The medicalisation net Here's a list of methods by which the net can be widened.
1. *Normal processes of growth and ageing are labelled as disseases. *The availability of drugs to treat erectile dysfunction (impotence) in men is a very well-known event in drug discovery. This is particularly true in the behavioural sciences, where traits like shyness, frugality, and the like are now included as disorders worth correcting with drugs. 2. *Mild symptoms of self-limiting disease being labelled as harbingers of serious problems.* The irritable bowel syndrome is one of the most common problems that a specialist gastroenterologist sees in their daily practice. For the majority, it is a mild disorder that only requires reassurance regarding its benign nature. The arrival of new drugs has been accompanied by efforts to repackage the condition as one deserving attention and drug treatment in every case. 3. *Personal and social problems are being recast as medical conditions.* A flood of drugs is now available for treating behavioural disorders like depression, anxiety attacks, social phobias, and impaired attention and learning abilities in children. Some, no doubt, benefit from these drugs, but the danger lies in being too quick to start people on drug treatment without making an attempt to identify and modify social and emotional factors that could be the trigger for many mild forms of the problem. Shyness is now a disease! 4. *Risk is recast as a disease.* Most people, doctors included, confuse risk with cause; drug marketers cash in on this flaw in reasoning. Osteoporosis (loss of bone mass) in women who have entered the menopause is inevitable. Osteoporosis is a risk for bone fractures in women, not the cause. A climate of fear is created by vigorous promotion of the consequences of bone fractures in older women. The promotion of drugs for the reduction of osteoporosis draws attention away from promoting simpler interventions such as dietary supplementation and regular exercise. 5. *Extending the boundaries of treatable disease.* The cut-off for the definition of high blood pressure has been slowly pushed downwards to the point where any figure above the well-known "120/80 mm Hg" is now labelled as abnormal and worthy of attention. Similarly, the borderline for fasting blood sugar has been set at 100 mg. There is no clear evidence of benefit from starting treatment at such low levels. 6. *The medicalization of dying.* We have lost the capacity to accept death and suffering as meaningful and inevitable aspects of life. Dying has been taken away from the family, to the hospital, and to the medical fraternity. *Downside.* Promoting therapies with dubious benefits causes a lot of harm. There is an ever-present risk of side effects from drugs, many of which may not become apparent until a few years after the remedy has been marketed. The direct economic burden is obvious; the indirect losses from the diversion of funds to unnecessary regimens are less so. Patients are emotionally burdened by being labelled as diseased. Society as a whole is distracted from the task of looking deeper into social factors that might be the cause of the problem. *Thus spake Prof. Gøtzsche.* Professor Peter C. Gøtzsche, a Danish physician, researcher, and outspoken critic of unsavoury practices within the pharmaceutical industry, has made several recommendations to prevent overdiagnosis and medicalization in healthcare. Here are six of them. 1. *Use fewer drugs.* Gøtzsche often emphasises the dangers of polypharmacy (taking multiple drugs) and recommends a reduction in the overall consumption of drugs. 2. *Be cautious with preventive interventions.* Many medical interventions are preventive and can lead to overdiagnosis. Gøtzsche recommends a more conservative approach to preventive medicine. 3. *Avoid industry-funded trials.* He warns about the potential biases and distortions in drug trials funded by pharmaceutical companies. He recommends relying more on independently funded research. 4. *Implement better training for doctors.* Gøtzsche believes doctors should receive better education on the risks and benefits of treatments and the potential for overdiagnosis. 5. *Promote transparency in research.* He emphasises the importance of access to complete clinical trial data and encourages the sharing of all results (both positive and negative) to avoid biassed reporting. 6. *Strengthen patient information and involvement.* Gøtzsche believes patients should be better informed about the risks and benefits of treatments, allowing them to make more informed decisions about their healthcare. These recommendations reflect his concerns about the undue influence of the pharmaceutical industry on healthcare practices as well as the broader issue of medicalisation, where normal life processes and conditions are treated as medical problems. ---------- Forwarded message --------- From: Rangarajan T.N.C. <[email protected]> Date: Wed, 8 Nov 2023 at 14:51 Subject: Fw: medicalisation To: {P}rescription - #8 <https://p4life.substack.com/p/prescription-8?utm_source=profile&utm_medium=reader2> {P}rescription - #8 Arjun Rajagopalan 8 November, 2023 <https://p4life.substack.com/p/prescription-8?utm_source=profile&utm_medium=reader2> -- You received this message because you are subscribed to the Google Groups "Thatha_Patty" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. To view this discussion on the web visit https://groups.google.com/d/msgid/thatha_patty/CAL5XZooeSekE02PBeC9mc1dOfmYDm1BgxpstjL4TNHgaSnFOqQ%40mail.gmail.com.
