Abstract
Background: Medicalization has been a topic of discussion and research for over four decades. It is a known concept to researchers from a broad range of disciplines. Medicalization appears to be a concept that speaks to all, suggesting a shared understanding of what it constitutes. However, conceptually, the definition of medicalization has evolved over time. It is unknown how the concept is applied in empirical research, therefore following research question was answered: How is medicalization defined in empirical research and how do the definitions differ from each other? Methods: We performed a scoping review on the empirical research on medicalization. The 5 steps of a scoping review were followed: (1) Identifying the research question; (2) Identifying relevant studies; (3) Inclusion and exclusion criteria; (4) Charting the data; and (5) Collating, summarizing and reporting the results. The screening of 3027 papers resulted in the inclusion of 50 empirical studies in the review. Results: The application of the concept of medicalization within empirical studies proved quite diverse. The used conceptual definitions could be divided into 10 categories, which differed from each other subtly though importantly. The ten categories could be placed in a framework, containing two axes. The one axe represents a continuum from value neutral definitions to value laden definitions. The other axe represents a continuum from a micro to a macro perspective on medicalization. Conclusion: This review shows that empirical research on medicalization is quite heterogeneous in its definition of the concept. This reveals the richness and complexity of medicalization, once more, but also hinders the comparability of studies. Future empirical research should pay more attention to the choice made with regard to the definition of medialization and its applicability to the context of the study.
Highlights
While the definition and understanding of medicalization has evolved over time, there has never been a broad consensus on its meaning.[1]
In 1992, Conrad defined medicalization as: “Medicalization consists of defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to “treat” it” (p. 211).[11]
Ten Categories of Medicalization Each category is discussed with reference to Figure 2, starting with the four categories ranging from top left to bottom left
Summary
While the definition and understanding of medicalization has evolved over time, there has never been a broad consensus on its meaning.[1] The debate started in the seventies with the notion that medicine increasingly gained social control.[2] Zola stated that society’s explicit wish for medicine to use its controlling potential resulted in medicalization.[3] He stated that medicine was replacing the traditional institutions that ‘shaped’ society, such as religion and law.[2] this resulted in more reliance on experts.[3] Zola criticized the assumed neutrality of this process.[3] According to Illich, medicine gained power at the expense of people’s natural competences.[4] This social control of medicine over people’s lives led to iatrogenic effects. Illich considered physicians’ imperialism central to this process. Illich never defined medicalization, he is generally understood as one of the first to address it and its consequences. Both Zola and Illich considered social control central to medicalization
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