Sick Role

Definition


Sickness represents an individual's experience when he/she deviates from the ‘well’ population. This state of sickness “evokes a set of patterned expectations which define the norms and behavior appropriate to his new status, both for the individual himself and for persons who interact with him”[1] The sick role is a socially recognized set of expectations and obligations for individuals with a socially recognized disease or illness . Patterns of expectations create the sick role. Conceptualizing sick roles demands awareness that the expectations, obligations,and experience of a person in this role varies cross-culturally; likewise recognition of and response to a sick role is dependent upon the shared understandings within any given culture.

History
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Sick roles are culturally constructed.


Sociologist Talcott Parsons (1902–1979) argued that the sick role defined by four socio-structural features.
  • The state of illness is not regarded as the sick person’s fault.
  • Those in the sick role are not directly responsible for their condition.
  • The sick individual is exempt from daily obligations and expectations of ‘well’ individuals.
  • The sick role is understood to be a temporary state, the individual should therefore cooperate with understood healers and/or practices in order to become healthy again.

Anthropological Example


A person who takes on a sick role may be exempt from occupational work, household tasks, or other obligations of ‘well’ individuals. Days may be taken off from work or school, chores may be taken care of by another family member, and special care might be afforded the person understood to be sick. In order to be exempt from these everyday obligations, the sick individual must prove the legitimacy of their disease or illness. An example of this legitimization in Western nations might be employers granting sick days only when presented with documentation from a doctor or other medical professional.

A more in-depth analysis of the sick role in another culture is examined by Basil Sansom. Sansom (1982) offers insight into the sick role recognized and enacted by Aboriginal Australians in "The Sick Who Do Not Speak". Sansom's research illustrates how personal agency, community obligation, and indebtedness are directly linked to a person's acceptance of his or her sick role and the ensuing negotiations of the care-giver who also plays an important part in the sick role. "To experience a sickness...is, of course, to go through a passage."[2] The negotiation between the sick person and care-giver as chronicled by Sansom is evidenced by the authority to speak. Among this Aboriginal community, the individual in the sick role forfeits his or her right to speak; it is the caregiver who becomes the proprietor of the history of that illness, both during the illness and after recovery. "The souvenirs of illness are necessary manifestations. They are held in consciousness not only as reminders of signal service rendered, but also as manifestations to provoke the telling of stories that have past sickness as their theme and the registration of long-lived obligations at their end."[3]


Another example from ethnographic research about the sick role is given by T. S. Harvey. Harvey suggests that in the west, "patients are 'singled out' for individualized (patient-centered) care [...] in keeping with a biomedical conception of the patient as a role inhabited by an individual" [4]


He describes an experience in Guatemalan cross-cultural biomedical interactions where both nonindigenous Guatemalans and Western health-care providers regularly offered Mayan women the opportunity to "do what they wanted with their bodies" and that "reproductive decisions were theirs alone" (Harvey, 2008, 585). This illustrates how cultural understandings affect sick role that is held by the patient focuses on the sick as an individual in need of care.

The sick role includes the expectation of the sick individual to seek appropriate help from professionals during the process of recovery and returning to the social functioning of the ‘well’ individual.

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  1. ^ Kassebaum, Gene G., and Baumann, Barbara O. (1965). Dimensions of the Sick Role in Chronic Illness. Journal of Health and Human Behavior 6(1):17-27. (link to text)
  2. ^ Sansom, B. (1982). The Sick Who Do Not Speak. In Semantic Anthropology. New York: Academic p. 183-95.
  3. ^ Sansom, B. (1982). The Sick Who Do Not Speak. In Semantic Anthropology. New York: Academic p. 183-95.
  4. ^ Harvey, T. S. (2008). Where There is no Patient: An Anthropological Treatment of a Biomedical Category. Culture, Medicine, and Psychiatry 32(4):577-606. (link to text)