Finding Health Between Personal and Disease Processes

Abstract

Patient autonomy on a personal level is ultimately rooted in biological autonomy on a subpersonal level. Patient decisional autonomy concerns the conscious choices patients make concerning treatments and lifestyle, whereas biological autonomy concerns the ability of patients to shape their environment. To understand the roots of health in this biological autonomy, we must bridge the chasm characteristic of modern natural science between personal meaning and impersonal mechanism. We will find that “health” and “action” represent blind spots for medical and biological theory, respectively. Modern medicine strongly distinguishes the impersonal disease from the patient who has the disease. Four disciplines at the margin of biomedicine are reviewed that challenge this separation: psychosomatics, placebo, alternative medicine, and geriatrics. Attention to personal goals during diagnosis and treatment is one way to bridge the gap between impersonal disease and the patient as person. But, ultimately, the impersonal biomedical disease model needs to be challenged.