Iatrogenesis is the negative effects of medical intervention and expansion on humans as humanity. Modern medicine has been effective and of great importance to the society. It has led to the development of drugs capable of treating a wide range of illnesses that cannot be managed through the traditional methods of disease management. More so, it has increased human lifespan on earth. However, multiple disadvantages and risks have come up as a result of medical intervention and development. This paper will discuss iatrogenesis in relation to the readings Being Mortal by Atul Gawande and The Spirit Catches You and You Fall Down by Anne Fadiman. Also, the paper will illustrate how medical advancements can have adverse effects on the society using the article The Shifting Engines of Medicalization by Peter Conrad. In other words, this paper will explain how medicine can be harmful to the society while it also does good using the readings.
In her book The Spirit Catches You and You Fall Down, Anne Fadiman portrays how Hmong culture and Western medicine conflict each other. The book is written in the Fadiman’s perspective after having experienced the two cultures. The book starts by explaining the traditions of the Hmong people. For instance they believe that something bad might happen during birth if a woman screamed or moaned. As Fadiman writes, “Foua believed that moaning or screaming would thwart the birth, she labored in silence” (Fadiman, 1998). Most importantly, Hmong community had a ‘txiv neeb’ who would provide health interventions such as dealing with in fertility by performing traditional rituals.
From Fadiman’s book, it is evident that advancements in the medical field has caused cultural iatogenesis among the Hmong people. Medical doctors have different ways of diagnosing illnesses when compared to how sicknesses are determined in the Hmong culture. For instance, Epilepsy is considered as a serious and a potentially harmful neurological disorder. In contrast, Hmong people refer to epilepsy as ‘quad dab peg,’ or ‘the spirit catches you and you fall down.’ They believe that a spirit chooses a person, who then, starts manifesting the symptoms of the sickness. ‘Quad dab peg’ is a highly regarded sickness in the Hmong society as those affected are said to have been selected “to be the host of a healing spirit, a neeb” (Fadiman, 1998). Fadiman explains how Lia’s parents took her to Merced Community Medical Center after her seizures from the ‘quad dab peg’ would not stop. For long, Foua and Nao Kao doubted the effectiveness of the Western medicine but after it had worked Lia’s siblings who were severely ill, they became convinced that it can be helpful. It changed led to cultural iatogenesis in the sense that it made Hmong people trust the Western medicine more than they trusted their traditional healers.
Clinical iatronenesis is also significant in Fadiman’s The Spirit Catches You and You Fall Down. As much as the Western medications treat multiple diseases, they also cause side effects. As Fadiman writes, “indeed the unpleasant side effects of many medications are one of the main reasons that patients so often stop taking them” (Fadiman, 1998). Conflict also arises during the administration of treatment. Fadiman gives an example of an encounter where a doctor named John Aleman wanted to determine which therapy to administer in Hmong child who had been hospitalized with severe jaundice. He was required to draw a number of blood samples from the child but after two to three extracts, the child’s parents refused, claiming that their child might die. Even worse, the guardians said that they would commit suicide if the doctor continued to extract more blood. It took the intervention of a Hmong leader who was educated to convince the couple to allow the physician continue with the blood tests on their child. From this example, it is clear on the extent to which disputes can arise when western treatment methods are being used on a stabilized culture.
On the other hand, Atul Gawande’s Being Mortal illustrates how medicine can impose harm in a society. Gawande’s book mainly explores how medicine has transformed the experience of creatures who die and age. Gawande argues that medical progress and specifically, public health has prevented the occurrence of deaths that would result from infectious diseases. Moreover, the fatal moment of most diseases has been prolonged (Gawande, 2014). For example, people with chronic diseases such as cancer can survive for long after diagnosis. As such, one of the advantages is that medical expansion has facilitated the longevity of the period from which a sick person eventually dies from a disease. However, this is also a disadvantage to the society. For instance, the cancer spreads to other parts of the body and within a short time, and sudden death may occur.
Medical progression, as Gawande claims, has resulted to longevity of life which is a disadvantage to the society as the aged population increases and this consequently, elevates the dependency rates. From Gawande’s point of view, old people, fear losses they encounter before death such as hearing, sight, memory, and friends, among others, instead of death itself. Proper dieting, exercise, and proper medical help enables one to manage longer. However, when old-age losses start accumulate, an individual becomes another person’s responsibility. Unfortunately, most people are often unprepared for and pay little attention to the moment when they will need assistance when they age (Gawande, 2014). Gandawale gives an account of a how a character, Bella became deaf in addition to blindness and memory loss problems which were as a result of old age. Felix, her partner experienced more stress as he had to take care of her. From this, it is clear that longevity in life as a result of medical expansion has increased dependency in the society.
Moreover, ageing is associated with multiple biological changes. For instance, loss of calcium and hardening of the body progresses with age. Consequently, Gawande argues that a low bone density which increases with age is a potential risk factor for cardiovascular diseases such as atherosclerosis. Gandawale also states that a major problem is that medicine has failed to address the changes it has accounted for (Gawande, 2014). In fact, a large percent of medical doctors do not like caring for the elderly people.
In the reading titled The Shifting Engines of Medicalization, Peter Conrad argues that the medicalization process has been altered over the past twenty years as a result of medical expansion. Most importantly, Conrad contends that biotechnology, managed care, and consumers are the key changes in the medical field which have facilitated medicalization. The improvement in biotechnology has promoted the increase of pharmaceutical companies which are mainly concerned with marketing their products for profit gains. As Conrad writes: “the pharmaceutical industry has been more aggressively promoting their wares to physicians and especially to the public” (Conrad, 2005). Conrad further gives examples of how the expansion of the pharmaceutical field has altered the process of medicalization in a negative way. For instance, the introduction of Viagra was initially meant for managing erectile dysfunction (ED) and male impotence among the older men.
However, the promotion of the drug changed the way the physicians, and more so, the physicians viewed Viagra. The drug industry made almost every male believe that they had ED and this increased the sales of the product. Conr4ad indicates in the reading that Viagra’s sales were $1.7 billion by 2003 and more than six million men consumed it. From this example, it is clear how the advancement in biotechnology can create the problem of misleading people to consume a drug even though they are not sick.
Overall, advancements in medicine has a wide range of negative effects to the society as much as it befits many people. Cultural iatrogenesis is one of the dr4awbacks of medical interventions which has been illustrated in the reading The Spirit Catches You and You Fall Down by Anne Fadiman. From the book, Hmong people adopted the Western medication which belittled the use of traditional healers who keep the society grounded. In addition, from the book Being Mortal by Atul Gawande, the availability of medications increases the longevity of life. Consequently, this leads to a large aged population which is dependent on other people and who has complicated medical conditions. Medical improvements can also lead to promotion of drugs through marketing where the public are made to believe that they need a certain medication while in real sense they do not.
Conrad, P. (2005). The shifting engines of medicalization. American Sociological Association.
Fadiman, A. (1998). The Spirit Catches You and You Fall. Farrar.
Gawande, A. (2014). Being Mortal. Metropolitan Books.