Medical power and surveillance Week 18 Embodiment & Feminist Theory

Recap Considered how embodiment is an organising structure which ‘values’ some bodies are more than others Look at how bodies are always markers of class, ‘race’ and gender Considered to what disability and ageing are socially constructed

Outline Looking at how medical power and knowledge shape our understanding of bodies Consider how women’s bodies in particular are medicalised Consider the advantages and disadvantages of surveillance medicine

Medical Professionalisation Medical professionalisation excluded and marginalised folk healers (often women). In the 17 th midwives were denied a royal charter following opposition by the Royal College of Physicians 1849, Elizabeth Blackwell became the first woman doctor after a long struggle

Medical Professionalisation As well as exclusion from the medical professions, women were the subjects of medicine Women’s bodies in particular were constructed as weak, vulnerable, and in need of treatment –Mental health –Reproductive health

Discuss how the ideas of Cartesian dualism support both women’s exclusion from professions and their treatment as the ‘weaker’ sex.

Defining Medicalisation The medical profession have control over bodily matters related to health and illness They are also have the power to define what is a medical matter Medicalisation is said to occur when the medical profession re/defines a bodily condition as a medical one

Medicalisation of pregnancy Oakley argued that pregnancy and birth are ‘natural’ conditions and are not states of illness During the 19 th Century, medical professionals replaced traditional midwives as the ‘experts’ Shifting care into hospitals, and unnecessary medical interventions put women at risk

Challenging medicine Oakley’s studies showed the extent to which medical power transformed ‘natural’ conditions into medical conditions Women’s knowledge and understanding were dismissed –Pregnancy, childbirth, –menstruation, menopause

Doctor knows best? Doctor (reading case notes): –Ah I see you’ve got a boy and a girl. Patient: –No two girls Doctor: Really are your sure? I thought it said… (checks in case notes) oh no, you’re quite right two girls Oakley A (2005) the Ann Oakley reader Bristol Policy press p173

Normal pregnancy? Women are told that pregnancy is a ‘natural function’ But are required to submit to: –Following medical advice –Regular medical check-ups –Increasing amounts of ante-natal testing ‘Normal’ pregnancy is only a retrospective label

Doctor knows best? Foucualt argued that biopower emerged as a form of social regulation during the Enlightenment period Biopower seeks to control populations throught discourse and productive power Medicine is a key sight of biopower

Biopower Biopower works though surveillance and the production of self discipline Metaphor of the panopticon Medicalisation defines normal and abnormal bodies and behaviours

Pregnancy don’ts? Pregnant women have long lists of acceptable and unacceptable behaviours Once visibly pregnant, women’s behaviour is monitored and judged by the public In the US, sanctions can include imprisonment

Do you think the prohibitions and judgements on pregnant women are always justified? In what ways do they undermine their position as equal citizens?

Medicalisation of the menopause Martin argues that understandings of the menopause are shaped by its medical construct Moved from a ‘normal’ life stage to a symptom of ‘bodily decline’ This shapes women’s understanding and experience of the menopause It also fuels pharmaceutical intervention

The rise of Surveillance Medicine Broadly the women’s health movement had two aims: –To take back control from medical professionals –To have women’s health matters taken more seriously There are conflicts in these two objectives

Surveillance Medicine Medicine used to confine itself to those it counted as ill The rise of surveillance medicine includes everyone It refers to the notion that bodies require constant monitoring for their own good –Child development clinic, screening programmes –Health promotion and lifestyle

Surveillance Medicine The case of cervical cancer The National Screening programme of cervical smear testing can be understood in two ways –A benefit to women brought about by the success of the women’s health movement. Ensuring the prevention of a significant cancer –The imposition of an unreliable and uncomfortable test in which thousands of women are over-diagnosed extending medical power over women’s bodies

Discuss the ideological and theoretical positions between these two viewpoints.

Defining Bodies Martin argues that surveillance medicine constructs itself as the ‘best’ way of staying healthy But it also constructs bodies as disease prone and in need of constant monitoring It re/constructs the ways in which we come to understand our bodies and that of others

Summary Consider how normal bodily processes have been defined as medical matters Considered the concept of biopower Considered the rise of surveillance medicine