Who Decides What Counts as Science: Professional Power and Health. Paradigms, Power, and Resistance to Change in Health Care Systems
Keywords:
Models, Theoretical Biomedical Model, Power, Health Systems, Person-centered care, Salutogenesis (MeSH)Abstract
This article critically examines how dominant scientific paradigms in health systems determine which forms of knowledge are considered legitimate and who holds epistemic authority. Drawing on the theory of paradigm shifts, it argues that biomedical positivism has become a dominant dogma that constrains the integration of care-centred, participatory, and community-based approaches. This hegemony contributes to fragmentation, dehumanization, and limited system responsiveness to complex health needs. The article contends that resistance to paradigm change is driven less by lack of evidence than by professional power dynamics, and advocates for expanding the scientific model as a matter of scientific integrity and social responsibility.
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The moral rights belong to the author, the economic rights belong to the Benemérita Universidad Autónoma de Puebla.
