Medicalisation: A Multi-dimensional Concept

Abstract

Originally, the concept of medicalisation was strongly associated with medical dominance, involving the extension of medicine's jurisdiction over erstwhile ‘normal’ life events and experiences. More recently, however, this view of a docile lay populace, in thrall to expansionist medicine, has been challenged. Thus, as we enter a post-modern era, with increased concerns over risk and a decline in the trust of expert authority, many sociologists argue that the modern day ‘consumer’ of healthcare plays an active role in bringing about or resisting medicalisation. Such participation, however, can be problematic as healthcare consumers become increasingly aware of the risks and uncertainty surrounding many medical choices. The emergence of the modern day consumer not only raises questions about the notion of medicalisation as a uni-dimensional concept, but also requires consideration of the specific social contexts in which medicalisation occurs. In this paper, we describe how the concept of medicalisation is presented in the literature, outlining different accounts of agency that shape the process. We suggest that some earlier accounts of medicalisation over-emphasized the medical profession's imperialistic tendencies and often underplayed the benefits of medicine. With consideration of the social context in which medicalisation, or its converse, arises, we argue that medicalisation is a much more complex, ambiguous, and contested process than the ‘medicalisation thesis’ of the 1970s implied. In particular, as we enter a post-modern era, conceptualizing medicalisation as a uni-dimensional, uniform process or as the result of medical dominance alone is clearly insufficient. Indeed, if, as Conrad and Schneider (1992) suggested, medicalisation was linked to the rise of rationalism and science (ie to modernity), and if we are experiencing the passing of modernity, we might expect to see a decrease in medicalisation.