Abstract
The utilization of alternative medical therapies and practitioners has increased dramatically in the U.S. in the last two to three decades. This trend seems paradoxical when one considers the rapid advances taking place in biomedical knowledge and technology during this same time period. Observers both inside and outside of the medical profession have attempted to explain the rising popularity of alternative medicine by proposing that it signals a growing sense of dissatisfaction and disenchantment with professional biomedical practices on the part of the lay public. This paper challenges this thesis and offers an alternative explanation, arguing that the rise of alternative medicine is a consequence of the success and expanding influence of biomedicine rather than its failure and declining authority. The argument presented draws primarily on Ulrich Beck’s “risk society” perspective and theory of “reflexive modernization,” with specific attention to his analysis of the “reflexive scientization” process. The application of this perspective allows us to understand the emergence and development of alternative medicine as an unanticipated consequence of the process of reflexive biomedicalization in the late modern era.
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Notes
Beck (1992, 158−159) sees this practice as characteristic of primary scientization, when contradictions, ambiguities, etc. “need not imply any loss in the credibility of scientific rationality claims so long as the sciences can succeed in handling the mistakes, errors and criticism of their practical consequences essentially within science”.
Support for this latter possibility can be found in two sources. First, Paul Starr’s (1982) study of the historical development of professional allopathic medicine in the U.S. reveals that the popularity of sectarian medical approaches peaked when they were subjected to the most intense attacks by the regular profession and declined during the period of “convergence and accommodation” between the regulars and sectarians that began at the beginning of the twentieth century. Second, Clarke et al. (2003) view the co-optation of elements of alternative medicine by biomedicine as one dimension of the broad-based structural trend they identify as “biomedicalization.” However, I would emphasize the difficulty of making future projections based on past patterns or conceptualizations of over-arching structural imperatives.
National surveys of the U.S. population indicate that about 85% of U.S. adults identify with religion, 86% believe in a divine power, and 56% say they pray at least once a day (NORC 2005, 169, 171, 442). By way of international comparison, 82.4% of U.S. adults state that they “gain comfort and strength from religion,” while only 30.6 of adults in Sweden agree with this statement (World Values Survey 2000).
References
Astin, J.A. 1998. Why patients use alternative medicine: Results of a national study. Journal of the American Medical Association 279(19): 1548–1553.
Avina, R.L., and L.J. Schneiderman. 1978. Why patients choose homeopathy. Western Journal of Medicine 128: 366–369.
Balint, M. 1957. The doctor, his patient and the illness. New York: International Universities Press.
Beck, U. 1992. Risk society: Towards a new modernity (trans: Ritter, M.). London: Sage.
Beck, U. 1994. The reinvention of politics: Towards a theory of reflexive modernization. In Reflexive modernization: Politics, tradition, and aesthetics in the modern social order, ed. U. Beck, A. Giddens, and S. Lash, 1–55. Stanford: Stanford University Press.
Beck, U. 1996. The reinvention of politics: Rethinking modernity in the global social order. Cambridge: Polity.
Bratman, S. 1997. Alternative medicine: How well does it live up to its own ideals? Alternative Therapies in Health and Medicine 3: 127–128.
Cassileth, B.R., E.J. Lusk, T.B. Strouse, and B.J. Bodenheimer. 1984. Contemporary unorthodox treatments in cancer medicine: A study of patients, treatments, and practitioners. Annals of Internal Medicine 101: 105–112.
Clarke, A.E., J. Fishman, J. Fosket, L. Mamo, and J. Shim. 2003. Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine. American Sociological Review 68: 161–194.
Conrad, P., and J. Schneider. 1980. Deviance and medicalization: From badness to sickness. St. Louis: C.V. Mosby.
Davidoff, F. 1998. Weighing the alternatives: Lessons from the paradoxes of alternative medicine. Annals of Internal Medicine 129(12): 1068–1070.
Duggan, R. 1995. Complementary medicine: Transforming influence or footnote to history? Alternative Therapies in Health and Medicine 1: 28–33.
Eisenberg, D.M., R.C. Kessler, C. Foster, F.E. Norlock, D.R. Calkins, and T.L. Delbanco. 1993. Unconventional medicine in the United States—Prevalence, costs, and patterns of use. New England Journal of Medicine 328(4): 246–252. http://content.nejm.org.proxy2.library.uiuc.edu/cgi/content/full/328/4/246 (accessed November 1, 2007).
Eisenberg, D.M., R.B. Davis, S.L. Ettner, S. Appel, S. Wilkey, M. Van Rompay, and R.C. Kessler. 1998. Trends in alternative medicine use in the United States, 1990−1997: Results of a follow-up national survey. Journal of the American Medical Association 280(18): 1569–1575.
Eisenberg, D.M., R. Kessler, M.I. Van Rompay, T. Kaptchuk, S.A. Wilkey, S. Appel, and R.B. Davis. 2001. Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey. Annals of Internal Medicine 135(5): 344–351.
Engel, G.L. 1977. The need for a new medical model: A challenge for biomedicine. Science 1976(4286): 129–136.
Engel, G.L. 1980. The clinical application of the biopsychosocial model. American Journal of Psychiatry 137(5): 535–544.
Eskinazi, D.P. 1998. Factors that shape alternative medicine. Journal of the American Medical Association 280(18): 1621–1623.
Foucault, M. 1991. Governmentality. In The Foucault effect, ed. G. Burchell, C. Gordon, and P. Miller, 87–194. Brighton: Harvester Wheatsheaf.
Freidson, E. 1970. The profession of medicine: A study in the sociology of applied knowledge. New York: Dodd, Mead and Co.
Furnham, A., and R. Bhagrath. 1993. A comparison of health beliefs and behaviours of clients of orthodox and complementary medicine. British Journal of Clinical Psychology 32: 237–246.
Furnham, A., and J. Forey. 1994. The attitudes, behaviors, and beliefs of patients of conventional versus complementary alternative medicine. Journal of Clinical Psychiatry 50: 458–469.
Furnham, A., and C. Smith. 1988. Choosing alternative medicine: a comparison of the beliefs of patients visiting a general practitioner and a homeopath. Social Science and Medicine 26: 685–689.
Giddens, A. 1990. The consequences of modernity. Cambridge: Polity.
Giddens, A. 1994. Living in a post-traditional society. In Reflexive modernization: Politics, tradition, and aesthetics in the modern social order, ed. U. Beck, A. Giddens, and S. Lash, 56–109. CA: Stanford University Press.
Goffman, E. 1967. Where the action is. In Interaction ritual: Essays on face-to-face behavior, 149–270. Garden City: Doubleday.
Illich, I. 1976. Medical nemesis: The expropriation of health. New York: Pantheon.
Jensen, P. 1990. Alternative therapy for atopic dermatitis and psoriasis: Patient-reported motivation, information source and effect. Acta Dermato-Venerological 70: 425–428.
Jonas, W.B. 1998. Alternative medicine—learning from the past, examining the present, advancing to the future. Journal of the American Medical Association 280(18): 1616–1618.
Kaptchuk, T.J. 2002. The placebo effect in alternative medicine: Can the performance of a healing ritual have clinical significance? Annals of Internal Medicine 136(11): 817–825.
Kaptchuk, T.J., and D.M. Eisenberg. 1998. The persuasive appeal of alternative medicine. Annals of Internal Medicine 129(12): 1061–1065.
Kirmayer, L.J. 2004. The cultural diversity of healing: Meaning, metaphor and mechanism. British Medical Bulletin 69: 33–48.
Kleinman, A. 1984. Indigenous systems of healing: Questions for professional, popular, and folk care. In Alternative medicines: Popular and policy perspectives, ed. J.W. Salmon. New York: Tavistock.
Knight, F. 1921. Risk, uncertainty, and profit. Boston: Houghton Mifflin.
Komesaroff, P.A. 1995. Troubled bodies: Critical perspectives on postmodernism, medical ethics, and the body. Durham: Duke University Press.
Luce, R., and H. Raiffa. 1958. Games and decisions. New York: Wiley.
Lynch, M. 2000. Against reflexivity as an academic virtue and source of privileged knowledge. Theory, Culture, and Society 17(3): 26–54.
Lyng, S. 1990. Holistic health and biomedical medicine: A countersystem analysis. Albany: State University of New York Press.
Marquis, M.S., A.R. Davies, and J.E. Ware. 1983. Patient satisfaction and change in medical-care provider: A longitudinal study. Medical Care 21: 821–829.
McGuire, M.B. 1988. Ritual healing in suburban America. New Brunswick: Rutgers University Press.
Murray, R.H., and A.J. Rubel. 1992. Physicians and healers: Unwitting partners in health care. New England Journal of Medicine 326: 61–64.
NORC. 2005. General Social Surveys, 1972−2004: Cumulative codebook. Chicago: National Opinion Research Center.
Oths, K. 1994. Communication in a chiropractic clinic: How a DC treats his patients. Culture Medicine and Psychiatry 18: 83–113.
Park, C.M. 2002. Diversity, the individual, and proof of efficacy: Complementary and alternative medicine in medical education. American Journal of Public Health 92(10): 1568–1572.
Parsons, T. 1951. The social system. Glencoe: Free.
Ramsey, P. 1974. The patient as person. New Haven: Yale University Press.
Riesmann, F. 1994. Alternative health movements. Social Policy 24: 53–57.
Romm, A. 2000. Growing professionalism of alternative practitioners: A personal account. Complementary Health Practice Review 6(1): 41–43.
Starr, P. 1982. The social transformation of American medicine. New York: Basic Books.
Sutherland, L.R., and M.J. Verhoef. 1994. Why do patients seek a second opinion or alternative medicine? Journal of Clinical Gastroenterology 19: 194–197.
Vincent, C., and A. Furnham. 1996. Why do patients turn to complementary medicine? An empirical study. British Journal of Clinical Psychology 35: 37–48.
Weber, M. [1921]1968. Economy and society, 3 vols. Totowa: Bedminster.
White, K.L. 1988. The task of medicine: Dialogue at Wickenburg. Menlo Park: Henry J. Kaiser Family Foundation.
World Values Survey. 2000. Official data file. v.20090914. Madrid: World Values Survey Association.
Zola, I.K. 1972. Medicine as an institution of social control. Sociological Review 20: 87–504.
Zola, I.K. 1991. Bringing our bodies and ourselves back in: Reflections on a past, present, and future “medical sociology”. Journal of Health and Social Behavior 32: 1–16.
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Lyng, S. Reflexive Biomedicalization and Alternative Healing Systems. Bioethical Inquiry 7, 53–69 (2010). https://doi.org/10.1007/s11673-010-9215-9
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DOI: https://doi.org/10.1007/s11673-010-9215-9