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医学化、愿望实现医学与疾病贩卖:走向一个美丽新世界?

Medicalization, wish-fulfilling medicine, and disease mongering: toward a brave new world?

作者信息

Blasco-Fontecilla H

出版信息

Rev Clin Esp (Barc). 2014 Mar;214(2):104-7. doi: 10.1016/j.rce.2013.08.012.

DOI:10.1016/j.rce.2013.08.012
PMID:24772477
Abstract

Western societies are characterized by a growing medicalization of life events, such as pregnancy, aging, or even death. Three concepts -medicalization, wish-fulfilling medicine, and disease mongering- are key in understanding the current practise of Medicine. Quite surprisingly, not a single study has addressed the relationship between all three of these concepts. The term medicalization expanded under the open-ended concept of health developed by the World Health Organization in 1946. One of the consequences of medicalization is the transition from patients to clients. Physicians are under increasing pressure to meet the insatiable demands of their clients. The term wish-fulfilling medicine refers to the increasing tendency of medicine to be used to fulfill personal wishes (i.e. enhanced work performance). The insatiable demand for healthcare is troublesome, particularly in Europe, where the welfare states are more and more under pressure. Finally, the term disease mongering refers to attempts by pharmaceutical companies to artificially enlarge their “markets” by convincing people that they suffer from some sickness and thus need medical treatment. Typical examples of disease mongering are social anxiety disorder, low bone mineral density, and premature ejaculation. Currently, some Public Health Services could be on the brink of collapse as they “navigate” between the scarce resources available and the users’ insatiable health demands. Therefore, it appears necessary to generate clear-cut Public Health Services Port-folios.

摘要

西方社会的特点是生活事件的医学化程度不断提高,比如怀孕、衰老甚至死亡。医学化、愿望实现医学和疾病贩卖这三个概念是理解当前医学实践的关键。颇为令人惊讶的是,尚无一项研究探讨过这三个概念之间的关系。医学化这一术语是在世界卫生组织1946年提出的开放式健康概念下发展起来的。医学化的后果之一是从患者向客户的转变。医生面临着越来越大的压力,要满足客户永不满足的需求。愿望实现医学这一术语指的是医学越来越倾向于被用于实现个人愿望(比如提高工作表现)。对医疗保健的无尽需求令人烦恼,尤其是在欧洲,福利国家面临的压力越来越大。最后,疾病贩卖指的是制药公司试图通过让人们相信自己患有某种疾病从而需要医疗治疗来人为扩大其“市场”。疾病贩卖的典型例子有社交焦虑症、低骨密度和早泄。目前,一些公共卫生服务机构可能正处于崩溃边缘,因为它们在可用的稀缺资源和用户永不满足的健康需求之间“艰难前行”。因此,制定明确的公共卫生服务组合似乎很有必要。

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