Pharmacracy: Medicine and Politics in America / Edition 1

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Overview

In recent decades, American medicine has become increasingly politicized and politics has become increasingly medicalized. Behaviors previously seen as virtuous or wicked, wise or unwise are now dealt with as healthy or sick--unwanted behaviors to be controlled as if they were health issues. The modern penchant for transforming human problems into diseases and judicial sanctions into treatments, replacing the rule of law with the rule of medical discretion, leads to the creation of a type of government social critic Thomas Szasz calls pharmacracy.

Medicalizing troublesome behaviors and social problems is tempting to voters and politicians alike: it panders to the people by promising to satisfy their needs for dependence on medical authority and offers easy self-aggrandizement to politicians as the dispensers of more and better health care. Thus, the people gain a convenient scapegoat, enabling them to avoid personal responsibility for their behavior. The government gains a rationale for endless and politically expedient wars against social problems defined as public health emergencies. The health care system gains prestige, funding, and bureaucratic power that only an alliance with the political system can provide.

However, Szasz warns, the creeping substitution of pharmacracy for democracy--private medical concerns increasingly perceived as requiring a political response--inexorably erodes personal freedom and dignity. Pharmacracy: Medicine and Politics in America is a clear and convincing presentation of this hidden danger, all too often ignored in our health care debates and avoided in our political contests.

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Editorial Reviews

Publishers Weekly - Publisher's Weekly
Nearly 40 years after psychiatrist Karl Menninger called the medical profession on the carpet for misnaming medical conditions so that various forms of treatment could be justified and, 24 years later, Susan Sontag declared that "illnesses have always been used as metaphors to enliven charges that a society was corrupt or unjust," noted and controversial psychiatrist Szasz (Fatal Freedom), as lively and contentious as ever, pursues similar lines of thought, examining the medicalization of politics and the politics of medicine in contemporary America. At the base of what he calls our modern "pharmacracy" a state where "all sorts of human problems are transformed into diseases and the rule of law extends into the rule of medicine" stands a virulent misunderstanding of disease, in the "literal" or scientific sense. It is, he argues in accord with the theories of 19th-century pathologist Rudolf Virchow, very simply an injury or abnormality in the cells, tissues or organs of the body. Yet, he maintains, the medical profession and politicians have today named as diseases a wide range of human behaviors, from alcoholism and obesity to mental illness and infertility. Moreover, some of these metaphorical diseases are elevated to public health problems subject to government intervention; thus, in Szasz's view, America has created a contemporary fascist health state in which its campaigns aimed at the eradication of smoking and obesity focus not on the responsibility of individuals to quit smoking or to lose weight but on the promise that well-funded research agendas will solve the problem. Plenty of health-care professionals and politicians will disagree with Szasz's definition of disease and his condemnation of the modern "pharmacracy," but no reader can put down this book without having been disturbed, provoked and challenged to see the American medical profession in a new light. (Apr. 30) Copyright 2001 Cahners Business Information.
Booknews
Szasz (emeritus, psychiatry, State University of New York Upstate Medical University) explores the development of a "pharmacracy" as the natural outgrowth of the tendency to medicalize social problems, deviance, and disruptive behavior. He describes the relationships between medical and political authority, between increased government control and increased funding for health care, and between the medicalization of individual behavior and the avoidance of personal responsibility. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780275971960
  • Publisher: Greenwood Publishing Group, Incorporated
  • Publication date: 5/1/2001
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 240
  • Product dimensions: 6.38 (w) x 9.50 (h) x 0.95 (d)

Meet the Author

THOMAS SZASZ is Professor of Psychiatry Emeritus, State University of New York Upstate Medical University, Syracuse, New York.

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Table of Contents

Preface
Acknowledgments
Abbreviations
Introduction: What Counts as a Disease?
1 Medicine: From Gnostic Healing to Empirical Science 1
2 Scientific Medicine: Disease 9
3 Clinical Medicine: Diagnosis 27
4 Certifying Medicine: Disability 57
5 Psychiatric Medicine: Disorder 77
6 Philosophical Medicine: Critique or Ratification? 111
7 Political Medicine: The Therapeutic Stare 127
Epilogue 161
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