Why It Matters How Medicine Views the Human Being
Biomedicine today is not just a field of knowledge about diseases and treatments. It is a complex system of ideas about what constitutes the human as a subject and how we acquire knowledge about health and disease.
Epistemological frameworks are essentially the "rules of the game" in science: which methods are considered reliable, what counts as evidence, how explanations are constructed for various phenomena. These frameworks directly influence how doctors diagnose diseases, how new drugs are developed, and even how we perceive our own bodies.
Scientific Foundations
Modern biomedical research is based on ideas rooted in philosophy
Limits & Possibilities
Understanding these roots helps see the boundaries and capabilities of modern medicine
Key Concepts: Foucault, Epistemes, and Sociotechnical Imaginaries
Michel Foucault's Influence
The French philosopher Michel Foucault significantly influenced contemporary understanding of biomedicine. He introduced the concept of "episteme"—a historically developed system of knowledge that determines what can be recognized as truth in a particular era1 .
Foucault showed how biomedicine involves the "construction of the subject"—how medical practices and discourses shape the perception of the human as an object of management and study1 .
Sociotechnical Imaginaries
An important concept influenced by Foucault's ideas is "sociotechnical imaginaries". These are collective representations of how science and technology should develop and be used in society1 .
For example, in genetics, such "imaginaries" can influence how society perceives genetic data: as a panacea for all diseases or as a threat to privacy. These representations often remain implicit but influence the entire system of technoscience1 .
Epistemological Frameworks in Genetics
In biomedicine, epistemological frameworks are particularly evident in genetics, where two main approaches exist1 :
- Medical genetics: Focuses on practical application for diagnosis and treatment
- Biological genetics: Oriented toward fundamental research on biological mechanisms
Despite methodological similarities, these fields differ in goals and specialist training, leading to different understandings of what constitutes knowledge and how to interpret data1 .
Comparison of Medical and Biological Genetics
| Aspect | Medical Genetics | Biological Genetics |
|---|---|---|
| Goal | Diagnosis and treatment of diseases | Study of fundamental mechanisms of heredity |
| Specialist Training | Medical geneticists | Biologists, biotechnologists |
| Primary Methods | Genetic testing, counseling | Sequencing, gene editing |
| Understanding of Subject | Patient as pathology carrier | Organism as genetic information carrier |
Experiment: How Epistemological Frameworks Influence Disclosure of Genetic Information
Methodology of the Experiment
In 2015, a research team led by V. Rahimzadeh conducted a study on how context influences decisions to disclose or not disclose genetic test results1 . The scientists analyzed various cases from medical practice, focusing on how doctors and patients make decisions depending on the type of genetic information (e.g., about hereditary diseases or predispositions).
Data Collection
Analysis of medical records and surveys of geneticists and patients
Case Studies
Detailed examination of specific cases where disclosure questions arose
Interviews
In-depth interviews with participants to understand motivations and fears
Results and Analysis
The study showed that decisions about disclosing genetic information depend not only on medical factors but also on the epistemological frameworks of specialists1 . For example:
- Geneticists oriented toward the medical model were more inclined to disclose information if it could affect treatment.
- Biological geneticists working in research contexts more often considered potential risks to patient privacy.
This demonstrates how different epistemological frameworks influence practical decisions in biomedicine1 .
Factors Influencing Genetic Information Disclosure
| Factor | Influence on Disclosure | Example |
|---|---|---|
| Disease Type | High risk of hereditary disease increases likelihood of disclosure | Disclosing BRCA1/2 mutation information for breast cancer |
| Data Context | Research vs. clinical context influences decision | Anonymity more often preserved in research context |
| Specialist's Framework | Doctors disclose more often, biologists more cautious | Different approaches in medical vs. biological genetics |
Disclosure Decisions by Context
| Case | Information Type | Disclosure Decision | Rationale |
|---|---|---|---|
| Case 1 | High hereditary disease risk | Disclosed | Possibility of preventive measures |
| Case 2 | Uncertain gene variant significance | Not disclosed | Lack of clear medical recommendations |
| Case 3 | Incidental finding (unrelated to main study) | Context-dependent | Less often disclosed in research context |
Scientific Toolkit: Key Reagents and Materials in Genetic Research
Modern genetic research relies on a range of key reagents and materials that enable data acquisition and analysis.
| Reagent/Material | Function | Example Use |
|---|---|---|
| PCR (Polymerase Chain Reaction) | Amplification of specific DNA regions | Diagnosis of infectious diseases |
| Restriction Enzymes | Cutting DNA at specific sites | Gene cloning |
| CRISPR-Cas9 | Genome editing | Correcting gene mutations |
| Next-Generation Sequencers | High-throughput DNA sequencing | Whole-genome sequencing |
| Bioinformatic Programs | Analysis of large genetic data arrays | Identifying pathogenic gene variants |
Genetic Research Process Flow
Sample Collection
DNA Extraction
Analysis
Interpretation
Conclusions: What This Means for Us
Epistemological frameworks of biomedicine are not just abstract philosophical concepts. They influence how each of us is perceived by the medical system: as a patient or as an active subject1 .
Understanding these frameworks allows for critical engagement with medical recommendations, participation in health decision-making, and awareness of how technologies shape our identity. As research has shown, it is often context and specialists' frameworks that determine whether genetic information will be disclosed and how it will be used. This highlights the need for developing humanities expertise in biomedicine so that technologies do not become disconnected from human values1 .
Current Challenges
- Balancing technological advancement with ethical considerations
- Addressing disparities in access to genetic technologies
- Ensuring patient autonomy in decision-making processes
- Protecting genetic privacy in the era of big data
Future Directions
- Development of personalized medicine approaches
- Integration of genetic editing technologies
- Application of artificial intelligence in genetic analysis
- Revision of epistemological frameworks to include holistic perspectives
Biomedicine stands on the threshold of changes: the development of personalized medicine, genetic editing, and artificial intelligence require reconsideration of old epistemological frameworks. Perhaps in the future we will arrive at a new "episteme" where humans will be viewed not as objects of study but as holistic subjects whose health depends on a complex interplay of biological, social, and psychological factors.