Treatment/ Enhancement

Within biomedicine, there is this belief that it operates within the world of facts – it is separate from fiction and not influenced by the social world. From here there are two authorities that hover over biomedicine, which are the claims of universality and objectivity. Western culture in many ways sees biomedicine as scientific and logical with no room for cultural interference. The claim of universality states that biomedicine is a reflection of nature and a universal truth. While the claim of objectivity states that biomedicine is neutral, autonomous, and free from the social influences of people. Obviously, both of these claims are far from the truth. Biomedicine is in no way separate from the culture it has been created in and one can see culture reflected in the institution, language, and rituals that surround it. The culture of biomedicine is an interesting one because similar to many religions the devout followers of biomedicine have stood by it as fact for a long time. However, with fact often turning into fiction or objectivity turning into subjectivity – people often begin to lose faith in what they believed in so deeply.

For an example of how biomedicine shifts our ideas one can look at the dichotomy of treatment verses enhancement. I think this is an interesting separation because I honestly have very little idea where I would draw the line. To me, treatment is something that heals or helps someone with an illness or an injury. If I break my leg I get a cast for it. If I cut myself chopping onions I get stitches, and maybe some antibiotics to prevent infection. These I see as treatments. You have a problem – you get it fixed. On the hand, enhancement happens when there is not real problem to begin with – you just want something to be better (or up to cultural standards). Your car is old – you buy a new one. Your teeth are not sparkling white – you get some Crest white strips. Though, here is where the line gets blurry. What if you have chronically yellow teeth and you believe it is interfering with you getting that job you want? Would getting your teeth bleached be considered treatment then? Or what if you are a man who feels you are too short to be taken seriously? Would having surgery to make you taller be treatment or enhancement? I think this is an accepted dichotomy in Western culture because in many ways we make it culturally acceptable. I believe the medicalization movement followed by the biomedicalization movement has influenced our views on this dichotomy, because we see medicine as a way to treat illness but also as a way to enhance our bodies. This is why we often confuse the two or we do not know where to draw the line. Is Viagra a treatment for erectile dysfunction? Or is it an enhancement to make people fit into our cultural mold of longevity, vitality, and masculinity? I think our culture has drawn some lines for us to distinguish between the two. However, I also believe allowing the lines to be blurred leaves room for people to be expert patients and assess what is treatment and what is enhancement. After all, Western culture is highly individualistic so this must be appealing, especially at a time when people have lost some trust in the medical profession.

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  1. Paige Smith says:

    I completely agree with your view on the treatment/enhancement dichotomy. It seems as if, while there are some health care practices that could be strictly viewed as a treatment or enhancement, others are objective and depend on how an individual ranks the importance of the procedure. I think most people would agree that treatments are procedures that are necessary to improve one’s health; chemotherapy as treatment for cancer. Enhancements, however, are not always necessary for better health but could elevate one’s social status, confidence, aesthetic, etc. It is because of this that I think the idea of an enhancement greatly depends on the individual. For instance, one person could get a nose job because they can afford the procedure and are simply unsatisfied with how their nose looks. But another person could be getting the same procedure to improve their airways and make breathing easier for when they sleep. Are they both considered enhancements even though one could greatly improve that person’s health? It is important for clinicians to understand this dichotomy because it could prevent them from suggesting an unnecessary procedure to a patient. However, like you mentioned, the expert patient is becoming more common so that the patient can determine whether they really need a procedure and if there are other options available. If a doctor should believe that an enhancement is an absolutely necessary part of a patient’s recovery, then a lot of money and time could be wasted on an unnecessary procedure.

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