Biomedical Hegemony: A Critical Perspective on the Cultural Imperialism of Modern Biomedical Perspectives on Human Life

• • 
  • Presentation speakers
    • Olaug S. Lian, University of Tromsø / The Arctic University of Norway, Tromsø, Norway

  Abstract:

  In western industrialised societies, the professional biomedical health system has become a core societal institution. Biomedical perspectives on human life extend the medical system’s existing power through the acquisition of new territories. This cultural imperialism makes biomedical perspectives on human life increasingly more powerful and influential – both in existing areas of jurisdiction and in new areas not previously considered to be of a medical kind. In the latest diagnostic manual of mental illnesses (DSM-V) for instance, we see new diagnoses created for character traits not previously seen as illnesses. These are presented as value-neutral judgements, yet, symptomology are usually described negatively (reduced, limited, lack of etc.) and raise questions that are inherently normative, such as: “what are narrow interests, and is it good or bad to have them?”, “what are proper social skills?”, “how much social activity should we engage in?” and “how shy is too shy?”. Answers to these questions are culturally contingent, and modern biomedicine has no value-neutral methods or knowledge to answer them. Still, society has granted the medical technocratic system the power to define it. When the medical system redefines personal characteristics from character traits to unwanted medical conditions, it is health professions – not the social culture – who decide what is good or bad, right or wrong. Another example of this trend is physical conditions unsubstantiated by so-called “objective” biomarkers obtained through technologically generated findings. These conditions are typically negatively described, and often presented as either fake, imaginary, a sign of weakness and/or self-inflicted. In what has been described as the age of tiredness (Widerberg), medically unexplained exhaustion is a topical case: cultural norms define socially acceptable ways of acting (norms stating who has permission to be exhausted, and when, where and how we are allowed to express it), but through medicalization of these conditions these norms increasingly become medically defined. These examples show that although the process of medical diagnosis is founded on historically and culturally contingent norms and values (socially acceptable ways of thinking, feeling and acting), it is presented as value-neutral science given by nature; human beings are seen in a one-dimensional biological perspective. Modern biomedical perspectives are currently moving towards a cultural hegemony, granted by society at large. In Gramscis words, it is “the ‘spontaneous’ consent given by the great masses of the population to the general direction imposed on social life by the dominant fundamental group” – in this case medical doctors – that leads to cultural hegemony. To evaluate the legitimacy of the moral crusade of biomedical system, critical perspectives on medical dominance is needed. It is argued that by granting power to a technocratic medical system to define the norms of desirable conduct, we might end up creating a cultural unification that leads to unnecessary stigma and deviance, while reducing our tolerance for human diversity. Irrespective of how we evaluate this development, my main point is this: leaving such normative decisions to professional medical systems, as if they were solely or mainly based on professional value-neutral judgements, means leaving the role of generating, changing and sustaining cultural norms and values to a technocratic system. Is that something we want to do, and what are the implications? A critical discussion of these questions is more than timely.

 

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