Paper short abstract:

Analysing a Canadian case of acupuncture regulation, we use postcolonial theory to examine the privileging of biomedical and non-immigrant practitioners using traditional medicine-rooted therapies. We propose a series of regulatory strategies aimed at prioritizing traditional knowledge protection.

Paper long abstract:

Many complementary and alternative medicine (CAM) interventions are rooted in traditional medicine (TM) systems. United Nations agencies have recommended that nations take steps to regulate both TM and CAM practitioners to enhance 'safety, quality and effectiveness'; but also to take steps to protect TM knowledge, and prevent further misappropriation of TM practices. The statutory regulation of TM-rooted CAM practices raises complex, but under-examined, questions at the clinical/cultural intersect. With reference to the case of acupuncture regulation in Ontario, Canada, we explore several regulatory complexities arising from: a) TM practices' globalized movement outside of their regions of origin; b) their increased adoption by biomedically-trained health care professionals; and c) the growing body of biomedical evidence substantiating these practices' efficacy. Our work engages critical theories of professionalization and boundary work within a postcolonial framework to discuss an extensive document review and thirty key informant interviews. By examining state risk discourses and regulatory boundary construction for acupuncture; the question of English-language fluency requirements for immigrant practitioners; and the negotiation of standards across acupuncture-practising professions, our work points to a systemic privileging of biomedical and non-immigrant practitioners. In addition, we find that the jurisdictional struggles between biomedical and TM acupuncture practitioner groups are fundamentally epistemic; and carry the weight of historical colonial relationships. In this light, we propose a series of strategies that regulators may engage in negotiating equitable approaches to CAM and TM regulation that prioritize protection of traditional knowledge, while seeking to accommodate biomedical practitioners and ensure the protection of the public.