“Left alone, unadvised by professionals, the tendency of the human body is perceived as prone to steady failure. Underlying this pessimistic view of health is a profound dissatisfaction with the fact of death. Dying is regarded as the ultimate failure, something that could always be avoided or averted if only the health-care system functioned more efficiently. Death has been made to seem unnatural, an outrage; when people die—at whatever age—we speak of them as having been “struck down,” “felled.” It is as though in a better world we would all go on forever… The system is being overused, swamped by expectant overdemands for services that are frequently trivial or unproductive. The public is not sufficiently informed of the facts about things that medicine can and cannot accomplish. Medicine is surely not in possession of special wisdom about how to live a life. It needs to be said more often that human beings are fundamentally tough, resilient animals, marvelously made, most of the time capable of getting along quite well on their own. The health-care system should be designed for use when it is really needed and when it has something of genuine value to offer. If designed, or redesigned, in this way, the system would function far more effectively, and would probably cost very much less. If our society wishes to be rid of the diseases, fatal and non-fatal, that plague us the most, there is really little prospect of doing so by mounting a still larger health care system at still greater cost for delivering essentially today’s kind of technology on a larger scale. We will not do so by carrying out broader programs of surveillance and screening. The truth is that we do not yet know enough. But there is also another truth of great importance: we are learning fast. The harvest of new information from the biological revolution of the past quarter-century is just now coming in, and we can probably begin now to figure out the mechanisms of major diseases which were blank mysteries a few years back as accurately and profitably as was done for the infectious diseases earlier in this century. This can be said with considerable confidence, and without risk of overpromising or raising false hopes, provided we do not set time schedules or offer dates of delivery. Sooner or later it will go this way, since clearly it can go this way. It is simply a question at this stage of events of how much we wish to invest, for the health-care system of the future, in science.” — On the Science and Technology of Medicine by Lewis Thomas
Posted on: Sun, 08 Sep 2013 17:52:48 +0000
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