ABSTRACT
Health and health care are dominated by medicine and the professionalisation of health is the focus for the selection of readings in the third section of the Reader.
Professionalisation has been seen by Freidson (Reading 17) to lend authority to a medical view and understanding of health and illness at the expense of lay views. The conflict between the perspectives of doctor and patient is seen to involve the submission of lay concerns about illness to a technical and scientific model of disease. The medical profession has been able to achieve this due to its ability, because of its professional status, to manage its own affairs ‘protected from lay interference’. Autonomous and self-directing, and supported by the power of the state, the medical profession is able to ‘recreate the layman’s world’, defining and constructing illness in terms of its scientific and technical knowledge base. In this sense, Freidson emphasises that illness is ‘socially defined’, that it is a social product of the doctor-patient relationship rather than a feature of the patient’s ‘organic state’. Medicine’s ability to dominate lay views does not involve a process of forcefully imposing its views on those of the lay person but instead requires the active co-operation of the layman in accepting the profession’s right to authority in health matters. This co-operation is achieved in the process of interaction which occurs in the encounter between doctor and patient. As such, both (medical) professional and lay persons are active in contributing ‘to the process of constructing the social reality of illness’. In the extract printed here, Freidson focuses on the increasing application of ‘medical labels’ in the control of social deviance. The reinterpretation of deviance as illness leads to ‘the strengthening of a professionalised control institution’ in which illness is defined as ‘something bad’ and medicine assumes the role of ‘moral entrepreneur’.
