Ethical issues in moral and social enhancement

5.2.5. Medicalization and over-medicalization 
Parens notes that in both bioethical and sociological literature there is a growing 
(yet implicit) recognition of good and bad forms of medicalization: ‘medicalization’ 
(which is presumably good) is contrasted with ‘over-medicalization’ (which is 
presumably bad; see: Parens, 2011, p. 2). Parens quotes Henry et al. (2007) who, in 
their argument for distinguishing between using memory-attenuating drugs to 
respond to Post Traumatic Stress Disorder (which they approve of) and using the 
same drugs to achieve non-medical purposes (which they do not approve of) write:
‘If memory-attenuating drugs prove effective, we argue 
that the most immediate social concern is the over-
medicalization of bad memories and its subsequent 
14
This may sound like a common sense and obvious point. And it is. Unfortunately, such 
assessment does not always happen. 
15
I am grateful to Søren Holm for this point. 
16
I am grateful to John Harris for that point.

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exploitation by the pharmaceutical industry.’ (Henry et al. 
2007, p. 13)
Yet to say that X is an instance of over-medicalization is to state the conclusion of a 
moral evaluation before giving reasons for this conclusion. The next sections 
examine the intuitions that may underpin the assessment of medicalization as 
ethically problematic. 
5.3.
Ethical appraisal: arguments against medicalization
A common criticism of medicalization is that construing non-medical (or life or 
human) problems as medical problems, construing normal human variations as 
pathological, commits a category mistake (Parens, 2011). Shyness can be an 
unpleasant state that many people experience upon meeting new people. Short 
stature can result in unpleasant feelings in some short individuals. However, as the 
critic of medicalization could observe, neither sadness nor shyness nor short stature 
is a 
medical 
problem. Although feelings that can go with being sad or shy or short 
may be difficult, they are not symptoms of disease. Similarly, critics of the DSM-5 
worried about its ‘potential to pathologize and stigmatize normal human 
experience’ (Pierre, 2013). To treat human problems as medical problems is to 
make a mistake about the nature of the world, and seeing clearly and living well 
requires that we avoid such a mistake.
The ‘category mistake’ objection often additionally mixes in the claim that those 
unpleasant parts of experience are normal and usual, for example that sadness is a 
normal, perhaps even essential part of a full human life. Living well requires that 
we learn to accept some problems, learning to affirm, rather than erase, variations 
in our moods, behaviours, and appearances (see: Parens, 2011). The above critique, 
in fact, comprises of a series of intermingled, yet separable threads. Let us look at 
them in turn.