Ethical issues in moral and social enhancement

CHAPTER 5: Medicalization 
5.1. 
 Introduction 
The recent scientific focus on the neuroscience of sociality and morality, the 
expansion of diagnostic and psychiatric assessment categories to encompass more 
social aspects of our behaviour (e.g. psychopathy, personality disorders, social 
anxiety) and the increased search for treatment of the conditions means that our 
social and moral behaviour is increasingly under a scientific, psychiatric and 
medical gaze. The medicalization of morality is not new: psychiatrist Thomas Szasz 
(1963) and sociologist K. Irving Zola (1972) first described how modern psychiatry 
helped to medically redefine conduct previously viewed as sin or crime (e.g. heavy 
drinking, homosexuality, masturbation, suicide). Although public health and 
psychiatry have long been concerned with social behaviour (Conrad and Schneider, 
1980), the recent boom in neuroscience research and the increased interest in 
pharmacology and brain stimulation for social and moral enhancement (in the sense 
of making morally better agents) – happening in the context of the increasing 
efficacy of biomedicine – means that the proposed medical solutions may become 
more and more effective in changing our behaviours.
Yet the widening reach of the scientific and medical gaze meets with opposition. 
Cognitive enhancement, mood enhancement and MB have all been subject to 
critiques that see medicalization as a morally problematic process. This chapter 
asks whether using specifically biomedical means of moral modification gives rise 
to a strong ethical reason to forgo using MB. In order to do that, it aims to explore 
and examine some critiques of medicalization, untangling the various threads 
running through the debate. First, the concept of medicalization will be explained 
with reference to early sociological critiques and the more current approaches to 
medicalization. I propose that ‘medicalization’ should be used as a descriptive term, 
pending the moral assessment of the process. Second, the chapter explores 
objections to medicalization, including the ‘category-mistake’ argument, the view 
that ‘normal and usual’ traits should not be medicalized, the stance that unpleasant 
experiences are often justified and necessary for a full and flourishing life, the 
social control worry, the critique of an exponential growth of medical care as well 
as the objection to what is seen as the undermining of autonomy and responsibility. 

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Thirdly, the chapter brings forward the positive aspects of medicalization. The 
chapter concludes that it is important that we attend both to the advantages and 
disadvantages of the medical and scientific gaze. After examining the force of 
various arguments related to medicalization, this Chapter concludes that the 
arguments related to the critique of medicalization do not provide a strong reason to 
forgo MB generally speaking.