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4 - Controlling the body

Published online by Cambridge University Press:  05 June 2012

Antonia C. Lyons
Massey University, Auckland
Kerry Chamberlain
Massey University, Auckland
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The physician as lifestyle expert, as wellness adviser, has already begun to appear. And as genetic and other predictive tools improve, the art of prevention will grow far more sophisticated. Physicians will administer tests and, armed with the results, prescribe preventive measures just as precisely as they now dispense medications … what all this means is that our present concept of medicine will disappear …

(Crichton, 1990, cited in Beck & Beck-Gernsheim, 2001, p. 143)

Learning objectives

This chapter introduces ideas about individuals' understandings and relationships with their bodies, and the body as a site which can be examined and controlled in order to maintain physical health. Thus, behaviours such as breast and testicular self-examination, screening for disease and genetic screening are considered. We discuss the implications of the current pervasive focus on disease risk, self-surveillance and engagement with technological screening programmes. By the end of this chapter you should be able to:

  • distinguish between primary, secondary and tertiary prevention efforts;

  • describe some of the major forms of secondary prevention of disease;

  • evaluate whether screening programmes have a psychological impact;

  • outline the costs and benefits of screening programmes;

  • identify factors which influence individual uptake of screening services;

  • describe the major types of genetic testing currently employed, as well as their psychological and social effects;

  • discuss the implications of secondary prevention approaches for the individual;

  • examine how secondary prevention practices influence individual perceptions of risk;

  • evaluate how morality is embedded within accounts of risk.

Health Psychology
A Critical Introduction
, pp. 106 - 139
Publisher: Cambridge University Press
Print publication year: 2006

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Armstrong, D. (1995). The rise of surveillance medicine. Sociology of Health and Medicine, 17, 393–404. In this paper Armstrong argues that the surveillance of healthy populations is a new form of medicine that has emerged in recent decades. It is very useful in highlighting how the concept of risk is inherent in such an approach, and how this has consequences for individual identity.CrossRefGoogle Scholar
Hogle, L. F. (2001). Chemoprevention for healthy women: harbinger of things to come?Health: an Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 5, 311–33. This paper provides a very good introduction to the whole area of chemoprevention. It examines how even the mere concept of chemoprevention would not work unless people are concerned about their risk of becoming ill. Excellent examples are employed to show how companies are advertising chemopreventive products to the public in the USA, and the implications of such advertising are discussed.CrossRefGoogle Scholar
Kaplan, R. M. (2000). Two pathways to prevention. American Psychologist, 55(4), 382–96. In this paper Kaplan provides a very clear introduction to primary and secondary prevention approaches employed to enhance the health of the population. He argues strongly that although current health policy emphasises secondary prevention, this approach is problematic. He ends with a list of very clear messages to health psychologists about the effectiveness of primary prevention.CrossRefGoogle ScholarPubMed
Lerman, C., Croyle, R. T., Tercyak, K. P. & Hamann, H. (2002). Genetic testing: psychological aspects and implications. Journal of Consulting and Clinical Psychology, 70(3), 784–97. This review provides a good account of what we currently know about the psychological effects of genetic testing. It considers and critiques the research in the field as a whole, and gives suggestions for where research should be heading.CrossRefGoogle ScholarPubMed
Special issue on ‘Screening for disease’. Clinica Chimica Acta, 315 (2002). This special issue provides a range of papers which examines screening from different perspectives, including statistical, economic and ethical. All authors consider the evidence that screening is effective, and what may help to improve the effectiveness of screening processes.

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