Every period in history has its share of medical practices that, in retrospect, were questionable. The liberal prescription of the painkiller morphine in the nineteenth century, for example. Or the controversial increase in the use of psychotropic drugs in psychiatry from the 1960s onward. Looking to the past can help us remain critical of current medical practices, argues Gemma Blok, Professor of Medical History.
Addicts, obese people, people with mental health issues: these are just a few of the individuals with problems whom the wider community readily views negatively. These people were there when they got into trouble, and if they just put in the effort, they can solve it themselves, is the implicit judgment. Gemma Blok calls this judgment the “stigmatization” of anything that deviates from the societal norm for self-control.
Stigma is an important aspect of Blok’s diverse research field. She has published on topics including “anti-psychiatry” in the twentieth century and the history of addiction care. Blok investigates, for example, the stigmatization of physical and mental health problems: how do such prejudices arise? How do the people being judged suffer? And how can we bring about a shift in the thinking of a society that judges negatively?
Blok will be Professor of Medical History at the UMC Utrecht, since February 1, 2026. She will succeed the retired Frank Huisman. Blok is also Professor of the History of Psychiatry at the Faculty of Humanities.
Prejudices against deviant people are as old as the hills, Blok argues. She studied history in the 1980s and met professor Marijke Gijswijt-Hofstra. She had been responsible for the theme of deviance and tolerance since roughly the sixteenth century. A subject at the intersection of medicine, history, sociology, philosophy, and ethics. “People with, for example, leprosy or the plague were stigmatized,” Blok says. “I was immediately captivated by the theme of health stigma. Such illnesses were seen as god’s punishment for sinful behaviour. That ‘punishment’ mindset is never far away. It also resurfaced during the HIV epidemic, with the position that HIV was a punishment for sexual promiscuity.”
Stigmatization continues to play a role in medicine today, Blok argues. “During the COVID era, we saw groups of people being scapegoated. For example, people of Chinese descent. But also overweight people, who were hit harder by the epidemic. The discussion quickly turned to: to what extent is this ‘your own fault, tough luck’?”
Prejudices about ailments reveal that what we call sick or healthy has changed throughout history, Blok observes. The way we label is always linked to the prevailing societal norms and values. Blok: “Therefore, you can never consider medicine neutral, not even now. The view on illness and the sick is always part of a society that is critical of behaviour.”
People are especially inclined to stigmatize when the cause of a condition is unclear, says Blok. “You see this with both physical and mental health problems. When experts don’t fully understand the origins of a condition, they start speculating. Hypotheses say a lot about how society views itself. You see this now with burnout: what causes it? People point to all sorts of things in society that they themselves believe are wrong.”
In her new position at UMC Utrecht, Blok will be part of the multidisciplinary department of Bioethics & Health Humanities at the Julius Center. Blok feels an affinity with the New Utrecht School, which focuses on humanizing healthcare. She also hopes to continue her existing research lines. Her research on the personal experiences of people who use drugs through the Drugs Monologues (website in Dutch), and on psychiatric medication: “That research focuses on the increased use of psychotropic drugs among young people since the 1990s.”
What can medicine learn from studies like this for the future? “For example, personal experiences offer insight into the impact of medication use on people’s lives. Analyzing mistakes can help improve medical practice. For example, scandals involving medications and their use have led to better quality control.
Furthermore, looking at the past can open your eyes to looming health stigma. Raising awareness is a key goal of what I do, both in society and in healthcare. You can learn from history how healthcare has always been embedded in therapeutic trends, scientific frameworks, and political culture.
Furthermore, it’s useful to be aware of the issues of the day. For example, we now live in a period in which much responsibility for health is placed on the individual. For example, individuals are expected to improve their lifestyle; a lot of misery is currently attributed to this.
It’s important to be aware of this as a healthcare provider: that you always operate within a specific political and social context.”
