Illness and sickness: What's the difference?

Medical sociology has long made the distinction between illness and sickness. Illness is the objective diagnosis that an external impartial observer is able to make based on the constellation of symptoms which the patient presents. Sickness is the social role that the patient adopts as the patient and other concerned stakeholders, in relationship with the patient, interpret the meaning of the illness.

It has long been recognized that health care providers can play an iatrogenic function by making sickness worse by focusing on symptoms and interpreting them in certain ways. We now see pharmaceutical companies doing this very thing in their drug advertisements convincing people that they may be sick, when in fact, they previously were unaware that they had a problem. To what extent is this "patient education" early detection that prevents further progression of serious illness, and to what extent is this "patient education" the creation of sickness?

I had a male friend one time tell me that it was a blessing to turn 50 because he was no longer horney all the time. Now the Viagra commercials would have us believe that the diminishment of libido is a medical problem that can be managed with medication. Even ex Senator Bob Dole, and Presidential Candidate, married to another prominent politician, Elizabeth Dole, advocates for the use of Viagra. I always wondered what Elizabeth thought of this.

At any rate, the link below points to an editorial in the British Medical Journal which raises this whole issue of the meaning of symptoms. Symptoms mean one thing to one person, and other things to other people, and who is to finally say what the meaning of symptoms should mean? The patient, the physician, the drug company, the family, the HMO or payor?

bmj.com Ogden 327 (7412): 409

Comments

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[LK]

Actually, this is not how Medical Sociology uses the term illness. It distinguishes three terms:
Disease : pathological, biological definition, diagnosis used by doctors.
Illness: subjective and personal experience of symptoms and ill-health.
Sickness: societal role and perception of the condition (i.e. stigma, legal arrangements (days off work), etc.
See Arthur Kleinman (1978) or http://jech.bmj.com/content/59/6/450.full.pdf+html