The Medicalized Life

June 4, 2020

Medications and treatments lead to more medications and treatments, rather than true health.

n 1793, a yellow fever epidemic hit Philadelphia, where the founding father and physician Benjamin Rush advocated aggressive bleeding – the removal of large quantities of blood from either an artery or vein, often with leeches. At the time, bloodletting was a common medical practice: it was thought to balance the body’s humours (blood, phlegm, black bile, yellow bile).

Subject to intense controversy as medicine developed a stronger basis in experimental evidence, Rush’s propensity to bleed, and bleed a lot, was condemned by some of his contemporaries, although other doctors also purged their patients. By the end of the 19th century, the practice was used only for a few rare conditions.

Now, in the midst of a devastating pandemic, and as scientists work feverishly to find COVID-19 cures and a viable vaccine, we look back at Rush’s treatments as archaic, useless and likely harmful. Indeed, bleeding seems barbaric today (although leeches have been approved by the United States’ Food and Drug Administration for certain purposes).

Yet, while medical therapeutics have advanced considerably, many current treatments are also aggressive. We voluntarily undergo them because they are based on a stronger understanding of the body and mechanisms of disease. That is, we think that they really save lives, unlike bleeding, which occasionally killed patients.

Not so fast: some contemporary critics claim that modern medicine is still risky, if not more so. Consider the expansion of disease categories to include personality quirks and body types, side-effects that demand further medications, drug interactions that are deadly, and medical supervision of things left well enough alone. If 18th-century medicine lacked a scientific basis, our problem might be too many therapies for our own good.

The expansion of treatment has led to a critical response – ‘medicalisation’, which describes a skeptical approach to mainstream medicine’s social role in defining health. It also directly criticises the enlarging pharmacopoeia that is now an expected part of life in modern times. Indeed, medicalisation suggests that we could be subjecting ourselves to treatments that involve so much overkill that they are killing us – the same way we look at bloodletting today.

The medicalisation critique underpins popular interest in alternative medicine, mind-body techniques for wellbeing and, most pointedly, vaccine skepticism. The mainstream usually attributes vaccine skepticism to vaccine misinformation online, science denial and scientific illiteracy. Parents want the best for their children, the story goes, but are primed to act irrationally because they don’t understand population health risks and benefits, or they mistakenly correlate prevalent chronic illnesses to vaccinations.

But the concept of medicalisation provides another compelling frame to understand why some people refuse what others consider to be life-saving preventive medicine. It’s not that these parents distrust science in totality – it’s that they, among others, disagree that medicine should have such an authoritative role in determining how to live a healthy life. In this, they echo distinctly modern anxieties about how advancements in science and medicine might not always be good for us.

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