Chapter 9 The Medicalization of Society
The medicalization of behaviour considered deviant is a historical and social process and is the outcome
of professional and social movement activity.
Medicine continues to play a key role in medicalization; however other forces, such as the
pharmaceutical industry, consumer groups, biotechnological discoveries, and health insurance are
important „engines of medicalization‟.
This chapter outlines the concepts of medicalization and examines the relationship between
medicalization and social control.
It looks at the role of psychiatry in identifying and regulating deviance and the role of pharmaceutical
companies in manufacturing illness.
Medicalization and Social Control
Increasingly, human experiences are coming under medical scrutiny with numerous aspects of daily life
being defined as medical issues, resulting in what Illich has called „the medicalization of life‟
Medicalization describes the process whereby nonmedical problems or phenomena become defines and
treated as medical issues, usually in terms of illnesses, disorders, or syndromes.
Successful medicalization means that the dominant form of social control is therapeutic and that
individuals diagnosed as deviating from a model of health confront a new set of normative expectations
stemming from the sick role.
The sick role exempts people from fulfilling their normal social duties; it does not hold individuals
responsible for their conditions and obliges them to seek medical assistance.
While the sick role legitimates some kind of social behaviours and imposes a new set of social norms,
access to this status is not automatic.
o The manifestation of certain physiological conditions is not the only or indeed a necessary
prerequisite for contact with institutionalized medicine.
Risk/risk discourse – risk refers to „ danger‟; risk discourse is often used in health-promotion message
warning people that certain actions involve significant risks to their health.
Conrad explains that early studies of medicalization focused on the medicalization of deviance;
however, today the concept is applies to broad areas of human life that now are subject to medical
interpretation and intervention.
The medicalization of deviance includes categories such as alcoholism, mental disorder, substance
addictions, eating disorders, sexual dysfunctions, learning disabilities, attention deficit hyperactivity
disorder (ADHD), premenstrual syndrome (PMS), and post-traumatic disorder (PTSD).
Social constructionism counters medicine‟s claim to be scientific, objective, and disinterested.
Like Illich, Eliot Freidson argues that medicine actively and exclusively constructs illness ad therefore
determines how people must act in order to be treated.
Within this context, empirical research identifies the social conditions under which certain illnesses
emerge, and it analyzes the effect of medical practitioner‟s claims on the development of conception of
Discussions of medicalization often refer to psychiatry as the primary example or prototype of medical
Such discussions tend to emphasize the negative and coercive aspects of social control, in contrast to
medical discourses that focus on medical intervention as positive and necessary for health and well-
Ivan Illich, a critic of the medical establishment, popularized the term social iatrogenesis to talk about
the extent to which medicine has gained control over every stage of the life cycle, beginning with
prenatal checkups to monitor a fetus‟s development to the decision to not resuscitate at the end of life. The medicalization thesis today focuses on both dimensions that is, on how medical categories are
increasingly applied to all parts of life, and, how, at the same time, people have internalized medical
perspectives and actively seek or demand medical remedies.
Catherine Kohler Riessman in her article „Women and Medicalization: A New Perspective‟
acknowledges the feminist critique of medicalization and the sexual politics embedded in conceptions of
sickness: however she argues that medicalization involves a symbiotic relationship in which „both
physicians and women have contributed to the redefining of women‟s experience into medical
Type of Medicalization
Conceptual level, at which a medical vocabulary is used to describe or define an issue or problem, but
medical professional and treatment may not be involved.
Institutional level, at which organizations may adopt e medical approach to particular problems and
medical personnel, may be gatekeepers for the organization but the everyday routine work is performed
by nonmedical personnel.
Interactional level, at which medicalization occurs as part of doctor-patient interaction, with the former
medically defining and/or treating the latter‟s problems.
Medicalization is not only about defining nonmedical problems as sickness or disease but also includes
broadening pre-existing medical categories to include more potential sufferers and situations.
Clarke et al. argues that medicalization today is being reconstituted through the development of
o Such processes are situated within political-economic contexts: „In the biomedicalization era,
what is perhaps most radical is the biomedicalization of health itself.
o Biomedicalization – describes increasingly complex, multi-sited, and multi directional processes
The History and Role of Psychiatry in Medicalization
The emergence and dominance of a medical approach to madness began in the late eighteenth century.
Back in the seventeenth century, enormous houses of confinement had been opened to accommodate
diverse populations of what were referred to as deviants, including so called mad people, criminals,
libertines, beggars, vagabonds, prostitutes, the unemployed, and the poor – that is, people deemed to be
economically (and politically) marginal.
By the eighteenth century, reformers sought to eliminate the physically punitive aspects o