Philosophy, medicine and healthcare: insights from the Italian experience.

To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified--the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the 'Postmodern' Era--which can be seen, à la Foucault, as 'fragments between philosophical fractures'. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care.