The Evolution of Medicalization, Technology and Social Control

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Looking at some of Foucault’s ideas this section will briefly discuss how certain medical discourses and knowledge are created and maintained. It will also explore theories of medicalization and how these theories have transformed over time, looking at newer forms of technology it will analyse how these may be manipulated by medicalization and some of the positive and negative effects this may have on individuals.

According to Foucault institutions create discourses, which are statements that contain an institution’s ideologies and values (Danaher et al 2000). Foucault suggests that knowledge (in this case medical) consists of different ideas, views, explanations and narratives being produced by institutions (Danaher et al 2000) such as medical bodies, using objective allegedly scientific principles. He states that it is possible for new knowledge to emerge from conflict within different institutions. Foucault suggests that power-knowledge turns individuals into subjects who have little autonomy of their own , as they are constantly referring back to various constructs of knowledge (Danaher et al 2000),suggesting that medical constructs can constrain an individual’s capacity to think. In Foucault’s The Birth Of The Clinic (1973) he analyses how throughout history several medical paradigms have arisen and changed the ways in which individuals interact with their bodies (Miah and Rich 2008). Foucault suggests that the process of medicalization interferes with the ways that we have come to understand our bodies and moves previously unproblematic phenomenon into the medical jurisdiction through the use of evaluative discourses and criteria and through the use of technical and socially neutral terms (Miah and Rich 2008).

Medicalization refers to the process of taking a given social problem, for example drug use, and transforming it into a medical problem (Conrad 1992) so that certain interventions and measures can be put into place to treat the problem or keep it at bay. Such as rehabilitation centres or the use of methadone to treat heroin addiction. According to Zola (1972) everyday life processes are not free from the gaze of medicalization and many have entered into the ring of the medical domain (Conrad 1992) as suggested by Foucault. Conrad and Schneider suggest that any social problem can be made medical at three levels (Conrad 1992). One level is the conceptual level where medical linguistics are used to define the problem,similar to Foucault’s technical terms .The second level is the institutional level where specific organisations attempt to approach the problem from a medical outlook. The third level is that of the interactional level where health professionals become directly involved and patient and doctor interaction often occurs (Conrad 1992).

Turner (1984) suggests that medicalization has flourished in modernity due to an increase in secularisation, he suggests that religion has been cast aside as medicine has replaced it as the dominant force of social control in modern society (Conrad 1992). A study by Greil (1991) also suggests that medicine has overtaken religion, using the example of infertility, Greil (1991) suggests what was once believed to be in the realm of the God’s is now squarely a medical problem fixed using medical interventions (Conrad 1992). Foucault (1973) suggests that many behaviours such as childbirth are now viewed through a medical gaze and that this is a form of social control (Conrad 1992).

The recent shift in technological media means that medicalization has entered onto a new platform and potentially may be able to reach out to more individuals . Fox (2006) and the Pew Internet and American life project found that 80% of all adult internet users in the United States had searched for medical advice on line (Miah and Rich 2008). In recent years there has been a surge in digitally enabled health services or e-health, such as the creation of websites online that offer self-diagnosis advice, images showing what individuals should look out for and online consultations with health professionals (Miah and Rich 2008). For Nettlton (2004) ‘e-scaped’ medicine (Miah and Rich 2008:39) suggests the emergence of new ways of producing, displaying and creating medical knowledge are arising (Miah and Rich 2008) and dominant discourse may be challenged by this. Nettleton (2004) does note however that the ways in which information is utilised and internalised by individuals, their ‘reflexive engagement’ (Miah and Rich 2008:41) varies in many ways. Some individuals are instrumentally reflexive or expert and so their decisions based on what they have read online and their decisions about visiting a qualified practitioner will be of a higher calibre than other less instrumentally reflexive individuals (Miah and Rich 2008).

Medicalization of the internet offers many positive benefits, Makus (2001) suggests that the internet enables medical practitioners to reach out to more patients and can offer a more egalitarian service as universal access is possible (Miah and Rich 2008). Many websites have also been praised for allowing individuals to contribute their personal experiences of illness or medical problems and Orgard (2004) suggests that the internet offers online communities and relationships to those who may be suffering or those who care for them (Miah and Rich 2008). This may strengthen their confidence and blot out fears of isolation as they realise they are far from alone in their experiences. Wright (2000) praises online technology for offering anonymity (Miah and Rich 2008) to individuals who may be too embarrassed to visit a doctor or who may feel that their condition, for example HIV, has been stigmatised or turned into a taboo by society. Participation in online groups can offer comfort and support to individual’s who may be housebound or who find face to face contact difficult and so the medicalization of the internet for these individuals can be deemed as nothing more than a blessing. Research by Walstrom (2000) has also suggested that individuals who share their experiences online, for example a cancer sufferer who writes a blog, may have a somewhat cathartic effect for them and may act as a ‘catalyst for recovery’ (Miah and Rich 2008:62) offering therapeutic benefits.

Riessman (1983) suggests that some members of society are more susceptible to medicalization than others, women he argues are most at risk of medicalization as many of their natural life processes have been scrutinised under the medical gaze (Conrad 1992). For example pregnancy, bulimia, anorexia, the menopause and Pre-Menstrual tension, many of these medicalized natural life processes are associated with femininity. For Harraway (1991) the internet has allowed women to tackle these stereotypes head on as they are able to contest many myths with ‘Feminist Cyborg Stories’(Miah and Rich 2008) and share their own experiences of what it is to be a woman (Miah and Rich 2008).

There are however sceptics of the medicalization of the internet who suggest that the infiltration of medicine into the internet is not a positive occurrence at all. It is estimated that only 40% of people in the world actually have access to the internet (Rodriguez 2014), and so Makus’ (2001) utopian view of egalitarianism is not quite accurate. Burrows et al (2000) are concerned that online e-health information may undermine the authority held by doctors and other health workers and cause detrimental effects to a state-funded health care system (Miah and Rich 2008) .Concerns have been raised by Burgermeister et al (2004) over the lack of statutory regulation of e-health sites which may spout inaccurate or unfounded medical claims which have the potential to cause harm to individuals, suggesting that some websites on the internet may cause greater misunderstanding of issues rather than enlightenment (Miah and Rich 2008). Impicciatore et al (1997) undertook a study of 40 websites analysing the content on how best to look after a child with a fever, their findings concluded that only 4 websites offered information similar to that of published, approved guidelines (Miah and Rich 2008). Research by Gustafson et al (1999) alongside the Federal Trade Commission warn internet users that much of the information available to them via the internet is purely fictitious and that professional medical advice should be sought after (Miah and Rich 2008). Culver et al (1997) raise the issue of accountability, they suggest that it is almost impossible to monitor who is publishing information online or what they are publishing and so warn of the dangers of an ill monitored internet and the possible damaging effects some publications may have on an individual’s health (Miah and Rich 2008). In an attempt to tackle negative effects an international e-health code of ethics was published in 2000 by the eHealth ethics initiative, a non-profit organisation whose aim was to ensure that knowledge passed onto the public is as accurate as possible (Miah and Rich 2008).

Conrad (1992) has warned that medicalization and technology do not always go hand in hand, it does not take much of an imagination to conjure up images of Nazi war crimes against Jewish people, many of the atrocities occurred because of the synthesis of technology and medical knowledge (Conrad 1992). Pastor (1978) also suggests that medicine and medical knowledge can be dangerous and in many cases may hold more control over individuals than the law (Conrad 1992).

This section has discussed how medical discourses are created and how medical discourses are maintained. It has discussed medicalization and the forms this can inhibit, whilst analysing both the pros and cons that the medicalization of technology can have.

Bibliography

Image source:

http://infinityhousemagazine.com/2014/12/10/prescription-drugs/

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