Ch.4 - Chriss, Social Control

1
Chapter 4

• Medical Control

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Introduction

• Louisiana, 1851
• Drapetomania
• Early example of medicalization
• Medical social control application of medical
  understandings and terminology to secure
  adherence to social norms
• Transitions
• Deviance as ignorance or vice (ancient Greece)
• Deviance as sin (Middle Ages onward)
• Deviance as badness (1600 to 1800s)
• Deviance as illness (mid-1800s, esp. with rise of
  psychiatry by late 1800s)

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Parsons Sick Role

• Illness can be considered a form of deviance
• But instead of punishment, best response is
  treatment
• Must excuse sick person (temporarily) from
  fulfilling role expectations (adaptation)
• Institutionalization of appropriate responses to
  sickness medical professionals (integration)
• Agreement that illness is undesirable (latent
  pattern maintenance)
• Responsibility to seek professional help (goal
  attainment)

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Medicine and Social Control

• Irving Zolas early statement in 1972 (p. 86)
• Making medicine and the labels healthy and ill
  relevant to more areas of human existence
• Medicalization redefining more and more social
  problems as medical problems
• States are concerned with the health and wellness
  of the citizenry
• Individual level normal medicine (body) and
  psychiatry (mind)
• Group level public health

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Definition of Mental Disorder

• Has always been hard to define
• New definition for DSM-V (p. 87)
• Occurs in an in individual
• Clinically significant distress or disability
• Not a reaction to common stressors or losses
• Reflects an underlying psychobiological
  dysfunction
• But not a result of deviance or conflicts with
  society
• No single definition can cover all possible cases
• New additions to DSM should weigh benefits of
  recognition versus harm from labeling

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Medicine and Social Control

• Public Health the art and the science of
  preventing disease, prolonging life, and
  promoting health
• Can lead to hygienization or even public
  healthification
• Governments obsessed with the health and
  well-being of citizens
• Biggest bang for the buck
• Utilitarianism, public safety are overriding
  concerns
• Even psychiatry moving more to the group level
  (e.g., relational disorders)

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More Terms

• Medicalization redefining more problems as
  medical problems
• But not a unilinear development, and not
  necessarily pushed by the medical establishment
  (e.g., doctors)
• Demedicalization earlier medical expertise and
  intervention in certain areas no longer apply
• The case of homosexuality
• Remedicalization finding new ways to medicalize
  a condition (e.g., through genetics, cognitive
  science, etc.)

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More Terms

• Biomedicalization tied to advances in medical
  technology
• Renders less relevant the human element in
  medical care and treatment
• Elevates to prominence the use of pharmacological
  interventions
• More social issues or maladies for which you can
  get a prescription drug
• Tied also to rise of managed care and reliance on
  primary care physicians rather than specialists
• Drug companies and disease mongering
• More persons willingly identifying themselves as
  patients, seeking drug treatment
• General process of pharmaceuticalization

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Therapeutic Ethos

• A cultural orientation in which the self is the
  new sacred object
• Must pay homage to feelings and emotions
• Must engage in public confessionals when caught
  in deviance
• Testifying to the greatness of medical
  intervention

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Therapeutic State

• Ascendancy of the medical model of disease as the
  prevailing ideology of the modern welfare state
  (p. 97)
• Indicators
• Therapeutic Jurisprudence
• Victims rights
• Medicalization of welfare
• Post-traumatic stress disorder (PTSD)

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Gender and Medicalization

• Impact of medicalization as it relates to
  sex/gender has passed through three phases
• Gender neutrality
• Women as victims explicit attention to
  medicalization of female issues
• Revival of reductionism explicit attention to
  male health issues

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Dark Side of Medicalization

• Dislocation of responsibility
• Culture of victimization
• Type II Error problem judging a well person to
  be sick
• Domination of expert control
• Exclusion of evil deviance has worldly causes
  which medicine can ascertain