Opponents of vaccination like to be demonized. One can understand their attitude as a reaction to the fact that the concept of health is increasingly being defined by the standardized body image in medicine. The partial (self-)disempowerment of the patient is at issue.
It is paradoxical: during the pandemic, modern medicine deserved the greatest credit. Instead, “skeptical” social and political circles keep the discredit simmering. The diagnosis of underexposure, ignorance and disinformation may partially apply to them, but skepticism is a symptom of a deeper uneasiness. It comes from the basic question of who actually defines health and illness. The medicine all alone?
The uneasiness found expression as early as 1974 in the much-discussed book “Nemesis der Medizin” by the controversial theologian and philosopher Ivan Illich. The subtitle in German is “The expropriation of health”. Health – so it is unmistakably suggested – “belongs” to a person, is their inalienable personal possessions, which the advance of modern, technological medicine is threatening and endangering. Illich accuses the doctors of turning their old motto “Above all, do no harm” into the opposite. An evil thesis, which in particular conjures up the “nostalgic” notion of the art of healing, that good medicine is based on the body’s own powers.
The thesis is echoed today, for example, in appeals to a basic right to physical integrity, from which a corresponding right to health is derived. Seen in this way, vaccination is not just an act of “damaging”, but a violation of a human right.
A kind of upper body
Of course, health is never just personal property. Of course, my health depends on my individual metabolism. Metabolism means that my body only functions normally in constant “exchange” with other bodies. You don’t just have to understand this materially, but also symbolically.
Clinical interpretations and diagnoses are increasingly incorporated into how we look at ourselves. The drug takes on a disciplining role.
All of our social and cultural intercourse is a constant exchange, based on our bodies as its medium. We always form a kind of superbody in a community. We are embedded in traditional behavioral repertoires, which also exert an implicit “dictate” on our bodies about norms, manners, customs, fashions, etiquette.
I’m not just my body, I’ve always been brought up with my body, in hygiene, nutrition, sexuality, and social interaction. And it is not just a functioning physiology, but a standard of living “inscribed” in it that guarantees health and well-being.
Physician: person and institution
It is precisely with this socialized body that the most radical critique of modern medicine, that of Michel Foucault, begins. And today it is proving to be – literally – extremely virulent. In Foucault’s view, modern medicine is never just settled on the interpersonal axis between doctor and patient, but has always been socially impregnated. The doctor in the office hours is both a person and an institution. And from the doctor’s words speaks the authority of his discipline; not simply ‘This is your condition’, but ‘This should or should not be your condition’.
This means that medicine has a normative, especially state-legitimized body image on which diagnostics, prognosis, prophylaxis and therapy are based. It comes from biology: The body is a complex organic system. Whether I like it or not, I have to accept this body image; I even have to submit to it under clinical conditions – for example in a computer tomography.
The crux of the matter is that medicine continues to export its body image from the clinic to social fields that are only remotely related to the task of healing. Foucault speaks of a “medicalization” of society. By this he doesn’t just mean the undoubtedly groundbreaking new methods of investigation and healing of a scientific medicine, but a whole complex of social practices and strategies that are intertwined with it: investigating, caring for, managing, monitoring, optimizing, disciplining. Today we are observing medicalization based on many symptoms, some of which are very worrying. Three are mentioned briefly.
Medicalization, Optimization, Monitoring
First the medicalization. The pharmaceutical market floods us with drugs. There is a “pill” against more and more broken people. This pill view is based on a special conception of “disruptive” behavior. When I have uncontrolled outbursts of anger, I can become a nuisance. Now my outbursts of anger come under the optics of pathologization. And they are already classified as “intermittent explosive interference”.
A medication might help. Similarly, numerous behaviors find themselves diagnosed as a medical problem at once. Clinical interpretations and diagnoses are increasingly incorporated into how we look at ourselves. The drug takes on a disciplining role. And in this sense, medicine is second to social technology, which always aims to influence and guide individual lifestyles.
The second aspect is closely related. Highly developed biotechnology is mutating from healing arts to optimizing the body machine, to its enhancement. For example, growth hormones have been administered to children who are short of stature due to a hormonal deficit for a long time.
These hormones also work in children without a deficit. Parents can now conceive tailor-made offspring according to their ideas and desires: for example a son à la Michael Jordan. What was originally intended as a means of correcting a biological deficit ultimately becomes a tool for correcting the biology according to one’s own ideas. A mother then no longer «conceives» her child in the sense of birth, but literally as a draft.
Then the surveillance. Traditionally, epidemics were stopped by disciplining the population, for example by enforcing hygiene regulations, identifying sources of infection, and controlling the routes of infection. Today, totalitarian regimes practice this epidemic policy by perverting government to a “medical” task. Criticism from the population endangers the “health” of the system. It then appears as a “pathogen” and provokes adequate political “immune defence”. If many citizens are dissatisfied with the regime, it is an “epidemic”. Then you send out an army of artificially intelligent tracking police officers to identify “infected” critical citizens.
The mature citizen
Whether I get sick or not is my business! – This defiance is often interpreted today as an expression of a will for freedom. But at some point the individual body’s desire for freedom reaches the threshold where it disturbs and endangers the stability of the social upper body – and thus itself. Complexity researchers speak of “criticality”. The smallest changes in a healthcare system can lead to unforeseen events – perhaps to collapse. A measure such as mandatory vaccination does not mean the establishment of a “totalitarian” system, but rather the defusing of its criticality.
Vaccination skepticism therefore appears much more as a reaction to the standard healing approach of technological medicine: the partial (self-) disempowerment of the patient. What is meant by this is made clear by a definition in the Oxford English Dictionary: “The patient is a person who endures pain, suffering, hardship, etc., serenely, without discomfort or complaint, in quiet expectation.”
Calm expectation has given way to the angry uneasiness of the citizen, who doesn’t want to simply be a “sufferer”. He empowers himself. Not in the sense that he renounces modern medical treatment, but dares to use his own bodily mind. The patient is replaced by the full-bodied citoyen. Physical maturity also in the sense of solidarity – that could be the beginning of an enlightened culture of health and illness. Or just a utopia?
Edward Kaser is a physicist and holds a doctorate in philosophy. He works as a teacher, freelance journalist and jazz musician.