Activists, suchas Ben Goldacre the author of bad pharma, argue that theindustry cultivates a culture of medicalised human existence – where everyexperience can be made better with a medication or a supplement in order forthe producers to make a profit. Reflecting on these ideas leads to anuncomfortable paradigm which sees patients as complicit in the, and propagatorsof the, medicalisation of human experience. Do people want their poor experiencesof (what a psychologist might call) an ‘unsuccessful life’ to be legitimisedthrough or blamed on a diagnosis?
This idea is a little bit a ‘snake inthe grass’ in that it is quite disruptive to Britain’s current healthcare modeland belief system. Indeed many people can identify and accept that their lifeproblems are caused or linked to a medical problem, i.e. “I can’t do thatbecause of my condition”. The difficulty of developing a narrative or talkingabout a medicalised culture is that patients will believe and argue,passionately, that their life problems are due to their diagnosis. Indeed manypatients may find it easier to accept a socially uncomfortable (resulting in isolation,stigmatisation) yet socially rewarding (access to benefits, time off work) diagnosisthan accept a more humanist paradigm of “life is unfair sometimes”. It could be argued that pathological diseasesclearly impact on how a person experiences life – a patient with cataracts can’tsee and no amount suspicion of misleading pharma-funded culture-creating researchwould be able to deny that that diagnosis would influence someone’s experiencesof life. Consider if you would the role of Female Sexual Dysfunction; arguablya normal human experience classified as a disease by the pharma and medicalprofessions to generate profits, yet a disease which many women can identifywith and passionately, coherently and sensibly argue has influenced their life.
There is clear discomfort when weconsider the role that marketing has on the medicalisation of normal humanexperiences 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 createdby what the society of the day is willing to accept. A philosophical questionthen takes us to ‘what is the nature of a medicalised culture’ … raisingepistemological and ontological questions. Epistemology and ontology are wordsthat many pharmacists and students, as well as members of the public andpatients, will not be familiar with and this could, again arguably, consolidatea failure of the medical professions to challenge the social norms ofmedicalising normal human experiences.
The above ramblings are the culminationof ideas from a workshop from three of Durham University's research institutes.These were the Wolfson Research Institute for Health and Wellbeing, TheInstitute of Advanced Study and the Biophysical Sciences Institute. The sessionwas a follow-up to a round table discussion last night focusing on patients'experiences of pain. The implications that the pharma industry and retail orcommunity pharmacy has had on developing the culture of painmanagement and the medicalisation of pain symptoms, to the pointwhere pain could, arguably, be considered a stand-alone diagnosis as anillness rather than a human response to doing too much, not exercising, eatingbadly etc.
The room was filled with a diversearray of academics and clinicians with one, lone, patient representative andone, lone, pharmacist – me! As expected there were lots of big wordsand opinions that raised a few eyebrows and (ironically fora workshop discussing the experiences of pain) theoreticalconcepts that made my head hurt.