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Acknowledgments
My thinking on medical institutions was shaped over several
years in periodic conversations with Roslyn Lindheim and John
McKnight. Mrs. Lindheim, Professor of Architecture at the University
of California at Berkeley, is shortly to publish The Hospitalization
of Space, and John McKnight, Director of Urban Studies at
Northwestern University, is working on The Serviced Society.
Without the challenge from these two friends, I would not
have found the courage to develop my last conversations with
Paul Goodman into this book.
Several others have been closely connected
with the growth of this text: Jean Robert and Jean P. Dupuy,
who illustrated the economic thesis stated in this book with
examples from time-polluting and space-distorting transportation
systems; Andre Gorz, who has been my principal tutor in the politics
of health; Marion Boyars, who with admirable competence published
the draft of this book in London and thus enabled me to base
my final version on a wide spectrum of critical reaction. To
them and to all my critics and helpers, and especially to those
who have led me to valuable reading, I owe deep gratitude.
This book would never have been written
without Valentina Borremans. She has patiently assembled the
documentation on which it is based, and refined my judgment and
sobered my language with her constant criticism. The chapter
on the industrialization of death is a summary of the notes she
has assembled for her own book on the history of the face of
death.
IVAN ILLICH
Cuernavaca, Mexico
January 1976
Contents
Introduction
PART I. Clinical latrogenesis
1. The Epidemics
of Modern Medicine
Doctors' Effectiveness—an
Illusion
Useless Medical Treatment
Doctor-Inflicted Injuries
Defenseless Patients
32
PART II. Social latrogenesis
2. The Medicalization
of Life
Political
Transmission of Iatrogemc Disease
Social latrogenesis
Medical
Monopoly
Value-Free
Cure?
The Medicalization
of the Budget
The Pharmaceutical
Invasion
Diagnostic Imperialism
Preventive Stigma
Terminal Ceremonies
Black Magic
Patient Majorities
PART III. Cultural latrogenesis
Introduction
3. The Killing
of Pain
4. The Invention
and Elimination of Disease
5. Death Against
Death
Death
as Commodity
The Devotional
Dance of the Dead
The Danse Macabre
Bourgeois
Death
Clinical Death
Trade Union Claims
to a Natural Death
Death Under Intensive
Care
PART IV. The Politics of Health
6. Specific
Counterproductivity
7. Political
Countermeasures
Consumer
Protection for Addicts
Equal Access
to Torts
Public
Controls over the Professional Mafia
The Scientific
Organization—of Life
Engineering
for a Plastic Womb
8. The Recovery
of Health
Industrialized
Nemesis
From Inherited
Myth to Respectful Procedure
The Right
to Health
Health
as a Virtue
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