The limits of scientific medicine: paradigm strain and social policy

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.