To Fix or To Heal: Patient Care, Public Health, and the Limits of Biomedicine

New York University Press

The collected essays in To Fix or To Heal do more than document the persistence of reductionist approaches and the attendant extension of medicalization to more and more aspects of our lives.

To Fix or To Heal: Patient Care, Public Health, and the Limits of Biomedicine

Joseph E. Davis and Ana Marta González (eds.), To Fix or To Heal: Patient Care, Public Health, and the Limits of Biomedicine, NYU Press, 2016, 358pp.

Do doctors fix patients? Or do they heal them? For all of modern medicine’s many successes, discontent with the quality of patient care has combined with a host of new developments, from aging populations to the resurgence of infectious diseases, which challenge medicine’s overreliance on narrowly mechanistic and technical methods of explanation and intervention, or “fixing’ patients. The need for a better balance, for more humane “healing” rationales and practices that attend to the social and environmental aspects of health and illness and the experiencing person, is more urgent than ever. Yet, in public health and bioethics, the fields best positioned to offer countervailing values and orientations, the dominant approaches largely extend and reinforce the reductionism and individualism of biomedicine.

The contributors to To Fix or To Heal also shed valuable light on why reductionism has persisted and why more holistic models, incorporating social and environmental factors, have gained so little traction. The contributors examine the moral appeal of reductionism, the larger rationalist dream of technological mastery, the growing valuation of health, and the enshrining of individual responsibility as the seemingly non-coercive means of intervention and control. This paradigm-challenging volume advances new lines of criticism of our dominant medical regime, even while proposing ways of bringing medical practice, bioethics, and public health more closely into line with their original goals. Precisely because of the centrality of the biomedical approach to our society, the contributors argue, challenging the reductionist model and its ever-widening effects is perhaps the best way to press for a much-needed renewal of our ethical and political discourse.

The chapters were informed by the "Construction of New Realities in Medicine" experts meeting.


Introduction: Holism against Reductionism
Joseph E. Davis

Part I. Reductionist Medicine in Cultural Context

Reductionist Medicine and Its Cultural Authority
Joseph E. Davis

The Problem of Suffering in the Age of Prozac: A Case Study of the Depression Memoir
Christina Simko

After Medicine: The Cosmetic Pull of Neuroscience
Luis E. Echarte

Reductionism, Holism, and Consumerism: The Patient in Contemporary Medicine
Robert Dingwall

Part II. Reductionist Medicine and the Disease Burden

After the Therapeutic Revolution: The Return to Prevention in Medical Policy and Practice
Anne Hardy

Digitized Health Promotion: Risk and Personal Responsibility for Health and Illness in the Web 2.0 Era
Deborah Lupton

The Global Threat of (Re)emerging Diseases: Contesting the Adequacy of Biomedical Discourse and Practice
Jon Arrizabalaga

Replacing the Official View of Addiction
Bruce K. Alexander

Part III. The Need for a More Holistic Ethical Discourse

Bioethics and Medicalization
John H. Evans

The Dominion of Medicine: Bioethics, the Human Sciences, and the Humanities
Jeffrey P. Bishop

In Search of an Ethical Frame for the Provision of Health
Ana Marta González

Conclusion: Limits in the Interest of Healing
Joseph E. Davis