Through a series of historical accidents, I happened to find myself one of the few sociologists close to the scientific committees advising the UK government on the management of the Covid-19 pandemic. It is not a role I would have chosen as I contemplate sliding into retirement with as much grace as I can muster. However, it has reminded me how much sociology still struggles for intellectual legitimacy in this country.
Every social science has its core question: economics is about scarcity; politics about power; geography about space; psychology about mind; anthropology about culture. Ours is about order. We have, though, frequently confused two elements. One is the matter of how order is accomplished at all – what prevents Hobbes’s counterfactual of the ‘war of all against all’. The other is the matter of what kind of order is accomplished – who is advantaged and who is disadvantaged. A pandemic is a fundamental challenge to the first, which has implications for the second. It is, however, arguable, that UK sociology has become so focussed on the second that it has weakened its own capacity to speak on the first – and left a vacuum.
Every major sociologist in the last 150 years has pointed in some way to the importance of trust as a basis of society. Most of the time, societies work precisely because we can assume that interactions and relationships with other people and institutions are not inherently risky. While this also creates opportunities for deceit, abuse and exploitation, trust is our default setting.
A pandemic turns this assumption on its head. Suddenly, other people are a source of danger and to be feared. As Phil Strong noted, from his observations of the early phases of the HIV/AIDS pandemic, a novel infection is potentially an existential threat. The Black Death killed 30-50 per cent of the population of Europe in the mid-14th century. It was clear by April 2020 that Covid-19 was not in remotely the same league. In previous pandemics, Strong observed, the initial waves of fear and suspicion rapidly subsided in proportion to the actual experience of the disease. This has not happened in the present pandemic. After 18 months, over 90 per cent of the UK population now have a sufficient level of immunity, from vaccination or infection, to have a high degree of protection from serious illness and death. Yet we are still acting as if Covid-19 were the same order of threat that it appeared to be when it first emerged in human populations in late 2019. What could sociologists be saying about this?
I have found myself turning to traditions and bodies of work in sociology that may not currently be fashionable but which should, perhaps, be reappraised.
My own research has been shaped by British sociology’s discovery in the late 1960s of the Chicago School work on deviance and social problems, and on work and occupations. UK sociologists had tended to take as given official definitions of problems like crime and sickness. Now we came to see social problems as claims about challenges to social order, to ask who was making those claims, how they were formulated to serve particular interests and who would benefit from their solutions. Organised occupational groups like professions tend to assert a mandate to identify problems, often framing them in ways that serve their own interests and identify themselves as solution providers. Where biologists study interactions between species, health and biomedical scientists and practitioners label these interactions in moral terms, defining them as ‘health’ and ‘disease’, requiring control and correction.
Medical sociology has profited greatly from a more accommodating attitude towards medicine in the last fifty years but has lost something in the process. It may have checked medical imperialism – but it has not changed the fundamental drivers. There has been a remarkable silence on the claim that a pandemic is a problem to be owned by medicine, public health, and the biomedical sciences rather than by the whole of science and the whole of society. All resources are to be mobilized around a single biomedical goal, of ‘defeating’ a virus, rather than considering the proportionality of its impact on other characteristics of a functioning society, like trust-based order in everyday life.
If sociologists have been silent, or co-opted to this programme, they have noted the asymmetry of its impact. The order defined by medical imperialism has reinforced familiar inequalities of class, race and gender. Sociologists have been quick to note these but slower to acknowledge that they are also part of the ‘working from home’ class served by the precarious labour of others. Pandemic management may be the first conspicuous display of the cruelty of meritocracy, predicted by Michael Young and analysed recently by Michael Sandel. Biomedical leaders are not the old elite of birth but are in many respects more indifferent to the losers in the competition for wealth and privilege.
The result is at least a partial realization of the scientific dream, or possibly nightmare, of a rationally planned and ordered society. In this case, it takes the form of an iatrocracy, rule by doctors and their allies. This rests on the ‘soft’ social control identified by Talcott Parsons in his discussion of the sick role, rather than on traditional forms of coercion. Compliance is achieved by behavioural ‘nudges’ in ways that are hard to call out but which depend upon the perpetuation and amplification of fear. Anything may be justified in the name of biosecurity. This emotional manipulation spills into the wider worlds of politics, science and, indeed, sociology.
Any society that is over-regulated by whatever means ultimately stagnates. The work of the late 19th century English sociologist, Herbert Spencer, became unfashionable but his analysis of the polar ideal types of militant, or highly controlled, and industrial, or trust-based, societies continues to resonate. Societies based on fear and control lack resilience and a capacity to evolve.
These resources are united by the way they draw on the deep history of our discipline, particularly an Anglo-American tradition that evolved in the shadow of laissez-faire and utilitarian thought. They are rooted in British intellectual culture and debates that are consequential in our current polity. Yet I suspect they are now rarely taught to our students. If we look at the textbooks used in our undergraduate courses, these traditions rarely seem to feature. When did a theory text last give much attention to either Parsons or Spencer? The sociology of social problems and the critical sociology of deviance have reverted to criminology. Health is mainly about identities and disparities rather than the interaction between our social and biological beings. Are we wedded to meritocracy without acknowledging its moral flaws? Have we unwittingly marginalized ourselves on some of the great issues of our time?
Robert Dingwall is a part-time Professor of Sociology at Nottingham Trent University and a consulting sociologist through Dingwall Enterprises Ltd. He has over 50 years research experience investigating a wide range of topics in medicine, law, science and technology while working at the universities of Aberdeen, Oxford and Nottingham. He was involved in UK pandemic influenza planning (2005-07) and has been a consultant to major pharmaceutical companies on ethics and social justice in access to drugs or vaccines. He was previously a member of NERVTAG and the JCVI sub-committee on Covid-19 vaccines and is currently a member of MEAG (DHSC Moral and Ethical Advisory Group). He has commented extensively on the Covid-19 pandemic. He is a Fellow of the Academy of Social Sciences and an Honorary Member of the Faculty of Public Health.