The ‘sick role’ revisited

1. The ‘sick role’ revisited Understanding and misunderstanding Parsons’ contribution

2. Talcott Parsons 1902-1979 • Topics: social action / social system • Fields: economics, politics, culture, health system • Publications: • Structure of social action (1938) • Social system (1951) • Toward a general theory of action (1951) • Social structure and personality (1964) • Harvard professor: 1939-1972 ESHHS - August 2006

3. ESHHS - August 2006

4. Health, illness and the social system • Achievement: health and motivation • Illness • as incapacity  sick role • as deviance  passive withdrawal • as a psychosomatic issue • Social system • doctor and patiënt as a collectivity • checks and balances • unconscious psychotherapy ESHHS - August 2006

5. The sick role • Exemption from duties • Unwilful deviance • Intention to get well • Seek professional help • Temporary regression • Fears and irrational beliefs ESHHS - August 2006

6. The doctor’s role • Welfare-oriented • Maintain professional standards • Right to enter privacy • Exclusiveness of care • Regulation motivational balances • Secondary gain and countertransference ESHHS - August 2006

7. Critical reception Parsons: • Idealizes medical practice and profession • Overemphasizes normalization • Underestimates conflict Parsons: a ‘reactionary functionalist’? ESHHS - August 2006

8. Parsons revisited • The limits of medical technology • The role of the social and behavioural sciences • Evidence versus experience based interventions • The optimistic bias • The rise and decline of medical power • The medicalization of almost everything, yet: • Withering of trust in the consulting room • Decline of professional autonomy • The power of theory ESHHS - August 2006