by Theodore Dalrymple
Published February 5, 1998
Andre Deutsch Ltd.
ISBN-10: 0233991379
ISBN-13: 978-0233991375
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by Theodore Dalrymple
Published July 12, 2001
Gerald Duckworth & Co. Ltd.
ISBN-10: 0715629735
ISBN-13: 978-0715629734
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Given the contemporary prominence of health care in the public debate, it is surprising that the views of perhaps our greatest intellectual, who happens also to be a doctor, are not more frequently cited. Anthony Daniels has written for years about the philosophic and public policy aspects of health care. He addressed the issue more fundamentally in these two consecutive books, which make arguments about both health and health care (not at all the same thing) that are original and provocative.
According to Dalrymple, our modern affluence has provided us longer and healthier lives than ever before, a fact which we now take for granted and regard as a right. We are so insulated from death that it is today an anomaly which requires an explanation and for which someone is to blame. We regard imperfect health as an infringement of our rights and attribute it to the poisons of civilization or the by-products of greedy corporations, rather than as one of the few problems the civilized world has not conquered. We increasingly look to government to protect us even from the foods we choose to eat or the cigarettes we choose to smoke. In spite of our longevity, we fear death more and not less, because we no longer believe in an afterlife.
In Mass Listeria, Dalrymple argues that there is no rational basis for the vast majority of health scares and that they are instead attributable to our modern existential crisis. “Health scares play an important part in the mental economy of modern Man,” he says. “They allow him to believe that, were it not for this or that pollutant, he might be immortal, while explaining the anomaly of death. And they do something more: they provide him with that most indispensable of creatures, a scapegoat.”
“The desire to hang on to life is the root of all health scares”, he says. “We fear what is not likely to happen, the better to avoid thinking about what is.” Dalrymple addresses health more generally in An Intelligent Person’s Guide to Medicine. He says that health as an ideal is overvalued, that it is not an end in itself but a means to enjoying life, that people today are too obsessed with health and that this represents self-absorption which trivializes and “obscures much more important aspects of life”. Finding a meaning and purpose in life is far more important. Furthermore, health care is not fundamental to good health. Basic food, clothing, shelter and access to antibiotics are what improve longevity, and while no health care system is perfect, almost all of them “do most of what they are supposed to do”.
Perhaps most importantly and in keeping with a theme of much of his writing, he argues that the problems of many patients are not medical but behavioral. “Medicine can cure some diseases, it can ease pain, it can bring comfort. But it will never alter the human condition, or relieve men of their responsibility.”