The Medicalization of Cyberspace

Communications, technological convergence, and even transhumanism are topics at the forefront of thinking of today's policy‐ and opinion‐makers. The Medicalization of Cyberspace is therefore a book likely to inspire a desire on their part for further research, especially empirical. Advanced through research programmes, it might also attract dedicated conferences, and special journal editions.

Policy and deployment advances in the same field are also pressing. For many working in the health arena, there is strong awareness of the growing importance of Health 2.0 and Medicine 2.0. Web‐based applications that sustain accessible, high‐quality healthcare are being explored actively by health authorities, service providers, payers, and industrial concerns. They are also welcomed by the public and patients.

Health‐related use of the internet is, however, not without controversy or concern. Health data protection and privacy, confidentiality, reliability, and the dignity of the patient are subjects ripe for policy consideration in the European Union, and wider. The need for this is rapid before precious – but, worryingly, diminishing – levels of trust are perhaps jeopardized irrevocably.

The Medicalization of Cyberspace explores, perhaps more tangentially, several of these challenging questions. The book collates theories about, and documents cases and examples, several concerns about eHealth internet‐based applications.

The volume aims to analyze four themes. It provides a historic analysis of “how cyberspace became medicalized”, a resource for health professionals to understand this development, advances on the “medicalization thesis” (how medical questions are being introduced increasingly into social contexts, and previously non‐medical questions are becoming medical in character), and “a transdisciplinary approach to understanding emerging technological cultures” (p. xv). Its case examples focus more on women's health than on men's, and on several sensitive, vulnerable, and often sexualized health conditions.

This is a slim volume of 160 pages. A lengthy preface, introduction, and a short set of conclusions surround its core. It contains two parts, of five and four chapters each. It has a comprehensive and useful 23 pages of bibliography. A helpful notes section avoids an overburdening of the text with footnotes. The index indicates that the book's main topics are: blogging; bodies; cyber‐related topics; obesity; posthumanism or transhumanism; sexuality; and Web 2.0 – a list pretty much also captured in the volume's blurb.

The first part of the book covers what the authors call “cybermedical discourse”, the second focuses on “cybermedical bodies”. Part I provides a comprehensive literature search. Chapter 1 covers medicalization in relation to cyberspace. Chapter 2 explores body studies of digital culture, and looks at what this might mean for web 2.0. Chapter 3 explores cybermedicalization, health expertise, reliability, and control. Chapter 4 looks at the governance of health behaviour in cyberspace. Finally, Chapter 5 overviews “patient narratives” on the internet. Part II shifts towards coverage of a variety of empirical cases, yet is still heavily theoretical. Chapter 6 focuses on three internet‐related experiences that have heightened public debate on medical and technological developments (human organ auctioning, human cloning, and egg pharming). Chapter 7 deepens a discussion of biological property rights. Chapters 8 and 9 examine online communities that offer support to women who experience anorexia. The conclusion describes a “trajectory through the multifaceted and multi‐disciplinary study of cybermedicine” (p. 14).

Overall, this is a book more for researchers than teachers. Those working in media/communications, and gender/feminist, theory may find it the easiest read. However, the book has a fundamentally transdisciplinary message that could appeal – as a minimum – to medical sociologists, health professionals, and ethicists (p. xv), an approach that could resonate more widely than a purely academic environment. Multi‐stakeholder perspectives are supported increasingly in other eHealth policy and deployment contexts.

The book is not without its weaknesses. It fails to cover the important role of national health authorities over the past decade in expanding internet use for patients. By their own admission, the authors did not develop a typology of internet communities and their practices. Now, the implicit research challenge is to explore a wider corpus of cases, internationally, with more diverse and larger samples and populations. While the book circumvents a “binary rhetoric” (back cover blurb), it does not avoid complexity in its text or structure. The manuscript would have benefitted considerably from more rigorous editorial control. Simpler vocabulary, expression, and presentation would have expanded accessibility. Reducing the impression of the journey that this research activity took over a six‐year period would have simplified the story. So too, would grounding it more firmly in the 2005‐2007 era.

Overall, however, The Medicalization of Cyberspace is stimulating and thought‐provoking. It poses challenging and difficult dilemmas. The book's title has been well chosen to whet appetites. Wherever I took the book physically while reading it, observers queried, “Medicalization of Cyberspace. What is that?” Publication is timely, opportune, and instrumental. The book is apparently a first. At a period of clarification and consolidation of this hot debate, it offers a contribution.

Diane Whitehouse

The Castlegate Consultancy, Malton, UK