Shifting Trends in Medicalization Theory : From the Medicalization of Deviant Behavior to the Expansion of Medicalized Categories

イリョウカロン　ノ　ドウコウ　イツダツ　コウドウ　ノ　イリョウカ　カラ　シッカン　ガイネン　ノ　カクダイ　ヘ

シミズ, ヒロト

Shimizu, Hitoro

オオサカ ダイガク ダイガクイン ニンゲン カガク ケンキュウカ シャカイガク ニンゲンガク ジンルイガク ケンキュウシツ

Sociology, Anthropology and Philosophy, Graduate School of Human Sciences, Osaka University

逸脱行動

疾患概念の拡大

診断基準

製薬産業

medicalization

deviant behavior

expansion of medicalized categories

diagnostic criteria

pharmaceutical industry

This paper outlines the theoretical framework of “medicalization.” Mainstream medicalization studies describe the process by which deviant behaviors such as hyperactivity, homosexuality, and alcohol dependence have been medicalized. These studies emphasize the radical change of the agents that socially control deviant behavior—from the home, school, law, and religion, to medicine. With the increasing use of medicine to achieve such control, the focus of current medicalization research has shifted from the medicalization of deviant behavior to the expansion of already medicalized categories, a move that can result in over-diagnosis. The number of individuals diagnosed with various disorders has explosively increased because of the expansion of medical categories and the marketing strategies of pharmaceutical companies. These factors have resulted in a relative shortage of medical care for those who are severely ill. However, policies that seek to reduce the socioeconomic burden of disease tend to focus only on early detection and identification of risk factors and do not assess the legitimacy of medicalizers such as diagnostic criteria and the role of the pharmaceutical industry in the increasing prevalence and incidence of certain diseases. Therefore, such policies can paradoxically increase the disease burden by helping to medicalize subthreshold conditions. Thus, there is a need for a sociological investigation of the expansion of medical categories and the legitimization of early-intervention-oriented policies. The structure of this paper is as follows: In section 1, I introduce medicalization theory. In section 2, I describe its two branches: “the medicalization of deviant behavior” and “the expansion of medicalized categories.” In section research. In section 4, I review case studies on medicalization in Japan and provide some suggestions for future research.