The limits of scientific medicine: paradigm strain and social policy. 1998

C F Longino
Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27109, USA.

In this essay, the historical roots of the dominant medical worldview will be drawn and its tenets will be outlined. The existing paradigm may be called the Western Biomedical Model, whose doctrines include body-mind dualism, physical reductionism, the mechanical analogy, specific etiology and the body as the appropriate focus of regimen and control. Some of the pressures straining the paradigm will be discussed, especially the force of human and population aging and the accompanying dominance of chronic illness as a focus of health care. The tentative outlines of an emergent model will be described in the context of the current health policy debate. The mind, biography, surrounding environment, and culture are a few considerations that become very significant in a non-Cartesian world.

UI MeSH Term Description Entries
D008962 Models, Theoretical Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment. Experimental Model,Experimental Models,Mathematical Model,Model, Experimental,Models (Theoretical),Models, Experimental,Models, Theoretic,Theoretical Study,Mathematical Models,Model (Theoretical),Model, Mathematical,Model, Theoretical,Models, Mathematical,Studies, Theoretical,Study, Theoretical,Theoretical Model,Theoretical Models,Theoretical Studies
D011050 Policy Making The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. Analysis, Policy,Policy Analysis,Policy Development,Analyses, Policy,Development, Policy,Developments, Policy,Making, Policy,Policy Analyses,Policy Developments
D011057 Politics Activities concerned with governmental policies, functions, etc. Political Activity,Conservatism,Decentralization,Liberalism,Political Factors,Activities, Political,Activity, Political,Factor, Political,Factors, Political,Political Activities,Political Factor
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003469 Culture A collective expression for all behavior patterns acquired and socially transmitted through symbols. Culture includes customs, traditions, and language. Cultural Relativism,Customs,Beliefs,Cultural Background,Background, Cultural,Backgrounds, Cultural,Belief,Cultural Backgrounds,Cultural Relativisms,Cultures,Relativism, Cultural,Relativisms, Cultural
D006291 Health Policy Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. Health Care Policies,Health Policies,Healthcare Policy,National Health Policy,Care Policies, Health,Health Care Policy,Health Policy, National,Healthcare Policies,National Health Policies,Policies, Health,Policies, Health Care,Policies, Healthcare,Policy, Health,Policy, Health Care,Policy, Healthcare
D006299 Health Services for the Aged Services for the diagnosis and treatment of diseases in the AGED and the maintenance of health in the ELDERLY. Age-Friendly Health Care,Age-Friendly Health Services,Age-Friendly Health Systems,Geriatric Health Care,Geriatric Health Services,Geriatric Health Systems,Health Care for the Aged,Health Systems for the Aged,Health Services for Aged,Health Services for the Elderly,Health Services, Geriatric,Age Friendly Health Care,Age Friendly Health Services,Age Friendly Health Systems,Age-Friendly Health Cares,Age-Friendly Health Service,Age-Friendly Health System,Care, Age-Friendly Health,Care, Geriatric Health,Cares, Age-Friendly Health,Cares, Geriatric Health,Geriatric Health Cares,Geriatric Health Service,Geriatric Health System,Health Care, Age-Friendly,Health Care, Geriatric,Health Cares, Age-Friendly,Health Cares, Geriatric,Health Service, Age-Friendly,Health Service, Geriatric,Health Services, Age-Friendly,Health System, Age-Friendly,Health System, Geriatric,Health Systems, Age-Friendly,Health Systems, Geriatric,Service, Age-Friendly Health,Service, Geriatric Health,Services, Age-Friendly Health,Services, Geriatric Health,System, Age-Friendly Health,System, Geriatric Health,Systems, Age-Friendly Health,Systems, Geriatric Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001294 Attitude to Health Public attitudes toward health, disease, and the medical care system. Health Attitude,Attitude, Health,Attitudes, Health,Health Attitudes,Health, Attitude to

Related Publications

C F Longino
January 1984, The Yale journal of biology and medicine,
C F Longino
July 2017, Zeitschrift fur Gerontologie und Geriatrie,
C F Longino
May 1953, British medical journal,
C F Longino
January 2003, American journal of public health,
C F Longino
January 1971, Archives of internal medicine,
C F Longino
February 1960, Social-Medicinsk tidskrift,
C F Longino
May 1986, Ceskoslovenske zdravotnictvi,
C F Longino
February 1986, Clinics in geriatric medicine,
C F Longino
January 2000, Policy studies review,
C F Longino
April 1993, The Journal of medicine and philosophy,
Copied contents to your clipboard!