Medicalization and social justice

Most social justice critiques of medical care focus upon the allocation of extant, but scarce, resources. In contrast to that focus, this article explores the preallocative arena of factors which shape the supply and availability of medical care. We identify four such factors: (1)medicalization — the tendency to regard as biologically caused various human problems which were in earlier eras ignored or attributed to other causes; (2)social inclusion — the bringing of economically deprived and socially marginal groups into participation in the medical care system; (3)biomedical transcendence — the elevation of biomedically derived concepts of human function into a social and personal world view; and (4)health absolutism — the ideology which holds individuals accountable for their own health and which, contrary to the thrust of the other factors, deemphasizes access and social equity for professionally provided medical care. While these forces all enhance the place of health as a social value, it is by no means certain that they will lead to a society which is more medically just. The article concludes with an appeal for critical analysis of the processes which shape both the medical care system and the broad social concern with medical care.