Extending Durkheim's sociology of suicide to healthcare decision-making: towards a sociology of choice as a social phenomenon of integration and regulation

The study of the social dimensions of healthcare (decision-making) behaviour lacks a foundational theory. Using extant studies, this paper argues and demonstrates that their results can be placed on the social manifold that is spanned by the four idealistic poles described by Durkheim’s (On Suicide, 1897) work ‘On Suicide’ and that these poles can therefore be extended to theoretically represent four ideal types (meanings) of healthcare choice: altruistic choice (excessive integration), egoistic choice (absence of integration), fatalistic choice (excessive regulation), and anomic choice (absence of regulation). By using Bearman’s (Sociological Forum 6(3): 501–524, 1991) structural model of suicide, this social manifold is theoretically unfolded by representing all possible tangible (network) structures as a function of integration and regulation, which additionally amplifies and extends Durkheim’s theory. This approach builds upon Pescosolido’s (Advances in Medical Sociology 3(1):161–184, 1991) Network Episode Model and provides opportunity to connect it further to the Social Symbiome.