Does more medicine make us sicker? Ivan Illich revisited
A proper understanding of health is a social and political challenge, the modern social medicine approach to public health and health approaches more generally tend to minimise this, making the isolated individual the primary unit of health. Ivan Illich, social critic and philosopher, was at the for...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-11-01
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| Series: | Gaceta Sanitaria |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0213911119300032 |
| _version_ | 1818254451771703296 |
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| author | Cormac Russell |
| author_facet | Cormac Russell |
| author_sort | Cormac Russell |
| collection | DOAJ |
| description | A proper understanding of health is a social and political challenge, the modern social medicine approach to public health and health approaches more generally tend to minimise this, making the isolated individual the primary unit of health. Ivan Illich, social critic and philosopher, was at the forefront of arguing for a collective health approach and challenging medical hegemony. His theories of institutional counter-productivity, proportionality and his critique of the medical model which he argued was entrenched within an economics of scarcity are as relevant today as they were at their height of popularity, in the 1970s. Applying his analysis to current trends in health approaches I conclude, as did he, that beyond a certain institutional scale or intensity more medicine is making us sicker. Therefore public health requires a dramatic shift away from a focus on individual deficits, lifestyle diseases, behaviour change and health promotion approaches towards genuine community building and significant political investment in the health creation of local communities. Moreover, there is need for more resolute regulation of the marketplace to prevent the health-harming behaviours of industrial and other institutional interests, including public sector and third sector organisations engaged in institutional overreach. Resumen: La sanidad, propiamente entendida, es un reto social y político. La medicina social moderna apunta a la salud pública y, por lo general, los enfoques sanitarios tienden a minimizar este hecho, convirtiendo a la persona aislada en la unidad primaria de la salud. Ivan Illich, crítico social y filósofo, encabezó el debate a favor de un enfoque basado en la sanidad colectiva y la lucha contra la hegemonía médica. Sus teorías sobre contraproductividad y proporcionalidad institucional, y su crítica sobre el modelo médico, del que argumentó que estaba arraigado en una economía de escasez, son relevantes hoy en día, al igual que lo eran en la cima de su popularidad, en los años 1970. Aplicando su análisis a las tendencias actuales, yo concluyo, como hizo él, que más allá de una cierta escala o intensidad institucional, el uso de más medicina nos vuelve más enfermos. Por ello, la sanidad pública requiere un cambio drástico, alejando su objetivo de los déficits individuales, las enfermedades relacionadas con el estilo de vida, los cambios de comportamiento y la promoción de la salud, centrándose en cambio en el desarrollo comunitario genuino y la inversión política en la creación de salud en las comunidades locales. Además, existe una necesidad de regular firmemente el mercado para evitar los comportamientos nocivos para la salud provenientes de los intereses industriales y demás instituciones, incluyendo el sector público y las organizaciones del tercer sector, implicadas en las extralimitaciones institucionales. Keywords: Illich, Institutional counter-productivity, Iatrogenesis, Health, Proportionality, Scarcity, Abundance, Palabras clave: Illich, Contraproductividad institutional, Iatrogénesis, Salud, Proporcionalidad, Escasez, Abundancia |
| first_indexed | 2024-12-12T16:56:11Z |
| format | Article |
| id | doaj.art-4bbab10362f04ad09a235e8685f87303 |
| institution | Directory Open Access Journal |
| issn | 0213-9111 |
| language | English |
| last_indexed | 2024-12-12T16:56:11Z |
| publishDate | 2019-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gaceta Sanitaria |
| spelling | doaj.art-4bbab10362f04ad09a235e8685f873032022-12-22T00:18:14ZengElsevierGaceta Sanitaria0213-91112019-11-01336579583Does more medicine make us sicker? Ivan Illich revisitedCormac Russell0Asset-Based Community Development Institute at DePaul University, Chicago, USAA proper understanding of health is a social and political challenge, the modern social medicine approach to public health and health approaches more generally tend to minimise this, making the isolated individual the primary unit of health. Ivan Illich, social critic and philosopher, was at the forefront of arguing for a collective health approach and challenging medical hegemony. His theories of institutional counter-productivity, proportionality and his critique of the medical model which he argued was entrenched within an economics of scarcity are as relevant today as they were at their height of popularity, in the 1970s. Applying his analysis to current trends in health approaches I conclude, as did he, that beyond a certain institutional scale or intensity more medicine is making us sicker. Therefore public health requires a dramatic shift away from a focus on individual deficits, lifestyle diseases, behaviour change and health promotion approaches towards genuine community building and significant political investment in the health creation of local communities. Moreover, there is need for more resolute regulation of the marketplace to prevent the health-harming behaviours of industrial and other institutional interests, including public sector and third sector organisations engaged in institutional overreach. Resumen: La sanidad, propiamente entendida, es un reto social y político. La medicina social moderna apunta a la salud pública y, por lo general, los enfoques sanitarios tienden a minimizar este hecho, convirtiendo a la persona aislada en la unidad primaria de la salud. Ivan Illich, crítico social y filósofo, encabezó el debate a favor de un enfoque basado en la sanidad colectiva y la lucha contra la hegemonía médica. Sus teorías sobre contraproductividad y proporcionalidad institucional, y su crítica sobre el modelo médico, del que argumentó que estaba arraigado en una economía de escasez, son relevantes hoy en día, al igual que lo eran en la cima de su popularidad, en los años 1970. Aplicando su análisis a las tendencias actuales, yo concluyo, como hizo él, que más allá de una cierta escala o intensidad institucional, el uso de más medicina nos vuelve más enfermos. Por ello, la sanidad pública requiere un cambio drástico, alejando su objetivo de los déficits individuales, las enfermedades relacionadas con el estilo de vida, los cambios de comportamiento y la promoción de la salud, centrándose en cambio en el desarrollo comunitario genuino y la inversión política en la creación de salud en las comunidades locales. Además, existe una necesidad de regular firmemente el mercado para evitar los comportamientos nocivos para la salud provenientes de los intereses industriales y demás instituciones, incluyendo el sector público y las organizaciones del tercer sector, implicadas en las extralimitaciones institucionales. Keywords: Illich, Institutional counter-productivity, Iatrogenesis, Health, Proportionality, Scarcity, Abundance, Palabras clave: Illich, Contraproductividad institutional, Iatrogénesis, Salud, Proporcionalidad, Escasez, Abundanciahttp://www.sciencedirect.com/science/article/pii/S0213911119300032 |
| spellingShingle | Cormac Russell Does more medicine make us sicker? Ivan Illich revisited Gaceta Sanitaria |
| title | Does more medicine make us sicker? Ivan Illich revisited |
| title_full | Does more medicine make us sicker? Ivan Illich revisited |
| title_fullStr | Does more medicine make us sicker? Ivan Illich revisited |
| title_full_unstemmed | Does more medicine make us sicker? Ivan Illich revisited |
| title_short | Does more medicine make us sicker? Ivan Illich revisited |
| title_sort | does more medicine make us sicker ivan illich revisited |
| url | http://www.sciencedirect.com/science/article/pii/S0213911119300032 |
| work_keys_str_mv | AT cormacrussell doesmoremedicinemakeussickerivanillichrevisited |