Editorial

Abstract

In setting out to write this editorial I organised the papers into what I thought would be themes on risks, individual responsibility for one's health, pregnancy issues, stress and health, and finally the paper by Collyer (2012) on the sociology of health and medicine in Australia. In coming then to the specifics I began at the end with Fran Collyer's paper of the history of the Sociology of Health and Illness within Australian Sociology. Many of our Australian readers will be familiar with this research project, they may have been interviewed by Fran as part of this project, or perhaps read it now, noting points they assent to, or those they take issue with. I suspect that it is a paper that will create much debate here in Australia and perhaps motivate readers in other countries to refl ect on the parallels. A key refl ection for me in Collyer's account is the old binary between the sociology in medicine and sociology of medicine. This distinction in health sociology did not really take hold in Australia - the former dealing with how sociology might assist medicine, the latter using sociology to critique or describe the workings of medicine within the wider health care system. I think both have been employed in Australia, but the strength of the various organisations mentioned by Collyer has been their role in ensuring that the sociology of medicine remained dominant, and was not captured by medicine. This is aptly illustrated in her careful use of the term Sociology of Health and Medicine, rather than Medical Sociology.A critical Sociology of Medicine provides a unifying theme for the other eight papers in this issue. The first paper by Almeida (2012) draws on her doctoral studies to outline the Portuguese medical professions' approach to two complementary therapies; acupuncture and homeopathy. Almeida outlines the continuing power of medicine to determine access to health care, in this case through the process of legitimisation of certain health modalities. In her example, both particular medical practitioners and lay people's access to homeopathy is limited by the capacity of medicine to determine what is legitimate. The study by Lane (2012) continues the sociology of medicine theme, illustrating the power of the profession of obstetrics to re-assert its control over the profession of midwifery. Drawing on the work of Douglas (1992) and Crook (1999) Lane illustrates the way in which the current Australian Federal government policy has reinstated medical dominance over midwives, following attempts by the Rudd Labor government to reduce the costs of obstetric private hospital and medical care, by providing midwives and birthing women with the options of midwife led care. This reassertion of medical dominance, demonstrates the complexity of neo-traditional ordering of risk; there is no clear argument, but rather a set of competing rights and preferences, based on the power of particular groups; in this case obstetrics. This is a reassertion of medical dominance after a time of positioning the consumer (read woman) at the centre. There is, as a consequence, a discourse of consumer rights, but also a plethora of policy guidelines, regulations, and demands that ensure that midwives are once again subordinate. As Lane argues this is a new radical conservatism, reminiscent of the general argument posed in other papers in this issue (see Harper and Rail 2012; Schirmer and Michailakis 2012; Williams 2012), whereby there is both a championing of consumer rights and choice, along with a demand for consumer engagement, yet somehow a continuation of medical control. How all modes of power operate is perplexing.A Sociology of Medicine throws up a number of themes; the medicalisation of everyday life; the medicalisation of deviance; individual responsibility for one's health; and the increasing shift of responsibility for care of those with chronic illnesses onto the individual and their carers. These themes are captures in the paper by Werner Schirmer and Dimitris Michailakis who remind us that lay people are increasingly being held responsible for their health. …