Published September 11, 2024
Whether the influence of big pharma that profits from sickness, compromised public health agencies controlled by the very industries they are supposed to regulate, a biosecurity state that tends to jump from one declared health emergency to the next, medicine is now in danger of causing more sickness than it heals.
The year I was born, 1976, saw the publication if Ivan Illich’s prophetic book, Medical Nemesis, which opens with the startling claim, “The medical establishment has become a major threat to health.”[i] The book explores the epidemic of iatrogenic disease—that is, illnesses caused by medical interventions—which has only worsened in the nearly half century since this book was published. Most of the current research literature on iatrogenesis focuses on the problem of medical errors, and how to institute systems that can minimize errors. This is obviously important to address, but medical errors are only part of the story of how medicine is harming us.
Illich’s basic thesis was that some systems, including our healthcare system, improve outcomes only until they expand to a certain industrialized size, monopolized scope, and level of technological power. Once this threshold is reached, without intending to do so, these systems paradoxically cannot help but inflict harm and undermine their stated aims. Illich diagnosed “the disease of medical progress” in its early stages; I believe this disease has now reached its advanced stage. The problem is political and not merely professional: he argued that “the layman and not the physician has the potential perspective and effective power to stop the current iatrogenic epidemic.”[ii] Indeed, “among all our contemporary experts, physicians are those trained to the highest level of specialized incompetence for this urgently needed pursuit.”
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Aaron Kheriaty, MD, is a Fellow & Director of the Program in Bioethics and American Democracy at the Ethics and Public Policy Center. He is a physician specializing in psychiatry and author of three books, including most recently, The New Abnormal: The Rise of the Biomedical Security State (2022).
