hope or a Hype?
Medicalization as a Cultural Process
Market Society: What money can’t buy? Individualization Transformation of Social Problems into Treatable Disorders. Pathologization of Life. Medical Definitions of Normality and Social Control. Medicalization of Mental and Emotional State. The Rise of Surveillance Medicine. Hospitals as Spaces of Discipline. Lines of demedicalization
Professions of Medicine
Boys in White. Ethic, Autonomy and Expert Knowledge. The Social Work of Diagnosis. Medical Community and Clinical Bureaucracy. Expert Power in Doctor-Patient Relationships and in Society.
Sick Role in the Remission Society
Sick Role in Classical Sociology, Paternalistic Biomedicine, Consumer Culture and Remission Society. The Self in Chronic Illness. Stigmas of Disability. Illness as a Source of Personal Growth. Trust and Compliance in Doctor-Patient Relationships. Empowerment of Patients. The Patient as a Partner.
Commodification of Body
Human Body in Sociological Theories. A Body-We-Have. A Body-We-Are. A Body-We-Do. Social Meanings of Body Parts. Physical and Bodily Capital as a Factor of Social Inequality and Discrimination. Constructing Ideal Bodies: Beauty, Cosmetic Surgery, and Eating Disorders. How Do Body Parts Become Commodities? Human Organ Transplantation, Commercial Surrogacy, Purchasing Intimacy.
Pain and Suffering
The Politics of Life Itself. Money Value of Human Life: Approaches to Estimation. The Weight of Social World: Suffering classical sociology (Marx on alienation, Durkheim on anomie, Weber on theodicy). Contemporary perspectives on suffering (Bourdieu, Alexander, Bauman, Baudrillard). Quality of Human Life as Social and Political Variable. Suffering as a Social Act. Social Aspects of Pain Experience.
Power in Medicine, Healthcare and Beyond
Challenges of Biomedicine and Competition of Medical Paradigms. Institutional Logics in Healthcare Field: State, Professional, Managerial, Sustainable. Midwifery and Medicalization of Childbirth.
Domains of Care
Patients Agency and Healthy Lifestyle. Life Chances and Life Choices in Different Social Groups. Imagined Futures and Individual Investments into Health. New Medicine: predictive, participatory, personalized. TeleMedicine and TeleHealth. Walmart Medicine and Retail Clinics. Surveillance Capitalism and On-line Medical Platforms.
Death in Society
Social and Political Dimensions of Death. Historical Evolution of Attitudes to Death. “Good Death” and Illusions of Immortality. Cultural Multiplicity of Death Criteria. Awareness of Dying. The Moralization of Economic Scarcity and the Rise of Palliative Care. Morality in the Funeral Markets. Obsequies as the Rituals of Transition. Burial vs Incineration: Economic Predictors of Cultural Choice. Funeral Agencies as Market Actors. Advertisement Ban and High Prices without Bargain. Palliative Care as a Challenge for Biomedicine.
The Pill for Every Ill: Pharmaceuticalization as Culture and Social Process
Pharma in the Bedroom and the Kitchen. Medical Management of Human Body, Mind and Social Efficiency. Markets of Life-Style Drugs. ‘Fact Making’ in Clinical Trials and Post-approval Drug Assessments. Pricing Innovative Drugs.
Psychological Help for Neo-Liberal Self
Capitalization of Self (Physical, Bodily, Erotic, Human, Cultural, Social, Administrative, Consumer, Emotional and Economic Capitals). Individual Self as a Managerial Project. Psychological Trainings for Personal Branding. Experience Economy Social Embeddedness of Emotions. Feeling Rules. Emotional Labor. Emotional Capitalism. Emotional Stratification. Emodities (Emotional Commodities). Manufacturing Depression. Saving Modern Soul: Psychological Therapy and the Culture of Self-Help.
Medical Markets
Uncertainty and the Welfare Economics of Medical Care. Contradictions in the Commodification of hospital care. The Quality Uncertainty, Information Assymetry and Prices. Trust and Complience in Doctor-Patient Relathionships. Mediated Medical Markets: State and Insurance Companies as Payers for Medical Care. Consumption in Healthcare and Divergent Rationalities. To be the Patient not a Consumer. Consumer as a Market Product in Experienced Society.

Assessment Elements

Analytical Essay
In an auto-ethnographic analytical essay, the students should give a theoretically grounded reflection on the results of self-observation. The educational meaning of writing the essay is to give the students an opportunity to demonstrate their skills of analytical work with empirical facts by applying these facts to interpretation of social theories studied in class. The quality of essay controls student’s knowledge of contemporary concepts of sociology of health and medicine, ability to use them for explanation of empirical facts of social life, understanding of complex nature of self care as socially embedded activity; also the essay validates students’ skills of analytical, interpretative work with theoretical sociological texts and qualitative empirical sociological data. The focus of self-observation relates to the sociological analysis of student’s healthcare decisions. Requirements for the text of the essay: 1) The text should be well-structured and consist of the following parts: Introduction with the statement of research problem; Theoretical framework description based on the following academic texts : Charmaz, K., & Belgrave, L. L. (2019). Thinking About Data With Grounded Theory. Qualitative Inquiry, 25(8), 743–753. https://doi.org/10.1177/1077800418809455; Cockerham, W. C. (2005). Health Lifestyle Theory and the Convergence of Agency and Structure. Journal of Health and Social Behavior, 46(1), 51–67. https://doi.org/10.1177/002214650504600105; 32. Williams, G.H. (2003) The determinants of health: structure, context and agency, Sociology of Health & Illness, 25, 3, 131–54; 23. Brown R. C.H. (2013) Moral Responsibility for (un)Healthy Behavior. Journal of Medical Ethics, (39): 695–6. Methodological part, that describes the aspect of self-care behaviour chosen for analysis; Analytical part with the sociological essence and conclusion on the self-care practices experienced; Conclusion, summarizing the analytical work done. 3) In terms of interpreting the observation results, the text should be based on academic literature and make a direct reference to it. 4) The text should be written using Times New Roman font, 12 pt, 1.5 spacing, and justified alignment; the recommended volume is up to 3000 characters without spaces.
Class participation
It is expected that for each class students will prepare responsive memos on the required readings. These memos should not summarize and retell the text but should bring reflection and insights on the problems raised in the text, connecting conceptual contents of the text with own experience of the student.
Mid-term Test
Final Exam

Interim Assessment

Interim assessment (2 module)
0.25 * Analytical Essay + 0.25 * Class participation + 0.25 * Final Exam + 0.25 * Mid-term Test

Bibliography

Recommended Core Bibliography

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Barney G. Glaser, P. H., PhD, & Anselm L. Strauss. (2015). Awareness of Dying Preface.
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Recommended Additional Bibliography

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Course Syllabus