Medical Nemesis Research Articles

Social Work and the “Medical Nemesis”

Social Work and the “Medical Nemesis” Get access Darwin Palmiere Darwin Palmiere Search for other works by this author on: Oxford Academic PubMed Google Scholar Health & Social Work, Volume 1, Issue 3, August 1976, Pages 182–189, https://doi.org/10.1093/hsw/1.3.182 Published: 01 August 1976

Medical Nemesis: The Expropriation of Health

Although Ivan Illich's rhetoric at times suggests otherwise,<i>Medical Nemesis</i>is not primarily an attack against greed for power on the part of physicians nor against "therapeutic greed" on that of patients. The book is rather an extension of Illich's ongoing critique of the impersonal and, to him, inhuman, "sociopolitical system of capital-intensive industrial production," as it applies to health care. (Hospital-based medicine is capital-intensive because it relies on the huge capital outlay of the centralized plant. Illich cites China's "barefoot medicine" as an example of the decentralized labor-intensive form of health care.) Illich focuses his principle of "counterproductivity" on the health care industry to demonstrate how medical technology, through the influence of capital-intensive methods, has burgeoned beyond the point of fulfilling legitimate human health care needs to become a powerful agent of dehumanization. He argues that technological expertise in medicine operates by a self-aggrandizing inner logic to dictate to

BOOK REVIEWS

Book reviewed in this article:MEDICAL NEMESIS: THE EXPROPRIATION OF HEALTH by Ivan Mich.THE END OF MEDICINE by Rick J. Carlson.

Medical Nemesis by Ivan Illich (Pantheon; 183 pp.; $8.95)

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Medical Nemesis; The Expropriation of Health

Medical Nemesis; The Expropriation of Health Leslie A. Falk CopyRight https://doi.org/10.2105/AJPH.66.3.299-b Published Online: October 07, 2011

Toward redesigning national health systems

Ivan IIIich. Medical Nemesis: The Expropriation of Health. London: Calder and Boyars Ltd., 1975. 184 pp. Bibliography. $1.50 (paper). David Mechanic. Politics, Medicine and Social Science. New York: John Wiley and Sons, 1974. x + 306 pp. Tables and index. $12.95. Howard B. Waitzkin and Barbara Waterman. The Exploitation of Illness in Capitalist Society. New York: The Bobbs‐Merrill Co., Inc., 1974. 129 pp. References. $2.75 (paper).

Book Review: Medical Nemesis, the Expropriation of Health

Book Review: Medical Nemesis, the Expropriation of Health

Medical Nemesis

Medical Nemesis

Special Book Review: “Medical Nemesis”

Special Book Review: “Medical Nemesis”

Stalking the Irrational in Medical Care

Other| June 01 1976 Stalking the Irrational in Medical Care Ivan Illich, Medical Nemesis, New York: Pantheon, 1976, 294 pages, $8.95.R. D. Laing, The Facts of Life, New York: Pantheon, 1976, 153 pages, $7.95. Budd N. Shenkin Budd N. Shenkin Search for other works by this author on: This Site Google J Health Polit Policy Law (1976) 1 (3): 355–371. https://doi.org/10.1215/03616878-1-3-355 Cite Icon Cite Share Icon Share Twitter Permissions Search Site Citation Budd N. Shenkin; Stalking the Irrational in Medical Care. J Health Polit Policy Law 1 June 1976; 1 (3): 355–371. doi: https://doi.org/10.1215/03616878-1-3-355 Download citation file: Zotero Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search Books & JournalsAll JournalsJournal of Health Politics, Policy and Law Search Advanced Search The text of this article is only available as a PDF. Copyright © 1976-77 by Duke University Press1976 Article PDF first page preview Close Modal You do not currently have access to this content.

Special Book Review: “Medical Nemesis”

Special Book Review: “Medical Nemesis”

Book Review: Books: Second Thoughts on Destructive Effects of Medicine: Medical Nemesis

Book Review: Books: Second Thoughts on Destructive Effects of Medicine: Medical Nemesis

Editorial: Radiology now. Choices.

This journal did not have a chance of reviewing Illich's book Medical Nemesis (1975)—little cause for regret there, you may say, thinking of those tortured words and paragraphs. But however muddy the book's style, its ideas have raised the dust; we talked them over at coffee breaks, read multiple reviews (British Medical Journal, 1974a; Lancet, 1974), even a leading article (British Medical Journal, 1974b). An author who strikes so many contemporary chords/discords in us is worth having: “when critics are silent, it does not so much prove the age to be correct as dull” (Voltaire, 1771). Any reader who has so far escaped the book or the comment can only be given a few sketchy pointers here. Illich argues that 20th-century medicine is sickening. Even in the past better food and plumbing did more for health than doctors.

The portfolio approach to health behaviour

Most of the existing literature in the field of health behaviour has been generated within an inappropriate paradigm. a fact that partly accounts for both its internal lack of development and its external lack of impact[l]. Far too much time has been spent discussing the nuances of behaviour seen as ‘directly’ relevant to health and far too little to the very wide spectrum of behaviour whose ‘indirectness’ would be radically reassessed if the dominant paradigm. that of proximate biological causality, were to be overturned. The proper context for the discussion of preventive health behaviour has been too readily accepted as the ‘medical-scientific’ one, the consequence of such acceptance being the classification and legitimation of causes on a biological rather than social. cultural and psychological basis. (As exceptions which prove the rule we can point to ‘accidents’ and ‘mental illness’ which stand out like sore thumbs in any standard disease classification). In other words because medical science has made such enormous advances in the explanation and ‘cure’ of disease at the immediate biological level it has been assumed that the framework for the study of health must be erected around. and dominated by, the medical-scientific contribution to our understanding of health. Recent moves towards social and ‘ecological’ medicine fail to make sufficient break with this assumption to constitute the necessary paradigmatic shift. Such is the argument underlying the present paper. It represents an attempt-and little more-to offer a distinctly new framework. Apart from making clear its incompleteness and tentative character two other points need emphasising immediately. First it is not claimed that many of the broad implications of the new perspective have not been individually argued before, merely that they have not been put forward in the context of a coherent theory’of behaviour. Second. the argument is not conducted at the same level as that in Ivan Illich’s recent Medical Nemesis[2] though it has clear associations with it. We have no particular views (or indeed knowledge) concerning for example, the contribution of chemo-therapeutic drugs to disease reduction or of the extent of iatrogenetic illness. however defined. Even if these are as high and low as conventionally assumed (wrongly according to Illich) we would still argue that a paradigmatic shift is needed. In other words the framework offered below should be regarded as ideologically neutral in the sense that it assumes no particular structural determinants of the existing position. whatever it is. But it is certainly not neutral in its grounding in a individualistic-humanistic-purposive model of behaviour within any structure and in its sympathy towards the fullest possible realisation of this model as a structural goal. We can thus endorse enthusiastically some assertions in Illich, in particular the view that

The medicalization of life.

Two contributions from Dr Ivan Illich follow. The first, in which he sets out his primary thesis of the medicalization of life, is a section from Dr Illich's book `Medical Nemesis'. (It is reprinted with the permission of the author and his publishers, Messrs Calder and Boyars.) The second is a transcript of the paper which Dr Illich read at the conference organized by the London Medical Group on iatrogenic disease. Both are ultimately addressed to the recipients of medical care, the general public, although the second paper is specifically addressed to young doctors and medical students. For Dr Illich the world is suffering from too much medical interference, and a medical edifice has been built which is one of the threats to the real life of human beings - a threat which so far has been disguised as care.

The industrialization of fetishism or the fetishism of industrialization: a critique of Ivan Illich.

This article critically assesses the ideology of industrialism in light of Ivan Illich's Medical Nemesis. The paper is divided into three sections. The first section is a description of the main features of that ideology, the most prevalent and influential one used in sociological literature to explain the state both of Western societies and of our health services. Also in this section, it is shown how these features appear in Illich's analysis of our societies, of our health services, and of the different clinical, social, and structural iatrogeneses that health services create. The second section examines the assumptions underlying Illich's analysis and discusses their validity to explain the nature and function of our Western health services and their iatrogenic effects. Where Illich's explanations are considered invalid, alternative explanations are presented. Among them, it is postulated that it is not industrialism, but the assumedly transcended category of capitalism that is the cause of the social and structural iatrogeneses. The third section discusses the political implications of Illich's analysis, in a moment when our Western societies are supposedly in crisis.

The industrialization of fetishism or the fetishism of industrialization: A critique of Ivan Illich

This article critically assesses the ideology of industrialism in light of Ivan Illich's Medical Nemesis. The paper is divided in three sections. The first section is a description of the main features of that ideology, the most prevalent and influential one used in sociological literature to explain the state both of Western societies and of our health services. Also in this section, it is shown how these features appear in Illich's analysis of our societies, of our health services and of the different clinical, social and structural iatrogeneses that health services create. The second section examines the assumptions underlying Illich's analysis and discusses their validity to explain the nature and function of our Western health services and their iatrogenic effects. Where Illich's explanations are considered invalid, alternative explanations are presented. Among them, it is postulated that it is not industrialism, but the assumedly transcended category of capitalism that is the cause of the social and structural iatrogeneses. The third section discusses the political implications of Illich's analysis, in a moment when our Western societies are supposedly in crisis.

By the London post, Christmas books.

IT would have been easy, at the end of 1974, to reflect upon the gloomy events of that year and to contemplate the coming year with equally gloomy anticipation. But, instead, I determined to try to look ahead in the light of three unusually interesting books that arrived in my Christmas stocking! Will Pickles of Wensleydale, by John Pemberton1; Aneurin Bevan 1945–1960, by Michael Foot2; and Medical Nemesis, by Ivan Illich.3 The first is a charming story of the man who practiced medicine in a Yorkshire dale from 1911 until 1964 and became famous as . . .

Medical Nemesis

2-Chloro-4-(ethylamino)-6-(isopropylamino)-<i>s</i>-triazine (atrazine, ATR) is a toxicologically important and widely used herbicide. Recent studies have shown that it can elicit neurological, immunological, developmental, and biochemical alterations in several model organisms, including in mice. Because disposition data in mice are lacking, we evaluated ATR9s metabolism and tissue dosimetry after single oral exposures (5–250 mg/kg) in C57BL/6 mice using liquid chromatography/mass spectrometry (Ross and Filipov, 2006). ATR was metabolized and cleared rapidly; didealkyl ATR (DACT) was the major metabolite detected in urine, plasma, and tissues. Plasma ATR peaked at 1 h postdosing and rapidly declined, whereas DACT peaked at 2 h and slowly declined. Most ATR and metabolite residues were excreted within the first 24 h. However, substantial amounts of DACT were still present in 25- to 48-h and 49- to 72-h urine. ATR reached maximal brain levels (0.06–1.5 μM) at 4 h (5–125 mg/kg) and 1 h (250 mg/kg) after dosing, but levels quickly declined to &lt;0.1 μM by 12 h in all the groups. In contrast, strikingly high concentrations of DACT (1.5–50 μM), which are comparable with liver DACT levels, were detectable in brain at 2 h. Brain DACT levels slowly declined, paralleling the kinetics of plasma DACT. Our findings suggest that in mice ATR is widely distributed and extensively metabolized and that DACT is a major metabolite detected in the brain at high levels and is ultimately excreted in urine. Our study provides a starting point for the establishment of models that link target tissue dose to biological effects caused by ATR and its in vivo metabolites.

Medical Nemesis

Medical Nemesis