Why the Medicalization of Everyday Life is Good

(I've posted this at another journal of mine, but I'm reposting it here.)

It is a common claim that Americans take too many drugs, that we are society that is overmedicated. Conditions like attention deficit disorder and depression are said to be overdiagnosed and drugs like Prozac and Ritalin overprescribed. In short, so it is said, we make the mistake of taking ordinary differences in mental and physical abilities as genuine diseases to be treated medically, instead of problems of character that require more complex solutions.

Not only are all of these claims false, but I will argue the opposite: the medicalization of ordinary life is ultimately a positive development.

It never ceases to amaze me that, in a society that develops and benefits from so much of the technological progress of recent decades, opposition to future technologies runs at such a high level. From stem cell research to genetically modifed crops, Americans (as well as many Western Europeans) incessantly cry "it's unnatural!" and invoke the specters of Brave New World and Frankenstein. (Brave New World is perhaps my least favorite book for this very reason.)

This is not the case everywhere, particularly in Southeast Asia, where increasingly more of the breakthroughs in biotechnology are coming from. According to Ramez Naam, author of the superlative More Than Human: Embracing the Promise of Human Enhancement, while a meager 20% of Americans advocate genetic engineering, 63% of Indians and an astounding 83% of Thais do. All the more reason why nations like China and India will overtake the West in the coming century (and why I may have to move to Asia).

What is interesting is that many Americans oppose augmenting human nature through genetic and cybernetic technologies, but have no issue with medical research to treat and cure diseases. The fact of the matter is, however, that research to treat a disease almost invariably can be used to enhance a normal condition.

Let me give but one example to illustrate. Attention deficit/hyperactivity disorder (ADHD) is commonly treated by the drugs Ritalin and Adderall. However, when "normal" indivduals take these drugs, their ability to pay attention and focus also improves.

Why is this? Part of it is the nature of the disease. Attention, like many human traits, is distibuted among the population along a normal distribution, or bell curve. Thus, most of the population falls near the average, with smaller percentages the further away in either direction.

ADHD, instead of being a condition with distinctive symptoms that one either has or does not (one example of this would be schizophrenia), is defined in a way that will include everyone below a certain point in that distribution. In other words, all it means to have ADHD is to be, say, in the bottom 20% (I'm not sure of the precise number) with regard to attention. This would be like saying that the dumbest fifth of the population suffers from "Intellect Deficit Disorder".

To extend the example of our hypothetical "Intellect Deficit Disorder", giving Ritalin only to those diagnosed with ADHD would be like giving a drug that increased intelligence only to those diagnosed with IDD. Such a thing would be absurd; if anyone could benefit from it, why shouldn't it be accessible to all? Many mental disorders, like depression and social anxiety, fall in the same category as ADHD.

Thus far, I have been giving an argument that would seem to oppose the point I'm trying to make. This is because I see "medicalization" as the means to fostering a wider acceptance of the use of medical treatments to improve human abilities. The more people who are diagnosed with these conditions, the more who take drugs, and the better off society is as a whole.

Why? Well consider what these drugs do. Prozac and other Selective Serotonin Reuptake Inhibitors (SSRIs) can work on both the depressed and the healthy (although the effects are not quite the same for everybody) to increase their happiness. The happiness that comes from an SSRI is not the mindless contentedness of Huxley's idiotic "soma" but a kind of increased energy to get things done and a better resilience to the setbacks that everybody faces from day to day. Not only are the conditions for an individual improved, but our economic productivity as a society increases. (This doesn't necessarily entail an overworked population, the value of which is questionable, because if an individual finishes her work sooner, there's no reason why some of her increased productive energy couldn't be devoted to leisure pursuits, should she so choose.)

The major objection here, would be the negative side effects of drugs, for instance, Prozac's sexual side effects. However, as our understanding of biology improves, increasingly selective drugs are developed that produce fewer adverse side effects. There are more antidepressants on the market today that have fewer or no sexual effects; I'm on two myself and experience no discernible impediments.

Thus, I will be honest; I'm being a bit disingenuous with the title of this post. Medicalization in itself is not the good thing, but rather, the acceptance of technological enhancements to human functioning. Quite frankly, the objections to human enhancement are silly (in part because the distinction between pathology and normality is often completely arbitrary) and basically come down to two: one is that it is "unnatural", the other is that unintended side effects could produce negative, even fatal, results.

The first is merely a prejudice, which I won't bother taking the time to refute here (I've done it elsewhere); the second is largely mitigated by the extensive process of animal and human testing that precedes the approval of any treatment for public consumption. This may not answer every objection, but is sufficient for the purposes of this post.

In short, I ultimately think that it should be up to individuals to decide what treatments or enhancements they want for themselves, and in the case of children, families rather than governments should decide. For this reason, I oppose disastrous and wasteful policies like the so-called "War on Drugs", as well as the efforts of radical rightwing organizations to impede the release of drugs that fail to satisfy their rigid and narrow constraints of what is acceptable behavior for human beings.

And really, like I've said, should the US become even more of a society of Luddites and bioconservatives, we will be all the more quickly and easily surpassed by those who lack our prejudices. The development of these technologies ultimately cannot be stopped, and in the future, like all the progresses of humanity in the modern era, history shall recognize those who opposed them as the truly short-sighted ones.


Anonymous said...

Did you noticed a little girl,4, died last december poisoned by her parents who pretended sedate her? That is what you call amazing progress a "medicalized life and death"

specter_of_spinoza said...

O my God. You're totally right. That single unreferenced anecdote completely refutes everything I've written here. I renounce all my former beliefs and my enthusiasm for technological progress! Thank you, kind stranger, for helping me to see the light.

IIO said...

I have nothing against technology and research for improving medicine. But I think as technology evolves, humanity is "devolving". We are externalizing our responsibilities and thus becoming less resilient as human beings. Every little pain or imperfection is treated as a disfunction that needs to be eliminated. But really, hardship was always intended a part of life. It is how we grow. And by seeking to eliminate all traces of adversity with technological and medical solutions, is creating a weaker human being.

Just a thought.

Brian said...

intended? by whom? Intent presupposes a purpose, an intender.

Anonymous said...

In reference to genetically modified foods, the reactions against GMO's are not entirely just based on them being unnatural. Its true that animals have been eating natural foods for millions of years. the case is, GMO's were created to serve those who sell the food, not eat it. People throw around the fear that we're running out of food, in many places it is the opposite. With GMO's, the bio-corps that own the COPYRIGHT to the organism, it is possible to be sued over growing their copyrighted plant. It has been documented that several US farmers have had to settle on vicious lawsuits saying they were illegally growing corn based on samples found near the fringes of their land near roads, where stray seeds could have easily germinated. The affects of additional substances from GMO's into our diets with no prior testings, not to mention the land it is grown on, local ecological effects, chemicals leaking into our water cycle through urine and feces, the corporate agenda regarding GMO's which I might add corporations are allowed to go into heirloom vaults, go through seeds of plants and COPYRIGHT an already existing plant that they did not create, all these are things to be concerned about regarding GMO's. Yes, they are unnatural. I feel you are playing the role that a swaying media wants you to play.

specter_of_spinoza said...

In response to the last anonymous comment:

The corporate tactics surrounding GMOs, not to mention all the abuses of prescription drug manufacturers, are aspects of the system that I do not condone. I don't think genes should be patentable, period. (The issue of drug patents is thornier.)

So, I agree with much of your criticism on that point. However, you also raise safety concerns. Depending on the type of genetic modification we're talking about, I think these are of varying degrees.

For instance, if one adds a gene to a crop from another plant or animal that is regularly consumed by humans, I think premarket testing need only be minimal (for discerning any immediate interaction effects). For more complex modifications, more should be required. I'm not sure of the current regulatory schema, but I would argue that some kind of supervisory board like the FDA should be in charge of making the decisions about testing requirements and should be as isolated as possible from the corporations who are selling the products.

In short, sensible policy and regulation can mitigate most of the concerns surrounding GMOs and similar technologies. What we shouldn't do is ban them outright, not only because a ban wouldn't work, but also because GMOs have the potential to do tremendous good (e.g., golden rice).

Lastly, about me "playing the role that a swaying media wants [me] to play": give me a fucking break. The media is largely responsible for stirring all this excessive fear about GMOs in the first place. If anything, you're the media tool. (I at least have the courage not to post anonymously.)

Anxiety and vague uneasiness should not stand in the way of progress!

Anonymous said...

This entry uses poor logic and no citations of research supporting your arguments.

Your "illustration" that the population's attention span is on a bell curve, therefore ADD medication simply moves anyone who takes the medication higher on the bell curve is a logical non-sequitor (it does not follow).