Medicalization 101

Were Franz Kafka alive today I could very easily imagine him writing a novel entitled The Hospital. Bureaucracy seems to be as much alive in this institution as it ever was in the banking industry. Just go to the emergency room or a regularly scheduled appointment even, at some hospitals, and see how long you are forced to wait. The paper work, the wrong turns, the complications, and the red tape seem endless. The faceless bureaucrat is certainly not dead in this industry, and here, ironically, that faceless bureaucrat has pretensions of appearing to be a care provider.

This revelation leads naturally to a consideration of my future shock word of the day: medicalization. Like Franz Kafka, if a George Orwell or an Aldous Huxley were writing now, I feel certain that aspects of this phenomenon would take center stage in whatever futuristic satiristic projection such an author might be envisioning.

Let’s look at what the dictionary has to say about this word.

Here’s what THE FREE DICTIONARY has to tell us.

med•i•ca•lize
tr.v. med•i•ca•lized, med•i•ca•liz•ing, med•i•ca•liz•es
To identify or categorize (a condition or behavior) as being a disorder requiring medical treatment or intervention: “Increasingly, [attention deficit disorder] has become a catch-all diagnosis that medicalizes troublesome behavior in kids” (Judy Foreman).

Merriam-Webster’s definition is even more disturbing as it is more direct.

Main Entry: med•i•cal•ize
Pronunciation: \ˈme-di-kə-ˌlīz\
Function: transitive verb
Inflected Form(s): med•i•cal•ized; med•i•cal•izing
Date: 1970
: to view or treat as a medical concern, problem, or disorder <those who seek to dispose of social problems by medicalizing them–Liam Hudson>
med•i•cal•i•za•tion \ˌme-di-kə-lə-ˈzā-shən\ noun

Your Dictionary.com gives us this definition.

medi•cal•ize (med′i kəl īz′)
transitive verb medicalized -•ized′, medicalizing -•iz′•ing
to use medical methods or concepts in dealing with (nonmedical problems, conditions, etc.)
Related Forms:
• medicalization med′i•cali•za′•tion noun

Wikipedia further elaborates on the development of the expression.

The term medicalization entered academic and medical publications in the 1970s in the work of Thomas Szaz, Emile Zola, and Peter Conrad. The expansion of medical authority into the domains of everyday existence was promoted by doctors and was therefore a force to be rejected in the name of specific kinds of liberation. Medicalization in this sense was characterized as “social control.” This critique was embodied in now-classic works such as Conrad’s “The discovery of hyperkinesis: notes on medicalization of deviance,” published in 1973 (hyperkinesis was the term then used to describe what we would now call ADHD) and immediately illiciting a round of commentary.

About 30 years on, the definition of medicalization is more complicated, if for no other reason than because the term is so widely used. Many contemporary critics position pharmaceutical companies in the space once held by doctors as the supposed catalysts of social transformation. Titles such as the The making of a disease or Sex, drugs, and marketing critique the pharmaceutical industry for shunting everyday problems into the domain of professional biomedicine. At the same time, to suggest that society simply reject drugs or drug companies in much the same ways some have suggested it “liberate” itself from the medical system is implausible. The same drugs that treat deviances from societal norms also help many people live their lives. Even scholars who critique the societal implications of brand-name drugs generally remain open to these drugs’ curative effects — a far cry from earlier calls for a revolution against the biomedical establishment. The emphasis has come to be on “overmedicalization” rather than “medicalization” per se.

More there than here I should add. Referring to ‘medicalization’ as ‘overmedicalization’ is kind of like directing your conservation efforts towards extinct species. What we find in this Wikipedia piece is a growing acceptance of the concept of medicalization, even as it is being critiqued.

On a more positive note, Wikipedia goes on to add:

The antithesis of medicalization is the process of paramedicalization, where alternative therapies and theories of health, wellness and disease are adopted. Even if medicalization and paramedicalization are contradictory, they also feed each other: they both ensure that the questions of health and illness stay in sharp focus.

When we speak of medicalization then we are talking about social control attained through the expansion of the medical authority into the domains of everyday life, and the use of medical concepts and methods on problems that are not, strictly speaking, medical.

Although I am all for universal health care, the idea of mandatory health insurance payments I find particularly distasteful and offensive for a country that prides itself on the amount of personal freedom it allows. I think everybody should be entitled to health care, yes, but I don’t think the way to achieve this universal care is by forcing people to buy insurance. This is 1. not going to decrease the amount of bureaucracy you get in the public hospital, and 2. going to entangle everybody in the bureaucracy of the insurance business, government run or otherwise.

Certainly, if universal health care of one kind or another is achieved, given the direction medicine is going in these days, it is likely to mean more rather than less medicalization as well.

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