title: Moral discourses and pharmaceuticalised governance in households.
abstract: This article extends our understanding of the everyday practices of pharmaceuticalisation through an examination of moral concerns over medication practices in the household. Moral concerns of responsibility and discipline in relation to pharmaceutical consumption have been identified, such as passive or active medication practices, and adherence to orthodox or unorthodox accounts. This paper further delineates dimensions of the moral evaluations of pharmaceuticals. In 2010 and 2011 data were collected from 55 households across New Zealand and data collection techniques, such as photo- and diary-elicitation interviews, allowed the participants to develop and articulate reflective stories of the moral meaning of pharmaceuticals. Four repertoires were identified: a disordering society repertoire where pharmaceuticals evoke a society in an unnatural state; a disordering self repertoire where pharmaceuticals signify a moral failing of the individual; a disordering substances repertoire where pharmaceuticals signify a threat to one's physical or mental equilibrium; a re-ordering substances repertoire where pharmaceuticals signify the restoration of function. The research demonstrated that the dichotomies of orthodox/unorthodox and compliance/resistance do not adequately capture how medications are used and understood in everyday practice. Attitudes change according to why pharmaceuticals are taken and who is taking them, their impacts on social relationships, and different views on the social or natural production of disease, the power of the pharmaceutical industry, and the role of health experts. Pharmaceuticals are tied to our identity, what we want to show of ourselves, and what sort of world we see ourselves living in. The ordering and disordering understandings of pharmaceuticals intersect with forms of pharmaceuticalised governance, where conduct is governed through pharmaceutical routines, and where self-responsibility entails following the prescription of other agents. Pharmaceuticals symbolise forms of governance with different sets of roles and responsibilities.
authors.affiliation: School of Social and Cultural Studies, Victoria University of Wellington, PO Box 600, Wellington, New Zealand. Electronic address: Kevin.Dew@vuw.ac.nz.
authors.forename: Kevin
authors.initials: K
authors.lastname: Dew
authors.affiliation: School of Pharmacy, University of Otago, New Zealand.
authors.forename: Pauline
authors.initials: P
authors.lastname: Norris
authors.affiliation: Centre for Criminology and Sociology, Royal Holloway, University of London, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gabe
authors.affiliation: School of Psychology, Massey University, New Zealand.
authors.forename: Kerry
authors.initials: K
authors.lastname: Chamberlain
authors.affiliation: Department of Psychology, University of Waikato, New Zealand.
authors.forename: Darrin
authors.initials: D
authors.lastname: Hodgetts
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002648:Child; D004345:Drug Industry; D004989:Ethics; D005191:Family Characteristics; D006801:Humans; D009014:Morals; D009520:New Zealand; D010344:Patient Advocacy; D010358:Patient Participation; D017060:Patient Satisfaction; D000067490:Prescription Drug Overuse; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012941:Social Responsibility; D013561:Symbolism; D016896:Treatment Outcome
chemical_list: D055553:Prescription Drugs
keywords: Governmentality; Moral discourses; New Zealand; Pharmaceuticalisation