Programme no. 545-OP
Professional Development
Creating Chronicity – The unsustainable medical making of multi-morbidity.
Anna Luise Kirkengen*1
1General Practice Research Unit,Norwegian University of Science and Technology,N -- 7489 Trondheim,Norway
* = Presenting author
Objectives: The knowledge brought forth in the trans-disciplinary PNEI-field, invalidating the traditional dogma of mind and matter as separate and different, allows for identifying the shortcomings of the fragmenting biomedical conceptualisation of the human body.
Background: This paper addresses the solid evidence, converging from the neurosciences including psychology, and from genetics, immunology, epigenetics and endocrinology (in short PNEI), which bespeak the high significance of burdening lifetime experience on human health.
Results: The analysis of the sickness history demonstrates how biomedical logic engendered a multi-morbid patient by failing to identify the underlying common source of what, in accordance with the a fragmenting view on the body, was diagnosed as separate and different health problems. When biographical accounts were given relevance, the apparent multi-morbidity and the high investment from the side of the health care system could be identified as biomedical artefacts, contributing to chronicity and an unsustainable use of health care resources.
Material/Methods: An authentic sickness history is the point of departure for a more comprehensive account of the biomedical approach to a multi-morbid patient.
Conclusion: The common message from the research field termed Psycho-Neuro-Endocrino-Immunology has, by now, engendered a new model of the impact of chronic overload, a rising interest in biographical accounts, and a renaissance for the concept of personhood.
Points for discussion: Personhood is incomprehensible within a strictly biologically oriented and scientifically grounded framework. Its significance calls for a theoretical reorientation in medicine in order to stem the unsustainable yet rising “tide” of multi-morbidity and chronicity in Western societies.