The industrialization of fetishism or the fetishism of industrialization: A critique of Ivan Illich

This article critically assesses the ideology of industrialism in light of Ivan Illich's Medical Nemesis. The paper is divided in three sections. The first section is a description of the main features of that ideology, the most prevalent and influential one used in sociological literature to explain the state both of Western societies and of our health services. Also in this section, it is shown how these features appear in Illich's analysis of our societies, of our health services and of the different clinical, social and structural iatrogeneses that health services create. The second section examines the assumptions underlying Illich's analysis and discusses their validity to explain the nature and function of our Western health services and their iatrogenic effects. Where Illich's explanations are considered invalid, alternative explanations are presented. Among them, it is postulated that it is not industrialism, but the assumedly transcended category of capitalism that is the cause of the social and structural iatrogeneses. The third section discusses the political implications of Illich's analysis, in a moment when our Western societies are supposedly in crisis.