Vernonia Freedom—Page 3
Thursday, January22,1981
Post WW!I disease treatment capabilities soar in U.S.
THE NATION‘S HEALTH III:
THE MEDICALIZATION OF AMERICAN SOCIETY
EDITOR* S NOTE: This is the third
in a series of fifteen articles exploring
“The Nation's Health." In this
article, science writer Joann Ellison
Rodgers discusses how we have come
to expect medicine to solve our
personal and social problems as well
as health problems. This series,
written
for • COURSES
BY
NEWSPAPER,
a program
of
University Extension, University of
California, San Diego, was funded by
a
grant
from
the
National
Endowment for the Humanities.
by Joann Ellison Rodgers
After World War II, stunning
scientific and technological advances
— from penicillin and tranquilizers to
brain scanners
and heart-lung
machines
—
gave
physicians
unprecedented ability to detect and
treat disease. Impressed by these
successes, patients and the public
inevitably came to expect the medical
profession to rescue them from an
ever-expanding . list of personal,
social, and behavioral problems.
By the 1980s, this process had
produced a unique,
broadened
definition
of
‘‘health”
that
encompassed not just the absence of
illness but, as the World Health
Organization interprets it, “a state of
complete physical, mental, and social
well-being.”
At first glance, this new trend may
seem eminently worthy. Who is not in
favor of healthier people? But in fact,
reliance on medicine to solve our
Copyright © 1980 by the Regents of the University of
California.
personal and social problems in
addition to our physical illnesses has
had some negative consequences.
social grounds, but as agents of
physical and mental disease.
Divorce, inflation, aging, job
COLLEGE COURSES BY NEWSPAPER
unfit, stupid, evil, or destined by God
to be that way.
NEGATIVE IMPACTS
Part Three
Nat ion's A Health
Goals once considered the exclusive
province of parents, clergy, teachers,
judges, lawmakers,
and. social
workers now are declared targets for
the health care system. Indeed, it is
hard to think of any condition that
people believe cannot be cured, or at
least eased, by the medical system. In
more
extreme
forms,
this
“medicalization” of American society
assumes that there are no “bad”
people, only “sick” ones, no
or
“failures,”
only
untreated
undertreated * * victims. ’ ’
Delinquency,
suicide,
laziness,
promiscuity,
poverty,
sagging
breasts, ignorance, sexual modesty,
and a disagreeable nature have all
been medicalized, redefined as
conditions that can be diagnosed,
treated, or prevented, like polio, heart
attacks, broken bones, and sore
throàts. Alcohol and drug abuse are
no longer fought on moral, legal, or
disappointments, and similar stresses
now get Americans referrals for
psychiatric and medical treatment.
Teachers routinely send children with
behavior and learning problems for
drugs to alter their classroom
behavior.
Such medicalization of our society
cannot be attributed to medical and
scientific discoveries alone. The
Industrial Revolution contributed, by
categorizing all human problems as
solvable with sweat, technology, and
money. The post-World War II boom
brought with it a new preoccupation
with youth and an affluence that
provided time to dwell on personal
and social ills. Additionally, the
social, humanitarian, and egalitarian
movements of the last 100 years
overturned the notion that the poor
and ill are poor or ill because they are
There is no denying that the impact
of modern medical technology has
been beneficial to many. Equally
important, but less widely publicized,
however, have been the negative or at
least questionable consequences of
labeling so many aspects of life in a
medical context.
In reality, medicalization harbors
unrealistic
assumptions
and
mandates that pose serious dangers
to good health care and the critical
doctor-patient
relationship.
It
encourages us to overlook medicine’s
limitations and to neglect the social,
environmental, and personal factors
that are the real determinants of
health.
Among the most misleading'
assumptions
^underlying
medicalization are the following:
- MEDICINE IS A PRECISE
SCIENCE
THAT
CAN
BE
APPLIED EQUALLY TO ALL
PATIENTS BY ALL PHYSICIANS.
In fact, much of clinical medicine is
an art; its practitioners are limited by
their individual skills, knowledge,
and imagination, and by a small set of
established probabilities. Contrary to
widespread belief, science does not
have much information about why
people get sick or get better. Most
human problems lie outside the
province of medical science, and most
ailments disappear with treatment.
- MENTAL AND SOCIAL
WELL-BEING AND HAPPINESS
ARE PROPER GOALS OF THE
HEALTH
CARE
z SYSTEM.
Evidence is being gathered showing
that'slums, poverty, and deprivation
are stresses that generate illness.
There is, however, no evidence that
physicians or psychotherapists are
any more competent to deal with
these
problems
than
families,
lawmakers,
teachers,
judges,
policemen, or philanthropists.
-WHEN IT COMES TO BEING
HEALTHY AND STAYING THAT „
WAY, DOCTORS KNOW BEST.
Research increasingly shows that,
while physicians can treat some
forms of disease, the patient is
responsible for the habits of health.
The factors that determine health
status are largely social, behavioral,
and environmental. They relate to
sanitation;
nutrition;
exercise;
pollution control; safety at home, at
work, in cities, and on highways; and
the ability to handle stresses of life
with skills learned at an early age.
-IF WE SPEND ENOUGH
MONEY, AND ENERGY TO
EDUCATE THE PUBLIC, WE CAN
PREVENT MOST DISEASE AND
INJURY.
With the exception of basic sanitation
continued on page 8