The use of metaphors for illness and disease forms the subject of Susan Sontag's remarkable little book [Illness as Metaphor]…. (p. 294)

One can be critical of the process of converting illness into metaphor without having to fall back on a single-cause theory of disease. So why does Miss Sontag yoke them together so tightly? The answer, it seems to me, lies in her fear that any tendency to locate any responsibility for one's disease inside oneself may lead to a relentless scapegoating…. The desire not to add to the victim's terrible misfortune by identifying with any precision his actual responsibility provokes, in some people, the impulse to deny the evidence linking smoking and cancer. How much this impulse is strengthened by her single-cause theory of disease is unclear; yet it does seem that she believes that the only alternatives lie between absolving the individual of any responsibility, or...