All posts by Yuezhu Sun

Opting out of forced longevity: the De-medicalization of American Society?

In her book, Ordinary Medicine, Sharon Kaufman contends that the increasingly complicated means by which modern medicine achieves its goals to alleviate symptoms, prevent diseases, and increase life expectance have fundamentally transformed how end-of-life experiences are anticipated and handled. Advanced medical technologies not only made more diseases into chronic conditions, which, in turn, prompts the demand to create more high-tech treatments, but they also start to redefine the ways patients and their family members envision healthcare options. The denial of medical treatment in preference for improved life quality is perceived more and more as a problematic, if not an unethical choice.

On the other hand, The New York Times published an article this summer stating that the rates of major age-related chronic illnesses, such as cancer, dementia, and heart disease are, in fact, on the decline, especially in developed nations such as the U.S. and European countries.

For instance, although still a leading killer, deaths caused by heart diseases (HD) such as stroke, or sudden cardiac arrest, have decreased for more than 30 percent from 2000 to 2012. Whereas physicians and medical scientists speculated that factors such as better prevention programs, healthier lifestyles, and higher quality medical treatment might contribute to the declining rates of major chronic diseases, these reasons, even all taken together, could not fully account for what is currently happening. Interestingly, this New York Times article also points out that, even though HD-related mortality rates have been on the decline for nearly more than half a century, lately, medical researchers have noticed that the rate of this decline appears to be decelerating.

How do we reconcile this apparent disparity between Kaufman’s ethnographic observations, through which she claims that the development and expansion of biotechnology has rendered more old-age related diseases chronic, and the New York Times column that depicts a conflicting social reality? One could argue that the medical report cited by the New York Times, which was originally published in a medical journal JAMA Cardiology, examines only the mortality rate due to heart diseases, while paying scant attention to the living conditions of those who choose to prolong or sustain their lives by accepting intrusive medical interventions, such as the implantation of cardiac defibrillator.

Even so, Kaufman’s thesis on the medicalization of old age still seems somewhat inadequate in elucidating, for example, why there has been a slow down in the decline of HD mortality rate since 2010.

As we have already touched on during our last class discussion, maybe an incipient sociological/anthropological phenomenon is taking place in American society today, where informed patients and their family members have become exceedingly disenchanted with biomedical procedures and pharmaceutical products. If this is the case, instead of studying the medicalization of American society, perhaps we should begin to study the de-medicalization of American society? Further, is the distinction between medicalization and de-medicalization a new manifestation of global inequalities, where individuals from less developed countries have just begun to fetishize biotechnologies, compared to the privileged, who have already decided to opt out of forced longevity for the pleasure of living.

*For an example, see the story why Lenard Cohen decided to pick up smoking on his 80th birthday