Assess the extent to which modern medicine challenges personal autonomy and well being in contemporary society and discuss whether sufficient efforts are being made to tackle these issues.

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Contemporary Health Issues

Assess the extent to which modern medicine challenges personal autonomy and well being in contemporary society and discuss whether sufficient efforts are being made to tackle these issues.

Assess the extent to which modern medicine challenges personal autonomy and well being in contemporary society and discuss whether sufficient efforts are being made to tackle these issues.

     How people think of medicine has changed very much over the years. Medicine in the early modern period used to be text based and doctors from within this period drew their wisdom from the ancient. However by the nineteenth century doctors started to realise that there was a lot more money involved in the profession and along with this the status of doctors began to rise.  Then by the 1950’s, doctors saw medicine as a curative factor. A very common definition of health that is given by the World Health Organisation (WHO) is ‘A complete state of physical, metal and social well being and not merely the absence of disease or infirmity’. (Üstün & Jakob, 2005:83:802) This definition was given over half a century ago and it seems that medicine, now, has a negative approach to health and sees it as ‘the absence of disease or illness’. (Blaxter, 2004: 6) With this in mind modern medicine can be seen as a threat to the wellbeing of the individual as it focuses on cure rather than prevention. However modern medicine has led to some benefits within society as it has helped to increase life expectancy over the years. On the other hand modern medicine has created a number of critiques such as; Illich who argued that modern medicine actually causes more risks than curing the individual, Parsons who believed that modern medicine is a threat to social order, Foucault who states that modern medicine is just an excuse for medical surveillance. There is also McKeown who argues that the only reason there was an increase in growth population was due to capitalism and not modern medicine. So within this essay I will be discussing and assessing all of these critiques and coming to a conclusion as to whether modern medicine is a threat to personal autonomy and well being. Along with this I will also be discussing if efforts are being made to solve these problems and if the solutions are adequate.

Illich and Iatrogenesis

     The core idea of personal autonomy is to have personal rule over one owns self whilst you are free from the interference of others and to act in a freely self chosen way. With this definition in mind, we could argue that modern medicine does challenge the concept of personal autonomy. We can take a look at Illich’s work to support this. Illich (1976) used the term Iatrogenesis to describe doctor-caused ill health.   There were three levels of Iatrogenesis that Illich proposed and one of these he termed cultural iatrogenesis. This was where the medical profession ‘undermines the ability of individuals to face reality, to express their own values, and to accept inevitable and often irremediable pain, impairment, decline and death’. (Illich, 1976: 133) Illich’s argument is that all humans are subject to pain, sickness and death. All cultures have developed means to help people cope with each of these three elements. Unfortunately modern medicine has destroyed these cultural and individual capacities; instead it gives an inhuman attempt to defeat pain, sickness and death. Now, due to modern medicine, individuals want to be ‘spoon fed’ or taught instead of leaning for themselves and trying to find their own way. An example of how modern medicine has undermined the individual’s capability to tolerate pain is that we has human beings need to take a pill for every ache or every stomach upset.

     Another level of iatrogenesis that Illich (1976) argued is called clinical iatrogenesis. This is where illnesses are caused due to harmful medical interventions, whether it is unnecessary surgery or an over prescribed drug prescription. (Illich, 1976) Since the coming of the Institute of Medicine Report in the US, it has been reported that an estimation of 44 000 to 98 000 Americans die due to medical errors. (Starfield, 2000) From this, an estimation of 12,000 deaths occurs from unnecessary surgery a year and roughly about 7000 deaths a year happen from medication errors in hospitals. (Phillips, Christenfeld & Glynn, 1998) Professior Starfield (2000) points out these estimates and states that this happens because of iatrogenic damage. These figures show the death of those patients that were hospitalised or those that got medication over the counter from pharmacies. Looking at these figures, it makes iatrogenesis the third biggest killer in the US. (Starfield, 2000) One specific example where medication which has been authorised by the doctor stating that it would be beneficial to the patient but has in fact caused severe damage is the drug Thalidomide. This drug is a sedative and an anti-flammatory medication. It was sold between the years of 1957 and 1961 and was mostly sold to pregnant women during the late 1950’s and 1960’s. The use of the particular drug was for pregnant women to help battle against morning sickness and help them sleep better. Due to the improper assessment of the drugs quality and safety, it resulted in disastrous effects for the children of the pregnant women. (Medic8, n.d)During 1956 to 1962, an estimation of 10,000 children that were born from the women that had taken the drug, were born with malformities which included phocomelia. This therefore shows that even though medication is seen as something that can be beneficial for the wellbeing of the individual, some do quite the opposite which can result of further illnesses.

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     The third level of iatrogenesis that Illich (1976) termed was social iatrogenesis. This is where society’s capacity to deal with health and illness is diminished through industrialised medicine. (Illich, 1976)Illich’s argument was that suffering was a part of our life and medicine dictates on how we should live our lives. Illich called this a technology nightmare. (Illich, 1976) We lose our human elements and we, as individuals, become subordinated by medical professionals hence we start to lose control over our lives. In spite of this we can argue that Illich’s view is far too radical and that modern ...

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