The CauseHealth Series: Chapter 5 - Complexity, Reductionism and the Biomedical Model with Dr Elena Rocca and Dr Rani Lill Anjum

The Words Matter Podcast with Oliver Thomson

Welcome to another episode of The Words Matter Podcast.

So we are up to the fifth episode on this CauseHealth Series, in which I’m speaking with the authors of The CauseHealth book Causality, Complexity and Evidence for the Unique Patient.and that you can download for free or order a hard copy.

So in this episode I’m speaking for the final time with Dr Elena Rocca and Dr Rani Anjum about Chapter 5, which they co-wrote titled Complexity, Reductionism and the Biomedical Model (read Chapter 5 here)

The chapter is a comprehensive analysis of some pretty hefty topics, who’s depths are rarely appreciated in day-to-day discussions in healthcare practice or academia. How often do we use terms and concepts such as reductionism or biomedicalism, without really knowing the premises of these positions? Fortunately, Rani and Elena do a great job of laying out these positions clearly so we can all have a greater handle on these theses so as to be more deliberate when using them or dismantling them.

In this episode we talk about:

• What reductionism is in medicine and how this relates to the biomedical model.
• We ask what does it mean to be a reductionist ontologically and epistemologically?
• Biomedicalism is frequently represented or Straw-manned, so we attempt to steel-man reductionism and offer an argument for its strengths, merits and contribution to healthcare.
• The role of the biomedical role in the (over)medicalisation of people (eg burnout into depression).
• The biopsychosocial model, and how this acknowledges complexity in theory and practice but how the CauseHealth approach argues we need to move beyond the BPS model by starting with a change in ontology, and how we can learn from ecology to resist the fragmentation of complexity and preserve it in its wholeness.
• We once again talk about the importance of the patient's narrative and the causal story it can tell.
• Finally we talk about how our ontological bias with respect to causation influence our norms and practice.

As always, I loved talking to Elena and Rani. Our discussion on complexity, biomedicalism and reductionism can help us become aware of our philosophical biases with respect to our practice, allowing us to analyse and reflect on them so we can begin to change them.

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