Chapter 7

Constructing Difference: Social Deviance

Micro-Macro Connection


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.