Can Medicine be Libertarian?

A differently formatted and illustrated version of this article appears in
Black Flag, Issue 231, Mid 2010, pp.20-23, under the title 

‘The war for control of our health. Overview: Libertarian approaches to medicine.’ 

Those who argue that anarchism would never work sometimes cite the practice of medicine as an example of the type of situation where a libertarian outlook would create insuperable problems and have disastrous consequences. Medicine is one of the areas which are sometimes said to be necessarily authoritarian and hierarchical, beyond the scope of a self-managed society based on workers’ control because of its complexities and the specialised knowledge required. Yet critiques of established or orthodox medicine, in theory and  practice over many centuries, have perhaps more often than not taken a markedly libertarian turn, whether from people who tried to find ways of helping and with luck healing themselves and each other, or from reformers within the profession who were ready to demystify and democratise their subject. Some of these have been consciously radical and even revolutionary in intention, seeing collective efforts at mutual aid as pointing a path towards a different organisation of society.

History

Traditional histories of ‘western’ medicine usually pointed out a path of progress, overall, towards ‘scientific’ remedies, and in Britain the supposedly universal access to a health service provided by a benevolent state. Writers who were often doctors themselves paid homage to the great men, ‘fathers’ of this and that advance or specialism – a history riddled with paternity suits, as someone said. By the later 20th century this view was being challenged from various perspectives, including feminist ones; the work of medical historians, notably Roy Porter, transformed the subject, and the debates continue.

Radical Thinkers

In Britain the later 18th century was a time of widespread satire and scepticism about medical practice and the power of doctors. John Moore, himself a Glasgow physician and surgeon, wrote in Medical Sketches, 1786: ‘The difference between a good physician and a bad one is certainly very great, but the difference between a good physician and no physician at all, in many cases, is very little.’ He advocated the ‘healing power of nature’ as against ‘being teased to swallow drugs... a species of distress to which the rich are more exposed than the poor, provided the latter keep out of hospitals.’