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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