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The school dropout and the commuter stuck in interminable traffic, according to Illich, are not accidental byproducts of insufficiently evolved systems that can be reformed towards greater efficiency. They are the necessary consequence of the paradoxical counterproductivity that afflicts all projects motivated by the modern dream of unlimited progress. Perhaps his most controversial application of this insight was to the field of medicine in the book Medical Nemesis, later reissued as Limits to Medicine. His subject in this book, the longest of what he called his “pamphlets” of the 1970s, is iatrogenesis, a term typically used in relation to unintentional physician-caused harms inflicted in the course of treatment. As Cayley explains, Illich “applies it much more widely to take in all the ways medicine reshapes the society it ostensibly serves.”
Medicine, in Illich’s account, does for health what education does for learning: it converts a good that people might autonomously cultivate into a scarce commodity only accessible through an institution that monopolizes its distribution. The recent pandemic has provided numerous illustrations of this phenomenon. For instance, it was clear from the earliest statistical measures that SARS-CoV-19 affected different demographics differently: severe disease was heavily concentrated among the old and sick. It followed that for wide swathes of society, “health” might well be obtained by experiencing a mild infection and gaining natural immunity to the virus. Yet a barrage of propaganda has obscured these differences, always in service of the notion that health could only be obtained by medical intervention: first via the ad hoc “non-pharmaceutical interventions” rolled out in 2020, later by vaccination. To admit that unvaccinated young people, particularly those in good physical shape, are at lower risk from Covid-19 than vaccinated older people would be heresy, since it implies that salvation is possible outside the church.
Illich also took aim at another assumption lately on display: as Cayley puts it, “the idea that suffering and death are unqualified evils and their postponement unqualified goods.” In the past two years, politicians and public health officials have proceeded from the view that an indefinite suspension of the positive goods of civic and familial life is legitimated by the imperative of “saving lives.” As Illich’s counterproductivity thesis anticipates, the result is a stripping down of the lives that are declared in need of saving to what Giorgio Agamben calls “bare life.” The reception of Illich’s book anticipated that of Agamben’s criticisms of the “techno-medical despotism” of pandemic emergency rule: he was accused of callous indifference to human life.
_________________ "The fatal flaw of all revolutionaries is that they know how to tear things down but don't have a f**king clue about how to build anything."
Maybe would have been better in the Philosophy thread, but then we summon the thread integrity police.
I think the statement:
"To admit that < an intuitive concept back by empirical data is true > would be heresy, since it implies that salvation is possible outside the church."
is a powerful way to look at how many institutions in our society work right now
_________________ "The fatal flaw of all revolutionaries is that they know how to tear things down but don't have a f**king clue about how to build anything."
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