Medicalization Case

Q1. Outline and discuss Peter Conrad’s (2005) thesis that consumers have become a major “engine of medicalisation”

“The shifting engines or the driving engines of medicalisation” as described by Peter Conrad have three major influences to the growing changes in the medical field and medical jurisdiction, starting with “biotechnology i.e. the pharmaceutical industry, then there is the consumers and managed care” throughout the thesis paper Conrad describes each of these factors in detail with examples referring to medications and illness or disorders that have become medicalised due to these factors.

Many symptoms and disorders have become medicalised in the past and resulting with the treatment of these disorders with medication, for example “hyperactivity, child abuse, menopause, post-traumatic stress disorder (PTSD), and alcoholism, among others, broadened our understanding of the range of medicalisation and the attendant social processes” (Conrad 1992) many symptoms and disorders became medicalised due to the pressures of society, if individuals didn’t conform to the society norms and beliefs they were deemed to medically ill and needed to be treated.

These individuals may actually have no medical problems, yet they were treated as if they were ill. As far back as 1838 The Dangerous Lunatic Act was brought in to deal with individuals in the society who had mental problems or just didn’t conform to society norms. This Act was aimed at many different types of individuals they even forced homosexuals to receive treatment as they weren’t seen as normal and were then classified as ill.

One aspect I found portrayed throughout the thesis was that the medical field is very monetary driven and money is a major influential factor and is a driving factor behind it all. Many pharmaceutical companies are in it to make the profits. They have resulted to the broadening of there products to treat other disorders “Since the FDA approved the use of Paxil for SAD in 1999 and GAD in 2001, GlaxoSmithKline has spent millions to raise the public visibility of SAD and GAD through sophisticated marketing campaigns” (Conrad 2005) Paxil was originally intended to treat depression but GlaxoSmithKline brought it forward to use it to treat an anxiety disorder due to the crowded market for anti-depressants they needed to expand.

They have even resulted to straight to the consumer advertising “Drug companies now spend nearly as much on direct-to-consumer (DTC) advertising as in advertising to physicians in medical journals, especially for “blockbuster drugs that are prescribed for common complaints such as allergy, heart burn, arthritis, ‘erectile dysfunction,’ depression and anxiety” (Relman and Angell 2002:36). Not only is biotechnology and consumers drivers for medicalization but Ivan Illich believes that physicians are the main drivers for medicalization. He believes that physicians are the main reason patients are becoming medicalised, they are being unnecessarily treated by doctors for conditions or symptoms that never before would have been treated by medicine.

“A professional and physician-based health-care system that has grown beyond critical bounds is sickening for three reasons: it must produce clinical damage that outweighs its potential benefits; it cannot but enhance even as it obscures the political conditions that render society unhealthy; and it tends to mystify and to expropriate the power of the individual to heal himself and to shape his or her environment. Such medicine is but a device to convince those who are sick and tired of society that it is they who are ill, impotent, and in need of technical repair.” (Illich 1995, p.9) Illich also talks of “Clinical Itrogenesis” (Illich) and how when one is admitted to hospital for treatment they may actually contract other illness while admitted and actually worsen their state of health even though they are in a health care setting.

“Clinical iatrogenic disease comprises all clinical conditions for which remedies, physicians, or hospitals are the pathogens, or “sickening” agents.” (Illich 1995, p.27) Within the thesis paper written by Conrad he mentions these three drivers of the medicalization which I have already mentioned the biotechnology side including the pharmaceutical companies but now for the rest of this essay I will be focusing on the “consumers” influence and contribution to the expansion of the medicalization of medicine.

Consumers in the health care have become major influences on what why and why they get treated, they have made the shift from being treated as a patient to a consumer and the health care system is providing a service to them and this can be influenced on how much money they can afford to spend. In recent years there is a major growth in the “cosmetic surgery” especially among women. “Cosmetic surgery is an exemplar of consumers in medicine” (Sullivan 2001) this procedure, may it be a breast enlargement or liposuction is not medically recommended but the consumers what it done to there bodies to enhance there looks.

The drive for these types of surgeries is on the rise as they are becoming less complicated and quicker healing time. Even if there is medical affects from these surgeries, simple studies are drawn up to ease the consumers mind are published. Consumers feed from this and hence forth this increases sales for these types of surgeries. “The market for implants plummeted. In1990 there were 120,000 implants performed; by 1992 there were 30,000. But with the introduction of apparently safer saline implants, breast augmentation increased by 92 percent from 1990 to 2000” (Conrad2005)

A major leading factor in helping consumers in becoming the drivers for medicalization is the ‘World Wide Web’. The internet is becoming a new home for the selling and marketing of new drugs, this can either be straight to the consumer advertising or to physicians also. “On many of the drug company’s website pages they have a self screening process to see if you may have this particular disorder” this is a form of planting ideas in peoples minds making them believe they may have this disorder even if it is untrue. These website pages provide the consumers with the information about the drugs and the small side affects, they generally highlight the more important parts and highlight the major benefits an individual could gain from the use of their drug.

The self diagnosis is a major concern in the medical field as non medical professions i.e. consumers are taking upon themselves to diagnosis oneself and prescribe a set course of medication that they can receive and purchase over the internet. ADHD which is primarily diagnosed in children is now been diagnosed in adults, “Adults would come to physicians and say, “My son is ADHD and I was just like him,” “I can’t get my life organized, I must have ADHD,” or “I know I’m ADHD, I read it in a book.”” People believe what they are reading on these websites and are empowering themselves to purchase these procedures or medication in thinking they are bettering there health.

The pharmaceutical companies are also fueling the consumers in the drive towards medicalization as in many non-profit consumer groups which are set up to provided information about a particular disorder or illness and are generally being financially backed by pharmaceutical companies, this is influencing the consumers decisions on the purchase of their product and has a major influence on which drugs are pushed in the market and what information is highlighted to the consumers. “These consumer advocacy groups are comprised of families, patients, and others concerned with the particular disorder. However, these consumer groups are often supported financially by pharmaceutical companies” (Conrad 2005)

A growing product available on the market is “Prozac” which is an anti depressant drug available on the market since 1987, “$10.9 billion in sales in 2003 have become the third best selling class of drugs in the United States” (IMS Health 2004) Prozac was brought onto the market to help individuals who were experiencing depressive like symptoms. With the economic climate at the state it is in the moment a vast majority of the population is experiencing these symptoms or think they are. Many people I think believe that by taking Prozac or any other anti depressant drug will help them gain rebalance in their life even If they aren’t actually suffering from depression. They feel the need and the reliance on these types of drugs so medicalization for even the smallest symptoms of depression present has become medicalised.

Medicalization is a growing development in the medical field and a growing concern; will every thing some day be treated by drugs? This can’t go on. Already the use of antibiotics is in trouble in the medical fields from the over use of antibiotics and the misuse of them by patients “it mean that they won’t work when you really need them for a serious infection. It also puts you at risk of side effects, like a rash, upset stomach or diarrhoea” (HSE) the infections bodies are becoming immune to the antibiotics so the antibiotics are having no affect on the bacteria in the body any more.

If we carry on at the rate we are at now we could be in some serious trouble in the future and become heavily dependant on the medical system and research to keep up to date with any new arising infections or disorders and finding a way to treat them. People in society feel as if they need to conform to society norms so they believe if they can control their difference every thing shall be fine, but is this really the case.

The consumer drivers for medicalization is becoming out of control and being constantly fed by the pharmaceutical industry or as Illich sees it the Clinical professions and physicians are the main drivers, but in my opinion on the research I’ve looked at I think the major player is the biotechnology as they don’t just drive the sale and production of the drugs but they also fuel the consumers minds and the consumers in turn are demanding more drugs to be made available to them, it all comes back to the information consumers are being fed and what they can and cannot understand.

Bibliography:

* Conrad, P. “the shifting engines of medicalization”, Journal of health and social behaviors, Vol. 46 No 1. March 2005, pages 3-14. * Relman, Arnold S. and Marcia Angell. 2002. “America’s Other Drug Problem.” New Republic, December 16, pp. 27-41. * Illich, I. 1995 (1975). Limits to Medicine: Medical Nemesis: The Expropriation of Health. London: Marion Boyars. * Illich, I. 1995. ‘Death undefeated’, British Medical Journal, 311,1652-1653 * O’Donovan, O. lecture slides, Lecture 1; the medicalisation of everyday life, September 2012. * IMS Health. 2004. “IMS Reports 11.5 Percent Dollar

* Growth in U.S. Prescription Sales.” Retrieved July15,2004 (http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_3665_44771558,00.html) * Action on antibiotics, HSE web page, December 5th 2012 (http://www.hse.ie/go/antibiotics?gclid=CIW073Tk7QCFUqV4Qod0B8A7Q)