Mohsen Khademi; Alireza Monajemi
Abstract
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 ...
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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.
Alireza Mansouri
Abstract
Abstract
This paper critiques the prevailing conflict and independence models of science-religion relations and proposes an alternative approach grounded in the non-justificationist critical rationalism. In this approach, religion provides a meaningful framework for scientific inquiry, helping to avoid ...
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Abstract
This paper critiques the prevailing conflict and independence models of science-religion relations and proposes an alternative approach grounded in the non-justificationist critical rationalism. In this approach, religion provides a meaningful framework for scientific inquiry, helping to avoid methodological nihilism. On the other hand, science collaborates with theology to critically re-examine its foundational concepts, thereby preventing religious dogmatism. The proposed model avoids unnecessary unnecessary antagonism and instead fosters dynamic collaboration, allowing both domains to jointly address existential and ethical challenges. Science and religion can thus enrich each other without collapsing into reductionism or conflation.
Keywords: Science and religion, independence model, fideism, instrumentalism, dogmatism, justificationism, critical rationalism.
Introduction
For centuries, the relationship between science and religion has been framed by philosophical paradigms that often intensified tensions. Classic conflict theorists like Draper and White depicted religion as an obstacle to progress, while Protestant theologians like Karl Barth insisted on strict independence, emphasizing faith as irreducible and immune to science. Later proposals, such as Gould’s “non-overlapping magisteria,” sought to reduce friction by assigning distinct roles—science answers the “how,” while religion addresses the “why.” Yet these models entrenched separation rather than enabling constructive dialogue.
Materials & Methods
Scholars like Ian Barbour later urged moving beyond rigid dichotomies, framing both science and religion as evolving, open-ended enterprises subject to critique. This paper develops that trajectory by drawing on critical rationalism, arguing that science and religion should be understood not as repositories of fixed truths but as fallible, dynamic processes of discovery. By rejecting justificationism—the insistence on indubitable foundations—the paper advocates for a shared epistemic framework of open critique, where uncertainty fuels growth rather than paralysis.
Discussion & Result
The Traditional Approach (Dogmatic and Institutional)
Dogmatic religion, rooted in fixed doctrines and ritual observance, has often portrayed itself as guardian of ultimate truth. This insistence on certainty produces intellectual stagnation, pits religion against empirical science, and leaves it ill-prepared to address modern existential crises.
Doctrinal rigidity: Institutionalized religion often discourages questioning, prioritizing rigid teachings over intellectual exploration. Ritual becomes a substitute for authentic spiritual wonder, alienating seekers who value inquiry.
Conflict with science: Historical clashes, such as the condemnation of Galileo or resistance to Darwinian evolution, reveal that the problem is less about empirical claims and more about metaphysical worldviews. When theology insists on immutable truths, it exposes itself to vulnerability in the face of scientific revision.
Existential inadequacy: Modern individuals confronting uncertainty, moral complexity, and suffering often find institutional religion’s black-and-white pronouncements inadequate. This disconnect risks either religious retreat into reactionary denial or total irrelevance, reinforcing the divide with science.
The Limits of Science and Rationalism
Science excels at explaining observable phenomena but struggles with metaphysical or existential questions about meaning, morality, and purpose. Instrumentalist philosophies, like those of Duhem and later van Fraassen, attempted to limit science to predictive models rather than claims about reality, thus insulating it from theological disputes. Yet this “retreat” reduces science to mere technology and drains its capacity to inspire wonder.
Even rationalism itself faces paradoxes: it rests on unprovable assumptions, such as the uniformity of nature or the validity of logic. Justificationist approaches demand ultimate grounds, but these either collapse into infinite regress or dogmatic halts. William Bartley’s critique shows how this turns science into a faith in reason. Critical rationalism offers an escape: instead of seeking secure foundations, it embraces fallibility and relentless critique, treating uncertainty as the motor of progress.
Non-Realist Approaches
Disillusionment with both dogmatic religion and science’s silence on existential questions has fueled various non-realist strategies to separate the two realms.
Existentialist and spiritualist views (e.g., Schleiermacher, Buber): Religion becomes a matter of subjective experience and immediate relation rather than truth claims. While this avoids dogmatism, it risks relativism, blurring distinctions between authentic experience and illusion, and sidelining religion’s ethical and social dimensions.
Polanyi’s tacit knowledge: By likening science to tradition-bound practices akin to religion, Polanyi highlights the role of commitment and personal participation. Yet this emphasis risks turning science into a quasi-religious, authority-driven activity, vulnerable to elitism and relativism.
Instrumentalism (Duhem, van Fraassen): Scientific theories are treated as useful fictions for prediction, leaving metaphysics and theology unchallenged. However, this truce weakens both domains: science loses its explanatory depth, while religion retreats into symbolic consolation.
Framework approaches (Wittgensteinian approaches): Science and religion are seen as distinct “language-games” with their own internal rules, immune to mutual critique. This enshrines separation but blocks critical engagement across domains, effectively silencing dialogue.
These non-realist approaches may ease tensions, but they do so by diminishing the critical and existential vitality of both science and religion.
The Critical Rationalist Approach
In contrast, critical rationalism insists that both science and religion remain open to critique. Religion, while offering meaning and moral grounding, must not rest on immutable dogmas. Myths and doctrines can serve as provisional interpretations, much like scientific theories, subject to reinterpretation in light of new understanding.
This approach sees both science and religion as fallible quests for truth, sharing the virtues of curiosity, humility, and openness. Neither domain offers final certainty, but both can enrich each other through dialogue. Examples from history—Galileo’s defiance of ecclesiastical authority, Newton and Boyle’s blending of piety and scientific rigor, Einstein’s “cosmic religion”—illustrate how science and religion have often intersected as complementary expressions of wonder and inquiry.
Critical rationalism reframes faith not as unquestioning belief but as an existential openness: a readiness to pursue meaning without guarantees. Similarly, science becomes more than technological utility, recovering its role as a source of awe and ethical orientation. Both activities embody a Socratic spirit: courage in confronting uncertainty and commitment to ongoing self-correction.
Conclusion
Science-religion dialogue, the paper argues, must be grounded in critical rationalism rather than dogmatism or compartmentalization. By shifting focus from rigid certainties to dynamic processes of questioning, this approach preserves both the existential depth of religion and the investigatory vigor of science.
Religion contributes a horizon of meaning and ethical motivation that science alone cannot provide, while science challenges theology to shed authoritarianism and remain intellectually alive. This reciprocal critique transforms conflict into collaboration, enabling both domains to address humanity’s deepest questions—about existence, morality, and truth.
The paper ultimately envisions a culture of “epistemic humility,” where neither faith nor reason claims infallibility, but both join in the shared human project of seeking meaning. Science, seen as a quasi-religious quest for truth, and religion, reimagined as an open-ended dialogue, become complementary companions in humanity’s endless but purposeful journey of discovery.
