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Introduction
Western societies in the early twenty-first century are characterized by
people’s increasing disillusionment with scientific medicine. Paradoxically,
there is also an increasing dependence upon biomedicine to provide the
answers to social as well as medical problems, and the mythology of the
beneficent, god-like physician remains dominant. On the one hand, doctors
are criticized for abusing their medical power by controlling or oppressing
their patients, for malpractice and indulging in avarice; on the other, in
most western societies, access to medical care is widely regarded as a social
good and the inalienable right of every person. Medical views on health,
illness, disease and the body dominate public and private discussions.
Some critics would argue that the medical profession has too much
power and too high a social status, that people are placing too much trust
in medical practitioners and the treatment they offer, that the resources
devoted to medical technology are disproportionate. In the past two centuries,
a range of behaviours from homosexuality to alcoholism have
come under the rubric of medicine. With the current obsession for locating
the genetic precursor of illnesses, diseases and behaviours, the knowledge
base of scientific medicine has encroached even further into defining
the limits of normality and the proper functioning and deportment of the
human body. Yet it cannot be denied that illness and disease are debilitating
states, and that the populations of western societies are vastly longerlived
and more free of pain and discomfort now than at any other time.
The increasing secularization of western societies, the dependence on
rationality and individualism which are legacies of the Enlightenment, the
increase in average life expectancies and decrease in numbers of deaths
from infectious diseases, the turn to biomedicine and science as the ultimate
weapons against illness, disease and premature death have generated
ideas and practices which tend to deny the fragility and mortality of
the human body. For the populations of western societies, serious illness
and death are strange, mysterious, frightening and unexpected events,
except perhaps for the very old. Medicine, or faith in medicine, is a creed.
There is a set of expectations surrounding health and the body prevailing
in western societies: we expect to feel well, without pain or disability, long
after middle-age; we expect all children to survive birth and infancy, all
women to give birth with no complications, all surgery and medical treatment
to be successful. And for the majority of people, these expectations
are indeed met, serving to reinforce them even more strongly.