9.1. Conceptual basis of biomedical model
The important role in the research methodology of sociology of medicine is played by the comparative medico-sociological analysis of the models and conceptions of health and disease, medical systems, the treatment paradigms, and the healthcare systems.
The theoretical basis of modern scientific medical paradigm of a disease is the biomedical model, which became dominant in Western countries from the end of 18th century. The conceptual basis of the biomedical model originates from those changes in medicine, which occurred in 18th century, when the developed potency to reveal a pathology 'inside an organism' had been employed in the methods of objective examination to establish diagnosis. This process was accompanied with the changes in the character of 'genuine essence' of the disease, which shifted from the humoral model of Galen (it considered a disease as a perturbation of the balance in the organism) to the status of 'thing in itself' detached from one's 'ego' and from sensations of the individual.
Medicine relies in the first place on biology, because its object is the human organism, its physiological state, vital activity, abnormalities, pathologies, the recovery process, etc. Separation of biological nature of human organism from the social essence of the human being is not always permissible, although sometimes it is necessary in certain limits. These changes in medical views took place in the period of dramatic social perturbations in Europe, which accompanied the development of capitalism, the growth of population size, and urbanization.
When observing a spectacular variety in the course of the same disease in dependence on social, biological, and other peculiarities of a patient, many physicians conclude that they should treat namely the patient, not the disease. The opponents stress that despite the variety of external manifestations, the basic mechanisms (etiology and pathogenesis) of a particular disease are identical in different patients, so the physicians should treat the disease. In other words, the doctor should always assess the balance of social and biological parts in any pathological process or phenomenon. The need in such assessment is not incidental, because the biological component is intrinsic to even clearly social phenomena and diseases (AIDS, tuberculosis, drug abuse, alcoholism, etc.). Therefore, the correct assessment of the balance of social and biological components in any specific phenomenon or disease is not only the theoretical task, but it is the problem of everyday practice, health improvement, treatment, rehabilitation, etc.