Biomedicine (also referred to as Western medicine, mainstream medicine or conventional medicine)^[1] is a branch of medical science that applies biological and physiological principles to clinical practice. Biomedicine stresses standardized, evidence-based treatment validated through biological research, with treatment administered via formally trained doctors, nurses, and other such licensed practitioners. ^[2]

Biomedicine also can relate to many other categories in health and biological related fields. It has been the dominant system of medicine in the Western world for more than a century.^[3][4][5][6]

Overview

Biomedicine is the cornerstone of modern health care and laboratory diagnostics. It concerns a wide range of scientific and technological approaches: from in vitro diagnostics^[7][8] to in vitro fertilisation,^[9] from the molecular mechanisms of cystic fibrosis to the population dynamics of the HIV virus, from the understanding of molecular interactions to the study of carcinogenesis,^[10] from a single-nucleotide polymorphism (SNP) to gene therapy.

Biomedicine is based on molecular biology and combines all issues of developing molecular medicine^[11] into large-scale structural and functional relationships of the  human genome, transcriptome, proteome, physiome and metabolome with the particular point of view of devising new technologies for prediction, diagnosis and therapy ^[12]

Biomedicine involves the study of (patho-) physiological processes with methods from biology and physiology. Approaches range from understanding molecular interactions to the study of the consequences at the in vivo level. These processes are studied with the particular point of view of devising new strategies for diagnosis and therapy.^[13][14]

Depending on the severity of the disease, biomedicine pinpoints a problem within a patient and fixes the problem through medical intervention. Medicine focuses on curing diseases rather than improving one’s health.^[15]

In social sciences biomedicine is described somewhat differently. Through an anthropological lens biomedicine extends beyond the realm of biology and scientific facts; it is a socio-cultural system which collectively represents reality. While biomedicine is traditionally thought to have no bias due to the evidence-based practices, Gaines & Davis-Floyd (2004) highlight that biomedicine itself has a cultural basis and this is because biomedicine reflects the norms and values of its creators.^[16]

The medical model of disability, or medical model, arose from the biomedical perception of disability. This model links a disability diagnosis to an individual’s physical body. The model supposes that this disability may reduce the individual’s quality of life and the aim is, with medical intervention, this disability will be diminished or corrected.^[1]

The medical model focuses on curing or managing illness or disability. By extension, the medical model supposes a “compassionate” or just society invests resources in health care and related services in an attempt to cure or manage disabilities medically. This is in an aim to expand functionality and/or improve functioning, and to allow disabled persons a more “normal” life. The medical profession’s responsibility and potential in this area is seen as central.

History

Before the introduction of the biomedical model, patients relaying their narratives to the doctors was paramount. Through these narratives and developing an intimate relationship with the patients, the doctors would develop treatment plans in a time when diagnostic and treatment options were limited.^[2] This could particularly be illustrated with aristocratic doctors treating the elite during the 17th and 18th century.^[3]

In 1980, the World Health Organization (WHO) introduced a framework for working with disability, publishing the “International Classification of Impairments, Disabilities and Handicaps.” The framework proposed to approach disability by using the terms Impairment, Handicap and Disability.^[4]

• Impairment = a loss or abnormality of physical bodily structure or function, of logic-psychic origin, or physiological or anatomical origin
• Disability = any limitation or function loss deriving from impairment that prevents the performance of an activity in the time lapse considered normal for a human being
• Handicap = the disadvantaged condition deriving from impairment or disability limiting a person performing a role considered normal in respect of age, sex and social and cultural factors

Components and usage

While personal narrative is present in interpersonal interactions, and particularly dominant in Western Culture, personal narrative during interactions with medical personnel is reduced to relaying information about specific symptoms of the disability to medical professionals.^[1] The medical professionals then interpret the information provided about the disability by the patient to determine a diagnosis, which likely will be linked to biological causes.^[1][2] Medical professionals now define what is “normal” and what is “abnormal” in terms of biology and disability.^[3]

In some countries, the medical model of disability has influenced legislation and policy pertaining to persons with disabilities on a national level.^[5][6]

The International Classification of Functioning, Disability and Health (ICF), published in 2001, defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (such as cerebral palsy, Down syndrome and depression) and personal and environmental factors (such as negative attitudes, inaccessible transportation and public buildings, and limited social supports).^[7]

The altered language and words used show a marked change in emphasis from talking in terms of disease or impairment to talking in terms of levels of health and functioning. It takes into account the social aspects of disability and does not see disability only as a ‘medical’ or ‘biological’ dysfunction. That change is consistent with widespread acceptance of the social model of disability

Criticism

The medical model of disability focuses on the individual’s limitations and ways to reduce those impairments or use adaptive technology to adapt them to society. Current definitions of disability accept biomedical assistance but focus more on factors causing environmental and social exclusion. Uncritical reliance on the medical model produces unwanted consequences.

Among advocates of disability rights, who tend to subscribe to the social model instead, the medical model of disability is often cited as the basis of an unintended social degradation of disabled people. Resources are seen as excessively misdirected towards an almost-exclusively medical focus when those same resources could potentially be used towards things like universal design and societal inclusionary practices. This includes the monetary and societal costs and benefits of various interventions, be the medical, surgical, social or occupational, from prosthetics, drug-based and other “cures”, and medical tests such as genetic screening or preimplantation genetic diagnosis. According to disability rights advocates, the medical model of disability is used to justify large investment in these procedures, technologies and research, when adaptation of the disabled person’s environment could potentially be more beneficial to the society at large, as well as financially cheaper and physically more attainable.

Also, some disability rights groups see the medical model of disability as a civil rights issue and criticise charitable organizations or medical initiatives that use it in their portrayal of disabled people, because it promotes a pitiable, essentially negative, largely disempowered image of people with disabilities rather than casting disability as a political, social and environmental problem (see also the political slogan “Piss On Pity“).