The biomedical model of health sociology
The biomedical model of health sociology- Social class, occupation, education, income, poverty, housing, and diet are examples of how society and our surroundings influence our daily health and well-being.
The biomedical model of health sociology
“Medical therapy and intervention are based on biochemical explanations of illness, in contrast to other kinds of non-allopathic medicine (see Alternative or complementary medicine), or as it has come to be called the “biomedical” or “science” paradigm.”
Sociologists and others have long held that even though biomedical interventions,
have made great strides in the treatment of certain forms of illness (but also see Medicalization),
the practice of biomedicine remains rooted in a knowledge base that is not as empirically bound,
as biomedical scientists would like us to believe.
As far as categorizing and manipulating an understanding of biological systems is concerned,
it is a process of building knowledge that implicitly incorporates cultural and social assumptions,
as well as relying on a biological basis of understanding to contextualize human sickness (Lock, 1988).
Today’s rational–scientific techniques linked with physicians’ employment in a hospital or clinic show,
how the biological model or paradigm continues to dominate contemporary health care systems.
A relational understanding of power has impacted Foucault (1973) and others who believe in a ‘bio-medical discourse,
that is constructed and reproduced via ordinary clinical procedures such as these.
A ‘discourse’ refers to how we learn about, comprehend,
and react to many elements of our existence, such as our health and sickness.
This biomedical discourse has been molded not just by an emerging scientific knowledge,
of the human body’s biological systems, but also by other social, economic, and cultural changes.
As an example, Jewson’s (1976) landmark study on medical knowledge formation and production,
established many “medical cosmologies,” or ways of perceiving the contribution of medicine to the diagnosis and treatment of patients.
Using these “cosmologies,” Jewson sought to explain how medical advancements have always been,
closely tied to the social structures and prevailing ideologies of the period in which they took place.
The ‘Age of Enlightenment and industrialization were considered as the nexus of person-oriented cosmology.
Because of this, doctors have to see their patients as a whole and make medical decisions based on the patient’s
unique characteristics (failing to do so would mean the doctor would be out of business!).
Late in the 18th century, the rise of hospital-based medicine may be linked to the wider socioeconomic,
changes taking place in British society at the time.
As a result of the emergence of capitalist production methods, industrialization, the expansion of towns and cities,
and the increase of scientific knowledge and explanation.
As the doctor-patient power dynamic shifts, an object-oriented cosmology emerges,
which represents the emergence of specialized scientific medical knowledge.
During this period, the medical profession was growing less reliant on the patronage of wealthy patients,
allowing clinicians to take ownership of medical knowledge away from patients.
Hospitals were transformed into centers for medical education and research.
Jewson’s third medical cosmology, laboratory medicine, emerged in the late nineteenth century
‘Physio-chemical process’ is a term used to describe the shift in the focus of medical treatment from the patient to the illness.
Foucault (1973) described the creation of a new ‘clinical gaze,
reflecting the shifting social relations of power between physicians and their patients, as a characteristic of this practice.
Important tenets of the biomedical model or “discourse” are outlined and discussed in the following paragraphs:
- Positivist methodology is heavily included in this body of knowledge. Science can only study what can be seen and measured, according to the positivist philosophy. Anything beyond that is considered impossible to know. Medical diagnoses may only be made by visible signs and symptoms, therefore all’re’ sicknesses must have detectable biological causes. The social and psychological determinants of health have often been marginalized or ignored while taking this approach to medicine
- As defined by the lack of any anomaly or change in the body, health is considered to be normal. Disease as its opposite is thus defined as an abnormality in the functioning of the human body’s internal systems. Every sickness is considered as being caused by one or more unique biochemical pathways, a biological reductionist approach.
- Separation of mind and body based on ontology. René Descartes, a seventeenth-century philosopher, first used the term “resentence” to describe the difference between the res cogitans and the resentence. First, the soul or mind; second, the material matter of the body; both were referred to as “things that think.” Modern bioscience and biomedicine have their origins in the latter, which is easier to see and quantify (Bracken and Thomas, 2002). Cartesian splits in biomedical research have resulted in the denial of any link between the mind and materiality. In recent years, discoveries in neuroscience have begun to address this issue.
- Making illness categories tangible or natural by making abstract concepts concrete or natural. Modern medicine introduced the concept of illness as a distinct collection of pathological processes that can be separated and found in the body’s organs and tissues. To build a body of clinical knowledge that could be used to train doctors and develop biomedical interventions, disease categories had to be constructed that included observed and measured ‘deviations’ from the ‘normal’ functioning of the body (often separating those localized to specific organs and those deemed to be more general or systemic within the body). A collection of nosologically (classificatory) tables was created by drawing differences between the pathological consequences of various illnesses
- Bioscan- tick knowledge of the natural and the pathological was not used only in the early stages of modern medicine to classify illness. Several studies have revealed how women were regularly ‘diagnosed’ as ‘hysterical’ when their behavior seemed to deviate from societal standards, for example. This and other examples show how illness categorization is influenced by social, political, and cultural norms. The International Classification of Diseases (ICD) is now in its tenth version (see WHO, 2008 for a history of the ICD’s evolution). That illness categorization is a contentious and frequently ambiguous endeavor, as this historical record illustrates, would be refuted by any attempt to reify sickness.
- This is the theory of a particular cause. Negative positivism (explained above) suggests that illnesses have single linear causation, i.e., a TB bacillus invades the “host” (the human) and causes tuberculosis (Comaroff, 1982). As a practical matter, this notion has limited our knowledge of the environmental elements that make individuals and social groups more vulnerable to illness.
- Although some critics say that bringing attention to the biomedical “discourse” is enough to argue that the whole biomedical superstructure is essentially a social fabrication, I disagree. All biological and clinical practices are put under scrutiny by this study. Clinicians themselves have been known to characterize the art of practicing medicine as such. An individual patient’s history and other clinical “facts and data” are combined to arrive at an accurate diagnosis, which is what is being discussed here. Finally, a systemic illness categorization is derived from this frequently inadequate and context-specific information, and the concept of medical practice as an “art” is born (Berg, 1992).
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