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April 30, 2007
iatrogenesis
Ivan Illich wrote Medical Nemesis in 1976, but he had already applied this concept to transportation, communications and education. Basically, the idea is that too much of something leads to it becoming harmful. Too much transportation ends up making us less mobile. Too much telecommunication decreases our ability to communicate. Too much formal education inhibits our ability to learn. Now it is not really the quantity of these things, but the quality that decreases as they become industrialized and centralized. A cell phone can be a great tool for communication but consider how much actual communication, edifying or necessary speech between people, occurs. The dumbing down of education is beyond question. Transportation, now that it is motorized and individualized, has consumed a huge portion of our production, and arguably limits our ability to transport ourselves, both because of the limiting infrastructure and the disabling immobility.
Illich identified three ways in which medicine has made us sicker, three forms, or levels, of iatrogenesis. These are clinical, social and cultural. Clinical iatrogenesis means that medicine is not only not responsible for the effective changes in life expectancy and health, but that it frequently causes more illness or death than it treats. Sometimes in the course of diagnosing a problem, sometimes in the treatment of it, illness or disability or death is actually caused by the doctor, or by the drug, or by the test. It is the case with overused antibiotics, that have led to MRSA and other very difficult to treat infections. It is the case with much of cancer care, with most of preventative medicine, with most of screening strategies.
| By Robert Maddox | 02:00 PM