Rosch P J, Kearney H M
Soc Sci Med. 1985;21(12):1405-9. doi: 10.1016/0277-9536(85)90450-2.
This is an attempt to present a comprehensive overview of two major trends in American medicine which suggests significant evolutionary biopsychosocial developments in the remaining decades of the 20th century. Comments have been confined to the U.S. because it is the geographical country of residence and practice of the authors, and because the U.S. appears to be the locus of two contemporaneous and seemingly antithetical popular movements: quantum leaps in the development and use of medical technology and a groundswell of interest and enthusiasm for health enhancement or wellness which advocates a natural approach to health and emphasizes the central role of the individual in the preservation of health and the prevention of illness. The dynamics of this modern dialectic in American medicine have generated important qualitative consequences in the nature of the doctor-patient relationship and the delivery of health care. They have also, it is submitted, generated the search for a new paradigm which will permit a workable equilibrium between the disparate imperatives of both movements. The delicate process of developing that equilibrium is made more difficult by the co-existence of a host of complex factors, many of which are inextricably interwoven with one or the other of these two major trends.(ABSTRACT TRUNCATED AT 250 WORDS)
本文旨在全面概述美国医学的两大主要趋势，这两大趋势预示着20世纪余下几十年中生物心理社会方面将出现重大的演变发展。评论仅限于美国，原因在于美国是作者居住和执业的所在国，还因为美国似乎是两种同时存在且看似对立的大众运动的发源地：医疗技术开发与应用的巨大飞跃，以及对健康改善或健康促进的浓厚兴趣和热情浪潮，后者倡导采用自然的健康方法，并强调个人在保持健康和预防疾病方面的核心作用。美国医学中这种现代辩证法的动态变化在医患关系的性质和医疗保健的提供方面产生了重要的质性后果。有人认为，它们还引发了对一种新范式的探寻，这种新范式将使这两种运动截然不同的要求之间达成可行的平衡。由于存在大量复杂因素，其中许多因素与这两大主要趋势中的一个或另一个紧密交织在一起，因此实现这种平衡的微妙过程变得更加困难。（摘要截选至250字）
