The Public Issues of Social Structure
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Poorni Arunachalam Professor Kathleen Hulton SOC 219 – Medical Sociology October 31, 2016 Individualism and Personal Responsibility through a Medical Sociological Lens A common theme used throughout the study of sociology is individualism and personal responsibility of one’s actions. In the words of Mills, “the sociological imagination works in between ‘the personal trouble of milieu’ and ‘the public issues of social structure.” His main theory was that many of the problems that people are faced with in society are rooted in the social and are shaped by others. These roots are often related to the structure of the society and the changes that happen within it. Specifically, seemingly impersonal and remote historical forces may be linked to incidents taking place in an individual’s life. This implies that people may look at their own personal problems as social issues and connect their own individual experiences with the workings of society. The sociological imagination enables people to distinguish between personal troubles and public issues. For example, Gloria’s reason for being a drug addict, homeless, and dependent on men, is not only being of the individual choices that she made, but because of the social forces that are relevant to the society that she lives in (Sered, 2014). In order to use the sociological imagination one must perceive a situation in a wider social context and and understand that those interactions and actions are influential upon other individuals and situations (Mills, 1959). In Susan Sered’s article, “Suffering in an Age of Personal Responsibility,” she examines the lives of women after being incarcerated. According to her, women like Gloria blame themselves for much of their life’s troubles. From getting sexually assaulting to being homeless, both society and their own minds tell them that they reason that they are in this situation is because of the mistakes that they have made. When Gloria was in rehab for her drug addiction, she was told that in order to cure her disease, which in this case was her addiction, she needed to take personal responsibility for her failings and that she could not blames others for her sufferings. Similar to therapeutic individualism that shown in reality pop culture shows today, the emphasis is coming to terms with their decisions. In Gloria’s case, one of the steps to the Twelve Step group, encouraged her to admit that she was powerless in the face of her addiction and that it was one of the deficits in her character. Throughout her life, she had been telling herself that she had a perfect childhood with a big and supportive family, a lie that she and the world believed. When taking another look into her life, it is revealed that she did not have a perfect childhood and that she was victim of abandonment. Being she was never provided the adequate resources to survive she was unable to move forward in her life. Women in particular are more likely to believe that their own short comings are their fault. This is most because a majority of their lives are under a microscope more than that of men. When a women is raped, society and media, tells her that she was “asking for it.” Men, are seen as people who cannot suppress their sexuality and that it is a woman’s responsibility to protect herself from their wrath. The blame is on the women because at the end of it, she is the one that would faces the consequences. At the base of the problems that many women like Gloria face is structural inequality. For example, structural explanations for rape emphasize the power differences between women and men similar to those outlined earlier for sexual harassment. In societies that are male dominated, rape and other violence against women is a likely outcome, as they allow men to demonstrate and maintain their power over women. Niether Gloria or the women in Lorde’s article, has control over certain aspects of their lives, respectful the drug addiction and breast cancer, yet they are faced with the overwhelming dilemma as to better or not their situation was coming that they cause. Even in a situation, where women have more control over the outcome, such as reconstructive surgery have breast cancer, there are several external social pressures that women face when making a decision that should not affect themselves. In Lordes chapter, Breast Cancer: Power vs. Prosthesis, she talks about the difficulties of dealing with the stigma around the removal of her right breast after having breast cancer as a black lesbian feminist. She felt pressured to wear false breasts and to fill her bra when going to doctor’s office, a place that she should have felt comfortable to go as she is. Breast cancer treatments today are likely to cause less physical deformity from surgery than a half-century ago, even in the 1970s (the time in this book was written in) but are more complex and extend over a longer period of time. Although clinical depression is not seen in many breast cancer patients, many have experienced treatment-related distress, fear of recurrence, changes in body image and sexuality, as well as physical toxicities that result from adjuvant therapy. Even though most of the side effects are on an individual level, they are driven by the social setting in which the person is in. In doctors office, medical professions give them no options to deal with the trauma of having a mastectomy, instead they provide ways to hid the consequences. The few women who actually decide to bare their bare chest are shunned and seen as people who bring the positive energy around them down. These professionals are also creating the image that a women is nothing without her sexuality. Prosthesis and surgical reconstruction can help to repair the emotional damage of having the disease and give survivors a renewed sense of wholeness. However, many feel forced into reconstructive surgery by those who want them to reinforce stereotypes. Like Lorde says, “With quick cosmetic reassurance, we are told that our feeling are not important, our appearance is all, the sum total self.”(Lorde, pg 59) Other groups that provide to this distorted image are Institutions like ACS, which are suppose to aid in the research cure of breast cancer, are instead funding projects that have not been proven to cause change. They are ignorant of the environment aspect of breast cancer, and are instead suppressing information. These types of organizations are suppose to provide women with hope, instead they are ignoring the chemical exposure agents to the environment and causing harm. The main point of question becomes, if women cannot depend on these institutions and doctors offices to provide them with the adequate information to make an educated decision, then who can they rely on for information?Individual choices can be see on other levels as well. Some medical professional such as doulas, midwifes, etc… believe that the way in which a baby is born sets up not the welling being of the child but also the identity of the mother. There is significant push from the home birth advocacy community to avoid c sections as it is seen as an easy way out for the mother and as a traumatic experience for the child. These people look down upon mothers who choose to get an epidural and want the attention of a doctor because they are choosing not to experience something that should to be natural. Mothers who the traditional way of birthing are judged harshly for their decision because it is seen as not being empowering for a mother. Experts not only believe that they are taking the easy way out, but that trusting medical professions who may not necessarily have the correct intentions. There is growing belief that mothers should know what is better for their body and child more than doctors. There is less trust in medical institutions because they are seen as corporations who want to make the most money. For example, having a c session costs more money, requires less time for the attending doctor, and has a greater success rate due to the growing advancement in technology. Many midwives and doulas argue that even though there is a growing number of c-sessions happening in the United States, this maybe not be the correct decision for mothers to make. Even though in most cases having a c-sections is medical decision several midwives believe that if a women takes a strong enough stance, she can give birth in a more natural way. (McCabe 2016, pg 177-184)Regardless of what the illness or situation may be, drug addiction, breast cancer, and childbirth all have some of the same themes. An individual’s choice to their is not as personal as we assume it to be. We are constantly being socialized by the institutions and individuals that surround us. AA/rehab centers and ACS are aimed at encouraging people to move past their illness through self awareness. In the case of rehab centers, attention is not given historical context from which the person is from but rather the present situation is which they are seen as a harm to society. Gloria wasn’t able to move past her addiction until she came to the understanding that change is only possible when the person is willing to hear it. The true reason she moved on is not because she stopped putting all the faults on herself, but because she understood that the reason why she was where she was was not entirely her doing. However ACS, has turned their heads to breast cancer patients in a similar way. The reason that breast cancer is become more prevalent in society is because of the increased environmental hazards that are present. However, instead of focusing on solving these issues they are funding treatment options instead of ways to prevent it. Individuals are not recognized in the preventions process but rather in the treatment process. Similarly, neoliberal parenting has lead to the domination of doulas, lactation consults, and childbirth educators in the birthing industry. What ones used to be a medical decision is now being seen as an empowering force. As a society, we are moving towards a system in which the individuals know best. Through self regulating and governance, the responsibility is shifting towards individuals. Neoliberal ideology is pertinent to all the situations described because even though responsibility is being shifted from institutions to individuals both formal and informal social control has played a major role in how people make decisions. Even though Mills sociological image predates the neoliberal ideology, his theory that context is important to understand the life of an individual still applies. Even when a neoliberal mother is making a decision about birthing she is not making it without an social pressures. Given the well documented relationship between lifestyle, disease burden and healthcare costs, it makes economic and medical sense to hold individuals morally responsible for their health related choices. However, holding individuals entirely responsible for their own health conflicts with medical professionals obligation to treat the sick and society’s obligation to take care of vulnerable people. Also, it is unfair to hold individuals responsible for their own health, especially if they cannot make sound health related choices because of ignorance, mental incompetence, addictive behaviors or cultural pressures. Therefore, it would be exceedingly difficult to implement a system that holds individuals responsible for their own health, since diseases and disabilities result from a complex interplay of cultural and environmental factors. Although individuals should play an important role in maintaining their own health, they should not be held entirely responsible for it. Assuming that society is partly responsible for the health of its members, however, does not settle the question of how it should fulfil this responsibility. Greater attention should be paid to strategies of promoting health other than access to healthcare, such as environmental and public health and health research.Work Cited Lorde, Audre . 1980. Breast Cancer: Power vs. Prosthesis: The Cancer Journals. McCabe, Katharine. 2016. Mothercraft: Birth work and the making of neoliberal mothers. 1007 West Harrison Street (MC 312), Chicago, IL: Elsevier Ltd. Mills, C. Wright. 1959. Sociological Imagination. New York: Oxford University Press.Sered, Susan. 2014. Suffering in an Age of Personal Responsibility. University of Massachusetts: American Sociological Associate.