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S207

9 January 2007
Week 2

 Parsons the most dominant figure in structural functionalism. critical in elevating Harvard
Dept of Soc to forefront of US soc (previously Univ of Chicago)
 Chi focused on small-scale phenomena, diads (interactions bet 2 actors), inductive
theorizing (start w/ data, develop generalizable explanations, then you build your theory)
 Parsons wanted to oppose Chi school and also inductive theorizing.
 deductive theorizing: start with theory, then find data & test hypotheses
 he started at Harvard circa 1927. his first entrée onto soc scene was in 1937 when he
published The Structure of Social Action. here he introduced US audience to European social
theorists (they weren’t necessarily known as sociologists at the time) and to grand theorizing.
broad changes in society. very large social patterns. more sweeping generalizations about
what was going on and why it was going on.
 theorist that Parsons explicated upon were Durkheim, Weber, and Pareto. he did not
include Marx. that has a lot to do w/ why Marx was largely neglected by US sociologists
till much later.
 this was his first phase of work. his effort to put sociology on the map. to argue ideas and
values were important as basis for social order.
 in contrast w/ Marx: what you think depends on where you stand. Parsons argued ideas
had independent force outside social position, wasn’t solely dependent upon position in
social structure. ideas had independent social force. independent social artifacts.
 start of lifelong attempt to figure out how we go from individuals having inward
thoughts, perceptions, experiences to more public, shared values and norms.
 so when you get individuals together, how does that group of individuals collectivize into
social action?
 do ideas come first, or then social action? or does social structure come first? Parsons
argued that ideas are universal, have independent existence, and do not purely arise out of
something else.
 other camp would call this essentialism. there are free-floating ideas out there that
people can latch onto.
 psychoanalysis. 1947. he trained in psychoanalysis. consequences for The Social System
(1951), which begins the 2nd phase of his work.
 he started to develop a lot of his ideas about the social structure of medicine.
 footnote on first page where he notes that it was in fact through his study of modern med
practice that helped to explicate a lot of his ideas about the social system. he used
medicine as a heuristic tool for coming to his general theories.
 he’s interested in developing a grand map of how society works to maintain social order.
he’s concerned with the broader social system, how we as individuals fulfill the broader
system. this is really the hallmark of structural functionalism. dominant through 1960s.
 third phase began in 1960s. starts to be a lot more widespread criticism of structural
functionalism. consensual / voluntaristic maintenance of social machine. Parsons tries to
respond to these critiques. he modifies/reiterates some of his original theses/assertions
 he starts to think more and more about social change.
 society and its historical context, sociopolitical transformations happening all the time.
so Parsons tries to tackle some of these ideas about social change and adapt his theories
to social change.
 3 broad phases of his scholarship. tendency is to jump at critiques of Parsons and structural
functionalism.
 Parsons picks apart modern medical practice in a way people had not done. modern med
really just getting underway. the era of modern med didn’t begin until 1910 or so. this was
the first widescale attempt to sociologically theorize about med practice. to take a practice
that at the time was just beginning to become routine and widely accepted in US society and
to make what seems routine and familiar strange. this is the stance of anthropologists, to
make the familiar strange. one of the striking features of his work is that he does this with a
lot of modern medical practice, which is why his work is foundational to medical sociology –
assuming a scholarly attitude, not taking anything for granted. any ritual, feeling, social role
can actually be analyzed explicitly, and should be analyzed explicitly. one of the first early
attempts to do it at such a systematic level.
 we often talk about the values, norms, social roles people have/fulfill. this whole vocabulary
only has currency b/c of Parsons’ work.

what attitudes do you see reflected in his work?


 this was a time when US higher education really got going, the beginnings of information
society. simultaneously, all the disciplines and social sciences in particular began jockeying
not only for resources, but for disciplinary prestige. attempt by some sociologists to
systematize sociology and make it more scientific. underlying belief in a lot of the sociology
at that time that society followed rules as systematic as those of nature. attempt by Parsons
and others to figure out what some of these roles were, and to elaborate them – and thus stake
a place for sociology in describing the world and predicting what would happen at a social
level.
 there are also people who mention that previous to this was the Depression, WWII, and the
rise of Communism, and some people read in Parsons an attempt to reassure themselves and
others that capitalism was functional, that it was the right way for society to be. in effect, an
answer or an antidote to the rise of Communism. so by saying that capitalism exists,
capitalism must serve some type of social function, and what are those social functions?
 sort of a tautology.

the theoretical bases of structural functionalism, what did they think the task of sociology
is?
 attempt to overlay structure and functions – this is how institutions and collectivities fit in
that overlay. how do we integrate them with one another?
 functionalist answer to the task of what the imperative sociology is.
 teleology
 prevailing principle in biology at the time was that giraffes developed long necks, and
that long necks have a function.. so this wasn’t limited to sociology at the time
 social structures have functions and goals, and they exist to fulfill those functions/goals.
 fairly circuitous logic. the fact they exist, they must have some function.
 role of values in structural functionalism
 ahistorical, universal values and norms are out there, they have an existence unto
themselves, a life of their own. this notion of values is really driving social action.
 he argues the way social institutions organize may change over time, but the values they
express are far less transient and far more long-standing.
 functional imperatives
 these are the things any kind of social system, whether an individual biological organism
or a society, these are the tasks that must be accomplished for it to survive and to work.
 social order and equilibrium always being the overarching goal. in order for this goal to
be attained, the imperatives must be accomplished
 latency the most important. what are the values that maintain all of us in organized
harmony w/ one another? quite consonant with his view on values and norms.
 latency – cultural system. schools, families.. it’s that system of norms and values that
people get socialized into. socialization.
 these are ideal types.
 e.g., you could argue part of integrating systems to work together is also fulfilled by
the cultural system.
 Ritzer p. 102 diagram
 sick role of the patient and caregiver function of the physician constitutes a social system
 the cultural values underlying that is what Parsons …
 core values that we don’t even sees as core values – it’s just the way we think. it’s like
traveling to another country and experiencing culture shock.
 cultural values are more long-lasting/enduring, and they give rise to particular types of
institutionalized roles
 the social systems may change over time, and different cultural values may be expressed
in different social systems. sick role = the social system created to address health/illness.
 cultural values more enduring than the ways we organize the social system.
 in the sick role, he’s only talking about US society. during structural functionalism in its
dominant period, they believed the AGIL scheme was universal / applied everywhere.
 because these functional imperatives are universal, all societies pay attention to certain
kinds of problem that were also universal.
 every society has a healing tradition (modern med in US society, shamanism in x
society, etc.).. always a system in place to take care of this place.
 also kinship that elaborated rules of relatedness. rules of kinship might vary from
society to society, but issue of defining relationships to one another within a kinship
system = universal
 importance of norms and values.
 he saw the status role, an institutionalized role or status, as being a basic unit of the social
system. this is kind of a backward definition - system of institutionalized status roles.
structural component of the social system.
 how to get people to fulfill their status role a central social problem.
 he saw status roles as being a structural component to the social system. to Parsons, a
central social problem faced by all societies is how to make sure those status roles get
fulfilled.
 the function of the status role is that it almost doesn’t matter who’s sitting in the role. it’s
more relationships of positions. what’s being institutionalized is the relationship between
the role of the doctor and the role of the patient, so no matter who’s in the respective
roles, the interaction and the practice of medicine will occur in much the same way. the
role of the patient will be circumscribed in certain ways; the patient will feel certain
feelings by stepping into that status role
 Parsons’ preoccupation is that if you structure the pipeline correctly, the right people will
find themselves in particular roles.
 it’s hard to pinpoint exactly what he advocated. separate in your mind the prescriptive
and analytic aspects of Parsons’ arguments.
 he’s saying in an ideal situation, this is how society organizes itself.
 advantages and limitations of deductive theorizing. in rarefied air of grand
theorizing, he can come up w/ very neat conceptualization of how society works.

The Sick Role


 exactly how does Parsons make health and medicine an object of sociological scrutiny? this
was not necessarily an obvious thing to do. what sorts of claims did he have to lay out to
make it a sociologically interesting case study?
 being sick = a special form of deviance. (can’t contribute to the greater social good)
 what’s the overarching goal? get well
 if you think about it in terms of a structured social mechanism to fulfill this greater
purpose, to reintegrate this sick individual into functioning society, the sick role is the
mechanism that is structured to get that to happen.
 secondary gain. being sick sounds like an opportunity to get an exemption from doing
work. but the sick role is structured in such a way to make that a nonissue.
 sick role = shorthand to refer to the institutionalized roles of the doctor and patient and
the relationship between the two. the concept of the sick role encapsulates the entire
institution of modern medicine.
 The Social System p. 429 – “A highly distinctive cultural tradition, certain parts of modern
science, provides a central focus for the activities of the medical profession. We have already
seen that there are important problems of the modes of institutionalization of such a cultural
tradition. This institutionalization fits into the functional context of a ubiquitous practical
problem in all societies, that of health, and is specially organized relative to distinctive role
patterns and value-orientations in our own society. Finally, as has already been brought out
briefly, the bearing of the therapeutic process on the problems of deviance and social control
is such that adequate analysis of the motivational processes involved has implications
reaching far beyond the particular field…”
 this is why it’s a sociological problem: all societies have to deal with what to do when
people are sick. in US, we have modern medicine, which is US society’s answer to the
ubiquitous problem of health.
 sickness is a special kind of deviance, and we have developed mechanisms of social
control to minimize that form of deviance. but our interest in this doesn’t just have
bearing on and relevance for this particular area, it also has relevance for other social
systems
 he’s interested in the motivation of people that occupy certain roles, in the process of
reintegrating people into the social order, the relevance of medical practice for the larger
society. implications for our understanding not only of medicine, but of society in
general.
 how cultural values are institutionalized, how they find their explicit manifest expression
in these particular institutional roles.
 this is how he makes health and sickness a sociological project. a novel move he makes
that sets part of the foundation for medical sociology.
 rationality
 vulnerability of the patient makes it impossible for the patient to act rationally and make
rational decisions about how they will fix themselves
 the doctor-patient relationship served functions not only for the patient, but also for the
doctor
 economic actor, rational actor, presented with an array of options/choices: that model
does not work for health/illness. sickness creates in patients or individuals particular
vulnerabilities, disabling them from making rational decisions about how to heal
themselves. so that’s why they need the technical competence of a doctor.
 he’s discarding what was the main model of how individual actors operate in society. the
rational actor model doesn’t work in this instance, therefore, how is it that sickness and
this relationship between doctor and patient, how can this situation be managed? and
that’s the sociological question for Parsons. the answer he says is encapsulated in the
sick role, the rights and obligations of it, and the rights and obligations of the physician
on the other hand.
 what are some of his definitions of illness?
 to him, illness is a state in which an individual’s capability to function normally is
disturbed.
 (p. 138 of Williams?) (p. 120 of Patients, Physicians, Illness?)
 mental illness – incapacity for role performance
 somatic illness – incapacity for task performance
 rights and obligations of the sick role
 the sick role as a temporary and contingent status. the only way you get to be in that
contemporary status is contingent upon you wanting to get better. it’s the only way you
get legitimized into this role as patient.
 you’re exempted from the responsibility for being sick.
 2 obligations:
 you have to want to get well
 you have to seek technically competent help (physician)
 what’s the situation of the physician – what are the ways in which this notion of the sick role
or the institutionalized role of the physician, how is it functional for the physician?
 he talks about the values that are supposed to orientation the physician (collective
orientation, etc.) – it’s an achievement-oriented role.
 he has the authority to ask patients to comply with their advice.
 if system working well, this almost automatically orients physicians and patients toward
fulfilling the roles that are established for them, and that in turn is the most efficient way
for sick people to get better.
 because they have to be technically competent, there’s this accepted notion that anybody
who enters into the physician’s role has a certain degree of technical competence, which
in turn establishes their moral authority to do all sorts of things to patients that people in
other roles would not be able to do
 what about the emotions of the physician?
 neutrality factor.
 dangers of physician being in that position. don’t want to get emotionally connected to
patient.
 assumption that physician was male, and patient often female.
 dealing w/ very intimate areas of life and death. and tendency of individuals to get
sucked into that.
 social distance. the phrase he uses is “detached concern” for the patient’s interests and
health. so you’re making decisions scientifically.
 having a bias toward treatment may not serve a social function, but it reassures
patient/society that everything is being done.
 the physician should be making his decisions based on the scientific data re: what
actually works, and not on how much you like or identify with the patient.
 Krista: a lot of Foucault in this
 paying no attention to the social person or to self
 Foucault talks about it as the disciplining that happens as an act of power. where
Foucault sees power, Parsons sees social order. the content of what they say is far
more similar , but it’s the “in service of what?” that’s drastically different
 optimistic bias. pseudo-scientific elements.
 what’s the functional significance of pseudo-science?
 all in modern medicine is not exactly scientific; there are some special problems, and
medical practice has developed ways to deal with them. one problem is uncertainty – we
don’t know everything there is to know about health and illness. medical practice’s
response = optimistic bias (p. 466 of The Social System)
 sickness as deviance, sick role as mechanism of social control
 the sick not getting in contact with other people who are sick.
 John: they could collectively organize and perpetuate that system as a way of life.
 Janet: own subculture with own cultural orientations that were deviant from those of
broader society
 subculture = pathological. not in a socially pejorative way, but if you’re thinking
about a smoothly functioning society, then it is a pathology.
 you’re only exempt from blame as long as you’re trying to get better.
 Parsons as judgmental, or is he being completely abstractly descriptive?
 the very way that the sick role is structured makes the sick person’s primary contact and
relation with someone who is not sick (physician), so they don’t have a chance to band
together. b/c if they band together and form a subculture, things fall apart.
 whole idea of a support group did not rise until 1960s. Parsons’ theory is historically
specific
 overarching value of activism = can-do attitude, gotta do something.
 part of structural functionalism .. obviously a preoccupation w/ functions.. but Robert Merton
(student of Parsons) came up with notion of manifest vs. latent functions.
 manifest = intended, latent = unintended functions. you could think of the manifest
function of the sick role = get people healthy, bring the patient to the doctor, have the
doctor manage the relationship so patient gets better.
 latent = sick role as mechanism of social control. preventing sick people from banding
together. making sickness undesirable.
 manifest vs. latent = another heuristic device you could use to analyze the situation

 critiques re: the sick role


 Martine: normal roles and responsibilities as functional for the social system. but as
illnesses get commodified, don’t they now serve their own function?
 Conrad
 pharmaceutical industry, medical-industrial complex – reintegrating with broader
societal notions of health
 Beth: latent functions have become profitable
 bad things can be functional. stratification being functional. on a purely analytic level.
which is not the only level we should be looking at these things. it’s an empirical
question.
 what happens when latent functions become the only functions?

 one of the broad critiques = lack of empirical evidence. given all the qualifications of it
being an ideal type, a heuristic tool, a typology.. when you hold it up to the real world, it
doesn’t fit for a lot of reasons.
 one of the latent functions .. sickness gets defined by definition as an undesirable status.
healthy people will see that they don’t want to be sick, and work to not get sick
 Martine: - Shilling: rise of informed consumer and implications for the patient-provider
relationship. he didn’t see this as challenging Parsons as much as others might think
 Janet: going back to cultural values being more enduring.. informed consumer (1980s
on), you have your own responsibility – in what ways does that violate the sick role?
though it doesn’t fit within the model of the sick role, it is very much in line with
these enduring cultural values of activism, inst., and worldliness that Parsons thought
were culturally significant. even though what we see on the surface may change
(institutionalized may change), the underlying values persist.
 what constitutes wellness or disease = continuum. an attitude toward medical knowledge
where we can intervene earlier and earlier in the disease process.
 Parsons never really talked about or questioned the social process of deciding what is
illness or not. he takes illness for granted. he doesn’t pick up that entity and subject it to
sociological scrutiny the way he does medical practice. it’s an issue other people we’ll
read this quarter will raise. for him, definition of illness was not a sociological problem.
 shades of psychoanalysis. psychoanalysis and Freudian thinking was a revolutionary way
to look at the self. and at the relationship between the individual and society. so it
inevitably had to be taken up / addressed by sociology. Parsons is one of those who takes
it up.
 John: Berger and Luckmann social constructionism
 Martine: no critique of power relations
 John: he ignores access