Introduction Holism against Reductionism
The Introduction sets out the major themes of the book. These include medicine’s role in the moral and cultural agendas of contemporary society, challenges to the biomedical model represented by new regimes of disease and disorder, and the limitations of principlist bioethics for moving in a more holistic direction. In the working definition of the book, “reductionism” suggests a mechanistic and narrowly somatic understanding of disease, monocausal theories of disease, and an exclusive preoccupation with cure to the neglect of prevention. Meanwhile, “holism” refers to a contextual understanding of disease causation, intervention, or practice. A systemic concern with the whole organism, a focus on the interconnected effects of the larger environment, and ethical concerns with the clinical encounter, can all be characterized as holistic. The Introduction situates the struggle between these perspectives in historical context, and calls for a renewed focus on the social determinants of health and a more holistic ethical perspective.