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SOSC 2150 (1)


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Social Science
SOSC 2150
Lykke Dela Cour

Medicalization/Biomedicalization  What is medicalization?  Foucault and bio-governance  Transforming health: technological, political, cultural transformations and neoliberalism  Defining biomedicalization Medicalization – Definition Irving Zola (1972): process whereby more and more of life comes to be of concern to the medical profession behaviours become codified and defined as entailing particular symptoms that are best managed through medical intervention components: • expansion of what is deemed of relevance to medicine • retention of absolute control by the medical profession over aspects of technical procedures • seen as rightfully under the domain of medicine Medicalization – Example 1  childbirthing (late 19 to early 20 c) • technological advances (forceps, anaesthesia and surgery) • shift from midwives to doctors • shift from home births to hospital setting regulation of women’s bodies and loss of control over birthing process - No doctors, mainly midwives helped with birth in the home. She helped with the birthing process with other female family members, so she had all the control of her “birthing experience” - Medical science started to colonize the birthing field. Because some mothers or children would die due to complications, they felt the need to start intervening - Doctors wanted to be more relevant to “life” and tried to infiltrate life processes by expanding the field of medicine. They also developed new technologies - They argued they should be the ones in charge of the child birthing process since they had the medical training and technology - Legislation passed that stated only those with a medical licence could attend the birth. It completely excluded midwives because women were not allowed to attend medical school - The shift - MIDWIVESDOCTORS - HOME HOSPITAL - WOMEN IN CONTROLDOCTORS IN CONTROL - Once this shift happened, child birthing was now characterized as a dangerous life event. Cesarean section over the years has become embedded in the medical culture and has become more popular than vaginal births in Ontario, even though C-section it is not needed for all births - The costs of medicalization of child birth - Women losing control of the process and they do not have a say in what goes on, they are under the doctor’s orders and other medical staff - It became an alienated and isolated event, rather than it being in the comfort of your home surrounded by family, you are surrounded by strangers - It did have the technology to save the women in distress, but not all births needed medical intervention - It was not until the 1990’s did we start to see the resurgence of midwives Medicalization – Example 2  addictions (early 20 to present) • alcoholism and illicit drugs • other addictions (smoking, gambling, sex) • from sin/crime to pathology (chemical imbalances, mental disorder, genetics, neurotransmitters) - C. May, “Pathology, identity and the social construction of alcohol dependence.” Sociology v. 35 no. 2 (May 2001): 385-401 → addiction is a problem both ‘of’and ‘for’medicine. - Medical conceptualization addictions = more humane, more compassionate?? (treatments, stigma) - The use of drugs in the 1800s was not criminalized - In the 19th century after industrialization, it became criminalized - Prohibition was introduced in the US and Canada, but pushed more in the US, drinking alcohol was prohibited - In the 20th century, addiction is something the medical field gets interested in. Doctors claim that they have a mental disorder and it is not a crime. - Addicts were sent to asylums (alcoholics) and other facilities to treat their addiction - Recast social perception of addiction, it was first considered a sin or sinful nature, then a crime and now a mental disorder that needs to be treated - The doctors said the causes were: mental health issues, chemical imbalances in the body, genetic factors, neuroscience –faulty neurotransmitters in the brain - C. May : Issue OF medicine FOR medicine. People are turning to doctors to help with their addictions, rather than family and friends, so it is made so people only seek help from doctors. Medicine actually lacks any effective treatments for addictions ( can help you manage, but not “cure” ) - It did help us look at the problem in a more humane way, treatment is better than jail, but …does this really help? Is it less of a stigma when using medical pathology, some treatments are a(aversionarsh therapy, electric shock) - Aplea for insanity does not actually give you less time incarcerated, you stay in the institution longer and may stay indefinitely Medicalization – Other Examples  menopause → hormone replacement therapies (HRT)  homosexuality  ADHD (attention deficit hyperactivity disorder)  FAS (fetal alcohol syndrome)  obesity Foucault and bio-governance  traditional sociological analyses → professional expansion (medicine), social control  foucauldian analysis → informal disciplinary function → social regulation (expert discourses define particular bodies as ‘different’, reinforcing social marginalization; surveillance; self-regulation) Political Economy Analyses  Conrad “Medicalization, Markets and Consumers” • medicalized marketplace (economic incentives) • corporations and insurance companies play role in medicalization (not just physicians) • consumers also drive medicalization  Biomedicalization  associated with technoscientific changes since mid 1980s that are transforming health and illness  Clarke et al. “Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine” • second transformation of medicine • biomedicalization = increasingly complex, multi-sited, multi-directional process • highly technoscientific Biomedicalization – Context  technological – computerization → expanded organizational and institutional information and reach – technoscientific innovations within biomedicine  political – ideological and political transformations associated with neoliberalism (privatization and commodification of health → health = individual responsibility (rather than collective right) - technological: - Less privacy - Easy access to your past medical issues through your patient file - This could lead to bias based on what may be written in your file. Doctors may treat you
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