The Postmodernist Perspective (AQA A-Level Sociology): Revision Notes
The Postmodernist Perspective
Core postmodernist arguments
Postmodernism challenges all other sociological perspectives by labelling them as 'meta-theories' - overarching explanations that are inadequate for understanding health in contemporary society. This perspective argues that traditional sociological approaches fail to explain how healthcare operates in our postmodern world.
The postmodernist view emphasises that power relations between healthcare practitioners and patients have become increasingly fluid rather than fixed. This represents a significant departure from traditional medical models where doctors maintained clear hierarchical authority over patients.
This shift from fixed to fluid power relations reflects broader postmodern themes about the breakdown of traditional authority structures and the emergence of more complex, negotiated relationships in contemporary society.
Healthcare transformation and consumerisation
Recent NHS reforms demonstrate postmodernist trends in healthcare delivery. The 'Choose and book' system and expansion of CAM (Complementary and Alternative Medicine) have created a fragmented approach to healthcare where patients can 'pick and mix' from various treatment options.
While healthcare providers present this as patient-centred care, postmodernists argue it reflects the extension of consumerist society into healthcare. This development represents a fundamental challenge to traditional medical authority and professional dominance.
The consumerisation of healthcare potentially undermines the traditional status and authority of the medical profession by repositioning patients as consumers with choice rather than passive recipients of medical expertise.
The medical profession has actively opposed CAM, particularly homeopathy, despite public endorsement from celebrities and the royal family. However, as public awareness of iatrogenesis (harm caused by medical treatment) increases, the medical profession's authority faces growing challenges.
Key concepts in postmodernist analysis
Medicalisation
Peter Conrad (2007) identifies medicalisation as a process where medicine increasingly penetrates everyday life. Over the past 50 years, normal human experiences have been transformed into 'medical conditions', including:
- Social anxiety
- Menopause and 'male menopause'
- Erectile dysfunction
- Ageing
This expansion of medical influence paradoxically both empowers and disempowers the medical profession while strengthening pharmaceutical companies, biotechnology industries, insurance companies, and patients as consumers.
The medicalisation process demonstrates the complex and sometimes contradictory effects of medical expansion - while increasing medicine's social reach, it also creates new challenges to traditional medical authority through the involvement of multiple stakeholders.
Surveillance and self-surveillance
Michel Foucault (1963) introduced surveillance as a defining feature of postmodern society. The medical profession increasingly serves employers (through annual health checks), insurance companies (risk assessment), and governments (benefit eligibility checks) in monitoring population health.
Simultaneously, self-surveillance emerges as people bypass medical professionals. Michael Senior (1996) describes how individuals use self-diagnosis kits for blood pressure and cholesterol testing. Future technology may enable widespread self-diagnosis through computer-generated assessments and treatment recommendations.
Discourse and power
Foucault argues that power originates from language use and expression through dominant discourse. Traditionally, doctors gained power over patients through their specialised knowledge of the body. However, patients now educate themselves through media and internet resources, creating more balanced power relationships and challenging medical monopolies over health knowledge.
Key sociologists
David Morris (2000)
Morris challenges medicine's separation of disease (objectively verified disorder) from illness (patient's subjective experience). He advocates for a biocultural model that situates illness at the intersection of biology and culture.
Biocultural Model in Practice:
Conditions like chronic fatigue syndrome and post-traumatic stress disorder demonstrate biocultural approaches to understanding sickness, where biological processes cannot be separated from cultural and social contexts in explaining patient experiences.
Critique of the postmodernist perspective
Strengths
The postmodernist perspective offers valuable insights into contemporary healthcare dynamics. It effectively recognises the medical profession's powerful position and adherence to biomedical discourse. The perspective embraces power relations analysis, demonstrating how medicalisation can both empower and disempower medical professionals while presenting people as healthcare consumers with diverse treatment choices.
Key Strengths of the Postmodernist Approach:
- Recognises complexity in modern healthcare relationships
- Challenges traditional assumptions about medical authority
- Highlights the impact of consumerism on healthcare delivery
- Provides framework for understanding changing patient-doctor dynamics
Weaknesses
Critics argue that advocating a DIY approach to diagnosis ignores the medical profession's legitimate power and expertise, potentially putting patients at risk through inadequate self-diagnosis and treatment.
Regarding social policy, CAM provision remains largely confined to private providers, making it inaccessible to lower-income groups. NHS CAM services are limited, though increasingly available as palliative care for cancer patients. Personal Health Budgets may expand CAM access for people with long-term conditions.
Critical Limitations: The postmodernist emphasis on patient choice and self-surveillance may overlook important health inequalities and the continued importance of professional medical expertise in diagnosis and treatment.
Contemporary application
A fundamental tension exists between society's increasingly postmodern character and the medical profession's persistently modernist outlook.
Key Tension in Modern Healthcare: Postmodernists warn that if the medical profession fails to adapt by reducing reliance on science and technology in a society increasingly distrustful of modernist approaches, they risk becoming outmoded and failing to meet postmodern patient expectations.
This tension highlights the ongoing struggle between traditional medical authority and emerging forms of health knowledge and practice in contemporary society.
Key Points to Remember:
- Postmodernists view other sociological theories as inadequate 'meta-theories' for understanding contemporary healthcare
- Power relations between doctors and patients have become more fluid through patient empowerment and self-surveillance
- Medicalisation transforms normal life experiences into medical conditions, affecting professional authority
- Key concepts include surveillance, discourse, and the biocultural model of illness
- The perspective highlights tensions between postmodern society and the modernist medical profession