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Chapter 10
ERIC PRUITT, MATT REDEKER, BETHANY HAWKINSON, MICHAEL HART
America Society as fertile ground
for medicalization.

•The medicalization of deviance has been nowhere more
persuasive than in the United States.

•Some people view America as the “Noble Experiment” because
it’s society is regularly open to new ideas and innovative ways of
doing things to solve problems.
America Society as fertile ground
for medicalization.

•American society has provided a particularly hospitable
environment for the Medicalization of Deviance.

•Humanitarianism is deeply-grained in Americas ethos.

•Along with Idealism and Humanitarianism, Americans have shown
a strong penchant for pragmatism for pragmatic solutions for
human problems.
America Society as fertile ground
for medicalization.

•Rather than engaging in philosophical or even a scientific debate
towards more full understandings of problems. Americans will mostly
ask “What can be done about it?” *giving power to who*

•Americas values is tipped more towards the individual. Certainly
when solving social problems, typical solutions involves intervention
not in established institutions of societies but rather the individuals
life.
America Society as fertile ground
for medicalization.

•This strategy is based on the assumption that the problem lies within
the person not the diverse conflicted social and cultural
environment.

•In a general sense American value of experimentation, newness,
humanitarianism, pragmatism, and individualism, all contributed to
a nurturing crucible for the medicalization for the medical
perspective of deviance.

•Health is used as a justification for controlling powerful
corporations, and as a criterion for defining activities as deviant. Ex.
“cigarette smoking and alcohol drinking”
America Society as fertile ground
for medicalization.

•In a society where high value is placed on health it isn’t surprising
the “sick” are considered “deviant” and the “deviant” is considered
“sick” because in both cases this commitment to health serves as a
justification for the treatment and control of the undesirable persons.

•Medicine is highly profitable in a capitalist society.

•In a capitalist society, medicalization can create new markets to
be highly profitable.
The Sequential Model

Five stage sequential model for the medicalization of deviance
1.
Definition of behavior as deviant
2.
Prospecting medical discovery
3.
Claims-making: Medical and Non-medical interests
4.
Legitimacy: Securing medical turf
5.
Institutionalization of a medical deviance designation
Prospecting Medical Discovery

The “discovery” of a medical conception of deviant behavior in a
professional medical journal in a form of a description of a new
diagnosis.

The articles are usually the product of work of a limited number of
physicians, usually researches specializing in the problem.

It’s prospecting for two reasons
1.
They can be buried or quietly refuted
2.
The articles are large, formal, informational, and represent a view point
to be “challenged” only in the most academic sense.
Claims-making: Medical & NonMedical

This is the key stage in emergence of new deviance destinations

Point when champions, moral entrepreneurs, & organized interest
begin actively to make claims in attempt to expand the medical
social control turf

Both medical and non-medical interest engage in claims-making
activities.
Claims-making: Medical & NonMedical Cont.

Small group claim-makers, are by and large, not organized
specifically around the promotion of new medical deviance but
came together because their similar professional interest and
viewpoints.

Some come together in professional forums and conferences at
which to display their claims to promote their views to others

The activities of non-medical claim-makers are more overt, and they
usually draw on already made professional claims

Media disseminates information, creating public pressure for new
designation of deviance (which creates a demand for new medical
treatment)
Legitimacy: Securing medical turf

This happens when proponents of the medical deviance
designation launch an instrumental to challenge the existing
deviant designation.

Usually involves some type of appeal to the state to recognize the
medical view point

The most common areas of conflict are legislatures and courtrooms

A “victory” here for the medical designation means the passage of
laws supportive of the medical viewpoint. Which grants medical
jurisdiction over the question of social control.
Legitimacy: Securing medical turf
Cont.

The professional dominance of medicine doesn’t extend to the
authority to override the criminal definition of deviance.

The state grants the right to a particular social control turf

When medical claim-makrs and their supporters achieve legitimacy
for their deviance designations, we say a claim has been
successfully staked.

Becoming institutionalized makes them less prone challenges
Institutionalization of medical
deviance designation

When a deviance designation is institutionalized, it reaches state of
fixity and supereminences

There are two types of instituatinalization:

1.
Codification
2.
Bureaucratization
Codified- becomes accepted as port of the official medical legal
classification system. Written into low and supported by the courts
decision.
Institutionalization of medical
deviance designation Cont.

Bureaucratization- The creation of large scale organizations, another
form of institutionalization. They support medicalization by providing
research money, technical assistance, and support from specific
viewpoints of deviance.

These bureaucratic “industries’ with large budgets and many
employees depend on existence by the acceptance form
deviance designation

Most cases of medicalization of deviance “lags behind’ professional
and bureaucratic support, which the public remains skeptical
Medicalization and
demedicalization of deviance are
cyclical phenomena

The changes to deviance designations do not all flow in one
direction, there is movement back and forth between badness and
sickness designations.

Examples: opiate addiction, homosexuality

Sickness redesignated as badness

What factors spur a cyclical shift in deviance designations?
Medical designations of deviance
are more often promoted as a
“foil” against criminal definitions
than as ends in themselves.

The champions of medical designations presented their claims
specifically as a critique of the dominant or ascending criminal
definition.

Time and again, medical and especially, nonmedical reformers
championed medical conceptions as a critique of harsh and
punitive practices.

These claims-makers often promoted medical definitions, not for
their own sake as more “valid” or “true” conceptions of reality, but
as “humanitarian” challenges to what they saw as excessively
punitive practices.
Only a small segment of the
medical profession is involved in
the medicalization of deviance.

Although these claims-making physicians are few in numbers, their
participation is central and critical to successful medicalization.

It is their conceptualization of the behavior or condition as a
medical problem that provides the rationale and justification for
medical designations of deviance, as well as supplying ammunition
for claims-making battles.

It is only when a medical claim is successfully staked and becomes
part of standard medical practice that most physicians have much
to do with it.
When medical designations of
deviance are proposed, they most
likely will be based on the notion of
“compulsivity.”

Compulsivity- the individual “cannot help it”
Medicalization and
demedicalization are political and
not scientific achievements.

Although science and medicine add prestige and authority to any
claim, supporters must still engage in the contests necessary to get
their claim recognized.

This is always a political process.

Medical technology
Sociologists as challengers

Sociologists are sometimes active participants in the contests of
deviance designations.

Many sociologists do adopt the medical model in their research;
sociological analyses represent a consistent potential challenge to
medical claims.
Hunches and hypotheses: notes for
further research

It appears that the medicalization of deviance increases after a
failure or crisis in previous systems of social control.

As a particular kind of deviance becomes a middle-class rather
than solely a lower-class “problem,” the probability of
medicalization increases.

Medicalization increases directly with its economic profitability.
In conclusion

The medicalization of deviance is an abiding feature of contempory
American society

It won’t disappear or decrease and is likely to expand and medical
definition will continue to be proposed
Journal Question

Deviance in the lower-class life is considered badness, but when it is
also a middle-class phenomenon only then is it considered a
sickness. Do you agree with this?