Medical Nemesis: The Expropriation of Health

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Cover of Medical Nemesis: The Expropriation Of Health

Medical Nemesis: The Expropriation of Health by Ivan Illich. Published by Calder & Boyars, 1975.


The health professions--embodied as profiteers, priests, and kings--are the target for Illich's brilliant polemic. An overindustrialized society has led to the multiplication of medical specialists, a Cartesian belief in the body-as-machine, and the hubris which elevates the art of healing into a science. The result is a counterproductive overmedicalization, Illich spells this out in terms of 'iatrogenesis' -doctor-caused disease. This can be clinical, in terms of faulty diagnosis and treatment; societal, in terms of policies and laws which distribute funds and determine who is healthy, who is not; and cultural, in terms of beliefs and values which undermine the individual's freedom and responsibility. Such a system creates fear, multiplies pain (and hence the demand for drugs), encourages custodial care, and deprives the individual of decision-making powers. Instead of learning from pain, of caring and sharing, of actively participating in healing himself, the patient becomes a passive consumer taught to demand health services from cradle to grave. This is the ultimate expropriation of health: the medical nemesis of unhealth is the inexorable consequence. Illich does not single out individuals for criticism but speaks in broader terms of the imbalance of industrial society. He does not deny the genuine advances in medicine, nor does he propose simple solutions. His final chapter on alternatives shows how not to go about reform. Though the health professions will protest, there is such power and documentation in Illich's arguments that even those most involved may see the point.

External Links


  1. Editorial Review - Kirkus Reviews Copyright (c) VNU Business Media, Inc.
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