Starting point for a targeted therapy is the reliable diagnosis of diseases. In their own interest, patients should only be treated when an illness or disorder actually exists and there are therapies that can prevent or heal the disease, or alleviate the symptoms. However, what is actually considered and treated as a disease does not always depend on medical facts alone. Cultural and economic factors may also play a role. As a result, some illnesses become fashionable.
As part of its “Bioethics Forum” series, the German Ethics Council addressed the ethical challenges that can arise in the health care system as a result of such fashionable trends, focusing in particular on the following questions:
- Are phenomena and variants of normal life reinterpreted as diseases and new diseases freely invented?
- How can we differentiate between mere disease mongering and actual diagnostic and therapeutic needs?
- How do the interests of, for example, the pharmaceutical industry, physicians or the media contribute to making certain diseases fashionable? Which social conditions promote disease mongering?
- Do such trends lead to overdiagnosis and overtreatment?
- What possibilities are there to prevent or counter excessive medicalisation?