“The undesirable side-effects of approved, mistaken, callous, or contraindicated technical contacts with the medical system represent just the first level of pathogenic medicine. Such clinical iatrogenesis includes not only the damage that doctors inflict with the intent of curing or of exploiting the patient, but also those other torts that result from the doctor’s attempt to protect himself against the possibility of a suit for malpractice. Such attempts to avoid litigation and prosecution may now do more damage than any other iatrogenic stimulus.
On a second level, 70 medical practice sponsors sickness by reinforcing a morbid society that encourages people to become consumers of curative, preventive, industrial, and environmental medicine. On the one hand defectives survive in increasing numbers and are fit only for life under institutional care, while on the other hand, medically certified symptoms exempt people from industrial work and thereby remove them from the scene of political struggle to reshape the society that has made them sick. Second-level iatrogenesis finds its expression in various symptoms of social overmedicalization that amount to what I shall call the expropriation of health. This second-level impact of medicine I designate as social iatrogenesis, and I shall discuss it in Part II.
On a third level, the so-called health professions have an even deeper, culturally health-denying effect insofar as they destroy the potential of people to deal with their human weakness, vulnerability, and uniqueness in a personal and autonomous way. The patient in the grip of contemporary medicine is but one instance of mankind in the grip of its pernicious techniques.” Ivan Illich, Defenseless Patients from Medical Nemesis: The Expropriation of Health (1982)