By Edward J. Hanrahan
Assessment in define layout of epidemiology and records for clinical scholars getting ready for board examinations. DNLM: Epidemiology exam questions.
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Extra resources for Appleton and Lange's Review of Epidemiology and Biostatistics for the USMLE
12 (emphasis added) Finally, he rejects a more environmental approach to medicine. He sees this 'engineering for a plastic womb' as potentially leading to an even greater extension of the boundaries of medicine - to what he describes as 'total treatment'. 13 Having rejected all the current proposals for reforming the medical care system, what does Illich himself propose? His solution emerges from his view that it is the medical bureaucracies and industrialised medicine which form the major obstacles to a healthy society.
Thus, poor health for some is seen as a necessary consequence of economic growth, which is itself assumed to be a desirable goal for everyone. It is certainly possible to argue (probably correctly) that the advantages to be gained from industrial production must always involve, to a greater or lesser extent, the destruction of human and physical resources. Yet the nature and extent of that destruction will reflect the priorities of the society in which the production takes place. Thus if, as we shall argue, it is ultimately profit, rather than a concern to improve overall living standards, which is the most important determinant of economic and social decision-making in capitalist society, this will be reflected in various ways in patterns of health and illness.
But again, it does so ahistorically, and within a theoretical context which accepts the status quo and is hostile to the development of a radical critique of medical science. It is clear then, that because of its commitment to a particular mode of analysis, most orthodox social science does not define the nature of medical knowledge as problematic and pays little attention to wider issues concerning the nature of medical practice in contemporary capitalist society. It is these issues which will be discussed in the final section of this chapter, and which form the basis for the theoretical framework of the rest of the book.