Day 181: THE RIGHT TO BE PUT RIGHT

‘Let them eat Prozac? – why not?  – if you’re happy, all well and good; if you’re unhappy, making of yourself a chemical machine that needs adjusting is as good a strategy as any to explore; you may even be able to use it to turn your life around. But do note who is in charge here – it’s you at every turn, not your chemistry, whatever that is. As far as I’m concerned, ‘your chemistry’ is a highly refined metaphor on the strength of which some statistically significant effects can be elicited that you can use as a signpost that might help you to get to where you want to be. It’s interesting how, for once, language gives us a hand here; we’re talking ‘your chemistry’ in the same way as we might talk about ‘your toes’; we are not talking about ‘the chemistry that you are’, although to hear some scientists talk you would think that was indeed what we are talking about. The lack of clarity surrounding these issues is potentially rather dangerous because when dealing with something as intimate as the way one feels, the balance can very easily tip in favour of identification rather than agency, which can seriously limit one’s options in life. If you believe that you are chemistry, it’s only a few short steps to believing that absolutely everything about your experience that is not how you would wish it can have a chemical fix. Then you have your uppers, your downers, your sleepers, your smart pills, your happy pills, your relaxed pills, your anything-you-can-think-of pills. What you are then becomes a ‘what’ rather than a ‘who’, because you have made of yourself an object that is to be constructed by other people according to an image that you have been conditioned to believe is desirable. Realise that and your life is over – you’ve no capacity left for learning. I can, however, see how the human species Powerful might be attracted to this scheme, given that personal change or transformation is not part of its agenda.

            Re-configuring as illness that which you perceive as shortcomings in the feelings you experience offers another take on all this, and there is no doubt that some states of feeling can be sufficiently debilitating to fully justify you exploring the chemical track. But, just as reconfiguring yourself as a chemical machine renders you dependent on chemists for who you are, so, too, does reconfiguring yourself as illness, although the range of specialists you may call on can be somewhat greater. Again, it’s a question of balance, but a balance made all the more difficult to keep precisely because you perceive your problem as not being able to keep your balance; so you reach out for a hand to hold. In all of this, any talk of a supposed ‘right to health’ sounds increasingly problematic; there are simply states that we find ourselves in and options we have for dealing with them; so the broader the options and the less prescriptive the interpretations the better – at least, in principle. In practice, however, what we have is a culture infused with the prevalent expectation that if you don’t feel right, you aren’t right and, there will be someone whose job it is to put you right. Does anyone have a right to health? Rights are something others give you, and if those others can give you what you cannot give yourself, that means they are more powerful than you. The question then is, how much power are you prepared to give away? – and this is a serious question, because there are many people out there who are only too happy to take on power that has been given away. For example, give away control over your own unhappiness and there will be billion dollar drug industries delighted to step in.

            How best to choose the locus of power in managing one’s own health is something it would be worth many people discussing in depth. I don’t have any easy answers and would guess that there will probably be six-billion valid answers – and counting. But it seems important to raise the question. It’s a question that’s all the more relevant when you factor in the dimension of public health, which concerns requirements placed on individuals that are based not on the good of the individual but on the good of the herd. Any number of recommendations are made and instructions issued that have their origins in the thinking of those charged with optimising the public’s health – and preventive measures figure largely in these recommendations and instructions. If you accept that the preventive therapy in question ‘works’, there are four possibilities: if you don’t take it and don’t get the disease, you were lucky; if you don’t take it and you get the disease, you were stupid and irresponsible; if you take it and you get the disease, well at least you tried and if you do take it and you don’t get the disease, well, that’s only to be expected.  Put this way, preventive therapy offers a hermetically sealed system of interpretation that militates against further progress or insights. That there could be further progress or insights is illustrated by the following four, equally valid, interpretations: if you don’t take the preventive therapy and don’t get the disease, it’s because you have some hitherto unsuspected characteristic that keeps you from contracting the disease; if you don’t take it and you get the disease, you don’t have that characteristic; if you take it and you get the disease, it’s because you have some hitherto unsuspected characteristic that means the preventive therapy didn’t work; and if you do take it and you don’t get the disease you might anyway have had the characteristic that meant you wouldn’t have got it, or you might lack that characteristic and the preventive therapy worked, or you might lack that characteristic and you got lucky, or you might have the characteristic that meant the preventive therapy didn’t work and you got lucky. I do find it surprising how little research seems to be done on the differences between people who do and don’t get diseases, especially infectious ones. It’s usually put down to some characteristic of the immune system, a bit like unhappiness is put down to some characteristic of neurochemistry.

~ by apostatescientist on September 7, 2011.