In modern society today, the use of medication to treat illnesses and conditions is on the rise. This in turn leads to prove the notion that gradually society is becoming medicalised.
Medicalisation can be defined as the process through which non-medical problems and conditions are increasingly described as illnesses or disorders and are thus treated as such. This results in experiences being interpreted, diagnosed and treated by medical health professionals. Today, there are several experiences such as pregnancy, ageing, loss of sexual function and dying that have become hugely medicalised.
Primarily medicalisation emerged during the 1950s and 1960s when medicine was expanding vastly to social illnesses. The current position of medicine has been developing since the last 150 years. Throughout this process, events that were once considered immoral for example suicide are now identified as medical problems. The process through which medical practices are applied to experiences and behaviours that were not historically considered medical conditions, is known as medicalisation. This notion results in experiences once seen as a normal process of human nature being interpreted now as a medical problem. Everyday social life problems such as relationship problems, antisocial behaviour, and bereavements are also now increasingly seen as diseases that need support from medical experts such as psychologists or psychiatrists.
To provide a theoretical background, the concept of iatrogenesis is provided. Many critics have argued that modern medicine, that is medication which has been influenced by technology and drug therapy, has resulted in iatrogenic disease. These are conditions caused by medical factors for example medical accidents, reaction to drugs, and complications as a result of surgery. Many theorists argue the effects of medicalisation can go further than just direct clinical harm. Some believe that medical health professionals create social iatrogenesis, in the sense that they create unrealistic health demands which can only be met by more health care and medication. Theorists state that medicalisation also results in cultural iatrogenesis, where individuals adapt to understanding every ache and suffering as requiring medical attention.
It is suggested that medicalisation may have emerged from a medical model of health approach to tackle health issues. Developed in the eighteenth and nineteenth centuries, the medical model influences society’s understanding of health illnesses, therefore is of central focus. The medical model focuses on eliminating diseases which in turn ignores the social environment of the individual therefore the model is individualistic in nature concerning illnesses only. In the past, this narrowed focus was an advantage, leading to the development of antibiotics such as penicillin. The medical model has a great influence on the norms and practices of society however its relevance is limited to only a small number of acute medical conditions such as an asthma attack, chest infection, and alcohol problems. Another implication of the medical model is that it has resulted in the medical gaze as suggested by Foucault in 1973. The medical gaze describes the practice whereby individuals are influenced to view their health as an individual problem, needing constant consultation from a medical professional.
Similarly, during the twentieth century, there was a major shift in the way death was addressed due to medicalisation. The place of death was replaced from the home to the public domain of hospitals, therefore the management was handed to medical professionals. Death is now increasingly defined and recognised as a medical event, requiring confirmation of medical professionals, and a process which could possibly be avoided or postponed by either preventing or treating diseases. The medicalisation of death has been further influenced by media coverage and autobiographical accounts, which present a specific ideology regarding the management of a good death, and appropriate mourning. This construction of a good death can create fragmentation, and leads to the false hope that there is choice in relation to death, whereas in reality this is somewhat limited. The medicalisation of death creates the ideology that death can be resisted, hence medicine has been criticised for not accepting the natural process of death.
Medicalisation increases the power that medical professionals have over the human body, through reducing social phenomena and instead focusing of biological pathologies. In some cases, the concept gives increasing power to medical professionals to define and expand their authority to include social experiences instead of just biological phenomenon. The problem with this notion is that it can potentially result in a society in whereby the opinion and advice of medical professional is of utmost importance. In this case, the subjective experiences and interpretations of individuals may not be considered or given any value. Increasing the power of medical professionals may threaten civil and human rights as it results in relying upon medical professionals as experts, who can and will provide medical solutions for a range of non-medical problems, thus making society hugely dependant on experts and technology.
Medicalisation has caused medicine to become a significant agent of social control in society, concerned with the relief of suffering. It defines the norms of behaviour, and labels individuals who may fail to conform to these discourses. For example homosexual people may be explained as the result of medical abnormalities. Furthermore, medicalisation assumes that the problem a person is facing is due to their own physical and psychological limitations, thus does not consider the wider social determinants which may be contributing towards the issue. For example, inappropriate student behaviour may be classified as hyperactive disorder, whereas in fact it may be additional factors such as bullying or peer pressure which may be causing the student to behave in a specific way. Thus, medicalisation turns social problems of the structure of society into technical medical conditions. It assumes a problem or state to be a deficiency, requiring medical intervention. The problem is identified as a physical or psychological dysfunction, and is separated from the broader social context. This medicalisation of deviant behaviour has raised concerns due to its disregard of the social environment of the individual, where the role of social structures in creating condition which raise problems is not considered.
In contrast, it is acknowledged that health education through the increasing accessibility of information for example leaflets and the Internet, means individuals are now more well-informed therefore are not passive consumers of medicine. Some theorists interestingly point out that individuals themselves may be contributing to making their bodies the subject of medical treatment, through self medication. Arguably, it is not only medical health professionals that practice medicalisation, but it may also be taken on board by lay individuals. Self medication can be seen as a form of social control, where an individual may personally interpret a problem in medical terms and therefore take on medical treatment. This may result in more control one has over their own body because the patient is playing an active role in their healthcare choices resulting in empowerment and independence. However, there can be health implications with this practice, because lay people may not necessarily diagnose and treat themselves in an appropriate manner, due to the lack of knowledge and expertise. Other potential risks include side effects, incorrect dosage, drug abuse, and delays in seeking medical advice which may be necessary for example in the case of cancer.
The experience of women in regards to Western medicine can also be explored through medicalisation. The studies focusing around this topic have found that it is women who are the subject of medical control through the adaptation of drugs and medical techniques. Deviant behaviour of women, in comparison to men, is likely to be medicalised instead of being considered as a crime. For example, women who are involved in physically abusing children have been dealt with by the mental health system. Furthermore, women’s natural life processes are much more likely to be medicalised than that of men. Examples of such experiences include, but are not limited to, pregnancy, childbirth, menstruation, and menopause.
Medicalisation has also had an impact on pregnancy in terms of egg freezing, the process through which women optionally freeze their eggs, in order to use them later on in life when they are ready for motherhood. In the past, eggs were only frozen for medical reasons for example the risk of premature menopause, disease related infertility and conditions such as polycystic ovaries. However today eggs are being frozen for social reasons such as career aspirations, finding a suitable partner, stability in terms of education and housing, and economic status. Although there are clear advantages of egg freezing in terms of the personal circumstances of women, it is argued that it results in further medical power over women’s bodies. Women who are perfectly healthy do not necessarily need to freeze their eggs, and may not be fully aware of the risks attached to egg freezing, such as the low success rate.
Medicalisation can potentially lead to a positive reinforcement, due to the idea that the disease can be addressed and treated. For example, rates of medical cure has increased in some areas and medical treatments contribute a great deal to improving quality of life. In addition, the growth of medicine and the development of medicalisation has resulted in many health interventions and services such as screening. Screening is an essential health initiative, which can fundamentally detect conditions such as cancer in early stages, or identify individuals who are at risk of developing conditions, therefore prevents diseases. At-risk individuals or those in the early stages of a condition can be provided with medical information and services; this eliminates the cost of advanced treatment which may have been necessary at a more deteriorating level. However screening sometimes detects conditions with no or little significance, therefore individuals may receive medication for diseases that they have not actually developed.
One implication of medicalisation is that it adds to the burden of the UK’s National Health System (NHS). The budget of the NHS is very tight and scarce, thus if there is in an increase in the demand for medication, it will result in more money and resources required to produce these drugs and medication. Medicalisation gives individuals the impression that their pain or suffering is not due to their own lifestyle choices, but is a result of some biological defect which can be treated with a pill. Due to this, there is an increased use of medicines, need for treatment for side effects from self medication, rising hospitalisation rates, and unnecessary services for example caesarean sections. In a system where resources are greatly challenged, medicalisation is now a major threat to the sustainability of the NHS.
To conclude, I have mixed feelings about medicalisation. I believe it is certainly has benefits in terms of prevention and early detection. However I also feel that it has many implications in regards to finance, and allowing society to think that there is a cure to everything – I feel that this is damaging as some natural experiences such as death cannot be cured. What are your guys thoughts on this one?