Life issues are more than just medical problems

Date: 23 mei 2017.

Energetic and overly active schoolchildren, an unfulfilled desire to have children, and growing old that comes with its shortcomings – problems such as these, which are related to specific stages in life, should not be viewed only from a medical perspective. As the Dutch Council for Health and Society (RVS) states in a recent report to the Dutch minister of Health, such problems are often caused by deeper, social phenomena, such as high expectations. A societal perspective is therefore required. This necessitates decreasing the self-evidence of solutions within the medical, professional domain, and investing in more realistic life expectations, such as growing up, young adulthood and growing old.

Realistic expectations
The Council notes expectations of life are unrealistically high in contemporary Western societies. We all aspire an ideal life: a care-free youth, a fast-forward career, cheerful parenthood and growing old in good physical and mental health. This, however, is not for everyone. When such expectations are not fulfilled and lead to individual problems, medical treatment is often seen to be the (only) solution. The number of people that visit their GP with a burnout as well as the number of medical and medicinal treatments such as AD(H)D-medication and IVF-treatments have increased significantly in recent years. Solutions such as these transform a societal problem into an individual, medical problem.

The RVS calls for a better acknowledgement of the societal causes of such individual problems. Acknowledging these causes also requires societal solutions. In the words of Prof. Pauline Meurs, chairwoman of the RVS: “We should focus on the role of teachers and schools, employers and social workers. They are in an unique position to prevent people from having to resort to the medical domain. Paying attention to sufficient room at school or at home for overly active schoolchildren, which may well be normal behavior for these children, can help prevent overmedication. And openly discussing the dilemma’s of having young children in combination with career ambitions can help young adults by raising awareness of reduced fertility in their thirties.”

Reducing the self-evidence of the medical domain
The Dutch Council also recommends that the ease in which medical intervention is sought as a solution to these problems should be reduced.
It should not be common practice to seek medical treatment when other forms of help can provide better solutions. The aim of their advice is to discourage the (financial) incentive to resort to medical treatment and stimulate an open discussion between doctor and patient about the desirability of medical treatment as opposed to other solutions. Medical education, the organization of medical work and medical guidelines do not as yet provide sufficient incentives and opportunities to develop such open discussion and therefore the ‘safer’ option of medical treatment is often chosen.
In the end however, as the title of the report by the RVS suggests: when society is the issue, medicine cannot be a satisfactory solution.

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