64 terms

Biomedical model

what is the focus of the biomedical model?
Looks at and inside the body
When did anatomical dissection begin and why?
16th century Europe.
This was for anatomy lessons for students and was a critical stage in the development of the biomedical model.
How is the biomedical model evident in society?
- dominant approach to disease in Western medicine
- underpins the organisation and delivery of health care
-assumes the health of society is largely dependent on the state of medical knowledge (disciplinary power) and resources (technology).
How is health defined within the biomedical model?
the absence of disease or pathology within an organism
What was the perception of Ill health prior to the enlightenment period?
- Religious views: sin, penance, evil spirits
- body and soul was sacred - beyond human intervention
- soul was seen as the essence of the human body. Not separate from body.
What was the perception of health on the enlightenment period?
- 18th C
- questioned traditional/religious values
- individualism, rational thought, knowledge
- orientated towards human progress
How was progress made in medicine?
- belief that knowledge could help to understand the world and maintain social order
- scientific study - observation, experimentation, control and intervene.
What is body-mind dualism and who created this idea?
- mind (non-material, like the soul) and body (part of physical world, operating like a machine) fundamentally different substances.
- Descartes.
- body and mind interact while remaining separate.
What did La Mattrie think about the mind and body?
Viewed the mind as dependent on the body in the treatment of the sick.
What did Arthur Keith say about the body?
Body is like a machine. It maintains constant temperature through cooling mechanisms e.g sweating in summer. Muscles in legs are like sprockets and chains on a motor cycle.
What did Jonathan Miller say about the relationship between medicine and industrialisation?
We needed the invention of certain mechanical devices to develop medical knowledge e.g not being able to understand what a heart was before knowing what a pump was.
What have the developments been for women involvement in medical care?
Before healing was associated with modern science, women made up the majority of health carers in the 17th century. Then the rise of medical science saw exclusion on women from professional medical practice meant that medical discourses were formulated by men. Although nearly half of newly qualified doctors are women, upper echelons of medical professionals are disproportionately men.
How did physicians diagnose illness historically?
Through the outward appearance of disease. This then moved to be apprehended through machines leading to the development of machines as healers.
What is the clinical gaze and who came up with it?
Perception of those inside medical institutions. Medical knowledge obtained from the clinical gaze established an authoritative truth about the body and person.
Who discovered the circulation of blood?
William Harvey
What is Pathological anatomy of the body?
Identification of specific causes for specific diseases.
What was Pasteur's 'germ theory'?
Illness caused by germs that infect the body.
When was the first vaccine developed and what was it for?
- 1796, smallpox, declared world free with last case in 1949.
What is specific aetiology? And how is it a linear process?
Every illness has a single specific cause, located in the biological or physiological systems of the human body.

Aetiology ➡️pathology ➡️manifestation
What did the germ theory and specific aetiology find?
Diseases caused lesions in the body which altered its anatomy

These two processes are considered symptoms.
What were some factors that contributed to the emergence of the biomedical framework?
- focus on processes inside the body
- surveillance and objectification of the body (clinical gaze)
- ability to find a diagnosis was positive
- perceptions of deviations from the 'normal' were based on tests and expert opinion
- doctor = expert - patient = passive recipient
- individualism - how the individual presents which can lead to victim blaming
- one-to-one interventions
What lead to the rise of the medical profession?
Laws passed to ensure formal training for doctors 🎓
Institution of medicine established alongside biomedical model 🔬
Achieved cultural authority 👮
Displaced institutions of law and religion in areas such as birth and death e.g from priests⛪️ ➡️ doctors 🏥
What are the assumptions of the biomedical framework?
- biologistic 🌱
- dualistic 💔
- mechanistic 🚘
- Reductionist 🔳◾️
- interventionist 🔧💉💊🔨
- Scientific 🔭🔬🔎

What is the biologistic assumption of the biomedical framework?
- disease as an occurrence of natural events largely independent of social relationships 🍂🍃🌳🌱✔️ 👬👫👭❌
What is the dualistic assumption of the biomedical framework?
- Separation of the mind and body, allowing the body to be focused on
What is the mechanistic assumption of the biomedical model?
- body as parts, segmentation of the body
- disease as a mechanical breakdown that needs fixing
- normative focus on the body
What is the reductionist assumption of the biomedical model?
- reduced to cause and effect relationships
- tend to see everything through the lens of the diagnosis
- all disease is exhibited through physical symptoms
- narrow focus on specific cells, genetics etc. 🔳◾️▪️
What is the interventionist assumption of the biomedical model?
- Emphasis on fixing
- curative approach
- cure if you can, manage if you can't
What is the scientific assumption of the biomedical model?
- Assumes methods of natural sciences are appropriate for treatment on the sick
- based on evidence based practice
What are some strengths of the biomedical framework?
- highly developed and specialised knowledge and treatment
- effective response to acute illness and emergencies
- contribution to overall health improvements - morbidity and mortality
- developments of life saving treatment - genetic medicine, stem cell research, reproductive medicine, cardiac surgery, organ transplant, cancers therapies
- it is rigorous and evidence based
- because of the clinical gaze it may not be discriminatory as it just looks at the disease, not the person. They will do good surgery on you regardless of ethnicity etc.
What is the fallacy of specific aetiology? (germov)
What is disciplinary power as a critique of the biomedical framework?
- Power to locate and name disease
- control over work of other professionals
What is the medicalisation of society?
- process by which non-medical problems become defined and treated as medical problems, usually in terms of illness or disorders
What does the biomedical model not consider?
- social construction of the body and that health is not purely a biological phenomenon
What are the ideals promoted by the dominant discourses of health; biomedicine, economics and law?
Enlightenment ideals of objectivity, rationality, individualism and linear notions of progress which profoundly shapes many aspects of social work practice.
How can knowledge of dominant discourses help to identify opportunities to improve services?
For example, where neo-liberal perspectives prevail, appeal to such values using relevant concepts, rather than social work values
What did 1970s radical social workers argue about the biomedical model?
That it ignores underlying structural causes of services user's problems.
What are some other limitations of the biomedical model?
- diagnosis in absence of symptoms
- latrogensis (adverse reactions in hospital)
- victim blaming
- value for money - very expensive. What should and should be subsidised?
How is biomedicine evident in the contemporary context?
- underpins financing and organisation of health care systems 💸💳💰
- multiple specialities focused on discrete subsystems of the body 👣👂👃😁💓
- diagnostic pathology and radiology 📻
- surgical procedures 🔪
- pharmacology 💊💊
- influences the training and practice of most health care professionals 👟🎒
- relevant approach to many diseases
What are the limitations of the biomedical model acknowledged in the contemporary context?
- narrow mechanistic view of body and illness. However this is still a fundamental aspect.
- dichotomous view of normal/abnormal - new framework incorporates view that health is a continuum
- one-to-one and episodic interventions
- complementary and alternative therapy
- costly - prevention of diseases more cost effective.
What has the biomedical model evolved to include in the contemporary context?
- subjective medicine (agency)
- doctors becoming more involved with prevention and promotion - preoccupation with risk factors over which individual has some control and surveillance and regulation of life style
- alternative therapies
- new. conceptualisations of health
How has biomedicine evolved?
- complexity of disease causation
Necessary and sufficient causation from multiple factors
- making mind-body links
Technology - robots for open heart surgery
- scientific discoveries and enhancements e.g genetics
What is the clinical gaze and who developed this idea?
- 'abstract' the body - the person becomes external to the disease
- distinct power relationships
- authoritative truth - focusing on the disease, not the person
What is the body as a machine?
- body is likened to a machine to be restored to health
- mapping/anatomical drawings
- segmentation of the body as parts
- mechanical structure and operation
How is health viewed by the biomedical model?
The absence of disease in the individual and was embedded in the social, cultural and environmental contexts of the 18th and 19th century in Europe, from which biomedicine emerged.
What is the normality-abnormality dualism?
Clear distinction between normal and abnormal functioning in the body with disease or pathology representing abnormality
How much of the Australian health care budget supports biomedical activities?
95% (AIHW) to diagnose and treat people with biomedical interventions
What is the result of the focus on biomedical interventions in Australia?
- focus of health care system is on existing pathology and disease, rather than prevention, creating an 'illness care system"
- Australia has a resistance to move beyond a disease-based perspective
How has the traditional biomedicine shifted from assumptions surrounding greater than absense of disease?
- contemporary context more inclusive of multiple determinants of health - specific aeitiology superseded by acknowledgement of internal and external contributions to ill health
- more closely aligned with social model of disease
what have been some concerns about biomedical effectiveness in improving overall health of the Australian population?
- cost of biomedicine and biotechnology
- need to address social and economic determinants of health
What is the contemporary perception of mind-body links?
- the significant role played by psychological and emotional factors within health and illness are now well established in contemporary biomedicine.
- e.g body immune system responses to stressful situations and emotional states or depression and anxiety that can contribute to development of illness
- psych factors can also influence the health outcome of people who experience the disease
What is the lay or consumer perspective of health and illness?
Subjective experience and perceptions of the patient within the health system, The consumer of health care services and the voices of people from culturally diverse backgrounds whose believe about health and illness may be based on non-scientific paradigms.
How do lay perspectives of health challenge biomedicine in regards to indigenous Australians?
- declining health of indigenous people partly attributed to failure of the biomedical model to incorporate more holistic approaches to health and well-being in keeping with indigenous ways of knowing about health and illness and culturally sensitive practice
How has the passive patient-expert practitioner dynamic changed?
- consumers seen as collaborative partners in their own health care rather passive recipients of expert knowledge which has lead to health system and policy reform
What are the two principles underpin the notion of consumers as active partners active partners?
Consumer information
Increased confidence
What are the challenges with these?
- people who are health-literate likely to be more vocal about health care decisions
- more info does not necessarily equate with active participation
- consumers require understanding of available options and the confidence to act on the information
- increasingly greater individual responsibility for managing personal health care risks shchi may not be possible for disadvantaged groups
How has the contemporary biomedical approach extended beyond people's existing pathology?
To include potential for illness
How is the biomedical dominance been challenged recently?
Approval of a range of health care professionals other than medical professionals to be designated primary health care providers due to workforce shortages in rural Australia
What does CAM stand for? And how does is challenge contemporary biomedicine?
- complementary and alternative medicines
- proposes natural framework of health like Chinese medicine, acupuncture, naturopathy which have little scientific validation.
Why do social workers need to understand and use biomedical terminology?
To communicate effectively in hospitals and to help clients understand the terminology
What are some preventative biomedical interventions?
Vaccinations, screenings - contributed to substantial declines in illness and death
What are some benefits of modern medical procedures?
Improve quality of life - e.g hip replacements
How is the biomedical approach in conflict with the holistic approach?
Holistic approach seeks to understand the person in their social context and promote optimal state or physical, mental and social well-being, not merely an absence of disease.
How can biomedical knowledge contribute to social oppression?
Genetic info can be used for discrimination e.g against those with disability given to employers and insurers to minimise economic risks