Sociology of medicine enters into a new stage of its development characterized with revaluation of numerous approaches and directions yielding novel interpretations to the political and cultural changes in the healthcare system. The changes in scientific paradigms, methodological pluralism, and interdisciplinary approach capable to incorporate the diverse methods and methodologies promote attaining novel and possibly extraordinary vital social aims.
In the time of social structural transformations and the related social changes, it is especially important to analyze the complex processes underlying modernization of medicine, which is one of the most important institutions of society. It is equally important to promptly take into consideration the full spectrum of influences produced by social activities and their impact on the development of medical science and education, organization of medical aid, population mobility, and the overall healthcare system in the Russian Federation (RF).
At this stage, it is necessary to assess the contribution made by sociology of medicine in understanding the social nature of modern activity aimed to improve the healthcare standards. Sociology of medicine in our country should carefully analyse and select the theoretical guidelines and socially important avenues of medico-sociological studies.
The novel socioeconomic conditions stress the importance and necessity to impart a novel momentum to sociology of medicine in the RF. This branch of science focuses on the integrated personalities within the context of medico-sociological environment. Moreover, this science can make important contribution to the development of adequate views and understanding of the health and disease realities in modern society. In our country, sociology of medicine possesses the adequate potential to meet this challenging task. Numerous domestic studies carried out during the past decades match the modern high-end level of investigations currently performed in this field in Europe and the USA. During the last decade, 21 doctor and 165 candidate theses were defended in the RF on sociology of medicine.
The major aim of this textbook is to present sociology of medicine as a branch of science. The common routine approach to sociology of medicine appeals to basic sociology categories filling them with some kind of sociomedical content. At present, it is not possible and unreasonable to entirely refuse medico-sociological ‘reengineering’ of the basic concepts and notions. However, it should be stressed that the advanced approach, i.e., to consider sociology of medicine as a practical application of the sociologic theories, finally substitutes and degrades the subject of sociology of medicine, which possesses its own field of study and cannot be reduced to general political and economic sociologic theories.
The modern methods of medico-sociological examination try to take into account the full spectrum of social-humanitarian achievements including those made in the fields of informatics, cybernetics, synergetics, system theory, and the catastrophe theory, which greatly enriches the entire range of science. The methods of sociology of medicine are the tools of theoretic and empiric study. When using the sociological conceptions in the field of healthcare, sociology of medicine elaborated its intrinsic logic and the related models to be delineated and described further on.
At present, the experience in teaching sociology of medicine in our country is rather limited. Traditionally, Russian medical education is based on teaching students with fundamentals of public health and organization of the healthcare system, incorporating lectures on sociological studies focused on some specific problems. Therefore, there is an acute need in scientific publications in the field of medico-sociological education to integrate harmonically a) the leading western theories and paradigms presenting the classical heritage of the international sociology of medicine; b) the best empirical studies and theoretical works performed in the recent soviet and post-soviet periods that compose the golden fund of sociology of medicine in our country; c) analysis of medico-sociological problems emerging in the current domestic realities and interpretation of dynamics of the underlying processes and phenomena with due attention to cause-effect relations.
The present textbook describes the most important subdivisions and vistas in the study of sociology of medicine which are the irreplaceable constituents in the process of socializing the medico-sociological knowledge.
Part I of this textbook describes the subject and object of sociology of medicine as well as the regularities in the study of medico-sociological phenomena and typology of the institutional changes in the system of health strengthening and protection.
The second part considers evolution and the place of sociology of medicine in modern scientific knowledge and in practical performance of the social systems. It explains the basic directions in the development of sociology of medicine and plays emphasis on interdisciplinary essence of this science as its methodological guideline.
The third part examines the models (patterns) and conceptions of health and disease. It carries out the comparative institutional analysis of the disease models and the conceptions of the development of various healthcare systems. In addition, this part investigates the social origin of sociology of medicine. Formation and development of fundamental concepts of sociology and social psychology are viewed on the basis of ideas and principles of sociology of medicine. The basic conceptions of social and economic institutionalization are explained in light of classical guidelines of social theories like Marxism, functionalism, and Weberianism with their reflections in diverse models of sociology of medicine.
Part IV considers the institutional changes in medicine and healthcare viewed as the public sphere of the society. An important place is given to the institutional changes in the sociocultural pattern of health-and-disease as well as doctor-and-patient.