THE SOCIOLOGICAL CRITIQUE OF THE BIOMEDICAL MODEL OF HEALTH AND HOW IT AFFECTS WOMEN'S HEALTHChallenges of Biomedicine
Biomedicine has being in existence since the ending of the eighteenth century. It is the major model used by health practitioners to detect diseases (Nettleton, 1995).This biomedical model of health have centred on how the human body functions and how diseases can be stopped, or healed through medical intervention(Taylor and field, 2003). This model continues to be the bedrock in which foundation of health care system is based in the western societies, but there has being a lot of queries concerning its influence on the general pattern of health, since majority of health determinant are social and environmental. Arkinson (1988 p.180)claimed that the biomedical model, which as taken over the formal health care system in the West since the last two decades view health along the reductionist approach. In this approach, illness is said to be caused by injury or infections and there is neglect of the psychological, socio-economical and environmental influences (Taylor and field 2003).
Over the last two centuries the biomedical model has being greatly challenged by scholars in the medical and sociological field (Engel, 1981). This criticism was brought about by the drastic increase in the medical expenses. Engel (1981) stated that the effectiveness of the medical model has been over emphasized. Mc Keown (1979) also argued that the reduction in the death rate which happened some years back within the developed world was influenced by good eating habit and proper hygiene than it was with immunisation, and other health care intervention. This view was supported by Powles (1973) by re-emphasizing that spending money on health care system had led to nothing but wastage. Illich (1990) also argued that instead of medicine providing a curative assistance to the populace, it added more to their problem by introducing what is called iatrogenesis which means "illness-brought by medical practitioners",for example, the aftermath effect of using drug and some harmful effect of surgery. Illich (1990) blamed the health care providers and the pharmaceutical companies of inventing the social iatrogenesis .This brought into limelight consumption of health care product which was caused by increase health need. He also testified that the system of medicalisation also brought about what we call cultural iatrogenesis, which means that the medical industry has robbed people off the ability to cope with sickness. Illich (1990) argued that human being should try to avoid the control of medicine over their lives. He claimed that the monopoly of medicine over cure should be stopped, so that people can make decision on their way of life. The medical model is in support of the clinical type of iatrogenesis (Illich, 1990),which was brought about by the advent of conception control technology like intrauterine contraceptive device (IUCD), inject able pills and oral pills usage, which we all know have a dangerous effect on the well being of women when considered as a solution(Stanworth,1987). Would drug companies continue to produce harmful family planning device if medicine was more controlled by women compared to men?
Stryer and Clancy (2005) reported that in Britain it was estimated that around 10% of people hospitalised undergo some kind of iatrogenisis, which is equivalent to roughly 850.000 occurrences per year. Health is said to be highly medicalised in this model which led to a general view of human beings (Illich, 1990). Oakley (1976) and Donnison (1977) reported this fact about medical jurisdiction by citing an example of childbirth. They accepted that this was taken away from women by the institute of medicine by ensuring that by the 1970s all child delivery took place in the hospital (Tew, 1990).This action made pregnant women to be handled like a sick person. In this respect a normal life experience was turned into a medical problem, which requires the assistance of the medical team (Martin, 1989).
The model focuses mainly on the healing process which is at a disadvantage to prevention and health promotion care closer to the populace (Taylor and field 2003, p.31). Wilmott (2003) supported this view by acknowledging that the model is purely negative, because it is so engorged with ailment and does not explain what health entails. Engel (1981) stated that biomedicine has refused to acknowledge the fact that the human body is linked with the social environment. Nettleton (1995) reiterated that the biomedical model neglected the presence of the social inequalities in health. She also argued that for effective treatment, the lay people experience about health and illness must be acknowledged (Nettleton, 1995).
According to the perspective of Marxists, he argued that doctors encourage the production rate of the society by explaining health as the potential to work, he also disseminated that "hard work is better than laziness"(Waitzkin, 1989).It was emphasized that the health professionals are blamed of medicalisation if they consider the societal influence of patient and if they ignore, the accusation still holds (Nettleton, 1995).Gilleard and Higgs(2000) also claimed that peoples aspiration in life as become medicalised from the result of a study conducted by the British Medical Journal (BMJ) which involve analysing some of the non-diseases that medical practitioners need to tackle (Smith,2002).Gender influence on Health
The gender bias within the biomedical domain was clearly emphasized from the conflict perspective (Nettleton,1995).It was cited by Nettleton from the feminist point of view that sexist ideologies of the medical profession present women as a second class citizen, compared to the men folks(Scully and Bart,1978;Martin,1989).For example, it was related by (Nettleton,1995)that the frequent female visit to the hospital and clinics compared to their male counterpart is because of the way their body is designed for childbearing and also for the care they provide for other family members.
Foster (1989) stated that there are many ways in which the feminist criticize how the medical practitioners interact with patient. She reiterated that most of the female problems from the medical point of view need to be questioned. She supported are evidence by citing an example of menstrual pain among women. She said that some female overstretch the severity of the pain, while most ignores it(Foster,1989 p.339).She also mentioned that the medical practitioners considers male as first class citizen in the ways they interact with them compared to their female folks.
Gendered nature of power in biomedical research and clinical practice was related in the US Public Health Service Task Force that there was neglect in the way women's health was being handled (Patricia and Chiloe 1999).They argued that the biomedical research laid more emphasis on diseases that can cause high risk of mortality in men compared to the women despite that the diseases were not sex-specific like "breast cancer". Robert (1990, 1992) also supported this fact by accepting that male gender still stands as a measure to evaluate the status of health of both sexes, despite the clamour to broaden people's knowledge about women's health. Different Research have demonstrated that women who complain about serious signs are not given thorough examination to tackle the symptoms compared to the way men having the same symptoms will be handled in areas of coronary arteriogram, and catheterisation(Shaw et al.,2004).Patricia and Chiloe (1999) reported that a social policy was promulgated which brought about putting a stop to the incessant use of women as research animals and to decrease the problem that could occur if foetus is exposed to research. Most feminist have cited that men are labelled as valuable being in the society compared to women whose psychological well being was said to be designed in a non-valuable domain(Scambler,1998).The feminists also suggest that in this modern days the oppression female goes through was brought about by the power structure given to their male counterpart(Irigaray,1985).Impact of Biomedicine on women's health
Women's health was endangered through abortion brought about by the biomedical model. This view was supported by Foster (1989)by relating that the doctors assist the male by encouraging the female to undergo tuba ligation which is a form of family planning that make women sterile forever. This action favours the male, but detrimental to the female forever because of their inability to be able to conceive again in life. This shows that men has really dominated the world and do not care about the well being of women. The radical feminist cited by Nettleton (1995) accepted that the western medicine have given men too much opportunity compared to the women. This has allowed men to take over the women's bodies, because men have capitalised on the fact that women are assessed based on their own judgement .This is in line with the fact that health practitioners often judge females psychological feelings based on their body conformation which is designed for reproduction (Abbott and Wallace, 1990).What about domestic violence and challenges women faces in the society in managing the home and their career?.Some societies also accuse only women of infertility without putting their husband (men) into consideration. This shows the extent to which the medical model has labelled women for not getting pregnant. Nettleton (1995) supported this by claiming that infertility is another thing that the biomedical model brought into existence by turning it to be a disease of the women not men and not including them into their treatment plan.
This idea as changed to an extent in the developed world, where several medical examinations will be carried out on both couples. But this is still rampant in the developing country among certain cultures. Can we consider this to be the reason why females are psychologically affected sometimes? It was suggested that this process can be controlled by ensuring that women doctors treat the sick women within the society that is antiracist, anti-sexist, and anti-heterosexist (Williams,1989;Abbott and Wallance,1990).This idea was also argued from another point of view by the reformist that the health system need to be changed from within .This is to ensure that female doctors are also employed in greater number and also enforcing accountability by the medical practitioners (Williams,1989;Abbott and Wallance,1990).
Stacey(1988,p.252) claimed that the medical model was also accused of bringing into existence what is known as social mothers (surrogate).This is a kind of technology which brought about conception by ensuring fertilisation of an ovum of one woman and replacing it back into that woman uterus or uterus of another woman . This kind of technology which is known as "New Reproductive Technology" deprives the women of the power of autonomy when they are artificially inseminated by a male sperm who might not be their spouse. The females are denied of their biological right by being told that the owner of the donated sperm is the real biological father while they are just a surrogate (not real) mother (Zipper and Sevenhuijsen, 1987, p.252).Corea (1985) also supported this view by claiming that sperm of male is seen to be more important compared to the female body that goes through the three trimesters period, stages of labour and delivery. (Doyal, 1998 andRaine, 2000) stated that gender difference may deprive females from some basic medical care, which could be as a result of bias and lack of wealth. They pointed out that the United kingdom was able to close the gap of gender differences by the introduction of the National Health Service (NHS).They reiterated that some health officers still treat women as non-valuable being, which could lead to unfair display of medical resources. Doyal (2001) suggest that if we want the discrimination in clinical studies to stop, the policy makers will need to make effort to endeavour all research methodology takes gender issues very important. This will assist in bridging the gap of peoples view on women's health. This will also augment the quality of biomedical research and findings. Doyal (2001) proposed that health promotion policies need to wear a new look by avoiding gender difference in delivering their educational messages to the populace because most of the campaign disseminated does not always focus on the health of women but on the care women give to other family members.
Scambler (2003) reported that mental health of women was seen to be dominated by medicine because of its dependence on drug prescription that is "medicalisation of female sadness". Ehrenreich and English (1979) wrote about the different ways by which females were assumed to be mentally weak by concluding that they suffer from hysteria, which was linked to their ability to reproduce. They are always rendered useless by being confided to an environment which might not be very conducive and forced to consult a medical practitioner that dictate solution to their problem.