The culture of biomedicine refers to the fact that it does not exist in solitude. Biomedicine is influenced by society, and in many ways is a society of its own. As far as being influenced by society, we need only look at history to observe how this influence works. One very easy example to look at is giving birth in the U.S. Not so long ago it was not common practice for women to have babies in a hospital, however over time pregnancy and birth have fallen under the category of “medical condition” and now it is considered unusual and perhaps even negligent for a woman to give birth outside of a hospital. This is of course only one example, but it serves the purpose of demonstrating how societal norms can influence biomedicine. Furthermore, the culture of biomedicine can also refer to the hospital as a its own society. Within a hospital, doctors, nurses, patients, and others all play specific roles. In western culture, we learn these roles from a young age so we take them in stride, but in other cultures these roles are not the same. The class materials illustrate this point well with the example of family involvement in illness. Biomedicine tends to isolate patients while they are treated, while this would be seen as unusual in other medical approaches, it is part of the culture of biomedicine that we have learned so we accept it.
I believe dichotomies are generally used because it is the simplest classification system. I will look at the case of life and death. The gray area of alive or not alive do not account for a large portion of a normal existence so for the purpose of keeping things simple we only use two categories. This is obviously an oversimplification as even those who don’t believe that life begins at conception would not call a fetus “dead”. Perhaps a resolution to this is to say that alive or dead is a sub-dichotomy under person or not a person.