Week 4: Discussion 1 and 2

Weekly Activities

Here is what you will be doing this week:

• Read Chapter 5 in the text: Ethics in Medicine

• Post to Discussion Board 1 on Equal Access to Healthcare (due by Day 3, Thursday)

• Post to Discussion Board 2 on Food Justice/Food Deserts (due by Day 3, Thursday)

• Respond to two discussion posts by classmates in each discussion (by Day 7, Monday)

• Weekly Quiz (due by Day 7, Monday)

Agency and Choice

All of us are born into a particular set of social circumstances―an arrangement of institutions that fulfill particular social functions, as well as hierarchies that rank groups of people based on perceived status. As we grow, we socialize with others and learn the ways of our society―the rules, expectations of others, and the values that society represents. Since each individual is born into particular circumstances, it is easy to perceive that society is given to us, that it exists outside of us and is something we must conform ourselves to. Sociologists offer a different interpretation. To a sociologist, society is something that we construct, something that we create and build, through our interaction with others. Although we may inherit a particular set of social rules that dictate how we interact with others, we can always break these rules in our interaction. Every time we choose to interact in ways that adhere to the rules, we essentially are recognizing and reinforcing the legitimacy of those rules. If we choose to break the rules, we likely will suffer sanctions of some sort―those with whom we interact will respond so we will know that we are outside the rules. This is how society is perpetuated―through a constant series of interactions that mostly uphold the structures that make up society.

Sociologists use the term agency to describe our ability to make choices within our social circumstances (Porter, 2012; Pursey, Heugens, & Lander, 2009). As we have seen, social structures exert control on us and shape our perceptions, but we also know that we make many decisions and choices every day. Our own personality, identity and worldview can be expressed by the choices we make. Our personal ethics also play a role in our choices and decisions.

Agency, Social Reproduction and Ethics

If society is constantly being constructed and reproduced, ethics and morals become important considerations. In constructing society, we need to establish moral codes so that society can function well (Cresswell & Karimova, 2010). Moral codes establish the goals for a good society. How can people apply moral codes? This is where ethics comes in; ethics provides guidelines for what people should do in order to uphold moral codes; how people should exercise their agency. Ethics allow people to interact with others in ways that are functional, that advance the social good rather than degrade it. Of course, ethics do not ensure that the social good will be protected, ethics merely offer the possibility that we can construct a good and functioning society. How we apply the ethics to particular circumstances will affect social outcomes. How we conceive of ethics also will affect the society we construct. The text offers different ethical theories, and uses case studies to illustrate how applying one ethical framework leads to particular outcomes, while applying a different ethical framework will lead to different outcomes.

For example, chapter 5 examines various ethical dilemmas that arise within the context of health care institutions. Doctors and other health care professionals must make tough ethical decisions every day (Mulligan, Shapiro, & Walrod, 1996). Many of the decisions doctors are called on to make involve evaluating serious risks, such as balancing the potential benefits that a treatment might bring to a sick patient, against the potential harm that the treatment might cause. Part of the evaluation also includes the potential harm that might come from doing nothing; if it is likely the patient will recover, and the treatment involves some risks, the best decision might be to do nothing. These are tough calls for doctors to make, particularly when a patient is likely to die without treatment, but the treatment may not stop the patient from dying. By beginning the treatment, the doctor takes on some responsibility, and risks a lawsuit or other sanction if the treatment is unsuccessful.

As you read about the different issues in medical treatment and research in Chapter 5, consider which aspects reflect social structure and which reflect agency on the part of the medical professionals. How much leeway do actors have to make choices within the existing social structures? What are the risks they take by the choices they make?

Here are some videos to support you in the discussion on access to health care...

This one is actually just thrown in for fun,

but does highlight the issue of evidence vs. perception...

More videos to support the discussion on food justice and food deserts...

References

Cresswell, M., & Karimova, Z. (2010). Self-harm and medicine’s moral code: A historical perspective, 1950–2000. Ethical Human Psychology and Psychiatry, 12(2), 158–175.

Mulligan, D., Shapiro, M., & Walrod, D. (1996). Managing risk in healthcare. McKinsey Quarterly, 3, 94–105.

Porter, F. (2102). Negotiating gender equality in development organizations: The role of agency in the institutionalization of new norms and practices. Progress in Development Studies, 12(4), 301–314.

Pursey, P. M., Heugens, A. R., & Lander, M. W. (2009). Structure! Agency! (And other quarrels): A meta-analysis of institutional theories of organization. Academy of Management Journal, 52(1), 61–85.