The Death of Humane Medicine and the Rise of Coercive by Petr Skrabanek

By Petr Skrabanek

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Regular health checks and the identification of 'risk factors' can be compared to the regular confession of believers, whose absolution is conditional on penance. This transition has been facilitated by the ambiguity of the term 'prevention'. In one sense, 'prevention' is better than an adverse outcome, but when used in the anticipatory sense, 'prevention' is only a promise of prevention. One general practitioner, shared his unease about the new fashion of anticipatory care with the readers of the British Medical Journal.

Optimal health is defined as a balance of physical, emotional, social, spiritual and intellectual health. 62 And the health promotion officer was described in the Health Education Journal as 'a new specialist who would concentrate on the social, economic and other barriers to health'. As some of these barriers include racism, intolerance, bigotry, contempt for losers and victim-blaming, the job of health promotion officer would be quite a handful. The journal Health Promotion International gave the year of birth of the health promotion 'paradigm' as 1975.

Then, finally, one doctor solved the mystery - the young man was a 'couch potato'. As Illich put it, 'death no longer occurs except as the selffulfilling prophecy of the medicine man'. It is commonplace 78 53 DEATH OF HUMANE MEDICINE that when a person dies of a 'preventable disease', such as cancer or heart disease, doctors can 'explain' the death by unhealthy 'behaviour', that is, by the person's misbehaviour. 'Socially approved death happens when man has become useless not only as a producer but also as a consumer' of heroic 'anti-death treatment'.

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