Medical Nemesis

The health professions--embodied as profiteers, priests & kings--are the target for this polemic. An overindustrialized society has led to the multiplication of medical specialists, a Cartesian belief in the body-as-machine & the hubris which elevates the art of healing into a science. The result is a counterproductive overmedicalization, Illich spells this out in terms of "iatrogenesis"--doctor-caused disease. This can be clinical, in terms of faulty diagnosis & treatment; societal, in terms of policies & laws which distribute funds & determine who's healthy, who's not; & cultural, in terms of beliefs & values which undermine individual freedom & responsibility. Such a system creates fear, multiplies pain (hence the demand for drugs), encourages custodial care & deprives the individual of decision-making powers. Instead of learning from pain, of caring & sharing, of actively participating in self healing, the patient becomes a passive consumer taught to demand health services from cradle to grave. This is the ultimate expropriation of the medical nemesis of unhealth is the inexorable consequence. Illich does not single out individuals for criticism but speaks in broader terms of the imbalance of industrial society. He doesn't deny the advances in medicine, nor does he propose simple solutions. His final chapter on alternatives shows how not to go about reform. The time is right for such a critique. Tho the health professions will protest, there is such power & documentation in these arguments that even those most involved may see the point.--Kirkus (edited)