9_Medicalization and Social Control - Conrad

9_Medicalization and Social Control - Conrad - 216 CONRAD...

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Unformatted text preview: 216 CONRAD likely replace other forms of control; while this has not occurred, it can be argued that medical social control has continued to expand (see below, The Range of Medicalization). While numerous definitions of medical social control have been offered (Pitts 1968, Zola 1972, Conrad 1979, O’Neill 1986), in terms of medicalization “the greatest social control power comes from having the authority to define certain behaviors, persons and things” (Conrad & Schneider 1980a28). Thus, in general, the key issue remains definitional—~the power to have a particular set of (medical) definitions realized in both spirit and practice. This is not to say that medical social control is not implemented by the medical profession (it generally is), or that it is not abetted by powerful forms of medical technology (it often is). It is to say that without medicalization in a definitional sense, medical social control loses its legitimacy and is more difficult to accomplish. The development of a technique of medical social control (e. g. a pharmaceutical intervention) may precede the medicalization of a problem, but for implementation some type of medical definition is necessary (e. g. Conrad 1975). More typically, however, medicalization pre- cedes medical social control. In the context of medicalizing deviance, Conrad (1979) distinguished three types of medical social control: medical ideology, collaboration, and technol- ogy. Simply stated, medical ideology imposes a medical model primarily because of accrued social and ideological benefits; in medical collaboration doctors assist (usually in an organizational context) as information providers, gatekeepers, institutional agents, and technicians; medical technology sug— gests the use for social control of medical technological means, especially drugs, surgery, and genetic or other types of screening. While these are overlapping categories, they do allow us to characterize types of medical social control. Perhaps the most common form is still “medical excusing” (Halleck 1971), ranging from doctor’s notes for missing school to disability benefits, to eligibility to the insanity defense. To these categories we can add a fourth-medical surveillance. Based on the work of Foucault (1973, 1977), this form of medical social control suggests that certain conditions or behaviors become perceived through a “medical gaze” and that physicians may legitimately lay claim to all activities concerning the condition. Perhaps the classic example of this is childbirth, which, despite all the birthing innovations of the last two decades (Wertz & Wertz 1989), remains firmly under medical surveillance. Indeed, the medical surveillance of obstetrics has now expanded to include prenatal lifestyles, infertility, and postnatal interaction with babies (Arney 1982). Some significant developments have occurred in medical social control .over the past decade. In terms of ideological control, PMS (premenstrual syndrome) has emerged as an explanation of a variety of types of female ...
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