medical nemesis

medical nemesis.png

(1976) by Ivan Illich



part 1 – clinical iatrogenesis

iatrogenesis: (from the Greek for “brought forth by the healer”) refers to any effect on a person, resulting from any activity of one or more persons acting as healthcare professionals or promoting products or services as beneficial to health, that does not support a goal of the person affected.

1 – the epidemics of modern medicine


after a century of pursuit of medical utopia, and contrary to current conventional wisdom, medical services have not been important tin producing the changes in life expectancy that have occurred. a vast amount of contemporary clinical care is incidental to the curing of disease, but the damage done by medicine to the health of individuals and populations is very significant. these facts are obvious, well documented and well repressed.

drs’ effectiveness – an illusion


in england by med 19th cent, infectious epidemics had been replaced by major malnutrition syndromes, such as rickets and pellagra.. these in turn peaked and vanished, to be replaced by the disease of early childhood and somewhat later by an increase in duodenal ulcers in young men. when these declined, the modern epidemics took over: coronary heart disease, emphysema, bronchitis, obesity, hypertension, cancer (esp of the lungs), arthritis, diabetes, and so called mental disorders.  despite intensive research we have no complete explanation for the genesis fo these changes. but two things are certain: the prof practice of physician cannot be credited w the elimination of old forms of mortality or morbidity, nor should it be blamed for the increased expectancy of life spent in suffering from the new diseases..

useless medical treatment

dr inflicted injuries


among murderous institution torts, only modern malnutrition injures more people than iatrogenic disease in its various manifestations. in the most narrow sense, iatrogenic disease includes only illnesses that would not have come about if sound and professionally recommended treatment had not been applied..

meds have always been potentially poisonous, but their unwanted side effects have increased w their power and widespread use.. every 24-36 hrs, 50-80% of adults in the us and the uk swallow a medically prescribed chemical. some take the wrong drug; others get an old or contaminated batch, and others a counterfeit, others take several drugs in dangerous combos; and still others receive injections w improperly sterilized syringes..

some drugs are addictive, other mutilating and others mutagenic.. in some patients antibiotics alter the normal bacterial flora and induce a superinfection, permitting more resistant organisms to proliferate and invade the host.. other drugs contribute to the breeding of drug resistant strains of bacteria.. … unnecessary surgery is a standard procedure.. .. the number of children disabled in massachusetts thru the treatment of cardia non disease exceeds the number of children under effective treatment for real cardia disease.. the depersonalization of diagnosis and therapy has changed malpractice from an ethical into a technical problem.. ie: system breakdown.. et al..

in 1971, 12-15k malpractice suits were lodged in us courts.. less than half of all malpractice claims were settled in less than 18 months.. more than 10% remain unsettled for over 6 yrs.. 16-20% of every dollar paid in malpractice insurance went to compensate the victim; the rest was paid to lawyers and medical experts..


us dept of health/ed/welfare calculate that 7% of all patients suffer compensable injuries while hospitalized, though few of them do anything about it.. accidents are the major cause of death in american children. in proportion to the time spent there, these accidents seem to occur more often in hospitals than in any other kind of place.. 1 in 5 children admitted to a hospital suffers an accident which requires specific treatment….1 in 10 comes from diagnostic procedures. despite good intentions and claims to public service, a military officer w similar record would be relieved, and restaurant or amusement center would be closed by police. no wonder that the health industry tries to shift the blame for the damage caused on to the victim, and that the dope sheet of a multinational pharma concern tells its readers that ‘iatrogenic disease is almost always of neurotic origin

oh my..

defenseless patients

first level..attempts of drs to avoid litigation/prosecution may not do more damage than any other iatrogenic stimulus,

second level..

medical practice sponsors sickness by reinforcing a morbid society that encourages people to become consumers of curative, preventive, industrial and environmental medicine..

on the one hand defectives survive in increasing numbers and are fit only for life under institutional care.. on other hand.. medically certified symptoms exempt people from industrial work and thereby remove them from the scene to political struggle to reshape the society that has made them sick..


social over medicalization .. i shall call the expropriation of health

third level.. destroy potential of people to deal w human weakness. vulnerability and uniqueness in a personal and autonomous way..

i will designate this self-reinforcing loop of negative institutional feedback by its classical greek equivalent and call it medical nemesis.. for them.. nemesis represented divine vengeance .. the inevitable punishment for attempts to be a hero rather than a human being.. our contemporary hygienic hubris has led to the new syndrome of medical nemesis

by using the greek term i want to emphasize that the corresponding phenom does not fit w/in the explanatory paradigm now offered by bureaucrats, therapists, and ideologues for the snowballing diseconomies and disutilities that, lacking all intuition, they have engineered and that they tend to call the ‘counterintuitive behavior of large system.’ by invoking myths and ancestral gods i should make it clear that my framework for analysis of the current breakdown of medicine is foreign to the industrially determined logic and ethos. i believe that the reversal of nemesis can come only from w/in man and not from yet another manage (heteronomous) source depending once again on presumptious expertise and subsequent mystification..

ie: hlb via 2 convos that io dance.. as the day..[aka: not part\ial.. for (blank)’s sake…]..  a nother way

i should be reading more of ivan.. feels like home

2 – the medicalization of life

political transmission of iatrogenic diseases


used to attempt to enhance what occurs in nature..  gone from interest of patient to proving success of each specialist..

social iatrogenesis

ie: when med bureaucracy creates ill health by increasing stress.. by multiplying disabling dependence… by abolishing even the right to self care.. when all suffering is ‘hospitalized’ and homes become inhospitable to birth, sickness and death..  when suffering, mourning and healing outside the patient role are labeled a form of deviance..t

outside mh


medical monopoly

ordinary monopolies corner the market; radical monopolies disable people from doing or making things on their own.. intensive ed turns autodidacts into *unemployables, intensive agriculture destroys the subsistence framer, and the deployment of police undermines the community’s self-control..

rather.. *unhuman.. employable is an ill as well.. earn a living ness is killing us

the malignant spread of medicine has comparable results: it turns mutual care and self medication into misdemeanors or felonies..

iatrogenic medicine reinforces a morbid society in which social control of the population by the medical system turns into a principal economic activity. it serves to legitimize social arrangements into which many people do not fit. labels the handicapped as unfit and breeds ever new categories of patients..  people who are angered, sickened, and impaired by their industrial labor and leisure can escape only into a life under medical supervision and are thereby seduced or disqualified from political struggle for a healthier world..

social iatrogenesis is not yet accepted as a common etiology of disease.. if so.. the industrial system would lose one of its major defenses..  and.. would shake the foundations of medical power much more profoundly than any catalogue of medicine’s technical faults..


value free cure?

the judge determine what is legal and who is guilty. the priest declares wha tis holy and who has broken a taboo. the physician decides what is a symptom and who is sick.. a moral entrepreneur, charge w inquisitorial powers to discover certain wrongs to be righted.. medicine, like all crusades, creates a new group of outsiders each time it makes a new diagnosis stick.. morality is implicit in sickness as it is in crime or in sin.

medicine is exercised by full time specialists who control large populations by means fo bureaucratic institutions..

the medical profession is a manifestation in one particular sector of the control over the structure of class power which the university-trained elites have acquired..t.. only drs now ‘know’ what constitutes sickness, who is sick, and what shall be done to the sick and to those whom they consider as a special risk..

paradoxically, western medicine, which has insisted on keeping its power apart from law and religion has not expanded it beyond precedent.. in some industrial societies social labeling has been medicalized to the point where all deviance has to have a medical label..


the divorce between medicine and morality has been defended on the ground that medical categories, unlike those of law and religion, rest on scientific foundations exempt from moral evaluations..

the technical enterprise of the physician claims value free power.. the assertion of value free cure and care is obviously malignant nonsense, and the taboos that have shielded irresponsible medicine are beginning to weaken

that in the 70s.. dang.. look at us still/worse..

medicalization of the budget

most handy measure of medicalization of life.. is the share taken out of a typical yearly income to be spent under dr’s orders..  during past 20 yrs cost of med care has escalated by 330%


much more of increase has gone to a host of well titled med paper shufflers.. whom us uni’s began to graduate in the 50s.. those w masters degrees in nursing supervision or w doctorates in hospital admin..  and to all the lower ranks on which the new bureaucrats feed.. the cost of administering the patient, his files, and the checks he writes and receives can take a quarter out of each dollar on his bill.. more goes to the bankers:; in some cases the so called ‘legit’ admin costs in med health insurance business have risen to 70% of the payment made to commercial carriers..

even more significant is the new prejudice in favor of high cost hospital care. since 1950 (to 70s) the cost of keeping a patient for one day in a community hospital in the us has risen by 500%… (lots more data of increases).. it is therefore ironic that during this unique boom in health care the us established another ‘first’ ..shortly after the boom.. the life expectancy for adult american males began to decline and is now expected to decline even further. the death rate of american males aged 45-54 is comparatively high..

rise explained in diff ways.. the most common.. relates to the growing incidence of prepayment of services.. hospitals register well insured patients ..the change in products seems due precisely to the increased insurance coverage which encourages hospitals to provide products more expensive than the customer actually wants, needs, or would have been willing to pay for directly..


like all other such remedies.. capitation enlarges the iatrogenic fascination w health supply.. people forego their own lives to get as much treatment as they can..t

while reading Philippe shares this video – in shadow.. on fb [] []


90% of all funds earmarked for health in developing countries is spent not for sanitation but for treatment of thr sick…. all countries want hospitals.. and may w most exotic modern equip.. the poorer the country, the higher the real cost of each item on their inventories.. modern hospital beds, incubators, labs, respirators, and operating rooms cost even more in africa .. they also break down more easily in the tropics and more difficult to service and more often than not ..out of use..

so much of all this sounds like Ed –

as to cost.. same is true of the physicians who are made to measure for these gadgets..

whenever tax funds are used to finance treatment above the critical cost, the system of med care acts inevitably as a device for the net transfer of power from the majority who pay taxes to he few who are selected because of their money, schooling, or family ties, or because of their specials interest to the experimenting surgeon..

it is clearly a form of exploitation when 4/5 of the real cost of private clinics in poor latin american countries is paid for by the taxes collected for med ed, public ambulances, and med equip..  concentration of public resources on a few.. ie: ability to pay out of pocket a fraction of total cost.. is a condition for getting the rest..


more health damage is caused by people’s belief that they cannot cope w their illness unless they call on the dr than drs could ever cause by foisting their ministrations on people..


the fundamental reason why these costly bureaucracies are health denying.. lies not in their instrumental but in their symbolic function: they all stress delivery of repair and maintenance services for the human component of the megamachine.. and criticism that proposes better and more equitable delivery only reinforces the social commitment to keep people at work in sickening jobs..

the pharmaceutical invasion

drs aren’t needed to medicalize a society’s drugs..  ie: sold by tv and radio..  as a consequence the physician’s function, esp in poor countries has become trivial.. he has been turned into a routine prescription machine that is constantly ridiculed and most people now take the same drugs, just as haphazardly, but w/o his approval..


overconsumption of med drugs not restricted to areas where drs are scarce or people are poor.. in us.. drug biz has grown by factor of 100 during 20th cent.. .. dependence oon prescribe tranquilizers has risen by 290% since 62.. a period during which the per capita consumption of liquor rose by only 23% and opiates 50%


in 73 the entire drug industry spent an avg of 4500 on each practicing physician for advertising and promotion, about the equiv of the cost of a yr in med school; in same yr, the industry contributed less that 3% to the budget of american med schools..

over all drug consumption in industrial societies is not fundamentally affected by the proportion of items sold by prescription, over the counter, or illegally, and it is not affected by whether purchase is paid out of pocket, thru prepaid insurance or thru welfare funds. in all countries, drs work increasingly w two groups of addicts: those for whom they prescribe drugs, and those who suffer from the consequences. the richer the community, the larger the percentage of patients who belong to both..

to blame drug industry for prescribed drug addiction is therefore as irrelevant as blaming mafia for the use of illicit drugs..


the fallacy that society is caught forever in the drug age is one of the dogmas w which medical policy making has been encumbered: it fits industrialized man.. he has learned to try to purchase whatever he fancies. he gets nowhere w/o transportation or education; his environ has made it impossible for him to walk, to learn, and to feel in control of his body.. to take a drug, no matter which and for what reason – is a last chance to assert control over himself, ..t.. to interfere on his own with his body rather than let others interfere.. the pharma invasion leads him to medication, by himself or by others.. that reduces his ability to cope w a body for which he can still care

hari addiction law

diagnostic imperialism

in medicalized society the influence of physicians extends not only to the purse and the medicine chest but also to the categories to which people are assigned.. bureaucrats subdivide people into those who may drive a car, those who may stay away from work, those who must be locked up, those who may become soldiers, those who may cross borders, cook or practice prostitution.. those who are dead, ..

in 1766 – empress maria theresa issued an edit requesting the court physician to certify fitness to undergo torture so as to ensure healthy ie ‘accurate’ testimony; it was one of the first laws to establish mandatory medical certification. ever since, filling out forms and signing statements have taken up increasingly more medical time.. each kind of cert provides the holder w a spacial status based on med rather than civic opinion.. used outside therapeutic process. this medicalized status does two obvious things: 1\ exempts holder from work, prison, military, marriage  and 2\ gives others their right to encroach upon the holder’s freedom by putting him into an institution or denying him work..


in a society in which most people are certified as deviants, the milieu for such deviant majorities will come to resemble a hospital. to spend one’s life in a hospital is obviously bad for health..

once a society is so organized that medicine can transform people into patients..t because they are unborn, newborn, menopausal or at some other ‘age of risk’ the population inevitably loses some of its autonomy to its healers..

lifelong medical supervision .. turns life into a series of periods of risk, each calling for tutelage of a special kind.. hygienic bureaucracy..t stops the parent in front of the school and the minor in front of the court, and takes the old out of the home. by becoming a specialized place, school, work , or home is made unfit for most people...

life.. reduced to a ‘span’ a statistical phenom which .. must be institutionally planned and shaped..t

between delivery and termination this bundle of biomedical care fits best into a city that is built like a mechanical womb. at each stage of their lives people are age specifically disabled.. the old are the most obvious ie: they are victims of treatments meted out for an incurable condition..

for a wide range of conditions, those who are treated least probably make the best progress..


the fact that modern medicine has become very effective in the treatment of specific symptoms does not mean that it has become more beneficial for the health of the patient..

in rich countries the life expectancy of those between 15 and 45 has tended to stabilize because accidents and the new diseases of civilization kill as many as formerly succumbed to pneumonia and other infections..


as more old people become dependent on professional services, more people are pushed into specialized institutions for the old, while the home neighborhood becomes increasingly inhospitable to those who hang on.. the mortality rate during the first year after institutionalization is significantly higher than the rate for those who stay in their accustomed surroundings.

dependence is always painful and more so for the old..

what medical labeling has done to the end of life, it has equally done to its beginning.. from mid nineteenth century.. spread from delivery room to nursery, kindergarten, classroom and medicalized infancy, childhood and puberty..

industrial parents, forced to procreate manpower for a world into which nobody fits who has not been crushed and molded by 16 yrs of formal ed, feel impotent to care personally for their offspring and in despair, shower them with medicine.. proposals to reduce med outputs in us from present (1976) leve of about 100 bn to their 1950 level of 10 bn, or to close medical schools in colombia, never turn into controversial issues because those who make them are soon discredited as heartless proponents of infanticide or of mass extermination of the poor..

the engineering approach to the making of economically productive adults has made death in childhood a scandal, impairment thru early disease a public embarrassment,  unrepaired congenital malformation an intolerable sight, and the possibility of eugenic birth control a preferred theme for international congresses in the 70s


physicians did pioneer antiseptic, immunization and dietary supplements.. they were also involved in the switch to the bottle that transformed the traditional suckling into a modern baby and provided industry w working mothers who are clients for a factory made formula..

the damage this switch does to natural immunity mechs fostered by human milk and the physical/emotional stress caused by bottle feeding are comparable to if not greater than the benefits that a population can derive from specific immunizations..

as the bottle became a status symbol, new illnesses appeared among children who had been denied the breast (and additional 32 000 cows added to chile’s overgrazed pastures to compensate)..  and since mother slack traditional know how to deal w babies who do not behave like sucklings, babies became new consumers of medical attention and of its risks..


on arguing that medical .. reflects the breakdown of society.. medicine does not simply mirror reality; it reinforces and reproduces the process that undermines the social cocoons w/in which mans has evolve..  medical classification justifies the imperialisms of standard staples like baby food over mother’s milk and of old age homes over a corner at home..

by turning the newborn into a hospitalized patient until he/she is certified as healthy, and by defining grandmas complaint as a need for treatment rather than for patient respect, the medical enterprise creates not only biologically formulate legitimacy for the man the consumer but also new pressures for an escalation of the megamachine ..genetic selection of those who fit into that machine is the logical next step of medicosocial control..

preventive stigma

along with sick care, health care has become a commodity, something one pays for rather than something one does.. people are turned into patients w/o being sick..


professional suspicion alone is enough to legitimize the stigma even if the suspected condition never existed..

in past.. med labeled people in two ways 1\ cure attempted  2\ beyond repair.. today.. third way 3\ diagnosis may exclude a human being w bad genes from being born, another from promotion and a third from political life.. et al..

ironically, the serious asymptomatic disorder which this kind of screening alone can discover among adults are frequently incurable illnesses in which early treatment only aggravates the patient’s physical condition.. in any case, it transforms people who feel healthy into patients anxious for their verdict..

costello screen/service law

the fail safe principle .. as if imputing a disease to the patient were better than disregarding one.. the med decision rule pushes him to seek safety by diagnosing illness rather than health..

diagnosis bias in favor os sickness combines w frequent diagnostic error..


attendance in public schools where teachers are vested w delegated med powers constitutes a major health risk for children..

this ultimate triumph of therapeutic culture turns the independence of the avg healthy person into an intolerable form of deviance..

live expectancy as a commodity

terminal ceremonies


hospital death is now endemic. in the last 25 yrs (from 76) the percentage of americans who die in a hospital has grown by a third…the cost of a citizen’s last days has increased by an estimated 1200 percent, much faster than that of over all health care.. simultaneously at least in us, funeral costs have stabilized..


the patient’s unwillingness to die on his own makes him pathetically dependent. the has now lost his faith in his ability to die, the terminal shape that health can take, and ahs made the right to be professionally killed into a major issue

people think that hospitalization will reduce their pain or that they will live longer in the hospital. neither is likely to be true.. people believe hospitalization increases chances of surviving a crisis… w some exceptions.. more often than not .. they are wrong…

patient majorities

sick until proven healthy


more and more people subconsciously know that they are sick and tired of their jobs and their leisure passivities, but they want to hear the lie that physical illness relieves them of social and political responsibilities..

in advance industrial societies the sick are once more recognized as possessing a certain level of productivity which would have been denied them at an earlier stage of industrialization.. now that everybody tends to be a patient in some respect, wage labor acquires therapeutic characteristics.. lifelong health ed, counseling, testing, and maintenance are built right into factory and office routine. homo sapiens.. now trained as a lifelong inmate of an industrial worlds..

part 3 – cultural iatrogenesis



the modern medical enterprise reps an endeavor to do for people what their genetic and cultural heritage formerly equipped them to do for themselves.. suffering healing and ying which are essentially intransitive activities that culture taught each man, are now claimed by technocracy as new areas of policy making and are treated as malfunctions from which populations ought to be institutionally relieved..

3 – the killing of pain


whereas culture recognizes pain as an intrinsic, intimate, and incommunicable ‘disvalue,’ medical civilization focuses primarily on pain as a systemic reaction that can be verified, measured, and regulated.. only pain perceived by a third person from a distance constitutes a diagnosis that calls for specific treatment.. pain calls for methods of control by the physician rather than an approach that might help the person in pain take on responsibility for his experience.. the med profession judges which pains are authentic..  society recognizes and endorses this professional judgment. compassion becomes an obsolete virtue.. the person in pain is left w less and less social context to give meaning tho the experience that often overwhelms him


what we call pain in a surgical ward is something for which former generations had no special name. it now seems as if pain were only that part of human suffering over which the medical profession can claim competence or control.. there is no historical precedent for the contemporary situation in which the experience of personal bodily pain is shaped by the therapeutic program designed to destroy it..


painkillers usually give more or less comparable results in guinea pigs and humans, provided those humans are used as experimental subjects and under experimental conditions similar to those under which the animals were tested.. as soon as same interventions are applied to people who are actually sick or have been wounded, the effects of the drugs are completely out of line with those found in the experimental situation.. in the lab people feel exactly like mice. when their own life becomes painful, they usually cannot help suffering, well or badly, even when they want to respond like mice..


oliver wendel holmes: nature provided better remedies for pain than medicine could..

the functionary of contemporary medicine is in a different position: his first orientation is treatment, not healing..

he rides himself on the knowledge of pain mechanics and thus escapes the patient’s invitation to compassion..


the new experience that has replaced dignified suffering is artificially prolonged, opaque, depersonalized maintenance. increasingly, pain-killing turns people into unfeeling spectators of their own decaying selves..

4 – the invention ane elimination of disease


1792..sickness is a symptom of political corruption and will be eliminated when the govt is cleaned up..


1790s.. like prisons, hospitals were considered a last resort; nobody thought of them as tools for administering therapy to improve the inmates..

1790s .. sickness becomes complex, untreatable, and unbearable only when exploitation breaks up the family ,, this kind of language made medicine first becomes  political issue. the plans to engineer a society into health began w the call for social reconstruction that would eliminate the ills of civilization..

only w the restoration was the task of eliminating sickness turned over to the medical professions.. med schools boomed.. hospitals proliferated.. so did the discovery of diseases. illness was still primarily nontechnical.. in 1770 little besides plague and pox.. but by 1860.. even ordinary citizen recognized the medical names of a dozen diseases..

sudden emergence of dr as savior.. due not to proven efficacy.. but to need for magical ritual that would lend credibility to a pursuit at which a political revolution had failed..


the use of physical measurements prepared fora belief in the real existence of diseases and their ontological autonomy from the perception of dr and patient.. the use of statistics underpinned this belief.. it ‘showed’ that disease were present in the environ and could invade and infect people..  1720s

during 17-18th centuries, drs who app;lied measurements to sick people were liable to be considered quacks by their colleagues…


became acceptable around 1845. w routine of taking pulse.. 30 yrs after first stethoscope

as dr’s interest shifted from the sick to sickness, the hospital became a museum of disease…

the hospital which at beginning of 19th cent had become a place for diagnosis.. was not turned into a place for teaching.. soon a lab for experimenting w treatments and towards 20th cent a place concerned w therapy..


in latin norma means ‘square’ the carpenter’s square. until the 1830s the english word ‘normal’ meant standing at a rt angle to the ground during the 1840s it came to designate conformity to a common type. in 1880s in america.. came to mean the usual state of condition not only of things but also of people..

not normal ness

the age of hospital medicine.. no more than 1.5 century.. is coming to an end… society has become a clinic.. and all citizens have become patients whose blood pressure is constantly being watched and regulated to fall ‘w/in’ normal limits..

while reading.. fb share by (don’t remember who)

Why I injected myself with an untested gene therapy


people would rebel against such an environ if medicine did not explain their biological disorientation as a defect in their health, rather than as a defect in the way of life which is imposed on them or which they impose on themselves. the assurance of personal political innocence that a diagnosis offers the patient serves as a hygienic mask that justifies further subjection to production and consumption..


before sickness came to be perceived primarily as an organic/behavioral abnormality, he who got sick could still find in the eyes of the dr a reflection of his own anguish and some recognitions of the uniqueness of his suffering. now, wha the meets is the gaze of a biological accountant engaged in input/output calculations.. his sickness is taken from him and turned into the raw material for an institutional enterprise.. his condition is interpreted according to a set of abstract rules in a language he cannot understand..

increasing dependence of socially acceptable speech on the special language of an elite profession makes disease into an instrument of class domination..


the price of what is significant health furthering in canadian medicine is so low that these same resources could be made available to he entire population of india for the amount of money now squandered there on modern medicine.. the skills needed for the application of the most generally used diagnostic and therapeutic aids are so elementary that the careful following of instructions by people who are personally concerned would probably guarantee more effective and responsible use than medical practice ever could..

5 – death against death

death as commodity

the devotional dance of the dead

the danse macabre

bourgeois death

clinical death

trade union claims to a natural death


just as at the turn of the century all men were defined as pupils, born into original stupidity and standing in need of 8 yrs of schooling before they could enter productive life, today they are stamped from brith as patients who need all kinds of treatment if they want to lead life the right way.. just as compulsory ed consumption came to be used as a device to obviate concern about work, so medical consumption became a device to alleviate unhealthy work, dirty cities, and nerve racking transportation.. what need is there to worry about a murderous environ when drs are industrially equipped to act as life savers..

death under intensive care


socially approved death happens when man has become useless not only as a producer but also as a consumer..dying has become the ultimate form of consumer resistance..

*traditionally the person best protected from death was the one whom society had condemned to die. society felt threatened that the man on death row might use his tie to hang himself.. authority might be challenged if he took his life before the appointed hour.. today, the man best protected against setting the stage for his own dying is the sick person in critical condition.. society, acting thru the medical system, decides when and after what indignities and mutilation he shall die.. **western man has lost the right to preside at his act of dying.. mechanical death has conquered and destroyed all other deaths

*fitting w this tweet – from week after finished book

Alan Spencer (@MrAlanSpencer) tweeted at 12:00 PM – 20 Nov 2017 :

Charles Manson was one of the worst human beings ever born in this country and unlike many Americans he had healthcare for forty seven years. (

**palliative care ness

6 – specific counterproductivity


in such an intensely industrialized society, people are conditioned to get things rather than to do them; they are trained to value what can be purchased rather than what they themselves can create… they want to be taught, moved, treated, or guided rather than to learn, to heal, and to find their own way..

7 – political countermeasures


all (policies) tend to stimulate further medicalization..

in following 5 sections.. examine merits of possible countermeasures.

consumer protection for addicts

equal access to torts

public controls over the professional mafia

the scientific organization – of life

engineering for a plastic womb

8 – the recovery of health


much suffering has been man made.. the history of man is one long catalogue of enslavement and exploitation.. war is the heart of this tale..

industrialized nemesis

from inherited myth to respectful procedure

the right to health

health as virtue


that society which can reduce professional intervention to the minimum will provide the best conditions for health..

healthy people need minimal bureaucratic interference to mate, give birth, share the human condition and die..




Eleanor Longden – “The medical model is the most complex form of avoidance I’ve ever seen.” Yes it is. #isps2017uk

Original Tweet:




outside mh


et al


ie: hlb via 2 convos that io dance.. as the day..[aka: not part\ial.. for (blank)’s sake…]..  a nother way