From Biomedical to Biopsychosocial: I. Being Scientific in the Human Domain

From biomedical to biopsychosocial refers to a historical transition in scientific thinking that has been taking place over the past century and a half. Particularly pertinent for medicine is its explicit attention to humanness. That alone identifies biopsychosocial as a more complete and inclusive conceptual framework to guide clinicians in their everyday work with patients. Physicians have always depended on what patients have been able to tell them about the experiences that led them to seek medical attention, which is testimony to verbal exchange between patient and physician as a primary source of the data required for the clinician's task. Scientists studying sick, diseased, or even dying animals or plants do not have a comparable resource; they are limited to what can be observed, as are all scientists dealing with physical or infra-human systems. That we humans are able to participate actively in our own study by looking inward and contributing information otherwise not available should be a great scientific advantage. Yet, paradoxically, biomedical thinking, a 20th century derivative of 17th century natural science, categorically excludes from science what patients have to tell us on the grounds of its being nonmaterial in form and not measurable, subjective and not objective. On those grounds alone, even posing such a question is axiomatically disallowed. Instead, the human domain as a whole is seen as the art of medicine, subject neither to systematic inquiry nor possible to teach. (PsycINFO Database Record (c) 2019 APA, all rights reserved)