The Engineering of Health: A Model for Critiquing and Assessing Medicalization
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Medicalization refers to the process by which human conditions are transformed into medical problems. While conceptualized initially as a critical tool in sociology, medicalization has since evolved, leading to its application beyond disease to enhancement-oriented practices. This paper proposes a new model for evaluating medicalization through the lens of technology, drawing on the philosophy of medicine and the intersection of medicine and technology. It argues that current sociological approaches, particularly Conrad’s framework, often neglect foundational concepts such as disease ontology and the epistemology of medicine. The author introduces the idea of medicalization as a socio-technical system, governed by instrumental rationality akin to engineering sciences, as opposed to the practical wisdom (phronesis) that governs medical practice. Central to the proposed model is a hybrid concept of disease, combining descriptive (biological dysfunction) and normative (harm) criteria, inspired by Wakefield’s “harmful dysfunction” model. This distinction allows for a more precise differentiation between legitimate medical practice and over-medicalization. The paper categorizes medicalization into disease-oriented and health-oriented types, each with distinct evaluation criteria. Disease-oriented medicalization is assessed based on the presence of real pathology, justification of demand, appropriateness of medical intervention, and safety. Health-oriented medicalization—e.g., cosmetic interventions—is judged through technology assessment rather than traditional clinical frameworks. Ultimately, the model aims to protect the integrity of medicine while acknowledging the role of biomedical technology and commercial interests. It calls for a transdisciplinary and contextualized approach to evaluating medicalization that includes public engagement, social sciences, and critical oversight to prevent the commodification of health.
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Aristotle. (2009). The Nicomachean Ethics. Oxford University Press. https://books.google.com.bz/books?id=4APQIW-TWwkC&hl=it&source=gbs_navlinks_s
Ballard, K., & Elston, M. A. (2005). Medicalization: A multi-dimensional concept. Social Theory & Health, 3, 220–241. https://doi.org/10.1057/palgrave.sth.8700053
Bodea, A. (2016). Medicalization Encyclopedia of Global Bioethics. Springer. https://doi.org/10.1007/978-3-319-09483-0_283
Clarke, A. E., & Shim, J. (2011). Medicalization and biomedicalization revisited: Technoscience and transformation of health, illness, and American medicine. Handbook of the Sociology of Health, Illness, and Healing: A Blueprint for the 21st Century. https://doi.org/10.1007/978-1-4419-7261-3_10
Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology, 18, 209–232. https://doi.org/10.1146/annurev.soc.18.1.209
Conrad, P. (2005). The Shifting Engines of Medicalization. Journal of Health and Social Behavior, 46(1), 3–14. https://doi.org/10.1177/002214650504600102
Conrad, P. (2007). The Medicalization of Society: On the Transformation of Human Conditions. https://doi.org/10.56021/9780801885846
Davis, J. E. (2010). Medicalization, Social Control, and the Relief of Suffering: The New Blackwell Companion to Medical Sociology. https://doi.org/10.1002/9781444314786.ch10
Frawley, A. (2015). Medicalization of Social Problems: Handbook of the Philosophy of Medicine. https://link.springer.com/rwe/10.1007/978-94-017-8688-1_74
Gadamer, H. G. (1996). The Enigma of Health: The Art of Healing in a Scientific Age. Stanford University Press. https://books.google.de/books/about/The_Enigma_of_Health.html?id=vtWSMenMOZgC&redir_esc=y
Hofmann, B. (2016). Medicalization and Overdiagnosis: Different but Alike. Medicine, Health Care and Philosophy, 19, 253–264. https://doi.org/10.1007/s11019-016-9693-6
Maturo, A. (2010). Medicalization: Current Concept and Future Directions in a Bionic Society. Mens Sana Monographs, 10, 122–133. https://doi.org/10.4103/0973-1229.91587
Monajemi, A. (2016). How to Prescribe Information: Health Education Without Health Anxiety and Nocebo Effects Biosemiotic Medicine. Springer. https://doi.org/10.1007/978-3-319-35092-9_7
Monajemi, A. (2018). Clinical Practice in the Techno-Science Age: Living in Crisis. International Journal of Body, Mind, and Culture, 5(2), 84–88. https://ijbmc.org/index.php/ijbmc/article/view/123
Monajemi, A. (2023). Medicalization Encyclopedia of Islamic Medical Ethics (Vol. 3).
Monajemi, A., Ayatollahi, H., & Moinzadeh, M. (2014). Medicalization as Technology Based on Heidegger, Borgmann, and Feenberg's Ideas on the Philosophy of Technology. Journal of Philosophy of Science, 3(6), 99-118. https://philosophy.ihcs.ac.ir/article_1041.html?lang=en
Monajemi, A., & Moghadam-Heidari, G. H. (2022). Medicalization: Transformation of Human Conditions into Treatable Problems. Farhameh Publishers.
Monajemi, A., & Moghadam, H. G. (2019). Medicalization as Technology: Frankenstein or Prometheus? Roozegareno Publishers.
Monajemi, A., & Mousavi, A. H. (2022). Medicalization of Complementary and Alternative Medicine: a Historical-Critical Analysis. Iranian Journal of Medical Ethics and History of Medicine, 15(1), 1-17. https://doi.org/10.18502/ijme.v15i1.11797
Monajemi, A., & Shabani, M. (2023). Medicalization and Technology: The Analysis of Healthism from the Perspective of Postphenomenology. Philosophy of Science, 12(2), 237-259. https://philosophy.ihcs.ac.ir/article_8521.html?lang=en
Sadegh-Zadeh, K. (2013). Handbook of Analytic Philosophy of Medicine. Springer. https://doi.org/10.1007/978-94-007-2260-6
Sadler, J. Z., Jotterand, F., Lee, S. C., & Inrig, S. (2009). Can Medicalization be Good? Situating Medicalization within Bioethics. Theory in Medicine and Bioethics, 30(6), 411–425. https://doi.org/10.1007/s11017-009-9122-4
Sholl, J. (2017). The Muddle of Medicalization: Pathologizing or Medicalizing? Theoretical Medicine and Bioethics, 38(4), 265–278. https://doi.org/10.1007/s11017-017-9414-z
Wieland, W. (2002). The Character and Mission of the Practical Sciences, as Exemplified by Medicine. Poiesis and Praxis, 1, 123–134. https://doi.org/10.1007/s10202-002-0014-1
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