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Medicalization and Biomedicalization Revisited: Technoscience and Transformations of Health, Illness and American Medicine

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Part of the book series: Handbooks of Sociology and Social Research ((HSSR))

Abstract

Medicalization theory has been at the heart of medical sociology or the sociology of health and illness for nearly 40 years (Zola 1972; Freidson 1970) and is also vital to medical anthropology (Hogle 2002; Lock 2001, 2004), the history of medicine (Nye 2003; Sinding 2004), medicine itself (Chervenak and McCullough 2005), bioethics (Bergeron 2007), and beyond. The still robust medicalization thesis is that the legitimate jurisdiction of Western or scientific medicine began expanding by including new domains of human life (such as alcoholism, drug addiction, and obesity) by redefining or reconstructing them as falling properly within medical (rather than legal, religious, etc.) domains (e.g., Ballard and Elston 2005; Conrad 1992, 2005, 2007; Conrad and Schneider 1980a, b).

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Notes

  1. 1.

    Fully nine chapters of a total of 38 in The Handbook of Science and Technology Studies focus on medical topics (Hackett et al. 2007). While presentations on medical topics at the Society for Social Studies of Science meetings have gone from 11% in 1988 to 29% in 2001 (Amsterdamska and Hiddinga 2004), both broader and deeper knowledge across these disciplines remains rare.

  2. 2.

    How much these national differences might be attributable to living under radically different health systems remains unclear, but this debate is ongoing. See special section in Society 43(6):14–56, (2006).

  3. 3.

    Little has been written directly on race and (bio)medicalization, but see Clarke et al. (2009b), Kahn (2009), and Shim (2002, 2009).

  4. 4.

    See Armstrong (1983, 2002), Jordanova (2004), Hess (1997), Wright and Treacher (1982), Restivo and Croissant (2007), and Hackett et al. (2007). On medical technologies, see Mechanic (2002), Lock (2008), and Hogle (2008).

  5. 5.

    On coproduction see especially Jasanoff (2005).

  6. 6.

    See Clarke et al. (2003) for thorough elaboration of these processes.

  7. 7.

    One recent transnational development of note is the elaboration of medical tourism. See, e.g., Ramirez de Arellano (2007) and Turner (2007).

  8. 8.

    Recent work has focused, e.g., on the pursuit of perfection (Rothman and Rothman 2003), human growth hormone (Conrad and Potter 2004), antiaging (Binstock and Fishman 2010), “replaceable you” (Serlin 2004), hormone treatments (Mamo and Fosket 2009; Watkins 2007), treatment of male and female sexual dysfunction (Fishman 2004; Loe 2004), depression (e.g., Healy 2002), and pharmacogenetics (Hedgecoe 2004).

  9. 9.

    Martin (2006) describes “the pharmaceutical person” and Davis-Berman and Pestello (2005) “the medicated self.” Tomes (2005) and Tone and Watkins (2007) analyze the evolving relationship between doctors, patients, and prescription drugs; Daemmrich (2004) takes up drug regulation as pharmacopolitics. See also Critser (2005) and Lakoff (2008).

  10. 10.

    While there are many kinds of medicines and healing systems on our planet, we focus on what seems best termed “scientific medicine,” with major roots in the West, also known as Western medicine. Today, however, it both dwells in many places in its “local” forms and is continuously (re)constituted through developments generated in many sites beyond the West.

  11. 11.

    See also Armstrong (2002), Conrad (1992, 2006a, b), Conrad and Schneider (1980a), and Freidson (1970). For historical overviews, see Ballard and Elston (2005), Nye (2003), and Pfohl (1985). On organizational dimensions, see esp. Light (2004) and Scott et al. (2000); on pharmaceuticals see Tone and Watkins (2007).

  12. 12.

    On the question of historical periodization, see Clarke (2010a).

  13. 13.

    Over the past 30 plus years, the Foucauldian turn has permeated the sociology, anthropology and history of medicine, perhaps more deeply in Europe and the UK but increasingly in the USA as well. See e.g., Armstrong (1983, 2002), Jones and Porter (1994), Peterson and Bunton (1997), Lupton (2003), Rabinow and Rose (2006), Sinding (2004), and Turner (1997).

  14. 14.

    With multiple parallels to biomedicalization, Rose (2007a), pp. 5–6) argues more broadly that “contemporary biopolitics has not been formed by any single event,” but by changes along five key dimensions which he calls “mutations”: Molecularization as a “style of thought”; optimization as securing “the best possible futures”; subjectification in terms of recoding the “duties, rights, and expectations of human beings” in terms of health and illness; somatic expertise as the growing numbers and kinds of subprofessions dedicated to managing aspects of somatic existence; and last, economies of vitality such that “biopolitics has become inextricably intertwined with bioeconomics.”

  15. 15.

    See, e.g., Franklin (2003, 2005, 2007), Friese (2007), Ganchoff (2004, 2007), Thompson (2008), and the Special Issue on the Hwang affair of East Asian Science, Technology and Society: An International Journal 2(1).

  16. 16.

    “Health social movements” or “patients’ organizations” differ from other social movements in several key ways too complex to detail here. See Brown (2007), Brown and Zavetoski (2005), Allsop et al. (2004), Novas (2006), Landzelius (2006a), and Epstein (2008).

  17. 17.

    There is a growing literature on such forms of citizenship (e.g., Ginsberg and Rapp 1995; Nguyen 2005; Novas and Rose 2000; Petryna 2002; Rose 2001; Rose and Novas 2004).

  18. 18.

    A conference on “Biomedicalization, New Social Conflicts, and the Politics of Bioethics” was held at the University of Vienna, Fall 2002, sponsored by Professor Herbert Gottweis. See also Prainsack and Siegal (2006).

  19. 19.

    In the American Sociological Association, the Medical Sociology Section is among the largest, reflecting the varied sites of employment of sociologists in teaching and research (e.g., NIH), as well as our domain of scholarly commitment. There is also a large Mental Health Section. However, medical sociology has not been prestigious in terms of curricular inclusion in leading American departments of sociology, although this situation seems to be changing.

  20. 20.

    Other recent work has also linked science and technology studies to these fields as well (e.g., Callon 2003; Gottweis 1998, 2005; Mirowski 2004).

  21. 21.

    Henderson and Petersen (2002) have pursued this viz. medicalization. On consumption studies, see e.g., Applbaum (2004), Hearn and Roseneil (1999), and Lury (2004).

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Acknowledgements

The authors are deeply indebted to Laura Mamo, Jennifer Fosket and Jennifer Fishman with whom we developed much of the work on biomedicalization upon which we draw here, and for comments on an earlier version of this chapter.

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Clarke, A.E., Shim, J. (2011). Medicalization and Biomedicalization Revisited: Technoscience and Transformations of Health, Illness and American Medicine. In: Pescosolido, B., Martin, J., McLeod, J., Rogers, A. (eds) Handbook of the Sociology of Health, Illness, and Healing. Handbooks of Sociology and Social Research. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7261-3_10

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