How Did “Medicalization” Transform a Patient-Doctor Relationship in the Field of Replacement Therapies for Hemophilia?

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  • 血友病補充療法の進展にみる医師役割の変質
  • 血友病補充療法の進展にみる医師役割の変質 : 「医療化」の観点からの検討
  • ケツユウビョウ ホジュウ リョウホウ ノ シンテン ニ ミル イシ ヤクワリ ノ ヘンシツ : 「 イリョウカ 」 ノ カンテン カラ ノ ケントウ
  • ――「医療化」の観点からの検討――

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Abstract

<p>Utilizing the concept of “medicalization,” this paper examines patient-doctor relationships in cases regarding the development of “replacement therapies” for hemophilia, which is caused by a hereditary lack of a coagulation factor. Peter Conrad and Joseph Schneider define “medicalization” as the process where previously nonmedical problems become defined and treated as medical problems, usually as diseases or disorders. This paper aims to refine the medicalization of replacement therapies by using the data from interviews and related materials collected through a joint research project conducted by the “Research Committee for the Problem of HIV Infection Caused by Imported Blood Products in Japan” from 2004 to 2010. For hemophiliacs, the introduction of non-heated concentrated blood products, especially when “self-injection (home infusion)” of such blood products was officially approved, brought a release from the “pain” caused by internal bleeding. For doctors, enabled the administration of different additional medical treatments such as operations rather than cooling the swelling. However, the development of replacement therapies caused a shortage of human blood plasma used for making blood products. The demand for plasma exceeded the domestic supply in Japan. It resulted in Japan’s dependence on imported purchased blood, which consequently led to the occurrence of multiple infections with HIV and hepatitis B or C.A study on those cases from the perspective of medicalization as a “sensitized concept” reveals that the introduction of non-heated concentrated blood products increased doctors’ intervention in hemophiliac’s lives, rather than it intensifying the dominance of the medical professionals as existing studies showed regarding medicalization. This suggests that “medicalization” consequently led to constructing a new image of doctors as also playing the role of an “educator” who can intervene and supervise patient’s lives. To elaborate on the concept of “medicalization,” further considerations of the concept of bio-medicalization and studies of “interaction level of medicalization” using interview data are required.</p>

Journal

  • SOSHIOROJI

    SOSHIOROJI 60 (1), 81-99, 2015-06-30

    SHAKAIGAKU KENKYUKAI

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