Ivan Illich was a strong advocate of patient empowerment. Ivan Illich

Ivan Illich

In the wellness movement, the concept of medicalization is attributed to Ivan Illich who was, also, one of the first to advocate patient empowerment.

Ivan Illich was a strong advocate of patient empowerment.

He was one of the movements greatest free thinkers who was born September 4, 1926 in Vienna and died December 2, 2002 of cancer at the age of 76 in Bremen, Germany.

Illich was a multilingual prolific writer who focused on the major institutions of the industrialized world. He applied a "model of social assessment of technological progress" to one of these institutions in each of his books in order to expose their current state of counter productivity. His most celebrated work is generally considered to be Deschooling Society, a critical discourse on education.

Illich's rhetoric is often described as polemic or rhetorically intoxicating. As a gifted linguist, Illich likes to play with words. As a nonconformist, Illich often uses words outside of their normal context and generally accepted meanings. And, unless you read Illich while you are in the correct frame of mind, you will find his writing to be just wordy, flowery rants that are generally hard to follow.

Looking at his mission, Illich considers "self-reliance, autonomy, and dignity for all, particularly the weaker"[5] to be the highest good. Illich advocates, "individual freedom [is] realized in personal independence."[5] He laments industrialized societies where ever-increasing production, consumption and profit are used to measure the quality of human life. In all of his books, Illich calls for people to rediscover the lost art of living. His universal theme is the "counter productivity of over industrialized civilization."[5] To Illich, in order for man to live creatively, man must reassert his autonomy and take control of his environment. From his point of view, society created the institutions in order to serve the society. But, according to Illich, these institutions have all become counterproductive to their original intent because they now exist to benefit themselves rather than the betterment of society. Health care is merely one of many institutions that Illich has written about.


Illich's classic criticism of Western medicine is called Medical Nemesis and was first published in 1976. A second edition was later issued as Limits to Medicine in 1995. In Medical Nemesis Illich applies a formulaic "model of social assessment of technological progress ... to the criticism of the professional monopoly and of the scientism in health care."[5]

In Medical Nemesis, Illich challenged the fundamental premise of medical progress, arguing that institutional medicine is overwhelmingly pathogenic and actively sickening.

Health, argues Illich, is the capacity to cope with the human reality of death, pain, and sickness. Technology can help, but modern medicine has gone too far launching into a god like battle to eradicate death, pain, and sickness. In doing so, it turns people into consumers or objects, destroying their capacity for health.

The concept of medicalization is attributed to Ivan Illich, who first wrote on the subject in 1976. He proposed that modern medicine had become detrimental to society, by amongst other things, "launching ... an inhuman attempt to defeat death, pain and sickness".[5] By doing so, he argued, medicine had deprived individuals and societies of their ability to cope with sickness and death.

According to Illich, "iatrogenesis cannot be understood unless it is seen as the specifically medical manifestation of specific counterproductivitiy." Illich sees three levels of iatrogenesis. Clinical iatrogenesis is the injury done to patients by ineffective, toxic, and unsafe treatments. Social iatrogenesis results from the medicalisation of life. Cultural iatrogenesis is the destruction of traditional ways of dealing with and making sense of death, pain, and sickness.

Evidence-based medicine is described in these pages 20 years before the term was coined. The explosion in ever escalating health care costs is both predicted and explained. Popular opinion wrongly credits medical science with the control of disease, when in fact the general decrease in morbidity and mortality are in fact the result of better standards of living. Further he claims, along with Weil, that awe-inspiring medical technology has combined with egalitarian rhetoric to create the impression that contemporary medicine is highly effective.

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Ivan Illich Comments:

Books Written by Ivan Illich

    1. Education (Deschooling Society, 1971)
    2. Energy, Transport and Economic Development (Energy And Equity, 1974)
    3. Historicity of Materials (H2O And The Waters of Forgetfulness, 1985),
    4. Literacy
      • (ABC, The Alphabetisation Of The Popular Mind, 1988, co-written with Barry Sanders)
      • (In The Vineyard Of The Text, 1993)
    5. Medicine (Medical Nemesis, 1976)
    6. Technological Development (Tools For Conviviality, 1973)
    7. Work
      • (The Right To Useful Unemployment And Its Professional Enemies, 1978)
      • (Shadow Work, 1981)

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