Pharmacracy: Medicine and Politics in America [Paperback]

Thomas Stephen Szasz (Author)

Book Description

Publication Date: July 2003

In recent decades, American medicine has become increasingly politicized and politics has become increasingly medicalized. Behaviors previously seen as virtuous or wicked, wise or unwise are now dealt with as "healthy" or "sick"--unwanted behaviors to be controlled as if they were health issues. 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 the creation of a type of government social critic Thomas Szasz calls "pharmacracy." Medicalizing troublesome behaviors and social problems is tempting to voters and politicians alike: it panders to the people by promising to satisfy their needs for dependence on medical authority and offers easy self-aggrandizement to politicians as the dispensers of more and better "health care." Thus, the people gain a convenient scapegoat, enabling them to avoid personal responsibility for their behavior. The government gains a rationale for endless and politically expedient "wars" against social problems defined as public health emergencies. The health care system gains prestige, funding, and bureaucratic power that only an alliance with the political system can provide. However, Szasz warns, the creeping substitution of pharmacracy for democracy--private medical concerns increasingly perceived as requiring a political response--inexorably erodes personal freedom and dignity. Pharmacracy: Medicine and Politics in America is a clear and convincing presentation of this hidden danger, all too often ignored in our health care debates and avoided in our political contests.

--This text refers to the Hardcover edition.

Editorial Reviews

From Publishers Weekly

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.

Copyright 2001 Cahners Business Information, Inc.

--This text refers to the Hardcover edition.

From 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. William Beatty
Copyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.

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Product Details

• Paperback: 248 pages
• Publisher: Syracuse University Press (July 2003)
• Language: English
• ISBN-10: 0815607636
• ISBN-13: 978-0815607632
• Product Dimensions: 9.4 x 5.6 x 0.7 inches
• Shipping Weight: 12.8 ounces (View shipping rates and policies)
• Average Customer Review: 3.6 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #791,772 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

27 of 28 people found the following review helpful:

5.0 out of 5 stars The Politics of Medicine, September 4, 2001

By A Customer

This review is from: Pharmacracy: Medicine and Politics in America (Hardcover)

This is a great book for laying to rest some orthodox but wrong ideas about our mental health. Szasz shows us that the orthodox way is not necessarily the right way. Certainly our own doctors are not going to blow the whistle on themselves, are they? This revolutionary psychiatrist shows us the real path to health, pointing us away from the wrong direction that the pharmaceutical companies have been leading us, and unfortunately, leading our doctors as well. It's a case of the fox guarding the henhouse.
Do you care that a psychiatrist is a doctor who prescribes drugs to change people's brains without ever actually examining those people's brains? Do you worry that nobody knows exactly what the long-term effect of these drugs are that we are now being given for bi-polar disorder, for attention deficit disorder, for depression or for anxiety; or even if they are really doing us more harm than good? Do you know how doctors today are becoming more and more controlled and subverted by the pharmaceutical industry? Do you think that unwanted behavior and unwanted feelings like anxiety and depression are diseases that can be cured by drugs? If you do, you should read the latest book by this world renowned psychiatrist.
"Psychiatrists have a long history of systematically validating fake diseases as real diseases, and getting away with it," says Szasz. They can get away with it because it serves everybody: the family whose medical insurance will pay only for certain diagnoses and not for others; the government officials who can allocate more and more federal funds for their universities and laboratories; and the doctors who can service many more patients in the "service station" atmosphere that has us all believing that everything can be made right with the right pill. The only person whom fake diagnoses and powerful drugs are not serving is the health of the individual who is having his birthright sold for a pharmaceutical mess of pottage.
We are confusing, warns Szasz, bodily diseases which are physiochemical phenomena located in the body and understood by cellular pathology with unwanted personal habits or behaviors which are located in the social context of society and understood by the interconnecting relationships. We are confusing the mind with the brain. And finally, we are confusing medicine with politics and social agenda. In so doing we are becoming less and less the land of the free and the brave and more and more the land of the mentally ill and deluded. Szasz makes a good case for a new look at the insidious subversion of our medical care by the politics of pharmaceutical managed care.

21 of 26 people found the following review helpful:

5.0 out of 5 stars Thomas Szasz Does It Again, June 15, 2001

By 

John Friedberg - See all my reviews

This review is from: Pharmacracy: Medicine and Politics in America (Hardcover)

Dr. Szasz, now 81 years old, has done it again: explained what's going on in the minds of psychiatrists and their adulators from the Surgeon General on down. And why.

For example, he tells us how doctors are really paid and explains the corrupting effect of third party reimbursement by DRG (Diagnosis Related Groups)on the most important and the kindest thing any doctor can do: make an accurate diagnosis.

There are new insights, new quotes and the usual entertaining anecdotes and fastidious footnotes.

Psychiatric obscurantism is impacting every American every time he or she is misinformed: "Depression is a disease like diabetes - ask your Doctor about...." And that's just TV.

What kills me is how the parrots of psychobaffle preen themselves on their courage at having broken through the mind body barrier - as if obliterating one of childhood's most important lessons - that thinking doesn't make it so - is an accomplishment to squawk over: "Look Mom, I can fly."

How dumb can we get? Read this book and find out. The bamboozlement of Mental Health already is to the 21st Century what the propaganda of Communism and National Socialism were to the 20th. Immunize yourself now.

Dr. Szasz has been one of the clearest thinkers and writers for 50 years and this book is another brilliant facet to the immense diamond which is his life's work.

11 of 16 people found the following review helpful:

5.0 out of 5 stars this book could save your life, September 1, 2001

By 

Arline Curtiss (Escondido, CA United States) - See all my reviews

This review is from: Pharmacracy: Medicine and Politics in America (Hardcover)

Pharmacracy

Do you care that a psychiatrist is a doctor who prescribes drugs to change people's brains without ever actually examining those people's brains? Do you worry that nobody knows exactly what the long-term effect of these drugs are that we are now being given for bi-polar disorder, for attention deficit disorder, for depression or for anxiety; or even if they are really doing us more harm than good? Do you know how doctors today are becoming more and more controlled and subverted by the pharmaceutical industry? Are unwanted behavior and unwanted feelings like anxiety and depression diseases that can be cured by drugs? If you think they are, please run as fast as you can and get this book. It could save your life.