GOOD health is not what it used to be. The rites of passage of a normal life 鈥� birth, mood swings, sexuality, the ageing process and so on 鈥� are increasingly being redefined as pathological by pharmaceutical companies and medical associations. Illness is becoming an industrial product, and health a state that nobody can live up to any more.
One of the most striking examples of this is the 鈥淪isi syndrome鈥�, an alleged form of depression that came to light for the first time in 1998 in a one-page advertisement by SmithKline Beecham (now GlaxoSmithKline). According to the company, people with the syndrome 鈥� of whom there are said to be 3 million in Germany alone 鈥� characteristically hide their illness by pretending to be active and positive about life, while in reality they are depressed and might need treatment with psycho-pharmaceuticals. The syndrome is named after the 19th-century Austrian Empress Elisabeth, nicknamed Sisi, who was said to have suffered from it. In 2003, however, sceptical researchers exposed the syndrome as an invention of the drug industry 鈥� they claimed their analysis of the literature revealed no proof of its existence.
The intrusion of medicine into new areas is not only due to market forces. It is also happening because the art of healing has not led to any real breakthroughs for decades. When treatments for real diseases such as cancer fail to materialise, medical professionals turn to the hale and hearty.
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There are myriad examples. Manufacturers of testosterone gels are promoting 鈥渁geing male syndrome鈥�, which allegedly afflicts men in their prime. Companies like Jenapharm are mobilising opinion research institutes, advertising agencies, PR enterprises, medical professors and journalists to publicise the male menopause as a real and common disease, thus creating a huge market for their products. We have been here before. In industrialised countries, a menopausal woman is today regarded as ill, thanks to advice based on no clear-cut scientific evidence that has persuaded millions of healthy women to take oestrogen and progestagen.
Similarly, pharmaceutical companies and psychiatrists have for decades been trying to portray restless children as unwell and in need of treatment. The producer of Ritalin, Novartis, has even launched a picture book for children that tells the story of the octopus Hippihopp, who gets 鈥渢erribly scolded鈥� because he is 鈥渆verywhere and nowhere鈥� and prone to accidents and mishaps. Fortunately, the turtle doctor knows what Hippihopp has: an attention-deficit syndrome. Moreover, it knows what Hippi lacks: a small white tablet.
Like travelling quacks in medieval times, disease-mongers are out in force tracking down potential patients. They are helped by the fact that while people in industrialised countries are living longer than ever before, they are still not living up to the standards set by modern medicine, since many medical risk factors are deliberately defined to ensure that nearly everyone has something wrong with them.
鈥淟ike medieval travelling quacks, disease-mongers are out in force tracking down patients鈥�
Take cholesterol. In July 2004, the US National Heart, Lung, and Blood Institute issued guidelines that recommend lowering threshold levels for treating 鈥渂ad cholesterol鈥� (low-density lipoprotein) for people without heart disease from 130 milligrams per decilitre to 100 milligrams. While the effect is unproven, these new guidelines 鈥� which were endorsed by the American Heart Association 鈥� are likely to have radically increased the number of people taking cholesterol-lowering drugs. The guidelines sparked a furore when it was shown that all but one of the nine authors had financial ties to the manufacturers of cholesterol-lowering drugs.
The result of lowering such thresholds is that fit and healthy patients end up 鈥渟uffering鈥� from nothing but misdiagnosis. The quip by Viennese satirist Karl Kraus, who died in 1936, that diagnosis is the most common disease is even truer in our day. The situation is made worse by the fact that once a new disease is accepted as real, patients and health insurers pay as a matter of course for the appropriate treatments. This amounts to a legally sanctioned exploitation of national social security systems and private insurance companies 鈥� and in many cases, to the theft of people鈥檚 most precious possession: their health. We are set to become nations of healthy invalids, incapacitated by imaginary illnesses.
What can be done to stop it? The British Nuffield Council in Bioethics has already recommended setting up a separate agency charged with controlling 鈥渢he deliberate medicalising of normal populations鈥�. Certainly, governments should sponsor independent consumer protection agencies that could evaluate new health threats and publish their conclusions on the internet. Armed with greater knowledge about the natural course of life, people would discover something reassuring: that they are healthier than they think.
