IVAN ILLICH ON HEALTH

(Author of Limits to Medicine: Medical Nemesis - The Expropriation of Health)

The following is a brief synopsis of the article 'Health' (1976) available online, written by the above author, followed by a review of the same.

Synopsis:

'Health' and 'health care systems' have become popular terms of debate in public with people worrying about a health care crisis. The human conditon is beset with pain and suffering which can not be wished away, or won over by any means. People have traditionally taken care of themselves and those around them in households and communuties, and have lived a happy life. Never was there any belief in some external 'health care system' that would solve all problems, and that everyone would have a right to access. Nor was there any glorification of medical technology with the power to solve any problem. Many of the symptoms treated by modern medicine are themselves products of the modern age and its vagaries. Health has become a commodity to be delivered and accessed, and a 'system' is supposed to take care of everyone. These are false beliefs. Everyone should have the liberty to take care of their sickness as they would wish, and decide on whether to take medicines or not, decide on the doctor, and whether to take treatment or not. Also the liberty to die without a diagnosis. We must accept the harsh reality of life - that living includes living with pain and enduring it, and that it is a part of life. Instead of thinking of medical care and health care systems, we should focus our attention on life with all its problems, which include suffering and death. By living with these certain truths, we can shed our dependence on external agencies and live more happily than we are doing at present.

Review:

Ivan Illich is a widely known author of books on education, and the above writing confirms his interest in issues of public and human importance.

Some of his observations are to the point. The present medical system treats patients too impersonally, and reduces them to helplessness. Often health information is not provided in simple terms, and the poorer the patient, the worse the consequences.

Sickness and disease have become the sole province of the professionals and experts. With new drugs and technology this power has increased manifolds. The antibiotic and the MRI machine are like weapons in the hand of professionals that they wield with style. The sick person no longer feels in control of himself or herself when entering such institutions.

Ivan Illich asks for many liberties - the liberty to refues treatment, to die without diagnosis, to chose one's doctor. These appear just right in shifting the control back to the patient. He wants us to go back to the community model care for the sick. He mentions alternative systems of healing. Still one doubts if it is really possible to break away totally from modern medicine.

It has taken centuries for modern medicine to arrive at the point it is today. It has cures for a large number of disease. And it has shown that drugs can help us fight off illnesses. It has saved many lives. Can all of this be put aside at a stroke? Of course, the liberty to select a doctor means one can chose modern doctors as well. He does not deny the choice. But the whole article seems to point in other directions of seeking medical help.

The dillemma is this - humans are the only animals perhaps who have developed such system of medicines and discovered cures for themselves. This is a evolutionary victory for the group, whose members can now live longer. Why should anyone deprive us of this advantage? The fact that I can live longer with modern medicine - and that is of course a debatable issue, side effects being one major factor - this very fact remains at the core of the whole debate.