Lay Acquiescence to Medical Dominance: Reflections on the Active Citizenship Thesis

Abstract

In this paper we demonstrate that the drive to regulate alternative and complementary forms of health care, in particular assessments of their safety and efficacy, reflects an entrenched medical dominance that excludes lay people from exercising active citizenship regarding determinations of the effectiveness of these therapeutic approaches. However, the almost virtual silence of lay perspectives in debates surrounding the efficacy of these therapies cannot be explained by a unidirectional process of professional exclusion alone. Using findings from qualitative research conducted with people living with Parkinson's disease, we argue that lay acquiescence to medical expert dominance plays a role in militating against the individual's exercise of active citizenship in shaping health policy. Our analysis also demonstrates that attention to lay meanings of efficacy, as well as to aspects of personal biography, such as age and health status, are factors that shape lay acquiescence.