MAJOR PARADIGMS OF HEALTH: A PHILOSOPHICAL ANALYSIS

Abstract

This article presents a comprehensive socio-philosophical and epistemological analysis of the phenomenon of health as a complex, multidimensional concept that differs fundamentally from purely naturalistic and reductionist definitions. The problem posed – the methodological limitations of classical medical science and the anthropological alienation of human subjectivity – is resolved through the conceptualisation of the historical evolution and interaction of four key paradigms: biomedical, sociocultural, phenomenological-existential and ecological.
The study demonstrates that the biomedical model, whose roots lie in Cartesian dualism and the materialism of J. Lamettrie, reduced the human body to the functions of an automaton (‘man-machine’), thereby negating the patient’s individual spiritual experience. It is shown that R. Virchow’s cellular pathology definitively localised disease at the micro-level of the cell through quantitative deviations from the statistical norm, thereby cementing the dominance of rigid nosocentrism in science.
It has been demonstrated that the sociocultural paradigm successfully overcame biological determinism by defining illness as a specific form of social deviance and the institutionalised ‘role of the patient’ within the structure of society, as per T. Parsons. It has been revealed that Michel Foucault’s poststructuralist critique exposed medicine as an apparatus of biopolitics and social control, where the ‘medical gaze’ constructs discursive notions of the norm in accordance with the dominant ideological and economic needs of the modern state.
It is revealed that the phenomenological-existential paradigm, through the concept of the ‘living, lived body’ (M. Merleau-Ponty), reintroduces the subjective human experience into scientific discourse, interpreting health as intentional freedom and authentic ‘being-in-the-world’. It is established that, in this context, illness emerges as an ontological rupture and a liminal situation that illustrates human finitude and compels a radical rethinking of the existential limits of being.
The scientific contribution of the article lies in the theoretical justification of a planetary (ecological) model of health and the demonstration of the necessity for the convergence of existing paradigms within a holistic biopsychosocial approach. The study demonstrates that the rethinking of health from the negative criterion of ‘absence of disease’ to the positive status of a global public good and humanity’s macro-ethical responsibility towards the biosphere remains an open philosophical problem of the 21st century.