Programme

(T044)
By Other means: On Complementary or Alternative Medicines (CAM)
Location 117a
Date and Start Time 03 September, 2016 at 14:00
Sessions 2

Convenor

  • Maria Wemrell (Lund University) email

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Discussant Ayo Wahlberg (University of Copenhagen)

Short Abstract

Medical knowledges and technologies complementary or alternative to biomedical ones have so far received limited attention in STS. This track welcomes papers on various aspects of construction, translation, collaboration, co-existence or conflict of CAM in biomedical and/or other medical settings.

Long Abstract

Inquiry into Complementary or Alternative Medicines (CAM) has so far not been a major focus of STS. Inquiry into how science and technology "could be otherwise" (Woolgar 2015), may have much to gain, however, from further studies of how complementary or alternative medical knowledges and technologies are construed, developed, pursued, communicated and translated, while collaborating, co-existing and/or conflicting with biomedical settings. How do CAM practices intersect and combine with biomedical networks? How have CAM knowledges and/or products travelled, been (re)negotiated and tinkered with (Mol 2010) in worlds of evidence-based and globalized medicine? How might CAM practices contribute to notions of body multiple (Mol 2002) or to post-phenomenological study of embodied processes of perception and interpretation of body, health and disease? How might CAM practice be framed as conducive or resistant to biopower? This track welcomes papers on various such aspects of medical knowledge and technologies complementary or alternative to biomedical ones.

SESSIONS: 3/3

This track is closed to new paper proposals.

Papers

Miscarriage Prevention: Point of Contact between Biomedicine and Traditional Medicine

Author: Wen-Ching Sung (University of Toronto)  email

Short Abstract

Doctors in Taiwan, China and Vietnam tend to overuse progesterone as miscarriage prevention without clinical evidences. Based on fieldwork in Taiwan, the researcher found that this medication is an object linking modern medicine with the traditional view of the fetus.

Long Abstract

Doctors in Taiwan, China and Vietnam tend to overuse progesterone as miscarriage prevention without clinical evidences. Based on fieldwork in Taiwan, the researcher found that this medication is an object linking the modern medicine with the traditional view of the fetus. Medicalization of early pregnancy is an outcome of such a fusion. The finding may shed light on the varieties of the seemingly universal reproductive biomedicine.

In standard biomedicine textbooks, early miscarriage is associated with a defective fetus or abnormal chromosomes. So proactive medical intervention of miscarriage is not always in patients' best interest. Securing the fetus (an'tai), however, is a pillar in the traditional Chinese medicine's management of pregnancy. Chinese medicine assumes that miscarriage, which often resulted from human errors, is preventable. In addition to being a key element in Chinese medicine for women, an'tai is also part of folk healing and religious beliefs. It contains a variety of daily taboos for pregnant women and their families to observe. All these practices assume that the fetus is highly vulnerable and that people should help secure it. In Taiwan, progesterone is interestingly called "the medicine for securing the fetus" (an'tai yiao) by lay people and doctors. This medication is thus a point of contact between biomedicine and traditional knowledge, and the intersection between the two views of the fetus.

A comparative analysis of formalising acupuncture and homeopathy training in the UK and Portugal: the localised dimension of professionalisation

Authors: Assaf Givati (University of Portsmouth)  email
Joana Almeida (Royal Holloway, University of London)  email

Short Abstract

This investigation compares the formalising of acupuncture and homeopathy training in the UK and in Portugal while emphasising another, often overlooked, dimension - the role of the local setting with its distinctive cultural-political make up.

Long Abstract

Sociological research of complementary and alternative medicine (CAM) has focused on CAM practitioners' efforts to professionalise within biomedically-dominated healthcare systems, a process characterised by structural/organisational changes and alterations to the knowledge or content of work. This investigation compares the formalising of acupuncture and homeopathy training in the UK and in Portugal while emphasising another, often overlooked, dimension - the role of the local setting with its distinctive cultural-political make up.

This study objectives are: (1) to compare and contrast the formalisation process of CAM therapies in two European countries, the UK and Portugal; (2) to consider the role of the political, historical and cultural context in explaining parallels and differences between the two settings; (3) drawing in particular on Bourdieu's 'field' concept, to enhance the theoretical conceptualisation of professional projects in CAM.

While reflecting on empirical findings gathered between 2008-2015 in the UK and Portugal, this investigation draws on a current documentary textual analysis of acupuncture and homeopathy courses' syllabi as well as educational guidelines and documents published by the main professional bodies representing the two practitioner-groups.

A preliminary analysis of the data points at different levels of state intervention and control in CAM's regulation in the UK and Portugal as well as differences in the evolvement of formalising education in both countries: in the UK CAM's undergraduate programmes were already established in the 1990s but have recently witnessed a significant challenge and decline, while in Portugal, prompted by direct government regulation, such programmes are only recently being created.

Hearts at Risk: risk and prevention of heart disease in Scandinavian conventional and Chinese Medicine

Author: Maria Wemrell (Lund University)  email

Short Abstract

In Sweden, acupuncture methods have entered conventional health-care, while discussions of complementary ontologies have generally not. This project looks at notions of prevention, health and disease, related to the heart, expressed in courses in Chinese (TCM) acupuncture and in biomedical training.

Long Abstract

In Sweden, as in many other countries, practices of acupuncture have to a certain extent been integrated into conventional health-care. Under the concept of Medical Acupuncture (White 2009), acupuncture needling is made legitimate while Chinese concepts such as qi, yin/yang and meridians are not. Space is thus made for method, but not for alternative or complementary ontologies. This project, located at the Medical Faculty, directs attention to questions of ontological difference, similarity and discussion, as expressed in Scandinavian courses in Chinese (TCM) acupuncture as well as in biomedical training. Focus lies on conceptions of prevention, risk, health and disease, related to the heart. Ethnographic material is analyzed through concepts of metaphor (Lakoff & Johnson 2003/1980, Pritzker 2007), key symbol (Ortner 1973), ontology (Johannessen, Helle & Lázar 2006; Mol 2002) and lines (Ingold 2015, 2007).

Alternative medical devices: Rendering meridians, parasites, toxins and other invisibilities

Authors: Jaroslav Klepal (Czech Academy of Sciences)  email
Tereza Stockelova (Institute of Sociology of the Czech Academy of Sciences)  email

Short Abstract

We focus on alternative medical devices using electricity as their diagnostic or therapeutic agent that thrive on the margins of the Czech healthcare system. Following Mol, we discuss how these devices enact entities such as living bodies, pathogens, and diseases with(out) respect to biomedicine.

Long Abstract

Technologies, translated, and embodied into various medical devices, have become highly visible features of biomedicine as it is practiced today. Medical devices have reshaped diagnostic and therapeutic practices, enacted human bodies in particular ways and helped new forms of biosociality to emerge (Casper and Morrison 2010). Yet, there have also been medical devices that supplement, challenge, or even subvert biomedicine. Based on our ethnographic fieldwork at the interfaces between biomedical and alternative therapeutic practices in the Czech Republic, we discuss 'alternative medical devices' that use electricity as their diagnostic and/or therapeutic agent, such as Akudiast, Stimul, Salvia, Akustim, Bicom, and Super Ravo Zapper. Some of these devices were designed, patented, and circulated only in the state socialist Czechoslovakia; others have been manufactured and marketed world-wide. Some of them work not only with human but also animal bodies. Some of them are used by lay people at home; others are to be operated by trained practitioners (sometimes physicians only) in consultation rooms. Foregrounding electrical energy, impedance, and electromagnetic waves we look at how these devices make particular versions of human body, organic as well as inorganic agents, and diseases "visible, audible, tangible, knowable" (Mol 2002), and how these enactments travel through and create partial connections within the Czech healthcare system largely dominated by biomedicine.

The proponents of Master Mineral Solution and the ineffectiveness of anti-MMS information campaigns

Author: Michal Stevove (University College London)  email

Short Abstract

The paper compares online communication strategies of proponents and opponents of complementary and alternative medicines (CAM) in Czech and Slovak Republics and provides an explanation as to why pro-CAM communication is more successful.

Long Abstract

As suggests the rise in use of complementary and alternative medicines (CAM), and subsequent outbreaks of vaccine-preventable diseases, efforts to tackle anti-science movements in society yield little success. This paper investigates the reasons of such ineffectiveness. It looks at two communities in Czech and Slovak Republics, studying and comparing their online communication strategies, with the primary sources being forums, websites and Facebook groups. The first community are users of Master Mineral Solution, sold as a remedy for malaria, cancer and other ailments. The second community are people who try to convince proponents of this CAM that they are misled. The study focuses on the differences between how pro-CAMs communicate among themselves and how anti-CAMs communicate towards the pro-CAMs. The analysis is symmetrical, as it looks at the two sides with the same conceptual tools.

Overall, the analysis shows that the two sides hold different positions to knowledge creation. The three identified misalignments are the understanding of who is an expert, what constitutes an evidence and how much the communication is inclusive. I group these under McKechnie's 'rules of play' and claim that we first need to understand those rules to be able to communicate with pro-CAM side effectively. The responsibility, however, also rests on public institutions which need to foster trust and public engagement to decrease the attractiveness of CAM. The continued usage of the deficit model of communication runs contrary to this. As such, my primary suggestion is that communication strategies should be revised to engage with the pro-CAM community via a position of mutual respect.

Reflexivity, tinkering, and good care: How CAM expertise is negotiated in runners’ (self)care practices

Author: Patricia Campbell (Red Deer College)  email

Short Abstract

Through an ethnographic study of running communities, this paper uses the concept of tinkering to examine the role of CAM expertise in laypersons’ negotiation of multiple medical realities in their (self)care practices.

Long Abstract

While many STS scholars have focused on governance and formal interventions, this paper attends to how laypersons participate in shaping technoscience of their own accord. The analysis focuses specifically on the role that CAM expertise plays in laypersons’ reflexive negotiation of multiple medical realities in their (self)care practices in two communities: the online network, Running Mania, and the face-to-face running group, the Red Deer Runners Club. The theoretical framework builds on science governance discussions regarding the nature of expertise by examining laypersons’ attitudes toward CAM practitioners and then applies the concept of tinkering to settings of spontaneous, user-based participation. The ethnographic methods include participant observation of the Running Mania site and thirty-seven email/face-to-face interviews. The findings indicate that most runners value the expertise of CAM practitioners, including the expert practices appropriated by Western medical practitioners, such as physiotherapists. Their individualized and active approach to care seem to articulate well with runners’ embodied understandings, often better than evidence-based medical approaches. While these expert discourses are sometimes perceived as “controversial” because they fall outside a formal scientific framework, this tension seems relatively absent in runners’ care practices as various ways of doing the body coexist to achieve “good care”; one form of knowing does not necessarily have to “win out” as the dominant form of expertise. In reflexively tinkering with multiple medical discourses in their self (care) practices, these laypersons participate in shaping expertise and (re)producing a multiplicity of medical realities that blur the boundaries between among Western and CAM medicine.

This track is closed to new paper proposals.