A Critical Genealogy of Punishment and Its Chilling Effect on Medical Practice

A Critical Genealogy of Punishment and Its Chilling Effect on Medical Practice

The modern physician practices under a panopticon of potential criminal liability. Federal prosecutors target doctors for "overprescribing" opioids (5,6). State legislatures threaten felony charges for providing abortions, gender-affirming care, or reproductive health services (7–9). Medical boards revoke licenses for recommending "unproven" alternative therapies (10). Insurance companies flag "suspicious" prescribing patterns (11). Electronic health records create permanent audit trails accessible to law enforcement (12). Prescription drug monitoring programs (PDMPs) track every controlled substance prescription (5,6). In this environment, the physician internalizes the gaze of the law enforcement apparatus, and this internalization produces a fundamental transformation of clinical consciousness—what I term "carceral subjectivity" in medical practice.