Health is one of the great possessions of every human being. We cherish it and strive to preserve it, despite the passage of years and the bodily and mental adversities associated with life.
However, defining what health is is not easy. To this end, different perspectives have been postulated, mainly stemming from philosophical thought on the ontology of man and woman.
The biomedical model is the most traditional, Forged in the warmth of 18th century positivism. In this article, we’ll define its most essential aspects, as well as its impact on how we understand health and its care.
What is the biomedical model?
Human beings are very complex, so any attempt to reduce them to a simple definition is doomed to fall into reductionist prejudices. The physical, psychological and social dimensions underlying each of us are obvious; and that they construct the fundamental intrigues of our organic, mental and interpersonal reality. All of them, even if they are virtually an endless way of interacting, fully shape the person.
This fact is evident when we reflect on our nature, but it is not so much when we address one of its most basic aspects: health. In this field, and for many years, medicine was based on the absolute of Cartesian dualisms. Thus, body and mind would end up being understood as sealed and unconnected entities, governed by different logics and devoid of any point of contact.
This is the epistemological and philosophical basis of the biomedical model of health, for which it is limited only to observable aspects of the organism. Therefore, all diseases could be explained by anatomical or functional changes in tissues, or by the action of pathogens external. Their identification would be based on objective and quantifiable signs, while the other factors that could intervene would only be secondary epiphenomena.
The biomedical model understands that all pathology has a single cause and that, being purely physical in nature, the action taken to resolve it will involve surgical or pharmacological manipulation. To achieve this objective, two basic strategies would be used: medical diagnosis (through techniques exploring the integrity or function of different organs and systems) and intervention (by modifying the anatomical structure or by restoring the chemical balance. ).
What are the positive aspects of the biomedical model?
The biomedical model has a positivist character, which is based on the experimental method to determine the sources related to the disease process. For this reason, it has made it easier to draw useful explanatory hypotheses on the functioning of the body and the pathologies that threaten it throughout life. This knowledge has made it possible to generate curative treatments, Contribute in a relevant way to regain health when it has been lost.
The survival of this biomedical model for centuries is eloquent proof of the benefits that flow from it. However, there are currently a number of shortcomings that have led to qualitative changes in the care provided to sick people.
What are the negative aspects of the biomedical model?
The biomedical model was the dominant perspective from the eighteenth century and into the twentieth century. It is honest to recognize their contribution to the advancement of knowledge on organic factors related to health, which are very relevant, but insufficient to fully define it. It is not in vain that the World Health Organization (WHO) described it, in the preamble to its constitution (1946), as “a state of complete physical, mental and social well-being, and not only the absence of conditions or diseases “. In the following, we will explore some of its limitations as a theoretical model of health.
1. Focus on physiological aspects of health
In accordance with the definition proposed by WHO; health must be understood as a multifaceted phenomenon in which the physical, psychological and social components are expressed in a complex and intimate interaction. In this way, a person could not consider themselves “healthy” when they lacked physical pathologies but suffered from emotional problems, or were isolated from their social and / or cultural environment.
This way of understanding health provides an explanatory framework from which to understand current evidence, such as the fact that bodily pathologies motivate an affective / emotional adaptation process or that loneliness reduces life expectancy. The focus on organic, on the other hand, would avoid the causes and potential consequences of some of the most common problems facing society.
The biomedical model understands the organic as the only variable worthy of consideration, directing all diagnostic and therapeutic resources in this direction. This way of proceeding there is a lack of reductionism in terms of current knowledge of human health.
2. Focus on curing illness, not promoting health
The biomedical model is effective in detecting a disease when it is already present, including in the best case tertiary prevention (avoiding aggravation or physical complications), but neglecting primary prevention (which extends to the whole society to reduce the prevalence or incidence of a health problem) and secondary (which focuses on people at risk or vulnerability).
3. Restriction in patient decision making
The biomedical model assigns the health professional an omnipotent role in the whole process, reducing the active participation of the patient. This passive role he considers the patient to be helpless in the face of the adversities he has had to go through, And that it would act as a simple receptacle for the therapeutic procedures decided by it. It is therefore a paternalistic prism.
We now know that stimulating decision-making by the patient and his family promotes better control of the health situation, Which has a positive impact on therapeutic adherence and the prognosis of the pathology. Plus, obviously, on motivation and emotion. Therefore, one of the functions of those providing care is to inform about the disease and the options available for its treatment, encouraging appropriate and consensual choice.
4. Life expectancy and quality of life
The basic purpose of the biomedical model is to sustain life, although it is not equally concerned with stimulating quality. Quality of life is a complex dimension that includes the integration of physical (bodily function, autonomy, pain, etc.), psychological (emotional well-being, life satisfaction, etc.) and social (personal relationships) aspects. ., Contact with the environment, use of health resources, etc.); which are also linked to the cultural and the subjective.
Focus on organic increases life expectancy, But does not offer any solution to improve its quality beyond maintaining the function. In fact, this attitude has in the past involved certain iatrogenic consequences, which they are now trying to avoid (such as therapeutic harassment by trying to prevent the onset of death in terminally ill people). While it is important that life be sustainable, it should not be limited to the mere accumulation of years.
5. Emphasis on labeling
Diagnosing a medical condition, especially in the field of psychology, involves the process of abstracting a complex expression and placing it within the narrow margins of clinical descriptions contained in textbooks designed for this purpose. However, the reality of problems compromising psychological integrity it tends to impose itself on any attempt at classification, Lose some of its wealth during identification and labeling.
The diagnosis is relevant to delimit a phenomenon which requires intervention, as well as to facilitate communication between different professionals, although it can also be a heavy burden for the person receiving it. It is therefore essential to weigh the pros and cons that could result and prioritize efforts to treat the symptoms of each individual. The emphasis on diagnostics is a legacy of biomedical traditions, utility in the field of mental health is still the subject of constant debate.
The biopsychosocial model: a path to integration
The biopsychosocial model of health starts from the weaknesses highlighted by the biomedical perspective; I it seeks to unite the biological, the social and the psychological in a coherent whole. It is a perspective from which he advocated the humanization of all health interventions, promoting a holistic perception of the person not only in the context of their physical vulnerability, but also of their own individuality and special needs. .
Pay attention to emotional life, motivation or thought; as well as family and community ties; provided a broader framework for understanding health and disease. This overview, which involves the synergistic effort of multiple professionals aiming to cover all human spheres, allows more complete attention to the path that must be taken to regain health and well-being.
- Havelka, M., Lucanin, JD and Lucanin, D. (2009). Biopsychosocial model: the integrated approach to health and disease. Collegium Antropologicum, 33 (1), 303-310.
- Wade, D. and Halligan, PW (2005). Are Biomedical Models of Disease Good Health Systems? British Medical Journal, 329, 1398-1401.