The document discusses the social construction of medicalization and how previously non-medical problems have become defined and treated as medical issues. It describes how the jurisdiction of medicine has expanded over the 20th century to encompass conditions like ADHD, eating disorders, and obesity. It examines how behaviors and normal life events have become medicalized, moving them from moral failings to medical issues. The social implications of this increasing medicalization are explored, such as how it can transform people's identities and experiences of their own bodies and problems.

1. Medicalization of Society
The social construction of medical knowledge
*
Medicalization of SocietyDescribes a process whereby
previously non-medical problems become defined and treated as
medical problems, usually in terms of illness, disorders, and
conditions. Some suggest that the growth of medical jurisdiction
is one of the most significant transformations of the last half of
the 20th century.
*

2. DefinitionThe term refers to the process by which certain events
or characteristics of everyday life become medical issues, and
thus come within the purview of doctors and other health
professionals to engage with, study, and treat. The process of
medicalization typically involves changes in social attitudes and
terminology, and usually accompanies (or is driven by) the
availability of treatments.
*
The prevalence of medicalization
Indicators:
percentage of gross national income increased from 4.5% in
1950 to 16% in 2006
# of physicians per population has doubled in that time frame,
extending medical capacity
Jurisdiction of medicine has grown to encompass new problems
not previously deemed ‘medical’
Examples: ADHD, eating disorders, CFS,PTSD, panic disorder,
fetal alcohol syndrome, PMS, SIDS, obesity, alcoholism
*

3. Medicalization concerns itself with deviance and ‘normal life
events’.Behaviors once defined as immoral, sinful, or criminal
have been given medical meaning moving them from badness to
sickness.Common life processes have been medicalized:
including aging, anxiety and mood, menstruation, birth control,
fertility, childbirth, menopause, and death.
*
Increasing MedicalizationNew categories of disease and drug
therapies.Expanding/contracting medical categories.Elastic
categories: Alzheimer Disease (AD) and the removal of age
criteria led to AD encompassing senile dementia sufferers,
sharply increasing the number of AD cases (now a top 5 cause
of death in the US).Demedicalization whereby a problem is no
longer defined as medical problem worthy of medical
intervention (e.g. masturbation, homosexuality). Unsuccessful
attempts include childbirth. Partial success includes disability.
*

4. Beyond Sociology…Numerous articles on medicalization in
Medline search.British Medical Journal (2002) special issue on
medicalization.PLoS Medicine (2006) devoted to ‘disease
mongering’.President’s council on Bioethics dedicated session
(2003).Seattle Times (2005) Suddenly Sick series.
*
Medicalization has gained attention beyond the social sciences.
Increased medicalizationNew epidemic of medical problems?
Or,Is medicine better able to understand and identify and treat
existing problems? Or, Are life’s problems increasingly defined
as medical problems despite dubious evidence of their medical
nature?
*
We’re not interested ncessarily in whether conditions are really
medical or not, rather, we’re going to think of medical
knowledge and the conditions which come to be understood as
medical - as social creations.

5. Social Constructionism Consider medicalization as the result of
discursive processes which construct ‘reality’ in particular
ways.Disease and conditions (scientific ‘facts’) are not stable
realities but are the product of social processes.‘Disease’ and
conditions(medicine’s ‘objects’) are created through language
and practices (going to the doctor, receiving a prescription,
activity in laboratories, and so on).These processes give rise to
a ‘way of seeing’: a pathological ‘gaze’ (Foucault). Our
perception - our reality - is shaped by discourse and practice.
*
Rather than ask the question of whether is something real or
not, we’re interested more in the processes which create
medical categories. We’re interested in the social underpinnings
of medicalization…
Specifically, we’re interested in how this phenomenon has come
about; that is, how have so many conditions and ordinary life
circumstances come to be under the jurisdiction of biomedicine.
Crucially, we’re concerned with the social implications or
consequences of this development.
Ways of Seeing
Medical ideas are constrained and enabled by the language and
culture of a society. Epistemological norms delimit the
representation of the world. Medical knowledge emerges from
these delimiting contexts.
Examples:
Biomedicine/Western World

6. Ayurvedic/Asia
Curanderismo/Latin America
*
Our understandings of our bodies, of illness, of the medical
system are the result of human activity: no matter how precise
the empirical ideas, these ideas are always open to the influence
of social factors in their production, transmission and
development.
Different societies have different cultural values and rules and
norms for producing knowledge - epistemology is tethered to
social and cultural contexts.
The Scientific ParadigmIn the West, the scientific paradigm is
privileged. Paradigms are socially created and are reproduced
and developed through institutional processes. This is a shared
paradigm that orients the medical community and is dispersed
through society.
Paradigm promoted through schooling and specialized,
professional organizations. Rules for ‘talking’ about illness and
suffering which limits what can be thought and
communicated.Rules of evidence and conceptual schemes limit
epistemologically.
*
Paradigms are frames for seeing - much like a lens. Different
socieities and different cultures within that society - will be

7. characterized by differing paradigms. Paradigms are formal
knowledge frameworks.
This paradigm means that we put much power in very particular
groups of people: In scientists and doctors, for example, who
are privy to this specialized and technical language and know-
how. At the same time, other forms of knowing and healing are
downgraded and re viewed as inferior.
We might say that biomedicine is hegemonic in that we
generally accept biomedical facts without questions - they are
always-already valid…
Social Constructionism Radical constructionists: don’t suppose
the existence of an external reality.
“The fact that the body became legible does not imply that some
invariate biological reality was finally revealed to medical
enquiry. The body was only legible in that there existed in the
new clinical techniques a language by which it could be read” -
Armstrong (1983).
*
Reality does not exist objectively - but is made. This is a more
Foucauldian perspective… the idea that the body and
medicalization is solely an effect of discourse.

8. Constructionism Cont…Realism: presume the existence of an
external reality, but argue that there are various, competing
accounts of that reality.
“[They] seek to demonstrate the social and cultural character of
all medical knowledge, but, there is, of course, a biological
reality, but the moment that efforts are made to explain, order,
and manipulate that reality, then a process of contextualization
takes place in which the dynamic relationship of biology with
cultural values and the social order has to be considered”
(Lock,1988)
*
Constructionism Cont…Different emphases within this
perspective - from radical to realist constructionist approaches.
However, they agree that ALL knowledge is socially
contingent.All constructionists are interested in how knowledge
(here, medical categories) is created.Also interested in the
effects of this knowledge production
*
Saying that knowledge is socially contingent is not the same as
saying that all knowledge is worthless…
Knowledge is contingent, however, and crucial to keep that in
mind. If we consider the shifting and changing disease
categories this past century and a half, we see, for example,

9. how ecomomic, political and religious forces impact knowledge
production. Afrcian Americans had specific diseases levied at
them during slavery. Masturbation in the end of the 19th
century.
Poitical forces can also influence scientific discoveries of new
diagnostic categories because of funding… (AIDS, women’s
health)More research done on men and the knowledge is
extended to women who might experience that disease very
differently. For example, heart disease…- thus shaped by social,
culural, and political factors.
Some painful conditions are not readily medicaized, too…
Black lung, is an example, also tardive dyskinesia (disorder of
the central nervous system)- caused by pharamceuticals - thus
an iatrogenic side effect of antipsychotic drugs. Largely not
accepted by medical establishment because it hurt the economic
and political interests of many clinicans who had prescribed the
actual drugs.
In examining medicalization the focus is:To examine how
medical ideas and concepts are produced and diffused through
culture and society (e.g. research, medical practice, marketing,
media processes, etc).To examine how (bio)medical intervention
is represented as a viable answer to our life problems.To
examine the multifarious effects of these collective
discourses/meanings.
*

10. Producers of knowledge
*
Others? Lay people, advocacy groups, drug companies, etc. Not
as simple as the annexation of new problems by doctors and
medical professions.
Knowledge ProductionBeyond the medical establishment, and
includes lay people social movement, corporations,
etc.Alcoholism became defined as a medical problem through a
social movement (AA). Physicians were late to define it as
disease.Public shift: less tolerant of mild symptoms, spurring a
“progressive medicalization of physical distress in which
uncomfortable body states and isolated symptoms are
reclassified as disease” (Boros, 1995: 1931)/
*
More than medical imperialism and moral entreprenuriship.
However, it is critical to keep in mind that different people in
society are afforded more power and authority to produce
knowledge. We often think about power and knowledge being

11. connected, but it’s not how much knowledge you have that
gives you power, it’s really the ability to create knowledge and
to define reality in a way that is accepted by others.
Power and knowledgeThe power and authority to medicalize and
to produce medical knowledge is of consequence.This capacity
is socially distributed.The medicalization of childbirth: battle
between medial establishment and midwifery (doctors’ interests
over patients’ interests). Increased scientism has increased the
pharmaceutical industry’s ability to produce medical
knowledge.
*
Case Study
Drug companies medicalize through DTC advertising and
through the physician-drug rep relationship.Ads create medical-
markets through the production of disease categories.Drug
companies do not just sell and create drugs, they are also
creating and marketing diseases. Paxil is a SSRI medication
competed with many other drugs (I.e. prozac) for
depression.GlaxoSmithKline responded to the saturated market
by specializing in the anxiety market.

12. *
Prfofit and corporate interests motivate much medicalization.
We consume ads and we often are encouraged to self diagnose.
Paxil
Paxil and SADSocial Anxiety Disorder (SAD), previously
obscure diagnosis, was targeted.Ads framed common
characteristics such as worry and shyness.Deep resonance with
the audience.Self-diagnosis through ‘awareness
campaigns’.Increased diagnosis of SAD and GAD.The
marketing of Paxil extremely successful: became 3rd most
widely recognized prescription drug in the US.
*
Female Sexual DysfunctionSuccess of viagra with the diagnoses
‘erectile dysfunction’.Researchers working closely with drug
companies to create a female equivalent, which can be similarly
medicated.In order to build markets, there is a need for a
medically diagnosable condition.‘Thought leaders’ collectively
creating criteria; funding research; sponsored conferences and
meetings, etc.(Pfizer)Female Sexual Function Forum.

13. *
Difficulties into DisordersArticle in JAMA in 1999 - the authors
linked to Pfizer. Article contained a statistic that 43% between
18-59 of women contend with dysfunction. Widely cited both in
scientific and lay literature.Highly problematic
statistic.Crucially, sexual dissatisfaction is reduced to female
pathology. Relationships and social settings are ignored in favor
of medical intervention.Who benefits?
*
Ideological InterestsIdeology: an organized system of ideas and
beliefs. Ideology circulates as the natural order of things - or as
common sense. However, ideologies serve the interests of
specific social groups at the expense of others.Medicalization
serves specific interests - e.g: medical establishment, corporate
pharmaceutical interests, patriarchy.

14. *
Legitimates the power and authority of social groups in society.
Power and knowledge intimately interconnected: always serves
interests….
Ideology and Media
Ideology is dispersed through culture and society via mass
communication (I.e media).
How are biomedical ideas promoted/not promoted through
cultural/media representations? How does the advertising of
drugs affect society and the individuals within that society?
*
FDA began allowing drug makers to advertise directly to
consumers on TV in 1997.
Spending on drug advertisements reached an all time high of 4.8
billion dollars In 2006 compared to 2.6 billion in 2002.
Media EffectsWe are socialized to have trust in
biomedicine.Biomedicine appears to provide answers for our
suffering.Legitimates ideological interests.Affects how we
experience ourselves.Affects our behavior.

15. *
Drugs Ads and Behavior
http://www.youtube.com/watch?v=XgOcFu3Kp5IPrescription
drug advertisements prompt nearly one third of US adults to ask
their physicians about an advertised medication.82% of those
who ask about drugs are given a prescription.Among adults who
requested a specific drug 44% said physicians prescribed the
one they asked for, slightly more than half were prescribed a
different one, and, in some cases, they received both.
Percentage of adults receiving prescriptions after asking about
an as has increased since 2005.
*
Consequences….Benefits Legitimates peoples’ experience of
pain when diagnoses are given. Also offer hope that suffering
can be alleviated. Affords rights to certain groups,Cons:

16. transforms everyday life into pathologies in need of
transformation, narrowing what is acceptable. Also focuses the
source of the problem in the individual rather than in the social
environment.
*
Cons Continued…Medicalization leads to reification - whereby
individuals are reduced to diseases (assigned to them by a
powerful entity), thus ignoring the socio-environmental
conditions. This leads to individual treatments - tranquilizers,
etc. Responsibility is placed on shoulders of individuals and the
inequities of society are ideologically overlooked.Usually,
specific medical interventions accompany ‘diagnoses’. The side
effects of these therapies are far ranging. (e.g. viox, Paxil,
xanax, psychotic medications).
*
Paxil Case-Study Cont…
http://www.youtube.com/watch?v=hfQUTHrWnRkThe creation

17. and extension of the diagnosis SAD and GAD was very
successful.However, Paxil has many side-effects, some of them
are fatal.Misleading ads were ordered halted by a federal judge
in 2002.Habit forming, severe withdrawal symptoms, increased
risk of suicide amongst adolescents. However, the
medicalization of anxiety is still the result.
*
Phenomenological EffectsHow we define reality affects our
experience of that reality.Medicalizing life’s problems and
events can further symptoms.Labeling: people incorporate their
diagnosis into their identity so that it becomes a master
status.Social meanings can affect physiological response and
experience; e.g. menopause viewed negatively in the West. In
Islamic and some African countries menopause is ‘freeing’ and
those women don’t experience the same symptoms of women in
the West.
*
When those women emigrate, they experience the symptoms of
their new cultural milieu, Social meanings thus influence
individuals’ physiological and psychological experience.
Little empricial evidence of pathology in respec to the
menopause- rather a concerted effort of medical elite in the 30’s
nd 40’s to formulate a specific etiology and the development of

18. specific pharmaceutical methods of treatment. In the 1970s the
menopause - described as a deficiency disease - was being
heavily medicated with estrogen and HRT - hormonal
replacement therapy - despite the numerous side effects and the
reality that 85% of women experuenced few or no problems.
Estrogen was the fifth most prescribed drug….
Medicalization and Social Control….
*
Medicalization of Society
The social construction of medical knowledge
*

19. Medicalization of SocietyDescribes a process whereby
previously non-medical problems become defined and treated as
medical problems, usually in terms of illness, disorders, and
conditions. Some suggest that the growth of medical jurisdiction
is one of the most significant transformations of the last half of
the 20th century.
*
DefinitionThe term refers to the process by which certain events
or characteristics of everyday life become medical issues, and
thus come within the purview of doctors and other health
professionals to engage with, study, and treat. The process of
medicalization typically involves changes in social attitudes and
terminology, and usually accompanies (or is driven by) the
availability of treatments.
*
The prevalence of medicalization
Indicators:

20. percentage of gross national income increased from 4.5% in
1950 to 16% in 2006
# of physicians per population has doubled in that time frame,
extending medical capacity
Jurisdiction of medicine has grown to encompass new problems
not previously deemed ‘medical’
Examples: ADHD, eating disorders, CFS,PTSD, panic disorder,
fetal alcohol syndrome, PMS, SIDS, obesity, alcoholism
*
Medicalization concerns itself with deviance and ‘normal life
events’.Behaviors once defined as immoral, sinful, or criminal
have been given medical meaning moving them from badness to
sickness.Common life processes have been medicalized:
including aging, anxiety and mood, menstruation, birth control,
fertility, childbirth, menopause, and death.
*

21. Increasing MedicalizationNew categories of disease and drug
therapies.Expanding/contracting medical categories.Elastic
categories: Alzheimer Disease (AD) and the removal of age
criteria led to AD encompassing senile dementia sufferers,
sharply increasing the number of AD cases (now a top 5 cause
of death in the US).Demedicalization whereby a problem is no
longer defined as medical problem worthy of medical
intervention (e.g. masturbation, homosexuality). Unsuccessful
attempts include childbirth. Partial success includes disability.
*
Beyond Sociology…Numerous articles on medicalization in
Medline search.British Medical Journal (2002) special issue on
medicalization.PLoS Medicine (2006) devoted to ‘disease
mongering’.President’s council on Bioethics dedicated session
(2003).Seattle Times (2005) Suddenly Sick series.
*
Medicalization has gained attention beyond the social sciences.

22. Increased medicalizationNew epidemic of medical problems?
Or,Is medicine better able to understand and identify and treat
existing problems? Or, Are life’s problems increasingly defined
as medical problems despite dubious evidence of their medical
nature?
*
We’re not interested ncessarily in whether conditions are really
medical or not, rather, we’re going to think of medical
knowledge and the conditions which come to be understood as
medical - as social creations.
Social Constructionism Consider medicalization as the result of
discursive processes which construct ‘reality’ in particular
ways.Disease and conditions (scientific ‘facts’) are not stable
realities but are the product of social processes.‘Disease’ and
conditions(medicine’s ‘objects’) are created through language
and practices (going to the doctor, receiving a prescription,
activity in laboratories, and so on).These processes give rise to
a ‘way of seeing’: a pathological ‘gaze’ (Foucault). Our
perception - our reality - is shaped by discourse and practice.
*
Rather than ask the question of whether is something real or
not, we’re interested more in the processes which create
medical categories. We’re interested in the social underpinnings
of medicalization…

23. Specifically, we’re interested in how this phenomenon has come
about; that is, how have so many conditions and ordinary life
circumstances come to be under the jurisdiction of biomedicine.
Crucially, we’re concerned with the social implications or
consequences of this development.
Ways of Seeing
Medical ideas are constrained and enabled by the language and
culture of a society. Epistemological norms delimit the
representation of the world. Medical knowledge emerges from
these delimiting contexts.
Examples:
Biomedicine/Western World
Ayurvedic/Asia
Curanderismo/Latin America
*
Our understandings of our bodies, of illness, of the medical
system are the result of human activity: no matter how precise
the empirical ideas, these ideas are always open to the influence
of social factors in their production, transmission and
development.
Different societies have different cultural values and rules and
norms for producing knowledge - epistemology is tethered to
social and cultural contexts.

24. The Scientific ParadigmIn the West, the scientific paradigm is
privileged. Paradigms are socially created and are reproduced
and developed through institutional processes. This is a shared
paradigm that orients the medical community and is dispersed
through society.
Paradigm promoted through schooling and specialized,
professional organizations. Rules for ‘talking’ about illness and
suffering which limits what can be thought and
communicated.Rules of evidence and conceptual schemes limit
epistemologically.
*
Paradigms are frames for seeing - much like a lens. Different
socieities and different cultures within that society - will be
characterized by differing paradigms. Paradigms are formal
knowledge frameworks.
This paradigm means that we put much power in very particular
groups of people: In scientists and doctors, for example, who
are privy to this specialized and technical language and know-
how. At the same time, other forms of knowing and healing are
downgraded and re viewed as inferior.
We might say that biomedicine is hegemonic in that we
generally accept biomedical facts without questions - they are
always-already valid…
Social Constructionism Radical constructionists: don’t suppose
the existence of an external reality.

25. “The fact that the body became legible does not imply that some
invariate biological reality was finally revealed to medical
enquiry. The body was only legible in that there existed in the
new clinical techniques a language by which it could be read” -
Armstrong (1983).
*
Reality does not exist objectively - but is made. This is a more
Foucauldian perspective… the idea that the body and
medicalization is solely an effect of discourse.
Constructionism Cont…Realism: presume the existence of an
external reality, but argue that there are various, competing
accounts of that reality.
“[They] seek to demonstrate the social and cultural character of
all medical knowledge, but, there is, of course, a biological
reality, but the moment that efforts are made to explain, order,
and manipulate that reality, then a process of contextualization
takes place in which the dynamic relationship of biology with
cultural values and the social order has to be considered”
(Lock,1988)
*

26. Constructionism Cont…Different emphases within this
perspective - from radical to realist constructionist approaches.
However, they agree that ALL knowledge is socially
contingent.All constructionists are interested in how knowledge
(here, medical categories) is created.Also interested in the
effects of this knowledge production
*
Saying that knowledge is socially contingent is not the same as
saying that all knowledge is worthless…
Knowledge is contingent, however, and crucial to keep that in
mind. If we consider the shifting and changing disease
categories this past century and a half, we see, for example,
how ecomomic, political and religious forces impact knowledge
production. Afrcian Americans had specific diseases levied at
them during slavery. Masturbation in the end of the 19th
century.
Poitical forces can also influence scientific discoveries of new
diagnostic categories because of funding… (AIDS, women’s
health)More research done on men and the knowledge is
extended to women who might experience that disease very
differently. For example, heart disease…- thus shaped by social,
culural, and political factors.
Some painful conditions are not readily medicaized, too…
Black lung, is an example, also tardive dyskinesia (disorder of
the central nervous system)- caused by pharamceuticals - thus
an iatrogenic side effect of antipsychotic drugs. Largely not
accepted by medical establishment because it hurt the economic
and political interests of many clinicans who had prescribed the
actual drugs.

27. In examining medicalization the focus is:To examine how
medical ideas and concepts are produced and diffused through
culture and society (e.g. research, medical practice, marketing,
media processes, etc).To examine how (bio)medical intervention
is represented as a viable answer to our life problems.To
examine the multifarious effects of these collective
discourses/meanings.
*
Producers of knowledge
*
Others? Lay people, advocacy groups, drug companies, etc. Not
as simple as the annexation of new problems by doctors and
medical professions.
Knowledge ProductionBeyond the medical establishment, and

28. includes lay people social movement, corporations,
etc.Alcoholism became defined as a medical problem through a
social movement (AA). Physicians were late to define it as
disease.Public shift: less tolerant of mild symptoms, spurring a
“progressive medicalization of physical distress in which
uncomfortable body states and isolated symptoms are
reclassified as disease” (Boros, 1995: 1931)/
*
More than medical imperialism and moral entreprenuriship.
However, it is critical to keep in mind that different people in
society are afforded more power and authority to produce
knowledge. We often think about power and knowledge being
connected, but it’s not how much knowledge you have that
gives you power, it’s really the ability to create knowledge and
to define reality in a way that is accepted by others.
Power and knowledgeThe power and authority to medicalize and
to produce medical knowledge is of consequence.This capacity
is socially distributed.The medicalization of childbirth: battle
between medial establishment and midwifery (doctors’ interests
over patients’ interests). Increased scientism has increased the
pharmaceutical industry’s ability to produce medical
knowledge.

29. *
Case Study
Drug companies medicalize through DTC advertising and
through the physician-drug rep relationship.Ads create medical-
markets through the production of disease categories.Drug
companies do not just sell and create drugs, they are also
creating and marketing diseases. Paxil is a SSRI medication
competed with many other drugs (I.e. prozac) for
depression.GlaxoSmithKline responded to the saturated market
by specializing in the anxiety market.
*
Prfofit and corporate interests motivate much medicalization.
We consume ads and we often are encouraged to self diagnose.
Paxil
Paxil and SADSocial Anxiety Disorder (SAD), previously
obscure diagnosis, was targeted.Ads framed common
characteristics such as worry and shyness.Deep resonance with
the audience.Self-diagnosis through ‘awareness
campaigns’.Increased diagnosis of SAD and GAD.The
marketing of Paxil extremely successful: became 3rd most
widely recognized prescription drug in the US.

30. *
Female Sexual DysfunctionSuccess of viagra with the diagnoses
‘erectile dysfunction’.Researchers working closely with drug
companies to create a female equivalent, which can be similarly
medicated.In order to build markets, there is a need for a
medically diagnosable condition.‘Thought leaders’ collectively
creating criteria; funding research; sponsored conferences and
meetings, etc.(Pfizer)Female Sexual Function Forum.
*
Difficulties into DisordersArticle in JAMA in 1999 - the authors
linked to Pfizer. Article contained a statistic that 43% between
18-59 of women contend with dysfunction. Widely cited both in
scientific and lay literature.Highly problematic
statistic.Crucially, sexual dissatisfaction is reduced to female
pathology. Relationships and social settings are ignored in favor
of medical intervention.Who benefits?

31. *
Ideological InterestsIdeology: an organized system of ideas and
beliefs. Ideology circulates as the natural order of things - or as
common sense. However, ideologies serve the interests of
specific social groups at the expense of others.Medicalization
serves specific interests - e.g: medical establishment, corporate
pharmaceutical interests, patriarchy.
*
Legitimates the power and authority of social groups in society.
Power and knowledge intimately interconnected: always serves
interests….
Ideology and Media
Ideology is dispersed through culture and society via mass
communication (I.e media).
How are biomedical ideas promoted/not promoted through
cultural/media representations? How does the advertising of
drugs affect society and the individuals within that society?
*

32. FDA began allowing drug makers to advertise directly to
consumers on TV in 1997.
Spending on drug advertisements reached an all time high of 4.8
billion dollars In 2006 compared to 2.6 billion in 2002.
Media EffectsWe are socialized to have trust in
biomedicine.Biomedicine appears to provide answers for our
suffering.Legitimates ideological interests.Affects how we
experience ourselves.Affects our behavior.
*
Drugs Ads and Behavior
http://www.youtube.com/watch?v=XgOcFu3Kp5IPrescription
drug advertisements prompt nearly one third of US adults to ask
their physicians about an advertised medication.82% of those
who ask about drugs are given a prescription.Among adults who
requested a specific drug 44% said physicians prescribed the
one they asked for, slightly more than half were prescribed a

33. different one, and, in some cases, they received both.
Percentage of adults receiving prescriptions after asking about
an as has increased since 2005.
*
Consequences….Benefits Legitimates peoples’ experience of
pain when diagnoses are given. Also offer hope that suffering
can be alleviated. Affords rights to certain groups,Cons:
transforms everyday life into pathologies in need of
transformation, narrowing what is acceptable. Also focuses the
source of the problem in the individual rather than in the social
environment.
*
Cons Continued…Medicalization leads to reification - whereby
individuals are reduced to diseases (assigned to them by a
powerful entity), thus ignoring the socio-environmental
conditions. This leads to individual treatments - tranquilizers,
etc. Responsibility is placed on shoulders of individuals and the

34. inequities of society are ideologically overlooked.Usually,
specific medical interventions accompany ‘diagnoses’. The side
effects of these therapies are far ranging. (e.g. viox, Paxil,
xanax, psychotic medications).
*
Paxil Case-Study Cont…
http://www.youtube.com/watch?v=hfQUTHrWnRkThe creation
and extension of the diagnosis SAD and GAD was very
successful.However, Paxil has many side-effects, some of them
are fatal.Misleading ads were ordered halted by a federal judge
in 2002.Habit forming, severe withdrawal symptoms, increased
risk of suicide amongst adolescents. However, the
medicalization of anxiety is still the result.
*
Phenomenological EffectsHow we define reality affects our
experience of that reality.Medicalizing life’s problems and
events can further symptoms.Labeling: people incorporate their

35. diagnosis into their identity so that it becomes a master
status.Social meanings can affect physiological response and
experience; e.g. menopause viewed negatively in the West. In
Islamic and some African countries menopause is ‘freeing’ and
those women don’t experience the same symptoms of women in
the West.
*
When those women emigrate, they experience the symptoms of
their new cultural milieu, Social meanings thus influence
individuals’ physiological and psychological experience.
Little empricial evidence of pathology in respec to the
menopause- rather a concerted effort of medical elite in the 30’s
nd 40’s to formulate a specific etiology and the development of
specific pharmaceutical methods of treatment. In the 1970s the
menopause - described as a deficiency disease - was being
heavily medicated with estrogen and HRT - hormonal
replacement therapy - despite the numerous side effects and the
reality that 85% of women experuenced few or no problems.
Estrogen was the fifth most prescribed drug….
Medicalization and Social Control….
*

36. Medicalization and Social Control
Social ControlTend to view medicine as humanistic.Yet
discourses around health, sickness and medicine have a
regulating affect on individual and collective behavior.The
institution of medicine and ideas & norms around health, thus
can be view as mechanisms of social control
*
One aspect of medicalization that might not be immediately
evident - is the connection between it and social control. We
tend to think of medicine as benign - or at least we tend to view
it as humanistic; that is, medicine, and the discourses which
circulate in our society which constitute medicine, is there to
help us.
Tend to view social control as having something to do with the
criminal justice system or any system of force and punishment -
such as the military, or even within the education system where
we’re disciplined - partly through punishments - to behave in
particular ways.

37. Social ControlThe informal and formal mechanisms which
socially regulate individual and society’s behavior.While our
behavior feels freely chosen, it is constrained and enabled by
external social regulations.Social controls lead to conformity
and compliance in society.Social control can be either informal
and/or formal
*
Social control, however, is a broader, more encompassing
concept and relates to social mechanisms which regulate our
behavior.
Informal Mechanisms
Social Norms
Socio-cultural beliefs and ideals give rise to social norms.
Socialized into societal values.
Internalization of norms and values exerts profound affect on
our thoughts and behaviors.
This is a largely unconscious process.

38. Norms are not natural but are rather the product of social and
discursive practices.
Examples of socialization?
*
Social control operates most effaciously through informal
controls. Informal controls operate through a society’s norms
and values… They guide behavior and model how things
‘should be’. If we think about gender - informally regulated
through images and ideas. We are not forced to do these things
in the usual sense of the word ‘force’, rather we are encouraged
to abide by them…
Social Norms and HealthSpecific values and beliefs circulate
around ‘health’ and sickness. Biomedicine is normative and
reflects broader ideological beliefs specific to Western
society.Health norms are internalized giving rise to a
conception of sickness which is culturally specific.
*
Power in society means being able to shape and mold social
norms….
It means we have beliefs about health - who and what
constitutes health - but also we have defined ways of
intervening in health problems.

39. Sickness and SocietySickness contravenes the social norm of
wellness.Like criminal or deviant acts, sickness breaches
societal values and thus illness and disease are threats to the
social order.Not a benign process: raises moral questions about
who is responsible for illness, etc.Norms of ‘health’ embody
broader societal values, giving rise to different meanings.
*
We don’t often think about the relationship between medicine
and social control. Today we’re going to be thinking about how
medicine is part of broader societal patterns of social control.
Having the authority to pathologize behavior and body types is
a form of social power…
Health is not an objective phenomenon, it is a socially created
idea… and it generlly embodies society’s broader values. What
it means to be healthy changes from culture to culture, from
society to society, and, within societies, histrocial shufts
transform what we view as health and sickness.
Health norms embody societal norms?
In your mind’s eye imagine someone is healthy and someone
who is sick….
Embodying Health

40. *
Beauty and health are closely related, Ideals of beauty translate
into ideals of health. In the 19th century the frail and delicate
woman was the middle class ideal. Robust women were viewed
as unrefined, and here in the States being fat and pasty was a
sign of upper social class… Today the ideals have changed
significantly. Overly thin women and muscular men.. Once
again tying in health with beauty.
Health TodayPicture health… describe what’s in your mind’s
eye when you think of a healthy person?Describe an ‘unhealthy’
person…How does body weight impact your commonsense
conceptions of health and wellness?How do we informally
sanction those those who contravene social ideals around
health?
*
There are moral connotations… As well as unhealthy, we
imagine people to be irresponsible, out of control, lazy, and
worse.
Health, Norms, PowerSince sickness contravenes norms, there
are social reactions.In the process of reacting to sickness we

41. reaffirm a society’s values, maintaining social
solidarity.Sickness and deviance are functional for society.The
power in society to define norms is socially distributed.Social
mechanisms which enforce and regulate norms are also socially
distributed.
*
Labeling someone as sick, then, tells us more about the
society;s values and cultural norms than it does about the
pathology of an individual. Labeling, according to Becker, is a
social product…
What are some of the social reactions to sickness?
Formal Control
*
Formal social control is expressed through law as statutes,
rules, and regulations against deviant behavior. It is conducted
by government and organizations using law enforcement
mechanisms and other formal sanctions such as fines and
imprisonment.[2] In democratic societies the goals and
mechanisms of formal social control are determined through
legislation by elected representatives and thus enjoy a measure
of support from the population and voluntary compliance.
The medical establishment is an important actor in both

42. officially defining people as deviant and sick. And also they are
pivotal in offically intervening.. This intervention, as we shall
see, is crucial as it is both is a mechanism which labels an
individual and it also serve to symbolically make people
outsiders who are in need of some sort of reform.
Making Sickness/DevianceHistorically, religious and legal
institutions have been responsible for defining
deviance.Medical institutions increasingly involved in defining
what is normal/abnormal.Badness becomes sickness.1954
precedent: Durham v. The United States court ruled that “an
accused is not criminally responsible if his unlawful act was the
product of a mental illness or mental defect”.
*
Middle ages - religious institutions involved in defining
deviance: thou shalt not kill. The legal code become ascendary
in the 18th and 19th ceturies. In the US, religious pluralism
pushed the move..
Increasingly medical institutions are defining behavior as
normal or desirable and what is not.
Why Medicine?Increasing medical authority because of larger
societal values.Religious discourses viewed as irrational.Legal
discourses (judgments, decisions, etc) viewed as too

43. subjective.Medical discourses appear more scientific, rational,
and objective.Technology and expertise underlying this value.
*
Religious discourse viewed as irrational… Also religious
pluraity means that one religious entitiy does not dominate.
Medical AuthorityMedical establishment more authority to
define behavior and conditions as deviant (sickness) or
not.Increasing authority in relation to moral issues such as what
is good, what is bad (drugs, alcohol, etc).Increasing nexus of
legal and medical institutions.The imposition of medical
‘treatment’ through court orders (e.g. Prenatal endangerment,
overriding religious convictions, superseding parental
responsibility in childcare).Euthanasia? A medical issue…?
*
Childbirth choices, blood transfusions for Jehovah Witnesses,
Med Authority Cont…Medical ‘diagnoses’ certify deviant
categories.Societal acceptance of medical categories legitimates

44. the institution’s response towards those labeled (Diagnosis,
treatment, therapy, counseling, etc).
*
Ritalin use: 90% of all the world’s use is in the US)
Examples of Social ControlIntersex people: the invasive
surgeries used to ‘correct nature’.Difficult to manage children
prescribed drugs such as Ritalin.Elderly people prescribed
sedatives to help manage them.Psychiatric care to normalize
unruly behavior.
Neutral?Zola (1983) argues that definitions of sickness are
never neutral. Definitions of sickness always involve a moral
evaluation which establishes normality and
desirability.Psychiatrists historically have defined many
behaviors as ‘sickness’ in need of treatment and intervention.
Many diagnoses carry stigma - AIDS, leprosy, TB, etc.The
‘type’ of patient you are (compliant, consenting, etc) also gives
rise to labeling.
*

45. Alcoholism, homosexuality. Hysteria,drug addicitiion, arson,
etc.
One reason the disabled movement has been so fierce in its
attempt to demedicalize disability (including deafness) is that
any sort of labeling of condition makes you outside the norm, it
makes you undesirable,….
“.. If anything can be show to affect the workings of the body
and to a lesser extent the mind, then it can be labeled an
‘illness’ itself or jurisdictionally a ‘medical problem”. (Zola,
1983).
Even normal and healthy behaviors and events (menstruation,
childbirth, body and facial shape, etc) are subject to
medicalization and thus carry a set of negative connotations.
Labeling and Social RolesThe ‘sick role’ is one controlling
mechanism.When we are labeled with illness we take on a social
role.With social roles come social expectations

46. QuestionsOutline Parson’s concept of the sick role.What
expectations do we associate with the sick role?What are the
positive consequences of being labeled ‘sick’.What are some of
the negative consequences of the sick role?List some of the
societal and institutional responses to sickness. How is the sick
role a mechanism of social control?
The Medicalization of Society
You should respond to ONE question/prompt from the following
choices:
1) The social construction of Medical Knowledge.
As we have explored, medical knowledge emerges from specific
social processes and practices. Diseases are not so much
‘discovered’ as they are made. The task here is to focus on one
disease/illness category and to investigate the processes which
have given rise to a specific form of medicalization.
Examples we’ve explored in class are ‘female sexual
dysfunction’ and ‘Social Anxiety Disorder’.
The project should not only be descriptive (i.e. you should
not merely describe what led to the creation of a medical
category), you should analyze your findings in the context of
the material we’ve explored in relation to the medicalization of
society. For example, you might consider why we as the public
are so quick to accept new categories of sickness; or you might
consider how certain ideological interests are served in the
creation of a new diagnosis/treatment,etc.
2) Medicalization and Social Control
The aim of this project is to explore and demonstrate how
medical discourses operate as mechanisms of social control.

47. Examples of specific topics:
· How do popular images/ideals of health and sickness affect
society?
· How has medicine usurped legal and religious institutions
when it comes to defining norms/deviance?
· What are the consequences of the medicalization of deviance?
· What effects does medicalization have on individuals labeled?
· How are some medical treatments ‘enforced’ and what are the
societal and individual consequences?Guidelines
· Essays should be around 5 pages
· Essays should be typed, double-spaced and should include a
reference page detailing the sources that you have used.
· Indicate on your paper which question you are addressing!
· Papers should have 5 quotes from the reading which should be
explicitly cited in the paper.
· Papers should use and reference at least TWO sources (text or
jounral) outside the course textbooks (one may be from the
Conrad reading).
Grading
Please see “Grading Rubric”
The Medicalization of Society
The aim today is:
A) To examine how medical ideas and concepts are diffused
through culture and society via media and marketing.
B) To examine how (bio)medical intervention is represented as
a viable answer to our life problems.

48. C) To examine the multifarious effects of these collective
discourses/meanings on society and culture, patients, and
physicians.
Medicine and the Media
1. List as many TV shows, films, advertisements, news
programs, documentaries, and more dedicated to medicine:
2. Consider House MD:
I. What is the premise of the show?
II. What biomedical assumptions are present in the show?
III. In what way is biomedicine promoted?
IV. How does this show contribute to the medicalization of
society?
3. How are biomedical ideas more broadly promoted/not
promoted through cultural/media representations? (Consider the
examples listed under #1).
4. How does the advertising of drugs affect society and the
individuals within that society?
Marketing and Physicians
5. Outline some of the marketing practices employed by drug
companies to promote their product:
6. How does this marketing affect the physician?
7. How is the doctor/patient relationships affected by both DTC
(direct to consumer) advertising and physician directed
marketing?

49. 8. What are the wider effects of marketing and media
representation of medicine for society and culture?