Contents | Issue 2 (2024)
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Sociology of Medicine and Health
Anastasia A. Novkunskaya, Artemiy A. Minakov, Anna A. Klepikova
Abstract
This article explores the bureaucratic, legal and economic dimensions of the neonatal care. Drawing analytically on the neo-Weberian approach in the sociology of professions [Freidson 2001] and the anthropology of bureaucracy in medicine [Berg 1996; Berg & Bowker 1997], we propose to analyse the medical documents and the practices of its composition as both a constitutive element of medical practice and as organisational infrastructure that ensures the coordination of different professional groups and their interactions with patients. Specifically, we define this part of the work of doctors, nursing staff and health care managers in the context of neonatal resuscitation care as a process of creating and modifying a 'paper body' for their patients, i.e. all the document flow that accompanies the processes of treating and routing the patient. Empirically, the study relies on qualitative data collected within ‘the Birth of the Patient’ project: diaries of included observations of a neonatal intensive care physician, ethnographic observations by social researchers, focus groups with neonatal intensive care unit staff and interviews with medical professionals and healthcare managers. As a result of this data analysis, we find that the documentary history of the newborn patient is shaped by multiple negotiations between different medical professionals and representatives of different health care institutions. In some cases, the patient's 'paper body' turns out to be a major determinant of his or her future trajectory of (de)hospitalisation. We also find that the formation of such a documentary biography of a newborn patient does not directly correlate with his or her clinical condition, but reflects the complex system of distribution of material and non-material resources that constitute the newborn care service and in some cases goes beyond it.
Ilya Utekhin, David V. Oganyan
Abstract
Medical doctors arrive at a diagnosis after considering various types of evidence, including the patient's complaints, their outer appearance, talk, and non-verbal behavior. In psychiatry, the role of conversation is more important than in somatic medicine, because it is in the patient's talk that the disease can express itself. Some elements of the conversational machinery have been studied in diagnostic interviews in a psychiatric ward. In the interviews, a recurrent pattern of the doctor’s questions and the patient’s answers was found. Schegloff (2007) showed that “known answer” questions form a distinctive three-part sequence type: question-response-evaluation. In diagnostic interviews in psychiatry, the questions don't address knowledge but the capacity to perform the task. Not all the test questions have a correct answer, and the result of the evaluation is not always announced by the doctor. The doctor consistently repeats the patient’s answer without evaluating it and then adds a follow-up question. At least parts of the repeated cycles in the sequence of doctor-patient interaction exhibit the following pattern: Doctor’s question > Patient’s answer > Doctor’s echo > (optional Doctor's follow-up question). When the doctor's questions seek real information—and do not just test capacity—they sometimes resort to a reformulation of the patient’s answers instead of just repeating it; this reformulation works as a prompt. The questions in the clinical interview appear to follow two lines of accountability: the ordinary conversational order and that which is provided by the professional reasoning aimed at checking diagnostic hypotheses. The second line is not usually accessible to the patient.
Dmitry M. Rogozin
Abstract
The article is devoted to understanding a healthy lifestyle in old age, significant limitations and differences that arise with age and redefine many basic ideas about health. The article begins by identifying basic ideas about healthy aging, which are questioned and clarified through an analytical analysis of dense interviews (the author’s terminology for qualitative interviews, the closest analogue of which in the Russian-speaking environment is in-depth interviews) with old people. Field work took place in the Republic of Khakassia in three cities: Abakan, Chernogorsk and Abaza. A total of 12 interviews were conducted with older people receiving long-term care services. Based on the received narratives, five conditions accompanying aging were identified: living in illness; accepting limitations; loneliness; support and withdrawal from others; emotional depression. Through a critical understanding of the life world of aging, four signs of a healthy lifestyle in old age are identified: attention to the old man, the need for the old man, the value of aging and the presence of a goal in life for the old man. Modern social policy in Russia is based on only one component of “attention to the elderly” (although other components are also declared by law), through the organization of long-term care, the development and implementation of rehabilitation means, and the creation of an accessible environment. But the most important elements remain the formation of the need for the old man among significant loved ones (relatives and others), joint agreement, the formation of goal-setting in the old man in life and the promotion of the value of aging as such. The article proposes an agenda for further research to more accurately shape domestic policies in the field of aging.
Articles
Anastasia D. Kazun, Daria V. Petrova
Abstract
This article examines two opposing media consumption trends—news avoidance and doomscrolling—through the lens of media environment and societal fragmentation. News avoidance refers to the conscious limitation of economic or socio-political content consumption to maintain emotional well-being, while doomscrolling is defined as compulsive and excessive attention to negative news. The study is based on 91 semi-structured interviews with individuals exhibiting these media consumption styles. News avoiders and doomscrollers demonstrate the ability to understand each other's logic through reflection on their own experiences and interactions with their social environment. However, both groups criticize the opposing media consumption style. Doomscrollers view news avoiders as passive and under-informed, whereas news avoiders accuse doomscrollers of addictive behavior. The interviews frequently reveal normative judgments about the necessity of consuming or avoiding news. Additionally, both groups perceive each other as more vulnerable to misinformation: news avoiders are associated with ignorance, while doomscrollers are seen as prone to believing false or biased media reports. A commonality between the two groups is anxiety about the future. The differences in news consumption volumes are explained by varied approaches to managing anxiety and assessing the usefulness of information. Thus, doomscrolling and news avoidance can be considered two sides of the same coin. However, these opposing media consumption styles contribute to further societal fragmentation, widening the gap in awareness of current events.
Anastasia P. Golubeva
Abstract
This article examines the critique of social contract theory in Thomas Hobbes' Leviathan through the lens of Georges Bataille's notion of sacrifice. Bataille and Hobbes share several key motifs, including death, violence and sovereignty. However, they interpret these motifs in different ways. Hobbes rationalises these concepts by introducing the concept of the social contract, whereby individuals relinquish their freedom in exchange for security. For him, the state is a means of protecting people’s lives through rational submission to the social contract. In contrast, Bataille emphasises the role of the irrational and the sacred, viewing them as a means of liberation from the fear of death, the material world and domination. Sacrifice plays a pivotal role in Bataille's philosophy, serving as a conduit to the sacred and a unifying force within communities through shared experiences of loss and sacrifice. Nevertheless, he acknowledges that over time, the significance of sacrifice has increased in terms of utilitarian value, while its intrinsic value as an act of gratuitous giving for the sake of affirming the "fertility of life" has diminished. Hobbes's social contract can be presented in basic terms as the sacrifice of a good for the sake of exchanging it for another good. This is exemplified by the exchange of the right to liberty for protection from the sovereign. For both Hobbes and Bataille, the fear of death is the rationale behind the relinquishment of freedom and the introduction of prohibitions. But Bataille, unlike Hobbes, proposes to build society not on the fear of death, but on overcoming this fear and sovereign rejection - the rejection of both one's freedom and the transfer of it to someone else. Thus, reading Leviathan through Bataille's logic helps to debunk the image of the sovereign as a mortal god and omnipotent protector.
Andrey I. Zhdanov, Andrey V. Korotayev
Abstract
There are some theoretical grounds to expect that general inflation can have an ambiguous effect on the likelihood of the outbreak of revolutionary actions: while high inflation has a positive effect on revolutionary activity, moderate inflation reduces the likelihood of revolution, whereas negative inflation values again increase revolutionary activity. At the same time, many researchers suggest to treat separately food inflation as a significant predictor of the unfolding of revolutionary processes, because food inflation is a much more sensitive macroeconomic indicator that aggravates many social ills, such as poverty, protest sentiments, frustration, socio-economic shocks, etc. The authors, based on modern political science concepts and quantitative calculations, test the corresponding hypotheses. Using a rare event regression model and a set of control variables (the main factors of revolutions, according to modern political science research — GDP per capita, population, share of youth, urbanization, level of education, level of democracy) to obtain more reliable results, the authors come to the conclusion that the general level of inflation does not have a significant impact on the risks of revolutionary destabilization. On the other hand, food inflation does turn out to be a fairly reliable predictor of the beginning of the unfolding of revolutionary processes. Food inflation has a particularly strong impact on low-income groups, so it is powerful destabilizing factor in the least economically developed countries. Furthermore, regionally, food inflation may have the most powerful destabilizing effect in Africa (especially in African cities).
Mikael D. Belov, Anton P. Kazun
Abstract
According to statistics, men in Russia and most countries of the world are significantly more likely to cause road accidents than women. Understanding the reasons for these differences may be important for developing measures to reduce the number of road accidents. In the literature on Russia, the issue of the causes of this gender gap remains understudied. We analyse the magnitude of the gap in the odds of committing a serious crash by drivers of different genders and discuss possible reasons for these differences. For this, we use a dataset of 158,000 published court decisions under Article 264 of the Russian Criminal Code for the period from 2010 to 2022. We show that 91.7% of all cases involve male drivers. But even after accounting for differences in the number of drivers of different genders and the number of kilometers they drive on average, men are 3.25 times more likely to commit crashes resulting in criminal prosecutions. One reason for these differences is driving safety. Men are also more likely to commit aggravated road accidents. In almost a quarter of cases, male drivers were driving drunk, while for women the figure is only 10 percent. Judges in turn are more likely to give men a serious sentence if it is a non-fatal offence; in more serious cases, the gender of the driver is less important. We also found a very strong variation in the odds of causing a serious road accident for men and women between Russian regions, suggesting the influence of cultural and socio-economic differences.
Translations
Natalia A. Volkova
Erik Rietveld, Julian Kiverstein
Book Reviews
Dmitry Yu. Kralechkin
Irina V. Mikhel