The end of professional dominance

Abstract

M edicalization is one of those rare successful sociological terms that has entered the vocabulary of everyday life. Even doctors, who are allegedly its main beneficiaries use the word and sometimes even denounce the threat of "creeping medicalization." The growing usage of this sociological concept is underpinned by its resonance with contemporary cultural processes. Conditions such as cancer, obesity and AIDS along with such drugs as Viagra and Prozac have as many cultural meanings as they have medical connotations. Since its emergence in the late 1960s and early 1970s, the thesis of medicalization has been a prism through which subsequent social developments have been viewed. There has been a steady expansion of medical boundaries and, increasingly, individual and social experiences are framed in medical terms as an illness or disorder. The promotion and celebration of health as the paramount value of Western society has encouraged people to interpret a variety of human activities through the vocabulary of medicine. Frequently, illness categories are used to make sense of routine problems of existence. Shyness, apprehension of failure, the inability to focus on tasks, promiscuity, and childlessness are just some of the problems that come with a medical diagnosis. Conditions that hitherto were confined to children, for example, ADHD (Attention Deficit Hyperactivity Disorder) are now diagnosed in adults. Men are now claiming to suffer from illnesses that were until recently regarded as specifically women's conditions such as postnatal depression and menopause. The ever-widening definition of illness has been paralleled by the steady growth in expenditure on health. Not surprisingly, the health industry has been an important beneficiary of, and contributor to, the medicalization process. The medicalization thesis emerged as a critique of medical professionalism and, specifically, of medical power. It represented a reaction against rationality, expert knowledge and the biomedical model of health. Frequently, the exercise of this power was portrayed as a form of social control--particularly the control of women's bodies or of behavior that failed to conform to prevailing norms. For many of its influential proponents, medicalization was associated with the conscious pursuit of medical interest through establishing hegemony in defining and managing health and illness. The metaphor of "medical imperialism" was used to represent the idea of the expansionary ambition of a predatory profession.