24 November 2007

Disease mongering

I recently ran across an interesting series of essays in the Public Library of Science (PLoS) from April 2006 on a phenomenon called "disease mongering":
"aspects of ordinary life, such as menopause, being medicalized; mild problems portrayed as serious illnesses, as has occurred in the drug-company-sponsored promotion of irritable bowel syndrome and risk factors, such as high cholesterol and osteoporosis, being framed as diseases."
But hold on, is this anything new? The distinction between bona fide diseases and mere medical complaints has probably always been blurry. Every culture I'm aware of, has the equivalent of the guy on the corner selling snake oil to cure your impotence or whatever. In traditional medical cultures based around shamanism there is by no means the clear and distinct separation of disease and suffering. Plus, people suffering seek relief and don't care if we in the medical community consider it to be from a real medical condition or not.

Sure menopause may be a natural event in the life of an aging woman, but it really can suck. Is there anything wrong with easing the symptoms of menopause in women who have a particularly hard time at it? Some say we have become a culture of whiners; but then why suffer needlessly? It may be true that suffering makes us stronger and more compassionate. It may be true that suffering brings us closer to god and the afterlife. Nevertheless, not many people refuse to have their suffering alleviated because they think suffering is a good thing for themselves!

There are two issues, however, that should concern the medical community regarding this "corporate-sponsored creation of disease" (I ripped off this phrase because I like it). Since we are treating more and more simple ailments (mostly of aging) as diseases that means we are using more pills, interventions, procedures and tests.
  1. All this stuff carries new risks and complications to our health
  2. This stuff is expensive and may divert resources away from more disabling diseases, indigent populations, and children

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