The Last Well Person?

Episode: 
49

A few days ago, an environmental group announced a lawsuit to protect the endangered Southern California mountain yellow-legged frog.[1]Yellow-legged frogs aren’t the only “endangered species.” Some of you might be on that list. Seventeen years ago, Dr. Clifton Meador speculated that one day there will not be a single “well” or healthy person left in the United States.[2] It won’t be because of a catastrophic pandemic, but because of reclassification. Dr. Meador was observing the trend to view human problems arising from aging and the normal limitations of our body, and to redefine these into diseases to be diagnosed and treated by medical professionals.

This process of redefinition is known as medicalization. Male pattern baldness, short stature, and social anxiety used to be considered a normal part of the human condition. Today, they are treated as medical abnormalities requiring doctor visits and medication or other more involved procedures. Natural life experiences—like grieving—are also being medicalized.

There is plenty of blame to go around, including our own desires to live longer, more attractive, and more indulgent lives. But, another significant factor is the influence of the pharmaceutical industry on our understanding of “health.” Industry watchdogs are concerned over the efforts to re-label some normal conditions as medical disorders requiring treatment with drugs. I’m sure you have noticed the increase in TV commercials. While many of these drugs do treat genuine disorders, some trigger anxiety that we might have a previously unsuspected disease or syndrome.

The relabeling of common human problems into medical conditions has become a popular marketing strategy for many drug companies. Relabeling helps to convince potential consumers of the seriousness of these conditions and their legitimacy as a medical disorder, Natural shyness may be re-labeled as “social anxiety,” with a pill to overcome introversion.

New uses for existing drugs may be based on little-known diseases. Requip has been used to treat Parkinson’s disease. But the manufacturer began marketing it for Restless Leg Syndrome. There was a sudden spike in the number of people diagnosed with the syndrome, and sales of Requip boomed.[3]

Changing diagnostic criteria has moved many people into a new “disease” category. Changes in blood pressure guidelines created pre-hypertension, a “pre-disease” affecting at least 45 million American adults.[4] Yes, we do want better preventative care for heart disease, but where will medicalization of everything end?

Understanding the meaning of “healthy” or “diseased” is “everyday bioethics.” Let’s not join the ranks of the “worried well,” alarmed over every germ, every twitch, and growing older. “Healthy” people should not be on the “endangered species” list!



[1] Janet Zimmerman, “Complaint lodged in endangered frog case.” The Press Enterprise. April 29, 2011. http://www.pe.com/localnews/stories/PE_News_Local_D_frogsuit30.1607d16.html (Accessed May 1, 2011).

[2]Victoria Stagg Elliott, “Are We All Sick? Doctors Debate ‘Medicalization’ of Life,” American Medical News, September 20, 2004 http://www.ama-assn.org/amednews/2004/09/20/hlsa0920.htm (accessed March 29, 2011).

[3] Steven Woloshi and Lisa M. Schwarts, “Giving Legs to Restless Legs: A Case Study of How the Media Makes People Sick,” PLoS Medicine, April, 2006, 3(4): e170, 452-455. doi:10.1371/journal.pmed.0030170. http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030170#s4. (Accessed May 1, 2011).

[4] Susan Kelleher and Duff Wilson, “Suddenly Sick: The Hidden Big Business behind Your Doctor’s Diagnosis,” The Seattle Times, June 26-30, 2005 (Reprint available at http://seattletimes.nwsource.com/html/health/sickabout.html).

 

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