Benjamin D. Koen
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195367744
- eISBN:
- 9780199867295
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195367744.001.0001
- Subject:
- Music, Ethnomusicology, World Music
Western medicine has conventionally separated music, science, and religion into distinct entities, yet traditional cultures throughout the world have always viewed music as a bridge that connects and ...
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Western medicine has conventionally separated music, science, and religion into distinct entities, yet traditional cultures throughout the world have always viewed music as a bridge that connects and balances the physical with the spiritual to promote health and healing. As people in even the most technologically advanced nations across the globe struggle with obtaining affordable and reliable healthcare, more and more people are now turning to these ancient cultural practices of holistic and ICAM healing (integrative, complementary, and alternative medicine). This book convincingly demonstrates the relevance of medical ethnomusicology in light of the globally spreading ICAM approaches to health and healing. Revealing the Western separation of healing from spiritual and musical practices as a culturally determined phenomenon, the book confirms their underlying unity. In a place poetically known as the Roof of the World, the culture found within the towering Pamir Mountains of Badakhshan Tajikistan serves as the paradigm of ICAM healing practices. The book’s research and immersion into the Badakhshani culture provides a well-balanced “insider” perspective while maintaining an “observer’s” view, as it effectively bridges the widespread gaps between ethnomusicology, health science, and music therapy.Less
Western medicine has conventionally separated music, science, and religion into distinct entities, yet traditional cultures throughout the world have always viewed music as a bridge that connects and balances the physical with the spiritual to promote health and healing. As people in even the most technologically advanced nations across the globe struggle with obtaining affordable and reliable healthcare, more and more people are now turning to these ancient cultural practices of holistic and ICAM healing (integrative, complementary, and alternative medicine). This book convincingly demonstrates the relevance of medical ethnomusicology in light of the globally spreading ICAM approaches to health and healing. Revealing the Western separation of healing from spiritual and musical practices as a culturally determined phenomenon, the book confirms their underlying unity. In a place poetically known as the Roof of the World, the culture found within the towering Pamir Mountains of Badakhshan Tajikistan serves as the paradigm of ICAM healing practices. The book’s research and immersion into the Badakhshani culture provides a well-balanced “insider” perspective while maintaining an “observer’s” view, as it effectively bridges the widespread gaps between ethnomusicology, health science, and music therapy.
Michael S. Goldstein
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780195388299
- eISBN:
- 9780199866519
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195388299.003.0013
- Subject:
- Political Science, American Politics
Goldstein describes how the prior personal experiences—political, physical, and emotional—of individual physicians were instrumental in the introduction of complementary and integrative medicine into ...
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Goldstein describes how the prior personal experiences—political, physical, and emotional—of individual physicians were instrumental in the introduction of complementary and integrative medicine into medical school facilities and curricula. He applies parallel arguments to past research on patient‐driven movements, which has emphasized the effects of personal experiences on involvement and leadership for those at risk for or affected by a particular condition or disease in the study of professionally driven movements. From eight of the medical schools currently belonging to the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), fourteen individuals, including five deans and nine other integrative medicine advocates, attended a key organizational meeting during the summer of 1999. Goldstein interviews a number of these participants about the extent to which attendees conceptualized their actions at the time of the meeting as part of a social movement and the degree to which personal experiences of participants were significant factors in their participation. The chapter findings indicate that most participants were conscious of being part of a social movement and recalled this as quite important. Additionally, many respondents reported self‐perceptions as “wounded healers” and saw movement participation as a means to address this status.Less
Goldstein describes how the prior personal experiences—political, physical, and emotional—of individual physicians were instrumental in the introduction of complementary and integrative medicine into medical school facilities and curricula. He applies parallel arguments to past research on patient‐driven movements, which has emphasized the effects of personal experiences on involvement and leadership for those at risk for or affected by a particular condition or disease in the study of professionally driven movements. From eight of the medical schools currently belonging to the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), fourteen individuals, including five deans and nine other integrative medicine advocates, attended a key organizational meeting during the summer of 1999. Goldstein interviews a number of these participants about the extent to which attendees conceptualized their actions at the time of the meeting as part of a social movement and the degree to which personal experiences of participants were significant factors in their participation. The chapter findings indicate that most participants were conscious of being part of a social movement and recalled this as quite important. Additionally, many respondents reported self‐perceptions as “wounded healers” and saw movement participation as a means to address this status.
Penelope Schofield, Justine Diggens, Sue Hegarty, Catherine Charleson, Rita Marigliani, Caroline Nehill, and Michael Jefford
- Published in print:
- 2010
- Published Online:
- November 2011
- ISBN:
- 9780199238361
- eISBN:
- 9780191730290
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238361.003.0024
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
The use of unproven therapies or complementary and alternative medicine (CAM) continues to evoke strong debate and diverse views within the medical community. Many doctors are concerned about the ...
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The use of unproven therapies or complementary and alternative medicine (CAM) continues to evoke strong debate and diverse views within the medical community. Many doctors are concerned about the lack of scientifically credible research to support the claims of CAM proponents. However, a large and growing number of cancer patients use CAM. Evidence indicates that clinicians neglect to appropriately discuss issues surrounding CAM use with their patients. Improving CAM-related communication between clinicians and cancer patients has been widely advocated by researchers, medical practitioners, CAM practitioners, and patients. Assisting clinicians to initiate and engage patients in discussions about CAM is an essential contribution to improving health-related communication. This chapter presents a definition of CAM, explores the rationale supporting the need to improve communication about CAM, and considers evidence-based guidelines about how to discuss CAM in a conventional oncology setting. The practical application of the guidelines is then described through the development and implementation of a communication skills workshop for training health professionals.Less
The use of unproven therapies or complementary and alternative medicine (CAM) continues to evoke strong debate and diverse views within the medical community. Many doctors are concerned about the lack of scientifically credible research to support the claims of CAM proponents. However, a large and growing number of cancer patients use CAM. Evidence indicates that clinicians neglect to appropriately discuss issues surrounding CAM use with their patients. Improving CAM-related communication between clinicians and cancer patients has been widely advocated by researchers, medical practitioners, CAM practitioners, and patients. Assisting clinicians to initiate and engage patients in discussions about CAM is an essential contribution to improving health-related communication. This chapter presents a definition of CAM, explores the rationale supporting the need to improve communication about CAM, and considers evidence-based guidelines about how to discuss CAM in a conventional oncology setting. The practical application of the guidelines is then described through the development and implementation of a communication skills workshop for training health professionals.
John S. Haller
- Published in print:
- 2014
- Published Online:
- November 2015
- ISBN:
- 9780231169042
- eISBN:
- 9780231537704
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231169042.003.0002
- Subject:
- Public Health and Epidemiology, Public Health
This chapter examines the rise of postmodernism in the second half of the twentieth century and the epistemological challenges it forced upon the core values of scientific positivism. Postmodernism ...
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This chapter examines the rise of postmodernism in the second half of the twentieth century and the epistemological challenges it forced upon the core values of scientific positivism. Postmodernism viewed objectivity as an illusion, a set of images or metanarratives that fragmented both reason and meaning. Applied to medicine, it questioned the “truth” of the physician's reductionist account of illness, including those conclusions drawn from evidence-based medicine (EBM). It also revolted against patient objectification, inferring that the “truth” of an illness is no longer in the physician's objectivist and biomedical account, but in the patient's narrative. This resulted in the rise of complementary and alternative medicine (CAM), a more intuitive and individualized approach to medicine. This new representation of illness involves social, psychological, and cultural components; innovative new discourses on pain, suffering, and empathy; and perceived limitations of the dominant biochemical model.Less
This chapter examines the rise of postmodernism in the second half of the twentieth century and the epistemological challenges it forced upon the core values of scientific positivism. Postmodernism viewed objectivity as an illusion, a set of images or metanarratives that fragmented both reason and meaning. Applied to medicine, it questioned the “truth” of the physician's reductionist account of illness, including those conclusions drawn from evidence-based medicine (EBM). It also revolted against patient objectification, inferring that the “truth” of an illness is no longer in the physician's objectivist and biomedical account, but in the patient's narrative. This resulted in the rise of complementary and alternative medicine (CAM), a more intuitive and individualized approach to medicine. This new representation of illness involves social, psychological, and cultural components; innovative new discourses on pain, suffering, and empathy; and perceived limitations of the dominant biochemical model.
Fabrizio Benedetti
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780199559121
- eISBN:
- 9780191724022
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199559121.003.0009
- Subject:
- Neuroscience, Molecular and Cellular Systems
Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer ...
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Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer chemotherapy session, with a basic mechanism of classical conditioning. In sports medicine, physical performance in sports activities is boosted by placebos and this poses some important ethical questions about doping. Placebo surgery may induce improvement as well. However, surgical clinical trials with placebos raise many ethical questions. Some alternative and complementary therapies, like acupuncture, have both a specific effect and a big placebo component. It is also important to realize that placebo and placebo-related effects represent a good model for the better understanding of the mechanisms underlying the patient-provider interaction.Less
Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer chemotherapy session, with a basic mechanism of classical conditioning. In sports medicine, physical performance in sports activities is boosted by placebos and this poses some important ethical questions about doping. Placebo surgery may induce improvement as well. However, surgical clinical trials with placebos raise many ethical questions. Some alternative and complementary therapies, like acupuncture, have both a specific effect and a big placebo component. It is also important to realize that placebo and placebo-related effects represent a good model for the better understanding of the mechanisms underlying the patient-provider interaction.
Susan MacDonald and Doreen Oneschuk
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199694143
- eISBN:
- 9780191739255
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199694143.003.0151
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter presents case studies to illustrate the desired skills, attitudes, and knowledge required to develop proficiency in discussing and advising patients about using complementary and ...
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This chapter presents case studies to illustrate the desired skills, attitudes, and knowledge required to develop proficiency in discussing and advising patients about using complementary and alternative medicine (CAM). It addresses a number of questions such as: What non-pharmacological therapies are available for symptom control in the palliative patient? Why do cancer patients use complementary and alternative therapies? Where do patients get information about CAM? Are there any concerns about natural health products interacting with prescription medications? What is the proposed biological mechanism of action for acupuncture in pain relief?Less
This chapter presents case studies to illustrate the desired skills, attitudes, and knowledge required to develop proficiency in discussing and advising patients about using complementary and alternative medicine (CAM). It addresses a number of questions such as: What non-pharmacological therapies are available for symptom control in the palliative patient? Why do cancer patients use complementary and alternative therapies? Where do patients get information about CAM? Are there any concerns about natural health products interacting with prescription medications? What is the proposed biological mechanism of action for acupuncture in pain relief?
David Numrich Paul
- Published in print:
- 2004
- Published Online:
- October 2011
- ISBN:
- 9780195167962
- eISBN:
- 9780199850150
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195167962.003.0022
- Subject:
- Religion, Religion and Society
Buddhists in the United States fall into two main camps: ethnic Asians, for whom Buddhism represents the primary religious component of their cultural heritage, and non-Asian converts to Buddhism. ...
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Buddhists in the United States fall into two main camps: ethnic Asians, for whom Buddhism represents the primary religious component of their cultural heritage, and non-Asian converts to Buddhism. These two broad groupings manifest significant differences in their perspectives and practice of complementary and alternative medicine (CAM), with important implications for the American health care system. This chapter focuses primarily on selected CAM practices among US Buddhists under the general heading of folk healing, which includes behaviors often identified with popular religion or folk religiosity. Two kinds of folk healing are discussed: herbalism and appeal to spiritual or supramundane healing forces. Supramundane healing forces could be classified under several CAM designations, such as mental and spiritual healing (healing power from the mind or divine sources); nonlocality (unmediated healing at a distance); biofield medicine (use of energy fields in or around the body); and even the placebo response in certain cases (healing effected through a patient's belief in the treatment). This chapter also considers the practice of Buddhist meditation.Less
Buddhists in the United States fall into two main camps: ethnic Asians, for whom Buddhism represents the primary religious component of their cultural heritage, and non-Asian converts to Buddhism. These two broad groupings manifest significant differences in their perspectives and practice of complementary and alternative medicine (CAM), with important implications for the American health care system. This chapter focuses primarily on selected CAM practices among US Buddhists under the general heading of folk healing, which includes behaviors often identified with popular religion or folk religiosity. Two kinds of folk healing are discussed: herbalism and appeal to spiritual or supramundane healing forces. Supramundane healing forces could be classified under several CAM designations, such as mental and spiritual healing (healing power from the mind or divine sources); nonlocality (unmediated healing at a distance); biofield medicine (use of energy fields in or around the body); and even the placebo response in certain cases (healing effected through a patient's belief in the treatment). This chapter also considers the practice of Buddhist meditation.
Linda L. Barnes
- Published in print:
- 2004
- Published Online:
- October 2011
- ISBN:
- 9780195167962
- eISBN:
- 9780199850150
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195167962.003.0020
- Subject:
- Religion, Religion and Society
Following a front-page story in the New York Times in 1972 by James Reston about his experiences with acupuncture in a Chinese hospital, virtually every article on complementary and alternative ...
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Following a front-page story in the New York Times in 1972 by James Reston about his experiences with acupuncture in a Chinese hospital, virtually every article on complementary and alternative medicine (CAM) in United States media has featured this modality as CAM's poster child, with the patient presented as a wide-eyed face bristling with needles. To a lesser degree, Chinese herbs have made the news as well. This chapter examines constructions of race in the United States; the ways that Chinese healing practices interface with issues of religious identity and expression for Chinese American practitioners; tensions between conversion and appropriation, particularly as both pertain to European American practitioners; and a different aspect of acculturation, the phenomenon of medicalization. These issues are reviewed in relation to broader issues of cross-cultural transmission in the context of globalization.Less
Following a front-page story in the New York Times in 1972 by James Reston about his experiences with acupuncture in a Chinese hospital, virtually every article on complementary and alternative medicine (CAM) in United States media has featured this modality as CAM's poster child, with the patient presented as a wide-eyed face bristling with needles. To a lesser degree, Chinese herbs have made the news as well. This chapter examines constructions of race in the United States; the ways that Chinese healing practices interface with issues of religious identity and expression for Chinese American practitioners; tensions between conversion and appropriation, particularly as both pertain to European American practitioners; and a different aspect of acculturation, the phenomenon of medicalization. These issues are reviewed in relation to broader issues of cross-cultural transmission in the context of globalization.
John S. Haller
- Published in print:
- 2014
- Published Online:
- November 2015
- ISBN:
- 9780231169042
- eISBN:
- 9780231537704
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231169042.003.0005
- Subject:
- Public Health and Epidemiology, Public Health
This chapter identifies the differences that separate homeopathy from biomedicine. The tension between homeopathy and conventional medicine is essentially that of two epistemologically different ...
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This chapter identifies the differences that separate homeopathy from biomedicine. The tension between homeopathy and conventional medicine is essentially that of two epistemologically different systems; one whose view of disease causation begins at the metaphysical level, and the other whose view begins at the cellular level. Conventional medicine believes that the causation of disease begins at the cellular level, and follows a complex course whose outcomes must be carefully analyzed to separate out bias and chance. In contrast, homeopathy views disease causation as highly individualized, meaning different things in different settings. In many ways, homeopathy is the poster child of complementary and alternative medicine (CAM) in that it faces the dilemma of justifying itself as a faith-based system, a form of psychotherapy or chaplaincy, a paranormal system that will eventually be explained to the satisfaction of reductionist science, or simply the equivalent of the placebo effect.Less
This chapter identifies the differences that separate homeopathy from biomedicine. The tension between homeopathy and conventional medicine is essentially that of two epistemologically different systems; one whose view of disease causation begins at the metaphysical level, and the other whose view begins at the cellular level. Conventional medicine believes that the causation of disease begins at the cellular level, and follows a complex course whose outcomes must be carefully analyzed to separate out bias and chance. In contrast, homeopathy views disease causation as highly individualized, meaning different things in different settings. In many ways, homeopathy is the poster child of complementary and alternative medicine (CAM) in that it faces the dilemma of justifying itself as a faith-based system, a form of psychotherapy or chaplaincy, a paranormal system that will eventually be explained to the satisfaction of reductionist science, or simply the equivalent of the placebo effect.
Jennifer Barraclough
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780199297559
- eISBN:
- 9780191730023
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199297559.003.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
In many parts of the developed world today, patients with cancer have access not only to standard medical and surgical care but also to a wide range of other therapies that are grounded in a more ...
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In many parts of the developed world today, patients with cancer have access not only to standard medical and surgical care but also to a wide range of other therapies that are grounded in a more ‘holistic’ philosophy of health and healing. Complementary and alternative, holistic, integrative, natural, unorthodox, mind-body-spirit are some of the many names given to a large and varied group of therapies that have become popular in cancer care. Approaches include lifestyle modifications through diet and exercise; psychological and spiritual support for individuals and groups; creative expression through art and music; and a range of other therapies grouped under the umbrella term complementary and alternative medicine (CAM). In this introductory chapter, the philosophy of holistic healthcare is discussed along with the reasons for the increased acceptance and popularity of these therapies, the attitudes of nurses and other professionals in oncology toward CAM, unwanted effects and limitations of the therapies, and some aspects of service delivery.Less
In many parts of the developed world today, patients with cancer have access not only to standard medical and surgical care but also to a wide range of other therapies that are grounded in a more ‘holistic’ philosophy of health and healing. Complementary and alternative, holistic, integrative, natural, unorthodox, mind-body-spirit are some of the many names given to a large and varied group of therapies that have become popular in cancer care. Approaches include lifestyle modifications through diet and exercise; psychological and spiritual support for individuals and groups; creative expression through art and music; and a range of other therapies grouped under the umbrella term complementary and alternative medicine (CAM). In this introductory chapter, the philosophy of holistic healthcare is discussed along with the reasons for the increased acceptance and popularity of these therapies, the attitudes of nurses and other professionals in oncology toward CAM, unwanted effects and limitations of the therapies, and some aspects of service delivery.
Catherine Zollman
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780199297559
- eISBN:
- 9780191730023
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199297559.003.0007
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The task of navigating the maze of potential complementary and alternative medicine (CAM) treatments and integrating CAM into a personal cancer care plan is often complex, time-consuming, and ...
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The task of navigating the maze of potential complementary and alternative medicine (CAM) treatments and integrating CAM into a personal cancer care plan is often complex, time-consuming, and stressful. It can also be empowering, health enhancing, and life transforming. A trusted and wise guide can provide valuable support for people along this journey. There are many facets to the role of a guide, depending on the individuals concerned and their circumstances. These might include helping them decide what they want from CAM, finding the right therapy and therapist, evaluating CAM interventions, preventing adverse effects, and co-ordinating their care while keeping sight of the bigger picture. Family doctors have a range of skills and attributes that make them eminently suited to being such a guide and this can be a tremendously satisfying and rewarding role.Less
The task of navigating the maze of potential complementary and alternative medicine (CAM) treatments and integrating CAM into a personal cancer care plan is often complex, time-consuming, and stressful. It can also be empowering, health enhancing, and life transforming. A trusted and wise guide can provide valuable support for people along this journey. There are many facets to the role of a guide, depending on the individuals concerned and their circumstances. These might include helping them decide what they want from CAM, finding the right therapy and therapist, evaluating CAM interventions, preventing adverse effects, and co-ordinating their care while keeping sight of the bigger picture. Family doctors have a range of skills and attributes that make them eminently suited to being such a guide and this can be a tremendously satisfying and rewarding role.
David H. Gorski
- Published in print:
- 2018
- Published Online:
- September 2018
- ISBN:
- 9780262037426
- eISBN:
- 9780262344814
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262037426.003.0014
- Subject:
- Psychology, Cognitive Psychology
Integrative medicine is becoming more and more accepted by mainstream academic medical centers and funding agencies. This chapter discusses and defines integrative medicine, complementary and ...
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Integrative medicine is becoming more and more accepted by mainstream academic medical centers and funding agencies. This chapter discusses and defines integrative medicine, complementary and alternative medicine (CAM), and science based medicine (SBM). Examples of each are discussed and comparisons are used to explore the pseudoscience behind integrative medicine and CAM.Less
Integrative medicine is becoming more and more accepted by mainstream academic medical centers and funding agencies. This chapter discusses and defines integrative medicine, complementary and alternative medicine (CAM), and science based medicine (SBM). Examples of each are discussed and comparisons are used to explore the pseudoscience behind integrative medicine and CAM.
John Haller
- Published in print:
- 2014
- Published Online:
- November 2015
- ISBN:
- 9780231169042
- eISBN:
- 9780231537704
- Item type:
- book
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231169042.001.0001
- Subject:
- Public Health and Epidemiology, Public Health
Can evidence-based medicine (EBM) and complementary and alternative medicine (CAM) find common ground? This book explores the epistemological foundations of EBM and the challenges these conceptual ...
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Can evidence-based medicine (EBM) and complementary and alternative medicine (CAM) find common ground? This book explores the epistemological foundations of EBM and the challenges these conceptual tools present for both conventional and alternative therapies. It explores a possible reconciliation between their conflicting approaches, and maintains a healthy, scientific skepticism yet finds promise in select CAM therapies. The book elucidates recent research on the placebo effect and shows how a new engagement between EBM and CAM might lead to a more productive medical practice that includes both the objectivity of EBM and the subjective truth of the physician-patient relationship. The book covers key topics in the standoff between EBM and CAM: how and why the double-blinded, randomized clinical trial (RCT) came to be considered the gold standard in modern medicine; the challenge of postmodern medicine as it counters the positivism of EBM; and the politics of modern CAM and the rise of the National Center for Complementary and Alternative Medicine. It conducts an in-depth case study of homeopathy, explaining why it has emerged as a poster-child for CAM, and assesses CAM's popularity despite its poor performance in clinical trials. It concludes with hope, showing how new experimental protocols might tease out the evidentiary basis for the placebo effect and establish a foundation for some reconciliation between EBM and CAM.Less
Can evidence-based medicine (EBM) and complementary and alternative medicine (CAM) find common ground? This book explores the epistemological foundations of EBM and the challenges these conceptual tools present for both conventional and alternative therapies. It explores a possible reconciliation between their conflicting approaches, and maintains a healthy, scientific skepticism yet finds promise in select CAM therapies. The book elucidates recent research on the placebo effect and shows how a new engagement between EBM and CAM might lead to a more productive medical practice that includes both the objectivity of EBM and the subjective truth of the physician-patient relationship. The book covers key topics in the standoff between EBM and CAM: how and why the double-blinded, randomized clinical trial (RCT) came to be considered the gold standard in modern medicine; the challenge of postmodern medicine as it counters the positivism of EBM; and the politics of modern CAM and the rise of the National Center for Complementary and Alternative Medicine. It conducts an in-depth case study of homeopathy, explaining why it has emerged as a poster-child for CAM, and assesses CAM's popularity despite its poor performance in clinical trials. It concludes with hope, showing how new experimental protocols might tease out the evidentiary basis for the placebo effect and establish a foundation for some reconciliation between EBM and CAM.
E. Haavi Morreim
- Published in print:
- 2012
- Published Online:
- May 2015
- ISBN:
- 9780199744206
- eISBN:
- 9780190267551
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:osobl/9780199744206.003.0035
- Subject:
- Philosophy, Moral Philosophy
This chapter examines whether complementary and alternative medicine (CAM) should be covered by health insurance. It first considers the philosophical and practical obstacles to science in medicine ...
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This chapter examines whether complementary and alternative medicine (CAM) should be covered by health insurance. It first considers the philosophical and practical obstacles to science in medicine before discussing the (sometimes) unfounded bias that paints all alternative medicine as quackery and the (sometimes) unwarranted confidence that portrays all conventional medicine as science. In order to respond appropriately to the health-related needs of patients, the chapter argues that health plans must avoid a double standard by using the same criteria for evaluating conventional and alternative modalities. A just system should promote good care within prudent limits by avoiding waste and harm, and by requiring empirical substantiation of the value of all interventions, conventional as well as alternative ones.Less
This chapter examines whether complementary and alternative medicine (CAM) should be covered by health insurance. It first considers the philosophical and practical obstacles to science in medicine before discussing the (sometimes) unfounded bias that paints all alternative medicine as quackery and the (sometimes) unwarranted confidence that portrays all conventional medicine as science. In order to respond appropriately to the health-related needs of patients, the chapter argues that health plans must avoid a double standard by using the same criteria for evaluating conventional and alternative modalities. A just system should promote good care within prudent limits by avoiding waste and harm, and by requiring empirical substantiation of the value of all interventions, conventional as well as alternative ones.
Elena J Ladas and Kara M Kelly
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780199297559
- eISBN:
- 9780191730023
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199297559.003.0006
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Many parents of children and adolescents with cancer investigate complementary and alternative medicine (CAM) to help manage the side effects associated with conventional medications and augment ...
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Many parents of children and adolescents with cancer investigate complementary and alternative medicine (CAM) to help manage the side effects associated with conventional medications and augment their efficacy and to help cope with the diagnosis. Parents pursue CAM to ensure that they have ‘left no stone unturned’ and feel they are doing all they can to help their child fight cancer or to support their child during cancer therapy. The high prevalence of CAM use has also brought attention to the potential for adverse interactions with conventional therapy, particularly when biological therapies (nutrition or herbal supplements) are used in combination with conventional agents. This chapter discusses considerations regarding CAM for children with cancer and describes selected CAM therapies such as acupuncture and acupressure, massage and reflexology, movement therapies, and herbal and nutritional supplements. The use of CAM on survivors of childhood cancer and its role in palliative care are also explored.Less
Many parents of children and adolescents with cancer investigate complementary and alternative medicine (CAM) to help manage the side effects associated with conventional medications and augment their efficacy and to help cope with the diagnosis. Parents pursue CAM to ensure that they have ‘left no stone unturned’ and feel they are doing all they can to help their child fight cancer or to support their child during cancer therapy. The high prevalence of CAM use has also brought attention to the potential for adverse interactions with conventional therapy, particularly when biological therapies (nutrition or herbal supplements) are used in combination with conventional agents. This chapter discusses considerations regarding CAM for children with cancer and describes selected CAM therapies such as acupuncture and acupressure, massage and reflexology, movement therapies, and herbal and nutritional supplements. The use of CAM on survivors of childhood cancer and its role in palliative care are also explored.
Candy Brown
- Published in print:
- 2013
- Published Online:
- September 2013
- ISBN:
- 9780199985784
- eISBN:
- 9780199367801
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199985784.001.0001
- Subject:
- Religion, Religion and Society
This book explains how and why complementary and alternative medicine (CAM) entered the American biomedical mainstream and won acceptance from evangelical Christians—although much of CAM is ...
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This book explains how and why complementary and alternative medicine (CAM) entered the American biomedical mainstream and won acceptance from evangelical Christians—although much of CAM is religious, but not distinctively Christian, and lacks scientific evidence of efficacy and safety. CAM providers make religious or spiritual assumptions about why CAM works: assumptions informed by religions such as Hinduism, Buddhism, and Taoism (Daoism) forged in Asia, or metaphysical spiritual traditions developed in Europe and North America. Before the 1960s, most of the practices considered in this book—yoga, chiropractic, acupuncture, Reiki, Therapeutic Touch, meditation, martial arts, homeopathy, and anti-cancer diets—if encountered at all—were generally dismissed as medically and religiously questionable. What causes practices once classified as illegitimate for medical and religious reasons to be redefined as legitimate routes to physical and spiritual wellness? Promoters of holistic healthcare, or integrative medicine, strategically marketed products to consumers poised to accept effective, spiritually wholesome therapies. Once-suspect health practices gained approval as they were re-categorized as non-religious (though generically spiritual) healthcare, fitness, or scientific techniques, rather than as religious rituals. Although CAM claims are similar to religious claims, CAM gained cultural legitimacy because it is interpreted as science instead of religion. Healthcare consumers, providers, policymakers, and courts need to know not just whether CAM works, but why it is supposed to work because CAM raises ethical and legal questions of informed consent and religious establishment—affecting values of personal autonomy, self-determination, religious equality and voluntarism—in biomedical ethics, tort law, and constitutional law.Less
This book explains how and why complementary and alternative medicine (CAM) entered the American biomedical mainstream and won acceptance from evangelical Christians—although much of CAM is religious, but not distinctively Christian, and lacks scientific evidence of efficacy and safety. CAM providers make religious or spiritual assumptions about why CAM works: assumptions informed by religions such as Hinduism, Buddhism, and Taoism (Daoism) forged in Asia, or metaphysical spiritual traditions developed in Europe and North America. Before the 1960s, most of the practices considered in this book—yoga, chiropractic, acupuncture, Reiki, Therapeutic Touch, meditation, martial arts, homeopathy, and anti-cancer diets—if encountered at all—were generally dismissed as medically and religiously questionable. What causes practices once classified as illegitimate for medical and religious reasons to be redefined as legitimate routes to physical and spiritual wellness? Promoters of holistic healthcare, or integrative medicine, strategically marketed products to consumers poised to accept effective, spiritually wholesome therapies. Once-suspect health practices gained approval as they were re-categorized as non-religious (though generically spiritual) healthcare, fitness, or scientific techniques, rather than as religious rituals. Although CAM claims are similar to religious claims, CAM gained cultural legitimacy because it is interpreted as science instead of religion. Healthcare consumers, providers, policymakers, and courts need to know not just whether CAM works, but why it is supposed to work because CAM raises ethical and legal questions of informed consent and religious establishment—affecting values of personal autonomy, self-determination, religious equality and voluntarism—in biomedical ethics, tort law, and constitutional law.
Colleen Derkatch
- Published in print:
- 2016
- Published Online:
- September 2016
- ISBN:
- 9780226345840
- eISBN:
- 9780226345987
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226345987.003.0003
- Subject:
- History, History of Science, Technology, and Medicine
Chapter Two examines how medical commentators on complementary and alternative medicine (CAM) situate their texts in medical journals, on subjects not typically under the purview of such journals, in ...
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Chapter Two examines how medical commentators on complementary and alternative medicine (CAM) situate their texts in medical journals, on subjects not typically under the purview of such journals, in relation to the historical-professional dynamics that have shaped biomedicine. It examines a set of coordinated journal theme issues on CAM as textual artifacts within the context of professional discourse as instances of constitutive rhetoric, calling forth a medical community that places research on CAM as already under its purview. The chapter examines peer review practices and shows how the theme issues define and categorize CAM in terms that preserve biomedicine’s historical coherence as a firmly defined discipline while simultaneously stretching its limits to reach practices formerly beyond its scope. This process functions as a form epideictic rhetoric, reinforcing conventional community values and the perceived borders separating health practices, even while some community members ostensibly seek to eradicate those borders.Less
Chapter Two examines how medical commentators on complementary and alternative medicine (CAM) situate their texts in medical journals, on subjects not typically under the purview of such journals, in relation to the historical-professional dynamics that have shaped biomedicine. It examines a set of coordinated journal theme issues on CAM as textual artifacts within the context of professional discourse as instances of constitutive rhetoric, calling forth a medical community that places research on CAM as already under its purview. The chapter examines peer review practices and shows how the theme issues define and categorize CAM in terms that preserve biomedicine’s historical coherence as a firmly defined discipline while simultaneously stretching its limits to reach practices formerly beyond its scope. This process functions as a form epideictic rhetoric, reinforcing conventional community values and the perceived borders separating health practices, even while some community members ostensibly seek to eradicate those borders.
Joana Almeida, Pâmela Siegel, and Nelson Barros
- Published in print:
- 2018
- Published Online:
- January 2019
- ISBN:
- 9781447332268
- eISBN:
- 9781447332282
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447332268.003.0010
- Subject:
- Public Health and Epidemiology, Public Health
Sociological research on the governance of complementary and alternative medicine (CAM) in Western societies has vastly increased in the last decades. Yet there has been a less marked expression of ...
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Sociological research on the governance of complementary and alternative medicine (CAM) in Western societies has vastly increased in the last decades. Yet there has been a less marked expression of qualitative studies which put such governance into comparative perspective. Furthermore, research has shown that CAM regulation in Western countries has been very diverse, and so is probably best conceptualised on a spectrum containing several regulatory models. This chapter investigates CAM’s modes of governance in two historically, culturally and politically related countries, Brazil and Portugal. It analyses the extent to which CAM governance has changed over time in these two countries, the main modes of CAM governance in these same countries, and the implications of these modes of CAM governance for CAM professionals themselves and the public. It is concluded that Brazil and Portugal present some similar patterns in the way they govern CAM, but also contrasting differences, particularly in relation to the status of these therapies within the public and the private health care systems, and the implications of this status for CAM professionals themselves and the wider public.Less
Sociological research on the governance of complementary and alternative medicine (CAM) in Western societies has vastly increased in the last decades. Yet there has been a less marked expression of qualitative studies which put such governance into comparative perspective. Furthermore, research has shown that CAM regulation in Western countries has been very diverse, and so is probably best conceptualised on a spectrum containing several regulatory models. This chapter investigates CAM’s modes of governance in two historically, culturally and politically related countries, Brazil and Portugal. It analyses the extent to which CAM governance has changed over time in these two countries, the main modes of CAM governance in these same countries, and the implications of these modes of CAM governance for CAM professionals themselves and the public. It is concluded that Brazil and Portugal present some similar patterns in the way they govern CAM, but also contrasting differences, particularly in relation to the status of these therapies within the public and the private health care systems, and the implications of this status for CAM professionals themselves and the wider public.
Colleen Derkatch
- Published in print:
- 2016
- Published Online:
- September 2016
- ISBN:
- 9780226345840
- eISBN:
- 9780226345987
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226345987.003.0006
- Subject:
- History, History of Science, Technology, and Medicine
This chapter examines scientific boundary work in popular reporting on biomedical research on complementary and alternative medicine (CAM), particularly a special report in Newsweek magazine on the ...
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This chapter examines scientific boundary work in popular reporting on biomedical research on complementary and alternative medicine (CAM), particularly a special report in Newsweek magazine on the “new science of alternative medicine.” It articulates a rhetoric of popular medicine vis-à-vis theoretical models of popular science developed in rhetoric, discourse studies, and social studies of science to argue that health reporting is both typical of and exceptional in science reporting: it is typical because medicine’s research values, generic forms, and institutional structures are closely aligned with those of science, yet it is exceptional because members of the public are significantly more invested as a rhetorical audience of medical reporting, due both to their own bodily experience and expertise, and to their need for health information. The chapter argues that CAM research demonstrates the bidirectional nature of science reporting, in contrast to the unidirectional model proposed by earlier theorists, because the major push for CAM research was motivated, in the first instance, by overwhelming public interest in and use of CAM therapies.Less
This chapter examines scientific boundary work in popular reporting on biomedical research on complementary and alternative medicine (CAM), particularly a special report in Newsweek magazine on the “new science of alternative medicine.” It articulates a rhetoric of popular medicine vis-à-vis theoretical models of popular science developed in rhetoric, discourse studies, and social studies of science to argue that health reporting is both typical of and exceptional in science reporting: it is typical because medicine’s research values, generic forms, and institutional structures are closely aligned with those of science, yet it is exceptional because members of the public are significantly more invested as a rhetorical audience of medical reporting, due both to their own bodily experience and expertise, and to their need for health information. The chapter argues that CAM research demonstrates the bidirectional nature of science reporting, in contrast to the unidirectional model proposed by earlier theorists, because the major push for CAM research was motivated, in the first instance, by overwhelming public interest in and use of CAM therapies.
Colleen Derkatch
- Published in print:
- 2016
- Published Online:
- September 2016
- ISBN:
- 9780226345840
- eISBN:
- 9780226345987
- Item type:
- book
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226345987.001.0001
- Subject:
- History, History of Science, Technology, and Medicine
This book investigates scientific studies of complementary and alternative medicine (CAM) as episodes of scientific boundary work that shift, and then seek to fix, the boundaries between what counts ...
More
This book investigates scientific studies of complementary and alternative medicine (CAM) as episodes of scientific boundary work that shift, and then seek to fix, the boundaries between what counts as proper medical science and what does not. Drawing on scholarship in rhetoric of science and medicine and science and technology studies, it shows how biomedicine itself responds to challenges both to its borders and its social and epistemic authority. Set against the backdrop of evidence-based medicine, it examines the rhetorical constituents of biomedical boundary work by analyzing a set of CAM-themed issues of the journals of the American Medical Association from 1998 and related textual artifacts. To answer the key question, “How does the notion of evidence determine the boundaries of biomedicine, from expert to public contexts?” the book examines the theme issues and related medical and public discourse to illuminate how members of a culturally dominant profession evaluate medical therapies in the face of disciplinary unrest, both within and beyond the borders of their profession. The chapters move from contexts internal to medicine to those external, mapping, sequentially, the historical-professional, epistemological, clinical, and popular dimensions of biomedical boundary work. The book provides a more nuanced, stratified account of the rhetorical negotiation of medical and scientific boundaries. Its main claim is that, despite the willingness of many medical researchers and practitioners to elide distinctions between mainstream and alternative medicine, this research on CAM, and its related activities (publication, clinical practice), ultimately strengthen those distinctions and expand science’s authority in medicine.Less
This book investigates scientific studies of complementary and alternative medicine (CAM) as episodes of scientific boundary work that shift, and then seek to fix, the boundaries between what counts as proper medical science and what does not. Drawing on scholarship in rhetoric of science and medicine and science and technology studies, it shows how biomedicine itself responds to challenges both to its borders and its social and epistemic authority. Set against the backdrop of evidence-based medicine, it examines the rhetorical constituents of biomedical boundary work by analyzing a set of CAM-themed issues of the journals of the American Medical Association from 1998 and related textual artifacts. To answer the key question, “How does the notion of evidence determine the boundaries of biomedicine, from expert to public contexts?” the book examines the theme issues and related medical and public discourse to illuminate how members of a culturally dominant profession evaluate medical therapies in the face of disciplinary unrest, both within and beyond the borders of their profession. The chapters move from contexts internal to medicine to those external, mapping, sequentially, the historical-professional, epistemological, clinical, and popular dimensions of biomedical boundary work. The book provides a more nuanced, stratified account of the rhetorical negotiation of medical and scientific boundaries. Its main claim is that, despite the willingness of many medical researchers and practitioners to elide distinctions between mainstream and alternative medicine, this research on CAM, and its related activities (publication, clinical practice), ultimately strengthen those distinctions and expand science’s authority in medicine.
