The Human Ecological Perspective and Biopsychosocial Medicine

With regard to philosophical anthropology, a human ecological framework for the human–environment relationship as an “ecology of the person” is outlined, which focuses on the term “relationship” and aims to be scientifically sound. It also provides theoretical orientations for multiprofessional clinical work. For this purpose, a multi-dimensional basic grid for the characterization of the individual human being is proposed. The necessity and meaningfulness of a differentiation and systematization of the terms “environment”, and above all “relationship”, are demonstrated, and practical examples and links to similar framework models are given.

Concussion in Sport: The Unheeded Evidence

Patients with repeated minor head injury are a challenge to our clinical skills of neurodiagnosis because the relevant evidence objectively demonstrating their impairment was collected in New Zealand (although published in theBMJandLancet) and, at the time, was mired in controversy. The effects of repeated closed diffuse head injury are increasingly recognized worldwide, but now suffer from the relentless advance of imaging technology as the dominant form of neurodiagnosis and the considerable financial interests that underpin the refusal to recognize that acute accelerational injury is the most subtle and insidiously damaging (especially when seen in the light of biopsychosocial medicine), and potentially one of the most financially momentous (given the large incomes impacted and needing compensation) phenomena in modern sports medicine. The vested interests in downplaying this phenomenon are considerable and concentrated in North America where diffuse head injury is a widespread feature of the dominant winter sports code: Gridiron or American Rules football. The relationship of this to shattered lives among the brightest and best of young men and the relatively dated objective evidence are a toxic mix in terms of ethical analysis and, therefore, there is a malignant confluence of social forces that tends toward minimizing the injury.

醫學模式中的精神性: 一個多餘的維度？

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Professor Bishop’s illuminating essay should be commented upon by attending to the three following questions. First, what is the theoretical advantage of the spirituality proposed by Bishop compared with the biopsychosocial model? Second, what is the content of his proposed medical spirituality? Finally, what is its significance to contemporary medical practice? Biopsychosocial medicine is still a form of modernism and reductionism. Neither biomedicine nor biopsychosocial medicine really treats patients as persons. In modern secular society, spirituality can be explained as the individual’s basic understanding of what constitutes a good life and personal integrity without reference to religion. A genuine understanding of spirituality, in contrast, fully recognizes patients’ experiences, needs, emotions, and values and the need to integrate them as a whole. It is also important to distinguish spirituality from the mere psychological dimension or autonomy of the individual. Spirituality as a holistic approach nourishes the discourse of the doctor-patient relationship and what constitutes a good professional life for doctors, whether we are talking about the Western or Chinese medical context.DOWNLOAD HISTORY | This article has been downloaded 99 times in Digital Commons before migrating into this platform.

從“生物醫學模式”到“生物社會心理精神醫學模式”——西方醫學史的教訓

LANGUAGE NOTE | Document text in English; abstract also in Chinese.生物－心理－社會－精神醫學在西方世界裡是一個歷史的產物。生物醫學發端於19 世紀後半葉，並在美國醫學中引發了一場大規模的醫學教育改革。這種科學的生物醫學在醫學實踐中表現出的冷冰冰的、無人格的態度，常常與病人的道德和精神需求相抵觸。為改善這種狀況，自20 世紀中葉起，醫生與倫理學家嘗試了多種方式的改革，包括生命倫理學，生物－心理－社會醫學，和生物－心理－社會－精神醫學。這些改革的共同社會歷史背景是世俗主義在美國的興起，而每一種改革也都以不同的方式試圖把握醫療照護中的超越維度，這一超越維度已被生物醫學的還原主義的態度所邊緣化。但是，因為生物醫學的科學主義態度，以上的改革都失敗了。雖然生物－心理－社會－精神醫學意圖以一種整全的方式照護病人，但是因為它仍然延續了一種科學主義的態度，以至於這種醫學模式不能滿足病人的道德和精神需求，也無法把握對病人而言超越的中心意義。Biopsychosociospiritual medicine is a product of the long history of medicine in the Western world. Biomedicine began in the latter part of the 19th century, and, by the early 20th century, major medical education reforms had mandated a revised scientific curriculum for all U.S. medical schools. These reforms resulted in reductive scientific materialism. By the mid-20th century, however, scientific biomedicine was felt to be cold and impersonal, and was often deployed against the patient’s moral and spiritual desires. From the mid-20th century onward, several reforms were attempted that fall under the rubrics of bioethics, biopsychosocial medicine, and biopsychosociospiritual medicine. These reforms took place at a time when secularism was on the rise in the U.S., and each reform attempted to capture the transcendent dimension of medical care that had been marginalized by the reductive attitude of biomedicine. However, the reforms failed because of the scientist attitude of biomedicine. Although biopsychosociospiritual medicine purports to be a comprehensive approach to patient care, because it maintains that scientist attitude it fails to consider patients’ moral and spiritual desires and or to capture the centrality of transcendence for those who are sick and in need of health care.DOWNLOAD HISTORY | This article has been downloaded 73 times in Digital Commons before migrating into this platform.