Adele E. Clarke, Janet K. Shim, Laura Mamo,
Jennifer Ruth Fosket, and Jennifer R. Fishman
A TheoreTiCAl And SUbSTAnTive inTrodUCTion
he rise of Western scientific medicine fully estab-
lished the medical sector of the U.S. political econ-
omy by the end of World War II, the first “social trans-
formation of American medicine” (Starr 1982). Then, in
an ongoing process called medicalization, the jurisdic-
tion of medicine began expanding, redefining certain
areas once deemed moral, social, or legal problems (such
as alcoholism, drug addiction, and obesity) as medical
problems (e.g., Zola 1972). In this book, we argue that
since around 1985, dramatic and especially technoscien-
tific1 changes in the constitution, organization, and prac-
tices of contemporary biomedicine have coalesced into
biomedicalization, the second major transformation of
American medicine (Clarke et al. 2000, 2003).
Biomedicalization continues today and is organized
around five key interactive processes:
1 a new biopolitical economy of medicine, health,
illness, living, and dying which forms an increas-
ingly dense and elaborate arena in which biomedi-
cal knowledges, technologies, services, and capital
are ever more co- constituted;2
2 a new and intensifying focus on health (in addition
to illness, disease, injury), on optimization and en-
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