Transformation in the Character of Bio-medicine - Term Paper Example

Critically evaluate claims that there has been a transformation in the character of biomedicine and the emergence of a new paradigm for health care Introduction Today, the development of the social and cultural ethics has led to the differentiation of aspects of health and illness. Towards this direction, in accordance with the study of Baron (1985, in Lindsay, 2003, 4) ‘we tend to see illness as an objective entity that is located somewhere anatomically or that perturbs a defined physiologic process’. In other words, often illness is considered to be closely related with specific psychological and social patterns. Towards this direction, it could be stated that the sociological and cultural theories could be used in order to explain the development of health and illness within a particular society or among a specific part of the population (using as criteria the gender, the ethnicity and so on). From a different point of view, it is suggested by Eisenberg (1977) that disease is a different concept from illness. In fact it is stated that disease could be better described using the following description: ‘physicians diagnose and treat ‘diseases’’ (Eisenberg, 1977, 11) whereas ‘… patients suffer ‘illnesses’’ (Eisenberg, 1977, 11). On the other hand, in accordance with a study of Helman published by Ember et al. (2004, 733) ‘traditional classification of illness can be divided into four classes: natural, supernatural, personal and social’. In other words, health is closely related with the social and cultural characteristics of a specific society. The level of technology developed within the particular society could be also regarded as having a significant impact on the health conditions of the specific population. Under these terms, the development of biomedical model of disease/ health can help in order to understand all the aspects of health and disease within a particular society or in relation with a specific part for the population (gender, race and class inequalities could be observed in this case regarding the level of health provided to people within a specific state). 2. Biomedical model of disease/ health – main elements The main characteristic of biomedical model of disease/ health is the fact that the above model regards health as the absence of disease. In this context, all theories referring to the relationship between health and disease could be equally applied in order to examine the credibility of this model in all its aspects. Figure 1 – Biopsychosocial model of health and illness [3] In accordance with the study of Turner (1987, 9, in [2]) ‘the model assumes that all human dysfunction might eventually be traced to such specific causal mechanisms within the organism and it presupposes a clear mind/body distinction where ultimately the causal agent of illness would be located in the human body’. On the other hand, it should be noticed that ‘the biomedical model was developed in the 1800’s and has been the standard for medical diagnoses. The model is focuses on standard performance or characteristics of the different physical process of the body, for example its chemistry and pathology, to determine deviations’ [4]. It should be also mentioned that the biomedical model can be related to many aspects of health and disease while in general terms it can be considered as closely related with the current development of medical science under the influence of modern social and cultural theories and the impact of the social and cultural characteristics of each particular society. An indicative representation of biomedical model of health and illness could be the one presented above in Figure 1. 3. Description of the rise to pre-eminence of biomedicine by the end of the 19th century Biomedicine has its roots in the ancient years. In fact the work of Hippocrates could be regarded as an aspect of biomedicine. During the centuries that followed, biomedicine has been developed in accordance with the social and cultural characteristics of each particular era. Referring to the work of Pasteur and Koch in the above period Blaxter (1990, 4) notices that ‘specific diseases could be caused by the invasion of specific micro-organisms – the so-called doctrine of specific etiology which leads to the assumption that illness is postulated as consisting of distinct and discrete clinical states, each with specific pathological manifestations and each caused by a different agent’. In other words, during the 19th century, biomedicine achieved a significant growth mostly due to the important works of medical researchers during the specific period. In the years that followed, biomedicine continued to get developed; however the principles of biomedicine applied during the 19th century have been the basis for the future growth of this science. 4. Sociological approaches to health, illness and medicine Health and illness have been extensively related with social and cultural theories as already explained above. In this context, it could be noticed that in accordance with Blaxter (in Radley, 1996, 124) two are the main concepts of illness as they can be observed in modern society: ‘a) the idea that illness is primarily ‘self-inflicted’ and has behavioural causes and b) the view that the major causes are structural and located in the environment’. On the other hand, Yardley (1997, 7) stated that ‘illness is seen as principally a problem of the individual, and psychological variables such as depression or locus of control are viewed as essentially personal characteristics’. It should be noticed that illness has been given many descriptions and explanations most of which focus on the relationship between the illness and the particular characteristics (gender, class, race and so on) of the person involved. In this context, the study of Radley (1996, 141) led to the conclusion that illness is ‘one’s own responsibility not only at the superficial level of quickly-offered survey responses, but also at a deeper level of claiming responsibility for one’s own identity’. From a different point of view, Blaxter (1990, 7) highlighted the following issues: ‘inequalities in health may not be the same as inequalities in death however there is evidence that social class trends in the experience of chronic illness, or in the proportion of people who assess their own health as poor, are steeper than class differences in mortality’. The above issues were also examined by Lewis (1998) who tried to investigate the level of care provided in people of specific cultural and social background as well as the influence of specific social and ethical elements to the provision of care under equal terms. In this context, it is noticed that ‘the very notion of “better” is defined by values, probabilities, preferences, risk assessments, technical capabilities and opportunity costs’ (Lewis, 1998, 62). When referring to ‘better’ the above research means the quality of care provided to people around the world no matter their social or cultural background. On the other hand, the research of Blaxter led to the conclusion that health can be also influenced by other issues, like the age of the persons involved. In other words, apart from social class and race, age is also viewed as a significant criterion for the development of specific models of health. Towards this direction, in the survey made by Blaxter (1990) ‘the respondents demonstrated clearly that health, more widely defined, was for them essentially a relative state, influenced notably by the normal ageing process’(Blaxter, 1990, 3). In fact, it could be stated that health could be related with a series of social and cultural patterns, as well as with the social and cultural background of the persons involved. Other factors that have been found to have a significant influence on health are family and personal experiences. In fact, the study of Shanley et al. (2002, 49) led to the conclusion that ‘family circumstances are the most important issues under consideration, although male and female work patterns differed markedly; these differences reflect different priorities in balancing professional and personal demands’. In accordance with the above, the personal environment is proved to be as powerful as the social and cultural environment when referring to health and its quality. 5. Conclusion Through the years, many issues have been examined regarding the development of health and illness within a particular society. Towards this direction, it is noticed by Merluzzi (1999, 7) that ‘from a behavioural perspective, health and illness in general, not just the specific diseases suggested by proponents of the psychosomatic medicine, are influenced by a diversity of factors that are psychological, social, environmental, as well as biological in nature’. On the other hand, differences in the cultural ethics can have a significant impact on the development of specific patterns of health and illness within a specific society. In this context, it could be stated in countries of the West ‘the traditional approaches of epidemiology have become more complex mostly because many of the health problems are degenerative and chronic; there is now recognition that most diseases have multiple and interactive causes’ (Blaxter, 1990, 4). In any case, it should be noticed that the development of social and cultural patterns regarding health and illness has not been continuous through the decades. However, this is not a phenomenon related only with health and disease but will aspects of medical science. Towards this direction, it is noticed that ‘during the 20th century many scientific disciplines have undergone a profound paradigm shift, which emanated from empirical reevaluations of the universe’s basic matter; medical science has not followed yet, and in the 21st century, modern Western health care is still dominated by a narrow, monocausal, reductionistic view of health and disease’ [1]. References Blaxter, M. (1990). Health and Lifestyles. London: Routledge Ember, C., Ember, M. (2004) Encyclopedia of Medical Anthropology: Health and Illness in the World’s Cultures. New York: Springer Verlag Lewis, S. (1998) Another day, another variation: when is enough, enough? Canadian Medical Association Journal, 158(1): 61-62 Merluzzi, T., White, R., Whitman, T. (1999). Life-Span Perspectives on Health and Illness. Mahwah, NJ: Lawrence Erlbaum Associates Radley, A. (1996). Worlds of Illness: Biographical and Cultural Perspectives on Health and Disease. New York: Routledge Shanley, B., Schulte, K., Chant, D, Jasper, A., Wellard, R. (2002) Factors influencing career development of Australian general practitioners. Australian Family Physician, 31(1): 49-54 Yardley, L. (1997) Material Discourses of Health and Illness. London: Routledge Websites http://www.priory.com/fam/gppublic.html [1] http://medicine.jrank.org/pages/1106/Medicalization-Aging.html [2] http://cnx.org/content/m13589/latest/ [3] Read More