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MEDICINE AS AN INSTITUTION OF
SOCIAL CONTROL
• Introduction:
• Frist conceptualized as an agent of social control by
Talcot Parsons in 1951
• Boundaries of medicine are elastic and expansive
• Medical social control- the way medicine specifically
secures adherence to social norms by minimizing,
eliminating or normalizing deviant behavior
THREE MAJOR IDEAL TYPES
• 1) Acceptance of medical perspective
• Example, a well balanced diet is healthy
2) Professional medical intervention
- Example, medical treatment (sick to not sick)
3) Medicalizing deviant behavior
- Example, underlying illnesses, symptom or disease
MEDICAL TECHNOLOGY
• Specialized medicine is growing
• Medicines fro disorders is now more prevalent
• Medicines are powerful, profitable potent and easily administered as
well as the treatment of choice in most cases
• Psychosurgery developed in 1930’s
• Behavior modification (discussed in class)
• Genetic explanations along with chromosome research and genetic
counseling have also been delved into as the cause of some
behaviors
MEDICAL COLLABORATION/
IDEOLOGY
• Collaboration idea, Physician serves as gate keeper of knowledge
regarding medical issues
• Highlights how medicine is woven into society
• Relieves patient of certain obligations demonstrating the power of
the medical excuse
• Ideology, A type of social control that involves defining behavior as
an illness because of social and ideological benefits because it is
conceptualized in medical terms
• Can also benefit individual or the dominant interest in society
THE BRIGHTER SIDE
• Humanitarian
• Sick Role
• Optimistic view for deviant
• Prestige of the Medical Profession
• Flexible and more efficient than legal controls
RESPONSIBILITY
• Medicalization diminishes responsibility from the
individual
• Separated from social action
• Lowering of status
• “not-completely-responsible” become dependent on the
responsible “non-sick”
POWER OF MEDICAL PROFESSION
• Medicine influenced by moral order of society
• Deviant behavior is labeled as medical problem society
deems it no longer deviant
• Problem defined as medical it is removed from discussion
among the public. Placed in a position where only
medical experts can discuss the issue.
TRENDS IN MEDICINE AND
MEDICALIZATION
• Due to the increasingly technological nature of medicine, medical practice has become increasingly
specialized. 80% of physicians considered themselves specialists in the early 1970s compared to
only 20% in 1940.
• Medicine is the fastest expanding part of the service sector with expenditures increasing more
than 10% yearly while the rest of the economy has grown by 6% to 7%.
• Rising costs of medical care has been attributed to the growth in third-party payments. Because
of this, “third parties” are increasingly deciding what is appropriate medical care and what is not
depending on what they help cover.
• Hospitals are becoming the center for health care delivery rather than private offices.
• Federal programs in the 1960s expanded medical schools increasing the amount of physicians. An
increase in medical personnel could increase the number of problems that become defined as
medical problems.
TRENDS IN MEDICINE AND
MEDICALIZATION CONT.
• Countertrends:
• Health is becoming defined as more of a personal responsibility and could potentially spur some
demedicalization.
• A “right to adequate health care” and the development of a National Health Insurance (NHI)
program.
• Possible scenarios resulting from enacting an NHI bill:
• Fewer deviant behaviors are defined as medical problems due to the high cost of paying for
treatment.
• More deviant behaviors will become medical problems because anything defined as a medical
problem is treated.
• Individuals are not considered responsible for their illnesses; so activities leading to medical
problems become defined as deviant and certain medical problems could be excluded from NHI
coverage.
PUNITIVE BACKLASH
• Since about 1970 there has been a “backlash” against the
“liberalization” of the treatment of deviance.
• In 1973, New York passed a “get tough” law with mandatory prison
sentences for drug dealers.
• Antiabortion are aiming to criminalize abortion and
antihomosexuality crusades are tying to limit the rights of
homosexuals.
• Swell in pubic action may be a response to the therapeutic ideology
and the perceived “coddling” of deviants and may cause a retreat
from the medicalization of deviance.
SOME SOCIAL POLICY
RECOMMENDATIONS
1.
The medicalization of deviance needs to be recognized as a
de facto social policy.
2.
Research is needed on the extent of medicalization, its
benefits, and its costs.
3.
Medicalization removes the constitutional safeguards of the
judicial process.
4.
Social policies toward deviance that hold people accountable
for their actions but do not blame them need to be
developed.
MEDICALIZATION OF DEVIANCE: A
FINAL NOTE
• The increasing dominance of the medical professional, the discovery of subtle
physiological correlates of human behavior, and the creation of medical
technologies have advanced the potential for medicalizing deviance.
• Medicalization has reduced societal condemnation of deviants but these benefits
do not mean these conditions are in fact diseases or the same results could not be
achieved in another manner.
• The most difficult consequence of medicalization to discuss is the exclusion of evil.
• Our own socialization and “liberal” assumptions make it difficult to view
individuals as “evil.”
MEDICAL SOCIAL CONTROL
•
Defining behavior as a medical problem allows certain things to be done
that could not other wise be considered.
•
Psychosurgery on an individual prone to violent outbursts requires a
diagnosis that something is wrong with his brain or nervous system.
•
•
These net and increasingly popular forms of medical control could not be used
without the prior medicalization of deviant behavior.
Not implying overt malevolence on the part of the medical profession,
but rather it is a part of a larger process, of which the medical
profession is only a part.
•
If a mechanism of medical social control seems useful, then the deviant behavior
it modifies will be given a medical label or diagnosis.
INDIVIDUALIZATION OF SOCIAL
PROBLEMS
• The medicalization of deviance is part of a larger phenomenon that is prevalent
in our society; the individualization of social problems.
• We tend to look for causes and solutions to complex social problems in the individual rather
that in the social system.
• “blaming the victim”
• Rather than seeing certain deviant behaviors a symptomatic of social conditions,
the medical perspective focuses on the individual, diagnosing and treating the
illness itself and generally ignoring the social situation.
• Hyperkeninesis is a good example of this.
• By giving medications, we are essentially supporting the existing social and
political arrangements in that it becomes a “symptom” of an individual disease
rather than a possible “comment” on the nature of the present situration.
DEPOLITICIZATION OF DEVIANT
BEHAVIOR
• Result of both the process of medicalization and the individualization of social
problems.
• By defining the overactive, restless, and disruptive child as hyperkinetic, we
ignore the meaning of the behavior in the context of the social system.
• Medicalizing deviant behavior precludes us from recognizing it as a possible intentional
repudiation of existing political arrangements.
• The medical ideal of early intervention may lead to early labeling and
secondary deviance.
• “The medical rule,” which approximates “when in doubt, treat,” is nearly the converse of the
legal dictum “innocent until proven guilty” and may unnecessarily enlarge the population of
deviants.
EXCLUSION OF EVIL
• While it is not the sole cause of the exclusion of evil, medicalization contributes to
the exclusion of concepts of evil in our society.
• Medical definitions of deviance serve to further exclude evil from our view.
• There are at least two different types of evil: evil intent and evil consequence.
• In either case medicalization dilutes or obstructs us from seeing evil.
• Susan Sontag has suggested that on a cultural level, we use the metaphor of
illness to speak of various kinds of evil.
• We suggest that the medicalization of social problems detracts from our
capability to see and confront the evils that face our world.
• The “darker” side of the medicalization of deviance has profound consequences
for the putative or alleged deviant and society.
MEDICALIZATION OF DEVIANCE AND
SOCIAL POLICY
•
“Social policy” may be characterized as an institutionalized definition of
a problem and its solutions.
•
In a complex society, social policy is only rarely implemented as a direct
and self conscious master plan.
•
•
It is far more common for social policies to evolve from the particular definitions
and solutions that emerge from various political processes.
The medicalization of deviance never has been a formalized social
policy.
•
It’s emerged from various combinations of turf battles, court decisions, scientific
innovations, political expediences, medical entrepreneurship, and other
influences.