Van Oudenhove Lukas, Cuypers Stefaan
Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Clinical & Experimental Medicine, University of Leuven, Leuven, Belgium,
Med Health Care Philos. 2014 May;17(2):201-13. doi: 10.1007/s11019-013-9521-1.
Psychosomatic medicine, with its prevailing biopsychosocial model, aims to integrate human and exact sciences with their divergent conceptual models. Therefore, its own conceptual foundations, which often remain implicit and unknown, may be critically relevant. We defend the thesis that choosing between different metaphysical views on the 'mind-body problem' may have important implications for the conceptual foundations of psychosomatic medicine, and therefore potentially also for its methods, scientific status and relationship with the scientific disciplines it aims to integrate: biomedical sciences (including neuroscience), psychology and social sciences. To make this point, we introduce three key positions in the philosophical 'mind-body' debate (emergentism, reductionism, and supervenience physicalism) and investigate their consequences for the conceptual basis of the biopsychosocial model in general and its 'psycho-biological' part ('mental causation') in particular. Despite the clinical merits of the biopsychosocial model, we submit that it is conceptually underdeveloped or even flawed, which may hamper its use as a proper scientific model.
心身医学以其盛行的生物心理社会模型，旨在将人文科学与精确科学及其不同的概念模型整合起来。因此，其自身常常隐含且不为人知的概念基础可能至关重要。我们捍卫这样一个论点，即在关于“身心问题”的不同形而上学观点之间做出选择，可能对心身医学的概念基础具有重要意义，因此也可能潜在地涉及其方法、科学地位以及它与旨在整合的科学学科（生物医学科学（包括神经科学）、心理学和社会科学）之间的关系。为了说明这一点，我们介绍哲学“身心”辩论中的三个关键立场（突现论、还原论和随附物理主义），并研究它们对一般生物心理社会模型的概念基础，尤其是其“心理 - 生物学”部分（“心理因果关系”）的影响。尽管生物心理社会模型具有临床优点，但我们认为它在概念上不够完善甚至存在缺陷，这可能会妨碍其作为一个恰当的科学模型的使用。
