Medicalisation and Overdiagnosis: What Society Does to Medicine

Document Type: Perspective

Authors

Celsus Academy for Sustainable Healthcare, and Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands

Abstract

The concept of overdiagnosis is a dominant topic in medical literature and discussions. In research that targets overdiagnosis, medicalisation is often presented as the societal and individual burden of unnecessary medical expansion. In this way, the focus lies on the influence of medicine on society, neglecting the possible influence of society on medicine. In this perspective, we aim to provide a novel insight into the influence of society and the societal context on medicine, in particularly with regard to medicalisation and overdiagnosis.

Highlights

Commentaries Published on this Paper

  • Mistaking the Map for the Territory: What Society Does With Medicine; Comment on “Medicalisation and Overdiagnosis: What Society Does to Medicine”Authors' Response to the Commentaries

          Abstract | PDF

  • On the Social Construction of Overdiagnosis; Comment on “Medicalisation and Overdiagnosis: What Society Does to Medicine”

          Abstract | PDF

  • Overdiagnosis: An Important Issue That Demands Rigour and Precision; Comment on “Medicalisation and Overdiagnosis: What Society Does to Medicine”

          Abstract | PDF

 

Authors' Response to the Commentaries

  • Define and Conquer: How Semantics Foster Progress; A Response to Recent Commentaries

          Abstract | PDF

Keywords

Main Subjects


  1. Hofmann B. Medicalization and overdiagnosis: different but alike. Med Health Care Philos. 2016. doi:10.1007/s11019-016-9693-6
  2. Welsh H, Schwartz L, Woloshin S. Overdiagnosed: Making People Sick in the Pursuit of Health. Boston: Beacon Press; 2011.
  3. Conrad P. The shifting engines of medicalization. J Health Soc Behav. 2005;46:3-14. doi:10.1177/002214650504600102
  4. Earp BD, Sandberg A, Savulescu J. The medicalization of love. Camb Q Healthc Ethics. 2015;24(3):323-336. doi:10.1017/S0963180114000206
  5. Carter SM, Rogers W, Heath I, Degeling C, Doust J, Barratt A. The challenge of overdiagnosis begins with its definition. BMJ.2015;350:h869. doi:10.1136/bmj.h869
  6. Morrison M. Overdiagnosis, medicalisation and social justice: commentary on Carter et al (2016) ‘A definition and ethical evaluation of overdiagnosis.’ J Med Ethics. 2016. doi:10.1136/medethics-2015-102928
  7. McLellan F. Medicalisatioin: a medical nemesis. Lancet. 2007;369:627-628. doi:10.1016/S0140-6736(07)60293-1
  8. Rose N. Beyond medicalisation. Lancet. 2007;369:700-701. doi:10.1016/S0140-6736(07)60319-5
  9. Illich I. Limit to Medicine. Medical Nemesis: The Expropriation of Health.London: Marion Boyars; 1995.
  10. Moynihan R, Cassels A. Selling Sickness. How the world's biggest pharmaceutical companies are turning us all into patients. New York: Nation Books; 2005.
  11. Sadler JZ, Jotterand F, Lee SC, Inrig S. Can medicalization be good? Situating medicalization within bioethics. Theor Med Bioeth. 2009;30(6):411-425. doi:10.1007/s11017-009-9122-4
  12. Conrad P. Medicalization: changing contours, characteristics, and contexts. In: Cockerham W, ed. Medical Sociology on the Move. Dordrecht: Springer Science + Business Media; 2013.
  13. Hofmann B. Diagnosing overdiagnosis: conceptual challenges and suggested solutions. Eur J Epidemiol. 2014;29(9):599-604. doi:10.1007/s10654-014-9920-5
  14. Freidson E. Profession of Medicine. A Study of the Sociology of Applied Knowledge.New York: Dodd, Mead & Company; 1971.
  15. Conrad P, Barker KK. The social construction of illness: key insights and policy implications. Journal of Health and Social Behavior. 2010;51 Suppl:S67-79. doi:10.1177/0022146510383495
  16. Kingma E. Naturalism about health and disease: adding nuance for progress. J Med Philos. 2014;39(6):590-608. doi:10.1093/jmp/jhu037
  17. Appel L. The verdict from ALLHAT--thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2003;288(23):3039-3042.
  18. Whelton P, He J, Appel L, et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA 2002;288(15):1882-1888.
  19. Clark J. Do the solutions for global health lie in healthcare? BMJ. 2014;349:g5457. doi:10.1136/bmj.g5457
  20. Mann J. Medicine and public health, ethics and human rights. Hastings Center Report. 1997;27(3):6-13.
  21. Mytton OT, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health. BMJ. 2012;344:e2931. doi:10.1136/bmj.e2931
  22. Weisberg SP. Societal change to prevent obesity. JAMA. 2002;288(17):2176-2176. doi:10.1001/jama.288.17.2176-JMS1106-2-1
  23. Woittiez I, Ras M, Oudijk D. IQ met beperkingen. De mate van verstandelijke handicap van zorgvragers in kaart gebracht. Den Haag: The Netherlands Institute for Social Research; 2012.
  24. Ras M, Verbeek-Oudijk D, Eggink E. Lasten onder de loep. De kostengroei van de zorg voor verstandelijk gehandicapten ontrafeld. Den Haag: The Netherlands Institute for Social Research; 2013.
  25. Van der Kwartel A. Brancherapport Gehandicaptenzorg 2012. Utrecht: Vereniging Gehandicaptenzorg Nederland; 2012.
  26. Older People & Dementia Team. Prime Minister’s challenge on dementia. Delivering major improvements in dementia care and research by 2015. Leeds: Department of Health; 2012.
  27. Couteur DGL, Doust J, Creasey H, Brayne C. Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis. BMJ. 2013;347:f5125. doi:10.1136/bmj.f5125
  28. Brunet M. Targets for dementia diagnoses will lead to overdiagnosis. BMJ. 2014;348:g2224. doi:10.1136/bmj.g2224
  29. Whitehouse P. The end of AD Part 3. Alzheimer Dis Assoc Disord. 2006;20(4):195-198.
  30. Whitehouse P. The end of Alzheimer disease. Alzheimer Dis Assoc Disord. 2001;15(2):59-62.
  31. OECD. Health at a Glance 2015, OECD Indicators.Paris: OECD Publishing; 2015.
  32. Takizawa C, Thompson PL, van Walsem A, Faure C, Maier WC. Epidemiological and economic burden of Alzheimer's disease: a systematic literature review of data across Europe and the United States of America. J Alzheimers Dis. 2015;43(4):1271-1284. doi:10.3233/JAD-141134
  33. Welch H, Schwartz LM, Woloshin S. Overdiagnosed. Making people sick in the pursuit of health. Boston: Beacon Press; 2011.
  34. Declercq E, Young R, Cabral H, Ecker J. Is a Rising Cesarean Rate Inevitable? Trends in Industrialized Countries, 1987 to 2007. Birth. 2011;38(2):99-104.
  35. World Health Organization (WHO). WHO Statement on Caesarean Section Rates.http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/.Published2015.
  36. Macfarlane A, Blondel B, Mohangoo A, et al. Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study. BJOG. 2015;123(4):559-568. doi:10.1111/1471-0528.13284
  37. Vimercati A, Greco P, Kardashi A, et al. Choice of cesarean section and perception of legal pressure. J Perinat Med. 2000;28(2):111-117. doi:10.1515/JPM.2000.014
  38. Malacrida C, Boulton T. Women’s Perceptions of Childbirth “Choices”: Competing Discourses of Motherhood, Sexuality, and Selflessness. Gend Soc. 2012;26(5):748-772. doi:10.1177/0891243212452630
  39. McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy DK. Elective Cesarean Section and Decision Making: A Critical Review of the Literature. Birth. 2007;34(1):65-79. doi:10.1111/j.1523-536X.2006.00147.x
  40. Christiaens W, Nieuwenhuijze M, de Vries R. Tendensen in de medicalisering van geboorte in Vlaanderen en Nederland. Tijdschrift voor Verloskundigen.July/August 2013.
  41. Raub W, Buskens V, van Assen MALM. Mirco-macro links and microfoundations in sociology. J Math Sociol. 2011;35:1-25.