The biopsychosocial model: Its use and abuse.

IF 2.3 2区 哲学 Q1 ETHICS Medicine Health Care and Philosophy Pub Date : 2023-09-01 Epub Date: 2023-04-17 DOI:10.1007/s11019-023-10150-2
Alex Roberts
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Abstract

The biopsychosocial model (BPSM) is increasingly influential in medical research and practice. Several philosophers and scholars of health have criticized the BPSM for lacking meaningful scientific content. This article extends those critiques by showing how the BPSM's epistemic weaknesses have led to certain problems in medical discourse. Despite its lack of content, many researchers have mistaken the BPSM for a scientific model with explanatory power. This misapprehension has placed researchers in an implicit bind. There is an expectation that applications of the BPSM will deliver insights about disease; yet the model offers no tools for producing valid (or probabilistically true) knowledge claims. I argue that many researchers have, unwittingly, responded to this predicament by developing certain patterns of specious argumentation I call "wayward BPSM discourse." The arguments of wayward discourse share a common form: They appear to deliver insights about disease gleaned through applications of the BPSM; on closer inspection, however, we find that the putative conclusions presented are actually assertions resting on question-begging arguments, appeals to authority, and conceptual errors. Through several case studies of BPSM articles and literatures, this article describes wayward discourse and its effects. Wayward discourse has introduced into medicine forms of conceptual instability that threaten to undermine various lines of research. It has also created a potentially potent vector of medicalization. Fixing these problems will likely require reimposing conceptual rigor on BPSM discourse.

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生物心理社会模式:其使用和滥用。
生物心理社会模式(BPSM)在医学研究和实践中的影响力与日俱增。一些健康哲学家和学者批评 BPSM 缺乏有意义的科学内容。本文对这些批评进行了延伸,指出生物-心理-社会模式在认识论上的弱点是如何导致医学话语中的某些问题的。尽管 BPSM 缺乏内容,但许多研究人员仍将其误认为是一个具有解释力的科学模型。这种误解使研究人员陷入了一种隐性束缚。人们期望《生物统计学原理》的应用能够提供关于疾病的见解;然而,该模型并没有提供产生有效的(或概率上真实的)知识主张的工具。我认为,许多研究人员在不知情的情况下,通过发展某些似是而非的论证模式来应对这一困境,我称之为 "偏离 BPSM 的论述"。偏离论述的论点有一个共同的形式:它们看似提供了通过应用 BPSM 所获得的关于疾病的见解;然而,仔细观察,我们会发现所提出的假定结论实际上是建立在诱导性论证、权威诉求和概念错误之上的论断。本文通过对 BPSM 文章和文献的几个案例研究,描述了偏离方向的话语及其影响。偏激言论给医学带来了各种形式的概念不稳定性,有可能破坏各种研究方向。它还创造了一种潜在的医疗化载体。要解决这些问题,很可能需要对 BPSM 话语重新施加严谨的概念。
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来源期刊
CiteScore
4.30
自引率
4.80%
发文量
64
期刊介绍: Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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