The commodification of women's health. The new women's health centers.
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Ambulatory Care Facilities↗
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Results for “Commodification”
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The patient commodification syndrome.
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Consumer Behavior↗
The commodification of the object in object relations theory.
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Affect↗
Commodifying the polyvalent good of health care.
This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. (1) How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? (2) If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"?
Commerce↗
The products of conception: the social context of reproductive choices.
This paper addresses the changing ideology regarding reproduction, an evolving American, and potentially worldwide, value system regarding children and parenthood. Children are increasingly being seen as products, and the new technology of reproduction, including the sale of reproductive material and services and especially prenatal diagnosis and selective abortion, encourage this commodification of the fetus. While the new technology does indeed offer new choices, it also creates new structures and new limitations on choice. In the contemporary American social structure, these choices are inevitably couched in terms of production and commodification, and thus do not offer individuals genuine choice or control.
Abortion, Induced↗
Prostitutes, workers and kidneys: Brecher on the kidney trade.
Brecher argues that the practices of selling blood and kidneys are akin to the practices of prostitution and wage-labour since they all involve commodification and, by implication, should be subject to legal prohibition. I suggest that these practices need not involve commodification and that they should only be condemned if people are forced into them because of their lack of power. Rather than these practices being prohibited, I suggest that it would be preferable if they were subject to state regulation in order to protect the weak from exploitation.
Commerce↗
Social and ethical aspects of in vitro fertilization.
In vitro fertilization (IVF) stands out as one of the contemporary period's most extraordinary technologies, and its social and ethical consequences among the most far reaching. Despite its uncertain effectiveness and medical consequences, IVF has contributed significantly to the medicalization of infertility and the increasingly imperative character of reproductive technology. New developments in IVF, particularly oocyte donation, have created new definitions of treatable infertility and new social needs for IVF; when the technology does not result in pregnancy or healthy babies, these developments have created profound new disappointments. IVF and the commodification of the extracorporeal embryo have also confused the social meaning and legal definition of parenthood. Ultimately the relationship between prospective parents, infertility specialists, and the embryos that they create is a highly ambiguous one. This ambiguity is likely to be a long-term characteristic of efforts to develop, use, and assess assisted reproductive technologies.
Commodification↗
Selling bits and pieces of humans to make babies: The gift of the magi revisited.
Reproductive medicine, a sector of a health care system increasingly captured by the demands of the marketplace, is enmeshed in a drive to sell certain human bits and pieces, such as gametes, cells, fetal eggs, and fetal ovaries, for reproductive purposes. The ethical objection raised by Kant and Radin to the sale of human organs - that this is incompatible with human dignity and worth - also applies to these sales. Moreover, such sales nullify the reproductive paradigm, irretrievably replacing it with a manufacturing paradigm. This represents a change in kind, not just of degree, in the way that we view our capacity to generate children and destroys our concept of reproduction as an essentially human activity. In the face of a struggle to retain those common ethical values at the foundation of reproductive medicine, this form of commodification of the human body should be viewed as ethically unacceptable.
Aborted Fetus↗
Defending commercial surrogate motherhood against Van Niekerk and Van Zyl.
The arguments of Van Niekerk and Van Zyl that, on the grounds that it involves an inappropriate commodification and alienation of women's labour, commercial surrogate motherhood (CSM) is morally suspect are discussed and considered to be defective. In addition, doubt is cast on the notion that CSM should be illegal.
Commerce↗
Holistic health and the critique of Western medicine.
The holistic view of health has been accurately criticized in the literature for its individualistic, victim-blaming ideology that obscures the social origins of illness. The paper explains how the contrasting view of the body and illness provided by the holistic model can help to show how Western medicine reflects the capitalist system in which it is promoted. It shows how evaluation of holistic therapies is problematic insofar as it is based on the analytical, reductionist criteria of the Western model. It suggests that one reason why holistic practices are not more fully accepted by Western medicine may be the challenge they pose to the Western model, and to the commodification of health needs promoted by this model.
Economics, Medical↗
(Over)eating success: the health consequences of the restoration of capitalism in rural China.
This paper reviews and evaluates some of the changes that have occurred in the Chinese health care system during the reform era associated with Deng Xiaoping (1978-1993). The reforms have helped to enrich the long suffering peasants in the Chinese countryside, and in many areas the peasants have experienced a significant improvement in the quality of their lives, including greater access to health care facilities, and better diets. The paper also considers some of the potentially negative side effects of the reform era, including the increasing income inequality between urban and rural areas; the commodification of Chinese medicine; declining access to health care for peasants in the poorest regions; and a concern about the changing patterns of diet and nutrition in the newly enriched parts of the Chinese countryside.
Cause of Death↗
Smoking prevalence among women in the European community 1950-1990.
The paper reviews trends in tobacco use among women in the European Community (EC) between 1950 and 1990. The data suggest that EC countries occupy different points on what appears to be a common prevalence curve. Southern EC countries are represented in the early phases of this curve, marked out by sharply rising prevalence. In northern EC countries, female smoking prevalence appears to have peaked. Across the EC, the commodification of tobacco use, and the production and promotion of manufactured cigarettes in particular, underlies this prevalence curve. Young women in higher socio-economic groups have led the way into cigarette smoking in both northern and southern Europe, with smoking prevalence declining first among women who are privileged in terms of their education, occupation and income. Because the decline in prevalence has yet to be repeated among women in more disadvantaged circumstances, cigarette smoking among women in the EC is likely to become a habit increasingly linked to low socio-economic status.
Adolescent↗
Purchasing a quick fix from private pharmacies in the Gaza Strip.
Increasingly, it is recognised by health planners and social scientists that self medication with drugs bought over the counter in private pharmacies is extremely widespread. Some anthropologists see this trend as an aspect of the 'commodification of health'. In this study, group interviews with health service users and providers in Gaza revealed many health service users reporting an inadequate supply of drugs resulting in the purchasing of drugs in private pharmacies. As a result, a survey of the pattern of utilization of three private pharmacies in three contrasting urban areas within the Gaza Strip was undertaken. Using a questionnaire, data were collected from all customers buying drugs. The results show that variations in the patterns of health seeking behaviour were associated with socioeconomic status. Adult males were the most frequent customers of all three pharmacies. They were buying medicines for members of their nuclear family more often than for themselves. Overall, pain and influenza were the most commonly reported conditions. The drugs purchased most frequently for women were for reproductive health problems, particularly infertility. Customers of the pharmacy in the relatively prosperous area more commonly purchased drugs which were prescribed by a private doctor.
Adult↗
Quantitative health research in an emerging information economy.
This paper is concerned with the changing information environment in the U.K. National Health Service and its implications for the quantitative analysis of health and health care. The traditionally available data series are contrasted with those sources that are being created or enhanced as a result of the post-1991 market-orientation of the health care system. The likely research implications of the commodification of health data are assessed and illustrated with reference to the specific example of the geography of asthma. The paper warns against a future in which large-scale quantitative health research is only possible in relation to projects which may yield direct financial or market benefits to the data providers.
Asthma↗
Low-cost diagnostic technologies and clinical outcomes. The impact of inappropriate utilization.
Commodification of low-cost diagnostic technologies (LCDTs) carries the risk of an unintended and potentially worrisome shift in how we conceive of health assessment. Optimizing practice requires a balanced understanding of both the beneficial and harmful impact of the use of LCDTs and the development of system incentives for appropriate use.
Diagnostic Tests, Routine↗
Status, sale and patenting of human genetic material: an international survey.
Following a decade of debate, the European Directive on the Legal Protection of Biotechnological Inventions was adopted by the European Parliament and the Council of the European Union on July 6, 1998. The Directive constitutes a legal and social policy landmark in biotechnology, taking an explicit position on the contentious issue of the patentability of higher life forms. It fails, however, to provide definitive statements on the legal status of human genetic material or the possibility of personal financial gain in relation to such material. An overview of the international, regional and national positions (as found in laws and official policy statements) on the status, commodification and patentability of human genetic material indicates that, although the Directive represents a consolidation of opinions, many issues remain unresolved.
Commerce↗
Feminist critiques of new fertility technologies: implications for social policy.
This essay aims to show how feminist theoretical and practical perspective have enriched and deepened debate about moral and social issues generated by the proliferation and commodification of new reproductive techniques. It evaluates alternative feminist appraisals beginning with the first group to organize a collective response to the medicalization of infertility and explores several weaknesses working within their assessment: objectification of infertile women, naturalizing constructions of motherhood, hostility to technology, and an overly simplistic conception of power relations. Next, it shows how subsequent feminists have reframed the issues to overcome these weaknesses, drawing on themes prominent in recent theoretical debates: the need to reclaim women's agency, to revalue mothering, and to reappraise power relations. Lastly, it weighs the prospects for a collaborative politics that is sensitive to the social marginalization of vulnerable women and suggests practical strategies for responding to mounting pressures to procreate at any price.
Dehumanization↗
Managed medical education?
The forces of rationality and commodification, hallmarks of the managed care revolution, may soon breach the walls of organized medical education. Whispers are beginning to circulate that the cost of educating future physicians is too high. Simultaneously, managed care companies are accusing medical education of turning out trainees unprepared to practice in a managed care environment. Changes evident in other occupational and service delivery sectors of U.S. society as diverse as pre-college education and prisons provide telling insights into what may be in store for medical educators. Returning to academic medicine, the author reflects that because corporate managed care is already established in teaching hospitals, and because managed research (e.g., corporate-sponsored and -run drug trials, for-profit drug-study centers, and contract research organizations) is increasing, managed medical education could become a reality as well. Medical education has made itself vulnerable to the intrusion of corporate rationalizers because it has failed to professionalism at core of its curricula-something only it is able to do--and instead has focused unduly on the transmission of esoteric knowledge and core clinical skills, a process that can be carried out more efficiently, more effectively, and less expensively by other players in the medical education marketplace such as Kaplan, Compass, or the Princeton Review. The author explains why reorganizing medical education around professional values is crucial, why the AAMC's Medical School Objectives Project offers guidance in this area, why making this change will be difficult, and why medical education must lead in establishing how to document the presence and absence of such qualities as altruism and dutifulness and the ways that appropriate medical education can foster these and similar core competencies. "Anything less and organized medicine will acknowledged... that it has abandoned its social contract and entered the temple of those who clamor, 'I can name that tune in four notes.'"
Cost Control↗