Explaining the Absence of the Lay Voice in Sexual Health Through Sociological Theories of Healthcare

Abstract

This paper seeks to use social theory to present a range of perspectives on why the lay voice has been under-represented in sexual health. The paper first of all describes the absence of the lay voice in sexual healthcare in relation to the public health practice of contact tracing in the context of a syphilis outbreak in the Greater Dublin Area. The paper then presents a range of perspectives from social theory which offer ways of understanding such lay–professional relations in sexual health and especially the absence of the lay-voice. It is argued that Parsons's model of the sick role presents an understanding of the process of cultural socialization, which have led to professional dominance over the lay perspective. It is argued that Foucault's understanding of the surveillance powers of medicine offers a critical vantage point on sexual healthcare. However, similar to Parsons, it is also a politically conservative critique as it does not present a radical understanding of how the laity might achieve greater power in their relations with health professionals. Finally, it is argued that Habermas' theory of communicative action and discursive democracy may be usefully applied to healthcare policy making. This is especially so in terms of the development of a communicative structure, which could foster equitable dialogue and the principle of mutual accountability within lay–professional relations in healthcare.