The End of Medicine and the End of Medical Sociology?

Abstract

Not so long ago from a graybeard's perspective a spate of writings burst forth like fireworks on Fourth of July, riveting our attention to idea of end of medicine. The phrase, the end of medicine, was used by a lawyer, Rick Carlson (1975), as title of a book in which he (1) argued that medicine has failed to reduce mortality and (2) called for new approaches to a healthy life. Philosophical underpinnings for this argument were set out in another volume written by Carlson's intellectual friend, Ivan Illich, a theologian. This book was originally titled Medical Nemesis when published in London in 1975 but was retitled Limits of Medicine when reprinted in New York following year. In this work Illich cried out that the medical establishment has become a major threat to health. The writings of Carlson and Illich, you may recall, attracted considerable attention. Reactions to their thesis of disabling impact of professional control over medicine were swift, frequent, and furious, ranging from political left to progressive sociomedical scientists, myself included (e.g., Horrobin, 1980). My view was that in marshalling of statistics for their argument they had fallen into trap of insensitivity of measures used for assessing impact of medical care (Elinson, 1977). After flurry of colorful verbal sparks,