Medicalization, a grave social problem
Medicalisation is a key concept in sociology which refers to the processes by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment.
Medicalization includes alcoholism, mental disorders, opiate addictions, eating disorders, sexual and gender difference, sexual dysfunction, learning disabilities, menstruation, birth control, infertility, childbirth, menopause, and ageing.
Once a condition — is categorised as medical, a medical perspective of disability is adopted, rather than a social model. Thus, medicalization becomes a ground for pathologization natural events that happen in anybody’s life. For instance, natural phenomena like stress are labelled as conditions and are treated with medication.
Patients are not always made aware that there are alternatives and that medication is not solving the root cause of a problem, but it only suppresses feelings.
Labels associated with medicalization link people to a set of undesirable characteristics that form stereotypes. A labelled person might experiencee status loss and discrimination). Studies have shown that stigmatised groups are disadvantaged when it comes to life outcomes like income, education, psychological well-being, housing status, medical treatment, and health
Researcher in ethics, Poitras gives examples of two types of medicalization:
1) Social medicalization is a form of social control in which different problems are framed as illness by the medical establishment, so that individuals can be coerced to consume medical products or services.
2) Economic medicalization refers to the use of clinical trials as a vehicle to market medication.
Medical sociologist Conrad criticised medicalization and described it as a force of social control. Due to the trust people have in science, especially medicine, the general public is made docile and reliant on the medical profession to help them cope with everyday life.
Medicalization allows pharmaceutical companies to take over the role of doctors, by promoting the false idea that pills are the cure for almost everything. Conrad argued that medicalisation increased consumer demands for medical solutions, thus contributing to the expansion of the pharmaceutical industry.
Marxists such as Vicente Navarro linked medicalization to an oppressive capitalism, arguing that medicine makes people see health as an individual problem rather than being determined by major social problems such as social inequality or poverty.
In his book “Limits to medicine: Medical nemesis” (1975) Ivan Illich described the harmful process of medicalisation through the term of ‘iatrogenesis’, which can occur on three different levels.
1) The clinical iatrogenesis refers to serious side-effects which are often worse than the original condition that is treated, thus the negative effects of the clinical intervention outweighing the positive. This includes medical malpractice, which harms, or even kills the patient.
2) Social iatrogenesis refers to the process by which medical practice sponsors sickness by encouraging people to become consumers of medical services. It makes people hypochondriac and willing to place themselves at the mercy of medical experts, a state that undermines individual willingness to reshape the society that has made them sick.
3) Cultural iatrogenesis, which refers to the fact that medical professionals destroy the potential of people to deal with their human weakness, vulnerability, and uniqueness in a personal and autonomous way. It implies that societies weaken the will of their members, by paralysing healthy responses to suffering, impairment and death. Medicalization contributes to the belief that people are not responsible for their actions. For example, obesity is seen as a disease, rather than a lifestyle choice that can be prevented or treated with non medical interventions.
Sociologist Meessen used the term “iatrogenic poverty” to describe impoverishment induced by medical care. Impoverishment is described for households exposed to catastrophic health expenditure or to hardship financing. Every year, worldwide, over 100,000 households fall into poverty due to health care expenses. A study reported that in the United States in 2001, illness and medical debt caused half of all personal bankruptcies.
More specific aspects of medicalisation are polypharmacy, institutionalisation, magic pill culture and the sick role.
Polypharmacy is the concurrent prescription of multiple medications for a patient. It is most common in the elderly and learning disabilities. Though polypharmacy is not necessarily ill-advised, the cumulative side effects pose many risks, without providing any major benefits.
Institutionalisation refers to deficits or disabilities in social and life skills, which develop after a person has spent a long period living in hospitals, prisons, or other remote institutions. These deficits in social skills occur because institutionalised people can be deprived of autonomy and of responsibility, thus once they are reinserted in their environment, they are often unable to function independently and they might develop mental health conditions.
The pill mindset is a mentality formed in childhood based on beliefs that there is a pill for every symptom, big or small and that medications can relieve symptoms, cure illnesses and even prolong life without necessary any other efforts.
There are quite a few problems with the pill mindset. In the first place any medication is treating the effect of a problem — most of the time an unhealthy lifestyle — and not the cause. People with a pill mindset have unrealistic expectations about their medication: they might feel they can continue an unhealthy lifestyle.
Sick role is another aspect of medicalization. Sick role theory, as described by researcher Talcott Parsons in 1951, is a way of explaining the particular rights and responsibilities of those who are ill.
Since those who are diagnosed with a medical condition cannot always fulfil the same duties that a person in good health can, society adapts to this situation and allows for a reasonable amount of deviation from behaviour that would be viewed as typical of a well person.
Parsons saw the sick role as a form of deviance, or going against societal expectations, because an ill person has different patterns of behaviour than the norm. He argued that people are generally expected to be productive members of society. However, if an ill person is not able to carry out his or her usual duties, such as work at a job, go to school or care for family members, this deviance from the usual is approved by the community or authority figures.
For the deviance to be sanctioned, a medical expert, such as a doctor, must certify that a person is actually ill, a process that legitimates their illness. Legitimization is proof that the person is truly sick and in need of a more lenient set of expectations.
The sick role has its own set of norms of expected behaviour because the individuals who assume this role are not held accountable for their illness; they do not have to fulfil their normal roles; and should seek medical attention, do as the doctor says, and try to get well.
How to reduce the impact on medicalization on you?
Prevention is better than cure
Promotion of healthy lifestyles and the prevention of ill health is a fundamental principle behind public health and improving the public’s health. The phrase ‘prevention is better than cure’ is often attributed to the Dutch philosopher Desiderius Erasmus in around 1500. It is now a fundamental principle of modern health care and inherent within health and social care strategies across the world.
Good health is not just the absence of disease or illness, it is a state of complete physical, mental and social well-being.
This means eating a balanced diet, getting regular exercise, avoiding tobacco and drugs and getting plenty of rest.
Consider complementary or alternative medicine
Complementary and alternative medicine (CAM) is treatment that falls outside of mainstream healthcare. These treatments range from acupuncture and homeopathy, to aromatherapy, meditation and colonic irrigation.
Some CAM therapies have undergone careful evaluation and have been found to be generally safe and effective. These include acupuncture, yoga, and meditation to name a few. However, there are others that do not work, may be harmful, or could interact negatively with your medicines.
Lower your stress levels
You can lower your stress through mindfulness practices — like meditation, deep breathing, journaling, or spending time in nature.
Strong relationships and staying in communication with friends and loved ones can support mental health.
If ill involve in your care and make informed decisions
Discuss with your doctors the risk versus benefits of taking a medication.
Check the long-term outcomes and adverse effects of medication before taking it.
Takeaways
Inappropriate medicalisation carries the dangers of unnecessary labelling, poor treatment decisions, iatrogenic illness, and economic waste, as well as the opportunity costs that result when resources are diverted away from treating or preventing more serious disease.
At a deeper level it may help to feed unhealthy obsessions with health.
The best way to avoid medicalization is to keep fit and prevent illnesses rathen than curing them.
