The sovereignty of medicine in our lives: medicalization

Year 2022, , 347 - 356, 27.09.2022

Tayyibe Bardakçı

https://doi.org/10.21673/anadoluklin.1082071

Cited By: 2

Abstract

Medical practices change dramatically because of the recent scientific and technological developments in areas such as genetics, biotechnology and digital technologies. As the boundaries of medicine have become blurred, the focus of physicians has shifted from “What we can treat?” to “What we should treat?”. In such a rapidly changing world, medicine and technology are intertwined more than ever before, and this has affected medical processes, particularly the nature of medical knowledge. The transformation of medicine to an unhesitating and powerful authority, accelerated by the development of modern medicine, is strengthened with more successful results in diagnosis and treatment. The medical authority holds the reins of power to determine who is sick, healthy, or normal, or what conditions should or should not be considered as a disease. Today, many phenomena including birth, childhood, eating and drinking habits, mental states, adolescence, sexuality, pregnancy, agedness or death have been included in the field of medicine. Hence medicine has declared its sovereignty in our lives. This condition, called medicalization, although comes to the fore in the 1960s-70s, is a concept that still maintains its importance today and needs to be addressed. Medical interventions to the human body, human mind and human behavior are increasing day by day, and the scope of medical activities is expanding. Despite the fact that medicalization and treatment of cases that should not be under the influence of medicine cause many harms at the individual and societal level, this situation has been so widely accepted without questioning.

Keywords

disease, health, medicalization, overdiagnosis

Tıbbın yaşamlarımızdaki hakimiyeti: medikalizasyon

Abstract

Genetik, biyoteknoloji ve dijital teknoloji gibi alanlardaki bilimsel ve teknolojik son gelişmeler nedeniyle tıbbi uygulamalar önemli ölçüde değişmiştir. Tıbbın sınırları muğlaklaştığı gibi, doktorlar için odak noktası “Neyi tedavi edebiliriz?”den, “Neyi tedavi etmeliyiz?”e kaymıştır. Bu kadar hızlı değişen bir dünyada tıp ile teknoloji her zamankinden daha fazla iç içe geçmiş, bu da tıbbi bilginin mahiyeti başta olmak üzere tıbba dair süreçleri etkilemiştir. Modern tıbbın gelişimi ile ivmelenen tıbbın sarsılmaz, güçlü bir otorite haline gelişi, teşhis ve tedavide daha başarılı sonuçlar elde edilmesi ile pekişmektedir. Tıp otoritesi, kimin hasta, sağlıklı veya normal olduğunu ya da hangi durumların hastalık olarak kabul edilip edilmeyeceğini belirleme gücünü elinde tutmaktadır. Günümüzde doğum, çocukluk, yeme-içme alışkanlıkları, mental durumlar, ergenlik, cinsellik, hamilelik, yaşlılık veya ölüm gibi pek çok olgu tıbbın alanına dahil edilmiş ve tıp yaşamlarımızdaki hakimiyetini ilan etmiştir. Medikalizasyon olarak adlandırılan bu durum, 1960-70’lerde gündemimize girse de, günümüzde hala önemini koruyan ve üzerinde düşünülmesi gereken bir kavramdır. İnsan bedenine, zihnine ve davranışlarına yönelik tıbbi müdahaleler her geçen gün artmakta, tıbbi aktivitelerin etki alanı genişlemektedir. Tıbbın etki alanına girmemesi gereken olguların tıbbileştirilerek tedavi edilmesinin bireysel ve toplumsal düzeyde pek çok zarara yol açtığı bilinmesine rağmen, bu durum geniş ölçüde sorgulanmadan kabul edilmektedir.

Keywords

aşırı teşhis, hastalık, sağlık, medikalizasyon

References

• Conrad P. Medicalization and social control. Annu. Rev. Sociol. 1992;18(1):209–32.
• Ballard K, Elston MA. Medicalisation: a multi-dimensional concept. Soc Theory Health. 2005;3(3):228–41.
• Janowitz M. Sociological theory and social control. Am J Sociol. 1975;81(1):82–108.
• Williams SJ, Calnan M. The ‘limits’ of medicalization?: modern medicine and the lay populace in ‘late’ modernity. Soc Sci Med. 1996;42(12):1609–20.
• Nye RA. The evolution of the concept of medicalization in the late twentieth century. J Hist Behav Sci. 2003;39(2):115–29.
• Kaczmarek E. Promoting diseases to promote drugs: the role of the pharmaceutical industry in fostering good and bad medicalization. Br J Clin Pharmacol. 2021;88(1):34–9.
• Parens E. On good and bad forms of medicalization. Bioethics. 2013;27(1):28–35.
• Sholl J. The muddle of medicalization: pathologizing or medicalizing?. Theor. Med. Bioeth. 2017;38(4):265–78.
• Conrad P, Mackie T, Mehrotra A. Estimating the costs of medicalization. Soc Sci Med. 2010;70:1943–7.
• Bardakçı T, Ertin H. Hastalık, sağlık ve normal kavramlarına felsefi bir bakış. Özekmekçi Mİ, Bardakçı T, Az A, Barış M (ed.) Hakan Ertin’e Armağan: Primum Non Nocere – Önce İncitme! İstanbul: BETİM Kitaplığı; 2022. p. 54-55.
• Zola IK. Medicine as an institution of social control. Sociol Rev. 1972;20(4):487–504.
• Foucault M. Discipline and punish: the birth of the prison. çev: Sheridan A. (2. Basım), New York: Vintage Books; 1995. p. 197–8.
• Busfield J. The concept of medicalisation reassessed. Sociol Health Illn. 2017;39(5):759–74.
• Illich I. Sağlığın gaspı. çev. Sertabiboğlu S. İstanbul: Ayrıntı Yayınları; 2014. p. 27–28; p. 36; p. 56–61; p. 48–51; p. 85–102; p. 109–112.
• Makary MA, Daniel M. Medical error—the third leading cause of death in the US. Br Med J. 2016:353–8.
• Campbell J. 65 year old woman set to become oldest person to give birth to quadruplest, The Independent; 2015. Erişim 20.02.2022 https://www.independent.co.uk/news/world/europe/65yearold-woman-set-to-become-oldest-person-to-give-birth-to-triplets-10172216.html
• Conrad P. The shifting engines of medicalization. J Health Soc Behav. 2005;46(1):3–14.
• ASPS National Clearinghouse of Plastic Surgery Procedural Statistics. 2020 Plastic Surgery Statistics Report; 2020. Erişim 20.02.2022 https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf
• McCabe SE, Knight JR, Teter CJ, Wechsler H. Non‐medical use of prescription stimulants among US college students: Prevalence and correlates from a national survey. Addiction. 2005;100(1):96–106.
• Rezahosseini O, Roohbakhsh A, Tavakolian V, Assar S. Drug abuse among university students of Rafsanjan, Iran. Iran J Psychiatry Behav Sci. 2014;8(2):81.
• Low KG, Gendaszek AE. Illicit use of psychostimulants among college students: a preliminary study. Psychol Health Med. 2002;7(3):283–7.
• Öner Ö, Yilmaz EŞ, Karadağ H, Vural M, Vural EH, Akbulat A, et al. ADHD medication trends in Turkey: 2009-2013. J Atten Disord. 2017;21(14):1192–7.
• Sepúlveda DR, Thomas LM, McCabe SE, Cranford JA, Boyd CJ, Teter CJ. Misuse of prescribed stimulant medication for ADHD and associated patterns of substance use: preliminary analysis among college students. J Pharm Pract. 2011;24(6):551–560.
• Blascofontecilla H. Medicalization, wish-fulfilling medicine, and disease mongering: Toward a brave new world?. Rev Clin Esp. 2014;214(2):104–7.
• Clarke AE, Shim JK, Mamo L, Fosket JR, Fishman JR. Biomedicalization: technoscience, health, and illness in the US Biomedicine. Am Sociol Rev. 2003;68:161–94.
• Metzl JM, Herzig RM. Medicalisation in the 21st century: introduction. Lancet. 2007;369(9562):697–8.
• Brennan R, Eagle L, Rice D. Medicalization and marketing. J Macromarketing. 2010;30(1):8–22.
• Hendl T, Chung R, Wild V. Pandemic surveillance and racialized subpopulations: mitigating vulnerabilities in COVID-19 apps. J Bioeth Inq. 2020;17(4):829-34.
• Blakkarly J. Concerns police using coronavirus powers to target marginalised communities in Australia. SBS News. 2020. Erişim 12.03.2022 https://www.sbs.com.au/news/concerns-police- using-coronavirus-powers-to-target-marginalised- communities-in-australia.
• Braslow JT, Messac L. Medicalization and demedicalization: a gravely disabled homeless man with psychiatric illness. N Engl J Med. 2018;379(20):1885–8.
• van Dijk W, Faber MJ, Tanke MA, Jeurissen PP, Westert GP. Medicalisation and overdiagnosis: what society does to medicine. Int. J. Health Policy Manag. 2016;5(11):619–22.
• Hofmann B. Medicalization and overdiagnosis: different but alike. Med Health Care Philos. 2016;19(2):253–64.
• Blair L, Shalmon M. Cosmetic Surgery and the Cultural Construction of Beauty. Art Education. 2005;58(3):14–8.
• Keegan N. Plastic Fantastic. The Sun; 2017. Erişim 20.02.2022 https://www.thesun co.uk/fabulous/2775699/human-ken-doll-rodrigo-alves-surgery-barbie-doll/
• Blom RM, Hennekam RC, Denys D. Body integrity identity disorder. PLoS One. 2012;7(4):e34702–7.
• Müller S. Body integrity identity disorder (BIID): is the amputation of healthy limbs ethically justified?. Am J Bioeth. 2009;9(1):36–43.
• Ertin, H. Modern Tıp ve Etik I. İstanbul: BETİM Kitaplığı; 2020.
• Triggle DJ. Treating desires not diseases: a pill for every ill and an ill for every pill?. Drug Discov. 2007;12(3):161–6.
• Cooper R. Disease mongering. In: La Follette H, ed. International Encyclopedia of Ethics. New York: John Wiley & Sons; 2020.
• Abraham J. Pharmaceuticalization of society in context: theoretical, empirical and health dimensions. Sociology. 2010;44(4):603–22.
• Bell SE, Figert AE. Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward. Soc Sci Med. 2012;75(5):775–83.
• Fox NJ, Ward KJ. Pharma in the bedroom… and the kitchen… The pharmaceuticalisation of daily life. Sociol. Health Illn. 2008;30(6):856–68.
• Stegenga J. Medicalization of sexual desire. EuJAP. 2021;17(2):5–33.
• Koenraadt R, van de Ven K. The Internet and lifestyle drugs: an analysis of demographic characteristics, methods, and motives of online purchasers of illicit lifestyle drugs in the Netherlands. Drugs: Educ Prev Policy. 2018;25(4):345–5.
• Gilbert D, Walley T, New B. Lifestyle medicines. BMJ. 2000;321(7272):1341–4.
• Reddy P, Gosavi D, Reddy S. Lifestyle drugs. Int J Pharm Pharm Sci. 2012;4(5):43–5.