THE BIOMEDICAL MODEL OF HEALTH

The biomedical model of health has been dominant around the globe since several decades. The main content of shared document is to explain its actual meaning, its core principles and its claims about health and illness. At the end, some of the critical suggestions have been highlighted for the readers to create an awareness among the health professionals for adopting the other more appropriate models of health in order to exceed the longevity with health promotion.

1. THE BIOMEDICAL MODEL HEALTH PSYCHOLOGY BY Ms. RABIA SHABBIR NUTRITIONAL PSYCHOLOGIS 1 T 1

2. KNOWN AS… “disease model” A reductionistic model Describing the complex phenomena in terms of its constituents only 2

3. Defining the BIOMEDICAL MODEL The dominant model of disease today is biomedical, with molecular biology its basic scientific discipline. It assumes diseases to be fully accounted for by deviations from the norm of measurable biological (somatic) variables. It leaves no room within its framework for the social, psychological, and behavioral dimensions of illness. The biomedical model not only requires that disease be dealt with as an entity independent of social behavior, it also demands that behavioral aberrations be explained on the basis of disordered somatic (biochemical or neurophysiological ) processes. P sychiatrist George Engel (1977) 3

4. A HISTORICAL DEBATE ON THE BIOMEDICAL MODEL 4

5. The discovery that general paresis was caused by a bacterial microorganism and could be cured with penicillin reinforced the view that biological causes and cures might be discovered for other mental disorders. The rapid and enthusiastic adoption of electroconvulsive therapy (ECT), lobotomy, and insulin coma therapy in the 1930s and 1940s encouraged hopes that mental disorders could be cured with somatic therapies. In 1950’s, the discovery of compounds that reduced the symptoms of psychosis, depression, mania, anxiety, and hyperactivity leads to the use of medicines for treating mental illnesses. Chemical imbalances theories was another bullet to explain the pathophysiology of mental illnesses; again putting stress on the biological causes. The policy adopted by US to let the drug companies advertise the psychotropic medicines freely led to shatter the influence of psychotherapy above biomedical therapy model. 5

6. BIOLOGICAL CONSTITUENTS OF THE BIOMEDICAL MODEL Biological constituents of Biomedical model: This model understands the complex diseases in terms of pure biological processes such as : Hormonal imbalance Neurophysiological abnormalities Genetic defects Bacterial infections Viral infections Physical causes 6

7. FOR INSTANCE Research has indicated that Bipolar disorder is due to gonadal hormonal issues in majority of the cases and BP can be treated with appropriate hormonal therapies. Traumatic brain injury is an example of acute trauma that has both the focal and diffuse effects. (but when we see at premorbid history, we found many psychological factors such as lack of social support, impulsive behavior, alcohol intake etc. which is not explained by the Biomedical model) Research results based purely on the biomedical model suggest that Prenatal  viral / bacterial infections  and inflammation play major roles in the genesis of schizophrenia . (ignoring the environmental triggers) 7

8. CORE TENETS OF THE BIOMEDICAL MODEL Core tenets of this approach include: (a) mental disorders are caused by biological abnormalities principally located in the brain, (b) there is no meaningful distinction between mental diseases and physical diseases, and (c) biological treatment is emphasized 8

9. CLAIMS ABOUT DISORDERS THE BIOMEDICAL MODEL OF MEDICINE 9

10. 1. Disturbances and abnormalities in biological structures and their physiology The biomedical model claims to identify the diseases as been attributed to the abnormalities or malfunctioning of bodily processes, the deviation from normal physiological functioning and also, any sort of disturbance that can cause an abrupt changes in normal functioning of the body; all can lead to disorders. 10

11. Contd … These type of aberrations lead to a significant pattern of abnormality that can be identified on the basis of “s/s” i.e. SIGNS & SYMPTOMS. e.g. An MRI of a person with schizophrenia shows abnormally large lateral lobes of brain, and diminished reduction in the grey matter . 11

12. For the TREATMENT of disorders arising due to previously mentioned causes, health practitioners rely on following methods: Surgeries Vaccinations Radiotherapies Chemotherapies Amputations Biotherapies Artificial implants Supportive materials 12

13. 2. Bacterial/Viral infections, Chemical imbalances & genetic predispositions For every disorder, there is a specific etiology. Every disease is unique in its pattern of s/s. The nature and form of disorder depends upon the underlying causes. 13

14. Contd … Underlying causes as discussed by the biomedical model, includes following: Bacterial infections Viral infections Chemical imbalances Genetic predispositions 14

15. Contd … E.g. 1 st degree family members of individuals with MDD have a high risk for MDD 2 to 4x higher than that of a general population. 15

16. 3. Health and illness (the only two continuum) The disease or biomedical model suggests that an individual can either be healthy or ill i.e., there is no continuum between the two states. Another supposition by this model is that the Quality of the person clearly declares him to be healthy or unhealthy. The healthy and unhealthy persons are QUALITATIVELY different. No other difference w.r.t . the range of s/s exists. 16

17. 4. No influence of cultural/social factors Another prediction by the biomedical model suggests that there is no influence of cultural or social pr environmental factors upon the diseases. The persons are not at all affected by their living circumstances. Infact , the onset of disorder relies solely on the factors discussed in claims 1 and 2 of the disease model. 17

18. Contd … The diseases are NOT TIME BOUND. This statement implies that cultural/social/environmental factors are subject to change with time, thus, they play NO ROLE IN ONSET OF A PARTICULAR DISEASE. Parental separation, war, environmental hazards don’t leave impact of the physiological functioning of individuals. 18

19. 5. MIND & BODY DUALISM The biomedical model, also known as disease model or biomedical model of medicine, prominently states the DUALISM OF MIND AND BODY, keeping them as SEPARATE ENTITIES. This concept has been famously known as DUALISM. 19

20. Contd … In the light of this model, the mind is capable of only the ABSTRACT FUNCTIONS i.e., thinking and feeling. The body, on the other hand, is capable of carrying out all the functioning necessary for survival and it consists of skin, muscles, brain, nerves, organs etc. This model regards the MIND as ABSTRACT & the BODY as PHYSICAL MATTER. 20

21. Contd … This model also implies that any change in physical matter (the biological/physiological functioning) owing to any causative factors is not at all going to have any impact on the mental functioning. 21

22. DISEASE MODEL- A SINGLE FACTOR MODEL Emphasizing only the biological aspects of diseases/disorders/malfunctioning 22

23. Contd … The main critics to the dualistic/disease/biomedical model of medicine is that it neglects the influence of other factors that are considered very significant in triggering the disease processes in any individual. It does not consider the social factors. It does not consider the cultural factors. It lays no emphasis on the environmental crisis as well. 23

24. CRITICAL REVIEW ON BIOMEDICAL MODEL 24

25. Contd … The biomedical model posits that mental disorders are brain diseases and emphasizes pharmacological and surgical treatment to target presumed biological abnormalities. Another objection to this model is due to its assumption that Mental disorders are brain diseases caused by neurotransmitter dysregulation , genetic anomalies, and defects in brain structure and function. 25

26. contd … M ental disorders have become more chronic and severe, and the number of individuals disabled by their symptoms has steadily risen in recent decades. This can not be treated with pharmaceutical or surgical procedures only. 26

27. Contd … The biomedical model views health as merely the absence of disease (not fulfilling the WHO’s criteria of HEALTH). Thus, stating that an individual is ill only if he/she presents with s/s. No emphasis is paid on the personality factors and traits of the individuals, which, in reality, have a profound role in maintaining or disturbing the well being. 27

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