The Limits of Pragmatic Medicine: A Case Study of Treating PMS and PMDD with Oral Contraceptives
Ilvie Prince
4 July 2024
In a world where an increasing number of social and political issues are being addressed by medical professionals, we face pressing questions. Should physicians address social and political problems? Is there a problem with this approach, and if so, what are the potential issues? Where should we draw the line? These questions are answered primarily in the context of debates about medicalization. However, this debate has changed considerably over the years. Its initial focus was on the internal morality of medicine, with references to concepts such as disease and health. Over the past decade, the debate has shifted to a more pragmatic stance. I consider a pragmatic use of medicine to be well-founded, normatively appropriate, and consistent with actual medical practice. A pragmatic approach is the basis for many beneficial interventions, such as hormonal contraception. However, it is also important to recognize that the pragmatic use of medicine should be subject to certain limitations. It is important to ensure that medical interventions are not used in a way that is harmful or oppressive. Interestingly, it is an intervention such as hormonal contraception, which medical professionals supposedly use to empower and liberate people, that is repeatedly suspected of being used to enforce and cement oppressive norms against users. I will focus on the use of hormonal contraceptives to treat PMS and PMDD in order to illustrate the complex boundaries between "good" and "bad" pragmatic use of medicine. While it is challenging to distinguish between beneficial and detrimental pragmatic use of medicine, taking social-epistemological circumstances into account can assist in analyzing complex cases and enabling potential users to reflect on their medicalization and make more autonomous decisions regarding the use of pragmatic medicine.
