Pressure from our aging population will broaden our understanding of medicine

This essay speculates about how medical philosophy may change to accommodate the technologic, organizational, and--in particular--population challenges of the future. The historical roots of the dominant medical world view are drawn and its tenets 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 object of regimen and control. Some of the pressures straining the paradigm are discussed, especially the force of human and population aging as it accelerates the dominance of chronic illness and focus of health care. The tentative outlines of an emergent paradigm are described. The mind, biography, surrounding environment, and culture are a few considerations that become very significant in a non-Cartesian world.