Report: Social and Moral Contexts of Healthcare in Practice

This report delves into the social and moral contexts of healthcare, focusing on the concept of medicalization and its impact on patient care. The report begins by defining medicalization and its implications, highlighting both its benefits and drawbacks, such as improved quality of life versus potential over-medicalization and profit motives. A case study involving a nursing student and a young man seeking treatment for erectile dysfunction illustrates the dynamics between healthcare providers, patients, and families. The report examines the influence of societal stigma and biological factors, as well as the roles of compliance, concordance, and adherence in treatment. Furthermore, it discusses the balance between patient choice and provider recommendations, emphasizing the application of ethical principles like autonomy, beneficence, non-maleficence, and justice. The conclusion underscores the importance of considering the multifaceted nature of healthcare and the need for careful consideration of medicalization's impact. The report also provides references to support its claims.

RUNNING HEAD: SOCIAL AND MORAL CONTEXT OF HEALTHCARE 1
Social and moral contexts of healthcare
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SOCIAL AND MORAL CONTEXT OF HEALTHCARE 2
Social and moral context of healthcare
INTRODUCTION
Medicalization can be defined or rather explained as the process where previously or
current normal conditions are perceived to be medical problems by the healthcare professions or
healthcare providers. The particular conditions can either be behavioral, physiological as well as
emotional. Medicalization is deep rooted in the biomedical model of diseases whereby particular
diseases, behaviors are seen as direct dysfunctions within the body and therefore the need for
medical attention (Gibbons & Poelker, 2017). This therefore means that the concept of
medicalization changes the understanding of human social nature as the normal biological
functioning to things which can be treated.
Medicalization for the previous years, has been associated with both benefits and harm.
On the benefits side, many argue that by labelling a condition that can be treated has the general
effect of improving on the quality of life. A good example is Alzheimer’s disease which
previously, was known associated with senility and could not therefore be treated (Barker, 2014).
However, the condition has now been associated to a form of mental disease and has been treated
effectively to improve on the quality of life. Besides, the ability to classify an individual
suffering from certain biological malfunctions offer relief from feelings of exclusion as it
provides reasonable and precise explanation as to why they are peculiar from the rest.
Medicalization has also met stiff critiques due to the negative outcomes associated with
the practice. One such argument is that the aim of medicalization is to ensure maximum profits
to the pharmaceutical companies. Another disadvantage of the practice is that by labelling certain
conditions like the avoidant personality disorder, self-perception of individuals is thoroughly

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affected. With medicalization, there comes different dynamics among healthcare providers as
well as the application of concordance, compliance as well as adherence by the healthcare
providers. There are also cases whereby there is balance between patient choice and provider
prescribed treatment. Furthermore, there are ethical frameworks that guide the healthcare
providers to meet the moral obligations that are defined under the ANA code of ethics.
SCENARIO
As a nursing student during my clinical attachment, I experienced a certain case
revolving around the concept of medicalization. The case entailed one young man in his early
twenties who was seeking advice on how to use Viagra since he explained that he would not
maintain an erection during sexual intercourse with her girlfriend. Previously, erectile
dysfunction has been a condition associated with the elderly generation. However, the condition
can also be caused by other biological factors like stress, anxiety as well as depression. Besides,
it can also be caused by certain medications. This therefore classifies treatment of erectile
dysfunction by the use of Viagra as medicalization.
Dynamics of the healthcare providers and the family in seeking treatment.
For any choice to be made, there are always factors or rather determinants behind the
choice. Likewise, in the healthcare sector, the choice by patients are as a result of an interplay of
different dynamics by the healthcare providers and the society (May et al., 2014). Going by this
case or rather scenario about the boy who is seeking Viagra as a treatment option, the choice was
affected by the healthcare providers who labeled erectile dysfunction as medical problem
associated with low sex hormones and that there is a need for medical attention so as to repair the
impaired hormone functions especially testosterone. On the other hand, erectile dysfunction

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always come with a lot of stigmatization within the society and a family when discovered. It is
due to this stigma within the family that made the young boy feel the necessity of the treatment
for erectile dysfunction.
Concordance, compliance and adherence
Compliance is used to imply working under the request or desire of someone. In this
scenario, it implies working at the request and desire of the healthcare provider. The desire by
the healthcare provider is to have the erectile dysfunction corrected and this can be achieved by
the prescription of different medications to improve functioning of the testosterone hormone
(Chakrabarti, 2014). The healthcare provider therefore requested the patient to take medications
which the patient did. Concordance on the other hand is being at an agreement between the
provider and the patient. This was applied by the nurse where he as well agreed with the patient
that there was need to treat the erectile dysfunction. Finally adherence means withstanding or
going by the set standards (Randall & Neubeck, 2016). Analyzing this scenario, the nurse
adhered to the fact that erectile dysfunction need medical attention and that is why he saw the
need to treat the patient.
Balance between the patient and the healthcare provider
The balance I witnessed between the two parties was the fact that the patient felt erectile
dysfunction is a medical abnormality and that is why he chose to seek treatment. For maximum
benefits, balance ought to be established between the nurse and the patient. (Morgan et al.,
2015). The nurse on the other hand did feel that indeed erectile dysfunction is a biological
abnormality that needs treatment and that is why he chose to prescribe medication to correct the
harm.

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Ethical framework
There are four basic ethical principles in nursing and they include autonomy,
beneficence, on-maleficence and finally justice. Going by this scenario, the nurse utilized all the
principles. First, the principle of autonomy was put to use whereby the patient selected what kind
of treatment he was in need without the influence of anyone (Farrimond, 2013). Justice on the
other hand was in application since it is the right of the patient to seek treatment which he
actually did and therefore it was the moral obligation of the nurse to provide treatment("Belmont
Report: ethical principles and guidelines for the protection of human subjects of research," n.d.).
Finally non-maleficence was in use since there was no potential harm to the patient in the
medication.
CONCLUSION
Medicalization is the concept of where natural processes in the human body are perceived
medical dysfunction by the healthcare providers and therefore the need for medical attention.
Some of the previously conditions perceived as medical conditions currently include the
Alzheimer’s disease, alcoholism and sexuality cases like erectile dysfunctions and
homosexuality. For my case, I experienced a young man who was seeking treatment concerning
an erectile dysfunction. The dynamics of both the healthcare providers and the family that made
the young man is due to the stigma that comes with erectile dysfunction and the fact that it is
caused by an imbalance In sex hormones particularly testosterone. Besides, concepts like
concordance, compliance and adherence and ethical principles like autonomy should always be
factored in. Despite medicalization being associated with some benefits, it comes with a lot of
negative consequences and should therefore be discouraged.

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References
Barker, K. K. (2014). Mindfulness meditation: Do-it-yourself medicalization of every
moment. Social Science & Medicine, 106, 168-176.
doi:10.1016/j.socscimed.2014.01.024
The Belmont Report: ethical principles and guidelines for the protection of human subjects
of research. (n.d.). Manual for Research Ethics Committees, 126-132.
doi:10.1017/cbo9780511550089.028
Chakrabarti, S. (2014). What’s in a name? Compliance, adherence and concordance in
chronic psychiatric disorders. World Journal of Psychiatry, 4(2), 30.
doi:10.5498/wjp.v4.i2.30
Farrimond, H. (2013). Ethical Principles and Codes. Doing Ethical Research, 25-37.
Gibbons, J. L., & Poelker, K. E. (2017). Fighting for Respect: Midwives and the
Medicalization of Childbirth in GuatemalaFighting for Respect: Midwives and the
Medicalization of Childbirth in Guatemala. PsycCRITIQUES, 6262(1313).
doi:10.1037/a0040789
May, C. R., Eton, D. T., Boehmer, K., Gallacher, K., Hunt, K., MacDonald, S., …
Shippee, N. (2014). Rethinking the patient: using Burden of Treatment Theory to
understand the changing dynamics of illness. BMC Health Services Research, 14(1).
doi:10.1186/1472-6963-14-281
Morgan, J. L., Burton, M., Collins, K., Lifford, K. J., Robinson, T. G., & Cheung, K. (2015).
The balance of clinician and patient input into treatment decision-making in older
women with operable breast cancer. Psycho-Oncology, 24(12), 1761-1766.
doi:10.1002/pon.3853

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Randall, S., & Neubeck, L. (2016). What's in a name? Concordance is better than adherence
for promoting partnership and self-management of chronic disease. Australian
Journal of Primary Health, 22(3), 181. doi:10.1071/py15140