Navarro V
Int J Health Serv. 1975;5(3):351-71. doi: 10.2190/QKBJ-TB26-WJDW-P3E4.
This article critically assesses the ideology of industrialism in light of Ivan Illich's Medical Nemesis. The paper is divided into three sections. The first section is a description of the main features of that ideology, the most prevalent and influential one used in sociological literature to explain the state both of Western societies and of our health services. Also in this section, it is shown how these features appear in Illich's analysis of our societies, of our health services, and of the different clinical, social, and structural iatrogeneses that health services create. The second section examines the assumptions underlying Illich's analysis and discusses their validity to explain the nature and function of our Western health services and their iatrogenic effects. Where Illich's explanations are considered invalid, alternative explanations are presented. Among them, it is postulated that it is not industrialism, but the assumedly transcended category of capitalism that is the cause of the social and structural iatrogeneses. The third section discusses the political implications of Illich's analysis, in a moment when our Western societies are supposedly in crisis.
本文依据伊万·伊里奇的《医疗的灾祸》对工业主义意识形态进行批判性评估。论文分为三个部分。第一部分描述了该意识形态的主要特征，这是社会学文献中用于解释西方社会及我们的医疗服务状况的最为普遍且具影响力的意识形态。在这一部分中，还展示了这些特征如何出现在伊里奇对我们的社会、医疗服务以及医疗服务所造成的不同临床、社会和结构性医源性问题的分析中。第二部分审视了伊里奇分析背后的假设，并讨论了它们对于解释我们西方医疗服务的性质和功能及其医源性影响的有效性。当伊里奇的解释被认为无效时，提出了替代性解释。其中假定，造成社会和结构性医源性问题的原因不是工业主义，而是被认为已被超越的资本主义范畴。第三部分讨论了在我们西方社会据称处于危机的时刻伊里奇分析的政治含义。
