Based on the Aristotelian dynamis-energeia-differentiation, a concept issuing dynamic coherence providers as the sub-level of individual realizations. This logical sub-level is given for any kind of realizations. Based on this two-level approach, to some degree similar to the two-level approach developed by Polanyi, model of biopsychosocial interaction is established. It is suggested as the theoretical basis for a person-centered approach in healthcare, integrating science and humanitites.

Evidence based medicine (EBM) is under critical debate, and person centered healthcare (PCH) has been proposed as an improvement. But is PCH offered as a supplement or as a replacement of EBM? Prima facie PCH only concerns the practice of medicine, while the contended features of EBM also include methods and medical model. I here argue that there are good philosophical reasons to see PCH as a radical alternative to the existing medical paradigm of EBM, since the two seem committed (...) to conflicting ontologies. This paper aims to make explicit some of the most fundamental assumptions that motivate EBM and PCH, respectively, in order to show that the choice between them ultimately comes down to ontological preference. While EBM has a solid foundation in positivism, or what I here call Humeanism, PCH is more consistent with causal dispositionalism. I conclude that if there is a paradigmatic revolution on the way in medicine, it is first of all one of ontology. (shrink)