Proposal and Perspective
Sigerist claimed that medicine was basically not only a social science but also an occupation – whose practice was inextricably woven into society, thus pointing out their interdependence. This interdependence can be seen in one branch of medicine that has built in socialemphasis – that of public health and, preventive medicine.
Freidson (in The Profession of Medicine) stressed the point that the jurisdiction of the medical profession over ‘illness’ labels can be categorised in a number of ways. One category of some importance to preventive medicine is the “expansion of what in life is deemed relevant to the good practice of medicine”. Furthermore, this implies that medicines commitment to specific aetiological models of disease has changed to one of multi-causal orientation. The greater acceptance of concepts of comprehensive medicine has therefore expanded that knowledge relevant to the prevention of disease. In prevention the expression ‘extension into life’ implies the very idea that primary prevention means getting there before disease starts. It is at this point that forms of social intervention and control emerge for the purpose of disease control
Freidson has developed the perspective (The Profession of Medicine) that the sociology of medicine has the purpose to analyse illness as a form of social deviance, as well as the scientific study of behaviour surrounding illness. In this respect therefore Zola’s view (Medicine as an institution of social control) could be incorporated into the research framework. More specifically as a topic entitled preventive medicine as a form of social intervention and control with reference to….”
For example, areas amenable to study by such a framework could include maternity services, peri-natal medicine, ischaemic heart disease and primary care, non-accidental injury (baby battering syndrome), and cancer, as well as aspects of health education. Using the continuous process of literature reference and review (as outlined by Conway and McKelvey in ‘The Role of the Relevant Literature: A Continuous Process, Journal of Educational Research, 63, (9), it would be possible to expand study of peri-natal medicine to include related topics (amniocentesis, clinical abortion, genetic counselling, and attitudes to screening etc).
A sociological perspective of preventive medicine as a form of social control would necessarily involve the determination of professional outlooks (attitudes, role conceptions, ethical considerations) as well as determine the attitudes, expectations, beliefs of patients and prospective patients. The embryonic model outlined above requires further development and clarification. To this purpose I am in the process of reading the following books in order to construct a firmer proposal, especially in respect of preventive medicine.
References and Sources Consulted
Medical Sociology: A Selective View. (D. Mechanic).
H.Sigerist on the Sociology of Medicine. (ed M. Roemer).
Politics, Medicine and Social Science. D. Mechanic).
Sociology and Medicine. (Susser & Watson).
Patients, Practitioners and Medical Care (D. Robinson).
The Process of Becoming Ill. (D.Robinson).
Social Science and Social Pathology (B. Wootton).
Originally accepted , after interview, by the University of Aston (for 1975), with offer of accommodation, plus cooperation of local peri-natal and post-natal services, but not pursued because PhD research studentship not available after financial cut-backs..
Eric Edwards Collected Works 