Khushf George
Department of Philosophy and Center for Bioethics, University of South Carolina, Columbia, SC 29208, USA.
Perspect Biol Med. 2008 Summer;51(3):432-49. doi: 10.1353/pbm.0.0033.
In current research on systems biology and nanomedicine, we often find an ideal of a new science-based preventive medicine. I consider how disease, cause, explanation, diagnosis, and treatment are understood within this ideal, with special attention to the role of nanoscience and technology in elucidating the "circuit diagram" of a healthy system. I argue that the developmental systems theory that informed George Engel's biopsychosocial model addresses some deficiencies in the current systems ideal, but it needs to be integrated with an ethical analysis that is more attentive to the socioeconomic, cultural, and institutional factors that condition how we understand and manage disease. We also need a richer account of top-down causal paths if we are to appropriately understand diseases as disruptions of inter- and intra-systemic integrity.
在当前关于系统生物学和纳米医学的研究中，我们常常能发现一种基于新科学的预防医学理想。我思考了在这一理想中，疾病、病因、解释、诊断和治疗是如何被理解的，特别关注了纳米科学和技术在阐明健康系统“电路图”方面的作用。我认为，为乔治·恩格尔的生物心理社会模型提供信息的发育系统理论解决了当前系统理想中的一些缺陷，但它需要与一种更关注社会经济、文化和制度因素的伦理分析相结合，这些因素制约着我们对疾病的理解和管理方式。如果我们要将疾病恰当地理解为系统间和系统内完整性的破坏，还需要对自上而下的因果路径有更丰富的描述。
