Medical Power and Knowledge

1. Medical Power and Knowledge Chapter 3

2. Main points • The medical profession exerts a great deal of power in society, though current social policy developments seek to limit clinical autonomy. • Some medical decisions can create and lead to illness (iatrogenesis). • Public health measures can lead to surveillance and control of people’s lives beyond their health.

3. Power A subject of much debate within sociology. In the context of this discussion, however, the concept refers to • the ability to ensure that a particular point of view prevails in a disputed situation; • the capacity to ensure that someone acts in a certain way; and • the ability to stifle opposition to a particular perspective.

4. Iatrogenesis • literally means harm caused by doctors. In its most literal sense it refers to the harmful consequences of medical intervention. • Illich also uses the concept to draw our attention to our cultural dependence on medicine and medical practitioners, such that we do not seek alternative explanations or alternative remedies for ill health.

5. Surveillance • A form of scrutiny and observation but one that does not necessarily depend directly on the physical proximity of the watcher and the watched. • Instead, subtle forms of surveillance are said to characterise modern society, as typified by the tendency of individuals to act in ways that they think they ‘ought’ to.

6. The sick role (Parsons 1951) • The patient is excused normal roles. • The patient is not responsible for their illness. • The patient must want to get well. • The patient must co-operate with the doctor.

7. Example of contesting medical power A contemporary example of the tendency of the population to contest the power of the medical profession is the current resistance to the MMR triple vaccine. Despite reassurances by the medical profession that the triple vaccine is safe, large sections of the general public remain sceptical.