Biomedical model: what it is and what ideas about health it is based on

Health is one of the great assets of every human being. We treasure it and we fight to preserve it, despite the passing of the years and the adversities on the body and mind that are associated with living.

However, defining what health is is not easy. With this purpose, different perspectives have been postulated, most of them coming from the philosophical thought on the ontology of men and women.

The biomedical model is the most traditional, forged in the heat of eighteenth-century positivism. In this article we will define its most essential aspects, as well as its impact on how we understand health and its care.

• Related article: "Neuropsychology: what is it and what is its object of study?"

What is the biomedical model?

The human being is very complex, so any attempt to reduce it to a simple definition is doomed to fall into reductionist biases. The physical, psychological and social dimensions that underlie each one of us are evident; and that build the fundamental plots of our organic, mental and interpersonal reality. All of them, in their virtually infinite way of interacting, shape the person in its entirety.

This fact is obvious when we reflect on our nature, but it is not so obvious when we approach one of its most fundamental aspects: health. In this field, and for many years, medicine was based on the most absolute of Cartesian dualisms. Thus, body and mind would end up being understood as stagnant 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 the observable aspects of the organism. Consequently, all diseases could be explained through anatomical or functional changes in tissues, or the action of pathogens external. Its identification would be based on objective and quantifiable signs, while the rest of the factors that could mediate would only be secondary epiphenomena.

The biomedical model understands that any pathology has a single cause, and that since it is of a purely physical, the action undertaken to resolve it will involve surgical manipulation or pharmacological. To achieve this purpose, two basic strategies would be used: medical diagnosis (through techniques that explore the integrity or function of the of the different organs and systems) and intervention (by modifying the anatomical structure or restoring balance chemical).

• You may be interested in: "Dualism in Psychology"

What positive aspects does the biomedical model have?

The biomedical model has a positivist aspect, which is based on the experimental method to determine the springs related to the disease process. For this reason, it has facilitated drawing useful explanatory hypotheses about the functioning of the body and the pathologies that threaten it throughout life. This knowledge has allowed to generate curative treatments, contributing in a relevant way to recover health when it has been lost.

The survival of this biomedical model, for centuries, is an eloquent proof of the benefit that came from it. However, currently a series of deficiencies are recognized that have motivated qualitative changes in the care offered to sick people.

What negative aspects does the biomedical model have?

The biomedical model constituted the dominant perspective from the 18th century, and well into the 20th century. It is honest to recognize his contribution to the advancement of knowledge about organic factors. related to health, which are very relevant, although insufficient to define it fully. It is not for nothing 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 merely the absence of disease or infirmity”. Hereinafter we will delve into some of its limitations as a theoretical model for health.

1. Focus on the physiological aspects of health

In line with the definition proposed by the WHO; Health must be understood as a multifaceted phenomenon in which physical, psychological and social components are expressed in complex and intimate interaction. In this way, a person could not be considered "healthy" when they lacked physical pathologies but suffered from emotional problems, or found themselves isolated from their social and/or cultural environment.

This way of understanding health enables an explanatory framework from which to understand current evidence, such as that pathologies of the body motivate a process of affective/emotional adaptation or that loneliness reduces the hope of life. The circumscribed emphasis on the organic would obviate, instead, potential causes and consequences of some of the most common problems that society faces.

The biomedical model understands the organic as the only variable worth considering, directing all diagnostic and therapeutic resources in this direction. This way of proceeding It is guilty of a certain reductionism in relation to current knowledge about human health.

2. Focus on curing the disease, but not on promoting health

The biomedical model is efficient when it comes to detecting a disease when it is already present, including in the best of cases a tertiary prevention (avoid worsening 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 (focusing on those individuals who are in a situation of risk or vulnerability).

3. Restriction in the patient's decision-making

The biomedical model attributes to the health professional an omnipotent role in the whole process, reducing the active participation of the sick person. This passive role contemplates the patient as a defenseless being before the adversities that have corresponded to him to live, and that it would act as a simple receptacle for the therapeutic procedures that are decided for it. It is, therefore, a paternalistic prism.

Currently we know that stimulating decision-making in the sick person and in their family promotes a greater sense of control over the health situation, which has a positive impact on therapeutic adherence and on the prognosis of the pathology. In addition to, obviously, about motivation and emotion. For this reason, one of the functions of those who provide care is to inform about the disease and the options available for its treatment, promoting a thorough and consensual choice.

4. Life expectancy and quality of life

The biomedical model's fundamental purpose is to maintain life, although it does not repair in the same way in stimulating its quality. Quality of life is a complex dimension that includes the integration of physical aspects (function of one's own body, autonomy, pain, etc.), psychological (emotional well-being, satisfaction with existence, etc.) and social (personal relationships, contact with the environment, use of care resources, etc.); that are also linked to the cultural and subjective.

The emphasis on organic allows to increase life expectancy, but does not offer any solutions to improve its quality beyond maintaining the function. In fact, such an attitude has implied certain iatrogenic consequences in the past, which today they try to solve. avoided (such as therapeutic relentlessness when trying to prevent the arrival of death in patients terminals). Although it is important that life be durable, it should not be limited to a simple accumulation of years.

5. Emphasis on labeling

The diagnosis of a health condition, especially in the field of psychology, involves the process of abstracting an expression complex to place it in the narrow margin of the clinical descriptions that appear in the manuals designed for this purpose. However, the reality of the problems that compromise psychological integrity tends to prevail over any attempt to classify, losing a part of its wealth during identification and labelling.

The diagnosis is pertinent to delimit a phenomenon that requires intervention, as well as to facilitate the communication between the different professionals, although it can also be a heavy burden for the person who receives. Thus, it is crucial to weigh the pros and cons that could result from this, and prioritize efforts to address each person's individual symptoms. The diagnostic emphasis is a heritage from biomedical traditions, whose usefulness in the field of mental health is always subject to constant debate.

The biopsychosocial model: a path towards integration

The biopsychosocial model of health is based on the weaknesses that have been highlighted from the biomedical perspective; and aims to unite the biological, the social and the psychological into a coherent whole. It is a perspective from which the humanization of all health interventions has been advocated, promoting a perception of the person not only in the context of his physical vulnerability, but also of his own individuality and needs individuals.

Attention to emotional life, motivation or thought; as well as family and community ties; It has provided a broader framework for understanding health and disease. This overview, which implies the synergistic effort of multiple professionals aimed at covering all spheres of the human, allows a more complete attention along the path that will have to be traveled to recover the health and the welfare.

Bibliographic references:

• Havelka, M., Lucanin, J.D. and Lucanín, D. (2009). Biopsychosocial Model - The Integrated Approach to Health and Disease. Collegium Anthropologicum, 33(1), 303-310.
• Wade, d. and Halligan, P.W. (2005). Do biomedical models of illness make for good healthcare systems? British Medical Journal, 329, 1398-1401.