Medicalization

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Medicalization is the process by which human conditions and problems come to be defined and treated as

prevention
, or treatment. Medicalization can be driven by new evidence or hypotheses about conditions; by changing social attitudes or economic considerations; or by the development of new medications or treatments.

Medicalization is studied from a sociologic perspective in terms of the role and power of professionals, patients, and corporations, and also for its implications for ordinary people whose self-identity and life decisions may depend on the prevailing concepts of health and illness. Once a condition is classified as medical, a medical model of disability tends to be used in place of a social model. Medicalization may also be termed pathologization or (pejoratively) "disease mongering". Since medicalization is the social process through which a condition becomes a medical disease in need of treatment, medicalization may be viewed as a benefit to human society. According to this view, the identification of a condition as a disease will lead to the treatment of certain symptoms and conditions, which will improve overall quality of life.

History

The concept of medicalization was devised by sociologists to explain how medical knowledge is applied to behaviors which are not self-evidently medical or biological.

ADHD).[3] Nevertheless, opium
was used to pacify children in ancient Egypt before 2000 BC.

These sociologists did not believe medicalization to be a new phenomenon, arguing that medical authorities had always been concerned with social behavior and traditionally functioned as agents of social control (Foucault, 1965; Szasz,1970; Rosen). However, these authors took the view that increasingly sophisticated technology had extended the potential reach of medicalization as a form of social control, especially in terms of "psychotechnology" (Chorover,1973).

In the 1975 book Limits to medicine: Medical nemesis (1975),

side effects
worse than the original condition; the social, whereby the general public is made docile and reliant on the medical profession to cope with life in their society; and the structural, whereby the idea of aging and dying as medical illnesses effectively "medicalized" human life and left individuals and societies less able to deal with these "natural" processes.

The concept of medicalization dovetailed with some aspects of the 1970s

hysterectomies
.

capitalist society. They argued that medicine disguised the underlying causes of disease, such as social inequality and poverty, and instead presented health as an individual issue. Others[4]
examined the power and prestige of the medical profession, including the use of terminology to mystify and of professional rules to exclude or subordinate others.

Tiago Correia (2017)

complementary and alternative medicine
) on the one hand, or the over-rapid and unregulated adoption of biomedical medicine in non-western societies on the other. The challenge is to determine what medical knowledge is present, and how it is being used to medicalize behaviors and symptoms.

Areas

Sexuality

Main article: Medicalization of sexuality

Many aspects of human sexuality have been medicalized and pathologised by psychiatry, psychology and the

biological reductionism and other tenets of medicalisation, individualism and naturalism, generally fail to take into account sociocultural factors contributing to human sexuality.[6][7]

The

HIV/AIDS pandemic allegedly caused from the 1980s a "profound re-medicalization of sexuality".[8][9]

The diagnosis of

Peggy Kleinplatz has criticized the diagnosis as the medicalization of normal human behavior.[10] Other medicalized aspects of women's health include infertility,[11] breastfeeding,[12] the childbirth process,[13] and postpartum depression.[14]

Although it has received less attention, it is claimed that masculinity has also faced medicalization, being deemed damaging to health and requiring regulation or enhancement through drugs, technologies or therapy.[15] Specifically, erectile dysfunction was once considered a natural part of the aging process in men, but has since been medicalized as a problem, late-onset hypogonadism.[16]

According to Mike Fitzpatrick, resistance to medicalization was a common theme of the gay liberation, anti-psychiatry, and feminist movements of the 1970s, but now there is actually no resistance to the advance of government intrusion in lifestyle if it is thought to be justified in terms of public health.[17] Moreover, the pressure for medicalization also comes from society itself.[17]

Psychiatry

For many years, marginalized psychiatrists (such as Peter Breggin, Paula Caplan, Thomas Szasz) and outside critics (such as Stuart A. Kirk) have "been accusing psychiatry of engaging in the systematic medicalization of normality". More recently these concerns have come from insiders who have worked for and promoted the American Psychiatric Association (e.g., Robert Spitzer, Allen Frances).[18]

Benjamin Rush, the father of American psychiatry, claimed that Black people had black skin because they were ill with hereditary leprosy. Consequently, he considered vitiligo as a "spontaneous cure".[19]

According to Franco Basaglia and his followers, whose approach pointed out the role of psychiatric institutions in the control and medicalization of deviant behaviors and social problems, psychiatry is used as the provider of scientific support for social control to the existing establishment, and the ensuing standards of deviance and normality brought about repressive views of discrete social groups.[20]: 70  As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances.[21]: 14 

According to Kittrie, a number of phenomena considered "deviant", such as

drug addiction, prostitution, pedophilia, and masturbation ("self-abuse"), were originally considered as moral, then legal, and now medical problems.[22]: 1 [23] Innumerable other conditions such as obesity, smoking cigarettes, draft malingering, bachelorhood, divorce, unwanted pregnancy, kleptomania, and grief, have been declared diseases by medical and psychiatric authorities.[24] Due to these perceptions, peculiar deviants were subjected to moral, then legal, and now medical modes of social control.[22]: 1  Similarly, Conrad and Schneider concluded their review of the medicalization of deviance by identifying three major paradigms that have reigned over deviance designations in different historical periods: deviance as sin; deviance as crime; and deviance as sickness.[22]: 1 [25]
: 36 

According to

therapeutic state swallows up everything human on the seemingly rational ground that nothing falls outside the province of health and medicine, just as the theological state had swallowed up everything human on the perfectly rational ground that nothing falls outside the province of God and religion".[26]
: 515 

Labeling theory

Further information: Labeling theory

A 2002 editorial in the

British Medical Journal
warned of inappropriate medicalization leading to disease mongering, where the boundaries of the definition of illnesses are expanded to include personal problems as medical problems or risks of diseases are emphasized to broaden the market for medications. The authors noted:

Inappropriate medicalisation carries the dangers of unnecessary labelling, poor treatment decisions, iatrogenic illness, and economic waste, as well as the opportunity costs that result when resources are diverted away from treating or preventing more serious disease. At a deeper level it may help to feed unhealthy obsessions with health, obscure or mystify sociological or political explanations for health problems, and focus undue attention on pharmacological, individualised, or privatised solutions.[27]

Healthism

Public health campaigns have been criticized as a form of "healthism", which is moralistic in nature rather than primarily focused on health. Medical doctors Petr Shkrabanek and James McCormick wrote a series of publications on this topic in the late 1980s and early 1990s criticizing the UK's Health of The Nation campaign. These publications exposed abuse of epidemiology and statistics by public health authorities and organizations to support lifestyle interventions and screening programs.[28]: 85 [29]: 7  Inculcating a fear of ill-health and a strong notion of individual responsibility has been derided as "health fascism" by some scholars as it objectifies the individual without considering emotional or social factors.[30]: 8 [29]: 7 [31]: 81 

Professionals, patients, corporations and society

societal norms
also help many people live their lives. Even scholars who critique the societal implications of brand-name drugs generally remain open to these drugs' curative effects – a far cry from earlier calls for a revolution against the biomedical establishment. The emphasis in many quarters has come to be on "overmedicalization" rather than "medicalization" in itself.

Others, however, argue that in practice the process of medicalization tends to strip subjects of their social context, so they come to be understood in terms of the prevailing biomedical

corporate capitalist enterprise.[35][36][37]

Scholars argue that in the late 20th century transformation within the health sector in the US altered the relationship between people in the healthcare sector.

advocates, consumers
, or even agents of change.

In response to theory based on medicalisation being insufficient to explain social processes, some scholars have developed a concept of biomedicalization which argues that technical and scientific interventions are transforming medicine. One aspect is pharmaceuticalization, the influence of the use of

pharmaceutical drugs rather than other interventions. Other components are computerization of parts of healthcare such as public health, the creation of a "biopolitical economy" of private research outside of state, the perception of health as a moral obligation.[39]

Medicalization has brought health issues to the fore, so people think more and more about things in terms of health and act to promote health. When it comes to health issues, medicine is not the only provider of answers, but there have always been alternatives and competitors. At the same time as medicalization, "paramedicalization" has strengthened: also many treatments for which there is no medical basis, at least for now, are popular and commercially successful.[40]

See also

References

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  10. ^ Offman A, Kleinplatz PJ (2004). Does PMDD Belong in the DSM? Challenging the Medicalization of Women's Bodies. The Canadian Journal of Human Sexuality, Vol. 13
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Further reading
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