Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine

TLDR

American medicine became institutionalized by the end of WWII, expanded through medicalization, and since about 1985 has entered a second transformation—biomedicalization—where technoscientific innovations reshape the organization, practices, and very nature of biomedicine. Biomedicalization is driven by five interrelated processes: political‑economic restructuring of the sector, a focus on health and risk surveillance, increasing technological and scientific complexity, changes in knowledge production, distribution, and information management, and transformations of bodies and identities that create new technoscientific selves.

Abstract

The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into new realms-became widespread. Since about 1985, dramatic changes in both the organization and practices of contemporary biomedicine, implemented largely through the integration of technoscientific innovations, have been coalescing into what the authors call biomedicalization, a second transformation of American medicine. Biomedicalization describes the increasingly complex, multisited, multidirectional processes of medicalization, both extended and reconstituted through the new social forms of highly technoscientific biomedicine. The historical shift from medicalization to biomedicalization is one from control over biomedical phenomena to transformations of them. Five key interactive processes both engender biomedicalization and are produced through it: (1) the political economic reconstitution of the vast sector of biomedicine; (2) the focus on health itself and the elaboration of risk and surveillance biomedicines; (3) the increasingly technological and scientific nature of biomedicine; (4) transformations in how biomedical knowledges are produced, distributed, and consumed, and in medical information management; and (5) transformations of bodies to include new properties and the production of new individual and collective technoscientific identities.