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'A thrilling account of the problems encountered by doctors in present-day medical practice ... highly recommended to be read also by nurses.' -Nursing Ethics 2003, 10 (3)
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In the preface to this remarkable book Dr. Fitzpatrick describes breaking into the house of an elderly couple during a bitterly cold February. The couple had succumbed to a combination of infection and hypothermia. While waiting for the ambulance, Fitzpatrick, a primary care physician working in a blue collar Borough of London, England, found an untouched leaflet describing the dangers of anonymous sex and the virtues of condoms. This leaflet had been distributed to 23 million homes in the UK, around half of which contained either an elderly couple or an old person living alone. At this moment Fitzpatrick reflected upon the absurdity of the "everyone is at risk" campaign and the motives of a government that did little to prevent the elderly from freezing to death and yet enthusiastically supported "healthy living". The conclusion that Fitzpatrick reaches will surprise and enrage both those who agree and disagree with his view. The author is nothing if not blunt stating, "the governments health policy is really a programme of social control packaged as health promotion." In an era when social institutions are increasingly discredited (think Congress, the Senate or any other political institution), irrelevant (e.g., unions) or ignored (e.g., religious proscriptions against premarital sex) the government has seized upon personal health as a means of reconnecting with society and regulating and supervising people's lives. At first glance Fitzpatrick's contention might be viewed as absurd and eccentric but think about it, how many aspects of your life are affected by concerns about health? Do you feel guilty driving to work when you might walk? Do you eat salad when you would prefer a steak?Read more ›
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It has become almost a commonplace to note that though we live longer and healthier lives, we are also more concerned about our health than ever before. Whilst many commentators have written on different aspects of this paradox , there has until now been no satisfactory survey of the whole. Fitzpatrick gives us, from his perspective as a GP, the most penetrating analysis yet published of the rise of the New Public Health, and of its dangers for patients, doctors and the relationship between them. Fitzpatrick presents a history of the way that health has become a major personal and political topic, by looking at the different health scares of the last few years, the screening tests and 'healthy living' recommendations that have been introduced and accepted in spite of dissenting academic criticism We are all familiar with instructions to eat healthily (just why is it five or six portions of fruit or vegetables per day anyway?), drink a certain number of units of alcohol a week, take exercise, and subject ourselves to screening tests of dubious efficacy . However, it is only when we are confronted by the whole panoply of measures that we realise how far things have gone and how rapid the pace of change has been. The result is that we now tolerate, if not actively seek out, a level of interference in our personal lives which would have been unthinkable even ten years ago. How to explain the astonishing success of the new public health amongst doctors and the public? A cynic would say that there is a straightforward financial motive for many doctors' enthusiasm for these measures, and though there is some truth in this, it is not the most important part of the story.Read more ›
Fitzpatrick wins me over right away with nail-on-the-head statements like:
> The government's public health policy is really a programme of social control packaged as health promotion.
Medicine has become a quasi-religious crusade against the old sins of the flesh.
While resources are poured into projects that use health to enhance social control, real health needs - especially those of the elderly - are neglected.
Only an epidemiologist could believe that data based on 'selfreported' levels of alcohol consumption can provide a useful basis for quantitative studies.
Such is the degradation of medical ethics that it is now considered virtuous for doctors to take on the role and responsibilities of the police and to subordinate the best interests of their patients to the dictates of government drug policy.
The invention of new disease labels - such as 'attention deficit hyperactivity disorder' in children or diverse forms of addiction in adults - reflects the trend to define a wider range of experience in psychiatric terms.
The propaganda of addiction finds a ready resonance in a society in which people are all too ready to accept a medical label for their difficulties.
There is ... a marked tendency for vulnerable people to develop an ongoing dependence on therapy, which is as likely to confirm their inadequacy as it is to enable them to overcome it.
Parenting projects are likely to weaken parental authority still further. <
He asserts that the government (he never mentions the industries that pull the government's strings) peddles health and longevity.Read more ›