Ivan Illich, Iatrogenesis and Pharmacogenetics

Abstract

In Medical Nemesis - The expropriation of health, IVAN ILLICH highlights several aspects of the medicalization of society, which was already observed in the mid-1970s. He addressed the various forms of iatrogenesis, classifying the new disease caused by the set of medical care as an epidemic that would not exist if there were no medical intervention. Of the various forms of iatrogenesis, he also addressed drug iatrogenesis, including the cause of hospital admissions. In this article, more than 40 years after Illich’s seminal publication, we sought to revisit his thinking and assess the relevance of his narrative regarding the inconveniences resulting from the use of medicines, especially in their impacts on hospitalization, in addition to reflecting on the potential of pharmacogenetics to mitigate adverse events related to drugs that victimize people. After a brief presentation of Illich’s trajectory, a digression is made on the association between the concepts of medicalization and iatrogenesis, to then make quick considerations about social iatrogenesis, considering the effects of this phenomenon on society. After presenting the consequences of iatrogenesis, from a fluent literature review, an update of the findings is made, showing that the problem is relevant today. A brief conceptual presentation of pharmacogenetics is followed by some examples of its clinical consequences. It is concluded that, despite the unequivocal importance of pharmacotherapy, iatrogenesis remains a problem of increasing relevance. Pharmacogenetics presents itself as a possibility to minimize the problem, making it possible to expand its use in the practice of medical services.