Subscribe
Notify of
guest

38 Comments
Most Voted
Newest Oldest
Inline Feedbacks
View all comments
Malcolm Webb
Malcolm Webb
4 months ago

I found this a somewhat confused and confusing article. However in one respect I found it helpful. It reminded me of how, in modern Britain, we now tend to shun and institutionalise death. Most of the elderly members of my family have died in a hospital. One recent exception however proved uplifting. Given the ability to suppress pain, dying in a real home in the company of family and true friends proved to be so very much better for all concerned, not only the person dying but also for all those who loved her. Institutionalising death it seems to me is not necessarily a good idea. I thank the author of this piece for reminding me of that.

Frank Sterle
Frank Sterle
4 months ago
Reply to  Malcolm Webb

The pharmaceutical industry, meanwhile, notably profits from the continual and even addictive sedation and concealment, via tranquilizers and/or antidepressants, of symptoms of cerebral disorders, including the anxiety and/or depression that often accompany higher-functioning autistic spectrum disorder — especially if there’s related adverse childhood experience (ACE) trauma.
From my understanding, only a small percentage of Canadian physicians currently are integrating ACE-trauma science into the diagnoses and (usually chemical) treatments of patients.
And I don’t believe it’s just coincidental that the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions. …
Where I reside, therapy is unaffordably $200-plus an hour. Such non-Big-Pharma-profiting health specialists as counsellors, therapists and naturopaths (etcetera) are not covered at all by the public healthcare plan.

Carmel Shortall
Carmel Shortall
4 months ago
Reply to  Frank Sterle

Betcha MAiD is!

Cathy Carron
Cathy Carron
4 months ago
Reply to  Malcolm Webb

Re: dying at home with those who love you…not sure about the UK, but families in the USA can be spread throughout the country, working full time jobs and have lots of their own family obligations. It becomes impossible to tend to the elderly who remain in the original location, many of whom are living beyond 85 years, etc. It’s unfortunate but that’s the modern world.

My 95-year-old mother is in as assisted living facility in Massachusetts, 150 miles from my current home of 40 years. It took massive planning just to get my adult children who have jobs and children in NYC to my mother’s facility to celebrate Thanksgiving this year, not to mention the expense of travel & hotels, meals, etc. Of course, she would like us to be with her 24/7 which she demands frequently but which is impossible. She would love to live with one of us but she’s wheelchair bound, legally blind and needs round-the-clock care – cooking, feeding, etc. not to mention increasingly more medical attention. A simple UTI (urinary tract infection) sends her to the hospital frequently. There has to be a better way to deal with aging but so far we haven’t seen it. Be careful wishing to live a long life if you don’t have the resources to leave this earth the way you want to.
By the way, she never smoked or drank alcohol, is 30 lbs overweight but pursued a very clean life which is why she coasting to 100.

Last edited 4 months ago by Cathy Carron
Mark Vernon
Mark Vernon
4 months ago

The dimension that’s missing, now widespread in writers using Christian insights to critique the present, is why Illich developed his analysis, which wasn’t ultimately for civic or cultural reasons, but religious and spiritual ones.

He feared that the over-institutionalisation of education and care saturates our imaginations, blocking awareness of transcendence and God. Humanising qualities are eroded and the technology-driven age takes root, with its odd mix of panicky hope and despair.

Mike Downing
Mike Downing
4 months ago

Death remains the one thing we can’t sort out (but watch this space) and is like the ultimate pesky fly in the ointment of our dream of a ‘life without limits ‘.

This is really what the Esther Rantzen story in the papers is all about. She wants to be in control right to the end, and make it her campaigning ‘legacy’.

Meanwhile the NHS swallows resources like a bottomless pit and the population gets fatter, lazier and more prone to depression. Something has gone seriously wrong somewhere and it will surely all collapse in due course.

Mr Tyler
Mr Tyler
4 months ago

Cardiovascular and other medicines may have improved since the 70s, but the great man-made iatrogenic monster that is Covid-19 is sufficient alone to condemn 21st century. medicine.

Alison Wren
Alison Wren
4 months ago
Reply to  Mr Tyler

And definitely not forgetting the medical disaster (but profitable idea) that letting people believe they can change sex has engendered. Malpractice suits are lining up everywhere this ideology has taken hold.

Carmel Shortall
Carmel Shortall
4 months ago
Reply to  Mr Tyler

“Cardiovascular and other medicines may have improved since the 70s”

They have not. But Big Pharma and a supine medical ‘profession’ has ensured mass prescription of statins. A jab in every arm and a statin in every gullet! Soon, I expect, they will all be compulsory…

S B
S B
4 months ago

An interesting read. Thanks to the author and to Unheard.

Jane Hewland
Jane Hewland
4 months ago

Is this good writing? Or bad? When you get to the end of an article and think I’m not sure what this guy has said except for a truism that modern society has a phobia about death, are you justified in wondering if you should cancel your Unherd subscription? Writers like Mary Harrington get away with over florid over complex language because there are genuinely interesting thoughts being expressed. Don’t think this guy does. A publication that falls too often for this kind of article, believing the writer must be clever because he’s difficult to understand is not one I can support for long.

Andrew McDonald
Andrew McDonald
4 months ago
Reply to  Jane Hewland

That’s a bit harsh – I thought he rather cleverly captured the Illich tone of voice, though you’re right that he seems to have little insight or exegetory scope. Illich’s point about health (like his view on undertakers*) was simply that modern civil structures were de-skilling and de-humanising us all. Not much to see here….though he had more to say on education I agree.

* family DIY best.

Paul Monahan
Paul Monahan
4 months ago
Reply to  Jane Hewland

Agreed

Richard Pearse
Richard Pearse
4 months ago
Reply to  Jane Hewland

Interesting take: I thought it was fun to read (mildly whimsical, ironic tone) and I’d never heard of this guy Illich so I’m still wondering whether he was just another crackpot wailing about modernity and capitalism (“Marxism-tinged, back-to-basics, Catholic revolution-cum-devolution”) or an interesting thinker.

The part about dying in the hospital (or drugged comfortably in a hospice until you stop eating) was very interesting (and close to home – for me and apparently other readers). We’ve outsourced death and dying to the land of tubes, urine bags, orderlies and white coats: is the spiritual and life-lesson impact the same as watching grandpa “old and gray and full of sleep and nodding by fire”? I feel it’s important to confront this occasionally (as we all, gradually, start to nod by the fire).

Ergo, I enjoyed the article, though it may not have been as profound as some.

Frank Sterle
Frank Sterle
4 months ago
Reply to  Richard Pearse

We Canadians are often envied abroad for our “universal” healthcare system, yet our health may soon-enough come second to profit maximization, in particular those insatiably amassed by the pharmaceutical industry. 
Resultantly, we continue to be the world’s sole nation that has universal healthcare but no similar coverage of prescribed medication, however necessary.
Not only is medication less affordable, but other research has revealed that many low-income outpatients who cannot afford to fill their prescriptions end up back in the hospital system as a result, therefore costing far more for provincial and federal government health ministries than if the medication had been covered.
Ergo, in order for the industry to continue raking in huge profits, Canadians and their health, as both individual consumers and a taxpaying collective, must lose out big time. 
So, while we are often envied abroad for our supposedly universal health care, our health may soon-enough come second to profit maximization, in particular those insatiably amassed by the pharmaceutical industry.

Cathy Carron
Cathy Carron
4 months ago
Reply to  Frank Sterle

We don’t envy Canadians their healthcare as we see enough of them driving into the USA to get treated when their system won’t address their concerns. People from all over the world take advantage; in the small Massachusetts town I grew up in, Portuguese who immigrated would bring their elderly over and after they’ve been in the USA for a year, they’d plop them in local nursing homes. There were so many that didn’t speak English so interpreters would be hired – all thanks to the American taxpayer. I know this because my mother used to process Medicaid payments for our town.

Robbie K
Robbie K
4 months ago
Reply to  Jane Hewland

It’s not just bad, it’s terrible. He writes: That being said, prescribed medication is still the third highest cause of death globally.
A fact apparently. Based on a Guardian article, which was based on some bloke’s blog where he claims the second biggest cause of deaths is old people falling over because they are dosed up on anti-depressants.
It’s absolutely absurd garbage.

Benedict Waterson
Benedict Waterson
4 months ago
Reply to  Robbie K

The opioid epidemic includes prescription medications

Robbie K
Robbie K
4 months ago

Of course it does and that’s a valid point. The article however, whilst making some good observations has been based on a load of old guff.

Andrew Fisher
Andrew Fisher
4 months ago
Reply to  Jane Hewland

Your comment is rather too self revealing, I would suggest. If you accuse this perfectly cogent and well written article – or the very sparse and focused prise of Mary Harrington of being “florid” then perhaps your issue might be actually “reading” itself! The absorption of a sometimes complex reality that can’t always be stripped down to a comic book level.

Last edited 4 months ago by Andrew Fisher
Michael McElwee
Michael McElwee
4 months ago
Reply to  Jane Hewland

The man can turn a phrase.

Edward De Beukelaer
Edward De Beukelaer
4 months ago

This piece is confusing because the author mixes two narratives of health: the first narrative is the one used by modern medicine coming out of the enlightenment and and Descartes area treating our bodies as bits working together, like in a machine, which medicine will fix. This has resulted in the modern medicine paradigm which has now lost to control of rising chronic illness and unpleasant deaths. It is clever at saving lives but not so much as providing health.
The other narrative is more associated with traditional views on health and disease seeing us as being systems where all is linked in endless feedback loops and as part of larger systems (household, family, town, environment, country, … earth). It is not always so clever at saving lives but very good as providing health.
Both narratives are valid and add value to medicine. the problem is often that ‘we’ prefer to believe in only one narrative and see the other as not right.
Illich narrative is perfectly sensible if you allow for the thinking of his time and his worry about modern medicine correct but maybe not perfectly adjusted.
Many still believe in the value of modern medicine: most of the improvement of quality of life and life expectancy has been achieved through better sanitation and only a possible a mere 10% due to modern medicine (https://rootsofprogress.org/draining-the-swamp)
health is altogether another thing from relieving pain and saving lives: see page 16-17 of this: https://files.visura.co/users/12837/8849a41e6cadcc2d07f3a8f032df11ba.pdf
It is about time that the medical profession wakes up to this because 1) no country can afford modern medicine for all its citizens, 2) modern medicine does not seek health, it is mostly interested in illness, 3) modern medicine is damaging to the environment (To just mention Anti microbial resistance)
We have tor educe modern medicine to what it is good at and learn from traditional medicine how it is possible to heal people to health (see G20 last August https://www.who.int/publications/m/item/who-traditional-medicine-summit-2023-meeting-report–gujarat-declaration)

Jacqui Denomme
Jacqui Denomme
4 months ago

Great distinctions. Your reply just clarified the article for me and in fact was more illuminating than the article itself and likely the book that inspired it. Unfortunately the systems our governments now fund seem to support a model that profits from sickness rather than the promotion of wellness.

Matt Soucie
Matt Soucie
4 months ago

Lias is such a rambler, but he’s great. Likewise with Ivan Illich, so this piece was a treat for me

j watson
j watson
4 months ago

As we know there has been a huge increase in average life expectancy last 50yrs. Some of that has much to do with modern medicine, as the Author notes with specific reference to cardiac care as but one example. Significant morbidity improvements have also been delivered – the benefits from things such as joint replacement and cataract surgery, thus alleviating immense pain, disability and blindness, are transformational and what preceded them sometimes forgotten.
Undoubtedly some clinical and esp pharmaceutical mismanagement occurs. But it would still be difficult to weigh all the interventions now possible against such mistakes and find modern medicine makes us sicker overall. Modern Medicine is one of the greatest achievements of the West.
Yet the Author is onto something about how some interventions may be inappropriate near to the very end of life. These judgments are not easy though, and the Author offers no suggestions on what might improve things. More time, support and the cultural encouragement to develop more Advanced Directives could help. But who should prompt these via discussion with us? Overstretched GPs? And when we are desperately trying to get a patient back home to die are the community support and care resources there? ‘Fast tracking’ is a process used every day by UK Hospitals to help get someone back home to die, but it often doesn’t manage to move fast enough because the support isn’t there.

Caroline Ayers
Caroline Ayers
4 months ago

I loved this article – I’d never heard of Illich. I agree he was something of a seer. Thank you Unherd x

David Harris
David Harris
4 months ago

I remember the book and its author (Deschooling, Ivan Illich) from my 1970s teacher training lectures. Had until now completely forgotten it. Nice to be reminded tho’. 🙂

Peter Lee
Peter Lee
4 months ago

Having just gone through the Covid Vaccine horror story , with young sports people are dying left right and centre, this article would seem quite topical.
We need to stop relying on institutional medicine and be responsible of our own healthy life style. A good walk every day with good eating habits will do the trick.

Last edited 4 months ago by Peter Lee
Mark Vernon
Mark Vernon
4 months ago

As William Blake, a comparable prophet, put it: “The bounded is loathed by its possessor. The same dull round even of a universe would soon become a mill with complicated wheels.”

Last edited 4 months ago by Mark Vernon
Alix Daniel
Alix Daniel
4 months ago

The iatrogenic development of medical science has got worse since Illich’s work. During Covid, countries with advance medical care have suffered much more than poor countries with an excess of mortality, morbidity, drug consumption and human despair at such a level, I can now comprehend. Western medical science does not care anymore and my profession of family doctor is doomed.

George Scialabba
George Scialabba
4 months ago
Janet G
Janet G
4 months ago

Thanks George Scialabba.

UnHerd Reader
UnHerd Reader
4 months ago

Well I don’t know about whether it makes us sick or not. If I ever get a chance to be treated by a doctor or the NHS I’ll let you know.

Alex Stonor
Alex Stonor
4 months ago

Brilliant.

Janet G
Janet G
4 months ago

Victoria Sweet’s writings about slow medicine are worth reading. The first I read was ‘God’s Hotel: A doctor, a hospital, and a pilgrimage to the heart of medicine.’ https://www.penguinrandomhouse.com/books/306891/gods-hotel-by-victoria-sweet/

Jacqui Denomme
Jacqui Denomme
4 months ago
Reply to  Janet G

I loved this book and wish all health care professionals could be inspired by its profound insights.

Katalin Kish
Katalin Kish
4 months ago

Freakonomics shares some insights also, about the harm too much medical help poses.

Wireless Internet connectivity of medical systems & devices e.g. pacemakers and insulin pumps pose a much bigger threat to life though, because as yet few medical professionals are able to grasp how far the risks of unprotectable technology outweigh any benefit.

Anything with a CPU is hackable.

I even experienced a Faraday Cage penetration in 2022 in my own home as a likely demo to a Science graduate of a new crime tech addition to Australia’s biker arsenals.

I am writing from 14+ years experience as a crime-tech-demo-dummy in a leafy suburb of Melbourne, Australia, where I have owned my home since 2001, investment properties since 2010.

I had to give up trying to earn a salary in 2017 due to devastating cyber-crimes, house break-ins evidently via utilising government/military-grade resources. Last obvious cyber-crime less than 2 hours ago.

Finances are mentioned, because in Australia all crime victims are assumed to be charity cases whose poor life decisions led to their inevitable demise.

Since I never even dated the stalker ex-coworker from the Victorian Electoral Commission trading stolen info for Crimes As A Service at least since 2009 with e.g. Australia’s bikers, ongoing crimes against me are not even domestic violence.

The stalker didn’t (still doesn’t?) just have unrestricted access to every woman’s home address in our state, possibly the whole of Australia, he had/has unrestricted access to the up-to-date whereabouts of people in witness protection.

Crimes against me have featured remote physical harm capabilities from the time I declared self-representation at court in 2019, as corrupt Victoria Police forced me to fight at court as an accused criminal in an admitted silencing attempt about crimes I witnessed as a public servant, crimes I am reduced to surviving at times every few minutes even seconds since mid-2009.

It was a relief of sorts to read about Kamala HARRIS’ Vietnam incident. My self-representation cut the court case short: prosecutors bluff.

The most severe of these incidents occurred on 9 July 2022.

A sudden, extreme dizziness came over me making me vomit for about 10 hours, giving me a scalp burn without any observable contact. Debilitating dizziness took 7 months+ to taper off, tinnitus continues.

Do corrupt Victoria Police / Australia’s bikers aim at cognitively disabling crime witnesses they cannot silence with violence, cannot discredit via bizarre crimes? A biker’s unpunished physical assault against me only increased my resolve to fight the crimes and corruption of Victoria Police.

Using military-grade tech against crime witnesses violates the Geneva Convention of course.

Remote-physical-harm acts via military-grade resources qualify as war crimes, yet they are unpunishable, because no victim can prove for the foreseeable future that the effects they experience are directly linked to remote-weapons-grade tech, let alone proving individual cyber-criminals’ guilt beyond reasonable doubt.

This article meets terrifying tech reality in health institutions’/doctors’ propensity to close ranks against patients with negative health outcomes.
Any punishment, if/when these crimes become punishable will be after the fact.
Coma is rarely reversible and the dead will remain dead.

#ididnotstaysilent

Last edited 4 months ago by Katalin Kish
Nick L
Nick L
4 months ago

This guy is a terrible writer. I expect more from UnHerd.