VII  Documentary chapter



37.    About the political economy of the identity of suicide = murder


1.    Patients' Info No. 35 - New University's Mirror No. 6 [Neuer Uni-Spiegel]


Material misery is progressive in the sense that it generates revolutionary potential. As we know, Marx claims this function (moment) for the (industrial) proletariat (subjective factor). Social proscription, however, is the mark of the "riff-raff proletariat" (the unemployed, the sick, the criminals = “it’s their own fault”). These people are – caused by the ruling ideology – outcasts and as such excluded from both the social process and the revolutionary movement. Their political honorary title varies between anti-social and anarchist ... "It's no shame to be poor" ... "Money lost, much lost / honour lost, all lost” … and as the related dicta (objective spirit) are otherwise called.

Capitalism generates material misery through exploitation (dialectical moment, as follows from Hegel, Philosophy of Law, analogously: capitalism is too poor to abolish the poverty it has produced).

Along with every person’s inner development capitalism produces the fear of, or respectively because of and by social proscription (historical process of a person in which the consciousness is always and essentially programed long before birth in such a manner to avoid at any rate each occurrence and each situation in which could arise any kind of social proscription).

Both factors, material misery and social proscription, are deadly, are instruments of murder of the capitalist society, by which this society continues to make us suffer until it is crushed between these its own millstones. The Faculty of Medicine, the Rector of the University, Rendtorff, and the Minister of Culture, Hahn, made use of these millstones until they had achieved to murder an SPK patient, a use as we know with rather dubious success. The lockout, the dismissal and the ban on entering the clinic, aimed equally at causing physical annihilation and social discrimination (public instigation to hatred by the press, television and so on).

From the first day of her appearance in the SPK, the now murdered SPK patient was confronted with these murderous instruments perhaps more directly than most of the others. It had been her urgent want to join our work as soon as possible. She had to materially safeguard her spontaneously expressed wish to join our work by continuing to go on sick leave. But leaving the city where she had come from (Cologne) she had got no money except a sickness benefit which the health insurance and the physicians at Heidelberg now refused to pay if she should continue to stay at Heidelberg instead of turning back to Cologne. Labelled as being a "schizophrenic person", she felt herself tainted by a hereditary disease up to the stigma of total inferiority, and she now also had to face the risk of being politically discriminated if she should continue to join the SPK, her intention, that as an upright personality she couldn't but express even to the authorities. Therefore, she was right with her fear that her participation in the SPK would be put on record due to the sick leave and that this could result in further disadvantages caused by this discrimination (rejection when looking for a job, compulsory hospitalization in a mental hospital, if she should continue her struggle for the sickness benefit to which she was legally entitled, etc.). And that was exactly the fear she expressively associated to the fact that the Minister of Culture, Hahn, had so far denied the legitimation to the SPK to become an institution of the University. As is well known, all her attempts to avoid her being politically discriminated, i.e. to avoid contact with the authorities, resulted in increase in material hardship.

Also she had experienced, when she visited the Medical Policlinic of the University, that it lacked any efficiency, even if she had been willing to take the stigma of social proscription ("schizophrenic") upon herself and to get along with it, and thus the failure to secure her immediate needs could not but reinforce her impression that her own situation in particular could only become more and more hopeless in the future ("to schizophrenic persons I never give any medical certificate" – so she was told by the assistant physician of the University's Medical Policlinic).

When she undertook her second attempt to get a job on her own account, the now murdered SPK patient had been praised for her efficiency when submitting a working sample. But she despaired all the more because of the great expectations placed on her by her employers because she felt socially inferior. The material situation of the SPK, caused by Rendtorff and Hahn, can't offer any chance of survival, let alone the possibility of any "rehabilitation", be it only by small steps. But we'll never forget that we have to struggle by all means to change this situation!

The physical annihilation, pushed ahead by the instigation on the side of our enemies, is expressed in the last letter of the now murdered SPK patient by the significant words: "I am dead". Her fear of her being socially proscribed seems to have been her companion even with regard to the time after her death: "I don't want to be buried along with Marx and Lenin". "I didn’t understand anything" means: I’m honest enough to know that I cannot behave actively against the murderous weapons of hunger and misery, and that's why I think that the behaviour I have chosen is now understandable and making sense. If KuMi Hahn (KuMi = abbr. signifying cowshit, instead of KultusMinister, ie. Minister of Culture), Rector Rendtorff and the pig compulsory physicians (Schweinepflichtaerzte instead of physicians bound to confidentiality = Schweigepflichtaerzte; NB: physicians paid with hush money) of the Medical Faculty (fucking medicine; German abbr.: Med.Fak.) believe that now they could wash their hands in innocence, it’s a huge deception of their perception (more about that in Hegel’s Phenomenology of Spirit, chapter II).

Murder is murder. But Schreibtischmoerder (desk murderers, wire pullers behind the scenes) can't be compared with ordinary murderers, they are worse. They are body snatchers, greasy vampires. Anyone who has experienced that and suffered this on their own bodies (SPK) knows what is meant by that.

But the murderous acts of the killer clique that pulls the strings behind the scene, namely of Hahn, Rendtorff and the pigs of the Faculty of Medicine will strike back on them according to the principle of dialectics determined by capitalism.

SOCIALIST PATIENTS’ COLLECTIVE                                                    April 16, 1971
at the University of Heidelberg
Rohrbacher Str. 12


2.    Patients' Info No 37 – New University’s Mirror No. 8


"A crime can be ruled out" – is what is written in the "suicide note" of the Heidelberg newspapers April 10, 1971. The newspapers, just like the bourgeois science must exclude the crime, namely the permanent destruction of human beings by the capitalist system of exploitation.

Freedom of the press is the freedom of those in power to veil connections and contexts.

Many readers of our first communication about "suicide = murder" have got more appetite for more details after having consumed that leaflet. No thought about that they could have gone to the press on their own initiative in order to insist resolutely on the publication of a coherent report; they also lacked any drive to feel stimulated to actively correct such murder shit, variations of which have been exhaustively analyzed for decades already. Their little bit of bad conscience can't but make them feel some remorse when they read the word "murder". Due to the pseudo-critical mentality they have acquired through conditioning habitually inculcated during their childhood and through education, they are fond of feeding that sort of conscience with some more details so that they can continue to sleep all the more peacefully afterwards. To comprehend connections is easy, you can learn to put them down in writing in a suitable adequate manner, but to act consistently is a very heavy task for those who still believe that they are healthy and fear that there might be something they might risk to lose; objectively, the exploited ones don't possess anything anyway that is not in the power of the rulers to dispose of. Long before our birth, all decisions with regard to our feelings, thoughts and even our body functions have already been made. You only get exactly that kind of body that you could have got under the conditions and under the dictatorship of the capitalist relations of production. So what does the exploited ones have to lose if one regards and notices this most important fact that everything (this means: each person’s potentials of development, the world, everything) is taken away from him anyway right from the start?

Back to the public opinion makers.

As they themselves are subject to the regime of capital accumulation – they must print advertisements and therefore they must dance to the tune of those who pay for the advertisements – the commissioned work of these opinion makers cannot be anything other than the result of being stuck to the codes of the ruling science. For them the duty to inform means: to feed the newspaper reader = omnivore and ready to swallow anything with some fucked up scraps (facts) – sex and age of the "culprit", place and time of the crime, etc. As a savory and tasty supplement to the reporting also may serve hints like "commune" and "pill poison" and soon to the reader’s mind will come the story belonging to it (German: dazugehoerig, hoerig wem? = belonging, also “be a slave to” whom?), an ideologically fashionable product that lacks any historical context. The so-called common sense (non-sense, ignorance) is the most reliable collaborator of capitalism (= crime).

From the "sui"cide, then, remains nothing but a tale, i.e. something that lacks any effectiveness as long as the deadly effects of the relations connected to it are registered in a template-like manner without the reader becoming conscious about them. The lack of consciousness prevents the reader from getting the related matters and their connection (suicide = murder) clear and therefore all consequences that otherwise would result from this insight are prevented likewise. It’s only when the historical connection and context are added that this suicide = murder becomes significant, that is dangerous for the "stability" of the currency, for it turns into murder, no longer into murder against human beings, but rather into murder against capitalism and its advocates.

Caused by the capitalist process of wear and tear combined with the capitalist practice of social proscription the murdered M. had been turned into a person who had become worthless in the eyes of the bureaucracy (sphere of distribution). Nevertheless, she too was under the compulsion to offer herself for sale in order not to starve to death either immediately or by and by caused by social proscription. Death is the consequent pursuit of the mass murder which is inherent in the plans and projects tied to capitalism by causal connection. Before she came to the SPK, M. had regarded herself as being "ruined" and as a "wreck". No wonder! The psychopharmaceutic pill poison, the body-destroying electroshocks, in general all kinds of special treatments used against her in abundance had shaped her consciousness, which was in no way schizophrenic, to the point of total comprehension of reality. Due to the permanent refusal of the society to give her what she needed to live her life, she was right to feel herself determined and abandoned. Therefore, M. suffered permanently from a life-threatening situation, which in our society is usual enough for millions of people up to the point that they are even unable to understand their situation in a reality-adequate manner, thus being unable to initiate the appropriate behaviour against this situation. There was another patient who once said that only special circumstances had made it possible for her to survive in a situation comparable to that described here. But "strokes of luck" like hers are produced by the capitalist bureaucracy as reluctantly as rarely. With M. it was different, that means, it contained more truth: the jungle of bureaucracy made her headless with fear.

But that doesn't count! The count-down triggered by the state and by the Rector for the last meal before the execution was running

Though being forced to surrender to the material emergency, M. had got a transitory occasion to breathe again due to the working conditions currently realized in the SPK and nowhere else. She always knew and said that, since she had joined the SPK, for the first time in her life she had got the feeling of being truly alive and that she could be herself in connection with other patients like her, despite all other difficulties she had suffered from outside the SPK. Only a few days before she was murdered, M. declared during a discussion that she was fully on the side of the SPK, because for her the SPK had represented the only possibility to find a way of realizing and developing her activities. From a report of her mother (written after the death of M.) we were informed that M. had expressed in her letters, again and again, that the time she had spent in the SPK was the "happiest" time in her life. The further stabilization of her political identity – because only that kind of identity can be achieved in the capitalist system, which is a schizophrenic system itself – a political identity, which she had sought in vain in a communist youth organization before joining the SPK, this further stabilization of her political identity, therefore, could only be stopped by the utmost pressure from outside (hunger blockade). Not only did she feel burdened by the label "schizophrenic", but she had also suffered for many years from the reproaches of other people and even of the family's physicians who did all they could to make her believe that in future by her illness she would cause the end of her family "ruining it". Although she had realized pretty much that the miserable conditions on the general labour market are caused by the mechanisms of the capitalist system, she transferred the feelings of guilt, acquired by inculcated conditioning, to her “employers”, by whom she expected to get punished because of her illness. She was also afraid of disadvantages that could arise because she now belonged to the SPK. From the fact that the Minister of Culture, on the initiative of the Faculty of Medicine and the Rector, had denied the SPK the legitimation to become an university institution, inevitably for everyone in the SPK results the total lack of any protection against the measures of state violence and their being totally exposed to the social proscription associated to these measures. M. not only had to reckon with rejections when applying for a job, but she was also confronted with a merciless alternative: either to apply to Dr. Kretz (!!) (and indeed, that’s what the doctors and staff physicians of the medical policlinic proposed her to do) for her sickness benefit to which she was legally entitled and thus running the risk of being transported to a mental hospital by force for a psychiatric examination, a mechanism established to separate her and other patients from the SPK, a mechanism established long before, or to remain in the SPK, which had become the basis for her survival, at the price of her being exposed to material impoverishment that was increasing day by day. The nonsense of the proceedings related to a sickness benefit to which she was entitled would only shock her to an extent that even all promises and arguments by the whole SPK that, based on active solidarity, it would prevent or undo by all means any compulsory hospitalization in a mental hospital, just like the evidence of a contraindication well assured under all conditions even from a psychiatric and neurologic point of view, could not help anything. Generally speaking, it is simply a matter of fact that all the twists and turns [German: Schneckentaenze, literally: snail dances], staged by psychiatry since it exists, performed on the back and with the money of the exploited people, together with all the twaddle from psychoanalysts, existence-analysts up to the hereditary-biologists, the whole twaddle (= "science") has never succeeded in lowering the suicide rate, not even in the hospitals, much less in abolishing it.

Rather, recently a "modernistic" ("progressive") branch of psychiatry came up that seems to be very proud of its finding that the only way to help "suicide candidates" is to kill them, according to the rules of the medical art, in special hospitals which have been built with the money of the same exploitation that finally drives people, destroyed by this very exploitation, to their death (see Frankfurter Rundschau of February 2, 1971: “We would be forced to choose hangmen"). That a change for the better is possible, namely how to abolish all psychiatry here and now, this has been proved by the SPK in its more-than-one-year-experience. For our work, the murder committed against M. can only mean that we have to struggle against the machinery of destruction and especially its bureaucratic functionaries (Faculty of Medicine, Rectorate, Ministry of Culture) even more decisively and effectively. Since this is a matter of life and death, we cannot wait and we are not allowed to wait until, perhaps one day in the distant future, the private ownership (private property) of the means of production will abolish itself.

Belonging to the SPK, M. too, had to defend herself against the attacks that the SPK had to fight against from its beginning: lack of means – the University withholds even the so-called donation account for the SPK; the chief of the Psychiatric Hospital of the University, von Baeyer, and the Rectorate of the University contrived a boycott against each patient of the SPK consisting in the rejection by all pharmacists in Heidelberg to whom they present a prescription for medication, although they are insured with the general health insurance, that means they have paid in advance through compulsory contributions for the pills they now can't get; for 450 patients (1-3 newcomers per day) there are only five rooms available; the patients being under a constant threat because of the eviction action brought against the SPK by the Rectorate and therefore in uncertainty about how long the continuation of their work in the SPK can be guaranteed; the Administration Board of the University broke the agreement to provide the houses promised to the patients with all the means necessary to continue their work. As a whole, these conditions constitute a permanent hunger blockade against the SPK and moreover they are a true mirror of the system of mass murder that is specific to capitalism. But in the judgement of Professor Häfner, the boss of the Policlinic, Kretz, and the forensic psychiatrist, Professor Leferenz, announced in the session of the Senate of the University on November 24, 1970 regarding the SPK this risk of suicide is "a risk that can be neglected". Rendtorff, the Administration Board, the Senate etc. permanently provide evidence to the fact that those who, based on their position in the social production process, are allowed to take decisions pro and contra the murderous conditions, do nothing but reproduce the contradictions of capitalism, acting according to their own will and by their own fault, pushing aside any historical context, what makes them guilty and responsible in any case. The re-actor of the University of Heidelberg (Reaktor – instead of rector is a play on words, related to nuclear danger), instead of presenting the SPK-project in a scientific way to the members of the Senate in order to enable the SPK to continue its scientific work within the scope of the University – reacts to the commands from above (decree of the Minister of Culture) with the cowardice typical of civil servants and comrades (Rendtorff was a member of the Social Democratic Party). He left the stage to the infamous Häfner, not even a member of the Senate but a ill famed specialist in social euthanasia (suicide = profit), where Häfner then pushed ahead with the liquidation of the SPK in the interest of his 45-million-project. At that time, it was the lives of about 250 patients that were at stake. Should one really ask whether the risk, regardless of any risk whatsoever, has become more dangerous since those responsible completely threw off their masks and since the number of SPK patients has approached the first half thousand?

The abolition of these relations is possible. Others who preceded us, have already demonstrated it. The self-organization of patients on its social basis corresponds to the radical-critical consequence that has pointed the way for us since the times of Ernesto Che Guevara (he himself an asthmatic but using his medical skills against the capitalist jungle).

As an inhibition, illness is a weapon of capitalism. But it is completely up to the exploited ones to commit this weapon and all other weapons to the scrap heap of history. Only for capitalism and its advocates, illness is a hell of a murderous pleasure.



SOCIALIST PATIENTS' COLLECTIVE                                                                 April 30, 1971
at the University of Heidelberg
Rohrbacherstr. 12


38.  About the difference between a patients' self-organization and democratic centralism

1.    Subjective necessities

Historically, we are in the transition phase between Nazi concentration camps and labour camps à la Grand Coalition. The aggravation of the contradictions in late capitalism – economically manifest in the economic crises that are piling up and, on the level of consciousness, in the fading away of future prospects in view of both existential and social life issues – are causing the rulers to take a series of preventive measures to overcome these crises, measures that, on the one hand are very intensive while, on the other, they hardly have a chance of being noticed by the public consciousness. Such measures are, for example, the drug-prohibition-law against the drop outs, the central registration of so-called mentally disturbed people, labour camps for political drop outs and finally life-long imprisonment on installments against those whose resistance to capitalist crime does not exhaust itself by sitting around in debate circles. Under these conditions it cannot be said that the existing forms of organizations of sick-care (= exploitation of illness) don't work. Rather, they work to the best in accordance with the measures described above. The functionaries of the hierarchically organized health system, in association with health insurances, medical associations, conferences of assistant physicians and last not least, in ideal competition with them, the bureaucracy of the Ministry of Culture as administrators and executors of science following the needs of capitalism, try to resolve the contradiction between what is their subjective conviction and their objective doing, a contradiction that concerns them indirectly and the sick ones directly. The medical plot treats this contradiction as if it did not exist and tries to conceal it from the public by lavish talk about the freedom of science and ostensibly necessary measures "for the well-being of the sick people". For those who need help, that is the sick people, this twaddle is only good for tying their consciousness closer and closer to the medical plot and its false promises of help from above. In any case, the sick people are suffering directly and immediately from this antagonism in real and practical terms, which they as the really affected quite in contrast to the medical functionaries can never put aside, not even through constant repetition and memorization of hollow phrases. For those involved in the medical plot the subjective convictions, if separated from the really existing conditions, are of no consequence, except that they are even more exposed to the mechanisms of exploitation and destruction under the pretext of being useful against illness.

Corrupted by material privilege or the prospect of it, those of the medical plot are always ready to spread their stupidity on to the public in mass scale and against the masses. They all refer to the so-called well-being of the sick, but objectively they work in favour of capitalism and thus necessarily they work against the sick population and finally against themselves, though without admitting it, but one can’t but notice it.

Under these circumstances, only those who are affected themselves can learn what they need to know and develop the necessary knowledge about these matters and they themselves must feel obliged to begin activities that may create a counter-public in order to bring about a change of the general public opinion.

Illness is the true mirror, adequate to reality, of the basic antagonism (collective production – usurpation by single persons): on the one hand collective production of illness, and on the other management and exploitation of ill people who are taken for and who take themselves for being nothing but single, lonely and atomized persons.


2.    Objective obstacles
(that is to say: the reason why the sick people themselves have to take care of their needs)

In the capitalist process of producing surplus value, i.e. the capitalist process of exploitation and valorization (CPV), the production process and illness are conditioning each other in a dialectical manner, that means illness is at the same time both a prerequisite and a result of the CPV. It makes the crippling of the worker to its condition. Its maintenance implies the reproduction of the worker as a social cripple. The consumption of labour force in the production process means therefore the production of illness. For all work happens "under conditions in which never the health of the workers is important, but only the way how to facilitate the production of products" (Marx, Capital III, chapter 5). All measures to veil this fact on the part of the ruling class only serve the purpose "to prove that killing is no murder when done for the sake of profit" (Marx, ibid.). In present-day capitalism (neo- or late capitalism*) the pivotal point of crises management is illness. This results from the following connections: so-called social contributions amounting to 35% of the take-home-pay are paid over to the state's treasury. These funds are put at the permanent disposal of the organized capital as a whole, that is the state, and used for the regulation of economic cycles by means of economic control, prevention and management in case of economic crises. By that these funds are not at the disposal of those who have worked for them.

* Additional note by SPK/PF(H): Today we call it: Iatro-Capitalism

Only a very small part of this money flows back to the health machinery where it is used to repair the defective labour forces. Secondly, the function of stabilizing the economic cycles consists in the maintenance of the ability to consume of the defective working machines (= sick people), of the working machines that are out of service (= unemployed people) and also of the ability to consume of those working machines that are now forever useless because of their having been subject to wear and tear all their life (= annuitants). In particular, illness is used and exploited in the interest of capitalism by means of the quantitative and qualitative alteration of the structure of unemployment: instead of mass layoffs, workers are dropping out of the production process in installments (because of illness) and seemingly there doesn't exist any connection between the exploitation of workers and their dropping out of the process of production. Their dismissals are done administratively, for example in the form of sick leaves and through forced admission to detention facilities by the agents of the health care apparatus if they are given the opportunity to do so.

For the person affected, illness seems to be nothing but a fateful event commonly brought about by their own failure and guilt. Quite in contrast to the unemployed, it is not easy for a sick person to realize that there exists a causal connection between the misery that has apparently hit the single person individually and the process of capitalist exploitation. This connection, which is veiled in subjective and objective view, also favours the tendencies of politically left groups to get stuck in abstract approaches by producing abstract conceptions which are without any use at all. The working class is under intense subjective pressure from suffering (mass misery). But there is also the “prosperity” in objective terms, the working class is not willing to connect with any sense of responsibility, let alone with an insight into the accumulation of suffering on the part of the people in the Third World and the suffering on the part of the ill people here (imperialism towards the interior) associated with this relative “prosperity”. The democratic-centralist left, for a lack of insight into the congruence of their own needs with those of the industrial working class, rather prefers to appeal to an abstract proletarian instead of being prepared to go into the concrete living conditions of everyone which of course contain misery both material and mental.


3.    Sick people have no rights whatsoever

Regardless of the social security contributions that have been forced out of him, the sick person has got no right to treatment for his illness. Rather, it is the other way around. The right to treatment is on the side of the established health care system. This apparatus is based on the principle of profit maximization, both in terms of its structure and its function, and from that follow the criteria by which the Whether and How of a treatment is determined in any case from the beginning. In this context, the ill person is placed in, he is deprived of his constitutional rights and of the human rights either by the treatment itself or by some other kind of manipulation. Thereby the legally enshrined health care machinery makes use of the "administration of justice" also established by law and, in turn, the latter makes use of the health care machinery in the same way. The modernization of the criminal law, at present in preparation, provides that all the sick people, who are prisoners in any case by their inner prison they are carrying with them (in the form of inhibition) for all their life wherever they go or wherever they may live, through their registration in a central register will have best chances to become life-long members in a ghetto of antisociality. The university legislation of the federal state of Baden-Württemberg, e.g., excludes people from studying if anyone else considers them to be sick. Here the wording: “Enrollment can be refused if the applicant suffers from an illness that seriously endangers the health of the other students or threatens to seriously impair the regular course of teaching or if the state of health of the applicant precludes proper study; to check the state of health, the submission of a medical certificate may be required" (University's Law – HSchG § 43.2). On the same ground the applicant can also be taken off the university register.

For the patients, the deprivation of their rights is based on their separation and isolation as single, lonely persons. The only possible way out of their being single, isolated and therefore lonely objects cannot be anything else but their joining together by forming self-organizations. However, this way is not provided for in the ruling system. From this it clearly follows that a self-organization of patients also has the task and is legitimized to create and claim rights by themselves and for themselves, and if need be they can only refer to their constitutional rights. However, these constitutional rights are in turn restricted by special laws, as it is said: "details are further regulated by law". If, by this clause, it is not already made almost impossible for anybody to make a progressive use of those constitutional rights, the state authority soon will find itself obliged to deny to the patients, who have become active by organizing themselves, the right to refer to the Constitution, that means that the forces of the state will attempt to eliminate the patients’ organization, all the more the state authority can never be sure whether they have really succeeded in protecting the constitutional and the human rights against the self-organized patients who in their eyes are neither human beings nor do they belong to any constitution, right from the beginning. The consequence for those like this exploited and deprived of their rights is that they must bring about a radical change in the material basis on which the violence of the state is founded.


4.    On the political implications of the self-organization

The principles of a patients' self-organization, which are its most important basic prerequisites, are to be determined as follows: characterized by the mark and stigma of their deprivation of rights, the patients are the exploited class par excellence. As it is the same everywhere, those allowed to make use of the "free democratic" legal order are only the capital-strong persons, the commanders within the capitalist system. But those who belong to the sick people don’t possess any right at all. This mark of belonging to the exploited class, in the Federal Republic of Germany, even if only in the view of psychiatrists, is distributed to ten million people with a manifested mental disturbance. However, the total number of those who are struck by illness is much higher. A relative measure of the power of illness as a productive force is offered by the fact that the total amount of money of the health and social insurance funds corresponds to the size of the federal budget.

From the connection with the production follows another second important principle for the patients' self-organization: the capitalist economic system draws from illness – as explained above – in the form of social contributions the unlimited buffer capacity for the economic crises INHERENT In the capitalist economic system. That is, only in reference to the specific criterion of illness, and by this criterion alone, the proletariat represents a revolutionary category both subjectively and objectively in the highly developed late capitalist systems, and nobody else but K. Marx has assigned the proletarian class this basic definition in the Communist Manifesto. Subjectively because of the possibility to conceive illness and to use it as protest, objectively because surplus value can be generated only through the exploitation of human labour. This, however, results in the increasing misery of the masses and the intensification of illness. The immiseration of the masses and the aggravation of illness represent the inner barrier of capitalism. "The capitalist production, if for a moment we don't care about its being superposed by the mechanisms of competition – the tendency of the rate of profit to fall [tendenzieller Fall der Profitrate] –, handles in a thoroughly economical way every kind of work that has been realized as objectified work which is incorporated in commodities. Yet, compared to all the other modes of production, the capitalist production is far more than any other mode of production a squanderer of human beings and of living labour; a squanderer not only of flesh and blood but also of nerves and brains. Indeed, it is only by spoiling up to a huge extent the development of human beings that the development of mankind as such is a guaranteed and maintained in the epoch of history immediately preceding the consciously performed reconstitution of the human society" (Karl Marx, Capital III, Chapter 5). With this, Marx has given illness an essential determination precisely as the inner barrier of capitalism while expressly disregarding the tendency of the rate of profit to fall, a diminution which at any rate is counteracted by augmenting the exploitation of the labour force – intensification of illness. As the outer barrier of capitalism, illness becomes significant because of the increasing number of sick people who drop completely out of the capitalist process of production (the so-called incurable psychoses, increasing number of people who incurably suffer from damages caused by drugs and medicaments).

By the substantial determination [Wesensbestimmung] of illness as being the number 1 crisis buffer in the capitalist economy and thus contributing necessarily to the stabilization of this system, illness, however, includes also a moment (tendency) which is objectively counter-revolutionary. Within the sectors of industry and administration this connection of exploitation cannot be broken. The counter-revolutionary factor of illness as far as it is determined as a crisis buffer predominates in these sectors. There, the moment of illness which otherwise is driving forwards, namely the sick people’s lack of rights, is inhibited by being veiled by trade unions, apparently worker-friendly social courts and similar institutions. Due to the determination by this constraint, which can be characterized as double exploitation, there results also the necessity for patients, who under those conditions are indeed revolutionary subjects, to form patients’ organizations. Double exploitation means: the sick person is a product of the production process that creates surplus value; the surplus value is divided into profit and crisis buffer capacity. As a patient, the sick person is functionalized by the health system to serve both as a means of production and as a crisis buffer.


5.    Dialectics of centralism and decentralism = Multi-Focal Expansionism (MFE)

Before we go into the organizational form of the patients' self-organization and its further perspectives, here a few basic comments on Democratic Centralism (DC). The democratic element of Democratic Centralism consists of decision-making based on the votes of the majority, that means all qualities are based on the category of quantity, just as in the capitalist process of valorization, in which all quality is reduced to the quantity of time and measured in working-hours. The centralistic element appears in the form of a pyramid-like organization with graded competences, thus as hierarchy. All the activities of the single ones are already organized before they appear and take effect; again a rigid system, totally corresponding to the capitalist exploitation and valorization process, which produces all the demands and requirements to which the activities of every single person must be oriented ( the person has to serve the economy, not the other way around ), instead of organizing the activities according to the concrete demands and needs with their focus on the solution of specific tasks, so that the organization changes with the task that has to be resolved and only exists as long as the work on the specific task requires it. The dialectics of subject - object (in the polarization between leader and the rank and file), of being determined - being spontaneous (spontaneity as a constituent element of the organization; also to think of the revolutionary productive force, the so-called “revolutionary instinct”, as it is called by Lukács), the difference between being produced - producing (objectified as the contradiction of passivity - activity), these dialectical contradictions can never be developed within Democratic Centralism; just as little as the dialectics of needs and production.

From caring for the needs of the single ones or in small groups that mutually control each other collectively follows the principle of multi-focal expansionism (MFE) as the specific characteristic of organization. There has to be developed the consciousness based on the unity of needs and political struggle, that is the political identity, in everyone. Within a non-centralized organization, every productivity, every initiative of the single one has to be promptly connected to the whole organizational scope through constant collective working on the respective productivity. Everyone can express herself or himself and also everyone should do so in order to get influence on the collective work and no one can escape the consequences of this work, because these consequences follow from the needs of everyone. For the class-enemy it will be definitively impossible to break an organization of multi-focal expansionism. In order to coordinate the activities developed in this way, the centralist element in this dialectics takes as a necessary moment the form of a collective memory. This memory can be used by the single ones, but the memory itself does not use the masses in turn (non-centralist element). In an organization determined in this way, centralism is dialectically abolished and transcended [dialektisch aufgehoben].


6.    History and future of the patients' self-organization

The development of the SPK can serve as an excellent mirror of what is meant by the formula of the dialectical abolition [dialektische Aufhebung] of centralism. There are several periods.

The first period consisted in the preparation of the patients' self-organization under the conditions of capitalist-hierarchical centralism. Only because the SPK started at the level of the university medicine, there could be clearly worked out what we have called above the contradiction of double exploitation. "It is practically impossible for workpeople to insist upon that which in theory is their basic sanitary right – the right that whatever work their employer assembles them to do, shall, so far as depends upon him, be, at his cost, divested of all needlessly unhealthy conditions; … while workpeople are practically unable to exact that sanitary justice for themselves (sanitary justice = care for health), they also (notwithstanding the presumed intention of the law) cannot expect any effectual assistance from the appointed civil servants [Beamte], whose duty is to apply the Removal of Grievances Act" (The Capital III, MEW 25, p. 106). Well then, it was exactly this kind of contradiction between the workers as patients and the "civil servants" that emerged in the very beginning of the SPK at the University, and the working out of the contradiction in what we have conceived as double exploitation there found its most appropriate occasion: in spite of their being exploited and in spite of their paying the social contributions, the patients are not legally entitled to claim medical treatment there. Of course, in this context the question cannot be that the legal claim to medical treatment is of no use other than to further perfecting the exploitation, regardless whether this treatment is given or refused. But what is important in this context is the fact that the medical representative of the University (e.g. the physician as a civil servant on revocation [Beamter auf Widerruf, whose task is to "remove public grievances"), confronted with the mass of the patients, can and must ensure that the privileges of the University available to him are used for the benefit of the mass of patients.

In this way, he connects the masses to the University and thus works out the contradiction between the pretention of the university to be an institution that, based on the fundamental rights, has to realize the freedom of science on the one hand and, on the other, its function of serving capitalism by preparing and supplying patients for their exploitation, valorization and consumption and as a legitimation agency of capitalism. By dealing with this contradiction, the medical doctor as a civil servant of the university makes the class-antagonism transparent, e.g. by working out collectively with the patients the kind of science they need. By doing so, he can't but abolish the violence that is at disposal against the ill people and thereby abolishing the power at disposal against illness, a power which is defended and assured by the capital-oriented science of the rulers.

Through his total commitment to basic matters he must stimulate a situation which, from the viewpoint of the ill people, equals to the abolition of their role as objects to which each ill person has been condemned to for their being conditioned by the constraints of the system. As to the abolition of their being conditioned, the ill persons having become aware of their situation, now will act against all influences which before they had taken for unchangeable symptoms and phenomena of their illness. However, as long as the organization, administration and containment of illness continue to function in a capitalist-centralist way, the crisis can only become concrete in the form of apparently non-directed violence. Exemplary for this is the system as a whole in its functioning as a crises buffer on a large scale. On a small scale, it was the hunger strike at the beginning of the SPK, this hunger strike which indeed was in the eyes of some of the enemies nothing but the manifestation of a weakness, demonstrated by some disturbed people. The tranquil result of such apparently non-violence is the compromise, the development and realization of which led to renewed polarization in the second period. This polarization no longer took place at the level of the University medicine, as it did during the first period, but presents itself as a confrontation between science – directly represented by the patients – and power – directly represented by the University.

During the third period takes place a decentralization towards the interior of the patients’ self-organization by the socializing of the therapeutic functions in the form of mutual self-control done within the personal and group agitation; the decentralization towards the outside is achieved by the spontaneous foundation of more patients' collectives, which have been stimulated and inspired by the work of the SPK. This decentralization is supported by constant self-objectification, which is mainly carried out in the scientific study groups. From the process of decentralization and self-objectification results the political identity* being the concept [Begriff] of the identity of needs and political struggle.

* Additional note by SPK/PF(H), March 1997:

Here is a necessary and more precise extension:

Within the political identity SPK/PF(H) distinguishes three identities:

1.     Political identity: stable against separation with respect to spatial distances and distancings. Today we call this identity: pathopractical identity.

2.     Ideological identity: stable against external temporal influences and affections. Today we call this identity: diapathical identity.

3.     Revolutionary identity: stable in its effects with regard to completeness, definitiveness and persistence. Today we call this: utopathical identity.

Marked by the attacks of the reactionaries using the judiciary machinery (eviction sentence – prohibition of scientific work by withdrawing the institutional and the immediate means of production) there follows the fourth period containing the deprivation of the patients both material and juridical, now completely realized.

The result of this development in four periods is in the fifth period the release of violence, which up to now consisted of illness tied and kept under control by capitalist-hierarchical centralism, in the form of a total separation of powers [Gewaltenteilung]: the state's machinery serving capitalism as a perfect mass murderer of his most vulnerable products, the latter representing at the same time the truest mirror reflection of what both the capitalist destructive force and the state’s machinery are.

Thus, in this fifth period, capitalism and its state-machinery – now both occupied with the annihilation of patients – find themselves in direct confrontation with illness as their essential product (which objectifies and concretizes their totality) – that is, they are in confrontation with themselves.

In the sixth period, the self-organization is dividing itself into two moments: into a militant activity on the one hand and into a propagandist moment on the other*. The first for the purpose to establish an effective self-defence against the reactionary forces of capitalism and the neo-fascist state machinery, the second in order to start a productive attack on the revisionist left in the FRG (Federal Republic of Germany), especially in order to socialize the SPK experiences in matters of organization and agitation.

While in the sixth period the element of propaganda, “the party”, that is the unity of collective memory and coordination, gets its progressive signification in relation to the expansion of the mass base, in the perspective seventh period this moment (“the party”) which is concerned mainly with the class antagonisms as they represent themselves in the people's war, then, because of its essential reference to the past, only has the task to engage in the confrontation which starts from the reactionary forces. The primary form of the propagandistic moment and, at the same time, its most perfect accomplishment becomes manifest in the political identity which is achieved in the process of decentralization, expansion and self-objectification. It is only because of the inimical violence against the patients' self-organization that this division of functions into two poles of a militant and propagandist moment will become a question of survival.

SOCIALIST PATIENTS' COLLECTIVE                                                 Heidelberg, June 12, 1970
at the University of Heidelberg
Rohrbacher Str. 12


* Regarding the relationship SPK and Patients’ Front compare also: division between militant and propagandistic pole (this means and meant: division in time but never in the matter). Observe as well the difference between militant and military. In the strategy of illness (pathopractice) there is no militarism. With regard to militancy in prison see also The Concept of Solitary Confinement in PATIENTENFRONT: SPK Documentation IV, especially the methods of patients' resistance in prison, compare also 6.11.1975: Unconditional and unlimited SPK/PF(H)-hunger strike, not for release, but with the purpose of confrontation against the physicians and their responsibility for prison and torture.

Militancy as pathopractice is the direct confrontation, sought after by front patients against the physicians. The prototypical situation in its pure unadulterated state is pre-conceived nowhere in a more exemplary way than in the prison hospital, where also the invisible and all traces erasing torture of solitary confinement and visible and perceptible torture tools (instruments of treatment) are set directly one into another under medical responsibility. Also this in so far certainly and not without propagandistic moment (dialectics, no: diapathics!).

In the history of the PATIENTENFRONT there were, by the way, two further confrontations in a prototypical situation: the hunger strike by another front patient in the prison hospital of Wittlich in 1977. This confrontation came to an end in such a way that the responsible physician had declared himself mad and the front patient was set free.
The other one was the hunger strike in 1978: the responsible physician at the prison Hohenasperg was unmasked one year later by the front patient and his advocate during a public trial as being a former, temporary participant of SPK and thus a "gangster". Thereupon he quit his service. This may sound strange, but it
was done just like this. Anything else may be right or wrong, better or worse, but this anything else at least was not and does not remain SPK/PF(H).

And again: The SPK was propaganda (propaganda and militancy, "naive and militant", students’ saying). Propaganda is impulse and propagation, consequently also transmission and not only the so-called "channeling". These are the hallmarks and distinguishing features that belong to a species that really deserves the name of human organism, or better said: human bodies, but not in the sense of racism (biologism, genocide-genetics), but in the sense of diapathic efficient knowledge [diapathisches Wirkwissen], a diapathic "science," which is therefore closer to authentic Marxism than any other sort of technological science ("humanities" and all the rest included, of course), for every science is nothing more than a normois and iatrarchic pseudo-science.
As opposed to the "science", to the existing "logic", there is urgently needed an epoché also in the sense of E. Husserl, that is basing everything again in a prehistoric situation, in which the developed mechanisms of the money economy still did not exist, but of course without resorting to the mythology of those remote times, because it is essential nowadays and in the future to actively change the individual illnesses of the human beings and
to create, in this process, from the individual illnesses the human species, thus raising the human species to the status of an event. And that is precisely why we need the diapathics, which replaces the "science" and the technology, that still exist and which therefore are used as tools that are not yet expendable, but only under the strict control of the diapathics.

Hey you, who are reading this, how does that strike you? We have tested it and recommend it, and it urgently needs to be done, because the present world we live in is nothing less than a disaster, and for you it is more urgent than it is for us.  


Chapter VIII