Monday, 28 November 2016

Talk : The Politics of Illness

Interesting Cafe Sci talk recently by Chris Ward, emeritus professor at the University of Nottingham, comes to Café Sci to talk about "The Politics of Illness". @GavSquires was there and has written this guest post of the event!

Prof Chris Ward

What is illness?
Prof Ward commented that illness isn't the same as disease. For example, an Ash tree can have dieback, a disease, but it isn't ill. Illness is specific to certain types of being - you might describe a dog as being ill but you wouldn't describe a fruit fly as being ill. Disease caries itself on its sleeve, it has an objective quality that illness doesn't have. You can have a disease but not really be ill, for example athlete's foot. But can you have illness without disease? Illness is a state of suffering and incapacity. For example, ME (or chronic fatigue syndrome) doesn't present any symptoms of disease. What are the states of being for ME sufferers and their families? This mystery illness for which we have yet to find a cure.

What is politics?
Prof Ward quoted a definition of politics as the "study or practice of the distribution of power in a given community". In the case of healthcare there is the doctor, the patient and the illness, a three-way relationship that involves the transfer of power. So, it is a political act. Politics filters all the way down to even the mother and infant relationship - we have the translation of very powerful intuitions into political life.

The politics of individuality are also at play - the stigma attached to illness. The idea of being classified, whether it is willingly, unwillingly or unknowingly. Just because someone is ill, they still have opinions. The highlighting if individual differences and the stigma that can come from something like ME. You also get situations where people are thinking, " I'm not myself therefore I must be ill". There can also be a certain prestige to being diagnosed as being ill and following such a diagnosis, one can deviate from regular behaviour. Those with a questionable diagnosis do not experience this.

The politics of illness often comes down to whether it is illness or something else - the battleground of the physical verses the mental. Often ill people are not heard, understood or believed. The can be denied help, confused, attacked, angry and incoherent. But what do these low level responses really mean? Those with ME are often not seen as "passing the test" of actually being ill. Mental illness attracts the same stigma. Most doctors accept that ME is a real disease but there are still some people who think that it can be overcome with positive thinking and exercise. The diagnosis generates such passion and energy that it's been known that ME researchers have faced death threats.

There's also an outer context - public issues of social structure relevant to illness. Medication is led by big pharma and doctors - doctors are seen as agents of social control. So, there can be issues of diagnosis verses social structure. How often do we hear of women's issues being dismissed as being emotional problems and mental illness being seen as a brain disease rather than psychological? All of this is happening at the macro level - how do we correct people to the higher level of thinking?

There are psychological influences at work when it comes to the politics of illness - fear of the other (the well vs the unwell) and of course the deeply ingrained the fear of death. With illness there is also a loss of sense of security in oneself. This is at the very heart of what illness is - not being oneself. Indeed, when you challenge someone's illness, you challenge their self. There is also an issue with language - it dictates that illness must be a thing. When someone says that they are ill, the first question is usually, "what is it?"

Café Sci returns to the Vat & Fiddle on the 12th of December at 8pm when Nicole Porter will speak on Biophilic Design - Buildings and Cities to Connect People With Nature. For more information, visit the Café Sci Meetup page:

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