The (late) George Engel believed that to understand and respond adequately to patients’ suffering—and to give them a sense of being understood—clinicians must attend simultaneously to the biological, psychological, and social dimensions of illness. He offered a holistic alternative to the prevailing biomedical model that had dominated industrialized societies since the mid-20th century. His new model came to be known as the biopsychosocial model. He formulated his model at a time when science itself was evolving from an exclusively analytic, reductionistic, and specialized endeavor to become more contextual and cross-disciplinary. Engel did not deny that the mainstream of biomedical research had fostered important advances in medicine, but he criticized its excessively narrow (biomedical) focus for leading clinicians to regard patients as objects and for ignoring the possibility that the subjective experience of the patient was amenable to scientific study. Engel championed his ideas not only as a scientific proposal, but also as a fundamental ideology that tried to reverse the dehumanization of medicine and disempowerment of patients. His model struck a resonant chord with those sectors of the medical profession that wished to bring more empathy and compassion into medical practice.
Source: http://www.annfammed.org/cgi/content/full/2/6/576
George Engel (1913 - 1999)
When these ideas were forming in the early 1950s, he had already made a name for himself in neurology and medicine through his studies of fainting, delirium, and ulcerative colitis and was beginning the studies that would document the correlation of loss with the onset of a variety of diseases.
1 comment:
Your man Engel looks a cheery cove. Also a cheery cove, around a century earlier, was his near homonym, Engels, whose dialectical and historical materialism flowed into Vygotkii's cultural-historical (or socio-historical if you prefer) theory of human mental development.
To state this is not to score points but rather to remember that there's nothing new in knowing the triad of factors in human existence and in the genesis of human personality.
There are differnt ways of expressing this, or course, and some people have elaborated it more extensively that others. All very obvious, I'm afraid.
All the more remarkable, therefore, that services and 'research' in medicine, education and rehabilitation have been hegemonised by such extraordinarily reductionist, mechanistic positions.
And all the sadder that so many who have reacted against this in the disability movement have done so in terms of just a crude reductionism, in this case a sociological one.
So, good on your memory, Dr Engel, and thank you Laszlo for bringing him to our attention.
Andrew.
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