RESOURCE FILES
Chapter 7
Constructing Difference: Social Deviance
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Social Control Through Medicine
To become a
physician, one must undergo years of rigorous training and be licensed by the profession's
governing body. We assume that admission into the ranks of physicians is so carefully
controlled because special expertise is acquired to treat human beings. However, we could
also assume that the medical profession carefully controls entry in order to maintain its
social power.
Physicians enjoy a
tremendously high status in American society. "Plumber's orders,"
"accountant's orders," or even "sociologist's orders" do not carry the
same influence and authority that "doctor's orders" carry. Because of their
status, physicians are able to claim jurisdiction over the label of illness and anything
to which the label can be attached, regardless of whether or not they can deal with it
effectively.1
Decisions regarding
diagnosis and treatment of a host of problems are almost completely controlled by the
medical profession. No other profession has such extensive access to a person's body or
mind as physical and psychiatric medicine.2
The consequences of
medical professionals' decisions reach far beyond the health and well-being of an
individual patient. Plastic surgeons have helped define or at least perpetuate cultural
standards of beauty. Any psychiatrist who prescribes drugs for a person's emotional
suffering alters our cultural conceptions of what conditions we need not tolerate. Organ
transplants have redefined our notions of death and dying.3
The more behaviors that
are defined as illnesses, the larger the legitimate domain of the profession:
The increasing acceptance
of technical [medical] solutions . . . results in the withdrawal of more and more areas of
human experience from the realm of public discussion. For when drunkenness, juvenile
delinquency . . . and extreme political beliefs are seen as symptoms of an underlying
illness or biological defect the merits of such behaviors or beliefs need not be
evaluated.4
Defining a problem as
medical removes it from the public arena and places it where only medical people with
medical expertise can talk about it.5
In addition, medicalizing
deviance justifies certain intrusive procedures to be performed on individuals not only in
the name of "treatment" but also in the interests of the common good. When
health professionals attempt to eradicate a disease or a bothersome social behavior, we
all supposedly benefit.
According to one critic,
however, a larger, more sinister motive may also be behind the use of medical techniques
to shape and control the behavior of deviants:
[A]uthorities have moved
beyond clubs, bullets, and eavesdropping devices and are resorting to such things as
electroshock, mind-destroying drugs, and psychosurgery. Since the established powers
presume that the present social system is virtuous, then those who are prone to violent or
disruptive behavior, or who show themselves to be manifestly disturbed about the
conditions under which they live, must be suffering from inner malfunctions that can best
be treated by various mind controls.6
Thus medical treatment
goes beyond "curing" problems and toward social control, attempting to alleviate
behavior defined by powerful groups as dangerous.
1Friedson, E. 1970. Profession of medicine. New York: Dodd,
Mead.
2Conrad, P. 1975. "The discovery of hyperkinesis: Notes
on the medicalization of deviant behavior." Social Problems, 23, 12-21.
3Zola, I. 1986. "Medicine as an institution of social
control." In P. Conrad & R. Kern (Eds.), The sociology of health and illness. New
York: St. Martin's Press.
4Reynolds, J. M. 1973. "The medical institution."
In L. T. Reynolds & J. M. Henslin (Eds.), American society: A critical analysis. New
York: David McKay, p. 200.
5Conrad, P. 1975. "The discovery of hyperkinesis: Notes
on the medicalization of deviant behavior." Social Problems, 23, 12-21.
6Parenti, M. 1988. Democracy for the few. New York: St.
Martin's Press, pp. 150-151.
David Newman and Rebecca Smith.
(Created September 14, 1999). Copyright Pine Forge Press.
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