There is something queasy about the way we sentimentalise illness. In HE Bates's Love for Lydia, Miss Aspen dies so Mr Richardson can reach maturity. There is nothing crass in this book; it is genuinely touching, and gently tragic. Still, there is something wrong here.

In Thomas Disch's 1968 novel Camp Concentration, volunteers are given a variant STD to boost their intellect. This is not a happy book. In it, life kills, and a more intensely grasped life tortures as it kills. Disch does not in any way attempt to make disease beautiful. Still, what happens to these men is strangely magnificent.

The fault is not with the books. It is with us. Fifty years in the future, in Juli Zeh's novel, the eminence grise behind a new world order called "the Method" puts his finger on our complaint: "Take a look at the history books  Everyone complained about hay fever, back pain and indigestion, when all they wanted was attention  undeserved attention. Physical suffering was a serious topic of conversation. A visit to the doctor's became a national sport. Illness was proof of one's existence, as if people had to suffer to know they were alive."

The world Heinrich Kramer has created corrects this flaw in our nature. It is pathologically healthy. Physical health has become the highest, arguably the only political virtue. Illness is an obscenity, and failure to take all reasonable precautions against disease is a crime. This is not a wholefood-and-healthy-walks future. This is an antibacterial scrubland. Head for the river and "You Are Leaving A Controlled Area" on your way to "a torrent of possible infections".

For all its dystopic one-liners (a TV show called What We All Think), this is not a heavy-handed book. It is a profoundly perverse one. Kramer's Method has set up a false dialectic between health and disease. Kramer's antagonist, Mia Holl, grieves for her rebellious brother, who has been murdered by the state. Her response to this loss is psychopathic: she sees things that are not there. And this madness becomes her method: an intelligent, nuanced riposte to the insane materialism that surrounds her.

This is a closely argued book, and Juli Zeh's rhetoric is top-notch. But we don't really need it. What we need (and get, in spades) is Mia's queer flirtation with the smiling, satanic Kramer, who understands, far better than she does herself, how dangerous she is to the state he has created. What we need (though it makes us flinch) is her masochistic determination to tear Kramer's Method from her very flesh. In another age, Mia would be recognised for a saint.

Zeh, who seems to have won every European literary prize going, is also a playwright, and the intensity of the Mia-Kramer dialogues is punctuated by some superb ensemble work. Much of the book is taken up with Mia Holl's trial on trumped-up charges of subversion. Both the naive, conscientious junior judge Sophie Stock and the impassioned, unprofessional public defender Lutz Rosentreter have Mia's interests at heart; needless to say, their sympathy proves catastrophic.

The Method has been compared to Orwell's Nineteen Eighty-Four. And it is true that Kramer and Winston Smith's nemesis O'Brien would make a heart-stopping double act. Better to say that The Method is a sort of hyperintellectualised Hans Fallada novel, pitiless in its compassion for people who find themselves compromised by the system (fascism in Fallada's case; nannyism in Zeh's). There are more splashes of Fallada: Mia lives in a self-policed, rumour-ridden housing block that might have toppled wholesale from Little Man, What Now? Of course that ghastly prison of a place might, more simply, be toppling wholesale out of Germany itself.

Three years since its first publication in German as Corpus Delicti (it is translated here with tremendous gusto by Sally-Ann Spencer), Zeh's novel is even more relevant to our over-structured, over-quantified times. Zeh imagines what will happen if our cultural obsession with metrics goes unchecked. She says we will be reduced to a vegetative state. Life, she says, will become something that is done to us.

Mia, always a doer, sets out to avenge her brother and bring down the system. That is the plot, and by God it works. But Mia's journey is as much spiritual as political. It is, in important ways, a journey of self-discovery; a revelation of the unmediated flesh. And in her passion, Mia comes to know what a very different writer, Arthur Machen, knew: "that matter is as really awful and unknown as spirit, that science itself but dallies on the threshold, scarcely gaining more than a glimpse of the wonders of the inner place".

Simon Ings's Dead Water is published by Corvus.