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Critique of modern medicine by Ivan Illich
Ivan Illich Wrote:"Physicians are taught today to consider themselves responsible for lives from the moment the egg is fertilized through the time of organ harvest. They have become the socially responsible professional manager not of a patient, but of a life from sperm to worm. Physicians have become the bureaucrats of the brave new biocracy that rules from womb to tomb."

"Health and responsibility have been made largely impossible from a technical point of view.
This was not clear to me when I wrote Medical Nemesis, and perhaps was not yet the case at that time. In hindsight, it was a mistake to understand health as the quality of "survival," and as the "intensity of coping behavior."

Adaptation to the misanthropic genetic, climatic, chemical and cultural consequences of growth is now described as health. Neither the Galenic-Hippocratic representations of balance, nor the Enlightenment utopia of a right to "health and happiness," nor any Vedic or Chinese concepts of well-being, have anything to do with survival in a technical system.

"Health" as function, process, mode of communication; health as an orienting behavior which requires management – these belong with those post-industrial conjuring formulas which suggestively connote much, but denote nothing that can be grasped. And as soon as health is addressed, it has already turned into a sense-destroying pathogen, a member of a word family which Uwe Poerksen calls plastic words, word husks which one can wave around, making oneself important, but which can say or do nothing.

The situation is similar with responsibility, although to demonstrate this is much more difficult. In a world which worships an ontology of systems, ethical responsibility is reduced to a legitimizing formality. The poisoning of the world is not the result of an irresponsible decision, but rather of our individual presence, as when traveling by airplane or commuting on the freeway, in an unjustifiable web of interconnections. It would be politically naïve, after health and responsibility have been made technically impossible, to somehow resurrect them through inclusion into a personal project; some kind of resistance is demanded.

Instead of brutal self-enforcement maxims, the new health requires the smooth integration of my immune system into a socio-economic world system. Being asked for responsibility is, when seen more clearly, a demand for the destruction of sense and self. And this proposed self-assignment to a system stands in stark contrast to suicide. It demands self-extinction in a world hostile to death.

Precisely because I favor those renunciations which an a-mortal society would label suicide, I must publicly expose the idealization of "healthy" self-integration.

To demand that our children feel well in the world which we leave them is an insult to their dignity. Then to impose on them responsibility for their own health is to add baseness to the insult."

On Health – a manifesto for ‘hygienic autonomy’:

Let us look at the conditions of our households and communities, not at the quality of "health care" delivery; health is not a deliverable commodity and care does not come out of a system.

I demand certain liberties for those who would celebrate living rather than preserve "life":
the liberty to declare myself sick;
the liberty to refuse any and all medical treatment at any time;
the liberty to take any drug or treatment of my own choosing; the
liberty to be treated by the person of my choice, that is, by
anyone in the community who feels called to the practice of
healing, whether that person be an acupuncturist, a homeopathic
physician, a neurosurgeon, an astrologer, a witch doctor, or
someone else;
the liberty to die without diagnosis.

I do not believe that countries need a national ‘health’ policy, something given to their citizens. Rather, the latter need the courageous virtue to face certain truths:
we will never eliminate pain;
we will not cure all disorders;
we will certainly die.

Therefore, as sensible creatures, we must face the fact that the pursuit of health may be a sickening disorder. There are no scientific, technological solutions. There is the daily task of accepting the fragility and contingency of the human situation. There are reasonable limits which must be placed on conventional ‘health’ care. We urgently need to define anew what duties belong to us as persons, what pertains to our communities, what we relinquish to the state.

Yes, we suffer pain, we become ill, we die. But we also hope, laugh, celebrate; we know the joy of caring for one another; often we are healed and we recover by many means. We do not have to pursue the path of the flattening out of human experience.

I invite all to shift their gaze, their thoughts, from worrying about health care to cultivating the art of living. And, today, with equal importance, to the art of suffering, the art of dying.

~ [url-]Brave New Biocracy: Health Care from Womb to Tomb – 1994[/url]

Ivan Illich and Richard Wall Wrote:<!-- m --><a class="postlink" href=""></a><!-- m -->
His fundamental argument, widely admired in some quarters and ridiculed and caricatured in others, was that once our institutions developed beyond a certain scale, they became perverse, counterproductive to the beneficial ends for which they were originally conceived. The end result of this paradoxical counter-productivity was schools which make people dumb, complacent and unquestioning; hospitals which produce disease; prisons which make people violent; travel at high speed which creates traffic jams; and ‘aid and development’ agencies which create more and more ‘needy’ and ‘underconsuming’ people.


"Each chapter in this volume," Illich wrote in the foreword, "records an effort of mine to question the nature of some certainty. Each therefore deals with deception – the deception embodied in one of our institutions. Institutions create certainties, and taken seriously, certainties deaden the heart and shackle the imagination. It is always my hope that my statements, angry or passionate, artful or innocent, will also provoke a smile, and thus a new freedom – even though the freedom come at a cost."

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