INTRODUCTION: THEORIES AND PERSPECTIVES

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INTRODUCTION THEORIES AND PERSPECTIVES

• A. HOW DO YOU KNOW WHEN YOU ARE ILL?
• 1. SYMPTOM ORIENTATION
• 2. CAPACITY ORIENTATION
• 3. FEELING STATE ORIENTATION

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• B. HEALTH IN RELATION TO SOMETHING CONSTANT
  COMPARISON
• 1.NORMATIVE NATURE OF HEALTH AND ILLNESS
• a. HOW TO FEEL, BEHAVE OR BE

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• b. ILLNESS PROTOTYPES
• 1) SIGNS AND SYMPTOMS
• 2) LABEL
• 3) CAUSE
• 4) SEQUELA
• 5) TREATMENT
• 6) CONSEQUENCES

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• c. SOURCE
• 1) CULTURE ZOBROWSKI
• 2) PARENT AND FAMILY
• 3) PERSONAL
• 4) MEDICAL PROVIDERS
• 5) MEDICAL MEDIA
• d. BODILY BACKGROUND EXPECTATIONS

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• 2. HEALTH EVALUATIONS ARE SITUATED
• a. EVALUATIONS ARE NORMATIVE AND
  SITUATIONALLY SPECIFIC
• b. DRIFT AND HEALTH EVALUATIONS MATZA

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• 3. HEALTH, SITUATIONS AND INSTABILITY
• a. HEALTH AND ILLNESS AS EXPRESSION OF
  RELATIONSHIP TO ENVIRONMENT

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• b. EPIDEMIOLOGY TELLS WHO IS AT RISK OF
  MAINTAINING GOOD OR POOR RELATIONSHIP
• c. WHOS CRITERIA DO WE USE AS TO GOOD OR
  POOR RELATIONSHIPS?

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C. TWO MAJOR PERSPECTIVES

• 1.REALISTS, ABSOLUTISTS OR POSITIVIST
• a. DISEASE IS EMPIRICAL, OBSERVABLE AND
  MEASURABLE
• 1) IT HAS A BIOPHYSICAL BASIS

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• 2)TRADITIONAL MEDICAL MODEL
• a) DISEASE IS THOUGHT TO STAND FOR ITSELF
  COMES WITH LABELS REALISTS POSITION

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• b) DISEASE INDEPNDENTOF INTERPRETATION OR
  EVALUATION OBJECTIVE

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• c) MEDICINE REVEALS BIOPHYSICAL
  REALITY REVEAL NATURAL DESIGN
• d) REALITY FROM ANATOMY, PATHOLOGY,
  PHYSIOLOGICAL CHEMISTRY, GENETICS,
  CELLULAR BIOLOGY

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• e) CRITERIA PATHOLOGICAL, STATISTICAL,
  POSITIVE WHO CAPACITY AND
  DEVELOPMENTAL
• f) MEDICINE AS AN OPEN VS CLOSED
  DISCIPLINE

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• 3) KOSA ROBERTSON SUGGEST
• a) GERM THEORY DISEASE AGENTS AND MAGIC
  BULLETS
• b) EPIDEMIOLOGICAL THEORY HOST, AGENT AND
  ENVIRONMENT PUBLIC HEALTH

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• c) CELLULAR GENETIC CONCEPTIONS CELL CHANGES
  AND CHRONIC DEGENERATIVE DISEASES
• d) MECHANISTIC CONCEPTIONS DEFECTIVE PARTS
  REQUIRE SURGICAL INTERVENTION

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2. CONSTRUCTIONISTS, INTERACTIONISTS,
IDEATIONAL PERSPECTIVE SUBJECTIVE
INTERPRETATIONS

• a) ILLNESS AS SUBJECTIVE
• b) SUBJECTIVE SIGNS AND SYMPTOMS

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• c) ASSUMPTIONS
• 1) DISEASE IS SUBJECTIVE, ONLY ILLNESS
  EXISTS
• 2) DISEASE INDEPENDENT OF OBSERVATIONS?

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• 3) EASILY SEEN IN MENTAL ILLNESS,
  ALCOHOLISM AND OTHER STIGMATIC DISEASES
  CAN YOU LOBBY?
• 4) ALL DISEASES ARE SOCIAL PROBLEMS
  OBJECTIVE CONDITION AND SUBJECTIVE
  INTERPRETATION

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• 5) MEDICINE GIVEN BODY, RELIGION GIVEN
  DEITY RELATIONS, AND LAW GIVEN RELATIONS OF
  MEN WITHIN IN FRAME-WORK OF LAWS
• 6) MEDICINE AS SOCIAL AND MORAL ENTERPRISE

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• 7) WE CREATE, SUSTAIN AND TRANSFORM
  DEFINITIONS OF HEALTH AND ILLNESS
• 8) DISEASE AND ILLNESS VARY INDEPENDENTLY,
  BUT NOT TOO INDEPENDENTLY CONSISTENCY
  AND COLLAPSE

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• 9) STUDY CONSEQUENCES OF LABELING
  SOMETHING AS DISEASE OR ILLNESS
• 10)WHAT IS DEFINED AS DISEASE IS NOT ALWAYS
  BIOPHYSICAL, BUT THE RESPONSE ILLNESS
  BEHAVIOR IS ALWAYS SOCIAL, PSYCHOLOGICAL AND
  CULTURAL

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d. MEDICAL MODEL AND EPIDEMIOLOGY
DISENTANGLE ETIOLOGY BY CONSTRUCTING
THEORY. CONSTRUCTIONIST LOOK AT THE
INTERACTION OF INDIVIDUAL AND ENVIRONMENT
AND THE CONSEQUENCES OF LABELING
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E. DUBOS IN ESSENCE HEALTH AND ILLNESS OR
DISEASE ARE AN EXPRESSION OF A
RELATIONSHIP WHICH WE ARE MAINTAINING WITH
OUR ENVIRONMENT AND NOT A PHYSICAL
ATTRIBUTE INDICATED BY AN ABNORMAL PART OF
US OR PROCESS IN US.
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1. BUT ENVIRONMENTS ARE ALWAYS CHANGING,
BECOMING AND EMERGING2. ADAPTION AND
EQUILIBRIUM OR PERFECT HEALTH IS NEVER
MAINTAINED3. PARABIOLOGICAL NEEDS AND VALUES
URGES AND STRIVINGS NOTHING TO DO WITH
SPECIES SURVIVAL
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4.SACRIFICE BIOLOGICAL FOR HIGHER FORMS OF
LIFE CONCEIVED IN THE SOUL RATHER THAN
EXPERIENCED IN THE FLESH CULTURE
EVOLVES FASTER THAN ABILITY TO ADAPT
BIOPHYSICALLY 5.MIRAGE OF HEALTHF. SUMMARY