The Death of Humane Medicine (1994)by Petr Skrabanek
About Petr Skrabanek
Petr Skrabanek died on 21st June 1994 from an aggressive prostatic cancer at the age of fifty three. The manuscript of The Death of Humane Medicine was completed a few days before his death.
Born in Czechoslovakia he acquired a doctorate from Charles University and worked as a forensic toxicologist. He had almost finished his medical studies when in 1968, whilst he and his wife, Vera, were in Ireland, the Russians entered Prague. They decided to remain in Ireland and Petr enrolled in the College of Surgeons medical school and qualified at the Society of Apothecaries.
After house officer posts he worked in the field of neuro-transmitters and became an authority on Substance P. He joined the Department of Community Health in Trinity College, Dublin in 1984, initially in a temporary capacity, aided by a grant from the Wellcome Foundation. He was sub- sequently appointed as a lecturer, then senior lecturer and finally associate professor. He was made a fellow of the college and a fellow of the Royal College of Physicians of Ireland.
The roads to unfreedom are many. Signposts on one of them bear the inscription HEALTH FOR ALL.
This book is about the danger posed by healthism—the ideology of the ‘health of the nation’—to our right to do as we like with our lives, to our autonomy to pursue our kind of happiness, to the liberty of the Savage in the Brave New World. All totalitarian ideologies use the rhetoric of freedom and happiness, with false promises of a happy future for all.
For those who do not, or do not wish to, recognise the Utopian nature of the health promotion movement, my critique will be misinformed at best and misanthropic or malicious at worst. How could striving for health lead to the loss of liberty? Is not health a necessary condition for freedom? Is a dying free man happier than a healthy slave?
The structure of the book is simple. The first section pro- vides a general background to the exploitation of ‘health’ for professional, political and commercial purposes. The ideology of healthism did not appear in Western democracies until the 1970s, initially in the USA. Healthism, however, was an ingredient of the totalitarian ideologies in Nazi Germany and Communist Russia. The first commentator who saw the danger of healthism in Western democracies was Ivan Illich and it is thus appropriate to start the debate where he left off.
The second section, on lifestylism, proceeds from historical examples of individual pursuit of the chimera of health to the collective normalisation of behaviour as state policy. Despite the variety of specific regimes to attain and preserve health, the moralists’ trinity of evils - drink, tobacco and sex - is a common thread. Modern lifestyle exhortations by health promotionists, though ostensibly based on science, bear a striking resemblance to these historical precedents.
The third section is about the tyranny of normalisation, the rise of Big Brotherism in the surveillance of ‘lifestyles’, and other manifestations of coercive medicine. Once the majority has been persuaded that ‘the health of the nation’ is a laudatory end, without understanding the means by which this end is to be achieved, healthism and lifestylism get universal support. The perversion of language obscures the power motive behind the seemingly altruistic pursuit of health for all.
It is useless to defend oneself against charges of ‘icono- clasm’ or to offer an apology for the tone which ‘will alienate even potential supporters’, as one well-meaning reader put it. The purpose of the book is not to please anyone but to sound a warning.
Some friends, who otherwise approved of the contents, have questioned my giving Illich’s Medical Nemesis such a promi-nent place, when Illich had his own hidden, traditional Cath- olic, ‘reactionary’ agenda. I have no interest in Illich’s religious views, but his perspicacity to discern the creeping evil of healthism long before anyone else saw it must be acknowl- edged. Some leftists found Solzhenitsyn’s mystico-religious views a suitable pretext for dismissing his Gulag Archipelago.
This book is not about medicine but about a perversion of its ideals, especially in countries dominated by the Anglo- American medical ideology. Yet Western medicine is the only one with a rational core. I don’t believe in medical relativism and my criticism does not imply an endorsement of Eastern ‘holistic’ claptrap. Just as a sick sheikh will seek medical treatment in a Western hospital, rather than relying on local magic, so a rich potentate from a fundamentalist Islamic state will travel to an oil conference in a Western-built aircraft and not on a flying carpet.
Find the entire book here
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