The Nobel Prize and the biomedical paradigm: is it time for a change?

An examination of the early history of Nobel Committee deliberations, coupled with a survey of discoveries for which prizes have been awarded to date--and, equally revealing, discoveries for which prizes have not been awarded--reveals a pattern. This pattern suggests that Committee members may have internalized the received, biomedical model and conferred awards in accord with the physicalistic premises that ground this model. I consider the prospect of a paradigm change in medical science and the possible repercussions of such a change on the distribution of Nobel prizes "within the domain of physiology or medicine." For expository purposes, I contrast a model based on a science of pathophysiology with one based on a science of pathopsychophysiology. I propose a means whereby members might minimize the potentially blinding effects of model-dependence and come to evaluate medical discoveries from an inter-model rather than an exclusively intra-model perspective. By bringing to light questions rarely asked and proposing answers, I seek to open a dialogue and furnish a vehicle by which the putative delimiting effects of model-dependence might be overcome.