July 12, 2008

Whining About Chronic Illness/Disability!

When a chronically ill person crosses over into disability, I believe that Parson's Sick Role Theory can no longer apply. 

Why? Well, because instead of insuring an acceptable status for the ill person, Sick Role Theory, as applied to the chronically ill or disabled, provides a conundrum in our perceptions of the disabled individual's status. 

This means that as long as the chronically ill or disabled individual participates in the guidelines established by the Sick Role Theory, the individual is left open to denigration of status, ridicule.

Instead of being an individual who is participating in his care, the chronically ill/disabled individual is now a whiner.

 Following doctors' orders and trying to 'get well' as his only task is now viewed as self-centered behavior. 
If we can recall, the nut of Talcott Parsons work centered around some pretty specific guidelines:

In 1951, sociologist Talcott Parsons tried to describe formally what ordinary people already seemed to be acting on at some level. Parsons published his Sick Role Theory, and in it he described two rights and two obligations apparently binding for those who become sick in our society. They are: 1) that the patient is exempt from his normal social duties because he is ill; 2) the sick person is not responsible for his illness; 3) the sick person should try to get well; and finally, 4) the sick person should…cooperate with his physician. 

Parsons' theory has been worked and reworked by sociologists to try to take into account the variations not accounted for in the Sick Role Theory. Parsons wrote what many plain folks already upheld: if you are sick, you aren’t to blame and you don’t have to work if you try to get well and obey your doctor, nurse, pharmacist, etc. 

Here is the seed of the authority we have been searching for in this piece: an apparent bargain between society tolerating the sick so long as the sick respond by respecting our authority and being obedient. But, this Theory presupposes that the ill will recover and that the process will be a finite one, not an enduring one.

Frustration with a never-ending illness creates a variety of responses, among them the urge to scapegoat. The chronically ill/disabled are unable to 'fix' themselves and must continue in their status as ill/disabled, making them vulnerable to scapegoating. The "everything would be OK if you..." or "the only thing you are concerned about is yourself" position creates a designation for the chronically ill/disabled impossible to escape. In place of support, all support of an emotional nature is suddenly withdrawn... it can be damaging for all concerned.  

For some, this kind of status confusion has led to violent attacks. The implicit thought seems to be, at least from outside of such frustration, 'if I can't fix your condition, at least I can fix my own frustration with your condition!'  This could explain some of the recorded episodes of violence against disabled people all by itself.

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