The collected essays in To Fix or to Heal examine the persistence of reductionistic approaches to medicine and public health. Despite widespread discontent with such approaches and good reasons to turn toward a more “holistic” model, an individualistic and mechanistic approach has survived decades of criticism. Indeed, reductionistic forces have grown stronger since the classic critiques of the 1960s and 70s. Besides describing the persistence of this approach in various spheres, and showing why it is so problematic, the book offers an account for why reductionism has persisted, and why more r ... More

The collected essays in To Fix or to Heal examine the persistence of reductionistic approaches to medicine and public health. Despite widespread discontent with such approaches and good reasons to turn toward a more “holistic” model, an individualistic and mechanistic approach has survived decades of criticism. Indeed, reductionistic forces have grown stronger since the classic critiques of the 1960s and 70s. Besides describing the persistence of this approach in various spheres, and showing why it is so problematic, the book offers an account for why reductionism has persisted, and why more richly human models have not gained much traction. The reasons include the moral appeal of reductionism (whose apparent value neutrality is in itself a powerful source of authority for defining value); the larger “rationalist dream” of technological mastery, a dream as old as the Scientific Revolution; the growing valuation of “health”; and the focus on individual responsibility as a seemingly non-coercive means of intervention and control. To Fix or Heal also identifies avenues of criticism that could be furthered if medical practice, bioethics, and public health were more faithful to their original goals.