تأملی تحلیلی-انتقادی بر تداوم پزشکی تقلیل گرایانه دکارت در مدل زیست پزشکی معاصر (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
این مقاله به واکاوی فلسفی-انتقادیِ پیوند میان رویکرد تقلیل گرایانه دکارت به پزشکی و مدل زیست پزشکی معاصر می پردازد. پرسش اصلی پژوهش حاضر این است که اولاً «چه ربط ونسبتی میان مدل پزشکی دکارت و مدل زیست پزشکی معاصر وجود دارد؟» و ثانیاً «آیا می توان مدل زیست پزشکی را نتیجه تداوم مستقیم تاریخیِ آموزه های تقلیل گرایانه دکارت در پزشکی دانست؟» در این راستا، ابتدا با مروری کوتاه بر عواملِ علمی-فلسفیِ دخیل در شکل گیری مدل زیست پزشکی، به شرحِ مبانی متافیزیکی این مدل می پردازیم. سپس با بازسازی ابعاد چهارگانه تقلیل گرایی دکارت در پزشکی (معرفت شناختی، روش شناختی، وجودشناختی و علّت شناختی) نشان می دهیم که این ابعاد، قرابتی آشکار با مبانی متافیزیکی مدل زیست پزشکی دارند. با این حال، استدلال اصلی مقاله این است که نمی توان از دل این قرابت، تداوم مستقیم تاریخی آموزه های دکارت در مدل زیست پزشکی را نتیجه گرفت، زیرا تحولات مهم فلسفی، علمی-تکنولوژیک و نهادیِ دو قرن نوزدهم و بیستم نیز قویاً در شکل گیری این مدل دخیل بوده اند. از این رو، می توان نسبت دکارت و مدل زیست پزشکی را در چارچوب «تداوم-گسست» فهمید: تداوم در سطح مفروضات متافیزیکی، و گسست در سطح علمی، تکنیکی و تجربی. این تفسیر نه دکارت را بنیان گذار مستقیم مدل زیست پزشکی می داند، و نه نقش او را تماماً انکار می کند، بلکه او را به مثابه رانه ای فکری می بیند که امکان شکل گیری و پذیرش این مدل تقلیل گرایانه پزشکی را فراهم آورد.An Analytical-Critical Reflection on the Continuity of Descartes’ Reductionist Medicine in the Contemporary Biomedical Model
This article offers a philosophical-critical examination of the relationship between Descartes’ reductionist approach to medicine and the contemporary biomedical model. It seeks to address two central questions: first, what is the relationship between Descartes’ medical model and the biomedical model? and second, can the biomedical model be regarded as a direct historical continuation of Descartes’ reductionist teachings in medicine? To answer these questions, we begin with a brief overview of the scientific and philosophical factors that shaped the biomedical model, followed by an account of its metaphysical foundations. We then reconstruct the four dimensions of Descartes’ medical reductionism—epistemological, methodological, ontological, and causal—and demonstrate their clear affinity with the metaphysical underpinnings of the biomedical model. Nevertheless, the main argument of the article is that one cannot conclude from this affinity a direct historical continuity of Descartes’ teachings in the biomedical model, because important philosophical, scientific-technological and institutional developments of the nineteenth and twentieth centuries have also strongly contributed to the formation of this model. Therefore, the relationship between Descartes and the biomedical model can be understood in a “continuity-discontinuity” framework: continuity at the level of metaphysical assumptions, and discontinuity at the scientific, technical and empirical levels. This interpretation neither considers Descartes as the direct founder of contemporary biomedical model, nor does it completely deny his role, but rather sees him as an intellectual drive that made possible the formation and acceptance of this reductionist medical model. Keywords: René Descartes, Dualism, Mechanism, Reductionism, Biomedical Model. Introduction In the light of the scientific revolution and the philosophical-epistemological developments of the 17th to 20th centuries, modern medicine found a new path, the most important manifestation of which was the formation of the “biomedical model”. By focusing on the body as a complex biological machine and relying on the sciences of biology, physiology, biochemistry and genetics, this model succeeded in achieving great triumphs in the field of diagnosing and treating diseases. However, the question of the metaphysical and historical foundations of this model has always been a matter of controversy. One of the focal points of this debate is the relationship between “Descartes’ reductionist medicine” and the “contemporary biomedical model”. Descartes took one of the first steps towards the scientificization of medicine by explaining the body as a machine and reducing vital processes to the laws of mechanics and physics. His teachings, especially in epistemological, methodological, ontological and etiological dimensions, have affinities with the assumptions of the biomedical model. But can this model be considered a direct continuation of Cartesian medicine? The answers to this question in the historiography and philosophy of medicine sometimes vary. Some consider the biomedical model to be the practical realization of Descartes’ dream and present it as a linear continuation of his mechanical-reductionist tradition. In contrast, some believe that the emergence of biomedicine is the product of structural, institutional and scientific developments of the nineteenth and twentieth centuries and has no direct connection with Descartes. This article, distancing itself from both readings, offers a third interpretation: biomedicine is neither simply an extension of Descartes’ teachings, nor is it completely unrelated to them, but rather the product of synergy between “the philosophical-epistemological developments of the 17th century” and “the scientific-structural transformations of the following centuries.” In the meantime, Cartesian metaphysics cast a conceptual umbrella over the minds of later generations, providing the
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