Pharmacracy: Medicine and Politics in America

by Thomas Szasz

Overview

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 a type of government social critic Thomas Szasz calls "pharmacracy." He warns that the creeping substitution of democracy for pharmacracyprivate personal concerns increasingly perceived as requiring a medical-political responseinexorably erodes personal freedom and dignity.

Product Details

ISBN-13:	9780815607632
Publisher:	Syracuse University Press
Publication date:	09/01/2003
Edition description:	1ST SYRACU
Pages:	248
Sales rank:	1,053,210
Product dimensions:	6.00(w) x 9.00(h) x 0.68(d)

About the Author

Thomas Szasz is professor emeritus of psychiatry at State University of New York Upstate Medical University in Syracuse. His books include The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement; The Meaning of Mind: Language, Morality, and Neuroscience; and Fatal Freedom: The Ethics and Politics of Suicide, all published by Syracuse University Press.

Table of Contents

	Preface	xi
	Acknowledgments	xvii
	Abbreviations	xix
	Introduction: What Counts as a Disease?	xxi
1.	Medicine: From Gnostic Healing to Empirical Science	1
2.	Scientific Medicine: Disease	9
3.	Clinical Medicine: Diagnosis	27
4.	Certifying Medicine: Disability	57
5.	Psychiatric Medicine: Disorder	77
6.	Philosophical Medicine: Critique or Ratification?	111
7.	Political Medicine: The Therapeutic State	127
	Epilogue	161
	Notes	167
	Selected Bibliography	191
	Index	203

What People are Saying About This

Milton Friedman

Milton Friedman Senior Research Fellow, Hoover Institution
A passionate warning of the danger of converting the welfare state into the therapeutic state. Professor Szasz presents a subtle, learned and exhaustive analysis of the difference between medical illness and mental illness and of the harm from confounding the one with the other.

Richard E. Vatz

Richard E. Vatz, Towson University Associate Psychology Editor, USA Today Magazine
To those who wonder what is Thomas Szasz's response to biological psychiatry, this book provides a devastating response. Pharmacracy will expand Szasz's reputation, as it includes a clear analysis of the definition and strategic rhetoric of the concepts of 'diagnosis,' 'disease,' and 'disability.' Finally, Szasz's examination of the 'certifying' of authenticating role of physicians and non-physicians throws a critically fresh light on a professional function of immense importance in our society.

Alvan R. Feinstein

Alvan R. Feinstein Sterling Professor of Medicine and Epidemiology Yale University School of Medicine
Dr. Thomas Szasz is at it again, continuing his long quest (a la Joseph Pulitzer) to comfort the afflicted and afflict the comfortable. This time Szasz is attacking 'pharmacracy' as a totalitarian, politics-ridden, individual-responsibility-shunning 'Therapeutic State' in which health care professionals act as 'certifying agents' and treatment providers for self indulgence, disability, and other socially undesirable behavior that are now diagnosed as diseases. Whether you agree or disagree, and whether you are pleased or enraged, Szasz will provoke you into an increasingly rare modern activity: critical thought.

David J. Theroux

David J. Theroux Founder and President, The Independent Institute
In Pharmacracy, Thomas Szasz has produced an excellent and seminal book on the pervasive, intrusive, and dangerous power of government officials over our health. Comprehensive, lucid, and provocative, Pharmacracy shows why such power must be ended so that people can control their own lives and benefit from the competitive health-care process only possible when the rights of individuals are fully respected. This book is must reading.

Robert Higgs

No development of the past 30 years threatens the liberty of Americans so much as the growth and the growing acceptance of the therapeutic state....No one has done more than Thomas Szasz to alert us to the menace of a government that regards all human conduct, no matter how private, as a matter of public health, and treats the citizenry as afflicted sheep in need of a coercive shepherd to provide for their rehabilitation. In Pharmacracy, Szasz illuminates an issue of critical importance for all Americans.
—(Robert Higgs, Author of Crisis and Leviathan:Critical Episodes in the Growth of American Government)

George Englebretsen

George Englebretsen,Professor of Philosophy, Bishop's University
One expects Thomas Szasz's work to exhibit not only a high level of common sense (a la Mencken or Twain), but a careful philosophical, analytic approach (a la Ryle or Russell), to the foundations of the problems addressed. Pharmacracy meets and far exceeds that expectation: It is a very fine piece of work both enlightening and frightening. I hope it enjoys a wide readership, but fear that few of those who should read it, will.

Editorial Reviews

The idiom, imagery, and technology of medicine have been taken over by politics and society, says longtime dissident psychiatrist Szasz, and that has essentially broadened and weakened the concept of disease. Bureaucrats have supplanted pathologists, and bioethicists have obfuscated the scientific approach. Szasz emphasizes the resultant dangers, especially those stemming from the forceful social influence of psychiatry and the burgeoning domain of mental illness. The current biopsychosocial image of illness is a regression, he says, not an advance. Mental illnesses in general don't have solid physical causes and therefore should not be seen as scientifically diagnosable, researchable, and treatable conditions. But the powerful and often insidious propaganda of drug companies, mental illness proponents, politicians, and recent surgeons general routinely infects legislation, the public press, and even the major medical journals. Szasz's quotable style, thoughtful delving beneath the surface, and often striking analogies should once again stimulate vigorous discussion in several fields.

Booklist

The idiom, imagery, and technology of medicine have been taken over by politics and society, says longtime dissident psychiatrist Szasz, and that has essentially broadened and weakened the concept of disease. Bureaucrats have supplanted pathologists, and bioethicists have obfuscated the scientific approach. Szasz emphasizes the resultant dangers, especially those stemming from the forceful social influence of psychiatry and the burgeoning domain of mental illness. The current biopsychosocial image of illness is a regression, he says, not an advance. Mental illnesses in general don't have solid physical causes and therefore should not be seen as scientifically diagnosable, researchable, and treatable conditions. But the powerful and often insidious propaganda of drug companies, mental illness proponents, politicians, and recent surgeons general routinely infects legislation, the public press, and even the major medical journals. Szasz's quotable style, thoughtful delving beneath the surface, and often striking analogies should once again stimulate vigorous discussion in several fields.

Booklist

Nearly 40 years after psychiatrist Karl Menninger called the medical profession on the carpet for misnaming medical conditions so that various forms of treatment could be justified and, 24 years later, Susan Sontag declared that "illnesses have always been used as metaphors to enliven charges that a society was corrupt or unjust," noted and controversial psychiatrist Szasz (Fatal Freedom), as lively and contentious as ever, pursues similar lines of thought, examining the medicalization of politics and the politics of medicine in contemporary America. At the base of what he calls our modern "pharmacracy" a state where "all sorts of human problems are transformed into diseases and the rule of law extends into the rule of medicine" stands a virulent misunderstanding of disease, in the "literal" or scientific sense. It is, he argues in accord with the theories of 19th-century pathologist Rudolf Virchow, very simply an injury or abnormality in the cells, tissues or organs of the body. Yet, he maintains, the medical profession and politicians have today named as diseases a wide range of human behaviors, from alcoholism and obesity to mental illness and infertility. Moreover, some of these metaphorical diseases are elevated to public health problems subject to government intervention; thus, in Szasz's view, America has created a contemporary fascist health state in which its campaigns aimed at the eradication of smoking and obesity focus not on the responsibility of individuals to quit smoking or to lose weight but on the promise that well-funded research agendas will solve the problem. Plenty of health-care professionals and politicians will disagree with Szasz's definition of disease and his condemnation of the modern "pharmacracy," but no reader can put down this book without having been disturbed, provoked and challenged to see the American medical profession in a new light. (Apr. 30) Copyright 2001 Cahners Business Information.

Publishers Weekly - Publisher's Weekly

Szasz (emeritus, psychiatry, State University of New York Upstate Medical University) explores the development of a "pharmacracy" as the natural outgrowth of the tendency to medicalize social problems, deviance, and disruptive behavior. He describes the relationships between medical and political authority, between increased government control and increased funding for health care, and between the medicalization of individual behavior and the avoidance of personal responsibility. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews