Abstract
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 basis for the formation and acceptance of a reductionist approach to medicine.
Material and Methods
This research is of a theoretical-analytical type and was conducted using the method of conceptual analysis and philosophical genealogy. The research data were collected in a library and documentary form and included the main works of Rene Descartes, philosophical interpretations of his thought, and reliable sources in the field of philosophy of medicine and history of science. In conceptual analysis, the metaphysical assumptions of the biomedical model (medicine as science, body as a machine, human being as mind-body duality, and disease as defect) were extracted and systematized. Then, using argumentative reconstruction, the four dimensions of Cartesian reductionism, including methodological, epistemological, ontological and etiological reductionism, were analyzed and its relationship with the aforementioned components was examined. Finally, by adopting a genealogical approach, linear and essentialist analyses have been avoided and the synergy between philosophical, scientific, and institutional fields in the formation of the biomedical model has been emphasized. This method has allowed the research to go beyond the level of mere description and provide a deep analysis of the philosophical foundations of this model.
Discussion and Result
The present study has shown that although there is considerable overlap between Descartes’ reductionist teachings and the foundations of the contemporary biomedical model, this overlap does not mean a linear and direct continuity. By emphasizing the duality of mind and body, the mechanization of biological functions, and the elimination of ends, Descartes opened up an epistemological horizon that made it possible to think of the body as an analyzable and predictable machine. This framework has many similarities at the conceptual level with the assumptions of today’s biomedicine. However, the actual formation of contemporary biomedicine must also be seen in the important scientific, institutional, and empirical developments of the nineteenth and twentieth centuries; developments such as the spread of modern hospitals, the development of laboratory sciences, the microbiological revolution, and the discovery of cellular and genetic structures.
The intricate relationship between Descartes’ philosophy and the biomedical model can thus be best understood through the lens of ‘continuity-discontinuity.’ We observe a fundamental continuity at the level of core metaphysical assumptions, yet a clear discontinuity emerges when considering scientific methodologies, technical advancements, and empirical practices. Such an interpretation refrains from designating Descartes as the direct architect of contemporary medicine; instead, it acknowledges his pivotal role as the intellectual catalyst whose foundational ideas enabled the subsequent formation and widespread acceptance of this reductionist medical paradigm.
However, future scholars could explore the historical and detailed point that the biomedical model is the product of a complex interaction and synergy between Cartesian metaphysics, Comte’s positivism, technological advances, and medical institutional structures. Nineteenth-century scientism redefined medicine as an empirical and objective science, basing it on experimentation, measurement, and prediction. Technologies such as the microscope, medical imaging, and clinical trials reinforced this mechanistic view. Hospitals, medical schools, and insurance companies also played a crucial role in institutionalizing and promoting this model. This multifaceted analysis allows us to gain a more comprehensive understanding of the foundations and limitations of the biomedical model and to move toward integrated or holistic models.
Conclusion
This study revolves around two central questions: first, what is the relationship between Descartes’ medical model and the contemporary biomedical model? and second, can the biomedical model be regarded as the direct historical continuation of Descartes’ reductionist teachings? With regard to the first question, we demonstrate the structural and metaphysical affinities between the two models in terms of methodological, epistemological, ontological, and etiological reduction. In response to the second, we propose a third interpretive approach: one that views the biomedical model neither as a straightforward continuation of Cartesian medicine, nor as entirely unrelated to it, but as the outcome of an intersection between the philosophical–epistemological shifts of the seventeenth century and the structural–empirical transformations of later centuries. From this perspective, the metaphysical framework initiated by Descartes cast a long shadow, preparing the intellectual ground for the emergence and acceptance of reductionist medicine. Therefore, despite historical differences and ruptures, the epistemological and ontological assumptions derived from Descartes's thought continue to secretly shape the structure of our understanding of the body, illness, and health in contemporary medicine. It is in this sense that Edmund Pellegrino has argued that “Cartesianism is the unspoken philosophical substratum of contemporary medicine—the source of many of its great strengths and equally of its deficiencies.” (Pellegrino, 1981: 98).
This analysis also carries broader implications. By uncovering the metaphysical underpinnings of the biomedical model, we show that, despite its seemingly empirical character, it rests on specific philosophical commitments. Acknowledging this hidden metaphysics opens the way for critical reflection on the conceptual foundations of conventional medicine—foundations too often taken as neutral and self-evident. Such reflection highlights that modern medicine might have developed differently, and alternative paradigms—such as phenomenological medicine based on lived experience, narrative medicine, or the biopsychosocial model—could have taken root. Moreover, this perspective invites historians to view the history of medicine not merely as a linear account of scientific and technological progress, but as the outcome of the consolidation of philosophical–metaphysical assumptions within broader scientific and social contexts.