The quotation “the medical establishment is a major threat to health” was one devised by Illich in Medical Nemesis (1976 p11) where he attempted to explain the detrimental effects medical professionals and their procedures can have on the health of individuals. In order to discuss the effects of the medical establishment it is necessary to evaluate its performance including the critiques of modern medicine. The concepts of iatrogenesis and medicalisation will be explored and case studies given as an example.
The medical profession have claimed responsibility for the eradication of the infectious diseases that plagued the population in the eighteenth and nineteenth centuries. Vaccination, chemical cures and advancements in medical understanding of the biological mechanisms of the human body were the means by which the medical establishment claimed this victory. McKeown argues that “medicine only played a minor role” (Davey, et. al., 1995) and that nearly 90% of the decline in mortality rates between 1860 and 1965 occurred before chemical treatments were available (Illich, 1976). Cochrane indicates that medical technology has never been evaluated. In fact, in a study observing differences between heart disease patients nursed at home and in coronary care units, the results showed that hospitalisation did not provide any advantage (Bilton et. al., 1996). According to McKeown, social, environmental measures were most effective in the control of infectious disease and the medical establishment should not be credited with the power they now possess.
In modern society the emphasis of illness has changed from infectious diseases to new epidemics in the form of heart disease, cancer and accidents. There is:
“no evidence of any direct relationship between the mutation of sickness and the so-called progress of disease” (Davey et. al., 1995 p237).
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