review article

Medicalization of Public Sphere: An Essay on Covid 19 Epidemic Phenomenon: Description and Some Associations

Dursun Ayan*

Senior Sociologist, Ankara, Turkey

*Corresponding author: Dursun Ayan, Senior Sociologist, Ankara, Turkey

Received Date: 29 December, 2020; Accepted Date: 11 January, 2021; Published Date: 15 January, 2021

Citation: Ayan D (2021) Medicalization of Public Sphere: An Essay on Covid 19 Epidemic Phenomenon: Description and Some Associations. J Community Med Public Health 5: 201. DOI: 10.29011/2577-2228.100201

Abstract

This study focuses on the Covid- 19 outbreak and is based on sometheoreticalconcepts of sociology and basichistorical events instead of empirical data. In other words, it may be more appropriate to say an essay about the pandemic based on sociological discourse. The main purpose of this article is to create a sociological imagination by using concepts and impressions from daily life. Three analogical elements in this essay are inspirations from geography; namely, “land,” “sea” and “beach.” Sociological analogies that are drawn are thought as “land” as “sociology,” “sea” as “political,” “beach” as “public.” The medicalization of the public sphere is actually intended to be made meaningful/significantwithin this analogy. In the study, it has been written in a literary and rhetorical style to facilitate sociological construction and several new concepts have been proposed for this purpose. This article also benefiting from the science of medicine, as well as the history of Turkey and the World epidemic has created some sociological associations. The aim here is to try to re-establish the links between history and daily life with the sociological imagination.For this purpose, concepts and phenomena such as medicalization of public sphere, transformation of para-medical and para-sociological, lockdown, distant sociological life, interference of the state in daily life were discussed.

Keywords

Sociological imagination; Everyday life; Public ethic; Public health; Stripped down sociological environment; Weak public sphere; Allowed horizontal social mobility

Introduction

This essay attempts to understand and explain the phenomenon of “medicalization,” which emerged with the spread of Coronavirus worldwide and throughout Turkey, in the context of “public sphere” and other concepts it connotes. This essay sprang from an analogy from daily life, andis based on impressionsformed and observations made on occasion during the coronavirus pandemic. This is an attempt to define a phenomenon by adapting knowledge based on observation and fictional analogy to sociology. It possesses the shortcomings of sociological fiction created in one’s mind, analogies and all patterns based on imagination.When sociological reality/truth is considered as a realm of existence and all the acts of knowledge trying to explain this truth/reality as epistemological, this essay readily admits all the errors to be made by knowledge in explaining existence. In this respect, even though this essay is not based on survey and scientific knowledge, it carries the aim of serving scientific knowledge and sociology of knowledge. Then again, it impossible to define a history of thought, and semantic fields without concepts without the tireless passion of scientific knowledge to understand existence. This essay is written despite all the shortcomings mentioned above. This very essay also finds it essential tobelong in the name ofsociological imagination[1],and make use of rhetorical elements. Although it considers respecting other disciplines as its main principle, this essay has a contemptuous tone for disciplines which violate sociological reality.

Analogical Principles

Three analogical elements in this essay are inspirations from geography; namely, “land,” “sea” and “beach.” Sociological analogies that are drawn are thought as “land” as “sociology,” “sea” as “political,” “beach” as “public.”

The “political” one is the religious, ideological, popular, financial one, or it is some other force, movement, impact and phenomenathat emerge at some point in history.All these phenomena that make up the “political” are human and societal and also, as long as they care about themselves and within the extent of their power, they can easily get their share from sociology, even further when the occasion arises, they might veil sociological reality. Apart from this, by collaborating among each other and using all the advantages of popular knowledge, they also try to eradicate sociological reality.For instance, if the medical reality had not shown itself with the recent coronavirus pandemic, public reality would have instrumentalized the sociological reality in a political framework.

Beach is the realm where the sociological and political show themselves; struggle, waves and solitude are here. In fact, although beach is located on land, its definition and existence are created through its association/relation with/to the sea. However, this state does not mean that beach will not be exposed to a flood approaching from the land side and not be defined by this condition.

Discourse

In the context of the analogical principles stated above it is safe to say that over the years, political, religious and popular matters,like waves hitting “a beach,” namely “public sphere,” carried their discourse and ideologies back and forthbetween the “terrestrial”areaand their domain. They turned the sociological domain into their own political beach. In this way, public sphere[2] stayed under the mandate of the political, and came to be known like this. As long as political knowledge or other types of knowledge are determined to keep what is sociological at bay, this state is going to continue the same way. The sea, which was used to determinethe border between the “beach” and the seauntil the beginning of coronavirus pandemic, seemed to have effacedthe beach as a terrestrial form; in other words, the sociology of the public sphere has been overridden by popular and other contemporary types of knowledge[3,4]. There was a lot of effort in that, and the attempt was successful, the quality of these types of knowledge would make it possible. The role of sociologistsoutside the academia in defending the sociological and helping it survive is crucial. The reason for this is that the obsession of “some sociologists” with political discourse, and the compromises they make to become visible and popular sometimes make sociology - which is placed on the sandy beaches of knowledge of politics - look like a sunbed on which cheap books are read.

Mainstream circles which shape “Public” sphere according to politics, religion and football chose to curtail “public” sphere for ideological reputation and money. The possibility of a “medical public sphere” has never been thought out outside medical history. Political determination created delusions in the minds of people who thought beach was not a part of land, sociology was not a part of public sphere and football is more than a sport. However, although there is an attempt to explain what is “public” in the context of epistemology (concerning knowledge) as religious, mystical, political, secular or even irreligious; ontologically (concerning existence), encompassing all of adjectives stated above it is sociological. This sociological real of existence is a realm that exists with elements that it is made up of, but it cannot be narrowed down to any of these elements: like a triangle which cannot be narrowed down to its intersecting line or hypotenuse. Although there may be benefits to studying what is public within a certain framework with the purpose of attaining knowledge or getting education, it must not be forgotten that what is public is integrally sociological.

Popular professions in the public sphere, in their so-called theory, frequently state that sociology offers no cure for any of the existing problems. This way, these professions from time to time try to choke the life out of sociology by wanting to narrow it down to social engineeringand in addition to that, they want sociology to make or imitate popular noises to prove their point. Doing this, in fact, aims to instrumentalize sociology and also deprives them of one of their main sources of knowledge. Because sociology has been one of the key ingredients of these professions since very old times.

Since ideological-popular simulations suffer from “epistemological weakness/,” they cannot conceive/comprehend what is ontological (public presence) and the inevitable gap between its existence and the popular knowledge it has. This, by widening the gap between sociology and other professions, even causes schizophrenic situations in the context of understanding and explaining public sphere. This situation, as it is widely used in the news media, evolved into a “fake news virus” as a “fake news plague,” thus finally evolving into another “sociological epidemic.”

Until coronavirus became a hot issue worldwide and in Turkey, the news media, which worshipped “early-grown, fresh, attractive news,” and the ideologies it supported were defining public sphere with political waves and flooding the beaches where sociology meant to be sunbathing. Unfortunately, the first wave on these beaches, initiated by coronavirus, came and medicalized beaches and the public sphere. This way, public spheres with political and sociological attributionswere also medicalized.

To sum up, the phenomenon that needs to be described is “medicalization of the public sphere.”This state is not a result of a sociological evolution but an emergency that emerged due to a pandemic. This, at the same time, shows that sociological reality--outside all the public simulations--is pregnant with new a reality. The coronavirus outbreak, in the realm of politicized public sphere, evolved into the birth sociological reality medically. What is public and sociological disappeared from beaches and public sphere thinking that it is coronavirus ridden. Coronavirus followed us back home for a while.

Associations

Medicalization of public sphere with coronavirus can be used to make some associations regarding some other concepts, views. Those concepts and views are going to be looked into in “Associations” section.

Associations 1: Views for Medical Public Sphere

As Chinese corona made an appearance, it is once again proven that the world, which was medically a globe when it was ridden with plaque and malaria in old times, is geologically a globe. Our thoughts, which limit globalisation to financial globalisation considering American hamburgers and chain stores as signs,has now expressed what it means to be global in a different language with the chains of airborne droplets flying out of our mouths when we cough or sneeze. Financially speaking, the globe which shelved what is sociological has now medicalized, and the world, even for a short period of time, evolved from financial globalisation to medical globalisation. Particularly Turkey and Mediterranean coasts have not been visited by dollars and young people but by “a watered down holiday,” and a “weak economy.”

Due to coronavirus pandemic, other similar situations regarding the medicalization of public sphere started to reveal themselves. To illustrate, the political reality of fashion initiated by the dilemma between miniskirt and headscarf evolved into a situation where surgical facemask become the formal attire of the public sphere but this time not in the name of freedom in the name of survival. To the contrary, surgical mask is as an act of restricting freedom which could be combined with either a miniskirt or headscarf.While public indicators, which are secular and religious, were being medicalized by surgical face mask, the same mask was favourably suggested for medical and state order. Not including the state’s previous attitude towards fashion and accessories, without causing any controversies or being criticised by any political fraction, in dialectics of to be or not to be, the coronavirus mask was welcomed. The surgical face mask, without being reduced to a problem related to the freedom of clothing, was medicalized to such an extent that it even resulted in an inclusive environment for all members of the society in the public sphere preventing social gender discrimination, making fun of all the mirrors on which social gender discrimination is reflected.

However, disguised reckless and suicidal persons who render their own lives worthless, and malevolent, anonymous criminals who think nothing of other people’s lives became daring enough to resist wearing surgical face masks. The rebelliousness of the ones who did not obey the law of the state stopped being political for reasons of survivalandbecame medical instead. A new kind of protest and terrorism emerged in the public sphere. By hearing people say “Damn those ignorant people,” the reason for the anger towards those who do not use face masks was legitimized medically rather than politically. Although it is difficult to foresee what kind of a legal or crime related ground it will be based on, it can be clearly seen that the ideological and political reality of public sphere has been replaced by a medical reality defined by a pandemicdressed asa surgical face mask. It is slowly understood that the situation which was hoped to be temporary was in fact a matter of life and death, and itreset humanity to its initial/factory settings.

Associations 2: State Politics

Statements such as “let your society live so that you can survive too” or “let people live so you can survive too” came in spirals in the face a new reality. Whatever public reflection, beach or wave is destined for humanity, society and sociology, it is important that society must exist. In modern times, the warrant for this seems to be the state. States, by keeping sociological reality and the reality that people depend on each other outside the domain of their fabricated political discourse, must let it take form as an antithesis of the state reality. Because sociological reality has the power to exist independently without feeding other symbiotic realities with the bits and pieces it cuts out of its own reality. Although this is a sign of an organic unity between sociology and other professions and disciplines, it is true that pro-conflict andfunctionalist-conflict dimensions of the subject are another topic of discussion.

It is important to note that the social conflict between people who take medical precautions and who do not will remain partial and small in scale. At this stage, decisions by the state authority will gain medical legitimacy under the category of public health (hıfzıssıhha in Turkish).

To repeat what has been mentioned, with medicalization of public sphere, which was caused by the coronavirus pandemic, sociological reality has attained a new outlook and a new quality. However, while coronavirus enforcements medicalized the public sphere, terms like quarantine, social distance, allowed horizontal social mobility started to emerge. This situation in fact showed that what is medical is mostly sociological. Although sociological existence has witnessed what is medical for a while through people wearing surgical face masks, sociology exhibits a para-medical outlook while medicine displays a para-sociological outlook.

Sociology carries out a medical function while medicine carries out a sociological one.“Hıfzıssıhha,” (public health institution in Turkish state) as a term which emerged from the deep corners of history through agonies and bad memories and made its way toour dictionaries and public signboards, is the embodiment of how medicine is para-sociological and sociology is para-medical during a pandemic. It is worth thinking that Hittite and Roman states[5,6] whose foundations were shaken by malaria, did not found public health institutions in today’s sense because of the conditions of their time. Nonetheless, a lot of things regarding public health originated around their time.

Only when state politics part ways with party politics, a possibility of an evolution from ideologies tostatism and modern state can be spoken of.A state must consider all aspects of social and public places. For example, a state that becomes successful in the medicalization of public sphere will also ensure the success of the ruling party it embodies in the field of public health. Keeping public places empty for a long period of time breeds a “diluted” communality.” The political authorities aremaximizing this dilution through temporary restrictions sincethey are unable to tolerate this and it seems to be the best way to set a clear and healthy political path for them. Lockdown precautions by alegitimatized political authority in the forma state are not only a political function or an implementation but a struggle for sociological existence which embodies society altogether.

Association 3:Sociologicalization of Medical Sphere from Health Institutions to Lockdowns or Para-medical-Parasociological Spiral ConcerningHıfzıssıhha (Public Health)

Medicine and its indispensable sub-disciplines such as biochemistry, microbiology, and anatomy--which let coronavirus escape from a laboratory, and now are trying to catch it on the street--imprisoned the virus inhealth institutions, observed it, defined it, and are trying to look into it even further. As long as their immunity allows, and there is enough medical support, people are going to learn to live with coronavirus by learning more about it and getting directly or indirectly vaccinated.

If the escape of coronavirus from laboratory to public sphere is not an accident or a biological warfare, it can be said that coronavirus called itself into being in the communality of humans. This medically identified/defined virus started to embrace sociology of things, and in the realm of contingence, became “obsessed with people.”

The phenomenon that gave coronavirus a chance to survive in a laboratory; in other words, the thing that brings coronavirus back to its birthplace, is a sociological existence. This way, the “public sphere” of coronavirus on its part is sociological rather than medical, and for people, its definition in public sphere is medical rather than political. As a result, in the battle between people and coronavirus, public sphere has also been medicalized.

To rephrase, the destiny of clinical medicine and medical sociology have already been registeredin history with their sociological quality through public health institutions and their implementations.The most special area where medical history and history of science and world history cross paths is public health. Medical sociology has flourished and played in the same hospital garden as public health and worked shoulder to shoulder with state law and its implementations.

Although the rational intensity of medical existence is watered down and unmonitored in broad public sphere, quarantined environments are the best places where medical practice is applied to sociological environments. In these environments, both state and people depend on medical knowledge and its practice to achieve humanitarian and tangible results. Lockdowns are directly human centred although they form certain block depending on age and gender. With this aspect, lockdowns become a symbol of a certain kind of humanism.

Quarantine (tehaffuzhâne) environments are special places where “medically sensitive units” are temporarily isolated from healthy public sphere. Lockdowns, which state politics use to monitor/control contagious diseases in public and private spheres, are protecting the society altogether. Precautions takento prevent a medical problem from causing a large scale sociological problem is the sign of a good knowledge of history of medicine. Although public memory depends on literary sources and history books to learn about the pandemics of the past until coronavirus, there are still people who witnessed and survived the relatively recent pandemics of the past. For the one who witness today’s pandemic, coronavirus will create a site of memory, and this will surely go down in history. From the point of sociology and sociography, writing about coronavirus is an act of self-expression by a sociologist who is the object of the pandemic but also the subject of his/her own reality. It is an act of becoming the subject of the topic a sociologist is writing on and interpreting, and this requires an insightful reading and carries a concern to base his/her experience on a theoretical background [7].

Associations 4: Other Creatures and Humans

When Charles Darwin is mentioned, many just remember volumes of discussion on humans versus monkeys. Instead of looking at the subject from a religious or evolutionary point of view, a zoological perspective tells us that monkeys were the carrier of a virus which was the source of AIDS plague. Now the link between coronavirus and bats is in the spotlight. Darwin also mentions bats as their skeletal structure and internal organs resemble human organs anatomically[8,9].Darwin passed away without witnessing coronavirus or AIDS, but it is known that these two species, namely monkeys and bats, have a record of contagious diseases leading to pandemics. He also includes seals in this category without making any reference to pandemics. Does this mean that society should be ready for a pandemic that could evolve from a virus carried by seals or animals that possess the same anatomical features?

What is meant by making a prediction like this is what kind of microorganisms in what kind of animal species is going to immunise human body which as a biological spherebeyond public, private and medical spheres.However, it is known that humans who are infamous for putting the blame on the goat (referring to the word“scapegoat”)--although it is an act of despising animals-- suffered from plagues such as “black death-rats” and “mosquitomalaria,” and it is also known thateven when all other zoonotic diseases are left out,the dogs we pet in our homes and in parks have been receiving coronavirus vaccines.

Conclusion

Sociological existence, which is home to all things that are human, is also a realm of existenceand being for coronavirus. Coronavirus, which doctors try to exterminate with all the medication in their power, although it can survive 15 minutes outdoors, increases its chance of survival in an environment which is “thinly medical” but “intensely sociological.” In this battle, coronavirus is not as lucky as the murderous and treacherous cuckoos, but both of them destroy homes and inflict pain and sorrow. Cuckoos kill young chicks they find weak in the nests they invade like coronavirus killing old and weak people by invading the deepest and darkest corners of their lungs. This can make one think that the virus is envying the bat it spread out from by mimicking its obsession with darkness.

The metaphors and analogies created here with animalsspace-people could inspire new ways of thinking, and analogies. However, one positive thing that remains after all these might be a theological tribute--inspired by philosophy of living beings and literary texts-- to the power of divine punishment targeted towards human excessiveness.

Although it is still hoped that medicalized public spheres become temporarily exempt from ideological statements, and they are united with their sociological aspects again, the return of political and ideological public spheres as mirrors to society and their appearance on sociological beaches, despite all criticism, is an inevitable part of sociological existence. The “stripped down sociological environment”and “weak public sphere” that the medicalized spheres made compulsory for the population will get back to normal with humanitarian and scientific knowledge becoming functional in this medical battle. The initiative that human effort and labour showed for again human and public life is a reflection of humanitarian reality. Nonetheless, it is sad to witness this reality not in the times of fabricated paradises and hasty prosperity but in a time when human life is threatened by a virus that is openly let loose.



References

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  2. Habermas J (2010) Kamusallığın Yapısal Dönüşümü, [Strukturwandel der Öffentlichkeit], (çe Tanıl Bora-Mithat Sancar), İletişim Yayıncılık, İstanbul.
  3. Gurvitch G (1949) “La sociologie de la connaissance”, Anneé Sociologique, III e serié, Paris.
  4. Gurvitch G (1957) “Le probléme de la sociologie de la connaissance”, Revue Philosophique, Paris.
  5. Smith NE (2015) The Paleoepidemiology of Malaria in the Ancient Near East, (doctoral dissertation), Arkansas University.
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  9. Darwin C (1874) The Descent of Man.

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