The Medicalisation of Life

Sir: David Martin Jones (September 2020) writes splendidly of “the medicalisation of life”, with particular attention to plagues and pandemics from the late middle ages to the present. He correctly states that after 1945 WHO programs “reinforced the authority of science and the medicalisation of life”.

However, the roots of the medicalisation of life are not simply the plagues and pandemics. In 1946 the WHO moved the goalposts, defining “health” as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. So, health is defined in terms of “well-being”, which is taken to mean the absence of distress and the experience of a little flourishing.

Formalising this definition of “health” was benevolent, but mistaken. Now, everybody who loses at the races (or similar real-world experience) has a well-being issue, that is, a health issue, and accordingly they can expect help from doctors, nurses and hospitals. 

The thinking and emotional aspects of our lives have been greatly medicalised. Suicide, as everybody knows, can be the response to feelings of guilt (Judas), wanting to avoid jail (Jeffrey Epstein), loss (Hitler), painful debilitating illness, even being “tired of life” (tedium vitae). However, the medicalised view is that all suicide is the result of mental illness, which can be cured.

The medicalisation of life has gifted us a raft of new diagnoses, including “sexual addiction”, and has discredited normal human experience, relabelling all sadness as major depressive disorder. I lack professional experience in the field, but as a newspaper reader I wonder if some transgender surgery is a result of medicalisation.

Saxby Pridmore
Hobart, Tas

The Managerialist Curse

Sir: Edwin Dyga’s piece in the October issue (“James Burnham in Australia”) has raised a crucial issue that few in the Australian political scene have even begun to reckon with. Managerialism, and its adjunct, bureaucratisation, lie at the heart of the malaise afflicting the entire West.

Where procedure overwhelms personal authority and consequently, responsibility, the machinery of government becomes unresponsive to the policy goals of elected representatives. Along with an over-reliance on the public-private conceptual dichotomy, this has allowed key decisions about our society to be outsourced to and controlled by corporations, media organisations or NGOs, rather than parliament.

The idea that government can be run without personal responsibility, that politics can be done without authority, is pernicious. Our political class has abrogated its responsibility to rule, and to accept the consequences of doing so. Consequently, they have been supplanted by media flunkeys, credentialled “experts” and left-wing ideologues in setting the direction for our society.

This state of affairs, which is extant across the West, has reached a (local) nadir with the fiasco of the Andrews government’s handling of the Covid flare-up, where it seems impossible to determine who even made certain decisions, let alone whether the right decisions were made. But the Liberal Party is just as much at fault, as the recent McGuire–Berejiklian debacle aptly demonstrated.

Only when government ministers take seriously their duties as guardians of the public good and ensure that in matters of state, the state is pre-eminent over the modern cesspit of quangos will we see a return to anything approaching sane governance, public order and freedom under law.

Pierce McNamara
Sydney, NSW

The Narrowed University

Sir: The crisis in Humanities studies at Australian universities Mervyn Bendle refers to in the October issue is symptomatic of a wider, deeper malaise afflicting the very core of what is understood as the true task of the university as a scholarly enterprise. 

In the early 1960s, a mandatory humanities program was instituted at UNSW to bridge what C.P. Snow identified as the estrangement of the two cultures. In my first year in Architecture, the Renaissance was reviewed in terms of exploration, political theory, philosophy, astronomy and science, literature, the revival of classical studies, and treated as a whole in a manner calculated to expose continuities and connecting threads of Renaissance civilisation. The experience was inspiring. It is now long gone, replaced by narrow technocracy.Universities are now large industrialised enterprises dedicated to churning out graduates by the tens of thousands with lecturing staff whose primary role is to ensure the units roll off the line on time.  

I recall Professor Bryn Newton-John (Olivia’s father) welcoming students to his office for lunchtime musical sessions and discussion. These days professors and lecturers communicate by email and are remote, and the uplifting personal element has been removed entirely. It is time for a royal commission into the function and relevance of universities and their wider importance and gift as reservoirs perpetuating independent ideas and inquiry to sustain and support civilised life and values.

Philip Drew
Sydney, NSW

Free the Barristers

Sir: What will the Victorian Bar look like post-Covid? Victorian barristers need to re-think themselves in several areas.

Many of the changes which should take place focus on finance and housing. For many years most barristers in the state have rented rooms from Barristers Chambers Ltd (BCL). This may have been a good idea back in 1959. It collected together all the barristers under one roof and enabled them to develop collegiality. It was the proud boast of the Victorian Bar that unlike their interstate counterparts, Victorian barristers could practise their profession without having to fork out large sums to buy rooms.

Over time, however, the Victorian Bar—the barristers’ professional organisation—became very strict in the matter. A barrister could not work at the Victorian Bar except out of rooms rented from BCL. They could not practise elsewhere—they were all centrally located—and there was no room-sharing. These rules have changed over time, as they should have, but most barristers still rent or hire rooms from BCL.

BCL, however, is now feeling the squeeze. Covid has struck at its heart. With little or no court work going on, barristers are finding it hard to keep up their rentals and at last count BCL had entertained about 1400 rent relief applications. Many more may be coming. The conduct of virtual hearings from home or elsewhere may be here to stay—with no need for rooms.

BCL reports that its sole asset is barristers’ rentals. With a single asset—a fluctuating one of income at that—BCL has now hit hard times. Many would say something like that should have been foreseen. Running a largish concern with a single asset is inherently risky.

BCL also is tied up with the Victorian Bar. But under recent leaderships the Victorian Bar has started speaking out on divisive social issues. This is not always appreciated by members whose interest may only be in scraping a living. It is a popular misconception that barristers are greedy and overpaid.

The Bar has also taken on modern managerialist terminology—frequent references to “diversity”, “harassment” and the like abound. Much of this is quite foreign to the notion of being a barrister but those in the administration—growing in size, cost and influence over the years—push on regardless. The Bar has become a vehicle for advancing “activist” views.

After Covid I suggest barristers do away with BCL and follow examples elsewhere of actually buying rooms to work from—should this still be wanted or the fashion—thereby having something to sell at the end of their working lives, not merely a record of rentals having been paid to BCL with nothing to show for it.

Another body could be developed to speak for barristers and their interests, thus sweeping away the old completely. Collegiality is with the barristers themselves—not because of BCL or the institution of the Victorian Bar.

From changes of this nature, other good things may follow including reduced legal costs (due to reduced overheads) and greater access to justice. There may also be greater separation between the Bar and the judiciary (with some judges pre-Covid dining daily on BCL premises) which in itself is eminently supportable.

Damien Cremean
Melbourne, Vic