Discuss how far Goffman`s analysis of `total institutions` offers a relevant framework for looking at present day care environments.
Erving Goffman’s theory of total institutions presented in his essay an asylums published in 1961 (Goffman, 1961). He based his essay on his observations in the National Institute of Mental Health in Washington, D.C., and describes that the concept of institutionalization as an effect to bureaucratic structures and patient decline that can be attributed to the state of Total Institutions. The total institution model has been criticized for its basic theoretical limitations but has remained popular with social scientists, rights advocates and lobbyists for hospitalization (Hebding & Glick, 1992).
The problem with Goffman’s stand is the negativity that it attributed to the institutions. The effect is that organizations will be considered inherently unproductive and detrimental and allows for individuals to be considered blameless for the circumstances by which an institution exists or operate (Goffman, 1961). An extremist implication is that it would be ultimately wiser to make do without these “total institutions” or that health care professionals have little impact on the quality of the service provided by these institutions.
The Welfare State proposed by William Beveridge in 1940`s Britain has been described as a `grand scheme for reconstruction`- or as sexist and racist. Which do you think is more accurate and why?
William Beveridge was asked by the Ernest Bevin, Minister of Labour to look into the state of England’s of social security system. Apart from developing a better social security system, the study was to be the foundation of England’s rebuilding efforts after World War II. 11. The 1942 report’s main thrust was the establishment of a welfare system to be supported by the work force in the form of contributions to a common insurance fund that will provide aid for sickness, unemployment, retirement and the widowed. The system was to subsidize living costs for a minimum standard of living in the country (Beveridge, 1942).
The post-war conditions that were the premise of Beveridge’s health care system have changed: post-war welfare policies afforded women little to no access to benefits for themselves and only as dependants of their spouse (Williams, 1993). Davies (1986) pointed out the need to review of Beveridge’s model not because it was a deficient, he points out that the model was sound for post-war conditions significantly, but because of the unprecedented developments for social security in today.
In spite of its successes, the biomedical model has been criticized. Why?
According to Boorse (1967), it is feasible to give objective, impartial observations using “teleological function statements” using biomedical models. Furthermore, Boorse says that a function is the determinant for the design of an organism and that, "function in a biologist's sense is nothing but a standard causal contribution to a goal actually pursued by the organism".
In contrast, De Vito (2000) has pointed physiology is not the central concern but the value-laden concept of life that acts as the criteria in considering structure of physiology and vital teleological goals. Attitudes and ideals health and illness contribute to the perception and identification of symptoms and the consequent medical course of action (Kirmayer, Young & Robbins, 1994). The concern is that standardized biomedical models continued consider of pathology rather than the development of knowledge of the disease and do not account for practical somatic conditions.
How do written records and oral histories contribute to our understanding of people's experience of care?
It is important that healthcare systems factor social institutions and their success depends on the development of models that consider patients’ histories as component and products of society and not just of their physiology (Wade & Halligan, 2003).
In this new model a consideration of a patient’s written records and oral histories provide insight that go beyond the biomedical models or statistical standards. Database of medical information also can provide greater insights to medical conditions and may provide reference for future researches.
Outline different categories of abuse and discuss how you would judge the seriousness of different forms of abuse.
Abuse, according to the Devon County Council (2006), comes in the forms of
- Neglects and acts of omissions
- Discriminatory and
- Financial or material maltreatment
Among these forms of abuse, abuse against children, women and the disadvantaged are the increasing areas of concern. The standard today is that all suspicious injuries or conditions must be reported to the police for investigation. Though abuse has significantly risen in recent surveys, it has not made a revolutionary impact on health care practices yet (Manfredi & Maioni, 2002).
Stereotyping in care work can lead to discrimination. Explain how this arises and how such discrimination can be challenged.
To create truly effective health care systems, there should be a prevailing effort to be aware of the changing society (Hughes & Lewis, 1998). Stereotyping in care work does not only lead to decline of service quality but also diminishes the value of health care and welfare professionals. It should be recognized that these professionals have to deal with not just health of welfare issues but must tackle societal ills as a whole (Bakan, 1997).
Why is paid home care work important? Is its importance reflected in training and levels of pay? If not, why not?
The need for coverage for home care will improve the quality of services provided as well standardizes training levels and rates of service. Health industry crises and budget cutbacks have forced some hospitals and health services to shut down does limiting the locations where services can be accessed. The development of home care as a profession may be the answer to this concern. To alleviate the cost of home are, may opt to get services privately. This raises the concern for medical risk and insufficient training. Home care should be viable profession in health care if it is developed as a sector in the health industry if the increasing demand for the service is to be met.
What is meant by accountability and why is it important in health and social care agencies? What are some of the difficulties that arise in practice?
Quality service is an accountability of the health care industry. The delivery of these services ensures the success of the community (Arendt, 1958). Health Care and Welfare providers must be responsive and able to change as society does otherwise they fail their role as an institution (Democratic Health Network, 2006). The increasing demands because on existing health because of either developing demographics is not just about funding but also entails the more important issue of effective management (Bakan, 1997).
What are the different approaches in which education and training has been framed for the health and social care workforce? Evaluate the strengths and weaknesses of the approaches you identify.
Current educational systems involve education and practicum. The system has been proven effective because it provided both technical and practical approaches essential to the filed.
However, the profession should be considered on that needs continuing education to be allow workers the ability to deal with the developing needs of society. Personal support education for the health welfare professional must also be given to help them deal with the emotional and psychological stress of their profession.
Standards and operating procedures in the field should also be responsive and suited to the needs of communities. A colder coordination with community groups and social interest groups can also provide insights to prevailing needs that have to be addressed by health and welfare workers (Wade and Halligan, 2003).
Care relationships can be both rewarding and demanding. Illustrate both aspects of such relationships.
Health and Welfare are essential institutions in society because of they center on the quality of life and life itself. Beyond diagnostics, prescriptions and treatment is Health and Welfare’s role in establishing the value of our existence and our significance in society.
Health care professionals are given a career that is rewarding and allows them to directly affect society. Individuals benefit from the improvement of the quality of their lives as well as their enjoyment of it. And as a whole, society is able to reflect, through its Health and Welfare system, its core values as well as build a secure and happy society.
Arendt, Hannah (1958). The Human Condition. Chicago: University of Chicago Press.
Bakan, Joel (1997). In Just Words: Constitutional Rights and Social Wrongs. Toronto: University of Toronto Press.
Beveridge, William (1942). The Report to the Parliament on Social Insurance and Allied Services. London: Ministry of Labour.
Boorse, Christopher. Wright on Functions. The Philosophical Review. LXXXII. pp 67-89.
Davies, S. (1986). Beveridge Revisited: New Foundations for Tomorrow’s Welfare. London: Centre for Policy Studies.
Democratic Health Network (2006). Accountability of the Health Service. Retrieved on September 9, 2006 from http://www.dhn.org.uk/module1-detail.jsp?section= what_we_do_dhn&id= 14.
De Vito, Scott. On the Value-Neutrality of the Concepts of Health and Disease: Unto the Breach Again. Journal of Medicine and Philosophy. Vol., 25, No. 5. 2000. pp. 549-556.
Devon County Council (2006). Forms of Abuse, including Signs and Signals of Abuse. Retrieved on September 9, 2006 from http://www.devon.gov.uk/index/socialcare/older_ people/adult-protection/appg/ap-alert-guide/ap-alert6.htm.
Goffman, Erving. (1961). Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. New York: Doubleday.
Hebding, D. E. and Glick, L. (1992) Introduction to Sociology. New York: McGraw-Hill Inc.
Hughes G. and Lewis, G. (1998). Unsettling Welfare. London: Routledge.
Kirmayer L.J., Young A., Robbins J.M. (1994). Symptom Attribution in Cultural Perspective.
Manfredi, Christopher P. and Maioni, Antonia (2002). Courts and Health Policy: Judicial Policy Making and Publicly Funded Health Care in Canada.
Sade, Robert. M. (1995). A Theory of Health and Disease: The Objectivist-Subjectivist Dichotomy. The Journal of Medicine and Philosophy. Vol. 20, No.5.
Wade D.T., Halligan P. (2003). New Wine in Old Bottles: The WHO ICF as an Explanatory Model of Human Behaviour.
Williams, F. (1993). Gender, Race and Class in British Welfare Policy in Comparing Welfare States: Britain in International Context, ed. A. Cochrane and J. Clarke. London: