Benning Tony B
Maple Ridge Mental Health Centre, Maple Ridge, BC, Canada.
Adv Med Educ Pract. 2015 May 2;6:347-52. doi: 10.2147/AMEP.S82937. eCollection 2015.
A commitment to an integrative, non-reductionist clinical and theoretical perspective in medicine that honors the importance of all relevant domains of knowledge, not just "the biological," is clearly evident in Engel's original writings on the biopsychosocial model. And though this model's influence on modern psychiatry (in clinical as well as educational settings) has been significant, a growing body of recent literature is critical of it - charging it with lacking philosophical coherence, insensitivity to patients' subjective experience, being unfaithful to the general systems theory that Engel claimed it be rooted in, and engendering an undisciplined eclecticism that provides no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social.
在恩格尔关于生物心理社会模型的原始著作中,对医学中一种综合的、非还原论的临床和理论观点的承诺清晰可见,这种观点尊重所有相关知识领域的重要性,而不仅仅是“生物学领域”。尽管该模型对现代精神病学(在临床和教育环境中)产生了重大影响,但最近越来越多的文献对其提出了批评——指责它缺乏哲学连贯性,对患者的主观体验不敏感,背离了恩格尔声称它所植根的一般系统理论,并产生了一种无纪律的折衷主义,无法防止生物、心理或社会这三个领域中的任何一个领域占据主导或被忽视。