Mechanisms of power, victimization and autonomy in the health care system

Erzsébet Takács

doi:10.18392/metsz/2016/2/7

Abstract

The aim of this paper is to describe power relations, doctor-patient relationships among themany ongoing changes in health care from sociological point of view. This paper is based oninterviews with 17 people who work in various fields of health care. To conduct the interviews aswell as to write the paper, a number of concepts and theoretical approaches were resorted to:Dominique Memmi’s ’delegated biopower’, Eve Bureau and Judith Hermann-Mesfen’s notion of’contemporary patient’, François Dubet’s concept of institutional programme as well as results ofHungarian health sociology. The main focuses of interest of the paper are role models in healthcare, the characteristics and consequences of new doctor-patient relations, their manifestationsin Hungary as well as potentials of defencelessness and autonomy in Hungarian health care.

Highlights

This paper is based on interviews with 17 people who work in various fields of health care1
The focus of the research wasthe old and new power mechanisms that are interwoven into health care institutions, doctor-patient relationships, victimization and autonomy
The final conclusion of our interviews is that global changes have a greater influence on the power relations of doctors and patients than domestic conditions such as burnout - which can interpreted as a sign of crisis, increasing hopelessness among health care workers, lack of trust toward everyone involved in the system, lack of reliable, realistic vision of one’s future, emigration, hospitals in debt,35 learned powerlessness, and total vulnerability of certain social classes

Summary

Introduction

This paper is based on interviews with 17 people who work in various fields of health care. (GP) As we saw earlier, influencing the patient to make the „right” choice for his health is not an ethical problem for some of the doctors: I think, a completely independent decision cannot be expected or allowed, because them taking the meds or not, certainly there is no-one standing there to put them in their mouth, but you must explain it to them, if they don’t take them, I don’t know, high blood pressure can lead to the development of complications, a heart attack, a stroke or something, and it will be too late,... Marie Ménoret arrived at the same results when analysing English and French literature on autonomy in terms of health care She says autonomy primarily comes up as an opposition to physical defencelessness of the patient, or in the peculiar context of chronic patients, because developing means and practices that enable patients’ selfcuring is gaining ground (Ménoret 2015). They often describe their professional duties by being subordinate and obedient to the doctor. Nursing is seen as one of the most exploited professions because of constraints and necessities due to work conditions and organisational structures, social inequality and low

26 Dubet 2002

Conclusion