Summary of the book
A Revolution for the Clinical Method and Biomedical Research : the Determinate and the Quality Indeterminate Relativity of Biological Reaction
Giuseppe R.Brera ©Copyright Università Ambrosiana 1996
The book introduces the concept of "Relativity of Biological Reactions" separating these from "Biological constants" necessary for survival., leading Medicine to an indeterministic paradigm against determinism and mechanism and limiting for clinics results of experimental investigations on animals. The book is the epistemological basis of Person Centered Medicine and introduces in Medicine the interactionist paradigm, causing the end of the Stimulus-Answer model, mechanistic and deterministic one of the Selye’s stress theory centered only on animals’ biological variables change determined by bio-chemical stimula . Humans differently through subjective symbolic affective ,cognitive resources related to emotions elaborate and interpret internal and external stimula, that are influent on the gene expression.
The theory has been based on experimental studies on the interactions between central nervous, immunitary and endocrinological systems, mind and behavior.
The core of this theory is expressed in 4 equations, A-B-C-D.
The base of the theory has been the experimental evidence about the variability of immunitary reactions in relation to the experimental possibility offered to animals to escape - or otherwise - conditions of stress determining the obsolescence of Selye’s concept of stress and permitted the formulation of a theory on «The determinate relativity of animal coping» called “Equation C” . Equation C (Rb = Bc x Pt (a)) draws the relativity of animal biological reactions to coping possibilities determined by the probability of positive or negative social and/or environmental conditions in relation to drives, Individual genotype and biological homeostasis. Equation D differently draws for humans a different relativity.
Pt x Qc
HmRb = --------------------
HmRB = Human biological Reactions
PT= Possibilities of coping
AC = Quality of coping
The equation introduces the concept of the “Quality” of coping related to the indeterminate subjective possibilities of humans ( values, emotions, affects, relations, behaviors) which determine a “ Coping quality” (Qc) related to choices in experience. This unforeseeable possibility (Pt) of choice but like animals related to genotype, biological homeostasis, social and environmental conditions but in a only human way to cognitive and psycho-sexual structural stage of development, is the indetermination constant of the Equation D. Biological constants (Bc) appear inversely related to possibilities of choices. Less possibilities of coping there are more biological reactions are determined by a direct actions of biological constants on life, how physicians and surgeons know when they work in emergency.
Different epistemological models for human and animals are dependent from the presence in humans of self-determined, cognitive and psychosexual levels, and indeterministic factors ( eg. : moral and religious thinking, hypothetic-deductive reasoning, meaning awareness and will, creativity, parents’ education ). which determine a ” quality” in cognitive and affective symbolic processes, emotions, behaviors, coping and consequently different biological reactions. These qualitative and subjective factors are strictly related to neuromodulators, hormones and immunitary system actions in a bidirectional way through a new gene expression and receptors synthesis. Quality of coping is caused by the only human quality to choose among perceived and interpreted possibilities according the cognitive and psychosexual level, like Piaget and Freud showed., but possibility of an experience is unforeseeable like a dream or an encounter. Persons give a meaning to these showing a transcendent not empirical teleology existent in human nature well described by kairological theory. Mechanistic theory of human nature is obsolete and wrong and introduces necessarily new variables in medical research, clinics and medical education if wants arrive to true results. A new concept of health related to protective factors played by human possibilities, quality of the interpretation of reality, existential choices corresponding to affective and cognitive processes and neuromodulations, hormones transduced messages to cell membranes, that is a new indeterministic universe to be explored and related to person is born. Health to date can be interpreted and defined in a new way : “ Possibilities and qualities for being an human person based on a balance between protective and risk factors, that is resilience vs/ vulnerability”
The theory of the relativity of biological reactions to possibilities and quality of coping (RBR theory) appears to introduce a new epistemological chapter in human biology and medical science allowing a reformulation of the scientific method applied to human nature and a new clinical method based on
a. the necessity of introducing into human biology and clinical research variables belonging to the subjective world of humans determining quality of life : values,beliefs,emotions, affects, coping, behaviour and level of cognitive and psychosexual development.
b. the existence of a teleology in human nature and the importance of affective and cognitive symbolic world in a culture determining possibilities and qualities in reality interpretation, choices and behaviours.
c. the impossibility to directly transfer and apply to humans experimental inferences, based only on results of experimental studies because of the difference between Equation C and Equation D
d the change of the health concept and the introduction in Medicine and Medical education the concepts of Resilience and Vulnerability.
e the necessity to change clinical method according RBR equations B and D
f the necessity of introducing in the experimental method new RBR variables according equation A and C
d. the existence in humans of a mysterious indetermination constant
The RBR (Relativity of Biological Reaction) theory opens new perspectives in Medical Science and Medicine and at clinical level constitutes the basis of the Person Centered Medicine Clinical Method.