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HLTA02H3 (135)
R Song (4)
Chapter 1

Chapter 1

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University of Toronto Scarborough
Health Studies
R Song

CHAPTER 1 NOTES It is instructive to examine topics such as the evolution of the dominant paradigm of scientific medicine determinants of health and illness and the focus of research and levels of analysis Essential to understand the current organization and delivery of health services and ideological constraints and limitations within which the policy alternatives to solve the health crises are being debated EVOLUTION AND THE DOMINANT PARADIGM OF SCIENTIFIC MEDICINE thy The germ theory of disease which gained prominence in the late 19 century had a profound impact on the practice of medicine KochPasteurCreated a profound change in medicines diagnostic and therapeutic assumptionsUnifactorial model of disease emerged y While the germ theory helped to develop the prevention of infectious diseases and improved medical practice the paradigm of specific etiology and specific therapies gave rise to the essentially curative orientation of medicine and medical practicePeople can be made healthy by medical technologies and technological fixesAdopted mechanistic model of the human bodyDisease then is an alteration a pathological change in the body machinery that must be fixed diseases viewed as mere technical defectsBrought about a shift from the consideration of illness as a breakdown of the total system to the notion that ill health could be caused by the malfunctioning of one particular part of the body machineryin other words localized pathologylocalized pathology had a profound impact on the division of labour specialization in medicine y Bacteriologists and other scientists undeniably had a positive impact on the control of infectious diseases and led to improvements in medical practiceSome argue that the major decline in mortality and morbidity was due to better nutrition and sanitation and other environmental improvements y The form and nature of medicine is determined by class and power relations in the society and not by scientific imperativesAscendancy of scientific labbased medicine and the dominant position of allopathic medicine in North America at the beginning of this century were aided by the publication of the Flexner Report
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