The Sociology of Traditional, Complementary and Alternative Medicine

Abstract

Complementary and alternative medicine (CAM) and traditional medicine (TM) are important social phenomena. This article reviews the sociological literature on the topic. First, it addresses the question of terminology, arguing that the naming process is a glimpse into the complexities of power and history that characterize the field. Second, focusing on the last 15 years of scholarship, it considers how sociological research on users and practitioners of TM/CAM has developed in that time. Third, it addresses two newer strands of work termed here the ‘big picture’ and the ‘big question’. The big picture includes concepts that offer interpretation of what is happening at a societal level to constrain and enable observed patterns of social practice (pluralism, integration, hybridity and activism). The big question, ‘Does it work?’, is one of epistemology and focuses on two developing fields of critical enquiry – first, social critiques of medical science knowledge production and, second, attempts to explain the nature of interventions, i.e. how they work. Finally, the article examines the role of sociology moving forward.

Epistemic cultures in complementary medicine: knowledge-making in university departments of osteopathy and Chinese medicine

“…The question, ‘does it work?’, increasingly haunts professional practice in the CAM fields (Gale, 2014) as the pressure to produce evidence of therapeutic efficacy has mounted with the growing dominance of the evidence-based medicine (EBM) movement in medicine and other practice-related fields. EBM was originally defined in 1992 as an approach that aimed to ‘de-emphasize intuition, unsystematic clinical experience, and pathophysiological rationale’ in clinical decision-making, instead stressing ‘evidence from clinical research’ (Evidence Based Medicine Working Group, 1992, in Howick, 2011, p. 15).…”

Cancer self-health programmes: an ethos for negotiating multiplicities of healthcare

“…Most notably, the relationship between CAM and biomedicine has been defined by a long history of mutual distrust and conflict (Saks 2003) and has frequently been viewed through simplified binary oppositions (Gale 2014) (e.g. scientific/quack; CANCER SELF-HEALTH PROGRAMMES 5 reductionist/holistic; cure/care etc.).…”

“…While more recent commentaries have focused on the lack of efficacy for many CAM modalities and provided a vocal critique of the dangers of using unproven treatments and therapies (e.g. Goldacre 2008;Singh and Ernst 2009), others have been able to emphasise the importance of historical, social and cultural factors related to the ongoing use of CAM (Bivins 2007;Gale 2014;MacArtney and Wahlberg 2014;Saks 2003;Sointu 2012;Wahlberg 2007). This literature highlights how epistemological conflicts about what constitutes acceptable modes of healthcare are frequently juxtaposed against a person with cancer's desire (or obligation) to do the best they can, at that time, for their health and wellbeing (Broom 2009 a and b;McClean 2005).…”

“…Part of the problem of bringing CAM modalities and biomedicine together is that the aim or outcome of that integration has not always clearly defined (Coulter et al 2010), or that their coming together is too frequently based on an asymmetric understanding (in favour of biomedicine) (Gale 2014). As a consequence the degree of success to which CAM modality might be integrated with biomedicine has often depended upon a complex array of factors, including the CAM discipline involved and its receptiveness to being subsumed within the biomedical framework (Coulter et al 2010;Tyreman 2011).…”

“…As a consequence the degree of success to which CAM modality might be integrated with biomedicine has often depended upon a complex array of factors, including the CAM discipline involved and its receptiveness to being subsumed within the biomedical framework (Coulter et al 2010;Tyreman 2011). Even where there is more potential for mutual transformation (Gale 2014) the success or otherwise has come down to individual preferences of those (in biomedicine) charged with implementing the policy (Broom and Adams 2009;Smithson et al 2010). As a result, while there have been successful attempts to integrate some CAM modalities and biomedicine, there is little evidence to suggest that these successes should not be treated as localised or marginalised, rather than a model that could be generalised.…”