Health is one of the greatest assets of every human being. We treasure it and fight to preserve it, despite the passage of time and the adversities on the body and mind that are associated with living.

However, defining what health is is not easy. For this purpose, different perspectives have been postulated, most of them coming from the philosophical thought on the ontology of men and women.

The biomedical model is the most traditional , forged in the heat of the 18th century positivism. In this article we will define its most essential aspects, as well as its impact on how we understand health and its care.

What is the biomedical model?

Human beings are very complex, so any attempt to reduce them to a simple definition is doomed to fall into reductionist biases. The physical, psychological and social dimensions that underlie each of us are evident; and which build the fundamental plots of our organic, mental and interpersonal reality. All of them, in their virtually infinite way of interacting, shape the person in all its extension.

This fact is obvious when we reflect on our nature, but not so obvious when we address one of its most fundamental aspects: health. In this field, and for many years, medicine was based on the most absolute of Cartesian dualisms . In this way, body and mind would end up being understood as watertight and unconnected entities, governed by different logics and lacking any point of contact.

This is the epistemological and philosophical basis of the biomedical model of health, for which it is limited only to the observable aspects of the organism. As a consequence, all diseases could be explained through anatomical or functional changes in the tissues, or through the action of external pathogens . Their identification would be based on objective and quantifiable signs, while the rest of the factors that could mediate would be only secondary epiphenomena.

The biomedical model understands that any pathology has a single cause, and that since this is of a purely physical nature, the action taken to resolve it will involve surgical or pharmacological manipulation. To achieve this purpose, two basic strategies would be used: medical diagnosis (through techniques that explore the integrity or function of the different organs and systems) and intervention (by modifying the anatomical structure or restoring chemical balance).

What are the positive aspects of the biomedical model?

The biomedical model has a positivistic character, which is based on the experimental method to determine the springs related to the disease process. For this reason, it has facilitated the drawing up of useful explanatory hypotheses on the functioning of the body and the pathologies that threaten it throughout life. This knowledge has made it possible to generate curative treatments , contributing in a relevant way to recovering health when it has been lost.

The survival of this biomedical model, over centuries, is eloquent proof of the benefit it brought. However, at present, a number of shortcomings are recognized that have led to qualitative changes in the care offered to sick people.

What are the negative aspects of the biomedical model?

The biomedical model was the dominant perspective from the 18th century, and well into the 20th century . It is honest to recognize its contribution to the advancement of knowledge about organic factors related to health, which are very relevant, although insufficient to define it integrally. It is not in vain that the World Health Organization (WHO) described it, in the preamble of its constitution (1946), as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”.
In the following, we will delve into some of its limitations as a theoretical model for health.

1. Focus on physiological aspects of health

In line with the definition proposed by the WHO, health should be understood as a multi-faceted phenomenon in which physical, psychological and social components are expressed in complex and intimate interaction. Thus, a person could not be considered “healthy” when he or she lacks physical pathologies but suffers from emotional problems, or is isolated from his or her social and/or cultural environment.

This way of understanding health provides an explanatory framework from which to understand current evidence, such as the fact that the body’s pathologies motivate a process of emotional adaptation or that loneliness reduces life expectancy. The emphasis circumscribed to the organic would obviate, instead, potential causes and consequences of some of the most common problems facing society.

The biomedical model understands the organic as the only variable worthy of consideration, directing all diagnostic and therapeutic resources in this direction. This way of proceeding sins of a certain reductionism with regard to current knowledge about human health .

2. Focus on disease cure, but not health promotion

The biomedical model is efficient in detecting a disease when it is already present, including at best tertiary prevention (avoiding worsening or physical complications), but neglecting primary prevention (which extends to the whole society to reduce the prevalence or incidence of a health problem) and secondary prevention (which concentrates on those individuals who are in a situation of risk or vulnerability).

3. Restriction in decision making by the patient

The biomedical model attributes to the health professional an omnipotent role in the whole process, reducing the active participation of the sick person. This passive role contemplates the patient as a defenceless being in the face of the adversities he or she has had to live through , and which would act as a simple receptacle for the therapeutic procedures that are decided for him or her. It is, therefore, a paternalistic prism.

We currently know that stimulating decision making in the patient and his/her family promotes a greater sense of control over the health situation , which has a positive impact on therapeutic adherence and on the prognosis of the pathology. In addition, obviously, to motivation and emotion. Therefore, one of the functions of those who provide care is to inform about the disease and the options available for its treatment, promoting a thorough and consensual choice.

4. Life expectancy and quality of life

The biomedical model has the fundamental purpose of maintaining life, although it does not take into account the stimulation of its quality. Quality of life is a complex dimension that includes the integration of physical aspects (function of the body itself, autonomy, pain, etc.), psychological aspects (emotional well-being, satisfaction with existence, etc.) and social aspects (personal relationships, contact with the environment, use of care resources, etc.); which are also linked to the cultural and subjective aspects.

The emphasis on the organic allows to increase life expectancy , but does not offer any solution to improve its quality beyond the maintenance of the function. In fact, such an attitude has implied certain iatrogenic consequences in the past, which today they try to avoid (such as therapeutic fierceness when trying to avoid the arrival of death in terminally ill patients). While it is important that life be long-lasting, it should not be limited to a mere accumulation of years.

5. Emphasis on labelling

The diagnosis of a health condition, especially in the field of psychology, involves the process of abstracting a complex expression to place it in the narrow margin of clinical descriptions in manuals designed for this purpose. However, the reality of the problems that compromise psychological integrity tends to impose itself on any attempt at classification , losing part of its richness during identification and labelling.

The diagnosis is relevant to delimit a phenomenon that requires intervention, as well as to facilitate communication between the different professionals, although it can also be a heavy burden for the person receiving it. It is therefore crucial to weigh up the pros and cons that may arise from it, and to prioritize efforts in addressing the individual symptoms of each. The diagnostic emphasis is a legacy from biomedical traditions, the usefulness of which in the field of mental health is always subject to constant debate.

The biopsychosocial model: a path to integration

The biopsychosocial model of health starts from the weaknesses that have been highlighted for the biomedical perspective; and aims to bring together the biological, the social and the psychological in a coherent whole . It is a perspective from which the humanisation of all health intervention has been advocated, promoting an integral perception of the person not only in the context of his physical vulnerability, but also of his own individuality and his particular needs.

Attention to emotional life, motivation or thought, as well as family and community ties, has provided a broader framework in the understanding of health and disease. This overview, which involves the synergistic effort of multiple professionals to cover all spheres of the human being, allows for more complete attention along the road to recovering health and well-being.

Bibliographic references:

  • Havelka, M., Lucanin, J.D. and Lucanin, D. (2009). Biopsychosocial Model – The Integrated Approach to Health and Disease. Collegium Antropologicum, 33(1), 303-310.
  • Wade, D. and Halligan, P.W. (2005). Do biomedical models of illness make for good healthcare systems? British Medical Journal, 329, 1398-1401.