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Disease mongering is a
pejorative A pejorative or slur is a word or grammatical form expressing a negative or a disrespectful connotation, a low opinion, or a lack of respect toward someone or something. It is also used to express criticism, hostility, or disregard. Sometimes, a ...
term for the practice of widening the diagnostic boundaries of illnesses and aggressively promoting their public awareness in order to expand the markets for treatment. Among the entities benefiting from selling and delivering treatments are pharmaceutical companies, physicians, alternative practitioners and other professional or consumer organizations. It is distinct from the promulgation of bogus or unrecognised diagnoses.


Term

The term " monger" has ancient roots, providing the basis for many common compound forms such as cheesemonger,
fishmonger A fishmonger (historically fishwife for female practitioners) is someone who sells raw fish and seafood. Fishmongers can be wholesalers or retailers and are trained at selecting and purchasing, handling, gutting, boning, filleting, displaying, ...
, and fleshmonger, for those who peddle such wares respectively. "Disease mongering" as a label for the "invention" or promotion of diseases in order to capitalize on their treatment was first used in 1992 by health writer Lynn Payer, who applied it to the Listerine mouthwash campaign against
halitosis Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder. ...
(bad breath). Payer defined disease mongering as a set of practices which include the following: * Stating that normal human experiences are abnormal and in need of treatment * Claiming to recognize suffering which is not present * Defining a disease such that a large number of people have it * Defining a disease's cause as some ambiguous deficiency or
hormonal imbalance Endocrine diseases are disorders of the endocrine system. The branch of medicine associated with endocrine disorders is known as endocrinology. Types of disease Broadly speaking, endocrine disorders may be subdivided into three groups: # Endocrin ...
* Associating a disease with a public relations
spin Spin or spinning most often refers to: * Spinning (textiles), the creation of yarn or thread by twisting fibers together, traditionally by hand spinning * Spin, the rotation of an object around a central axis * Spin (propaganda), an intentionally b ...
campaign * Directing the framing of public discussion of a disease * Intentionally misusing statistics to exaggerate treatment benefits * Setting a dubious
clinical endpoint Clinical endpoints or clinical outcomes are outcome measures referring to occurrence of disease, symptom, sign or laboratory abnormality constituting a target outcome in clinical research trials. The term may also refer to any disease or sign tha ...
in research * Advertising a treatment as without side effect * Advertising a common symptom as a serious disease The incidence of conditions not previously defined as illness being medicalised as "diseases" is difficult to scientifically assess due to the inherent social and political nature of the definition of what constitutes a disease, and what aspects of the human condition should be managed according to a medical model. For example, halitosis, the condition which prompted Payer to coin the phrase "disease mongering", isn't merely an imagined social stigma but can stem from any of a wide spectrum of conditions spanning from bacterial infection of the gums to kidney failure, and is recognized by the Scientific Council of the American Dental Association as "a recognizable condition which deserves professional attention".


Examples

Australian journalist Ray Moynihan has argued that the pharmaceutical industry engages in disease mongering to enlarge its profits, and that it harms citizens. His use of osteoporosis as an example of a "made up" disease in this article prompted an angry retort from the president of the British
National Osteoporosis Society The Royal Osteoporosis Society (ROS), formerly the National Osteoporosis Society, established in 1986, is the only UK-wide charity dedicated to improving the prevention, diagnosis and treatment of osteoporosis. It is based in Camerton, Somerse ...
, stating that the article was insulting to people with osteoporosis and vastly understated the risk of disabling fractures associated with the disorder. Moynihan published a satire of disease mongering in the 2006 April Fool's Day issue of ''
BMJ ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origina ...
'' titled "Scientists find new disease: motivational deficiency disorder". Other conditions which have been cited as examples of disease mongering include:
restless leg syndrome Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is generally a long-term disorder that causes a strong urge to move one's legs. There is often an unpleasant feeling in the legs that improves somewhat by moving them. This ...
,
testosterone deficiency Androgen deficiency is a medical condition characterized by insufficient androgenic activity in the body. Androgenic activity is mediated by androgens (a class of steroid hormones with varying affinities for the androgen receptor), and is dependen ...
, erectile dysfunction, and hypoactive sexual desire disorder. Some of these conditions are recognized as medical disorders by professional medical societies and the
National Institute of Health and Clinical Excellence National may refer to: Common uses * Nation or country ** Nationality – a ''national'' is a person who is subject to a nation, regardless of whether the person has full rights as a citizen Places in the United States * National, Maryland, c ...
. In 2014, an FDA advisory committee voted to limit the use of testosterone replacement therapy products due to potentially increased cardiovascular risk associated with their use. A 2006
Newcastle, New South Wales Newcastle ( ; Awabakal: ) is a metropolitan area and the second most populated city in the state of New South Wales, Australia. It includes the Newcastle and Lake Macquarie local government areas, and is the hub of the Greater Newcastle area, w ...
international conference, reported in '' PLoS Medicine'', explored the phenomenon of disease mongering.


See also

*
Inverse benefit law The inverse benefit law states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively a drug is marketed. Two Americans, Howard Brody and Donald Light, have defined the inverse benefit law, ...
*
Medicalization Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions, and thus become the subject of medical study, diagnosis, prevention, or treatment. Medicalization can be driven by new ev ...
* Quaternary prevention *
Schooliosis Schooliosis, a pun on "school" and "scoliosis", is a term for a type of medical misdiagnosis. The word was coined by Petr Skrabanek and James McCormick. The authors asserted that there is some degree of overdiagnosis of scoliosis in school, which ...
– an example of disease mongering due to overdiagnosis


References


Further reading

* * * * * {{DEFAULTSORT:Disease Mongering Pharmaceutical industry Medicine in society Human diseases and disorders Unnecessary health care Health fraud Social constructionism Social problems in medicine Ethically disputed research practices Ethically disputed business practices