Medicalization for understanding shifting ideas about health and illness Essay Example

"medicalization" was introduced in the 1970s by scholars like Peter Conrad and Thomas Szasz. They argued that medical professionals were expanding their authority into everyday aspects of life, which they saw as a form of societal control that should be resisted. This critique was exemplified in Conrad's influential work "The discovery of hyperkinesis: notes on the medicalization of deviance," published in 1973 (hyperkinesis referring to what we now call ADHD).

Medicalization is the transformation of concepts previously understood in moral, spiritual, or societal terms into issues categorized under medical and scientific knowledge. In the past, certain children were considered troublesome and misbehaving, while some men resorted to wearing hats to hide their baldness. Justifications for these behaviors were simply accepted and life went on. However, in present times, these descriptions might be seen as symptoms of an illness or disorder and could be diagnosed and treated with medication. Medicalization provides an explanation for this phenomenon.

Medicalization has been applied to a wide range of jobs, such as childbearing, the climacteric, alcohol addiction, and homosexuality (Gabe et al. 2006: 59). This term explains the process in which aspects of everyday life are explained medically, thereby falling under the authority of doctors and other health professionals for examination, diagnosis, prevention, and treatment. Initially, medicalization was closely associated with medical dominance, where medicine's power extended to "normal" life events and experiences. However, more recently, this perception of a submissive public under the control of expanding medicine has been challenged.

Therefore, in the current post-modern era, with increased concerns about risk and a decrease in trust of expert authority, many sociologists argue that healthcare consumers today play an active role in either

promoting or challenging the medicalization process. However, this involvement can be problematic as healthcare consumers become more aware of the risks and uncertainties associated with many medical choices. The emergence of the modern consumer not only raises questions about the concept of medicalization as a one-dimensional idea, but also requires examining the specific social contexts in which medicalization takes place. In this article, we explain how the concept of medicalization is discussed in the literature and present different explanations of power dynamics that shape the process.

Previous accounts of medicalization have focused too heavily on the medical profession's imperialistic tendencies while disregarding the benefits of medical specialization. We argue that by considering the societal context in which medicalization occurs, we can see that it is a more complex and contested process than what was suggested by the "medicalization thesis" of the 1970s. In today's post-modern era, it is insufficient to view medicalization as a one-dimensional and unchanging procedure or solely as a result of medical dominance. If we connect medicalization to the rise of rationalism and science during modernity, and if we are currently witnessing the decline of modernity, we might anticipate a decrease in medicalization. The concept of medicalization may be indirectly related to social constructionism since it doesn't challenge the foundation of medical knowledge itself but questions its application. Additionally, Nettleton argues that it demonstrates how medicine serves as an influential mechanism for social control (Nettleton 2006: 25).

According to Conrad and Schneider (1980) as cited in Nettleton (2006: 25), medicalization occurs by claiming expertise in areas of life that were previously not considered medical issues. This includes various life stages such as aging, childbirth,

alcohol consumption, and childhood behavior. Furthermore, the availability of new pharmaceutical treatments and genetic testing amplifies these processes, ultimately defining aspects of normal life as medical problems.

The first concept was described as using a medical vocabulary to specify a job. In some cases, physicians do not need to be involved, such as in the example of AA. The second concept is at the institutional level, where organizations adopt a medical approach to treating a specialized problem. The third concept is at the level of physician-patient interaction when a problem is defined as medical, and medical treatment is given. These examples all involve direct involvement of physicians and their interventions, except for alcohol addiction which has other figures like AA to assist individuals.

The third degree was referred to as the "interactive degree", where the job of societal job is defined as medical and medicalization takes place within a doctor-patient interaction. Medicalization reflects changing perceptions of health and illness, encompassing not only conditions like the flu or common cold, but also deviant behaviors. Previously, deviant behaviors were simply characterized as criminal, immoral, or indecent, but now they are attributed with medical connotations. Conrad and Schneider coined the term "five-staged consecutive process" to describe the medicalization of aberrant behavior.

The first phase involves viewing the behavior itself as abnormal. The term 'chronic inebriation' was initially seen as undesirable before it was officially diagnosed as such. According to Conrad and Schneider, the second phase occurs when the medical community acknowledges the behavior as abnormal. Ivan Illich, an influential philosopher, extensively studied medicalization and was one of the first to use the term.

Illich's assessment of professional medical specialty, particularly his use

of the term medicalization, has made him highly influential in the field. He is quoted as saying, "Modern medicine is a negation of health. It is not organized to serve human health, but only itself, as an institution. It causes more people to become sick than it heals." Illich attributes medicalization to the growing professionalization and bureaucratization of medical institutions linked to industrialization.

According to Illich, the development of modern medical specialty has created a reliance on doctors and has diminished peoples' ability to take care of themselves and pay attention to their own well-being. In his book "Limits to Medication: Medical Nemesis" (1975), Illich argued that the medical profession actually harms people through a process called 'iatrogenesis'. This refers to the increase in illness and social problems caused directly by medical intervention. Illich identified three levels of iatrogenesis, with the first being clinical iatrogenesis, which involves serious side-effects that are often worse than the original condition.

The deleterious consequences of clinical intervention surpassed the beneficial outcomes and also highlighted the hazards associated with contemporary medicine. Numerous adverse effects, including toxicity, were reported in relation to medication and drugs. Furthermore, hospital-acquired infections such as MRSA and medical negligence-induced errors were prevalent. The second aspect was social iatrogenesis, whereby the general public became subservient and dependent on the medical field for assistance in navigating their lives within society.

Furthermore, the hospitalization of all agony and the indirect undermining of wellness by medicine has an impact on societal administration of society. In this process, people no longer give birth, become ill or die at home. The third level is cultural iatrogenesis, also known as structural iatrogenesis. This is when life

processes like aging and dying become "medicalized," resulting in a society that cannot handle natural life processes and becomes dependent on medicine. Additionally, people lose their ability to cope with pain or grief as they rely on medicine and healthcare professionals.

(Illick 1975) Sociologists like Ehrenreich and English argued that women's bodies were being medicalized. Menstruation and pregnancy were seen as medical issues requiring interventions like hysterectomies. Nettleton expanded on this idea and discussed it in relation to childbearing. The medicalization of childbearing is a result of professional dominance, with a predominantly male medical profession taking control of pregnancy and childbirth. Consequently, medicine can be seen as patriarchal, exerting excessive societal control over women's lives. From conception to birth, women are closely monitored, making medical monitoring and intervention in pregnancy and childbirth routine procedures.

The idea that childbirth is a medical procedure and encourages women to give birth in hospitals, creating a reliance on medical care, has been challenged by recent research. Studies suggest that giving birth at home may actually be safer for women due to lower infection risk and less technological intervention. The concept of medicalization, which combines phenomenological and Marxist approaches to health and illness, argues that definitions of illness are influenced by unequal social interactions. Marxism views medicalization as a form of oppression that hides the true causes of disease like poverty and social inequality. Medicalization is analyzed in terms of power dynamics among professionals, patients, and corporations, as well as its impact on individual self-identity and choices concerning health and illness.

The use of a medical model of disability is prevalent when a status is deemed medical, rather than a societal model. According

to Nettleton (2006:26), the medical model "constructs, or redefines, aspects of normal life as medical problems." This process, known as medicalization, involves perceiving and treating social phenomena as illnesses. It involves redefining issues and experiences that were previously addressed in spiritual, moral, or social contexts as the subject of scientific medical knowledge. The concept challenges the belief that physical conditions themselves constitute an illness. It argues that the classification and identification of diseases are socially constructed.

The text suggests that medical specialty is influenced by the subjective premises of society in which it developed. It argues that the categorization and designation of diseases are socially constructed and lack objectiveness and neutrality, like other areas of scientific discipline. The medical thesis supports the creation of a new understanding of the societal processes involved in medical diagnosis and treatment. Conrad explains that doctors have medicalized societal aberrance to exert societal power through medicalization. This includes medicalizing issues such as hyperactivity, lunacy, alcohol addiction, and compulsive gaming. By medicalizing social issues, doctors can legitimize negative behavior, like suspected murderers claiming temporary insanity to be acquitted. The Endocrine Society may have also medicalized societal aberrance in men experiencing decreased work motivation or becoming unpleasant due to andropause.

Consequently, experiencing despondency in older male workers may be seen as a symptom of male climacteric rather than an indication of social deviance. Doctors also play a significant role in medicalizing social experiences. In examining the doctor-patient interaction within medicalization, Kaw argues that medical professionals have medicalized racial features by encouraging cosmetic surgery among Asian American women. This is done to avoid the stereotypical physical traits of "small" and "slanted" eyes, which are often

associated with passiveness, dullness, and a lack of sociability (Kaw, p. 75). Kaw further suggests that plastic surgeons use medical terminology to problematize the shape of the eyes, thereby defining it as a medical condition (Kaw, p. 81).

The use of proficient footings and appearances should be questioned as it influences Asian American women to seek unnecessary plastic surgery [Kaw, p 82]. Similarly, the medicalization of testosterone deficiency as Andropause by the Endocrine Society perpetuates the idea among older individuals that they should seek medical attention for symptoms such as low sex drive or depression, instead of understanding it as a natural phase [Conrad, p 111]. The healthcare industry's role in medicalizing conditions is further aided by the pharmaceutical industry, which relies on the medicalization of a problem to market drugs successfully [Conrad, p 111]. Once a medical definition for male menopause was established, pharmaceutical companies launched advertising campaigns targeting older men and doctors to promote their drugs [Groopman, 2002]. Time magazine advertisements used emotional appeals to link low sex drive to declining testosterone levels instead of presenting it as a part of the aging process [Groopman, 2002].

In this mode, the pharmaceutical industries ' net income based political orientation supports the medicalization of testosterone lack by popularising conditions that may be extremely common among wellness merchandise consumers. Furthermore, medicalization influences patients' beliefs about biomedicine, leading them to think that biomedicine should provide not only remedies for illnesses but also life enhancements. Just as drugs like Viagra were promoted for enhancing sexual performance and solutions like Rogaine for hair re-growth, male climacteric has also been medicalized due to the low "sex drive" it causes among other general

symptoms [ Groopman, 2002 ]. Consequently, older men will choose to seek and demand life enhancements achievable through medicine, disregarding the potential harm to their health.

According to Groopman (2002), known side effects of testosterone therapy include unnatural chest expansion, testicular shrinking, congestive heart failure, and prostate gland enlargement. However, medical professionals continue to medicalize conditions that patients seek to handle for their own well-being, despite the harmful consequences. Conrad (p 115) emphasizes that medicalization is not solely the result of "medical imperialism," but rather a collaborative process involving society and the health community, including both patients and physicians. Nevertheless, it is crucial to be aware of how the medical community influences society, as medicine impacts all healthcare consumers.

Male menopause is just one example of how the medical community has medicalized various life experiences. The concept of medicalization originated with the dominance of medical expertise, which involved labeling and medical intervention in events and experiences considered "normal". However, this perspective has been challenged in recent times. As we enter a post-modern era, where there is more concern about risks and less trust in expert authority, sociologists argue that health care consumers now actively play a role in either promoting or resisting medicalization. This can be problematic as consumers are increasingly aware of the uncertainties and risks associated with many medical decisions.

Furthermore, the growth of modern consumerism not only raises questions about the concept of medicalization as a one-dimensional idea, but also necessitates examination of the specific social contexts in which medicalization takes place (Ballard and Elston 2005). Additionally, they propose that viewing medicalization as solely a result of medical dominance is insufficient as we move into

a post-modern era.