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The Rise of Iatrocracy by Sebastian Morello

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The Rise of Iatrocracy

"Physicians disputing while the patient suffers," oil on canvas by an anonymous painter after Johann Geyer (1807-1875).

Photo: Courtesy of the Wellcome Collection; Public Domain.

Is providing healthcare among the duties of the State? Prior to the rise of State-provided healthcare, treatments and remedies were provided by private institutions of civil society, charities, guilds of doctors and surgeons, or by monasteries and convents. Knowledge of how to maintain one’s health, however, was something that was also expected of each individual. Governments certainly took a keen interest in the activities of healthcare providers and invited them if there was a deficit of such initiatives, but the State was not the direct provider. The advantage of healthcare being a feature of private initiative and civilian interaction, rather than a branch of the State, is that the limits and reach of governmental involvement in healthcare can be better established by custom and over time, rather than by direct governmental decree.

When healthcare becomes a part of politics, directly gifted by the State, rather than associated with the State’s duties in an indirect way, it necessarily becomes part of the State’s governmental repertoire. Why is this a problem? Well, because the State exists as a fundamentally coercive entity. There is nothing wrong with this when in its proper place. After all, I do not drive through red traffic lights even when there are clearly no oncoming vehicles about, not because I am an exemplary citizen who feels at that moment the impressions of political piety, but because many traffic lights have cameras and I do not want a heavy fine and points on my licence. One of the key purposes of government is that of directing society towards a condition of flourishing by passing laws and legislation, attaching threats of punishment to disobedience.

The precise degree to which the State may justly encroach on civil society and its established liberties cannot be known in the abstract. That is for each people to settle by custom and tradition, over time, hopefully slowly. The State taking to itself the direct providing of healthcare has not happened over time and slowly, but, at least in the UK, immediately in the middle of the last century, and since then has become the chief reason for the existence of government in the government’s own self-understanding.

Currently, the State clearly uses healthcare as a major part of its coercive repertoire. Over the past eighteen months, the government has effectively dissolved thousands of private businesses, barred free association, suspended the right of assembly (unless you are on the ‘right side of history’ and, therefore, congregating to commit vandalism with Black Lives Matter or Extinction Rebellion), and declared the limits of familial interaction. Such liberties are now deemed the gift of the State, with their return necessarily accompanied by its medications.

Many are facing the prospect of losing their jobs unless they take the jabs prescribed by the State. It does not seem to matter that these jabs are of morally dubious origin; that their long-term adverse effects are unknown; that they remain in an experimental stage of development; that safety measures have been bypassed to distribute them quickly; that they are based on novel technology; that reports of adverse reactions are being suppressed by an alliance of government and social media stooges—if you do not take these jabs, you could very well lose your livelihood, especially if you work for a State institution. This certainly means that healthcare is firmly placed within the State’s coercive repertoire. By that I mean that medical treatment is now an established means by which the State may regulate the lives of its citizenry. To some extent, this has been the case for some time, but never so extreme, and the arrival of this new health-based political settlement has been revolutionary. If we want to detect State encroachment on civil society, then the State has just taken a massive and unprecedented leap.

As noted, throughout most of history, healthcare has remained part of the domain of civil society and the private arena. Healthcare was traditionally understood as a skill that everyone was meant to possess to some measure. I want to suggest that healthcare is indeed a skill—much like coherent reasoning or managing one’s temper—that is necessary for anyone who wants to participate in a polity and flourish as a human being.

Allow me a personal digression. I was diagnosed with asthma as a child. My breathing was further weakened by picking up a pulmonary ailment whilst travelling in Asia in my late teens. In my twenties, whilst living in Italy, I contracted swine flu, and from this I developed double pneumonia and nearly suffocated to death. I am grateful to the doctors who emptied my lungs and saved my life (to be clear: I am not hostile to medical practitioners; my point is a political one). What followed was a decade of regular chest infections. Each time I suffered another bout of bronchitis and was bedridden, I was prescribed antibiotics and would get better, only to fall ill again a few weeks later. Doctors put me on various steroid inhalers and encouraged me to regularly take a reliever inhaler throughout the day. This treatment helped to suppress symptoms of what was clearly an underlying problem but did not get rid of the problem. It became clear that my immune system was so wrecked that I could not fight any infection without relying on more antibiotics, which in turn further weakened my immunity response. The cycle of debilitating bronchitis episodes went on, month in month out.

One day, distressed at my ongoing suffering, my wife recommended that I consume dried and powdered elderberries—a traditional immune system support—in capsules. I began to take two in the morning and two in the evening. Months passed, and it suddenly occurred to me that I had not had any spontaneous chest infections. I still, however, fell ill with bronchitis if I caught a cold or cough and frequently had to take my reliever inhaler. I further enquired into how to support my immune system and began to study the lymphatic system. I was amazed to discover the degree to which these two ‘systems’ are not only essential to the stable and healthy functioning of the body but seem to be inordinately neglected aspects of the human body in mainstream modern medicine. I began to eat, alongside processed elderberries, dried turkey tail mushrooms and lion’s mane mushrooms. I also started to eat nettles, drink fennel seed tea, undertake daily breathing exercises, lift dumbbells, and swing kettlebells. I continued to learn, and I adopted other traditional and natural therapies and treatments. Soon I found that, for the first time since I was a child, I did not need to use an inhaler, and I did not get chest infections anymore.

No wonder people are increasingly turning to herbalism, Asian medicine, and ‘alternative healthcare.’ It is unfortunate that, with the mainstreaming of ‘evidence-based medicine,’ everything from Reiki and crystal-healing to acupuncture and well-established herbal treatments have been grouped together as ‘alternative’—for indeed while some of this is true healthcare, some is quackery. In any case, it is certainly problematic that ‘evidence-based medicine’ is often based on thin evidence. Indeed, my experience of seeking treatment for respiratory problems marked an encounter with dogmatism rather than healthcare, with its ministers insisting on the truth of the dogma irrespective of the results. Now, this approach to healthcare has State-patronage, and it looks like the future holds much trouble for those who do not accept its treatments.

Perhaps those who fear a less technological, more traditional, and herbalist approach to healthcare do so because it marks a skill that everyone can learn, at least to some degree (such fear was expressed in a not entirely humble performance on Jimmy Kimmel Live recently). This approach shifts the responsibility for personal health away from the experts and back into the lore of civil society, partly removing it from the repertoire of the State. Frankly, it was creepy that throughout this pandemic almost nothing was said about immune system care. It was said that the COVID virus was more or less dangerous depending on your ‘underlying health problems,’ but there was silence as to what people could actively do to reduce such problems. Indeed, the message we all heard was that we were helpless without a jab, which the ‘miracle of science’ would eventually provide.

Little could have been worse for the functioning of the immune system than the advice we were given, or rather the measures that were forced upon us: stay indoors, do not go out for fresh air or exercise for longer than an hour each day, cover your mouth and nose when breathing fresh air, be alone, maintain high levels of anxiety and stress (‘stay alert!’).

I cannot blame ‘conspiracy theorists’ for getting the heebie-jeebies from what they have witnessed over the past eighteen months. There may very well be something odd afoot that explains the phenomena.

We moderns belong to the first civilisation in history that has sought to establish a totally secular polity, free from any public religion. With this aspiration, however, has come a redefinition of humanity. Prior to modernity, we did not consider ourselves mere members of a species, just human beings, but human persons. It was believed that the behaviour of persons—unlike other animals—could not be explained purely in terms of the avoidance of sufferings and the fulfilling of appetitive pursuits. Since the rise of modernity and the privatisation of religion (and its corollary, the banishment of religion from the public arena), we have had to find a concept for ourselves that is suitable for modernity. Such a concept would fit specifically in its rejection that we exist for any transcendent finality, which is what personhood entailed before it was orphaned by philosophes. Julien Offray de La Mettrie attempted to do this in his famous 1748 work, L’homme Machine, by encouraging us to think of ourselves as automatons, a superstition that still lingers in most university faculties. Since then, however, it has become more widespread to think of ourselves as mere organisms, differing from other animals only in degree rather than kind. Since we are, in the popular mind, mere animals, the modern State treats us accordingly.

As human life can be explained, it is believed, in terms of the avoiding of sufferings and the fulfilling of appetitive pursuits, the most serious problems to be avoided are not, as we once thought, moral misfortunes but medical ones (the nihilism to which this anthropology leads has been well expressed recently by Roger Crisp). The principal role of government, then, becomes its gifting of healthcare. Indeed, it is no longer clear whether it is politicians or the medical experts who are governing, since politicians can only legitimately govern when they ‘follow the science.’ Whence comes Iatrocracy: rule by physicians.

If, like all other animals, the flourishing of humans can be explained by nothing beyond the enjoyment of pleasures and the diminishment of sufferings, then the State, whose role is the securing of human flourishing for society’s members, must have its primary duty in the emancipation of unfettered appetite and the providing of healthcare. Thus, in the UK, national loyalty is measured by one’s praise of the National Health Service, and the most important event of the national calendar is Gay Pride, which now has an entire liturgical month of festivity attached to it, during which every feature of the sexual revolution is publicly celebrated.

The secular experiment, then, has failed. We now have, in the UK, a public cultus. Indeed, the rainbow flag, the icon of ongoing sexual revolution, has been combined with the acronym NHS as a national symbol, which all integralist politicians are expected to wear on their lapels as a sign of their piety. The prescriptions of the new priesthood, like the sacraments, must be received or the result is expulsion from society. State officials govern simply by proclaiming ‘the science,’ like preachers of an unquestionable revelation, and not by political prudence for whose failings they can be blamed. Our political settlement now sits somewhere between a sanitary dictatorship and a common fleshpot, and this chaotic combination has received consecration.

Can I offer any solutions? Nothing beyond the old conservative solution of prioritising the familiar, the local, and the tangible over the revolutionary, the removed, and the abstract. If you share my unease about the inordinate political power given to the healthcare profession, you can discover neglected wisdom about how to heal yourself. You cannot do everything; but you can do what you can. If all the people worried by the power of multinational corporations chose to shop only at privately owned local shops, that alone would be devastating to the former. So too, if all those troubled by the rise of Iatrocracy were to opt for less dependence on this new political settlement, it would cease to possess its current power.

Sebastian Morello was trained in philosophy by Sir Roger Scruton, by whom he was supervised for his master’s and doctoral degrees. He is a lecturer, public speaker, and columnist, and has published books on philosophy, history, and education. He lives in Bedfordshire, England, with his wife and children.

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