Medicalization, medical necessity, and feminist medicine

Bioethics

Volumn 15, Issue 3, 2001, Pages 248-261

  Purdy, Laura ^a  

^a WELLS COLLEGE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONSUMER; ETHICS; FEMININITY; HUMAN RIGHTS; MATERNAL WELFARE; MEDICAL PRACTICE; MEDICAL TECHNOLOGY; SCIENCE;

ANALYTICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH;

ABORTION, INDUCED; FEMALE; FEMINISM; GOALS; HUMANS; MEDICINE; PHILOSOPHY; PREVENTIVE MEDICINE; SOCIOLOGY, MEDICAL; WOMEN; WOMEN'S HEALTH; WOMEN'S HEALTH SERVICES;

EID: 0035001052     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00235     Document Type: Article

References (55)

1. Thanks to Anne Donchin and Ann Garry for their enormously helpful comments on earlier drafts. Thanks, too, to Patrycja Maksalon for her thoughtful response, and to Barbara Secker for guidance on the literature of medicalization. An earlier version of this paper was presented at a meeting of the North American Society for Social Philosophy at the Eastern Division Meeting of the American Philosophical Association, Dec. 28, 1999, in Boston.
2. Edward O. Laumann, Anthony Paik, and Raymond C. Rosen. Sexual Dysfunction in the United States: Prevalence and Predictors. JAMA 1999; 281: 537.
3. Denise Grady. Sure, We've Got a Pill for That. New York Times. February 14, 1999: 1, 5.
4. 'Medicalization' is not listed in the index of The New Our Bodies, Ourselves, by the Boston Women's Health Collective, a successor of the original bible of the women's health movement. Awareness of the problems of medicalization is pervasive in the book; see for example, 'The Politics of Women and Medical Care,' pp. 651-98, and 'Organizing for Change,' pp. 699-712 in the current edition (NY: Simon & Schuster, 1992).
5. See, for example, Irving Kenneth Zola. Medicine as an Institution of Social Control. Sociological Review 1972; 20: 487-504; Catherine Kohler Riessman. Women and Medicalization: A New Perspective. Social Policy 1983; 14: 3-18; Renee Fox. The Medicalization and Demedicalization of American Society. Daedalus 1977; 106: 9-22; Peter Conrad. Medicalization and Social Control. Annual Review of Sociology 1992; 18: 209-232; and Peter Conrad and Joseph W. Schneider. Deviance and Medicalization: From Badness to Sickness (expanded edition) Philadelphia. Temple University Press.
6. See, for example, Irving Kenneth Zola. Medicine as an Institution of Social Control. Sociological Review 1972; 20: 487-504; Catherine Kohler Riessman. Women and Medicalization: A New Perspective. Social Policy 1983; 14: 3-18; Renee Fox. The Medicalization and Demedicalization of American Society. Daedalus 1977; 106: 9-22; Peter Conrad. Medicalization and Social Control. Annual Review of Sociology 1992; 18: 209-232; and Peter Conrad and Joseph W. Schneider. Deviance and Medicalization: From Badness to Sickness (expanded edition)Philadelphia. Temple University Press.
7. See, for example, Irving Kenneth Zola. Medicine as an Institution of Social Control. Sociological Review 1972; 20: 487-504; Catherine Kohler Riessman. Women and Medicalization: A New Perspective. Social Policy 1983; 14: 3-18; Renee Fox. The Medicalization and Demedicalization of American Society. Daedalus 1977; 106: 9-22; Peter Conrad. Medicalization and Social Control. Annual Review of Sociology 1992; 18: 209-232; and Peter Conrad and Joseph W. Schneider. Deviance and Medicalization: From Badness to Sickness (expanded edition) Philadelphia. Temple University Press.
8. See, for example, Irving Kenneth Zola. Medicine as an Institution of Social Control. Sociological Review 1972; 20: 487-504; Catherine Kohler Riessman. Women and Medicalization: A New Perspective. Social Policy 1983; 14: 3-18; Renee Fox. The Medicalization and Demedicalization of American Society. Daedalus 1977; 106: 9-22; Peter Conrad. Medicalization and Social Control. Annual Review of Sociology 1992; 18: 209-232; and Peter Conrad and Joseph W. Schneider. Deviance and Medicalization: From Badness to Sickness (expanded edition) Philadelphia. Temple University Press.
9. See, for example, Irving Kenneth Zola. Medicine as an Institution of Social Control. Sociological Review 1972; 20: 487-504; Catherine Kohler Riessman. Women and Medicalization: A New Perspective. Social Policy 1983; 14: 3-18; Renee Fox. The Medicalization and Demedicalization of American Society. Daedalus 1977; 106: 9-22; Peter Conrad. Medicalization and Social Control. Annual Review of Sociology 1992; 18: 209-232; and Peter Conrad and Joseph W. Schneider. Deviance and Medicalization: From Badness to Sickness (expanded edition) Philadelphia. Temple University Press.
10. See Jana Sawicki. 1991. Disciplining Mothers: Feminism and the New Reproductive Technologies. In Disciplining Foucault: Feminism, Power, and the Body. NY. Routledge: 119, n. 15.
11. Kathryn Morgan. 1998. Contested Bodies, Contested Knowledges: Women, Health, and the Politics of Medicalization. Agency, Autonomy, and Politics in Women's Health, Susan Sherwin (ed.). Philadelphia. Temple University Press; and Marcel Verweij. Medicalization as a Moral Problem for Preventive Medicine. Bioethics 1999; 13: 89-113.
12. Kathryn Morgan. 1998. Contested Bodies, Contested Knowledges: Women, Health, and the Politics of Medicalization. Agency, Autonomy, and Politics in Women's Health, Susan Sherwin (ed.). Philadelphia. Temple University Press; and Marcel Verweij. Medicalization as a Moral Problem for Preventive Medicine. Bioethics 1999; 13: 89-113.
13. Morgan, Contested Bodies, p. 86.
14. Conrad, Medicalization and Social Control, p. 211.
15. Sawicki, Disciplining Mothers, p.119, n. 15.
16. Conrad, op. cit., pp. 212-13.
17. Riessman, Women and Medicalization, p. 3; Morgan, Contested Bodies, p. 102ff.
18. Riessman, Women and Medicalization, p. 3; Morgan, Contested Bodies, p. 102ff.
19. Kwok Wei Leng. 1997. Menopause and the Great Divide: Biomedicine, Feminism, and Cyborg Politics. In Reinterpreting Menopause: Cultural and Philosophical Issues, Paul Komesaroff, Philipa Rothfield, and Jeanne Daly (eds.). NY. Routledge: 256.
20. Catherine Kohler Riessman, op. cit., p. 15.
21. Paula Treichler. 1990. Feminism, Medicine and the Meaning of Childbirth. In Body/Politics: Women and the Discourses of Science, Mary Jacobus, Evelyn Fox Keller, and Sally Shuttleworth (eds.). NY. Routledge.
22. Sawicki, op. cit., p. 91.
23. John Stuart Mill. 1970. The Subjection of Women. In Essays on Sex Equality. Alice S. Rossi (ed.). Chicago. University of Chicago Press.
24. Christine Pierce. 1977. Natural Law Language and Women. In Sex Equality. Jane English (ed.). Englewood Cliffs, NJ. Prentice Hall.
25. See Adele E. Clarke and Virginia L. Oleson. 1999. Revising, Diffracting, Acting. In Revisioning Women, Health, and Healing: Feminist, Cultural, and Technoscience Perspectives, Adele E. Clarke and Virginia L. Oleson (eds.). NY. Routledge. They recount developments in feminist theory in the last twenty years, describing one strand of that development as what they call 'complicating the binaries' (p. 6).
26. Among the works that I've found riveting are: Sandra Harding. 1986. The Science Question in Feminism. Ithaca. Cornell University Press; Ruth Bleier. 1984. Science and Gender. NY. Pergamon Press; and Bonnie B. Spanier. 1995. Im/Partial Science: Gender Ideology in Molecular Biology. Bloomington. Indiana University Press. These constitute only a small sample of the eye-opening feminist work here. For a helpful discussion of construction, see Ian Hacking. 1999. The Social Construction of What? Cambridge, Mass. Harvard University Press.
27. Among the works that I've found riveting are: Sandra Harding. 1986. The Science Question in Feminism. Ithaca. Cornell University Press; Ruth Bleier. 1984. Science and Gender. NY. Pergamon Press; and Bonnie B. Spanier. 1995. Im/Partial Science: Gender Ideology in Molecular Biology. Bloomington. Indiana University Press. These constitute only a small sample of the eye-opening feminist work here. For a helpful discussion of construction, see Ian Hacking. 1999. The Social Construction of What? Cambridge, Mass. Harvard University Press.
28. Among the works that I've found riveting are: Sandra Harding. 1986. The Science Question in Feminism. Ithaca. Cornell University Press; Ruth Bleier. 1984. Science and Gender. NY. Pergamon Press; and Bonnie B. Spanier. 1995. Im/Partial Science: Gender Ideology in Molecular Biology. Bloomington. Indiana University Press. These constitute only a small sample of the eye-opening feminist work here. For a helpful discussion of construction, see Ian Hacking. 1999. The Social Construction of What? Cambridge, Mass. Harvard University Press.
29. Among the works that I've found riveting are: Sandra Harding. 1986. The Science Question in Feminism. Ithaca. Cornell University Press; Ruth Bleier. 1984. Science and Gender. NY. Pergamon Press; and Bonnie B. Spanier. 1995. Im/Partial Science: Gender Ideology in Molecular Biology. Bloomington. Indiana University Press. These constitute only a small sample of the eye-opening feminist work here. For a helpful discussion of construction, see Ian Hacking. 1999. The Social Construction of What? Cambridge, Mass. Harvard University Press.
30. My own recognition of the depth of our lack of awareness was triggered by Alison Jaggar's point that girls' height is in part determined by when they begin menstruation, which is in turn influenced by diet and exercise. Sex Inequality and Bias in Sex Differences Research. In Science, Morality, and Feminist Theory, Marsha Hanen and Kai Nielsen. (eds.). Canadian Journal of Philosophy 1987; 13: 34.
31. Indeed, the interpenetration of our notions of nature and culture may seem so complete that the temptation arises to demolish the distinction altogether. (For work that attempts not just to complicate the binaries, but dismantle them, see Nancy Tuana. Re-fusing Nature/Nurture. Hypatia 1983 (Women's Studies International Forum); 1: 621-32; Judith Butler. 1990. Gender Trouble: Feminism and the Subversion of Identity. NY. Routledge. Donna Haraway. 1991. A Cyborg Manifesto: Science, Technology, and Socialist-Feminism in the Late Twentieth Century. In Simians, Cyborgs, and Women: The Reinvention of Nature. NY. Routledge. Kwok Wei Leng. Menopause and the Great Divide. I am not yet convinced that we must accept this radical move. I also suspect that there may be compelling social and political reasons to distinguish these concepts as conflating them might relieve environmental polluters of responsibility on the grounds that there is no such thing as nature that can be harmed.
32. Indeed, the interpenetration of our notions of nature and culture may seem so complete that the temptation arises to demolish the distinction altogether. (For work that attempts not just to complicate the binaries, but dismantle them, see Nancy Tuana. Re-fusing Nature/Nurture. Hypatia 1983 (Women's Studies International Forum); 1: 621-32; Judith Butler. 1990. Gender Trouble: Feminism and the Subversion of Identity. NY. Routledge. Donna Haraway. 1991. A Cyborg Manifesto: Science, Technology, and Socialist-Feminism in the Late Twentieth Century. In Simians, Cyborgs, and Women: The Reinvention of Nature. NY. Routledge. Kwok Wei Leng. Menopause and the Great Divide. I am not yet convinced that we must accept this radical move. I also suspect that there may be compelling social and political reasons to distinguish these concepts as conflating them might relieve environmental polluters of responsibility on the grounds that there is no such thing as nature that can be harmed.
33. Indeed, the interpenetration of our notions of nature and culture may seem so complete that the temptation arises to demolish the distinction altogether. (For work that attempts not just to complicate the binaries, but dismantle them, see Nancy Tuana. Re-fusing Nature/Nurture. Hypatia 1983 (Women's Studies International Forum); 1: 621-32; Judith Butler. 1990. Gender Trouble: Feminism and the Subversion of Identity. NY. Routledge. Donna Haraway. 1991. A Cyborg Manifesto: Science, Technology, and Socialist-Feminism in the Late Twentieth Century. In Simians, Cyborgs, and Women: The Reinvention of Nature. NY. Routledge. Kwok Wei Leng. Menopause and the Great Divide. I am not yet convinced that we must accept this radical move. I also suspect that there may be compelling social and political reasons to distinguish these concepts as conflating them might relieve environmental polluters of responsibility on the grounds that there is no such thing as nature that can be harmed.
34. Indeed, the interpenetration of our notions of nature and culture may seem so complete that the temptation arises to demolish the distinction altogether. (For work that attempts not just to complicate the binaries, but dismantle them, see Nancy Tuana. Re-fusing Nature/Nurture. Hypatia 1983 (Women's Studies International Forum); 1: 621-32; Judith Butler. 1990. Gender Trouble: Feminism and the Subversion of Identity. NY. Routledge. Donna Haraway. 1991. A Cyborg Manifesto: Science, Technology, and Socialist-Feminism in the Late Twentieth Century. In Simians, Cyborgs, and Women: The Reinvention of Nature. NY. Routledge. Kwok Wei Leng. Menopause and the Great Divide. I am not yet convinced that we must accept this radical move. I also suspect that there may be compelling social and political reasons to distinguish these concepts as conflating them might relieve environmental polluters of responsibility on the grounds that there is no such thing as nature that can be harmed.
35. Kathryn Pauly Morgan, Women and the Knife, pp. 25-53.
36. Ibid., p. 39.
37. Laura M. Purdy. 1996. A Feminist View of Health. In Feminism and Bioethics: Beyond Reproduction. Susan M. Wolf (ed.). Oxford. Oxford University Press: 171ff.
38. It seems to be widely believed (falsely, I think) that only a postmodern outlook can generate this insight. For example, Kwok Wei Leng argues that her postmodern cyborg model alone 'allows for a vision of menopausal women as always already culturally, socially, and historically manipulated, which means that their "natural" bodies cannot become the resources for "truth" and "experience". …' (p. 269).
39. Nikki Jones. 1999. Culture and Reproductive Health: Challenges to Feminist Philanthropy. In Embodying Bioethics: Recent Feminist Advances. Anne Donchin and Laura Purdy (eds.). Lanham, MD. Rowman & Littlefield: 227.
40. James Mohr. 1978. Abortion in America. Oxford. Oxford University Press.
41. The situation is, of course, somewhat more complicated than that, given the governing structure in the U.S.: several states had already liberalized abortion laws, and what the Supreme Court did was to declare that laws prohibiting abortion were unconstitutional.
42. Purdy. 1996. Abortion and the Argument from Convenience, and Abortion, Forced Labor, and War. In Reproducing Persons. Ithaca. Cornell University Press.
43. Riessman, op. cit., p. 8.
44. For a fascinating discussion of women and smoking, see Lorraine Greaves. 1996. Smoke Screen: Women's Smoking and Social Control. Halifax, Canada. Fernwood Publishing.
45. Purdy, A Feminist View of Health.
46. Benjamin Freedman and Franc;oise Baylis. Purpose and Function in Government-Funded Health Coverage. Journal of Health Politics, Policy and Law 1987; 12: 97-112.
47. Thanks to Virginia Warren for reminding me of this point.
48. This kind of feminist medicine is unlikely to develop in a sexist society without substantial prodding.
49. For a promising model, see Sue Fisher. 1994. Is Care a Remedy? The Case of Nurse Practitioners. In Reframing Women's Health: Multidisciplinary Research and Practice, Alice J. Dan. (ed.). Thousand Oaks, CA. Sage Publications.
50. The central reason is, of course, the inability of the current system to provide universal access to decent care.
51. Purdy, A Feminist View of Health, pp. 165-67.
52. I would argue for the thin, 'core' definition of feminism discussed in the Introduction of Embodying Bioethics: Recent Feminist Advances, 1999. Anne Donchin and Laura Purdy (eds.). Lanham, MD. Rowman and Littlefield and in 1996. Good Bioethics Must Be Feminist Bioethics,' Philosophical Perspectives on Bioethics. L. W. Sumner and Joseph Boyle (eds.). Toronto. University of Toronto Press.
53. I would argue for the thin, 'core' definition of feminism discussed in the Introduction of Embodying Bioethics: Recent Feminist Advances, 1999. Anne Donchin and Laura Purdy (eds.). Lanham, MD. Rowman and Littlefield and in 1996. Good Bioethics Must Be Feminist Bioethics,' Philosophical Perspectives on Bioethics. L. W. Sumner and Joseph Boyle (eds.). Toronto. University of Toronto Press.
54. Among the ones that occur to me are the following: (1) encouraging students intending to enter medicine to major in the humanities or social sciences, not science, (2) promoting the use of nurse practitioners, (3) reforming medical education to focus on patients, and (4) changing the career track for medicine such that those who aspire to become physicians must first work as nurses for a given number of years. Presumably there are many other approaches that could be tried.
55. For an entrée to the huge literature here see, for example, work by Sue V. Rosser, Delease Wear, and Donna Stewart from within medicine, and writers such as Susan Sherwin, Helen B. Holmes, Mary B. Mahowald in bioethics; it would also be worth exploring writers like Andrew Weil and Samuel Epstein.