Biomedicine
as a Religion
of Salvation from Sickness
“Science
is the new religion.”
Nowhere, outside perhaps cosmology, is this saying by Martin
Heidegger more evident than in the field of biomedical science,
which, like a religion, claims an absolute monopoly on true
‘knowledge’ in matters relating to illness and the human body –
regarding all other or earlier forms of medicine as based on
primitive or pre-scientific ‘beliefs’ in contrast to true
biological ‘knowledge’ in the form of biomedical ‘science’ –
the ‘one true faith’.
The cultural kinship between biological
medicine and religion goes even further and deeper however. To begin
with, the words ‘whole’, ‘hail’, ‘hale’, ‘heal’ and
‘holy’ share a common origin. Hence the unhealthy is also the
‘unholy’, as echoed in the German word ‘Unheil’. It is not
surprising then, that some religions have therefore traditionally
associated sickness with sin, not least Christianity – which also
laid emphasis on the healing powers of Christ as part of his
salvational role.
The theme of this chapter is that
biomedicine effectively offers the same type of
salvation as a religion, so
that even whilst its emphasis is on salvation from sickness rather
than from sin, nevertheless in today’s health-obsessed culture,
health as such has become a synonym of what is ‘good’ whereas
illness is regarded as something not only intrinsically ‘bad’ but
also associated with ‘unhealthy’ (read ‘sinful’) activities
such as ‘bad’ foods, smoking, overeating, not taking enough
exercise etc.
Thus it was only a small step from the
demonization of smoking
to the demonization and ostracization of smokers
– who are constantly reminded by medical propaganda and gruesome
images on cigarette packets that they will pay the price for their
filthy habit or ‘sin’ – for example through eventually
contracting one or another form of serious lung or heart disease as a
form of punishment.
Biomedical science is not only a religion
of salvation from the implicit ‘evil’ of illness but also and in
this way a search for salvation from death itself. Indeed through
advances in genetics, biomedical science holds out the ultimate
prospect of overcoming death itself – through a form of physical
immortality.
“Through the medicalization of death,
healthcare has become a monolithic world religion.” Ivan Illich
The new religion has evolved to the point
of having its own Bible and Book of Genesis – namely the human
genome – a bible which is understood by the medical-scientific high
priests of this religion as literally holding all
the keys to life and death,
sickness and health – yet which only those high priests can decode
and master.
Through this new bible the long-standing
quasi-religious quest for ‘miracle cures’ on the part of
biomedical science continues. For though medical researchers
regularly complain about the exaggeration of such cures on the part
of the media, pharmaceutical companies still promote their pills as
‘magic bullets’ with miraculous powers – and that however
negligible their effectiveness in comparison to placebos, or however
mysterious their mechanism of action is to biomedical science itself.
Nevertheless, as Illich also points out:
“Public fascination with high-technology care and death…”
continues, and can be understood, as the expression “…of a
deep-seated need for the engineering of miracles.”
A case in point is ‘intensive care’,
which Illich describes “…as but the culmination of public worship
organised around a medical priesthood struggling against death.”
On the other hand, he also points out
significant differences between the religion of biomedicine and the
approach of traditional religions to illness and suffering.
“The major religions reinforce
resignation to misfortune and offer a rationale, a style and a
community setting in which suffering can become a dignified
performance.” The difference also lies in the different modes of
interpretation of illness that these religions offer, whether “…as
karma accumulated through past incarnations, as an invitation to
Islam, the surrender to God; or as an opportunity for closer
association with the Saviour on the Cross.”
In contrast:
“Medical procedures turn into black
magic when, instead of
mobilising his self-healing powers, they transform the sick man into
a limp and mystified voyeur of his own treatment.” They also “turn
into sick religion
when they are performed as rituals that focus the entire expectation
of the sick on science and its functionaries instead of encouraging
them to seek a poetic interpretation of their predicament or find an
admirable example in some person – long dead or next door – who
learned to suffer.”
Illich himself became a supreme
embodiment of such an “admirable example” during the last ten
years of his life, during which he refused hi-tech biomedical
treatment for a painful and disfiguring facial cancer on the grounds
that it would prevent him from engaging in the most innately
fulfilling and therefore most essentially healthy dimension of his
life – namely his work.
Yet as he also observed, the religious
dimension of biomedicine is nowhere better exemplified than by the
money poured into hi-tech cancer research and treatment, which
increases in direct proportion to the ineffectiveness of such
treatment – or its iatrogenic effects in either triggering or
worsening cancer conditions as well as severely damaging the
patient’s quality of life (for example through carcinogenic chemo-
or radiotherapy) and all this on the pretext of saving that life.
This paradox can only be accounted for by
recognising that “Paradoxically, the more attention is focussed on
the technical mastery of disease, the larger becomes the symbolic and
non-technical function performed by medical technology … Not only
white coats, masks, antiseptics, and ambulance sirens but entire
branches of medicine continue to be financed because they have been
invested with non-technical, usually symbolic power.”
This would also explain why entirely fake
operations relying only on the symbolically suggestive power of
mysterious forms of technology and belief in the god-like power of
clinicians or surgeons have been shown, like placebos, to be capable
of producing exactly the same results as real operations – with
operating theatres serving as the innermost holy sanctum of hospitals
– the temples of
biomedicine.
This is not to say that emergency-room
operating theatres and intensive care units do not and have not saved
lives or that they should be abolished. But intensive hospital care
for the ‘terminally ill’ is a different matter entirely – for
as Illich notes, evidence suggests it does not increase life
expectancy at all and in many cases it actually reduces it in
comparison with home care
– which allows the patient to “avoid the exile, loneliness and
indignities which, in all but exceptional hospitals, await them.”
Thus “…patients who have suffered cardiac infarction themselves
tend to express a preference for home care; they are frightened by
the hospital, and in a crisis would rather be close to people they
know. Careful statistical findings have confirmed their intuition:
the higher mortality rate of those benefited by mechanical care in
the hospitals is usually ascribed to fright.”
‘Putting the fear of God’ – and of
death – into patients is a more recent and one of the most
perversely religious dimensions of biomedicine. Thus the current
standard of what is bizarrely understood as ‘ethical’ practice on
the part of biomedical clinicians is to present patients diagnosed
with terminal illness with a worst
case scenario as regards their
maximum life-expectancy.
Thus a patient may be told that he or she
has at most
one year or less to live, even though the clinician well knows from
experience and empirical evidence that though this may
be the case, there can be absolutely no ‘scientific’ certainty in
this respect – and that the patient may in fact live on for
anything up for an indefinite number of years – or even, as also
happen, go into remission.
The profound and stressful psychological
impact of such prognoses – and that not just on the patient’s
state of mind but on their body – goes without saying. As a result
it can prove tantamount to a self-fulfilling prophecy – a form of
‘death by prognosis’ – akin to a doomsaying religious prophecy
or a witchdoctor’s curse.
Just as religion has its own temples so
does biomedicine – the hospital or clinical surgery. These are
truly clinical temples, unadorned, like Lutheran churches, and
replacing uncomfortable pews with cheap plastic chairs. Stands or
shelves abound in every waiting room, replete with glossy printed
religious tracts warning of the evils of this or that disease and/or
of the price to be paid by unhealthy (read ‘sinful’) lifestyles.
The institutional hierarchy of
biomedicine is also like that of a church, except that its bishops
are managerial bureaucrats who preach the gospel of cost-cutting and
the sanctity of efficiency. Consultation with the patients are
ritualised time-limited ‘procedures’ which severely restrict the
patient’s ability to share their own lived experience of illness
and its effects on their lives – something which anyway counts for
nothing to the clinician unless the patient’s own words can be
immediately translated into the dry liturgical language and
terminology of biomedical science.
The physician is not there to listen,
understand and empathise but, like the dogmatic mouthpiece of a
religious belief system – simply to prescribe
what the patient must do – whether this means taking a pill or
undergoing a further standardised ‘procedure’ whether in the form
of a blood test, a scan, an operation or a further tightly time
controlled consultation with a ‘specialist’ in one or other area
of biomedical theory and practice. All such procedures are of course
documented in the form of medical records, reports, test results and
communications. The result is that the patient is ultimately reduced
to a set of documented, biomedically framed accounts of their illness
in which all traces of the patient’s experience of illness have
been purged.
As for the written ‘prescriptions’
with which patients regularly leave their clinic or hospital, these
are comparable to the so-called ‘indulgences’ granted (or even
sold) by the Catholic church, “proving relief from the temporal
punishment resulting from the effect of sin” – or in this case
sickness.
Finally, we should not forget also the
religious and globally ‘crusading’ role of biomedicine in seeking
to displace local, culturally and ethnically rooted understandings of
illness – which, again, are seen as mere systems of ‘beliefs’
in contrast to the supposedly universal truth of biomedical
‘knowledge’. Here we see something akin to the historical
appropriation of local ‘pagan’ gods and symbols by Christianity.
Yet if traditional local remedies can be displaced by – or, as is
increasingly the case – modified and repackaged as patented
pharmaceutical products, then
of course this crusade also reaps big profits for Big Pharma – just
as the Crusades were as much about bringing home booty as imposing
new belie
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