Sociology in medicine

Sociology in medicine

Book reviews vacy. While the major emphasis here is on physical abuse, it is noted that psychological abuse may continue long after the physical abuse...

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Book reviews vacy. While the major emphasis here is on physical abuse, it is noted that psychological abuse may continue long after the physical abuse has been brought under control. The discriminatory reporting of poor and working-class parents and their children is recognized as a problem. Examples of abuse in the more affluent classes are described. emphasizing that the life stresses and the demands that a child may place on his parents can be just as real and devastating for the affluent as for the poor. But the rich are under reported and therefore often do not receive the services they need. While the strengths (Lcthe book are .!he vivid presentations of the problems of interdisciplinary practice and the sympathetic portrayal of abusive parents, the section on definition of terms used in protective services is symptomatic of the confusion and disagreements in the field. Neglect is a more complex phenomenon than the author indicates, and the distinctions drawn between abuse and battering as a subcategory beg the issue. There remains a need for more precise and conceptually sound definitions. The collaborative efforts described in the book are few and on a small scale. They tend to be highly dependent upon personal relationships among those who can exercise discretionary decision-making power as opposed to having to strictly adhere to legally mandated reporting and service delivery programs. The research data are sparse because the number of cases is small and therefore conclusions regarding casual factors can only be tentative. The recommendations for improvement are adequate but fail to point to the prob lems with the legal framework for practice and to the professional problems of the workers, despite the obvious importance of these issues in the body of the work. Here is a book that persons in protective services should read in order to hear from their colleagues in other disciplines. One may hope that this hearing will result in more effective efforts to help families and children.


outline treatment. For example. five theories of deviant behavior were covered within the space of two pages. and illness and death were treated in a single chapter of eleven pages. While the authors compromised on length, they remained dedicated to presenting issues in their full corn-, plexity. As an introduction to the field. therefore, the book needs to be fleshed out by a scholarly teacher. One of the unresolved issues concerning the teaching of sociology to health care professionals is to what extent it should provide grounding in “straight sociology”, and to what extent it should focus on the applications of sociology to health and medicine. The authors of the present book clearly decided to provide both. When it came to organizing for the task, they were indecisive about whether to integrate or to treat separately general sociology and medical sociology. Separate chapters were assigned to medical sociology topics, five of the book’s 14 chapters. These were generally placed in the latter half of the book, except that a chapter on illness and death was placed among the general sociology chapters. No overview of the role of sociology in medicine was provided to introduce these chapters or to distinguish between the general applications of sociology in medicine and the sociological study of medicine. A chapter titled “Sociology of Medicine” fails to make the distinction and is placed too late in the book to serve as an orientation to medical sociology. The general sociology chapters include some health and medical applications of sociological concepts, but many additional examples could have been given to bring home the relevance of sociology in medicine; e.g. belief systems which provide explanations of disease, the health care team as a small group, and health care as a family function. Some of the medical sociology materials were carelessly assembled. For example. the chapter on “The Professions and Nursing” includes a section on bureaucracy, even though another chapter examines the hospital as a bureaucracy, and physicians are not discussed in the chapter on professions. A section on the myth of mental illness Department qf Psychiatq> JESSICAHENDERSONDANIEL was inserted between two sections on professional-client Children’s Hospital Medical Center relations. The book needs revision of its headings. Major section headings were used for some specialized topics, Boston. MA, U.S.A. such as a 12 line treatment of Paedophiha. The authors were generally objective in analyzing the medical professions. Their infrequent lapses included the evaluation that “the care and devotion lavished by nurses Sociology In Medicine. by R. KENNETHJONESand PATRICIA and doctors on terminal cases is of a high order” (p. 121), JONES.Wiley. New York. 1975. 222 pp. $9.95. and that “education of the patient in order to better understand medical knowledge has the unfortunate concomitant of also making the educated layman more critical of proSociology, in Medicine is an introductory text in general fessional performance” (p. 175). sociology and medical sociology intended primarily for The authors criticized sociologists for “using what has doctors and nurses in training or practice. The approach been termed outlandish jargon, often obtuse and pseudois generally micro- rather than macro-sociological. The scientific” (p. 12). They could have shown how concepts major sociological concepts discussed are socialization, are used in both sociology and medicine to clarify and beliefs. values. norms. family. individual behavior in small stimulate thought. but are also used to obfuscate and ingroups. social differences. and social deviation. An excephibit thought (as in the case of the iatrogenic disease contion is the chapter on human ecology and demography. cept). It is ironic that these authors assumed this patronizin which the authors effectively demonstrate that different ing posture. because one of their considerable accomplishquestions and evidence are generated when aggregates. ments is that they enlarge their readers’ intellectual caparather than individuals. are used as the units of study. The bilities precisely because they so capably defined and principal medical sociology topics examined are definitions applied such concepts as functionalist theory, endogamy, of illness. illness behavior. dying in the medical setting. pemeinschaft relationships, norms of recruitment. the ecocare of the sick. the health professions. and the structure logical fallacy. radial sectors. and the life table. of hospitals. The authors skillfully condensed an enormous amount The book is noticeably British in these regards: precision of language. morbidity and medical care data chosen priof material-concepts. theory. data. even alternative interpretations of data. and methodology. Some sections promarily from British experience. and an emphasis on social vide remarkable breadth of coverage: e.g. a section on reclass influences on health. These features should enhance ligion and a chapter on the social structure of hospitals. the book’s value for American readers. Overall. however. the book suffers because the authors LOISPRATT Departmerlt of’Sociolog.r attempt to cover too much in a mere 199 pages of text. undoubtedly because of the publisher’s restrictions on Jei3r.r City. State College ,Vor Jersey. U.S.,4. manuscript length. Some complex issues were given only