The Sick Role

(http://www.unc.edu/~rmatteo/SOCI122/Handouts/SickRole.doc

The Sick Role

(Talcott Parsons, 1951)

Sociologists conceptualize social roles as the expected behaviors (including rights and obligations) of someone with a given position (status) in society. Generally, people hold a status (position) and perform a role (behaviors).

Parsons (1951) utilized these concepts to construct a theoretical view of individuals who are sick, hence the “sick role.” This theory outlines two rights and two obligations of individuals who become sick in our society (See Cockerham (2001) Medical Sociology, (8^th Edition) Prentice Hall; pp 156-178.):

Rights:

(1) The sick person is exempt from “normal” social roles. An individual’s illness is grounds for his or her exemption from normal role performance and social responsibilities. This exemption, however, is relative to the nature and severity of the illness. The more severe the illness, the greater the exemption. Exemption requires legitimation by the physician as the authority on what constitutes sickness. Legitimation serves the social function of protecting society against malingering (attempting to remain in the sick role longer than social expectations allow – usually done to acquire secondary gains, or additional privileges afforded to ill persons).

(2) The sick person is not responsible for his or her condition. An individual’s illness is usually thought to be beyond his or her own control. A morbid condition of the body needs to be changed and some curative process apart from person will power or motivation is needed to get well.

Obligations:

(1) The sick person should try to get well. The first two aspects of the sick role are conditional upon the third aspect, which is recognition by the sick person that being sick is undesirable. Exemption from normal responsibilities is temporary and conditional upon the desire to regain normal health. Thus, the sick person has an obligation to get well.

(2) The sick person should seek technically competent help and cooperate with the physician. The obligation to get well involves a further obligation on the part of the sick person to seek technically competent help, usually from a physician. The sick person is also expected to cooperate with the physician in the process of trying to get well.

Although this concept presents some flaws, it is a valuable contribution to understanding illness behaviors and social perceptions of sickness. (It is perhaps best considered an ideal type – a general statement about social phenomena that highlights patterns of “typical.”) We discussed a number of criticisms of Sick Role theory, including: a violation in the “ability to get well” for a number of conditions (particularly chronic illnesses); individuals or groups may not possess the resources to “seek technically competent help” or to “cooperate with the physician” based upon health insurance, income, role conflicts to compliance, etc.; certain illnesses may reflect an element of personal “blame” due to unhealthy lifestyle choices (i.e. smoking leads to emphysema); the potential inability to be “exempt from normal social roles” due to issues of status (i.e. parent), income (need to work), gender, age, etc.

However, as we will see throughout the next few weeks, the Sick Role does exist at some level in society, if not in the form identified by Parsons, then in regards to more general social beliefs about the expectations for individuals who are diagnosed with illness (be it a chronic or mental disorder).