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Abstract: This paper revisits the concept of medicalisation and considers its value as a framework for understanding the ongoing development of new reproductive technologies, and their impact on women’s reproductive decision-making. This evaluation is drawn from a qualitative discourse analysis of the public debate about the first extended cycle oral contraception (ECOC) to suppress menstruation in the United States of America in 2003/2004, and subsequent interviews with women living in Australia who had already extended their cycles without it being medically approved for widespread practice. Firstly, the debates about menstrual suppression are couched within a discussion of the ongoing usefulness of medicalisation as an analytical tool. It is posited that medicalisation occurs in a particular social and cultural moment, and is a dynamic process where dominant social relations can be both reproduced and challenged. Secondly, qualitative interviews with women about practices of menstrual suppression are used to explore the productive nature of agency in this particular medicalisation contest. Specifically, the ways in which these women engage with the discourses of ‘risk’, ‘choice’ and ‘nature’, as canvassed by menstrual suppression advocates, reveal accommodation and modification as much as resistance and contradiction. This paper suggests that if the concept of medicalisation is to have ongoing traction as a frame of analysis, such a critique must incorporate a generative discussion of agency. [Copyright &y& Elsevier]

Abstract: Medication is critical to the management of medical problems, however relatively little attention has been paid to the treatment recommendation process where a new medication is first prescribed. This article argues that how and when a patient agrees to a physician’s treatment demonstrates a patient’s active involvement in decisions about treatment. Using 100 video recorded primary care visits across 10 internal medicine clinics in the Western United States, this paper uses conversation analysis to document the delivery and reception of treatment recommendations in acute medical visits with adult patients. Specifically, this article analyzes patients demonstrating active participation regarding treatment decisions as a limited form of agency. Starting from the premise that participants orient to physicians’ treatment recommendations as normatively requiring patient acceptance before moving to a next activity, this article argues that when patients resist a recommendation, they actively participate in how the treatment recommendation emerges as acceptable. This article argues that through resistance to a treatment recommendation, patients work to negotiate and collaboratively co-construct what counts as an acceptable recommendation. Overall, this article argues that patient resistance is an interactional resource for patients to assert their agency by ensuring the ensuing recommendation is acceptable and in accord with their treatment preferences and concerns. [Copyright &y& Elsevier]