Online research in philosophy

Modern scientific medicine is increasingly challenged by complementary and alternative therapies. Reviewing policy options for contemporary healthcare development, the World Health Organization's first global strategy on traditional and alternative medicine, released in May 2002, advocates integration. However, experience in East Asia, the only part of the world where state of the art modern scientific facilities are commonly found alongside thriving traditional practices, reveals that medical integration can take several forms. To clarify the available policy options, this article categorizes those forms, identifying three types of integration (unification, equalization and subjugation), plus one type of non-integration (marginalization). It marks out a zone of balanced healthcare development that cuts across two of the integrationist types, and comprises non-discriminatory state treatment of separate but linked sectors of traditional and modern medicine. The article closes by exploring arguments for and against locating state policy in this zone, and holds that policy should be situated here for medical practices that can meet broadly acceptable professional standards, demonstrate an existing social demand, and generate an adequate supply of medical practitioners, possibly through some state subsidy.

In the first part of this paper, I will sketch the main features of traditional models of evidence, indicating idealizations in such models that I regard as doing more harm than good. I will then proceed to elaborate on an alternative model of evidence that is functionalist, complex, dynamic, and contextual, which I will call DYNAMIC EVIDENTIAL FUNCTIONALISM. I will demonstrate its application to an illuminating example of scientific inquiry, and defend it from some likely objections. In the second part, I will use that alternative to solve a variety of classic and contemporary problems in the literature on scientific evidence having to do with the empirical basis of science and the use of evidence in public policy.

Homeopathic medicine is based on the two principles that “like cures like” and that the potency of substances increases in proportion to their dilution. In November 2009 the UK Parliament’s Science and Technology Committee heard evidence on homeopathy, with several witnesses arguing that homeopathic practice is “unethical, unreliable, and pointless”. Although this increasing scepticism about the merits of homeopathy is to be welcomed, the unethical effects of funding homeopathy on the NHS are even further-reaching than has been acknowledged.

In "Propositions about Images" Philip Cam accurately analyzes and criticizes the grounds I gave, in the works he cites, for my denial that we have privileged access (of any sort) to anything deserving to be called a mental image. He shows that I did not deal properly with the question of how I would interpret the ostensive force of "this" and "that" in an introspective judgment of the sort: "Now it looks like this and now it looks like that." What can one be ostending or referring to in such a case, if not to an image (or some feature of an image)?

Energy medicine includes a broad variety of complementary/ alternative medicine (CAM) therapies, such as acupuncture, kinesiology, and spiritual healing. The term "energy medicine" derives from the perceptions and beliefs of therapists and patients that there are subtle, biological energies that surround and permeate the body. Recent research is confirming that these therapies can be helpful in treating many problems for which conventional medicine may have no cures. Growing numbers of doctors are integrating these therapies in their practices.

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM.

Against the backdrop of the political intrigue in biomedicine’s ascendancy to orthodoxy, this article examines its contemporary rapprochement with Complementary Alternative Medicine (CAM), in the move toward an integrated medical regime. It also identifies and explores factors underlying the rapprochement, as well as different ethical challenges that face integrated medicine. It argues that a major approach to tackling these challenges hinges on devising just and equitable criteria for evaluating the efficacy of plural therapeutic paradigms inherent in CAM models. This is attainable through a policy that encourages creating public health policy and medical personnel deliberately exposed as part of their curriculum to the philosophical and theoretical features of diverse therapeutic traditions.

The convergence of complementary and alternative medicine (CAM) and evidence-based medicine (EBM) is a prominent feature of healthcare in western countries, but it is currently undertheorised, and its implications have been insufficiently considered. Two models of convergence are described – the totally integrated evidence-based model (TI) and the multicultural-pluralistic model (MP). Both models are being incorporated into general medical practice. Against the background of the reasons for the increasing utilisation of CAM by the public and by general practitioners, TI-convergence is supported and MP-convergence is rejected. MP-convergence is epistemologically and clinically incoherent, and it cannot be regulated. It is also inconsistent with developments in the legal determination of the standard of care for both diagnosis/treatment and disclosure. These claims concerning MP-convergence are justified by the fact that science is not a member of the group of perspectives or world-views which postmodernism treats as equally valid, and this is especially important for healthcare.

Complementary and alternative medicines (CAM) have become increasingly popular over recent decades. Within bioethics CAM has so far mostly stimulated discussions around their level of scientific evidence, or along the standard concerns of bioethics. To gain an understanding as to why CAM is so successful and what the CAM success means for health care ethics, this paper explores empirical research studies on users of CAM and the reasons for their choice. It emerges that there is a close connection to fundamental principles of medical ethics. The studies also highlight that CAM’s holistic ontology of health and illness has an empowering effect on people in caring for their health, and on an even deeper level, safeguards against biomedicine’s reducing image of oneself as biological body-machine. The question is raised what lessons bioethics should draw from this emancipatory social movement for its own relationship with biomedicine.