title: Growth hormone, enhancement and the pharmaceuticalisation of short stature.
abstract: This paper takes the biological drug human Growth Hormone (hGH) as a case study to investigate processes of pharmaceuticalisation and medicalisation in configuring childhood short stature as a site for pharmaceutical intervention. Human growth hormone is considered to have legitimate applications in treating childhood growth hormone deficiency and short stature associated with other recognised conditions. It is also regarded by bioethicists and others as a form of human biomedical enhancement when applied to children with idiopathic or 'normal' short stature. The purpose of this study is not to evaluate whether treatment of idiopathic short stature is enhancement or not, but to evaluate how some applications of hGH in treating short stature have come to be accepted and stabilised as legitimate 'therapies' while others remain contested as 'enhancements'. A comparative, historical approach is employed, drawing on approaches from medical sociology and Science and Technology Studies (STS) to set out a socio-technical history of hGH in the US and UK. Through this history the relative influence and interplay of drivers of pharmaceuticalisation, including industry marketing and networks of drug distribution, and processes of medicalisation will be employed to address this question and simultaneously query the value of enhancement as a sociological concept.
authors.affiliation: Centre for Health, Law & Emerging Technologies (HeLEX), Nuffield Department of Population Health, University of Oxford, Room 120, Rosemary Rue Building, Old Road Campus, Headington, OX3 7LF Oxford, Oxon, UK. Electronic address: michael.morrison@dph.ox.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Morrison
mesh_terms: D024803:Biomedical Enhancement; D001827:Body Height / Q000187:drug effects*; D004393:Dwarfism, Pituitary / Q000175:diagnosis / Q000188:drug therapy*; D006130:Growth Disorders / Q000175:diagnosis / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D062528:Medicalization; D000067490:Prescription Drug Overuse; D011788:Quality of Life; D006113:United Kingdom; D014481:United States
chemical_list: D019382:Human Growth Hormone
keywords: Growth hormone; History; Human enhancement; Medicalisation; Pharmaceuticalisation; STS; UK; USA