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Overdoing prevention: Beware of regular check-ups, healthism by numbers and genetic profiling
Author : Pierre Biron ©
2013
Affiliation : Honorary professor, Faculty of Medicine, Université de Montréal, Montreal, Canada
Affiliation : Honorary professor, Faculty of Medicine, Université de Montréal, Montreal, Canada
Humane medicine as usually
practised by general practitioners is a threatened species. In the
old days doctors observed their patients in the circumstances of
their lives; at least they watched them walk from the waiting room
into the consultation room and they listened more than 123.4 seconds
before interrupting them.
Another historical period
bore witness to a technological medicine centred on systems, organs
and cells, practised by true engineers of the human body, these
second- and third-line specialists better paid than a dedicated
general practitioner with a good clinical judgment. Medical progress
became synonymous with medical specialisations in hospital settings
which required expensive machines, expensive drugs and expensive
training programmes to learn their use. High-technology fragmented
care saves lives but treats Homo
Mechanicus.
In the wake of the craze for
a healthy lifestyle (mostly associated with our social, economical,
educational and environmental status), we’ve entered another period
characterized by proactive laboratory-based preventive measures based
on schedules to screen for anomalies in plasma molecules, in body
images and soon in genetic material, in hot pursuit of markers and
risk factors, the significance and utility of which will
unquestionably be exaggerated by interested parties.
It is your dossier that is
dealt with, and nobody asks you any more how you’re getting on in
general; no interest is shown in your social or economic situation,
your living environment or habits, whether you live alone; nobody
inquires about the stability of your job or your relationship, nobody
even touches you any more [1], and nobody wastes any time over
non-verbal signals that might differentiate a real depression from a
bout of hypochondria.
The ritual stethoscope is applied over the
clothes, missing a melanoma brooding on the back; the pulse is felt
half-heartedly, a hand is passed over the abdomen without conviction,
the blood pressure taken rather too swiftly, the lymph nodes are not
systematically palpated, the breasts are examined too coyly. Your
life, your body, your worries are less important than your blood
assays, your body images, your answers to simplistic questionnaires.
Following the successful
dissemination of medicalization
(disease
mongering),
the giving of disease-names to all the natural symptoms that may well
be turn up in the course of a life, wealthy societies are now facing
prevention zealotry, based
on test results and known as health
by numbers.
An
ideology maintaining that any aberrant value in your specimens is a
disease that ought to be treated. If your health check is within
standard values, then you are in good health.
If not, you ought to follow
official recommendations and make sure your results return to the
accepted range. The way is now open for a general intimidation of the
population and for considerable wealth for the sponsors of preventive
medicines, which a decade ago was already qualified as presumptuous,
authoritarian and overbearing by a father of evidence-based
medicine.[2]
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