Sociological Theories of Disability and Chronic Illness - Essay Example

Conflicts between Sociological Theories of Disability and Chronic Illness Roll No: Teacher: 9th April 2009 Conflicts between Sociological Theories of Disability and Chronic Illness Introduction Disability and chronic illness can be regarded as stigmatizing, as, there are many issues associated with such deprivations such as, prejudice, fear, and misconstruction, at one end, and degrading and patronizing empathy at the other end due to which, people with these problems frequently acknowledge their disability and chronicle illness in their everyday social existence. In most societies, any disability or illness is negatively perceived, and non-curable chronic illnesses are specifically considered problematic. Parsons (1975) fittingly sums up emphasizing that the society declares the favourability of mastery to the dilemmas of health. Parsons maintains that the notion of health is specifically significant in any society because of the value system of the societies, which underline self-autonomy and individual accomplishment, and the advanced level of demarcation in its social structure. Parsons (1975) proposes that disability and illness is dysfunctional to the social system for the reason that it hampers individuals and debilitates their successful fulfilment of social roles. He claims that society perceives disability and illness as forms of deviance that have to be regulated since they create difficulties for the individual and for the larger society. In UK, people suffering from chronic illnesses and disabilities also face problems like in other societies. The social system of the society is somehow in disadvantage because of disabled and chronically diseased people (Gouldner 1973). Parsons (1975) argues that individuals who are disabled or ill are permitted to have particular immunities and opportunities denied to other forms of social deviance. Disability studies have a political obligation to materialist social model standpoints that identify the centrality of disability as oppression, created through social structures and systems (Abberley, 1987).  Whereas medical sociology favours interpretive viewpoints that facilitate a focus on micro-social interactions.  It remains entrenched in and is largely dedicated to a notion of disability as social deviance (Bury 1997, Williams 2001). Yet simultaneously, these individuals get hold of particular responsibilities, indicating that the individual who takes in the ‘sick role’ has to address four traditional expectations and responsibilities: the sick individual is excused from normal social role obligations; the sick individual is not held accountable for the disability or illness and cannot become healthy merely by an act of determination; the condition of being ill is detrimental and assumes a task to recover and get well; and the sick individual is compelled to look for professional competent assistance and to cooperate with that assistance to reach a swift recovery (p. 260). From the perspective of Parsons (1975), sickness is a momentary deviant role an individual fulfils to cope up with a specific difficulty while attempting to recover or return to a healthy, normal functioning condition. Hence, the sick role in principle, and almost utterly, matches severe illness and short-term disabilities caused by accidents. Society’s members endure such temporary deviance because it is reasonable, can be experienced by anyone, and, eventually, is advantageous for the group, yet should be legitimated and regulated (Moos 1976). This essay will provide an overview of the primary themes of sociology of disability and chronic illness. Until the initiation of the disability rights movement, disability was largely believed to be as an issue of individual medical diagnosis (Oliver 1996). Individuals with disability were believed to be in dire need of fixing; those who are impossible to fix became object of humiliation and pity (Gordon 1966). The growing influence of the disability rights movement programs has altered the recognition of the notion of disability from the individual or medical to the social; it established disability as a social construct (Finkelstein 1980). Basically, the physical or mental disability, of sight, hearing, cognitive ability, and others is genuine, but the connotation that society bestows upon the disability is resilient, transforms over time and from society to society (Oliver 1996). Therefore, throughout the essay, I will examine the conflict between the long-established perceptions of disabled individuals, such as that of Parson’s, as medically impaired with the surfacing perspective of what has turned out to be recognized as ‘disability theory’ (Williams 2001, 124). This perspective has asserted that individuals with acknowledged or identified disabilities are immobilized by society’s barefaced failure to address their needs and demands. We will not take for granted the importance of any definite disability in people’s lives. The Conflict between the Medical and Social Paradigms The medical paradigm regards disability a predicament of the individual that is directly brought about by a disease, impairment, or other health conditions and demands medical care or treatment and rehabilitation (Baumeister 1982). The medical framework points the predicament to the individual, who is enduring a condition that is undesirable and that situates him/ her in the ‘sick role’ (Parsons 1975). As elaborated by Pfeiffer (2001), if an individual has a long-term disability or illness, which leads to using moving equipment such as a wheelchair to transfer to one place to another, that individual will never recover. This paradigm is firmly normative; individuals are believed to be disabled because of their inability to act or think as an average or normal individual does. Rehabilitation has a significant contribution in bringing back the individual or if not close to the normal societal expectations (Boss 1979). The primary concern of the medical paradigm at the political arena is to offer medical care as well as treatment and rehabilitation services. This paradigm has been disapproved on various bases, comprising its normative force (Elwan 1999). The medical paradigm is frequently called the traditional model and stands in opposition to the social paradigm of disability. The latter has a minimum of nine descriptions, which are enumerated and summed up in Pfeiffer (2001): the social paradigm of the United Kingdom; the exploited and oppressed minority framework; the social constructionist rendition of the American society; the impairment account; the self-sufficient living account; the postmodern description; the continuum description; the human differences account; and the discrimination description (p. 35). Generally, the social paradigm perceives disability as a social construct. It stipulates that disability is not the feature of the person; instead, it is fashioned by the social context and demands social change. Disability advocates in the Union of the Physically Impaired Against Segregation (UPIAS) designed the social paradigm of the United Kingdom, at the core of which rests societal domination (Yeo & Moore 2003). The main description of the UK social paradigm originates from the UPIAS paper Fundamental Principles of Disability, an abridged translation of which is reproduced by Oliver (1996); according to edited version of the paper, it is society, which impairs physically disabled individuals. Disability is something above people’s impairments by the manner they are needlessly secluded and omitted from full involvement in society. As emphasized by Pfeiffer (2001), the UK social paradigm is somewhat Marxist in its perspective of disability, a perspective not often located in the American society. The second account of the social paradigm, which of the exploited and oppressed minority argues that individual with disabilities confront prejudice and discrimination through behavioural, sensory, cognitive, physical as well as economic hindrances, and their experiences are thus believed to be identical to those of an exploited and oppressed minority class (Pfeiffer 2001); Hahn (2002), along with others in the American society, promotes this perspective. According to him, social inequalities experienced by individuals with disabilities are regarded as identical to those experienced by other oppressed minorities such as unusually high incidences of poverty, high rates of unemployment and social service dependency; educational discrimination; poor housing and substandard transportation; and segregation from several public facilities. Exploring the general picture of disability paradigms is not as uncomplicated as demonstrating a dichotomy between a medical paradigm and a social framework. There are other paradigms that have been formulated, as continuations of the medical or the social paradigm or as combination of the two (Williams 2001). The social paradigm is a suggested description of disability that is related to human weakness. Melted down to basics, the paradigm transforms causal accountability for weakness from physically and mentally disabled people to their social, aesthetic and economic context (Fox 1980). Not automatically moral obligation, even though that could follow, but causal accountability. Either way, the paradigm is influential and dominant within its discipline. This is particularly true when traditional knowledge accounts a disabled existence to individual misfortune, or curse, or transgression, or some other quite personalized facts (Haber 1971). The social paradigm readdresses interests to the environment surrounding of a disabled person (Albrecht 2001). Disability analysts differentiate the social paradigm to a medical paradigm of disability (Qizilbash 1997). This model emphasizes the weakening effect of physical or mental disabilities rather than that of the context in which they function. The disabilities themselves are believed to be disabling. If any help were suitable, hence, it would most probably be the providing of individualized services such as wheelchairs, personal care givers, medicines and others (Albrecht 2001). Explanations of the medical paradigm frequently involve a subordination issue as well (Antonovsky 1979). Enthused by Talcott Parson’s concept of the ‘sick role’ in the society, opponents of the medical paradigm relate it with the demeaning standards that alleviate disabled individuals of social responsibilities yet require them to conform with the expert medical diagnosis. Both obligation and freedom are in so doing lessened. It is hard to locate intellectuals who advocate any such paradigm of disability (Dreitzel 1970). Parsons was fascinated in defining social equilibrium, and practitioners of disability studies claim that the medical paradigm is a mistake. It is their perspective of the manner long-established health and social service systems understand, or rather misunderstand, disability. Hence, the medical paradigm could depict inherent principles in need of examination, rather than a conflicting academic position (Amundson 2000). Disability in Contemporary British Society The 1986 Collins Concise English Dictionary denotes disability as the health condition of being incapable of carrying out tasks or activities due to a physical or mental impairment (Klavus 1999). This puts emphasis on the incapability of the individual. On the contrary, the 1995 Disability Discrimination Act denotes disability an individual that has a physical or mental impairment, which has a considerable, or enduring detrimental affects on his/her capability to normally perform everyday tasks and activities. These denotations underline the external domination of society rather than an element not present in the individual. These two cases hold very distinct prominences on what qualifies a person as disabled and undoubtedly emphasizes the various interpretations of disability in contemporary British society (Barton 2001). The Union of Physically Impaired Against Segregation (UPIAS) formed a revolutionary substitute to the medical paradigm through arguing that there was a fundamental difference between ‘disability’ and ‘impairment’, which were at the time believed to be the same. The UPIAS description of impairment is “lacking part of or all of a limb, or having a defective limb, organ or mechanism of the body” (Giddens 2006, 281). This description was basically recognized as a biomedical attribute of individuals. Disability as defined by UPIAS as “the disadvantage of restriction of activity caused by a contemporary social organization which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities” (Giddens 2006, 281). This can as well be associated to the manner the 1995 Disability Discrimination Act describes disability in supplementary, the manner society coerces disability rather than the person. Taking into account, UPIAS the social paradigm of disability was formulated. The social paradigm gave emphasis on the reason there are historical, cultural and social hindrances against disabled individuals (Barton 2001). Paul Hunt, the pioneering member of the UPIAS claimed that the predicament of disability rests not merely in the impairment of function and its consequences or impacts on the individual, but as well, more significantly, in the dimension of their relationship with average or normal individuals (Giddens 2006). Medical sociologists disapproving the social paradigm dispute that individuals cannot at all times be involve completely in society because of impairments comprising pain and intellectual incapability and a transformation in a society cannot change this (Braden 1990). Perhaps this is where proponents of medical sociology do not consider the difference between ‘disability’ and ‘impairment’ (Giddens 2006, 281). The opening of the twentieth century propelled the emergence of the traditional perception and response to disability. Such involvement believed in the enduring character of impairment, which depended greatly on the seclusion, and discrimination of disabled individuals from the normal society (Haveman and Wolfe 1989). The triumph of traditional discrimination began to be questioned by the medical discipline and the recent policy intervention to the predicament of disabled individuals in contemporary British society is the transition from traditional care to community care (Alkire 2002). The primary principle of the National Health and Community Care Act 1990 is on guiding and helping individuals to live securely in the community and demands fulfilment of particular duties on Local Authorities to both evaluate and offer people with an array of social services needed to address their needs (Hughes, et. al 1995). Fascinatingly, this transition in the structure and the condition of interventions towards individuals with mental health disorders has as well resulted in an alteration in language from ‘retarded’ or to having ‘special needs’ or ‘sub-normal’ or ‘learning disabilities’. This notion of learning disability, of ‘sub-normal’ individuals as being trainable and educable is a perspective that is inherent in the 1980 Education Act (Barton 2001, 72). Nevertheless, this shifting notion of the advancement of assimilating individuals with ‘special needs’ into the mainstream society and furnishing them with the useful and social abilities required to be self-sufficient is not without disparagement. This paradigm is disapproved as being all ears on individual difference which implies that rather than welfare services assimilated, they continue to be distinct which consequently results in to undesirable distinctions such as ‘special needs’ being referred to disabled individuals (Giddens 2006, 284). The previous decade has witnessed a greater knowledge and understanding of housing and the disabled individuals (Fujiura 2000). Care in the community has glimpsed an increase in disabled individuals transferring from institutions to the mainstream society (Halambos 2004). It has become obvious that most of present housing is poorly furnished for their needs. Several local housing divisions are aspiring to reform this and understand the manner equipment and adjustments make a great deal of dissimilarity and facilitate disabled individuals to live self-sufficiently. Programs such as Lifetime homes plan to make everybody’s home more available and affordable, and if or when necessary can be adjusted appropriately (Joseph Rowntree Foundation 2008). The 1995 Disability Discrimination Act was ratified and was formulated to give disabled individuals particular legal protection from inequity in sectors such as employment. Additional legislation was opened up in 1999 to operate towards the abolition of discrimination against disabled individuals. Still, individuals with impairments associated to disability fit in to one of the most disadvantaged people in the UK. More than 8 million people living in the UK are classified as disabled, among them 6 million are of employment age. Barely about 3 million of this working age group have jobs and the individuals in employment have a tendency to earn lower income compared to non-disabled employees (Giddens 2006, 287). The expenditure of the UK government is lofty for disability related expenditure, for instance, incapability and disability assistances, possibly to compensate the lack of employed disabled people. However, this further segregates the disabled from the physically able individuals of mainstream, society, as they can at present be seen as a burden and trouble to society and reliant on the welfare state (Barton 2001). Conclusion The above cases on the discussions of disability have shown evident transitions in the ownership of the predicaments of disabled individuals. However, what is apparent is, even though there has been a clear-cut shift in thinking how the predicament of disability must be addressed, from traditional seclusion and dependence to the welfare state or community care; the medical paradigm of disability, which emphasizes weakness, helplessness, and dependence continues to enlighten majority of recent policy legislation on disability. This social policy of the United Kingdom has resulted in the disablement of social care services that give out interventions to cater to the needs and rehabilitation of individuals rather than shared demands has obvious implications for the lives of disabled individuals in contemporary British society. 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