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 Introduction a 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 involves i Using the medical model to interpret the phenomenon ii Using medical technology to treat the phenomenon 2 2 of the 3 kinds of medicalization medicalization of natural processes and medicalization of deviant behavior 3rd genetization a Medicalization of natural processes i Death and Dying 1 More and more people dying in hospitals instead of at home 2 Respirators life support 1 Hormone Replacement Therapy HRT estrogen Osteoporosis b Medicalization of Deviant Behavior ii Childbirth and Reproduction Intense monitoring limits movements 1 2 Epidurals iii Premenstrual Dysphoric Disorder PMDD 1 A medically recognized cognition 2 Happens in the days right before your period 3 Symptoms are way more severe than PMS iv Menopause i Deviance behavior that departs from expectations ii Mental illness 1 SSRI s most popular drug 2 Proliferation of mental hospitals iii ADHD iv Alcoholism 1 A term given to hyper children 2 Massive prescription of ADHD medications 1 Now seen as a disease that requires treatment 2 Proliferation of Rehab v Fetal Alcohol Syndrome 1 Symptoms small head low nasal bridge underdeveloped jaw thin upper lip short nose small eye openings 3 Recent Engines for Medicalization there were old and new engines a Old engines b New Engines i Professions ii Social Movements and interest groups iii Organized interprofessional groups i 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 reimbursed 2 Pays for psychotropic drugs over therapy ii Consumers 1 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 ADHD 3 Consumer groups urge medicalization a Conrad The Shifting Engines of Medicalization medicalization sometimes occurs through the activities of social movements and interest groups i Ex with alcoholism with Alcoholics Anonymous 4 Use of internet to form groups which create demand and markets a 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 provide ii Consequently physicians increasingly encounter patients who already have information about their problems and how they might be treated 1 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 regulations allowed 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 advertising a FDA allows 3 types of this i Product claim advertisements which included the product name and specific therapeutic claims ii Reminder advertisements have the name of the drug but did not state its use iii Help seeking advertisements which told consumers about unspecific treatment possibilities for diseases or conditions 3 Defining a new disease ED a Erectile Dysfunction i Viagara a Fibromyalgia 4 Legitimizes a contested illness fibromyalgia PMDD i Result of overactive nerves Results in widespread chronic pain and tenderness all over 5 Turns a condition into a common one restless leg SAD GAD a SAD Social Anxiety Disorder 6 Creates new indications for existing drug adult ADHD 4 Consequences of this Medicalization a For Medicalization of natural processes i Bright Saving lives lowering morbidity and mortality ii Down side 1 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 Spain 2 For menopause costs of defining a natural process as a disease a HRT can cause problems increases risk of stroke heart attacks blood clots breast cancer and cardiovascular disease 3 Saving lives vs quality of life b For Medicalization of Deviance i Pros 1 More sympathy less blame a Geneticism lessens stigma in homosexuality 2 Optimism Belief person can be helped a 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 effective ii Cons 1 Decreasing the power of the sick person a Ex Declaring someone as mentally ill can provoke stigma i Hard to be accepted by the community once labeled as mentally ill b Thomas Szasz father of radical psychiatry movement said treating people against their will can be worse than prison Zola Medicalization as an Institution of Social Control medicine is becoming a major institution of social control c d Zola Medicalization as an Institution of Social Control automatic multiphasing testing 3 large institutions are now or are planning to make use of this method not to treat people but to deselect them 1 The armed services use it to weed out the