Cultures in Biomedicine

Question 1

What is the biomedical model?

Answer 1

-Western approach to medicine - moving away from previous religious views of health
-Medical profession @ apex of health work hierarchy
-Health = absence of illness
*power
*discourse
*authoritative knowledge
= all features

Question 2

What are the 6 assumptions of the biomedical model?

Answer 2

1-Mind and body are separate
2-Body as a machine
3-Universalised
4-Reductionist – aetiology
5-‘Germ theory’ of disease
6-Reliance on particular knowledge- Evidence based medicine

Question 3

What is mind-body dualism (1/6 biomedical assumption)?

Answer 3

-Mind = superior to body
-Mind = mental processes, thoughts, consciousness, learning
-Body = physical aspect of brain & its structure
-BUT - can 1 exist without other? - physiotherapy, stress response
-Descartes’ –> body is distinct - non-thinking thing so is separate from body - can exist without

Question 4

What is the dualistic nature of healthcare?

Answer 4

-Priority on diagnosing, treating
-Physical complaints = more important
-Bio interventions
-More access for people w/ disease
-Many tests, specialists for diagnosis w/ disease
-Treatment = high priority
-Prevention = low priority

Question 5

What are dualistic training programmes?

Answer 5

Train mental & physical health providers separately
-Psychologists = for behs, cogs, emots
-Physicians = for physical health
–> no inter-professional practice

Question 6

How does the biomedical model view mental health?

Answer 6

-Disease = derangement in underlying physical mechanism
-Explained through physical deficits

Question 7

Why does the biomedical model view mental health in this way?

Answer 7

As views body as a machine - all bodies work in same way

Question 8

What does the body as a machine mean, along with universality (2/6 & 3/6 biomedical assumptions)?

Answer 8

-Metaphor
-Can repair body by Drs (engineers)
-Body = passive object made of other passive objects –> no reference to sociocultural context
-Universality = of human body & so subsequent treatments too - applicable to all (as ‘all bodies are same’)

Question 9

What is Foucault - clinical gaze?

Answer 9

-Movement away from clinical gaze - only described disease seen (observe, measure, treat as body seen as physical object)
-Now using more individualised approach - more holistic
-Qs for pat - ‘where does it hurt?’ instead of ‘what’s the matter?’
-Reduced the previous dehumanising approach (as previously non-biomed info ignored)

Question 10

What is meant by the reductionist aetiology of the biomedical approach (4/6 of biomedical assumptions)?

Answer 10

-Health explained biologically = anatomy + physiology
-Assumed - “all disease causes can be understood biologically”
-Ignores other factors & other diseases without bio cause
–> implications for long-term/chronic conditions
-Led to: identifying & treating the underlying bio defects of diseases - = mapping of human genome

Question 11

What is the germ theory of disease (5/6 biomedical assumptions)?

Answer 11

-Pathogens/germs = microorganisms
–> can cause disease
-Ext disease cause
-Genetic theories align w/ aetiology - vaccines, antibiotics
-Led to: sanitation, antibiotics, pharm industry inc, dec in infectious diseases, inc life exp

Question 12

What is evidence based medicine (6/6 biomedical assumption)?

Answer 12

-Scientific knowledge, method-objectivity
EBM = ‘conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’
-Use of clinical expertise alongside current, best available clinical evidence (from systematic research)

Question 13

What is the hierarchy of evidence - EBM?

Answer 13

Systematic reviews = way of going through all research/relevant data - pull best forward = best evidence method

Question 14

How are pharmaceuticals involved in the medicalisation of society?

Answer 14

-Inc in pharm industry
-NHS spends lots on patented products
-‘Big Pharma’ = global pharm industry
Has led to:
*overprescribing
*over-reliance
*don’t treat diseases - creates diseases
-Based upon universality of body function - that can prescribe same meds to people w/ same conditions

Question 15

What does medicalisation mean?

Answer 15

= aspects of life are medically constructed as medical problems
-e.g., in social problems deemed morally problematic - drug abuse
–> so when is sub-optimal functioning a medical problem?

Question 16

What is the medicalisation of mental illness?

Answer 16

-Religious solutions = confession, repentance
-Care & control of the ‘insane’ by state in asylums –> few therapeutic methods used
-Led to emot & beh ‘problems in living’ becoming medicalised
= ‘trade in lunacy’:
*social control using cruel treatments
*services by men to oppress women (science replaced religion)

Question 17

Is menopause a medical problem?

Answer 17

-Age = valued in some cultures
-Some countries - list of diagnostic criteria - symptoms & risks e.g., UK & US

Question 18

Is childbirth a medical issue?

Answer 18

-Often requires medical interventions
-Induction - few natural births
-Systems put in place = based on general birth trends - understand birth physiology based on ‘norms’ e.g., length of time
-Interventions occur when birth doesn’t fall into confines of medical ‘normality’

Question 19

What are Jewson’s 3 paradigms of medical knowledge?

Answer 19

Jewson = concerned w/ ‘disappearance of the sick man’
-Shift from bedside medicine to hospital medicine to lab medicine

Question 20

How successful has the biomedical model being?

Answer 20

*Germ theory of disease led to:
-Sanitation
-Antibiotics & rise of pharmaceutical industry
-Dec in infectious disease
-Inc life expectancy

*Reductionism lead to
-Identification & treatment of underlying bio defect (e.g., insulin replacement in type 1 diabetes)
-Mapping human genome

Are it’s successes overplayed? - e.g., antibiotic resistance

Question 21

What are some limitations of the biomedical model?

Answer 21

*ME (Myalgic Encephalitis/CFS – Chronic fatigue Syndrome)
-No legitimate disease can be ruled
-Pat’s symptoms not taken seriously
-May dismiss as - limited clinical importance
-Often assumed to be indicative of a psychological disorder rather than organic pathology

Question 22

What is ICD - International Classification of Health & Diseases?

Answer 22

-Contains diagnostic criteria
-Inc in no. of diagnostic categories
-New editions = new diagnoses - scientific progress
-Not all new diagnoses link to pathogen

Question 23

What is meant by the biomedical model focussing on -ve interpretations of health?

Answer 23

*Western view: health = death & disease –> so improved health = inc life expectancy
-Health standards = measured in terms of potential years of life or heal adjusted expectancy
-Diffs between diff groups - calc by standard mortality ratio - chances of death @ given age

Question 24

What is the social model of health?

Answer 24

-Individual/community health = complex beh-cult & material-cult factor
-Focus on env & collective measures
e.g., soc model of disability

Question 25

What are the guiding principles of the social model of health?

Answer 25

-Commitment to empowerment
-Community participation
-Equity in health
-Accountability
-Co-operation and partnership w/ other agencies & sectors

Question 26

What ate the objectives of the social model of health?

Answer 26

-Improve adverse features of env - pollution, bad housing, poor work conditions
-Reduce health inequalities - work w/ groups e.g., older people, ethnic minorities - whose health needs may be overlooked
(model does not discard medical model - but emphasises importance of soc & enc framework in health & ill health)

Question 27

What are the structural factors determining health within the social model of health?

Answer 27

Obesity rates
-> aims to lower - work w/ food industry:
-Make healthy food available to all
-Work w/ leisure industry to give space & affordable recreational facilities
-Give healthy food options, facilities in workplaces

-Also inc access to stable employment

Question 28

Biomedical model vs social model of health?

Answer 28

Question 29

Why has there been a shift from the biomedical to the biopsychosocial model of health?

Answer 29

-Changing nature of disease
-Inc healthcare costs
-Inc recognition of role of pat & provider beh
-Not addressed mental health adequately before

Question 30

Biomedical vs biopsychosocial model of health?

Answer 30