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Should Journalists Take Sides in the Medicalization Debate?

Should Journalists Take Sides in the Medicalization Debate?

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When I wrote a series of pieces recently about disease mongering, freelance health writer Kate Benson wrote me. Benson has worked in journalism for nearly 25 years at small and mid-sized dailies, including the Rochester Democrat and Chronicle and The Selma Enterprise. She has worn multiple hats, including photographer, reporter, designer and assignments editor. Whenever she writes me, she has something interesting to say, and this time she was critiquing my take on whether reporters spend too much time making everyday problems seem like conditions that need medical treatment. I asked her to write a guest post on the topic. The first part is below. The second part will appear later in the week.

I know this will set me directly against many health journalists, not to mention some researchers, but I have some strong ethical and professional concerns about the concepts of “disease mongering” and “medicalization” and how they are used in journalistic circles. It seems the jury already has returned a verdict on whether too many diseases/conditions are “medicalized.” In my view, there needs to be an open conversation about these concepts that is not happening. So let’s make it happen. 

We can start with the term disease mongering as a phrase. Calling someone a disease monger is little more than a way to shut down your opponents. How can someone make a strong counter argument when that sort of label is slapped on them?

At the same time, the term disease monger is pejorative and inflammatory. It has no more place in journalism than racial epithets or words that demean someone for their sexual orientation. An associated term, the “worried well,” is also pejorative and presumes that people have been scared into a state of anxiety by drug companies and the “disease mongering” journalists who reprint their press releases. Is there any evidence that this is really happening? Not that I have seen, and yet this term is used frequently as an accepted description for the average consumer.

Now to the concept of "medicalization.” What journalists need to realize is that this is not a concept where the debate has been settled. It is a term, instead, used to capture one point of view in an ongoing war over the role of medicine – both nonprofit and for-profit medicine – in society. This has been well described by Harvard medical history professor Dr. Allan M. Brandt.

Your response may be to tell me that I should be reading philosopher Ivan Illich or sociology professor Peter Conrad instead of Brandt. I have read them. The scientific literature doesn’t always support their assertions.

And that makes me wonder how many journalists who casually toss around the term "disease-mongering" have done their homework. How skeptically do they read the literature? And how open are they to the possibility that there are other equally valid points of view?

Accepting that disease mongering is a common and corrosive force is to take the point of view of an activist and not a journalist. It’s to adopt a stance and thereby run the risk of missing critical elements in this very important battle over the future of medical advancements.

Next: Health Writers Should Look for All the Vested Interests in Medicine

Related Posts:

Complete Health Reporting: Avoid Extremes to Avoid Disease Mongering

Complete Health Reporting: Steer Clear of Disease-Mongering Quicksand

Kate Benson: Does stigma begin with me?

Kate Benson: Should Science Journalists Have an Ethical Code?

Photo credit: Melanie Tata via Flickr


Picture of Nathanael Johnson

Where's a good place to start with Brandt? Is there one seminal paper or necessary book that I should read? Note that medicalization is not pejorative. It can be good as well as bad. Medicalizing the way we deal with childhood infectious diseases through vaccinations, was clearly a good idea. I've spent a lot of time looking at the evidence and I am deeply concerned about a lot of the ways we have medicalized recently - the data is pretty clear that we are killing more people than we save. And it's far from conventional wisdom. You don't have to agree with Illich and argue for rolling back medicine in general to be convinced by the evidence. That said - I completely agree that it's a bad idea to start name calling or dividing people up into good and evil.

Picture of Kate  Benson


The second part of this column contains a link to Brandt's seminal paper.

Medicalization is a concept and as you say, may happen. I don't disagree with that. I do however worry when journalists buy into the concept so completely to that they don't even question the use of pejorative terms such as "disease monger" or "disease mongering." The danger with buying into any concept that completely is that you may fail to ask hard questions of both sides or give only token space to other sources. 

You state that "medicine" kills more people than it saves. Do you have definitive evidence that this is the case in all instances? What sources would you seek out to give multiple points of view?

As for convincing evidence, I'm a born skeptic. I ask the same hard questions of everyone as I'm sure you do as well.  

Picture of Nathanael Johnson

Medicine kills more than it saves in all cases? certainly not! The evidence I'm refering to (in what was obviously too sweeping a statement) was examples like this What I should have said is that too much care is killing more people than those who die from lack of access. You've certainly convinced me to be more careful in the way I use the term disease mongering.

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