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SOC243 Lecture 4

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William Magee

SOC243 Lecture 4 10/01/2012 1. The Macro Context of Medicalization and demedicalization 2. Some sources of medicalization 3. From medicalization to enhancement 4. Demedicalization: the case of women’s health 5. Revisiting somatization in the context of (re)medicalization 6. Discussion of assignment The Macro Medicated processes: structural and culture processes Macro processes (of social control of risks industry, of political economy and culture) > science/technology medicine> understandings/(de) medicalization (lay->expert, illnessbodies) > practices experiences (illness) - Influence across and within each - Sick role of gate keeping - Institutional medicalizations Medicalization and demedicalization Institutional medicalization … (Zola) “a process whereby more and more of life comes to be of concern to the medical profession - The staining attachment to the medical profession and institution Two components by which medicalization expands 1. Retention of control over certain technical procedures by the profession of medicine 2. Retention of control over access to the profession (licensing and schooling) - Insurance reimbursements - Medicalization is complete or not complete, a lot of leeway o “I think it might work” “try this” Demedicalization: removal of a medicine that response to an issue - “De fact of” - Through processes of demedicalization Conceptual/Definitional Medicalization Zola: “the expansion of what in life is deemed relevant to the good practice of medicine” - Defining a problem in medical terms, or using a medical intervention to address a problem or form of deviance - … Developing arguments and evidence that a social problem should be considered a medical problem - Problems of medicalization falling in between the scales Current (late modern) contestation around medicalization-demedicalization - Anecdotal evidence suggest in late modernity, lay publics have become increasingly skeptical of risks claims of experts o 60s and 70s more questioning of the expertise of medicalization - associated with rise of postrstructionism and postmodernism- many knowledge claims are “undecidable”, and what is considered knowledge is “determined by the play or power” - the idea of progress is questioned Legitimacy claims of business, professions, and governments are more often contested - Claims to safety and public health o Challenged by consumers group, NGOs, in the public sphere - Greater public concern with risks and allocations of risks o Banning toys from China Some source of medicalization - Health care is an expanding economic sector - What are the interest of medicalization and demedicalization? o Finding out the solutions to the problems first - Bio societies – groups of activists around medical/biological issues o Advocates of medicalization o For and against medicalization  i.e. stem cells (moral concern) - Consumerism o Top down and bottom up processes - Economic, social and technological concerns Technological Development - New technologies allow for new ways to decompose the body, “conferring new mobility on the elements of life” (Rose, pg.5)& new possibilities for profit through the redeployment of bodies and tissues, which have “biovalue” in the economy - in conjunction with technological development is interest group activism that results in “…novel alliances between political authorities and promisory capitalism” (Rose, pg18) o For example, bio- societies, those that are on the opposite side of the spectrum Moral Imperatives and Biocapitalism - in practically all social systems the duration and quality of human life is of such extreme ethical importance that “..the technologies for maintaining and improving (life) can represent themselves as more than merely the corrupt pursuit of profit and personal gain…” Claims and realities and ambiguities - Must more is claimed than is actually known…most diseases can be managed, not cured. Patients are misled by distorting media hype (Kleinman and Hanna) - In individual case, when faced with ambiguous situation, having to choose to do something rather than nothing … “medical decision rule” o When is doubt, treat Technological Imperative - The tendency to use the available technologies o Inevitability thesis: a logic impress of technology “If its there, use it” Moral implications of biotechnologies - as science has progressed to the point of u
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