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Lecture 2

Health Sciences 1002A/B Lecture Notes - Lecture 2: Rudolf Virchow, Social Medicine, Health Canada


Department
Health Sciences
Course Code
HS 1002A/B
Professor
Jessica Polzer
Lecture
2

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Tuesday, September 13, 2016
Health Sci 1002 - Lecture 2
Key Concepts
TA - Marudan Sivagurunathan
-biomedical model
-medical dominance
-epidemiology
-public health
-health promotion
-Ottawa Charter for Health Promotion
-The Lalonde Report
-Health Field Concept
-WHO definition of health
-Population Health Approach
-Iatrogenesis
Origins of Biomedicine
-biomedicine = scientific medicine
-biomedicine and the biomedical model:
-origins in classical Greece, 4th cent. BECAUSE
-Hippocrates - humoral theory of disease (related health to the balance of humors, substances in the
body)
-scientific revolution - 17th cent
-period of major intellectual growth
-observation became basis of scientific method (empirical verification)
-anatomical drawings
-art of healing became the science of medicine
-key contributors
-Descartes: mind/body dualism, conceptualizing body as machine with distinct parts
-body is separate from mind and were mechanical object (ex. clock), separate substances
-Virchow: pathologist, cell theory
!1
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Tuesday, September 13, 2016
-looked at the level of cells, explanation of disease involved cell health and cell functioning
-Pasteur: chemist, germ theory
-pasteurization, contemporary medical understandings of the body and medicine
-somewhat social explanation, germs spread between bodies and social environment plays a role
Biomedical Model
-by late 1800s, germ theory had taken hold
-cause of disease located within the body
-biomedical model became dominant in the 1900s
-prevails because they have official definitions, endorsed by powerful institutions, popular media
-still the prevailing individual theory of health
Defining Features (assumptions)
specific etiology
etiology = cause
each disease has a specific cause and can thus be discovered and treated
therefore there is the assumption that every disease can thus be treated
ex. mutation location = certain disease
machine metaphor - body is a machine, doctors are mechanics
if it is broken, we must fix it
health is reduced to the functioning of the parts, mental and psychological health is ignored
reductionist views - reduce disease and illness to discrete elements within the body, ignore
interactions within the body
mind/body dualism/Cartesian dualism
physical and mental processes can be separated
should be treated completely distinctly
human body is treated as a physical object and mental issues are not considered as they apparently
have no impact on the physical health of the body
chronic pain may have mental impacts and that is not considered, the body is treated, not the mind
Limitations
fallacy of specific etiology
often more than one cause, only search for one
objectification
ignore the patients emotional aspects
!2
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Tuesday, September 13, 2016
reductionism and biological determinism
organs-cells-molecules-genes-etc
increase in medical specialization (ex. cardiologist)
ignores the bigger picture
our health is determined by our genetic code, no research to the relationship between biological and
social
victim blaming
health lies within the individual, is a compilation of individual choices and failure to comply to health
recommendations
often does not explain the health at a population level
Iatrogenesis
more attention to disease than health
negative definition of health
health is presumed when disease is absent, which is not necessarily the case
not a preventative approach, a curative approach
Caveat
critique of the biomedical model
not a critique of the perspective of individual physicians or medical researchers, this is a general
assumption
often not quite so black and white
Biomedicine
-informs most health professions and services
-very individual conception of health
-tends to ignore social production of health/illness
5 Assumptions
health is biologically determined
body-as-machine
health care = curing disease
medicine is scientific
doctor is authority
!3
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