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1. Basing your answer on the lectures and the readings, where appropriate:a. In what ways have natural processes and social problems (deviance) become medicalized?b. What are the recent “engines” driving medicalization?c. What are the consequences of this medicalization process presented in lectures and/or the readings?d.. Now, returning to the first part of the course, in what ways does your answer to part "a" illustrate a sociological perspective on health and illness?1.Introductiona. With better technology and more scientific knowledge, the medical field is making trends toward medicalization and genetization.b. Medicalization definition- Medicalization is redefining a problem once seen as a natural process or deviant behavior as an illness.c. This usually involvesi. Using the medical model to interpret the phenomenonii. Using medical technology to treat the phenomenon2. 2 of the 3 kinds of medicalization- medicalization of natural processes and medicalization of deviant behavior. 3rd = genetizationa. Medicalization of natural processesi. Death and Dying 1. More and more people dying in hospitals instead of at home 2. Respirators & life supportii. Childbirth and Reproduction1. Intense monitoring limits movements2. Epidurals iii. Premenstrual Dysphoric Disorder, PMDD1. A medically recognized cognition. 2. Happens in the days right before your period.3. Symptoms are way more severe than PMSiv. Menopause1. Hormone Replacement Therapy- HRT estrogen. Osteoporosisb. Medicalization of Deviant Behaviori. Deviance= behavior that departs from expectationsii. Mental illness1. SSRI’s most popular drug2. Proliferation of mental hospitalsiii. ADHD1. A term given to hyper children2. Massive prescription of ADHD medicationsiv. Alcoholism1. Now seen as a disease that requires treatment2. Proliferation of Rehabv. Fetal Alcohol Syndrome1. Symptoms: small head, low nasal bridge, underdeveloped jaw, thin upper lip, short nose, small eye openings3. Recent Engines for Medicalization- there were old and new enginesa. Old enginesi. Professionsii. Social Movements and interest groupsiii. Organized interprofessional groupsb. New Enginesi. Managed Care- both enables and constrains. Requires preapprovals for medical treatment and sets limits on some types of care. Has given 3rd party payers more leverage and often constrained both the care given by doctors and the care received by patients. To a degree, managed care has commercialized medicine and encouraged medical care organizations and doctors to emphasize profits over patient care. 1. Key in deciding what’s illness, and what is reimbursed2. Pays for psychotropic drugs over therapyii. Consumers1. Conrad- The Shifting Engines of Medicalization- consumer self-medicalization, with patients taking their troubles to physicians and often asking directly for a specific medical solution. A prominent example of this has been increasing medicalization of unhappiness and expansive treatment with antidepressants. 2. Provide markets- cosmetic surgery, adult ADHD3. Consumer groups urge medicalizationa. Conrad- The Shifting Engines of Medicalization- medicalization sometimes occurs through the activities of social movements and interest groups.i. Ex- with alcoholism, with Alcoholics Anonymous4. Use of internet to form groups, which create demand and marketsa. Barker- Electronic Support Groups, Patient-Consumers, and Medicalization: the case of Contested Illness. : ESGs (Electronic Support Groups for illness sufferers i. ESGS can play a crucial role in defining patient suffering in medical terms and engendering patient-consumer demand for medical recognition that physicians are often reluctant to provideii. Consequently, physicians increasingly encounter patients who already have information about their problems and how they might be treated1. The widespread public availability of such health and medical information alters the traditional doctor-patient relationship. iii. Biotech (especially pharmaceuticals)- 1. Conrad- The Shifting Engines of Medicalization- long been involved in promoting its products for various ills. Revisions in FDA regulationsallowed for a wider usage and promotion of off-label uses of drugs and facilitated direct-to-consumer advertising, especially on TV. 2. Direct-to-consumer advertisinga. FDA allows 3 types of thisi. Product claim advertisements: which included the product name and specific therapeutic claimsii. Reminder advertisements have the name of the drug but did not state its useiii. Help-seeking advertisements: which told consumers about unspecific treatment possibilities for diseases or conditions3. Defining a new disease-EDa. Erectile Dysfunctioni. Viagara4. Legitimizes a contested illness- fibromyalgia, PMDDa. Fibromyalgiai. Result of overactive nerves. Results in widespread chronic pain and tenderness all over.5. Turns a condition into a common one- restless leg, SAD, GADa. SAD- Social Anxiety Disorder6. Creates new indications for existing drug- adult ADHD4. Consequences of this Medicalizationa. For Medicalization of natural processesi. Bright- Saving lives, lowering morbidity and mortalityii. Down side1. For reproduction- is it cost-effective?a. US spends most money on childbirth, but has higher infant mortality than many countries including Great Brittan, Greece, Spain2. For menopause- costs of defining a natural process as a diseasea. HRT can cause problems- increases risk of stroke, heart attacks, blood clots, breast cancer, and cardiovascular disease3. Saving lives vs quality of lifeb. For Medicalization of Deviance i. Pros1. More sympathy, less blame?a. Geneticism lessens stigma in homosexuality2. Optimism. Belief person can be helpeda. Treating ADHD- school personnel. Can provide important information to those involved in the care of a child with ADHD. Provide constructive feedback and help students to fulfill their potential.3. Medical control can be more flexible or cost effectiveii. Cons1. Decreasing the power of the sick persona. Ex. Declaring someone as mentally ill can provoke stigmai. Hard to be accepted by the community once labeled as mentally illb. Thomas Szasz, father of “radical psychiatry” movement, said treating people against their will can be worse than prisonc. Zola: Medicalization as an Institution of Social Control- medicineis becoming a major institution of social controld. Zola: Medicalization as an Institution of Social Control- automatic multiphasing testing. 3 large

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U of M SOC 475 - Notes

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