From the The Social Issues Research Centre in Oxford UK:
an independent,non-profit organisation founded to conduct
research on social and lifestyle issues, monitor and assess
global sociocultural trends and provide new insights
on human behaviour and social relations.

http://www.sirc.org/articles/tyranny.html

The Tyranny of Health: Doctors and the regulation
of lifestyle

Michael Fitzpatrick - Routledge, Taylor and Francis
Group, 2001

Michael Fitzpatrick is a GP who works in Hackney - a man who is
in daily contact with the sick, and sometimes with the dying.
Increasingly, he is also in daily contact with the 'worried well',
people who have been driven to fear the very world they live in
by unfounded scares and inappropriate health promotion. And
now he regularly encounters people who blame themselves for
their own illnesses - those who have been persuaded that they
are sick only because they have failed to lead the lifestyles
which an increasingly authoritarian government has prescribed
for them.

This a powerful book. It is written with true feeling, sometimes
bordering on despair. It is as much a crisp analysis of the
decline of libertarian values among the political left as it is a
damning critique of the basis of health provision in Britain. For
example:

"The left's endorsement of the government's Aids
campaign, following earlier feminist approval of the mass
removal of children from parents in Cleveland, signalled
the radical movement's abandonment of its traditional
principles of liberty and opposition to state coercion. While
most conservative commentators loyally defended
government policy, only a small group of free-market
radicals was prepared to advance a, rather limited,
defence of individual freedom against the authoritarian
dynamic revealed in the government's health policies."

This is strong stuff, and it will win him few friends among the
chattering classes who have now almost entirely succumbed to
reach-me-down prescriptions for every aspect of their daily lives,
whether they be to do with 'safe' sex, smoking, drinking or the
perils which lurk inside genetically modified foods. But Fitzpatrick
is used to this. He has already experienced the narrow
intolerance shown by the 'new' left when his earlier book, Truth
About the Aids Panic, suggesting that the generation of this
panic was essentially an attempt to regulate sexual behaviour,
was shunned by radical bookshops.

This book is much broader in its scope, challenging received
wisdoms on everything from health screening to drug
'treatment'. Some of his criticisms are by no means new. The
late Petr Skrabanek, a renegade medic from Bohemia who
worked for most of his life in Dublin, also warned about 'moral
panics and health scares'. Skrabanek's book The Death of
Humane Medicine and the Rise of Coercive Healthism was a
seminal work which laid bare the authoritarian undercurrents
evident in much of what passes for modern health promotion
and the politically motivated abuses of epidemiology. But
Fitzpatrick is quick to note the limitations of what, in Skrabanek's
case, was a critique from a right-wing libertarian standpoint:

"[Skrabanek] further commented that 'simple minds,
stupefied by the sterilised pap of television and the bland
diet of Bowdlerised culture and semi-literacy, are a fertile
ground for the gospel of new lifestyle.' Though this
revealed the author's patrician contempt for 'the masses',
seriously compromising his claims to advance a humanist
perspective, it did little to explain the rise of health
promotion in the particular context of Western society in
the 1990s."

Fitzpatrick proceeds to argue that the reason for the rapid rise
in prescriptive health promotion in the 1990s was the State's
attempt to increase its apparent legitimacy after periods of social
instability and insecurity. Through the complicity of the medical
profession arose increased scope for government intervention
in private life which was, perhaps perversely, welcomed by a
majority seeking the security of ready-made lifestyles and codes
of conduct. He stops short, however, of seeing in this trend
some very unsavoury historical parallels. The work of
paediatrician Hanauske-Abel, for example, which compared the
modern-day convergence between the interests of the medical
profession and the interests of the state with that which occurred
in Nazi Germany, receives no mention. In an article in the BMJ
Hanauske-Abel wrote: "Contextual analysis of events during the
summer of 1933 in Germany may not just improve an
understanding of the past but may also help to assess the
present and near future. Developments within medicine and
society during the past decade, particularly in North America
and Europe, may found another convergence of previously
separate political, scientific and economic forces." But perhaps
that is just a bit too scary.

In his conclusion to the book Fitzpatrick returns to his blunt
message that "Doctors should stop trying to moralise their
patients and concentrate on treating them", and he enlists the
help of the microbiologist Renee Dubos to reinforce his point:

"In the words of a wise physician, it is part of the doctor's
function to make it possible for his patients to go on doing
the pleasant things that are bad for them - smoking too
much, eating and drinking too much - without killing
themselves any sooner than is necessary." (The Mirage of
Health, 1960)

Fitzpatrick's disenchantment with the new left, as represented by
Tony Blair's Labour Party, and its seeming inability or desire to
resurrect its historical roots and values, is one which we, the
directors of SIRC, having similar roots in the socialist tradition,
personally share with equal regret. The very word 'libertarian'
has now become synonymous with right-wing, free-market
positions, having been discarded by the left as a 'redundant'
concept. And we also share with him the same grave doubts
about the political agendas which underlie much of what passes
for benign, caring health 'advice'. The Tyranny of Health
expresses with great clarity and precision the growing sense of
unease that many people, both inside and outside of the
medical profession, are beginning to experience.

Please buy this book. Please read it.