marxist approaches to health

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Marxists argue that capitalist societies like Britain are based on conflict. This is due to a
minority group of rich and wealthy individuals (the bourgeoisie) economically exploit the
proletariat (the working class) through the way work and economic rewards are organised.
This exploitation has led to fundamental inequalities in the distribution of wealth, income,
educational opportunities, political power and health chances and these inequalities bring
groups, particularly social classes into conflict with each other.
Illich contradicts the biomedical model arguing that doctors are responsible for a great deal of
the illness that exists today in the western world. illich argues that modern medicine causes
great personal and social `harm' which he named `iatrogenesis'.
Illich suggests that the most common medical harm is `clinical iatrogenesis' ­ this refers to
the large numbers of people who die or who are seriously harmed by direct medical
intervention such as mistakes made during operations, unnecessary surgery, infections
picked up whilst in hospital such as MRSA, addiction to prescribed drugs and from the
sideeffects of painkillers or antidepressants. Illich argues that clinical iatrogenesis is the
third biggest cause of death in the USA after heart disease and cancer ­ approximately
225,000 people in the USA die directly or indirectly due to medical intervention. 80,000 a year
die from infections picked up in hospitals in the USA.
Illich also identifies `social iatrogenesis' which he defines as the increasing influence that
medical professionals have over many areas of social life. He suggests that aspects of social
life such as obesity, shyness, lack of concentration in children, juvenile delinquency, learning
difficulties and even sex are increasingly becoming medicalised, i.e. doctors, especially
psychiatric doctors, are either reinventing aspects of social life as medical problems or
suggesting that they have more expertise than other professionals such as social workers or
Illich suggests that `cultural iatrogenesis' is increasingly becoming the norm in the UK
although this trend is probably more firmly entrenched in the USA. It refers to the view
encouraged by the pharmaceutical industry and mass media that there is a pill or medical
solution for every ache, pain, stress, tiredness, sad mood, anxiety or unhappiness.
Finally, Illich notes that one of the pitfalls of modern medicine increasing life expectancy is
what he calls the `Sisyphus Syndrome'. He notes that modern health care may keep more
people alive for longer periods however this often comes at the expense of quality of life
because chronic degenerative diseases such as Alzheimer's disease seriously reduce
people's capacity to enjoy old age and require expensive health care.
However, in criticism of Illich, his observations on the harms done by doctors and the
biomedical approach may differ considerably from the interpretations of those being treated
by doctors and hospitals for lifethreatening chronic illness. The risks that Illich identifies may
be worth taking if a life is actually saved. Furthermore, Illich fails to consider that medicine
may actually improve people's quality of life by reducing pain etc.

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Finkelstein a Marxist says that capitalism and its emphasis on work as a source of identity, status and
power is to blame for the prejudices against the impaired. Finkelstein says that in preindustrial
societies disabled people not segregated and treated differently as people worked at their own
pace on farms etc. however industrialization was responsible or a dramatic shift in cultural attitudes
as capitalist society needed a healthy and fit workforce to generate profits or the bourgeoisie.…read more


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