ARTICLE ANALYSIS

Article Analysis

Article Analysis

In a parallel with Alan “racial hygiene” (the term Rassenhygiene was coined by Alfred Ploetz), today's new public health ideology can be characterized as moral hygiene— moralischehygiene. Both are forms of medical and public health imperialism. The rhetoric of moral hygiene certainly recalls Robert N. Proctor's description of the philosophical dimension of the “leader principle” (Führerprinzip), in which health care (Gesundheitsfürsorge) was replaced by health leadership (Gesundheitsführung), and curative medicine (Fürsorge) by preventive medicine (Vorsorge).

In this article, moral hygiene seeks to bring all human activity within the domain of medicine and public health. Human beings are again being homogenized by the state, in a manner reminiscent of National Socialist Gleichschaltung. It goes without saying that the old racial hygiene and the new moral hygiene have many differences; what they have in common is that they provide a legitimizing formula, based on an extension of the medical metaphor, to sanctify physical coercion of individuals who behave in ways that powerful people dislike. The ideology of moral hygiene extends the imperial boundaries of public health in two ways. The first is by viewing all health matters as “public health” concerns, even if they are purely derived from voluntary human behaviour. The second is by applying a medical metaphor to every sphere of life, and then, quite absurdly, taking the metaphor literally.

The article says that the point at issue is not whether smoking, drinking, eating potato chips, or drinking soda are good or bad, but who decides what the individual can put in his mouth: the individual or the government? Is it obvious nonsense to say that people who eat potato chips can't stop? Of course it is, but it is just as obvious nonsense to say that people who smoke cigarettes can't stop. It is just as obvious nonsense to say that people who drink beer or snort cocaine can't stop (Szasz 2001). Some of them won't stop, just as some folks won't stop watching baseball or going to church. That's their choice. At bottom, I think everyone understands this. We all know that such behaviours are matters of voluntary choice, and that some people, given liberty, will make foolish choices. But the metaphor of moral hygiene is bewitching.

Today, however, the person-host component in this model is misconstrued as if it were a nonliving agent, a thing, and the agent component is misconstrued as if it were a person, a moral agent. People are misinterpreted as things and things are misinterpreted as persons. This perversion of the original public health model is an integral part of the increasingly prevalent practice of medicalizing behaviour. Violence, crime, suicide, illiteracy, guns, drugs, depression, over-eating, under-eating, under exercising, buying too much in shopping malls, or having too many sexual partners, are all viewed as “public health problems.” Medicalizing behaviour is also used in an attempt to evade personal responsibility for the consequences of one's behaviour. When responsibility is theoretically removed, it is frequently assigned or attributed to something or someone else--a thing, another person, or the environment. When people attribute responsibility for their behaviour to addiction, drugs, mental illness, or a bad environment, paternalism is rationalized, legitimized, and justified by powerful others. One group of adults asserts that it knows what is best for another group of ...