iatrogenesis

Literally ‘doctor-generated’, the term refers to sickness produced by medical activity. Widely recognized as a phenomenon, the debate is over its extent. The term was introduced into social science by Ivan Illich (Medical Nemesis, 1976), as part of his more general attack on industrial society and in particular its technological and bureaucratic institutions, for limiting freedom and justice and for corrupting and incapacitating individuals. Illich claims that iatrogenesis outweighs any positive benefits of medicine. He distinguishes three major types of iatrogenesis. Clinical iatrogenesis concerns ill-health contracted in hospital-largely the unwanted side-effects of medications and doctor ignorance, neglect, or malpractice, which poison, maim, or even kill the patient. Social iatrogenesis refers to the process by which ‘medical practice sponsors sickness by reinforcing a morbid society that encourages people to become consumers of curative, preventive, industrial and environmental medicine’. It makes people hypochondriac and too willing to place themselves at the mercy of medical experts-a dependence on the medical profession that allegedly undermines individual capacities. Finally, cultural iatrogenesis implies that societies weaken the will of their members, by paralysing ‘healthy responses to suffering, impairment and death’. Here, the whole culture becomes ‘overmedicalized’, with doctors assuming the role of priest, and political and social problems entering the medical domain.

Illich's arguments may be placed in the context of wider debates about the excessive professionalizing and bureaucratization of modern life. Other sociologists (such as Jack Douglas) have suggested that medicine is not the only sphere in which the activities of the professionals may have unintended consequences: attempts at intervention in other social problems sometimes seem merely to exacerbate the original difficulties. This is also part of the labelling theory of deviance. See also medicalization.