Ivan Illich Talks About Medicine

As a member of the medical profession the individual physician is an inextricable part of a scientific team. Experiment is the method of science, and the records he keeps—if he likes it or not—are part of the data for a scientific enterprise. Each treatment is one more repetition of an experiment with a statistically known probability of success. As in any operation that constitutes a genuine application of science, failure is said to be due to some sort of ignorance: insufficient knowledge of the laws that apply in the particular experimental situation, a lack of personal competence in the application of method and principles on the part of the experimenter, or else his inability to control that elusive variable which is the patient himself. Obviously, the better the patient can be controlled, the more predictable will be the outcome in this kind of medical endeavor. And the more predictable the outcome on a population basis, the more effective will the organization appear to be. The technocrats of medicine tend to promote the interests of science rather than the needs of society. The practitioners corporately
constitute a research bureaucracy. Their primary responsibility is to science in the abstract or, in a nebulous way, to their profession. Their personal responsibility for the particular client has been resorbed into a vague sense of power extending over all tasks and clients of all colleagues. Medical science applied by medical scientists provides the correct treatment, regardless of whether it results in a cure, or death sets in, or there is no reaction on the part of the patient. It is legitimized by statistical tables, which predict all three outcomes with a certain frequency. 

The individual physician in a concrete case may still remember that he owes nature and the patient as much gratitude as the patient owes him if he has been successful in the use of his art. But only a high level of tolerance for cognitive dissonance will allow him to carry on in the divergent roles of healer and scientist.

Ivan Illich, Medical Nemesis, 1976 pg. 95