Medical technologies and the life world
Fredrik Svenaeus in Phenomenological Bioethics, 2017
Admittedly, the criterion would have to be developed and refined in order to solve the hard cases. It is easy to make an argument with the help of such a criterion that we should refrain from uploading our brains to computers in order to live forever, or from cloning babies to be grown in artificial wombs, but what about the borders of assisted reproduction and the limits of organ transplantation? In many cases the same technology will have ‘good’ and ‘bad’ uses – think of the current use of ventilators or genetic diagnosis. And the impact of medical technologies should not be thought about only through the drastic examples of making human life radically different by ‘producing’ human life, as Heidegger himself puts it in the quote from ‘On the Essence and Concept of Physis’ above (1978: 255), but also through examples of technologies that tend to narrow the scope of health by inventing new diseases, or by expanding the boundaries of the diseases that we currently treat (Conrad 2007; Stempsey 2006; Svenaeus 2007a). Medicalization – the expansion of medical concepts and treatment methods beyond the borders of health and illness in redefining other forms of human suffering and morally deviant behaviours in terms of diseases – is a major bioethical issue that we have touched upon in previous chapters and will soon return to below.
Expanding medicine
Kevin Dew in Public Health, Personal Health and Pills, 2018
Gaining medical or social acceptance for extending the range of conditions that are suitable to be treated by pharmaceuticals enables the expansion of the medical market and the term ‘pharmaceuticalisation’ has been used more recently to capture this. Pharmaceuticalisation can be seen as both an extension of medicalisation in that it expands conditions that are treated medically, and a challenge to medical dominance in that medical professionals may not be in control of this expansion. Pharmaceuticalisation has been defined as the ‘translation or transformation of human conditions, capabilities and capacities into opportunities for pharmaceutical intervention’ (Williams et al. 2011: 711). The development of lifestyle drugs is an example of an opportunity being exploited by drug companies that target conditions that fall between medical and social conditions, such as hair loss and sexual potency. Other pharmaceuticals are marketed for a particular condition but used for lifestyle purposes, such as drugs for menorrhagia being used to delay menstruation during holidays (Fox and Ward 2008). Pharmaceuticalisation is a complex mix of biology, chemicals, expansion of disease classifications, consumer adoption and corporate interests.
An uncomfortable intimacy
Alan Bleakley in Medical Education, Politics and Social Justice, 2020
Here, medicine operates as a dominant discourse or is hegemonic so that a wide range of behaviours and experiences previously unlabelled become marked as symptoms – medical or health issues. For example, everyday angst becomes treatable “anxiety”. Social behaviours are read as symptomatic ills of a social body that can be treated largely by pharmaceuticals. “Big Pharma” (Law 2006) colludes with, or even shapes, the medicalization project with a promise of profit. Szasz (2003) suggests that this leads to a “pharmacracy”, a culture dependent upon prescribed drugs, where Big Pharma, embracing the most profitable and largest of global companies (Ledley et al. 2020), exerts undue power. Medicine and politics are inextricably mixed, as pharmaceutical companies also become major lobbyists, particularly in American politics.
Addressing Anti-Fat Bias in Psychology: Education and Resistance
Published in Women's Reproductive Health, 2019
One reason that fat bias is difficult to combat is the medicalization of fat that is promoted and overwhelmingly accepted in the United States; social disapproval of fat is reinforced and justified by the medicalized approach to weight. Medicalization refers to the process by which everyday experiences and problems become framed as illnesses, often in the pursuit of profits (Moynihan & Cassels, 2005). A number of critics have challenged the medicalization of weight (e.g., Bacon, 2008; Bacon & Aphramor, 2014; Campos, 2004; Gaesser, 2002; Kasardo & McHugh, 2015), including labeling fat individuals as “obese.” The term “obesity” turns the size of an individual into a disease. Calling fat people “obese” medicalizes human diversity and inspires a search for a cure for something that is a naturally occurring difference (Wann, 2009, p. xiii).
The medical model and its application in mental health
Published in International Review of Psychiatry, 2021
Over medicalization is an issue that concerns all of medicine (Sackett et al., 1991) not least because of the risk of iatrogenic harm for little chance of benefit (Treadwell & McCartney, 2016) and some critics of psychiatry have highlighted this as a particular issue in psychiatry due to lack of clear differentiators between health and purported mental disorder (Kinderman et al., 2013). If clear rules for defining medical disorders existed this would help focus medical care on appropriate problems avoiding over-medicalization, but naturalist models so far have not been able to successfully carve out notions of dysfunctions in a value-free manner. Normativist models also do not provide any clear boundary with regards to the domain of medicalization (Bortolotti, 2020). In the absence of such a philosophical boundary, ‘medicalization’ often ends up as a rhetorical or political manoeuvre rather than as a useful scientific concept (Pies, 2013).
Ethics of Early Intervention in Alzheimer’s Disease
Published in AJOB Neuroscience, 2021
Alex McKeown, Gin S. Malhi, Ilina Singh
In both cases the argument for an EI approach to AD can be construed as defending a radical medicalization from early in life. However, although medicalization often carries negative connotations, it cannot be appealed to as necessarily ethically problematic (Parens 2013). Rather, whether medicalization in the context of AD is or is not ethically permissible, desirable, or necessary, can only be determined by the values we attach to the various consequences of doing so. A challenge for being able to determine this at present follows from the state of our knowledge of AD, its causes, and ways to effectively mitigate or prevent its effects. Consequently, more evidence is required for the effectiveness of EI strategies to intervene in AD. Given the scale of the consequences for individuals that may result from intervening early in their lives, not least in view of the practical ramifications of uncovering new, more readily testable and reliable biomarkers such as reported in the p-tau 181 study, investment into the production of such evidence is required, in spite of concerns about EI being understood as creeping medicalization in the AD context.
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