BEHAVIORAL SCIENCES NOTES (1)

MEDICO LEGAL ISSUES IN HEALTH CARE

• Kibiriti Hillary

  • MSC.HSM (KEMU)

  • BSc.N (MOI)

  • Student MA Psychology (MKU)

  • PHD Candidate (KEMU)

BEHAVIOURAL SCIENCES MODULE ONE

• ETHICS AND MEDICOLEGAL ISSUES

Reality Check: The Mindset

• Doctor's interaction with a patient highlights the importance of recognizing fallibility and respecting patient rights.

• Message: Health workers are not infallible; patients have rights and choices, not passive recipients.

Introduction

• Modern healthcare and research involve value conflicts with unclear consensus on the "right thing to do."

• Conflicts require moral decisions, choosing between alternatives.

• Examples:

  • Parental right to refuse immunizations.

  • Public safety vs. individual rights.

  • Life support for children with defects.

  • Woman's right to abortion.

Ethics And Law: The gist of medico- legal issues

• Ethics and law are similar, providing frameworks for conduct.

• Ethics is the science of standard human conduct, providing guidelines.

• Law provides rules and regulations and elaborates on accountability for violations.

• Law has structures for detailed examination and adjudication of ethical questions, unlike bioethics.

Ethics

• Moral philosophy involving right and wrong behavior.

• Principles, values, standards, or rules guiding decisions, procedures, and systems.

Types of Ethics

• Normative ethics: practical means of determining moral action.

• Traditionally, it studies what makes actions right and wrong.

Applied/Virtue Ethics

• Focuses on achieving moral outcomes in specific situations.

• Deals with how people should act in specific situations

Medical Law

• Concerned with the relationship between healthcare and patients/clients.

• Composed of bits from a large number of branches of law:

  • Family law: family relations

  • Private law: relationships between individuals (contracts and obligations)

  • Public law: relationship between individuals and the state

  • Human rights

Medical Law - Continued

• Contract law: mutual obligations enforceable by law

• Property law: ownership of legally protected claims (land, intellectual property)

• Criminal law: conduct threatening property, health, safety, etc.

• Civil law: disputes between individuals, organizations, etc.

Sources of Law

• The constitution

• The acts of parliament

• The religious books/doctrines

• Culture

• Court/judicial decisions

Sources of Ethics

• Society

• Religious codes

• Social class codes

• Corporate codes

• Scientific codes

• Research codes

• Professional codes

Legal Framework in Kenya

• Kenya Health Policy Framework 2014-2030

• The constitution of Kenya 2010

• Clinical officers act 260(find the new version)

• Nurses act cap 257

• Food, drugs, and chemical substances 254

• Medical practitioners and dentists253

• Human tissues act 252

• Mental health 248

• Pharmacy and poisons 244

• Public health act cap 242

• Blood transfusion bill

• Health Act 2017

The Die Flips

• Something may be not ethical but not illegal i.e. to be discourteous to a patient

• Something may be illegal but ethical – i.e. a clinician not acting in time to a private patient because she was attending a more serious client

Importance of Ethics in Health

• Protects the client: Minimizes harm within clinician's competence.

Importance of Ethics in Health - Continued

• Protects the professional: Guides appropriate behavior, aids ethical decisions.

Importance of Ethics in Health - Continued

• Protects the profession:

  • Criteria for assessing competence.

  • Differentiates clinicians from quacks.

Importance of Ethics in Health - Continued

• Defines the profession:

  • Sets minimum qualification standards.

  • Outlines expected behaviors.

Ethical Dilemmas and Theories

• Ethical dilemma: Value conflict with no clear consensus on what is “right.”

• Conflict between moral obligations requiring moral reasoning.

• Situations necessitating choice between equal (undesirable) alternatives.

• Modern healthcare technology creates many ethical dilemmas.

  • Examples:

    • Assisted suicide justification.

    • Stem cell research (aborted fetuses).

    • Marijuana for pain/chemotherapy effects.

Theoretical Frameworks: Ethical Theories

Deontology /Non-consequentialism Theory

• Derived from Greek word “Deon” (duty).

• Some acts are right/wrong independent of consequences.

• Based on duty.

• Determines ethics by answering: "What should I do and why?"

Example of Deontology

• Example duty to offer information versus the stress caused by the information

• Anita believes she has a duty to give cardiac clients detailed information on their condition even if it causes distress.

Consequentialism Theory

• Also called Teleological theory.

• Actions determined/justified by consequence.

• Considers consequences before deciding.

• Answers: "What should I do and why?"

Consequentialism Theory Example

• Anita respecting client wishes, giving only beneficial information to avoid stress, motivated by beneficence, would be deontological betrayal.

Utilitarian Theory

• Considers the greatest good for the largest number.

• Answers: "What should I do and why?"

• Problem: determining who defines "greatest" and "good".

Intuitionism Theory

• Resolves dilemmas by appealing to intuition (moral faculty knowing right/wrong).

• A gut feeling.

• Difficulty: deciding whose moral position is more valid.

Rights Based Theory

• Resolves dilemmas by determining rights/moral claims involved and precedence.

• Rights may be absolute (uninfringed) or conditional (infringed in some cases).

• Positive rights (requiring action)

• Negative rights (prohibiting action)

• Rights come with obligations.

• Medical law rights: life, autonomy, dignity

• Consider abortion debate (mom vs. fetus/child, choice vs. potential life).

Virtue Ethics Theory

• Focus on character (goodness) of the person, not just actions.

• Qualities like prudence, integrity, respectfulness, benevolence.

Hermeneutics

• Based on listening.

• Resolves disagreements between professionals and patients through shared understanding.

Casuistry

• Emphasizes each case's unique circumstances and facts.

Feministic Approach

• Takes gender and sex as centrally important and the power balance that flows from the two

Principilism

• Based on principles applied to any bioethical issue.

• Respect for autonomy, non-maleficence, beneficence, justice.

• Fidelity (faithfulness), confidentiality, veracity (accuracy).

Principles of Ethics/Plus the Legalese

• Autonomy: Stresses client's freedom of choice.

• Respect rights/dignity.

• Encourage decisions consistent with values.

• Need for consent for interventions.

Principles of Ethics/Plus the Legalese - Consent

• Consent Types: Express, Implied

• Needs capacity.

• Factors interfering with informed consent.

• Information sharing scope.

• Risk perception due to inadequate information.

• Withdrawal option

• Adults with/without capacity

• Children without/with capacity: Gillick competence

• Assignment: Discuss the foundations and application of the Gillick Competence concept.

Principles of Ethics/Plus the Legalese - Dilemmas

• Burden of proof: Criminal Prosecution

• Civil liability, Kennedy and Grubb: consent defense for medical pros, patient capacity required

• Emergency situations, life-saving measures

• Defense line: Defense of necessity

Principles of Ethics

• Non-maleficence: Do no harm.

• Avoid intentional pain/harmful actions.

• Therapist responsibility not to worsen client via intention, recklessness, incompetence.

Principles of Ethics - Continued

• Beneficence: Contribute to client welfare by preventing harm, being proactive.

• Safeguards client and others' rights.

Principles of Ethics - Continued

• Justice: equal treatment for all clients.

• No discrimination.

• Stereotyping/biases unethical.

Principles of Ethics - Continued

• Fidelity: honoring commitments

• Therapist must guard client trust, not threaten relationship.

• No cheating, fraud, misrepresentation.

Principles of Ethics - Continued

• Confidentiality: Respecting client's right to privacy.

• Keeping information secret, not sharing with third parties.

• Cornerstone of patient-psychiatrist relationship.

• Importance aligns with advocating for patients, physicians, public health.

Principles of Ethics - Legal Basis and Breaching

• Legal basis: Contract law, tort law (negligence/defamation)

• Breach scenarios:

  • Not personal information

  • Shared by healthcare teams

  • Group therapy

• Assignment:Discuss the foundations and application of the Terasoff concept.

Health Policy and the Constitution of Kenya 2010

• Constitution of Kenya 2010 provides legal framework for people-driven health services.

• Rights-based approach:

  • Right to highest attainable health standard.

  • No denial of emergency medical treatment.

  • State provides social security to those unable to support selves/dependents.

Health Policy and the Constitution of Kenya 2010 - Continued

• Constitution emphasizes healthcare for children, persons with disabilities.

• Guarantees determinants of health:

  • Adequate housing

  • Food

  • Clean water

  • Social security

  • Education

• Seeks to realize right to health for all Kenyans.

Health Policy Orientations and Objectives

• Orientations: Delivery systems, H/Workforce, Medical Products, H/Financing, H/Infrastructure, Leadership, H/Information

• Objectives: Communicable and Non-Communicable Conditions, Risk Factors & Behaviors, Violence & Injuries, Medical Services, Health related actions

• Goal: Better Health

Basic Rules of Medical Ethics

• Put saving life/promoting health above all.

• Keep patients comfortable, preserve life when possible.

• Respect choice to die peacefully/with dignity (advanced directive).

• Treat all patients equally, avoid bias/discrimination.

• Provide care to best of ability.

Basic Rules of Medical Ethics - Continued

• Maintain skill level consistent with occupation.

• Maintain confidentiality.

• Avoid gossiping about patients.

• Avoid immoral, unethical, illegal practice.

• Show loyalty to patients, co-workers, employer.

• Be sincere, honest, caring.

Sociology & Anthropology MODULE TWO

• KIBIRITI

Module Competence

• Enable learner to apply sociology/anthropology concepts in assisting patients/clients to promote health, prevent illness, manage, and rehabilitate patients.

Module Outcomes

• Utilize sociology/anthropology concepts in healthcare services.

• Utilize socialization process in enhancing group dynamics.

• Involve the family in promotion of health.

Mode of Teaching

• Lecture

• Group discussions

• Assignments/ take-away

• Individual study

• Role plays

Mode of Evaluation

• Summative= End of semester exam.

References

• Elaine D. and Earle S. (2013). Sociology for Nurses, 13th edition, New York: Lippincott Williams and Wilkins.

• Hinkle, J and Cheerer, K. (2014). Brunner and Suddsrth’s Textbook of Medical-Surgical Nursing (14th ed), Philadelphia: J.B. Lippincott Company.

SOCIOLOGY AND ANTHROPOLOGY BROAD OBJECTIVE

• By the end of the course, the students will be able to apply the principles of medical sociology and anthropology in day to day delivery of health services to all clients from different works of life.

SPECIFIC OBJECTIVES

• Explain basic concepts in medical Sociology and anthropology

• Discuss the socialization process and its relevance to health and illness

• Describe Culture and its effect on health and Illness

• Explain social change and its effects on health

• Discuss Social stratification and mobility and its effects on health

• Describe social institutions and their significance in Health care delivery

Introduction to Sociology & Anthropology Sociology

• The term 'sociology' can be traced to Auguste Comte in 1837. He combined the Latin word for society (socio) with the Greek word for science (logy) thus identifying an area of study that pertained to the science of society.

• Sociology is the study of social life, social change, and the social causes and consequences of human behaviour.

Introduction to Sociology - Continued

• Sociologists investigate the structure of groups, organizations, and societies, and how people interact within these contexts.

• Sociology is a social science concerned with social behavior, why people behave as they do, what factors in society affect their behavior, and how groups of people in the society organize themselves.

Introduction to Sociology - Continued

• Sociology as a scientific and systemic study of how societies operate.

• Sociologists look for similarities and patterns that can be detected in the behavior of individuals who may be sharing same environment, or social class or nationality.

• They try to make accurate generalizations about the characteristics of human social activity.

Anthropology

• Is the scientific study of human culture i.e. human values, rules, and behavior or conduct in different types of societies.

• Is the scientific study of people’s biological and cultural development. It is particularly concerned with non-industrialized societies.

What is Anthropology?

• Anthropology is divided primarily into physical anthropology and cultural anthropology.

• Physical anthropology focuses on the problems of human evolution, including human palaeontology and the study of race and of body build features or constitution (somatology)

Cultural Anthropology

• Cultural anthropology includes:

  • Archaeology, which studies the ancient & recent human past through material remains of prehistoric and extinct cultures.

  • Ethnography, which is the descriptive study of living cultures.

  • Ethnology, which utilises the data furnished by ethnography, the recording of living cultures, and archaeology, to analyse and compare the various cultures of humanity.

  • Social anthropology, which deals with human culture and society.

  • Linguistics, the science of language

Differentiating Sociology from Anthropology

• Sociology deals with all aspects of human activities and relationships, their outcomes, rules and regulations

• Anthropology deals with the classification and analysis of humans and their society, descriptively, culturally, historically and physically.

Importance of Medical Sociology and Anthropology for Health Workers

Help the Health Workers in

• Provision of total and comprehensive patient care in any set-up.

• Understanding individual, family and societal needs in a holistic manner.

• Meeting identified societal needs fully

• Creation of good social interaction (nurse- client relationships)

Importance of Medical Sociology and Anthropology - Continued

• Understanding the cause and meaning of varying patient behaviors to make them comfortable and treat them all alike for improvement of client care.

• Gaining greater insight into the human problems as related to illness, sickness and disease

• Provision of right motivation, treatment and physical attitudes and responses of others.

• Understanding emotional reaction patterns among clients in relation to health and disease.

Concepts in Sociology

• Introduction:

• Concepts are ideas, they are expressed through certain words, which are understood to have a particular meaning that defines an underlying reality:

  • Group - this is a combination of more than two persons with common values and objectives, for example, a group of boys walking to the market, a family.

Status

• A status is simply a rank or position that one holds in a social system. Can also mean honor or prestige.

• Two basic types:

  • Ascribed Status

  • Achieved Status

Roles

• The behavior expected of an individual who occupies a given social position.

• It is a comprehensive pattern of behavior that is socially recognized, providing a means of identifying and placing an individual in a society

• Role derivatives are:-Role confusion, conflict, strain, embracement and distance

Power

• Ability to influence the behavior of others with or without resistance.

Values and Norms

• Values: Group conceptions of the relative desirability of things. Sometimes 'value' means 'price‘.

• Norms: Are the rules and regulations that groups live by or simply the standards of behavior of a group and passed from generation to generation.

Types of Norms

• Four common types:

  • Folkways-standards of behavior that are socially approved but not morally significant.

  • Mores- are norms of morality(THE MUST).

  • Taboo – behaviors absolutely forbidden by a certain culture.(THE SHALL NOT)

  • Laws are a formal body of rules enacted by the state and backed by the power of the state.

Belief

• Belief is the psychological state in which an individual holds a proposition or premise to be true.

• Core beliefs

• Dispositional belief

• EXAMPLES…………………..

Conformity and Deviance

• Conformity:

  • The state of strictly following certain norms and values in a society.

  • Helps to achieve order in the society.

  • Sometimes people are compelled to conform.

• Deviance:

  • Is any behavior that violates social norms, and is usually of sufficient severity to warrant disapproval from the majority of society.

Social Structure and Systems

• Social structure:

  • Refer to patterned social arrangements in society that are both emergent from and determinant of the actions of the individuals.

• Social systems:

  • A social system basically consists of two or more individuals interacting directly or indirectly in a bounded situation.

Social Institutions

• A social institution is an establishment or an organ that carries out certain functions for the benefit of the society e.g. marriage, family, religion, education, politics etc.

• An institution: An organized , formal, recognized established way of doing something or of performing an activity in a society .

Social Institutions - Associations

• Association: a component of a social institution i.e. a formal group organized for a special purpose.

• Institutions are for doing things (procedure or activities) while associations are groups that do them

• A social institution comprises of the institution (procedure)and the associations

Social Institutions - Continued

• Institutions are organizations, or mechanisms of social structure, governing the behaviour of two or more individuals.

• Institutions are identified with a social purpose and permanence, transcending individual human lives and intentions, with the making and enforcing of rules governing human behaviour

The Family

• A group of persons united by ties of marriage, blood, or adoption constituting a single household, interacting with each other in their respective social roles e.g. husband and wife, mother and father, brother and sister, creating a common culture

• A family is a basic social unit made up of people related to each other by blood, adoption or marriage

• A family is a universal institution whose most important functions are socializing, and nurturing the younger generation

Types of Families

• Nuclear or conjugal: husband, wife, and immediate offspring (natural, adopted, or both)

• Family of orientation: family of origin or unit into which a person is born

• Extended family or consanguine: nuclear family and other related persons (by blood). These are “kin “- grandparents, aunts, uncles and cousins

Types of Families - Continued

• Blended families: formed when parents bring unrelated children from prior marriages into a new, joint-living situation because of remarriage or cohabitation (refers to a man and woman living together without being married, or homosexual living together .

• Single parent families: formed when one parent leaves the nuclear family because of divorce, desertion(abandon), separation or death.

Authority and Characteristics of a Family

• According to authority, family can be classified as matriarchal (mother in authority) or patriarchal (father in authorities) families.

• Characteristics of a family

  • Every family is a small social system

  • Has its own cultural values and rules

  • Has its own structure

  • Performs basic certain functions.

  • Moves through stages of the life cycle

Functions of the Family

• The control of sexual behavior in the society

• Procreation purposes to preserve the society

• Provision of basic needs to all family members

• Care of socio-emotional needs of its members

Functions of the family - Continued

• Primary socialization of the children aimed at making them responsible members of the society

• The provision of leisure and recreation for family members e.g. cerebration of significant occasions

Kinship

• A social relationship based on family ties. It is a system of defining and classifying one’s relatives.

• Kinship is a relationship between any entities that share a genealogical origin or lineage through either biological,(genetic or blood relation i.e. consanguine relations ) the descent of an individual is reckoned either from the mothers (matrilineal) or from father’s (patrilineal)descent group, cultural(related by marriage i.e. affinal relations)e.g. husband or wife, parents in law etc.

• A descent group - a social group whose members claim common ancestry

Kinship - Continued

• Kinship implies ties of blood (biological kinship), descent (jural or legal kinship) and marriage (affiliation).

• People descended from a common ancestor are referred to as cognatic kin or cognates; those who become kin through marriage are affinal kins or affines.

• As a basic principle of social organisation, kinship gives a person his place in society;

Marriage

• Marriage-A universal social institution which is the basis of the establishment of a family.

• Types of marriage

  • Monogamy-one man to one woman

  • Polygamy-marriage of one person to two or more people

  • Polygyny-marriage of two or more women to one man

  • Polyandry -marriage of two or more men to one woman e.g. Ashanti in Ghana, kandyans in Sri lanka

  • Cenogamy- group marriage. Several men and several women are married to each other.

Educational Institutions

• Education is the deliberate instruction through which a society’s social and technical skills are acquired (Casper Odegi Awuondo, 1993).

• It is a lifelong process that begins as soon as a child is conceived.

• There are two aspects of education: formal and informal.

Education - Continued

• Formal education is acquired through formally established institutions of learning

• Informal education takes place in informal places, for example, the work place, recreational place, among peer groups, in the church or other religious settings

Functions of Educational Institutions

• Transmission of values, attitudes, and behavior from one generation to another. (secondary socialisation)

• Transmission of skills and knowledge

• Provision of job security and economic stability

• Provision of opportunity of talent exploitation i.e. social/psychological functions where one relates with other people outside his family set- up

Functions of Educational Institutions - Continued

• Preparation of children for future responsibilities . E.g. careers, politics etc (personal development)

• Custodial functions. Care of youngsters or most time of the day

• Social integration- binds community together

The Religious Institution

• Religion is an emotional attitude towards the unknown and uncontrolled

• Religion include a belief in the supernatural or sacred. These are things that lie beyond our knowledge and control

The Religious Institution - Continued

• Religion is the shared beliefs and practices which make us recognize the existence of supernatural being and the sacred and man’s relationship to him.

• Religion provides us with moral definition as to what is good or bad. It helps us to come to terms with our environment especially those aspects we do not understand e.g. death, pain and suffering

Functions of Religion

• Group integration -religious beliefs provide a basis for people to unite together

• Social control- religion clearly states what is right and what is wrong. Rules and regulations may be derived from the holy books e.g. the Bible for Christians, Quran for Muslims etc

Functions of Religion - Continued

• The control of stress -religion help the believers to accept and bear pain or agony, sorrow or stress, because it offers them an explanation on why a situation arises.

• Humanitarian function- service for those in need e.g. hospitals, orphanages, homes for the aged and the handicapped schools. The believers provide emergency care in cases of natural disasters such as floods, wars, drought etc

Political Institution

• Major role is to provide social control and to protect the society from internal and external threats.\n* Types of government

  • Oligarchy- government by a small group of people. Power is concentrated in the hands of a few people at the top. This is most common where military elites have seized power from the government in power

  • Monarchy - only one person rules, who comes to power through inheritance e.g. the king, emperor or the queen

Political Institutions - Types of the Government - Continued

• Dictatorship- one person controls all the power to make and enforce laws. Dictators usually seize power by force

• Democracy- the government of the people by the people for the people. It is based on rule by the consent of the majority. The leader is usually voted into power at a general election and his authority is therefore legitimate

Styles of Leadership

• Authoritarian

• Democratic- participative

• Laissez-faire- delegative, free reign

Functions of the Government

• Protecting the constitution

• Maintenance of social order by enacting laws and enforcing them through authorized agents such as police force, court judges etc

• Co- ordination of essential services for the smooth functioning of the society. This is done through establishment of ministries.

• Protecting citizens from enemies either from other countries or rebels within the society . This is done by the army, Navy, and air force.

Health Care Institution

• The purpose of this social institution is to promote health, prevent occurrence of diseases and to cure diseases

• Some of the institutions in the health care include:

  • Traditional medicine

  • Private health facilities

  • Public health facilities

THE SOCIALISATION PROCESS

Socialization process

• According to Peil (1977) it refers to all the things that a child needs to know in order to function as a confirmed member of society.

• Akinsola (1983) defines socialisation as the fundamental social process by which a person is introduced to be part of society into which one was born and learns its culture.

Socialization process - Continued

• Although much of this learning takes place in the first two or three years of life, socialisation continues throughout life.

• When we attend school, move to a new place, take a new job or whenever we are called to make changes in customs, norms or behaviour, additional socialisation is necessary.

Socialization process - Continued

• Socialisation integrates a child into the community by teaching them the disciplines, aspirations, social roles and skills necessary for group membership.

• By comparing the two definitions it can be observed that socialisation is a process or adjustment and this adjustment starts from birth and continues throughout one's life (Myles, 1983).

• Human infants are born without any culture. They must be transformed by their parents, teachers, and others into cultural and socially adept animals

Socialization process - Aims

• The general process of acquiring culture is referred to as socialisation

• During socialisation, we learn the language of the culture we are born into as well as the roles we are to play in life.

Aims / Goals for Socialization

• To inculcate basic disciplines.

• To instill aspirations

• To teach social roles

• To teach skills

• To teach conformity to norms

• To create acceptable and constructive personal identities.

Types of Socialisation

• Primary socialisation

• Secondary socialisation

Primary Socialisation

• This is the type of socialisation that starts from infancy with parents and other family members who are in close contact with the young one.

• The mother plays an active role in bonding with her infant.

• As the child advances in age, they are taught the expected roles according to age and sex.

• Children also learn by observing and imitating others. Therefore, parents should be role models if they expect their children to attain acceptable behavior

Secondary Socialisation

• This takes us outside the home with playmates in the neighborhood, at school and with other community agents, for example, religious forums.

• In addition, children in various neighbourhoods play with their peers who also influence their behaviour and attitudes.

• As these children continue their education through primary, secondary and college levels, they come into contact with several social groupings, all of which are in a position to influence their behaviour

Secondary Socialisation - Continued

• As a member of one group, the individual recognizes that there are several roles one is expected to fulfill.

• This calls for emotional and physical maturity in order to fulfill all these roles without conflicts.

Agents of Socialisation

• The family is made up of parents, children and close relatives. These are the primary agents of socialisation who influence the child's behaviour and attitudes within the society

• Examples of social institutions are the, schools, religious organisations, government and hospitals, helps children acquire secondary socialisation

• The peers, schoolmates and neighbours that a child spends most of their waking hours with also become major agents. Children have friends whom they want to be similar to

Agents of Socialisation - Electronics and Printed Media

• Electronic and printed media These include books, magazines, journals, television, radio, computer (internet) and others.

• A child may begin to emulate what they are seeing on television and may act negatively if they are not able to filter the good and the bad based on earlier teachings. This can have both positive and negative influences on the child or even an adult.

Agents of Socialisation - Influence

• Generally, it can be seen that various socialising agents encountered by an individual may support each other by promoting the same goals, or they may provide contradictory advice.

• The child may be taught one thing at home and another at school. The influence of either the parents or the school thus becomes weakened and the child may not fully internalize any norms because they are not sure which ones are most valuable

Social Stratification

• Stratification is the organization of society resulting in some members having more and others having less.

• Social stratification is thus defined as a process ranking members of society according to wealth, prestige and power. This definition mainly applies in European communities

Social Stratification - Continued

• In African societies, members are ranked according to sex, age, ethnic origin and occupation (Peil 1977)

• Other definitions of social stratification include the arranging of members of a society into a pattern of superior and inferior ranks, which is perhaps determined by their birth, wealth, power, education, and so on

Social Stratification - Theories

• A stratification system has both a moral/cultural base and a structural base Much more attention is usually paid to the structural aspect of stratification (the processes for allocating people to roles and the societal structure which results) than to the cultural aspect (beliefs about how and why people are allocated and the justice or injustice of the process).

• Some roles are held to be important, but are in fact given to less able people or are poorly rewarded

Theories of Stratification

• The Functional Theory of Stratification

  • The functional theory of stratification holds that a society, through its members, makes certain decisions about the allocation of desirable roles. Choice is limited by the number of these roles and the number of people available to perform them.

  • The rewards attached to various roles (wealth, prestige or power) are justified by the service to society involved (especially to societal survival) and the rarity of the abilities needed to fill them.

Theories of Stratification - Conflict

• The conflict theory of stratification draws largely on the writings of Karl Marx, though adjustments have been necessary to adapt in the changing nature of twentieth century capitalism.

• Marx saw society as divided into two major groups (capitalists and proletarians or workers) who are inevitably in conflict

Theories of Stratification - Weber

• Whereas Marx was particularly concerned only with the economic or market hierarchy, which he termed class, Max Weber suggested that people are also stratified according to status (prestige or lifestyle) and power.

• These three hierarchies may be closely related, but this is not necessarily so. Marx assumed that those with a high economic position would also have power, but rich businessmen often have less power than higher civil servants on moderate salaries

Status

• Another way of ranking society members is according to their status. Status can be defined as any position within the stratification system

• A particular status or position can be high or low on the basis of the property, prestige or power (or all three) associated with that position.

• There are two types of status:

  • Ascribed

  • Achieved/acquired

Status - Achieved/Acquired

• Achieved status is a position gained on the basis of merit or achievement. This is defined as the position in society earned through the individual’s efforts or choice, for example, being a father, mother, nurse or a teacher

Status - Ascribed

• This is explained as grouping individuals according to their social position, for example, by virtue of one's age, sex or position of birth(indicates that the holder of this position was born within or inherited a given status in society).

• Ascribed status is a position based on who you are not what you can do.

Social Classes

• Social classes /strata

  • Upper class-for company directors , large scale farmers etc

  • Middle upper class-middle level