Biology and biography: revisiting the biosocial pathogenesis of non-communicable diseases

Abstract

The modern idea of a disease as a situation, an event, increasingly includes the social side along with the biological one. Although the biomedical side of the problem still dominates, factors such as adherence, decision-making and informed consent or refusal, psychosocial aspects of etiology and pathogenesis and other non-biological disease components become part of care provision. Of course, the social side was predominant before the development of evidencebased medicine. But in the modern context, the development of the humanities and social sciences, as well as neuroscience and psychology, makes it possible to take into account the biographical narrative of the patient’s personality as an integral part of the doctor-patient relationship. At the intersection of "biological" and "biographical" in the disease nature there are a number of factors, such as loneliness, stress, emotions, that reify, enact a person’s social self into somatic pathology or somatic health. The problem of combining humanities and natural science knowledge is very complex due to the fundamental difference in the methods of study, but for modern medicine such a connection is absolutely necessary.