Advertisement

Medicine, Health Care and Philosophy

, Volume 14, Issue 2, pp 209–217 | Cite as

Values in complementary and alternative medicine

  • Stephen TyremanEmail author
Scientific Contribution

Abstract

In recent years so-called Complementary and Alternative Medicine (CAM) practices have made significant political and professional advances particularly in the United Kingdom (UK): osteopathy and chiropractic were granted statutory self-regulation in the 1990s effectively giving them more professional autonomy and independence than health care professions supplementary to medicine; the practice of acupuncture is widespread within the National Health Service (NHS) for pain control; and homoeopathy is offered to patients by a few General Practitioners alongside conventional treatments. These developments have had a number of consequences: one is that both CAM and Conventional and Orthodox Medical (COM) professions have had to reappraise their professional identity. In manual therapy for example, questions have been asked about the differences between physiotherapy, osteopathy and chiropractic, and what the justification is for having separate professions. A wider question concerns the relationship between CAM and COM; are CAM distinct professions or should they, as has happened to a limited extent in the UK, be absorbed into the broader field of ‘Medicine’ or ‘Health Care’ as adjunctive therapies. CAM professions have also had to develop, implement and enforce codes of practice for practitioners and clarify the scope of practice within a profession. At the heart of these issues lies the need to identify and clarify professional values. A key claim of CAM professions is that their practice is distinct and the outcome of treatment at least as effective and in many cases more effective than with conventional therapies. In addition, what counts as effective outcome is often different from conventional medical understanding, involving more subtle humanitarian considerations, for example. Three values are identified as being commonly held across CAM professions. These are: offering ‘natural’ treatment; being patient rather than disease focussed; and being holistic. However, these may not be as distinctive of CAM as is claimed either because the meaning is unclear or because COM professions claim similar values. The paper argues that the values that inform ‘good practice’ and ‘effective outcome’ should be seen as distinct components of professional competence. This has implications for establishing professional identity and codes of practice.

Keywords

CAM Complementary and alternative medicine COM Conventional and orthodox medicine Holistic Natural health Professional values Patient-centred care 

References

  1. Capra, F. 1975. The tao of physics. Berkeley: Shambhala.Google Scholar
  2. Chua, S.A., and A. Furnham. 2008. Attitudes and beliefs towards complementary and alternative medicine (CAM): A cross-cultural approach comparing Singapore and the United Kingdom. Complementary Therapies in Medicine 16: 247–253.PubMedCrossRefGoogle Scholar
  3. Corbyn, Z. 2009 Science boost for alternative medicine Bscs Times Higher Education, London Issue 5th February 2009.Google Scholar
  4. Department-of-Health. 2001. Government response to the House of Lords select committee on science and technology’s report on complementary and alternative medicine. London: Her Majesty’s Stationary Office. Retrieved from http://www.archive.official-documents.co.uk/document/cm51/5124/5124.htm.
  5. Edgar, A. Professional values, aesthetic values, and the ends of trade. Medicine, Health Care and Philosophy. This Issue.Google Scholar
  6. Fadlon, J., C.M. Granek, I. Roziner, and M.A. Weingarten. 2008. Familiarity breeds discontent: Senior hospital doctors’ attitudes towards complementary/alternative medicine. Complementary Therapies in Medicine 16: 212–219.PubMedCrossRefGoogle Scholar
  7. Fulford, K.W.M., G. Stanghellini, and M. Broome. 2004. What can philosophy do for psychiatry? World Psychiatry 3: 130–135.PubMedGoogle Scholar
  8. Greaves, D. 1979. Disease concepts models and classification in western medicine–illustrated by reference to pulmonary tuberculosis and coronary heart disease. Society for the Social History of Medicine Bulletin (24): 31–35.Google Scholar
  9. Greaves, D. 1996. Mystery in western medicine. Aldershot: Avebury.Google Scholar
  10. Joos, S., D.C. Eicher, B. Musselmann, and M. Kadmon. 2008. Development and implementation of a ‘curriculum complementary and alternative medicine’ at the Heidelberg medical school. Forsch Komplementarmed 15: 251–260.CrossRefGoogle Scholar
  11. Launer, J. 2002. Narrative-based primary care. Oxford: Radcliffe Medical Press.Google Scholar
  12. Licciardone, J.C. 2007. Osteopathic research: Elephants, enigmas, and evidence. Osteopathic Medicine and Primary Care. BioMed Central, BioMed Central.Google Scholar
  13. Lindlahr, H. 1975. Philosophy of natural therapeutics revised. Saffron Walden: The C. W. Daniel Company Ltd.Google Scholar
  14. Mcmullin, E. 1995. Underdetermination. Journal of Medicine and Philosophy 20: 233–252.PubMedGoogle Scholar
  15. Porter, R. 1989. Health for sale: Quackery in England 1660–1850. Manchester & New York: Manchester University Press.Google Scholar
  16. Sadler, J.Z. 1997. Recognizing values: A descriptive-causal method for medical/scientific discourses. Journal of Medicine and Philosophy 22: 541–565.PubMedGoogle Scholar
  17. Schaffner, K.F. 2002. Assessments of efficacy in biomedicine: The turn toward methodological pluralism. In The role of complementary & alternative medicine, ed. D. Callahan. Washington DC: Georgetown University Press.Google Scholar
  18. Sellman, D. 2010. Professional values and nursing. Medicine, Health Care and Philosophy. doi: 10.1007/s11019-010-9295-7.
  19. Sewitch, M.J., M. Cepoiu, N. Rigillo, and D. Sproule. 2008. A literature review of health care professional attitudes toward complementary and alternative medicine. Complementary Health Practice Review 13: 139–154.Google Scholar
  20. Thomas, K., and P. Coleman. 2004. Use of complementary or alternative medicine in a general population in great Britain. Results from the national omnibus survey. Journal of Public Health 26: 152–157.PubMedCrossRefGoogle Scholar
  21. Thomas, K., J.P. Nicholl, and P. Coleman. 2001. Use and expenditure on complementary medicine: A population based survey. Complementary Therapies in Medicine 9: 2–11.PubMedCrossRefGoogle Scholar
  22. Tyreman, S.J. 2000. Promoting critical thinking in health care: Phronesis and criticality. Medicine, Health Care and Philosophy 3: 117–124.CrossRefGoogle Scholar
  23. Tyreman, S.J. 2008. Valuing osteopathy: What are (professional) values and how do we teach them? International Journal of Osteopathic Medicine 11: 90–95.CrossRefGoogle Scholar
  24. Wolpe, P.R. 2002. Medical culture and cam culture: Science and ritual in the academic medical center. In The role of complementary and alternative medicine: Accommodating pluralism, ed. D. Callahan. Washington DC: Georgetown University Press.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Dean of Osteopathic Education Development at the British School of Osteopathy (BSO)LondonUK

Personalised recommendations