p.436 ...for common sense there may be some question of whether "being
sick" constitutes a social role at all - isn't it simply a state of fact, a
"condition"? ...The test is the existence of a set of institutionalised
expectations and the corresponding sentiments and sanctions.
There seem to
be four aspects of the institutionalised expectation system relative to the
sick role.
- First, is the exemption from normal social role
responsibilities...[p.437]
- The second closely related aspect is the institutionalised definition
that
the sick person cannot be expected by "pulling himself together" to get
well by an act of decision or will. In this sense also he is exempted from
responsibility-he is in a condition that must be "taken care of"...
- The third element is the definition of the state of being ill as
itself
undesirable with its obligation to want to "get well"...
- ...the fourth..is the obligation...to seek technically competent
help...
...the role of motivational factors in illness immensely broadens the scope
and increases the importance of the institutionalised role aspect of being
sick...The privileges and exemptions of the sick role may become objects of
a "secondary gain" which the patient is positively motivated, usually
unconsciously, to secure or to retain.
p.439 ...a pattern of behaviour on the part not only of the physician, but
also of the patient, is expected...
p.440 ...it must be remembered that there is an enormous range of different
types of illness, and of degrees of severity. Hence a certain abstraction
is inevitable in any such general account as the present...
By institutional definition of the sick role the sick person is helpless
and therefore in need of help. If being sick is to be regarded as
"deviant"
as certainly in important respects it must, it is as we have noted
distinguished from other deviant roles precisely by the fact that the sick
person is not regarded as "responsible" for his condition, "he can't help
it."