Medicalization of Deviance

Illness, Deviance, and Social Control

Historical roots of medicalization of deviance trace to Parsonian models that define illness as deviant because it disrupts social cohesion and, in turn, the stability of social systems. Although criminal behavior and illness are both violations of social norms, the labels and sanctions are often prescribed differently. Deviant behavior is seen as purposeful, and therefore, the social response imposed on deviant behavior seeks to alter behavior in the direction of conformity. However, nonpurposeful deviance is regarded as an illness and, in turn, is treated with the goal of altering the conditions that restrict conformity to social norms. It is in this regard that Talcott Parsons developed the “sick role” model. While this model sees illness as a deviance, Parsons clearly differentiates between deviance and illness and develops a framework for the medicalization of deviance.

For Parsons, the sick role consists of four elements: Two of the elements exempt individuals from their normal social responsibilities (i.e., work obligations) and two present new requirements for the individual. First, those in the sick role are exempted from their social roles and responsibilities. Second, the individual in this role is not held responsible for his or her condition and cannot be expected to recover by an act of will. Third, the individual must recognize that his or her ill state is undesirable and is, therefore, obligated to seek wellness. Fourth, the sick person is required to seek competent help and cooperate with the process to get well.

For illness, then, the institution of medicine is an “appropriate” institution in which behavior can be socially controlled and regulated by holding the sick accountable to ensure that social norms are maintained. Furthermore, the institution of medicine legitimizes the illness, and physicians, institutions, and organizations function as agents of medical social control. This line of thinking implies that behavior that is not considered socially acceptable is deemed as illness. Thus, like criminal behavior, illness is often defined within social, cultural, and ethnic contexts—not medical frameworks. Although medicalization of deviance draws on medical terminology and frameworks to treat problems, the process by which problems are medicalized or medically controlled may or may not involve the medical profession.

[Page 427]In the medical profession, the greatest social power lies in the ability to define certain behaviors and individuals. Thus, the key to social control is definitional. Social control is conceptualized as the means by which society ensures conformity to social norms; specifically, how it reduces, eliminates, or normalizes deviant behavior. Social control can operate formally or informally. Formal social controls are institutionalized and include social agents such as the criminal justice system, correctional facilities, and medical institutions. Informal social controls are less structured and include self-controls and relational controls. Self-controls (i.e., conscience) usually are internalized and reside within the individual. Although self-controls are internal sources, they are created and maintained by external forces, such as society's norms, values, and beliefs. Relational controls are conceptualized as face-to-face interactions of everyday life. They include praise, gossip, ostracism, support, and alienation.

...