Sudden Infant Deaths: models of health and illness

ABSTRACT The assumptions underlying the traditional biomedical model of health and illness and criticisms of it are described. An examination of the historical development of ideas concerning cot (crib) deaths shows how early explanations, which were congruent with this model, came to be discredited. Because subsequent explanations have also been considered unsatisfactory, cot deaths have come to be regarded as medically problematic. The relationship of models of health and illness to cot deaths has therefore been exposed to an unusual degree of scrutiny. Two possible contending models, social epidemiological and socio-economic are identified, and their status vis-à-vis the biomedical model is considered. The choice as to which of these models is applied to cot deaths is shown to be not only of theoretical interest but also to have ethical implications for health care policy and medical practice.