Over the last few weeks, we've been running a series of posts on the biomedical model. This approach, perhaps more than any other, forms the solid foundations for a lot of physiotherapy theory and practice, so it makes sense to try to understand it better. Here are the links to all the respective posts that make up the complete set: What is the biomedical model #1 - introduction and specific aetiology#2 - germ theory#3 - Cartesian dualism#4 - experimentation#5 - reductionism#6 - normalisation#7 - body-as-machine Critique of the biomedical model #1 - mind-body dualism#2 - medical power#3 - what it means to be a person#4 - standard deviation#5 - (ab)normal … [Read more...] about The biomedical model – for better or worse
Critique of the biomedical model #5
So far in this short series on the problems with the biomedical model we’ve looked at the mind-body separation, biomedicine’s claims to objectivity and access to the truth about health and illness, it’s construction of atomistic individuality, and last week, the problematic nature of normalisation. In this post we’ll look at the passivity that biomedicine engenders in patients. Biomedicine is a powerful discourse and it has brought enormous power and social capital not only to the medical profession, but also to those who practice in its image. One of the most widely voiced critiques of medicine is that it is hegemonic (or dominant not through force but a degree of consent and … [Read more...] about Critique of the biomedical model #5
Critique of the biomedical model #4 – Standard Deviation
In many ways, the entire Western healthcare system is built around normalisation. The fact that it is the job of ‘the system’, and all those that work within it, to identify those people who are ill, sick, or suffering, and to offer them a cure, is so deeply entrenched in the way health services work that it would be hard to imagine it otherwise. But imagine it otherwise we must, or else the more problematic aspects of the approach remain hidden. Firstly, we should remember that normalisation is a social construct. What this means is that there is no object that you can point to to say “that is normalisation right there”. It is an idea; an invention, based on a set of principles that … [Read more...] about Critique of the biomedical model #4 – Standard Deviation
Critique of the biomedical model #3 (or what it really means to be a person)
Physiotherapy, and biomedicine generally, owes a lot to René Descartes (for a refresher on an earlier post on the critical issue of Cartesian Dualism in PT, go here). But Descartes’ influence extends much further than just the body-as-machine, and has fundamentally shaped medicine and physiotherapy practice ethics for more than 100 years. 400 years ago, Descartes set out to discover what could be known beyond doubt. His method was to doubt everything, from the existence of physical objects around him, to dreams and ideas. What was left, he surmised, would be the basis upon which all knowledge could be built. The first thing Descartes believed he could trust was that he himself was … [Read more...] about Critique of the biomedical model #3 (or what it really means to be a person)
Critique of the biomedical model #2
The second major critique of the biomedical model is less about the model itself, and more about the arrogance and hubris that it engenders in its followers. Since the 1950s, dozens of writers have taken biomedicine to task for its hegemonic power (meaning its ‘preponderant influence or authority over others’ ) and control over the way we think about health and illness. People like Elliot Freidson, Terry Johnson, Magali Sarfatti Larson, Anne Witz, Ivan Illich, Mike Saks, and Anthony Giddens have offered scathing critiques of the biomedical model. The biomedical model, they argue, attempts to penetrate too deeply into people’s lives, leaving little room for other ways of … [Read more...] about Critique of the biomedical model #2
Critique of the biomedical model #1
The Critical Physiotherapy Network is a diverse group of people, but if you was one thing that probably unites most of its members, it would be the critique of the biomedical model. In one way or another, we are united in our sense of frustrations with the limits of this model and the way it is applied to physiotherapy. But we are not alone, and outside of the walls of the traditional medical library, there is a wealth of critical commentary on the model, much of it emanating from the social sciences. Whether because of the rising cost of medically-led healthcare, the growing skepticism of its effectiveness, the knowing prescription of useless treatments, stories of medical … [Read more...] about Critique of the biomedical model #1
What is the biomedical model #6
Thus far, we’ve covered five of the main features of the biomedical model - the model that underpins so much of the theory behind the way physiotherapy functions. These have been: Specific aetiology, or the search for the specific cause of the patient’s signs and symptoms Germ theory and the belief that illness is caused by disease within the body Cartesian dualism and the mind-body split Objectivity and experimentation And reductionism, or the anti-holistic belief that the person can be understood as a collection of systems and structures In this penultimate post, we’ll look at normalisation. Normalisation is the belief that certain people, certain … [Read more...] about What is the biomedical model #6