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Case Reports
. 2021 Oct 2;16(1):10.
doi: 10.1186/s13010-021-00109-7.

The pharmaceuticalisation of life? A fictional case report of insomnia with a thought experiment

Emmanuel Bäckryd  1
Affiliations
Case Reports

The pharmaceuticalisation of life? A fictional case report of insomnia with a thought experiment

Emmanuel Bäckryd. Philos Ethics Humanit Med. .

Abstract

Background: The safety of sleeping pills has increased dramatically during the last 100 years, from barbiturates to bensodiazepines to modern day so-called Z-drugs.

Methods: The circumstances of prescribing sleeping pills in the early 20th century are illustrated by summarizing the main storyline of a novel by Swedish writer Vilhelm Moberg. This is followed by a thought experiment and a theoretical discussion.

Results: In his 1937 novel Sömnlös (Swedish for sleepless) Vilhelm Moberg portrayed existential and relational distress in relation to insomnia. In a thought experiment, past progresses in sleeping pills safety are projected into the future. Thereby, it is claimed that important issues in the area of philosophy of medicine come to the fore. This leads to a theoretical discussion about broader questions concerning the role of the physician, the goals of medicine (as described by Lennart Nordenfelt), the concept of pharmaceuticalisation (as described notably by sociologist of sleep Simon J. Williams and co-workers), and health enhancement (c.f. Carl Elliott and the alleged wish to be better than well).

Conclusion: Insomnia is a prism through which important philosophical and sociological questions related to the practice of medicine can be asked.

Keywords: Hypnotics; Medicalisation; Moberg; Pharmaceuticalisation; Sleep; Sleeplessness.

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Conflict of interest statement

The author declares no competing interests.

Figures

Fig. 1
Fig. 1
A model of the pathophysiology of insomnia according to Levenson and co-workers [18]. Reused with permission
Fig. 2
Fig. 2
Number of deaths from barbiturate poisoning in England and Wales 1933-1953, according to Registrar-General's Statistical Review. The figure is based on a data table retrieved from [14]. Blue line: Deaths by suicide. Red line: Deaths by accident
Fig. 3
Fig. 3
Increasing safety of sleeping pills over time – a thought experiment
See this image and copyright information in PMC

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