• Ivan Illich

Scott-Samuel offers a clear and cogent memoir of Illich’s contributions to our perspective on medicine in society.¹ The brevity of his memoir should not, and does not, suggest that Illich dealt merely a glancing blow to the negatives in medicine’s dominance in matters of health. His thinking pried open the historically impenetrable vault of true belief that medicine is above critique, particularly by those who are not “qualified.” Illich clearly stunned the establishment with his powerful and often epigrammatic volleys at medicine’s hegemony regarding all-things-health, its often arrogant protectionism, and its failure to deal forthrightly with its shortcomings.

Scott-Samuel’s memoir helps us see Illich’s themes change to be sure, but they seem to be less evolutionary (re fundamental values, etc) than expansive—that is, more inclusive of medicine’s capacity to incorporate changes in society’s interests (and concerns) about health. Illich sensed, for example, the emergence of a powerful new “market” for achieving health and wellbeing …