Biomedical Model Flashcards
Biomedical Model
The conventional western model of health and illness. It sees the body like a biological machine, with each part of the body performing a function. The Doctors job is to restore the functions by solving the problem of what is wrong. HEalth is seen as the absence of biological abnormality. The health of society is regarded as dependent on the state of medical knowledge.
Niki Hart (1985) 5 feature of the Biomedical Model
- Disease if physical - the BM concentrates on physical symptoms of disease, mot social and environmental factors.
- Doctors are elite - The medical elite are the only ones sufficiently qualified and skilled to identify and treat illness.
- Medicine is curative - The body can be repaired with drugs and surgery.
- Illness is temporary - Illness can be cured by the medical elite. Wellness is the normal state of affairs.
- Treatment is special - Treatment of disease takes place in recognised health care environments, which are distinct from the environment where the patient got ill.
Critics of the Biomedical Model
- It suggests that health can be defined objectively, as the absence of disease. However, illness disease and good health are a social construct, varys by time, place and culture. Not biological fact.
- It does not take into account of the culture and social context which influences health and well-being, and the wider social conditions that may have created ill-health.
- It focuses on treating sick individuals, instead of looking at health education and preventative measures that should be taught, to prevent people getting sick in the first place.
- It exaggerates the role and effectiveness of medicine. Improvements in social conditions led by government intervention and support, such as public sewers and clean water, are far more important than the application of scientific medicine.
- It serves the interests of doctors and the medical establishment, and gives them a great deal of power as agents of social control. Doctors have legal monopoly over treatment.
- It leads to growing medicalization. Identification of healthcare with medical care has led to a “pill for every ill”. growing a trend towards defining terms of the BM a range of issues that were once regarded as non-medical matter, then diagnosed and treated as medical disorders or illnesses under the authority of doctors.
- It over-emphasizes treatment and cure rather than care. Modern medicine has often proved unable cures for the new degenerative diseases such as cancer, are the main killers of people. Medicine is almost completely ineffective in curing some new diseases like AIDS.
- It is just one more metanarrative. Postmodernists see it as just one big story claiming to provide the only universal truth and solution to ill health, when really it is just a story that mainly serves the interests of doctors and benefits the medical establishment and the pharmaceutical industry.
- It diverts attention away from health education and preventive medicine. Suggests resources are best channelled into medical science, new drugs and medical technology. This focus on cure means prevention is not given the resources needed.
- It underestimates Iatrogenesis and exaggerates the extent to which medical intervention always produces beneficial results. It suggests there is a steady march of medical progress with the medical and nursing professions generally doing a good job in promoting good health and preventing or curing ill-health.
- Is ineffective because it directs medical resources into the wrong areas. Focus’ on the body as a machine , means the NHS spends more of its financial resources on treatment and cures such as drugs, machines and surgery.
Marmot (2010)
Health and well-being were shaped by a wider range of factors in daily life, including material circumstances, such as hazardous work environment, poor-quality food, poverty or environmental pollution, social position, education, occupation, income, gender and ethnicity.
White (2005)
Health, illness and well-being are influenced by a combination of biological, psychological and social factors.
Dubos (1966) and Dunes and Pines (1980)
Explored the interplay of environmental, physical, mental and spiritual dimensions of health, and stressed that individuals were not just biological units but thinking individuals living in a social context.
McKeown (1976) and Szreter (2003)
Doctors are not solely responsible for improving life expectancy and health. Improvements in social conditions led by government intervention and support are far more important than the application of scientific medicine.
Bury (2001)
Contemporary medicine is faced less with the treatment and cure on which the BM is based, and more with the management and care of chronic and degenerative illnesses which have no cure. Doctor’s role is now less likely to involved the medical gaze of diagnosis, treatment and cure, but more emphasis on care, listening to patients’ own accounts of their illnesses and providing whatever professional help and guidance they can to maintain quality in their lives as they live with their illnesses.
Illich (1976)
Argued that medical intervention, surgery and drugs can actually have more harmful effects than the condition they were meant to be curing. He calls this Iatrogenesis.
Clinical Iatrogenesis Illich
The large number of people who die or seriously harmed by direct medical intervention, such as mistakes during operations, unnecessary surgery, infections picked up whilst in hospital, addiction to prescription drugs and from side affects-effects of painkillers or anti-depressants. The 3rd biggest cause of death in the USA.
Social Iatrogenesis Illich
The increasing influence that medical professionals have over many areas of social life. Suggests that aspects of social life such as obesity, shyness, lack of concentration in children, learning difficulties and sex are increasingly becoming medicalised. Doctors are re-inventing aspects of social life as medical problems, or suggesting that they have more expertise than other professionals.
Cultural Iatrogenesis Illich
Is increasingly becoming the norm in the UK although this trend is more firmly entrenched in the USA. It refers to the view encouraged by the pharmaceutical industry and mass media that there is a pill or medical solution for every ache, pain, stress, tiredness, sad mood, anxiety or unhappiness.
CAMs
Wide range of therapies which pre-date the BM.
Ernst and White (2008)
20% of the population use complementary medicine, spending £1.6 billion each year.
Eisenberg et al (2001)
Found people using conventional and complementary medicine together and believing this to be the most effective treatment.
Sharma (1992)
Showed people use contemporary therapies when conventional ones have been unsuccessful. Their perspective is that the therapies have fewer side effects and that they are treated better by the practitioner than by their doctor. Most do not tell their doctor that they are using complementary therapy.
Complementary medicine
An approach that uses both biomedical and non-orthodox practices. I.e. acupuncture on the NHS.
Alternative medicine
Medical practices that are quite different from the orthodox ones used on the NHS.
Examples:
-Electromagnetic therapy
-Reiki
-Qigong
-Hypnosis
-Chinese medicine.
Holistic
Both alternative and complementary medicine can be holistic, that is they aim to investigate the body and mind or spirit. I.e. Acupuncture aims to restore balance on an emotional, spiritual and physical level.
Giddens
Late 20th century, saw the development of new ways of thinking and acting in contemporary society, particularly with regards to illness and the role of medical science.
Hardey (1998)
States that the growth of self-expression and freedom and choice have pushed CAMs. People may reject science for religious or philosophical reasons. They may belong to a counterculture who prefers to experiment with holistic approaches.
PostModernists
Believe the resurgence of alternative therapies reflects the move to a postmodern society, characterised by plurality and choice. Saks (1998) believes the BM is a feature of modernity, when scientific explanations were paramount, and other therapies dismissed as superstitious or irrational.
Neo - Weberian
Friedson (1994) attributes the dominance of biomedicine to the successful occupational strategy of marginalisation competing therapies. Saks (1998) argues the dominance of biomedicine comes from interest-based politics. The British Medical Association has succeeded in ensuring that only scientific treatments can e regarded as medicine, however the fall in number of children being immunised with the MMR vaccination shows that people do not always accept biomedical advice.
Bakx (1991)
Distinguishes three types of medicines:
-Popular medicine-informal caring done by women in the home.
-Folk medicine - a wider range of complementary medicine.
-Biomedicine.
Most health care happens through popular and folk medicine. State provision and insurance schemes are based on biomedicine.
