Today's entry in the Lexicon will be "medicalization." Medicalization is, I tend to think, an important concept in the medical humanities, and has particular application in all manner of fields, including anthropology, sociology, bioethics, disability studies, gerontology, etc. Though I am not aware of the precise origin of the term, it received its most direct expression in Irvin Zola's 1972 seminal article, "Medicine as an Institution of Social Control." (1972). Sociology Review, 20(4):487:504.
As I understand it (and, as always, the Lexicon is irreducibly a product of my own understanding), the term "medicalization" generally refers to the encroachment of culturally (Western) biomedical concepts, terms, and values into a discursive space the boundaries of which need not necessarily be defined in biomedical contours. This excellent web resource on medicalization defines it as an "expansion of the medical institution and reviewing deviance and the processes of human life from a medical perspective. In the process of medicalization the power of medicine extends to areas which were considered non-medical."
In studying the medical humanities, I have been chiefly struck by a sense of how entrenched medicalization is, such that it becomes difficult to even perceive its wide-ranging social effects and influences. The study of aging, for example, has been dominated by medical views and attitudes towards aging. Under the medical model of aging, aging is often seen as akin to a kind of deterioration, of a winding down of cellular processes, accompanied by a concomitant increase in disease, dysfunction, and disorder. Senescence thus becomes something requiring (medical) management, and its associated breakdowns and malfunctions become forces to be resisted and, to the extent possible, overcome (by the formidable armentarium of biomedicine, chiefly).
Naturally, this is both a polemic and an oversimplified formulation, but it is not, I submit, so crude as to be wholly inaccurate. A medicalized sense of aging is conveyed quite clearly, for example, in Michael Gazzaniga's recent book, The Ethical Brain. The problem with the medicalization of aging or senescence is that, of course, there are myriad different ways to view aging aside from a condition of deterioriation and disease. Indeed, one might, as gerontologists have for some time, begin by even questioning whether senescence is something that should be resisted. Cicero refuted this conception himself in his famous essay, On Old Age.
As another example, the medicalization of old age commonly produces a conception that older persons are more likely to have rigid, ossified, thought, and are less capable of creativity (consistent with the functional deterioration model of aging). Why? Why should one believe that older persons are generally less able to think creatively, to generate, as younger persons can? Joan Erikson argues for the concept of generativity in senescence in The Life Cycle Completed.
All of this is ripe for debate, of course, and by asking such questions, I do not pretend to answer them here. The point is simply to offer an example of the ways in which a particular social conception results from viewing it through "medicalized" lenses, and to suggest that there are a number of social phenomena that merit analysis from gazes that are derived from non-medical milieu. Regardless of the position one takes, awareness of the medicalization of phenomena that could theoretically be explored through values, concepts, and lenses that are not traceable to the culture of biomedicine is itself significant. For better or worse, the medical paradigm is so conceptually dominant that it is often difficult to see the ways in which phenomena that are arguably not reducible to medical phenomena are characterized, explained, and conceived of largely in medical terms.
Found you blog from the link re hosting the next disability blog carnival. Thank you so much for posting a link to "On Old Age" an essay I read many many years ago, when I was in my teen years. It seems so much of what I read then has been homoginized, and I no longer remember exactly the sorrec of my ideas and opinions.
I did enjoy your discussion of medicalization, and embrace much of what you experss. I just posted my "complaint" in a comment on Rackel's blog, that I found from a link on your page, re the Ashley Treatment.
In another long list of comments on Mary's blog re Ashley's treatment, I pointed out that I had never heard of anyone suggestion the amputation of the breasts of old women who were physically disabled considered senile, and that were full size adults, and back in the day, cared for at home. Someone responded back to my post that old people were not disabled, they were just waiting as they aproached going into death.
It had never occured to me that a disability was age related. I wonder what the cutoff age is for disability is, then? Or, like you say, is it assumed that old age is a condition that embodies disfunction and degeneration?
Posted by: Kathy Podgers | January 28, 2007 at 11:55 AM