Medicine, Health Care and Philosophy

, Volume 7, Issue 3, pp 311–320 | Cite as

Biomechanical and phenomenological models of the body, the meaning of illness and quality of care

  • James A. MarcumEmail author
Scientific Contribution


The predominant model of the body in modern western medicine is the machine. Practitioners of the biomechanical model reduce the patient to separate, individual body parts in order to diagnose and treat disease. Utilization of this model has led, in part, to a quality of care crisis in medicine, in which patients perceive physicians as not sufficiently compassionate or empathic towards their suffering. Alternative models of the body, such as the phenomenological model, have been proposed to address this crisis. According to the phenomenological model, the patient is viewed as an embodied person within a lived context and through this view the physician comes to understand the disruption illness causes in the patient’s everyday world of meaning. In this paper, I explore the impact these two models of the patient’s body have had on modern medical practice. To that end I first examine briefly the historical origins of the biomechanical and phenomenological models, providing a historical context for the discussion of each model’s main features in terms of machine-world and life-world. Next, I discuss the impact each model has had on the patient–physician relationship, and then I examine briefly the future development of each model. The meaning of illness vis-à-vis each model of the patient’s body is finally examined, especially in terms of how these two models affect the patient’s interpretation of illness. The paper concludes with a discussion of the biomechanical and phenomenological models, in terms of the quality of care crisis in modern western medicine.


biomechanical embodied person lived body meaning of illness mechanized body phenomenology quality of care 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Baron, R.J. 1985‘An Introduction to Medical Phenomenology: I Can’t Hear You While I’m Listening’Annals of Internal Medicine103606611PubMedGoogle Scholar
  2. Bayles, M.D. 1981‘Physicians as Body Mechanics’Engelhardt, HT,Jr.McCartney, JJ eds. Concepts of Health and Disease: Interdisciplinary PerspectivesAddison-WesleyReading, MA665675Google Scholar
  3. Beinfield, H., Korngold, E. 1991Between Heaven and Earth: A Guide to Chinese MedicineBallatine BooksNew YorkGoogle Scholar
  4. Brown, T. 1981The Mechanical Philosophy and the ‘Animal Oeconomy’Arno PressNew YorkGoogle Scholar
  5. Burnham, J.C. 1982‘American Medicine’s Golden Age: What Happened to It?’Science21514741479PubMedGoogle Scholar
  6. Charon, R. 2001‘Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust’Journal of the American Medical Association28618971902CrossRefPubMedGoogle Scholar
  7. Daniel, S.L. 1986‘The Patient as Text: A Model of Clinical Hermeneutics’Theoretical Medicine7195210CrossRefPubMedGoogle Scholar
  8. Descartes, R.: 1998, in: S. Gaukroger (ed. and trans.), The World and Other Writings, Cambridge: Cambridge University Press.Google Scholar
  9. Deutsch, E. 1993‘The Concept of the Body’Kasulis, TP eds. Self as Body in Asian Theory and PracticeSUNY PressAlbany, NY519Google Scholar
  10. Frank, A.W. 2002At the Will of the Body: Reflections on IllnessHoughton MifflinBostonGoogle Scholar
  11. Glick, S.M. 1981‘Humanistic Medicine in a Modern Age’New England Journal of Medicine30410361038PubMedGoogle Scholar
  12. Guttmacher, A.E., Collins, F.S. 2002‘Genomic Medicine–A Primer’New England Journal of Medicine34715121520CrossRefPubMedGoogle Scholar
  13. Ingelfinger, F.J. 1978‘Medicine: Meritorious or Meretricious’Science200942946PubMedGoogle Scholar
  14. Kleinman, A. 1988The Illness Narratives: Suffering, Healing and the Human ConditionBasic BookNew YorkGoogle Scholar
  15. Leder, D. 1990The Absent BodyUniversity of Chicago PressChicagoGoogle Scholar
  16. McWhinney, I.R.: 1978, ‘Medical Knowledge and the Rise of Technology’, Journal of Medicine and Philosophy 3, 293–304.Google Scholar
  17. McWhinney, I.R. 1978‘Medical Knowledge and the Rise of Technology’Journal of Medicine and Philosophy3293304PubMedGoogle Scholar
  18. Pert, C.B. 1997Molecules of Emotion: The Science Behind Mind-Body MedicineSimon & SchusterNew YorkGoogle Scholar
  19. Reiser, S.J. 1978Medicine and the Reign of TechnologyCambridge University PressCambridgeGoogle Scholar
  20. Schwartz, M.A., Wiggins, O. 1985‘Science, Humanism, and the Nature of Medical Practice: A Phenomenological View’Perspectives in Biology and Medicine28331361PubMedGoogle Scholar
  21. Siegler, M., Epstein, R.A. 2003‘Organizers’ Introduction to the Symposium on Quality Health Care’Perspectives in Biology and Medicine4614PubMedGoogle Scholar
  22. Svenaeus, F. 2000The Hermeneutics of Medicine and the Phenomenology of Health: Steps Towards a Philosophy of Medical PracticeKluwerBostonGoogle Scholar
  23. Thirteen/WNET: 1993, ‘Code of Silence’, in: Medicine at the Crossroads, vol. 2. New York: Public Broadcasting Service.Google Scholar
  24. Toombs, S.K. 1993The Meaning of Illness: A Phenomenological Account of the Different Perspectives of the Physician and PatientKluwerBostonGoogle Scholar
  25. Warwick, K.: 2000, ‘Cyborg 1.0’, Wired 8.02, online at Scholar
  26. Zaner, R.M. 1981The Context of Self: A Phenomenological Inquiry Using Medicine as a ClueOhio University PressAthens, OHGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  1. 1.Department of PhilosophyBaylor UniversityWacoUSA

Personalised recommendations