Adolescence 3 medicalization - biering article

Question 1

focus

Answer 1

power relations between involuntary hospitalized adolescents and their caregivers in the nursing field - emphasis on concept of medicalization

Question 2

problem

Answer 2

the silence within this field about the issue of power in these encounters and their consequences, for patient practitioner
- linked with self assumptions about non-hierarchical relationships and the idea of patients right to self-determination

Question 3

objective

Answer 3

to develop nursing theories that can improve the care of this population
- especially those that include the role of power

Question 4

important of autonomy

Answer 4

• indv right and ability to govern their own life and make decisions without coercin
• very important when deciding on involuntary hospitalizations of adolescents
• during adolescence the capacity for thinkg about and wanting autonomy is significant in identity construction

Question 5

ethical issues about autonomy among these youth

Answer 5

• capacity for rational thought but they also experience emotional suffering and instability
• risk of depriving them of their autonomy because they are hospitalized involuntary

Question 6

the authoritive role of medicine

Answer 6

• psychiatry in particular - controls and regulates their behaviour
• repressive but also productive
  it controls but ALSO produces knowledge that adds to its power (by increasing medical categories and the attendant modes of surveillance and regulation)

Question 7

Some of critical issues linked with medicalization

Answer 7

-adolescents social and psychological suffering
2 critical aspects
1. determining if problematic behaviour is an outcome of family dysfunction or unjust social order
2. questioning their disciplinary power that medicine exercises through diagnostic techniques
Family and community
- revived by new advances in genetics and neuroscience
- cant discount nurture and the fact that most troubled adolescent live in a dysfunctional environment

Question 8

Medicalization cont’d

Answer 8

• suffering of these adolescents are medicalized not because they have the greatest need for psychiatric interventions BUT because they are the most powerless members of their families and communities
• lends itself into an arguement for interventions that are contextualized at the family and community

Question 9

Powers of psychiatric diagnosis

Answer 9

privileged way of thinking
- power imbalance between professionals and lay people produces unequal control over the situation or condition under question
creating reality
- language that reflect but also creates power
categorizing patients
- the suitability of medical interventions depends on the category people are placed in
- production of categories further extends and expands medical power

Question 10

plus side of medicalization

Answer 10

• medicalizing adolescent behaviour problems is about social control and responding to social need
• medicalization can be part of an interactive process between patient and provider
• the transformation of senseless sickness into meaningful suffering

Question 11

caring for these adolescents - the politics care

Answer 11

• nurses are agents of social control
• likely agree with the law and cultural norms that constrain adolescents autonomy for the purpose of improving their health

Question 12

nurses also need to ask themselves

Answer 12

• are the potential therapeutic gains great enough to justify medicalization?
• are the benefits from suffiicient enough in each case to justify involuntary hospitalization?