Davis Courtney
Department of Social Science, Health and Medicine, School of Social Science and Public Policy, King's College London, Strand, London WC2R 2LS, UK.
Soc Sci Med. 2015 Apr;131:207-14. doi: 10.1016/j.socscimed.2014.12.007. Epub 2014 Dec 2.
There is evidence from some countries of a trend towards increasingly aggressive pharmacological treatment of patients with advanced, incurable cancer. To what extent should this be understood as a progressive development in which technological innovations address previously unmet needs, or is a significant amount of this expansion explained by futile or even harmful treatment? In this article it is argued that while some of this growth may be consistent with a progressive account of medicines consumption, part of the expansion is constituted by the inappropriate and overly aggressive use of drugs. Such use is often explained in terms of individual patient consumerism and/or factors to do with physician behaviour. Whilst acknowledging the role of physicians and patients' expectations, this paper, drawing on empirical research conducted in the US, the EU and the UK, examines the extent to which upstream factors shape expectations and drive pharmaceuticalisation, and explores the value of this concept as an analytical tool.
一些国家有证据表明，对于晚期无法治愈的癌症患者，药物治疗有日益激进的趋势。这在多大程度上应被理解为一种进步的发展，即技术创新满足了以前未被满足的需求，还是这种扩张在很大程度上是由无效甚至有害的治疗所导致的？本文认为，虽然这种增长的一部分可能与药物消费的进步观点相一致，但部分扩张是由药物的不当和过度激进使用构成的。这种使用通常从个体患者的消费主义和/或与医生行为有关的因素来解释。在承认医生和患者期望的作用的同时，本文借鉴在美国、欧盟和英国进行的实证研究，考察上游因素在多大程度上塑造了期望并推动了医药化，并探讨这一概念作为一种分析工具的价值。
