Dorothy Pawluch

Ontological gerrymandering: the anatomy of social problems explanations

Recent explanations of social problems have increasingly adopted the “definitional” perspective. This paper provides a critical commentary on the form of sociological explanation common to this approach. Viewed as a practical accomplishment, both theoretical statements and empirical case studies manipulate a boundary, making certain phenomena problematic while leaving others unproblematic. We call the main strategy for managing this boundary ontological gerrymandering. After applying this concept to both theoretical and empirical studies of social problems, we show that the same conceptual problems arise with respect to the labeling theory of deviance. We argue that investigation of the practical management of these problems will contribute to a deeper understanding both of social problems explanations and sociological explanation more generally.

Lay constructions of HIV and complementary therapy use

This study examines the meanings that individuals with HIV attach to their use of complementary therapies. A qualitative analysis of 66 interviews completed between 1993 and 1998 showed that complementary therapies represent different things for these individuals--a health maintenance strategy, a healing strategy, an alternative to Western medicine, a way of mitigating the side-effects of drug therapies, a strategy for maximizing quality of life, a coping strategy, and a form of political resistance. We found that the meanings individuals ascribe to complementary therapies and the benefits they expect to derive from them are not idiosyncratic, but linked to social characteristics--sexuality, ethnocultural background, gender--and to beliefs about health and illness, values and experiences. We found as well that these meanings are neither mutually exclusive nor fixed. The therapies often appeal to individuals on different levels and their appeal may change over time.

Medical Students and the Cadaver in Social and Cultural Context

If, on a bright September morning, you were to walk into the anatomy laboratory of a typical North American faculty of medicine, one of the first things to strike you might be the smell of formaldehyde — next the air of calm, studious concentration of white coated figures, men and women in teams of four, bent over their gleaming stainless steel tanks. Moving closer to one of the groups, and glancing over a medical student’s shoulder, you might be horrified to see that the young man or woman was contemplating a cadaver, perhaps its face and midriff draped, a lab manual or textbook nearby opened for easy consultation to help in identifying elements of a neatly dissected portion of human anatomy.

Transitions in Pediatrics: A Segmental Analysis

Pediatricians, once concerned solely with treating disease in children, are becoming increasingly involved in managing troublesome behavior. This paper shows how the pediatric mandate began widening after 1950 as medical advances drastically reduced the infant and child mortality rates. Worried about their declining status and possible disappearance as primary care specialists, pediatricians sought a new mission in ministering to the psycho-social and behavioral needs of children. This case study contributes to our understanding of the problems and strategies of threatened professional segments in medicine.

How People With HIV/AIDS Manage and Assess Their Use of Complementary Therapies: A Qualitative Analysis

The objective of this article is to provide a qualitative analysis of the practical concerns that people with HIV/AIDS have with regard to their use of complementary therapies. In-depth semistructured interviews were conducted with a diverse range of people with HIV/AIDS (N = 46). An inductive grounded approach was used to collect and analyze the data. There were five central concerns: (a) selecting which therapies to use, (b) judging which therapies work, (c) combining Western medicine with complementary therapies, (d) assessing the safety of complementary therapies, and (e) dealing with the barriers to the use of complementary therapies. A better understanding of the practical dimensions of complementary therapy use highlights the treatment and care issues that people with HIV/AIDS face and offers insights into the role that nurses might play in addressing some of these issues.

Stockholm syndrome as vernacular resource

First coined in 1973 to describe a pathological response on the part of individuals involved in kidnapping or hostage-taking situations, the label “Stockholm syndrome” has since been used in a much broader range of contexts including reference to wife battering and human trafficking, and in debates about gender and race politics as well as international relations. Tracing the domain expansion of Stockholm syndrome since the 1970s, we examine how the label offers claims-makers a device for neutralizing the arguments of those with opposing points of view, and, in so doing, reinforces collective narratives and “formula stories” of victimization.

What Do People Living With HIV/AIDS Expect From Their Physicians? Professional Expertise and the Doctor-Patient Relationship

This qualitative study identifies the types of professional expertise that physicians are seen to possess in clinical encounters from the perspective of people living with HIV/AIDS (PLWHA). Respondents looked to their physicians for expert knowledge in 3 key areas: medical/clinical; legal/statutory; and ethical/moral. Physicians were seen to be authorities in each of these areas and their judgments, though not always agreed with, were taken seriously and influenced the health care decisions made by PLWHA. The authority that comes with professional expertise in each of the areas identified was experienced both positively and negatively by PLWHA. Understanding the expectations of patients in the medical encounter can assist physicians in providing optimal care in the management of HIV/AIDS.