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Chapter 9

Chapter 9 The Medicalization of Society.docx

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York University
SOCI 3820
Eric Mykhalovskiy

Chapter 9 The Medicalization of Society Introduction  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 illness.  Discussions of medicalization often refer to psychiatry as the primary example or prototype of medical social control.  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- being.  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 categories‟ 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 technoscientific biomedicine, 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 of medicalization. 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
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