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The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders

Peter Conrad

ISBN: 978-0-8018-8585-3 2007 204 pages The Johns Hopkins University Press

Susie Scott
Department of Sociology, University of Sussex, United Kingdom

Sociology has a long-standing, and complex relationship with medicine. Its role has been variously critical, exploratory, cautious and revelatory, creating many opportunities for dialogue between the two disciplines. Now two books are published which comment on the dimensions of this relationship, drawing on empirical studies, theoretical debates and analytical methodologies.

Peter Conrad’s The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders, revisits a classic debate within sociology. The medicalisation thesis refers to the extent to which medicine is encroaching upon everyday life as more and more non-medical, arguably social problems come to be re-defined as illnesses or disorders (Zola 1972; Conrad & Schneider 1980). ... In this new volume, Conrad brings together data from these and more recent studies, demonstrating the continuing relevance of the medicalisation thesis to social and political thought.

The structure of the book is balanced and logical. Conrad begins with a definition of medicalisation, its key concepts and some recent examples: the medicalisation of obesity, Pre-Menstrual Syndrome, Post-Traumatic Stress Disorder, and so on. He then examines four case studies, each of which demonstrates a unique conceptual dimension of medicalisation:

• its extension from ‘female' problems to those affecting both genders
• its diagnostic expansion to affect larger sections of the population
• biomedical enhancement of the body through growth hormones and surgery, and
• the continuity or re-medicalisation of conditions that had been de-medicalised, namely homosexuality.

The final section of the book considers some methodological issues, social consequences and policy implications associated with the medicalisation of society: if indeed such a process is taking place.

The four empirical chapters comprise the majority of the book, and successfully demonstrate the widening net of medicalisation:

Chapter 2 provides some original insights into the ways in which male bodies are increasingly subjected to the ‘clinical gaze' (Foucault 1997), in the context of concerns about our ageing - and ageist - society. Conrad identifies three new medical conditions here, which have always existed but only recently defined as problematic: andropause (or the male menopause), baldness, and erectile dysfunction. He argues that the medical treatments offered for these conditions ... reveal more about Western culture's obsession with youth than about any individual's physical constitution.

Chapter 3 addresses the issue of ‘domain expansion', insofar as the definitional boundaries of medicalised social problems tend to widen. This is illustrated by the case of Attention Deficit Hyperactivity Disorder (ADHD), which was identified in the 1970s as a children's illness but has recently been applied as a diagnostic label to adults as well. Conrad explores the social consequences of this, such as the reduction of blame and stigma for ‘underperforming' adults in the workplace or in higher education, which reminds us alongside the negative implications of medicalisation, of the many benefits that tend to be overlooked (Broom & Woodward 1996).

Chapter 4 examines the introduction of the human growth hormone (hGH) in 1985 as a treatment for short stature in children, even when there is no evidence of a hormone deficiency, and later to improve the fitness levels of athletes. As in Chapter 2, Conrad relates this to the pursuit of cultural values of youth, beauty and longevity through regimes of self-improvement, but also points to the role of the pharmaceutical industry in advertising ‘off-label' drugs.

In Chapter 5, Conrad makes an interesting argument about the sequential stages of medicalisation, de-medicalisation and re-medicalisation that have affected homosexuality, in line with changing social attitudes.

Following on from these chapters, Part 3 of the book considers the methodological question of how to ‘measure' medicalisation; the various driving forces behind it (consumers, the pharmaceutical industry and managed care), and its social consequences. Not surprisingly, this final chapter emphasises the more negative implications - the ‘pathologisation of everything' and the expansion of medical power and knowledge - but there is some discussion of the aforementioned benefits.

This is an extremely interesting, timely and thought-provoking book, which will have a wide appeal amongst academics. Medical sociologists will welcome the opportunity to see Conrad's various writings brought together in one volume, and will appreciate the way he has revisited and updated his own work. The book is written in a style primarily aimed at postgraduate or faculty researchers in the field, but would also be accessible and engaging to more advanced undergraduate students. It could provide a helpful addition to reading lists for courses on the sociology of health and illness, the sociology of science, and perhaps also those on medical law and politics. Readers can study the complete text or dip into individual chapters, each of which has a self-contained, clear line of argument.

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