Medicalisation has been the subject of study by many sociologists since the 1960s, with the first main area of focus examining the medicalisation of deviance. The impact of medicine and medical concepts in the West have developed immensely over the past 50 years with the growth of medical authority and social implications around this topic (Conrad, 2007). Debates arise within society on what constitutes as a ‘real’ medical problem, who has the authority to define a problem as medical and whether medicalisation is considered a form of social control (Conrad, 2007).

Within this Social Sciences blog, we will examine the notions of ‘medicalisation’ and ‘medical imperialism’, key concepts coined by Ivan Illich (1976). We will explore and examine what is meant by both concepts, how they arose within society and how the process of medicalisation has shaped individuals’ perceptions of medicine. An analysis of case studies within the blog will look at how wider topics within society are addressed based on the notions of medicalisation. We will finish with a conclusion, on whether Illich’s notion of medical imperialism is still relevant and dominant within society today.

Medicalisation in turn is a process in which human conditions are labelled, pathologized and defined as medical conditions (Cole et.al, 2015). It is a process in which “non-medical problems are defined and treated as medical problems” (Conrad, 2007: 4).  The medical profession through medicalisation contributes to its controlled role within society, which helps sustain the “status quo for the benefit of the powerful elite or manages social change in a way that doesn’t dislodge the power of the elite” (Morrall, 2009: 121). The medical industry expands the boundaries of what is seen as ‘normal’ and ‘abnormal’ medical conditions within society that need to be fixed based on the powerful elites. It is a form or regulating and controlling ‘illness’ (Szasz, 2007).

Additionally, Illich (1975) introduced the concept of medical imperialism. We live in an epoch of tyranny from health and disease scares. Risks that are linked to particular diseases are being exaggerated, creating high levels of fear and panic among individuals and wider society. The public is bombarded with new government policies and as a result, individuals demand treatment when in fact they are healthy (Morrall, 2009).  Medicine may not be necessary and may become harmful to a patient’s overall health (Illich,1975). Industrialisation and bureaucracy are seizing areas of life which was previously regarded as private and personal. The medical field has extended its control and influence over the human body. Illich (1975) acknowledged that drugs and medical technologies remove personal responsibility and individuals are now dependent on healthcare providers. The dependence individuals have on medical professions strips away their ability to cope with their own problems and illnesses (Illich, 1976). Additionally, Illich (1975) also draws upon the idea the people have become deskilled in terms of coping with illness. The self-care and the care of family and friends has become regarded as inferior to that care provided by trained health professions (Nettleton, 2013).

Zola (1972) states that medicine is more of a focus for social control than the church or the criminal justice system. The medical profession has convinced the population that they have valuable knowledge and skills. As a result, this has decreased the persons ability to manage health and illness themselves. This allows the professionals to secure a growing market, from outside sources such as investors in private health.

The notions of medicalisation and medical imperialism are heavily linked with Iatrogenesis. For Illich, the medical profession has become extremely damaging for both the individual and society (Morrall, 2009). Modern medicine has reached the stage where, in itself, it has become a major threat to health (Illich, 1976). It has put “both health of society and individuals in jeopardy as a consequence of doctor-inflicted injuries and loss of self-autonomy” (Morrall, 2009: 123).

Illich (1976) considered three forms of iatrogenesis. First, there is clinical iatrogenesis. Illich refers to the negative consequences of medical intervention. These consequences include the damage that is done to the patients both physically and mentally from the medication that they take to the surgery they undergo (Morrall, 2009). Pharmaceutical products all come with side effects, it was recorded in 2006 that 5,000 patients in Britain alone per year are dying from “adverse reaction to their prescribed drugs” (British Medical Association in Boseley, 2006: cited in, Morrall, 2009: 123). This accounts to 1 in 10 patients globally (World Health Organisation, 2005: cited in Morrall, 2009).

Social Iatrogenesis is Illich’s second form of medical misfortune.  It is stated that the whole of society becomes dependent on the medical profession. It is where the medical profession expands to all areas of life, producing an “artificial demand for its services” (Giddens et.al, 2006: 262). Individuals become addicted not just to medication but also the medical profession (Morrall, 2009).

Cultural iatrogenesis closely links to social iatrogenesis, this is Illich’s third concept. Cultural iatrogenesis has incapacitated the individual (Morrall, 2009). This is when the ability to cope with the challenges of everyday life are progressively reduced by medical intervention (Giddens et.al, 2006). Within society, people no longer take responsibility for their own health problems (Nettleton, 2013). Illich emphasises that “medical practice promotes sickness reinforcing a morbid society that encourage people to become consumers of curative, preventative, industrial and environmental medicine” (Illich, 1973: 158). The dependency we have produces ‘medical nemesis’. The harm that is caused by medicine and the medical industry is difficult to eliminate without the need for further medical intervention, which in itself creates further harm (Barry and Yuill, 2016).

Regarding the concepts stated above, it is important to consider that there is now a stance against medicalisation. Individuals now imply that the medical industry does not have the best interests at heart for patients (Calnan and Sanford, 2004). There has been a rise in the use of online tools for self-diagnosis, relying on uncredited information for healthcare and illnesses. This shows a trend in individuals relying on uncredited sources of information regarding medicine and ignoring healthcare professionals. The de-professionalisation of medicine has been introduced due to the factors of iatrogenesis, medical imperialism and the stance against medicalisation as individuals are now relying on websites such as MedicalNet and WebMD to check their symptoms in their home without the need of being referred to a doctor (Jagosh et.al, 2011). This can have a negative affect as individuals may misdiagnose symptoms and therefore, may not get correct medical treatment (Ryan and Wilson,2008).

It is clear that the concepts mentioned above can be criticised. It is not to say that the blog will agree with Illich’s theories throughout, as we are discussing how relevant they are today. The remainder of the blog will focus on men’s, women’s and enhanced bodies and how the concepts of medicalisation can be applied to different aspects of life.

By Caitlin Martin