Posted by: Adam Pattison Rathbone8 MAY 2014
Activists, such as Ben Goldacre the author of bad pharma, argue that the industry cultivates a culture of medicalised human existence – where every experience can be made better with a medication or a supplement in order for the producers to make a profit. Reflecting on these ideas leads to an uncomfortable paradigm which sees patients as complicit in the, and propagators of the, medicalisation of human experience. Do people want their poor experiences of (what a psychologist might call) an ‘unsuccessful life’ to be legitimised through or blamed on a diagnosis?
This idea is a little bit a ‘snake in the grass’ in that it is quite disruptive to Britain’s current healthcare model and belief system. Indeed many people can identify and accept that their life problems are caused or linked to a medical problem, i.e. “I can’t do that because of my condition”. The difficulty of developing a narrative or talking about a medicalised culture is that patients will believe and argue, passionately, that their life problems are due to their diagnosis. Indeed many patients may find it easier to accept a socially uncomfortable (resulting in isolation, stigmatisation) yet socially rewarding (access to benefits, time off work) diagnosis than accept a more humanist paradigm of “life is unfair sometimes”. It could be argued that pathological diseases clearly impact on how a person experiences life – a patient with cataracts can’t see and no amount suspicion of misleading pharma-funded culture-creating research would be able to deny that that diagnosis would influence someone’s experiences of life. Consider if you would the role of Female Sexual Dysfunction; arguably a normal human experience classified as a disease by the pharma and medical professions to generate profits, yet a disease which many women can identify with and passionately, coherently and sensibly argue has influenced their life.
There is clear discomfort when we consider the role that marketing has on the medicalisation of normal human experiences and how big corporate powers can influence culture. Activists, academics and theologians might argue that culture is developed through art, music and activities however I am much more minded to believe culture is created by what the society of the day is willing to accept. A philosophical question then takes us to ‘what is the nature of a medicalised culture’ … raising epistemological and ontological questions. Epistemology and ontology are words that many pharmacists and students, as well as members of the public and patients, will not be familiar with and this could, again arguably, consolidate a failure of the medical professions to challenge the social norms of medicalising normal human experiences.
The above ramblings are the culmination of ideas from a workshop from three of Durham University’s research institutes. These were the Wolfson Research Institute for Health and Wellbeing, The Institute of Advanced Study and the Biophysical Sciences Institute. The session was a follow-up to a round table discussion last night focusing on patients’ experiences of pain. The implications that the pharma industry and retail or community pharmacy has had on developing the culture of pain management and the medicalisation of pain symptoms, to the point where pain could, arguably, be considered a stand-alone diagnosis as an illness rather than a human response to doing too much, not exercising, eating badly etc.
The room was filled with a diverse array of academics and clinicians with one, lone, patient representative and one, lone, pharmacist – me! As expected there were lots of big words and opinions that raised a few eyebrows and (ironically for a workshop discussing the experiences of pain) theoretical concepts that made my head hurt.