Parsons and the sick role

I am currently studying disability in uni and I thought I might post a bit about it this semester in case anyone was interested.

This week, I started off my course by reading “Social Structure and Dynamic Process: the Case of Modern Medical Practice,” which is a chapter in a book Talcott Parsons wrote in the 1950's that talks about functionalism (a sociological theory). It is an important theory in the sociology of health, but it has serious flaws when it comes to chronic illness and disability.

Parsons' sick role theory has four parts. The first part of the sick role is an exemption from certain societal normative expectations. For example, when you can call in sick to work with the flu. Second is the belief that the sick person cannot just will themselves to get better – they must be healed, and this often requires being taken care of. So you can't just wish you were better, you must go to the doctor (according to the theory). These two points are dependent on the third part of the role, which is that being ill is undesirable and the patient must wish to get better. The final part of the role is an “obligation” to go to a doctor and “cooperate” with him in order to get better(p. 437).

Parsons’ model for the sick role is based upon the idea that, ultimately, the person will heal, which is a fundamental problem when you apply it to people who will not heal. However, I think there is also a societal expectation that people will be primarily healthy and, if sick, will heal quickly.(Wouldn't that be nice....) So I supposed the theory does align with reality in that regard, it's just a problematic reality.

Because the foundation of the theory does not stand up when applied to chronically ill people, the sick role theory is not accurate in describing the lives of chronically ill people. We are often no longer exempt “from normal social role responsibilities”(p. 436), even if we need to be. For example, when I need to miss a class with a migraine but a professor gets angry because I have missed so many. There is also often anger if the person does not seem to be actively trying to get well (i.e. fulfilling the last two parts of the role), even if the health problem is chronic and getting well is just not a possibility.

Another thing that interested me was the role of the doctor. Parsons wrote that the job of a doctor is “attempting to restore [patients] to health or normality”(p. 429). But what is the role of a doctor if it is impossible to make the patient "healthy"? I think this is something the medical field and society are still struggling with.