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Michailakis, Dimitris
Publications (10 of 10) Show all publications
Löf, J., Michailakis, D. & Olaison, A. (2018). HBTQ-äldre i den politiska debatten (1ed.). In: Magnus Dahlstedt (Ed.), Gränsöverskridande Socialt arbete: Kritiska perspektiv (pp. 41-61). Malmö: Gleerups Utbildning AB
Open this publication in new window or tab >>HBTQ-äldre i den politiska debatten
2018 (Swedish)In: Gränsöverskridande Socialt arbete: Kritiska perspektiv / [ed] Magnus Dahlstedt, Malmö: Gleerups Utbildning AB, 2018, 1, p. 41-61Chapter in book (Other academic)
Place, publisher, year, edition, pages
Malmö: Gleerups Utbildning AB, 2018 Edition: 1
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-151279 (URN)9789151100586 (ISBN)
Available from: 2018-09-14 Created: 2018-09-14 Last updated: 2018-09-14Bibliographically approved
Michailakis, D. & Schirmer, W. (2015). The Help system and its Reflection Theory: A Sociological Observation of Social Work. Nordic Social Work Research (1), 1-14
Open this publication in new window or tab >>The Help system and its Reflection Theory: A Sociological Observation of Social Work
2015 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, no 1, p. 1-14Article in journal (Refereed) Published
Abstract [en]

The relation between sociology and social work is analysed in this article as a relation between observer and object of observation. As a theoretical framework, we use Luhmannian systems theory, according to which modern society is characterised by functional differentiation, that is a horizontal structure of function systems such as polity, economy, education, science, law, etc. Each of these ful fils a particular function for society. One such system is the help system, referring to social services and their practice. Its societal function is the management of inclusion/exclusion and social integration. Function systems contain what Luhmann calls‘reflection theories’, which are associated with specific academic disciplines (such as the political system/political theory/political science or the education system/pedagogical theory/ educational science). Although their basic operations are linked to science (research, theories and methods, publications), reflection theories are part of their system; their function is to reflect on the unity and meaning of the function system. This article argues that the discipline of social work serves as the reflection theory for the help system. A solid reflection theory in the help system is important in order to define guiding criteria for professional ethics to be used in social services. The lack of an adequate reflection theory can lead to the intrusion of ideologies that are inappropriate to the logic of the help system, such as New Public Management or administrative technocracy, which might threaten the integrity of the help system.

Keywords
help system; Luhmann; reflection theory; social work; social work science
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-117491 (URN)10.1080/2156857X.2015.1012106 (DOI)
Available from: 2015-04-29 Created: 2015-04-29 Last updated: 2018-01-11
Michailakis, D. & Schirmer, W. (2015). The lost Gemeinschaft: How people working with the elderly explain loneliness. Journal of Aging Studies (33), 1-10
Open this publication in new window or tab >>The lost Gemeinschaft: How people working with the elderly explain loneliness
2015 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, no 33, p. 1-10Article in journal (Refereed) Published
Abstract [en]

We conducted a qualitative interview study with people of different professions working with lonely elderly people. The rationale of the study was to examine how these respondents explain loneliness among the elderly. The present article focuses on the social explanations, i.e. explanations that identify causes of loneliness in the structure of modern society. We found that many of the social explanations given are aspects of a more encompassing and general pattern underlying all the reasoning about loneliness among the elderly. This pattern is the expression of two contrasting images of society which the classical sociologist Ferdinand Tönnies termed Gemeinschaft (community) and Gesellschaft (society). The former refers to traditional or small-size rural communities characterized by high degrees of social cohesion, integration, solidarity, proximity and familiarity, whereas the latter refers to functional differentiation, distance, individualization, exchanged-based social relations and anonymity. Loneliness among the elderly is explained by the lack of Gemeinschaft and its characteristics in contemporary society. This explanatory pattern goes hand in hand with a critical view of contemporary society and a nostalgic yearning for the lost communities of past societies, where inhabitants find their staked-out place and sense of belonging, and thus loneliness hardly seems to occur. We summarized this view under the label the "lost Gemeinschaft".

Keywords
Community, 
Elderly
, Loneliness, Modernization, Qualitative methods, Society, Tönnies
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-117486 (URN)10.1016/j.jaging.2015.02.001 (DOI)000353729300001 ()25841724 (PubMedID)
Available from: 2015-04-29 Created: 2015-04-29 Last updated: 2017-12-04
Michailakis, D. & Schirmer, W. (2014). Social work and social problems: A contribution from systems theory and constructionism. International Journal of Social Welfare, 23(4), 431-442
Open this publication in new window or tab >>Social work and social problems: A contribution from systems theory and constructionism
2014 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 23, no 4, p. 431-442Article in journal (Refereed) Published
Abstract [en]

Social work builds its identity on social problems. The goal is to generate knowledge about causes, consequences and solutions. However, there is a lack of theory of social problems. We suggest that research on social problems can benefit by ‘bringing the observer in’: Loseke's constructionist framework and Luhmann's systems theory. According to Loseke, social problems appear differently when constructed by different observers. Constructions vary in terms of morality, conditions, victims/villains and solutions. From Luhmann we learn that modern society consists of a multitude of social systems (e.g. politics, science, economy etc.), each operating with their own communicative codes. Combining both approaches, we hypothesise that any social system constructs its own (version of) social problems. Illustrating with the empirical case ‘suicide among mentally ill people’, we examine how a phenomenon is constructed differently as a social problem by four different social systems: the disability movement, politics, medicine and social work.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
constructivism, Luhmann, social problems, social work theory, systems theory, suicide
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-107377 (URN)10.1111/ijsw.12091 (DOI)000342813800010 ()
Available from: 2014-06-11 Created: 2014-06-11 Last updated: 2017-12-05
Schirmer, W. & Michailakis, D. (2014). The Luhmannian approach to exclusion/inclusion and its relevance to Social Work. Journal of Social Work
Open this publication in new window or tab >>The Luhmannian approach to exclusion/inclusion and its relevance to Social Work
2014 (English)In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296XArticle in journal (Refereed) Published
Abstract [en]

Summary: Although the concept of social exclusion is central to the academic discipline of social work, there is not much theoretical clarity about what it actually means. For instance, exclusion is used as a synonym for poverty, marginalization, detachment, unemployment, or solitude. We argue that the systems-theoretical framework developed by the German social theorist Niklas Luhmann (1927–1997) provides the conceptual tools to understand inclusion and exclusion in a theoretically adequate way that is highly relevant to Social Work.                 

Since there is scarcely any literature on Luhmann's work in the field of social work not written in German, this article aims to provide a systematic introduction to the Luhmannian theory of society with respect to the distinction of inclusion/exclusion and its relation to social work to an English-speaking audience.

Findings: After a presentation of some basic concepts, it will be argued that exclusion is not a problem per se nor is inclusion always and per se unproblematic. The Luhmannian approach suggests that inclusion and exclusion are operations of social systems that treat human beings as relevant addresses for communication. Against that background, systems theory gives a clear and accurate description of what social work can (and cannot) do in terms of inclusion/exclusion.                 

Applications: The main purpose of social work is exclusion management. Exclusion management involves working on the social addresses of individuals with the aim of improving their attractiveness for other social systems, a (re)orientation towards being includable. It appears in three forms: exclusion prevention, inclusion mediation, and exclusion administration.

Place, publisher, year, edition, pages
Sage Publications, 2014
Keywords
Exclusion, inclusion, Luhmann, social work theory, systems theory
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-107376 (URN)10.1177/1468017313504607 (DOI)000347279700003 ()
Available from: 2014-06-11 Created: 2014-06-11 Last updated: 2017-12-05
Schirmer, W. & Michailakis, D. (2014). Two ways of dealing with polycontexturality in priority-setting in swedish health care politics. In: Morten Knudsen, Werner Wogd (Ed.), Systems theory and the sociology of health and illness :: observing healthcare (pp. 63-80). London: Routledge
Open this publication in new window or tab >>Two ways of dealing with polycontexturality in priority-setting in swedish health care politics
2014 (English)In: Systems theory and the sociology of health and illness :: observing healthcare / [ed] Morten Knudsen, Werner Wogd, London: Routledge, 2014, p. 63-80Chapter in book (Refereed)
Place, publisher, year, edition, pages
London: Routledge, 2014
Keywords
Hälso- och sjukvård, Sjukvårdspolitik, Sverige
National Category
Sociology
Identifiers
urn:nbn:se:liu:diva-117494 (URN)978-11-3879-491-7 (ISBN)978-13-1575-891-6 (ISBN)
Available from: 2015-04-29 Created: 2015-04-29 Last updated: 2015-05-06Bibliographically approved
Michailakis, D. & Schirmer, W. (2014). Vad händer när teori och praktik i socialt arbete integreras?. Socialvetenskaplig tidskrift (4), 127-141
Open this publication in new window or tab >>Vad händer när teori och praktik i socialt arbete integreras?
2014 (Swedish)In: Socialvetenskaplig tidskrift, ISSN 1104-1420, no 4, p. 127-141Article in journal (Refereed) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-117484 (URN)
Available from: 2015-04-29 Created: 2015-04-29 Last updated: 2017-12-04
Michailakis, D. & Schirmer, W. (2012). Solidaritet som finansieringsform och som prioriteringsprincip. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Solidaritet som finansieringsform och som prioriteringsprincip
2012 (Swedish)Report (Other academic)
Abstract [en]

Solidarity is a central value in Swedish healthcare. Not only are healthcare costs financed by taxpayers proportional to their income (solidarity-based funding), solidarity is also one of the basic ethical principles for priority setting in healthcare (the so called need- and solidarity principle). Despite its significance, the term 'solidarity' has been given different, sometimes contradictory meanings, in both academic and political contexts. In a political context such contradictions can be handled since political standpoints always try to embrace a big variety of meanings within a certain terminology. In the context of healthcare, though, semantic ambiguities will severely hamper efficient decision‐making.

Against this background this report aims at examining potential semantic ambiguities/contradictions with respect to the meaning of 'solidarity' as it is used in Swedish public debates on healthcare funding and prioritization between 1990 and 2010. We investigated relevant public reports and policy documents on prioritization as well as articles in medical journals and major daily newspapers in which the meaning of 'solidarity' had a key role. The selected data were analyzed with a method based on the systems-theoretical epistemology by sociologist Niklas Luhmann.

The study shows that 'solidarity' as a value in Swedish healthcare appears in two separate, at best loosely coupled debates. One mainly takes place in mass media and is a political debate on whether the healthcare system should be opened to private investors and insurances. Here, solidarity is discussed as a means of healthcare funding. The other debate takes place in professional forums and discusses formulations of guidelines for priority setting. Here, solidarity is discussed as an integral part of an ethical platform for priority principles.

Our study of the debate in media reveals that there are surprisingly few differences in the meaning of 'solidarity'. There is a vast consensus that those who are better off should stand up for the weak, which resembles a Christian liberal understanding of solidarity. The positions differ in the reference of solidarity: who is the legitimate recipient/address of solidarity? We found that these references can be interpreted with help of the guiding distinction agency/(in)equality. If society is mainly understood as a stratified society, the agency of patients is seen as a potential reason for inequality and a threat for equality. By contrast, if society is mainly seen as an assembly of individual agents, too much significance given to equal health outcomes is interpreted as a limitation of people's scope. Whether agency appears as a threat or blessing depends on two mutually exclusive value systems that are guided by their own views on the distinction agency/(in)equality.

We argue that the difference between the two most important positions in the other debate, i.e. the prioritization debate, also can be described in terms of the distinction agency/(in)equality. The positions are clearly expressed in two major reports: the Swedish Government Official report Health Care's difficult choices as provided by the Priorities Commission and the report by The Swedish National Centre for Priority Setting Resolving Health Care's difficult choices. Both reports conclude a proposal of guidelines for priorities. In the same way as in the fundingdebate, the term 'solidarity' in the priorities-debate is used in the meaning that the better off should help the weak. Again, the difference is to be found in the references of solidarity, that is, the definition of the 'weak': Who can justifiably be considered as weak? The Priorities Commission defines weakness by low socioeconomic status. In the report by the Swedish National Centre for Priority Setting the weak are rather identified by lack of sufficient agency (such as children, dementia-patients, unconscious patients or mentally ill).

In accordance with the guiding difference agency/(in)equality we can distinguish an agency-based solidarity (the weak as non-agents) underlying the report by the Swedish National Centre for Priority Setting and an inequality-based solidarity (the weak are the marginalized) underlying the report by the Priorities Commission. These different references of 'solidarity' have considerable consequences on which role the solidarity principle can play in an ethical platform.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. p. 45
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-75196 (URN)
Available from: 2012-02-21 Created: 2012-02-21 Last updated: 2012-02-21Bibliographically approved
Schirmer, W. & Michailakis, D. (2012). The latent function of responsibility for ones health in Swedish healthcare priority-setting. Health Sociology Review, 21(1), 36-46
Open this publication in new window or tab >>The latent function of responsibility for ones health in Swedish healthcare priority-setting
2012 (English)In: Health Sociology Review, ISSN 1446-1242, E-ISSN 1839-3551, Vol. 21, no 1, p. 36-46Article in journal (Refereed) Published
Abstract [en]

Applying Luhmanns theoretical framework, this article analyses the function of the notion responsibility for ones health in prioritisation in Swedish healthcare. A document called Ethical Platform was adopted in 1997 in order to guide decisions about prioritisation. Evaluations deemed it a failure. Against its official purpose, we argue that this document is not a failure as it has the latent function of protecting the credibility of the self-description of the Swedish political system as a highly inclusive and caring welfare-state. Since prioritisation implies exclusion it poses a threat for this self-description. less thanbrgreater than less thanbrgreater thanThe responsibility principle, suggested in 2007 as an improvement for the platform, has the latent function of helping overcoming the contradiction between the self-description of the welfare-state (inclusion) and prioritisation (exclusion). While inclusion into healthcare is still offered for everybody (respect), this right becomes conditional when citizens are regarded as agents who account for their unhealthy lifestyle (responsibility).

Place, publisher, year, edition, pages
e-Content Management, 2012
Keywords
latent function, Luhmann, healthcare prioritisation, responsibility, sociology, welfare-state
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-77544 (URN)10.5172/hesr.2012.21.1.36 (DOI)000303029600004 ()
Available from: 2012-05-25 Created: 2012-05-22 Last updated: 2017-12-07
Schirmer, W. & Michailakis, D. (2011). The responsibility principle. Contradictions of priority-setting in Swedish healthcare. Acta Sociologica, 54(3), 267-282
Open this publication in new window or tab >>The responsibility principle. Contradictions of priority-setting in Swedish healthcare
2011 (English)In: Acta Sociologica, ISSN 0001-6993, E-ISSN 1502-3869, Vol. 54, no 3, p. 267-282Article in journal (Refereed) Published
Abstract [en]

Medical priority-setting has been discussed heatedly in Sweden since the 1990s. While criteria such as medical need, solidarity and cost-effectiveness were established long ago, they failed to give clear directives to decision-makers on how to apportion priority. The notion of individual responsibility for ones health was suggested as one solution out of the impasse. According to the responsibility principle, anyone who fails to live up to the norms of a healthy lifestyle can legitimately be given lower priority. Although the principle is gaining support, its effectiveness is being hampered by structural problems. We have analysed official reports and pertinent fora of the Swedish debate on priority-setting from the period 1990-2009 and have examined the responsibility principle using a Luhmannian framework. Unlike common criticism emphasizing difficulties of assessing whether individuals can actually be held accountable for their lifestyle, we found that the responsibility principle fails in its current form because it unifies two incompatible logics deeply rooted in the functionally differentiated structure of society: those of medical reasoning (connecting health condition with lifestyle) and political expediency (attributing responsibility). We conclude that future policy-making cannot simply overlook this conflict, but has to acknowledge its presence and constructively utilize its potential.

Place, publisher, year, edition, pages
SAGE Publications (UK and US), 2011
Keywords
healthcare, lifestyle, Luhmann, responsibility, systems theory, welfare state
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-70743 (URN)10.1177/0001699311412624 (DOI)000293513600004 ()
Available from: 2011-09-16 Created: 2011-09-16 Last updated: 2017-12-08
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