Viniegra-Velázquez Leonardo
Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
Bol Med Hosp Infant Mex. 2019;76(2):55-65. doi: 10.24875/BMHIM.18000081.
The critique of medicine begins at unveiling and specifying its network of predominant logics, ideas and practices: logics of disjunction and reductionism; the health-disease binomial; the natural history of the disease; the medicalization of social life; the dehumanizing technologization of medical practice and reductionist suppressive medicine. It goes on to argue about its role as agents of domination of limitless profit interests and as an expression of the power of the health industry, justifying itself with the proposal of alternatives tending to overcome that network: transdisciplinarity and the concept of organism as hierarchical totality and interacting with its environment, with respect to disjunction and reductionism; the cultural history of the disease in relation to the health-disease binomial and the dehumanizing technologization; good living, the search for spiritual, intellectual, moral and coexistence growth as meaning of human life, as an alternative to the medicalization and antidote of degrading traits and stimulating medicine of the endogenous healing forces of the organism whose foundation of possibility and credibility is the placebo effect as an alternative to suppressive therapy for non-communicable chronic conditions, based on the pharmacological effect with unfailing side effects. It concludes that without an education based on critique, liberating knowledge would hardly accompany and guide the various social groups in the search for an inclusive, pluralistic, egalitarian, fair, solidary and caring of the planetary ecosystem world.
对医学的批判始于揭示并明确其主导逻辑、观念和实践的网络:分离与还原论的逻辑;健康与疾病的二元划分;疾病的自然史;社会生活的医学化;医疗实践的非人性化技术化以及还原论的压制性医学。接着,批判探讨了医学作为无限利润利益支配的推动者以及健康产业权力的一种表现形式所扮演的角色,并通过提出旨在克服该网络的替代方案来为自身辩护:就分离与还原论而言,是跨学科性以及将有机体视为层级整体并与环境相互作用的概念;就健康与疾病的二元划分以及非人性化技术化而言,是疾病的文化史;良好生活,即寻求精神、智力、道德和共存方面的成长作为人类生活的意义,以此替代医学化,并作为对有机体内在治愈力的退化特征和刺激性医学的解毒剂,其可能性和可信度的基础是安慰剂效应,以此替代针对非传染性慢性病的基于有必然副作用的药理效应的压制性疗法。批判得出结论,没有基于批判的教育,解放性知识很难在各个社会群体寻求一个包容、多元、平等、公平、团结且关爱地球生态系统的世界的过程中陪伴并引导他们。