The biopsychosocial model (BPSM) is increasingly influential in medical research and practice. Several philosophers and scholars of health have criticized the BPSM for lacking meaningful scientific content. This article extends those critiques by showing how the BPSM’s epistemic weaknesses have led to certain problems in medical discourse. Despite its lack of content, many researchers have mistaken the BPSM for a scientific model with explanatory power. This misapprehension has placed researchers in an implicit bind. There is an expectation that applications of the BPSM will deliver insights about disease; yet the model offers no tools for producing valid (or probabilistically true) knowledge claims. I argue that many researchers have, unwittingly, responded to this predicament by developing certain patterns of specious argumentation I call “wayward BPSM discourse.” The arguments of wayward discourse share a common form: They appear to deliver insights about disease gleaned through applications of the BPSM; on closer inspection, however, we find that the putative conclusions presented are actually assertions resting on question-begging arguments, appeals to authority, and conceptual errors. Through several case studies of BPSM articles and literatures, this article describes wayward discourse and its effects. Wayward discourse has introduced into medicine forms of conceptual instability that threaten to undermine various lines of research. It has also created a potentially potent vector of medicalization. Fixing these problems will likely require reimposing conceptual rigor on BPSM discourse.

生物心理社会模型（BPSM）在医学研究和实践中的影响力越来越大。一些健康哲学家和学者批评 BPSM 缺乏有意义的科学内容。本文通过展示 BPSM 的认知弱点如何导致医学话语中的某些问题来扩展这些批评。尽管缺乏内容，许多研究人员仍将 BPSM 误认为是具有解释力的科学模型。这种误解使研究人员陷入了隐含的困境。人们期望 BPSM 的应用能够提供有关疾病的见解；然而，该模型没有提供用于生成有效（或概率正确）知识主张的工具。我认为，许多研究人员在不知不觉中通过发展某些似是而非的论证模式来应对这种困境，我称之为“任性的 BPSM 话语”。任性话语的论点有一个共同的形式：它们似乎提供了通过应用 BPSM 收集到的关于疾病的见解；然而，经过仔细检查，我们发现所提出的推定结论实际上是基于回避问题、诉诸权威和概念错误的断言。本文通过对 BPSM 文章和文献的几个案例研究，描述了任性话语及其影响。任性的话语已将概念不稳定的形式引入医学，这有可能破坏各个研究领域。它还创造了一个潜在的有效的医疗化载体。解决这些问题可能需要对 BPSM 话语重新施加概念上的严格性。