Structural theories
In order to understand sociology it is important to view the development of sociology theory against the emerging background which it evolved to provide context and enable an understanding of its importance and relevance at that time. The term ‘sociology’ was coined by the French philosopher Auguste Comte (1798–1857). Comte made reference to the term sociology in his 1822 publication ‘Plan des travaux scientifiques nécessaires pour réorganiser la société’ or ‘terms of scientific work needed to reorganise society’ and is believed by many to be one of the original founders of sociology.
Comte was born at the end of the French Revolution and a period of eighteenth-century European philosophy known as the Age of Enlightenment. This period was identified as an intellectual movement that encouraged and advocated scientific investigation and political philosophical debate as a way to create an influential system of ethics, aesthetics and knowledge. Comte put forward a considerable argument for the justification of sociology as an academic discipline and presented a law of three states whereby he believed that society must progress through three periods of intellectual development: theological, metaphysical and scientific. Comte believed that this progression was the principal cause of social change and that was also reflected within the scientific development apparent at that time.
Comte’s philosophy subscribed very much to a positivist approach (Comte, 1854) and he proposed that the objective of positivism was to ‘generalise our scientific conceptions and to systematise the art of social life’ (Comte, 1854, p. 3). The traditional scientific or experimental approach to conducting research has its underpinnings in positivism (Robson, >2002) and positivists hold a fundamental belief in objective reality and the assumption that phenomena have antecedent causes (Polit and Beck, 2004). Comte argued that the study of sociology should be based on empirical evidence that was drawn from observation, comparison and experimentation and set out his proposal for a scientific method of organising experience.
Comte also suggested that society is a system whose parts are interconnected in ways that would have consequences for the maintenance of the social whole. Structural theories of society are described as having a macro perspective, whereby the focus is less on the specific actions of an individual but on the roles that they occupy and how these relate to each other and interconnect to form the whole (Sharp, 2010). When analysing roles the focus of structural theories is not on the individual occupying the roles but on the nature of the role itself and the expectations and standards expected by society of a particular role. This enables groups and organisations to be considered independently of the different people that constitute them (Sharp, 2010).
Trigger
Consider how midwives are viewed within society. You may wish to think about recent media coverage and terms used when describing midwives as a professional group. How might your own views of midwifery have changed since starting your midwifery training?
The two main structural theories are functionalism and Marxism. Functionalism is a branch of sociology that emphasises how different elements of society work harmoniously as a series of interconnected parts that together form a whole (Haralambos and Holborn, 2013). Social institutions such as the family are therefore analysed as a whole rather than as isolated components and it is believed that in order for such institutions to survive within society, there must be the fulfilment of necessary conditions of existence called functional prerequisites (Haralambos and Holborn, 2004). These functional prerequisites are based upon the socialisation of shared customs and values and various approaches have been used to identify what these are and the factors that different societies have in common. Thus functionalists focus on how social systems are maintained by the contribution of the specified prerequisites.
Functionalism became the dominant social theory within sociology up until the 1940s and 1950s and was developed by another French philosopher Émile Durkheim (1858–1917) who is widely regarded as one of the most influential functionalist theorists and important in establishing sociology as a serious academic discipline. Durkheim was active at a time when France was undergoing great social and economic upheaval and strove to consider how social groups could function together to form a cohesive society.
Often referred to as consensus theory, functionalism emphasises an essential consensus that should operate within societies and is particularly concerned with the maintenance of social order. Durkheim believed that the essence of human nature was twofold: partly driven by selfish desires and partly by an ability to believe in and adhere to moral values. By having a collective conscience comprising of shared beliefs and attitudes, Durkheim believed that it was possible for humans to become integrated into the dominant values of society and achieve social order. Like Comte, Durkheim adopted a positivist approach and focused upon the observable and the measurable as opposed to the internalised subjective experience.
Although Durkheim had little to say about healthcare, later functionalist sociologists sought to consider the various aspects of health and its management. Talcott Parsons (1902–1979) considered the concept of the sick role and argued that adhering to such a role helps to ensure the smooth running of society and ensure disruption is kept to a minimum. A criticism of the functionalist approach is its tendency to disregard conflict and play down the degree of independence that those inhabiting the role possess. There is also scope for exploitation within these roles as could be seen in the abuse of medical power and disempowerment of the patient or sick person (Sharp, 2010).
Application to practice
Consider the culture within the unit where you work. What are the shared values, beliefs and customs that you see being upheld within your day-to-day practice? How might these influence your behaviour and relationships with colleagues and women and their families?
By way of contrast, conflict theory or critical theory, which has its origins in the work of Karl Marx (1818–1883) has its roots in the economic conflicts that exist between social classes within society. Whereas consensus theory emphasises the importance of having a collective consciousness to facilitate harmonious integration within society, conflict...