Iatrogenesis
Irises by Vincent van Gogh
I've been reading and reflecting on how we conceptualize and manage human experiences like grief in Canada. As always, I'm concerned about health authorities' propensity to label people to individualize and pathologize the experiences of the "Other."
Ivan Illich's work, particularly Medical Nemesis: The Expropriation of Health, was recommended to me by one of my mentors. Illich, an Austrian philosopher and social critic, presents a significant critique of the medicalization of human experience in this book. Illich focuses on "iatrogenesis," which he defines as clinical and social harm.
Iatrogenesis is illness caused by medical examination or treatment.
In Medical Nemesis, Illich highlights a few forms of iatrogenesis that exist in the “West,” including:
Clinical iatrogenesis refers to the harms inflicted by doctors with the intention of curing or exploiting a patient and other harms caused by the doctor's attempt to protect themselves from the possibility of a malpractice suit.
Social iatrogenesis refers to the various forms of social over-medicalization of human experiences and distress.
I'm still trying to wrap my head around these concepts and the social consequences of our society's fixation on "curing" symptoms at the expense of ignoring the systemic causes of distress.
This work points to the importance of engaging in meaningful patient-centred care, engaging with the whole person, and recognizing the power of the patient's life story in healing. Practicing empathic listening is paramount to care. Recognizing and emphasizing the importance of social determinants of health and striving to reduce the suffering borne of poverty, low levels of education and access to resources, and racism are also important to compassionate and patient-centred care.
I'm fascinated with the causes and consequences of iatrogenesis and medicalization, so if you have any book recommendations, please share!
Book referenced: Ivan Illich. Medical nemesis: The expropriation of health (pp. 13-14). KKIEN Publ. Int.