A Theoretical Model of Biomedical Professionals' Legitimization of Alternative Therapies

Abstract

Alternative therapies receive mixed recognition from biomedical professionals. In this article, a theoretical model of biomedical professionals' legitimization of alternative therapies is proposed, drawing on the sociologies of profession, science, and innovation. The model consists of four components corresponding to the different ways of legitimizing a certain alternative therapy: the biomedicine model, the paradigm shift model, the specialization model, and the technical adoption model. As a case study, biomedical professionals' legitimization of acupuncture is explained according to the model. The proposed model is designed to clarify the analysis of issues concerning the legitimacy of various alternative therapies as medical therapies. In summary, biomedical professionals' attitudes toward alternative therapies may be studied utilizing the four models in this article. These models may represent not only different patterns of legitimization among professionals but also different phases of the development of alternative therapies as a component of scientific knowledge. Biomedical professionals would first attempt to legitimize alternative therapies in the biomedicine model, and, if that is not feasible, they would shift to other models depending on various factors. If basic research advances and a paradigm shift can be expected, these professionals would move to the paradigm shift model, and if clinical research provides solid proof of its efficacy and safety, they would shift to the technical adoption model. If professionals inquire more into the theoretical frameworks of alternative therapies such as Chinese medicine and come to appreciate them as comprehensive and valid systems of medicine, they would shift to the specialization model. The analysis of biomedical professionals' legitimization of alternative therapies would also demonstrate the change of biomedical professionals' definition of science, scientific therapy, and scientifically proven efficacy. Some alternative therapies' mechanism of efficacy is not biomedically proven. Other alternative therapies' advocated effects might include the placebo effect and are difficult to evaluate by double-blind studies. Analysis of how biomedical professionals legitimize alternative therapies by utilizing the four models would clarify problems of establishing policies and regulations related to alternative therapies. Today, the emergence of highly effective alternative therapies seems to weaken the biomedicine model, and this makes current regulation centered around biomedicine obsolete. If the technical adoption model becomes prevalent, policy and regulations will mostly concern the effectiveness of alternative therapies. Practitioners of alternative therapies would be qualified not by theoretical knowledge but by the accuracy and safety of their practices. If the specialization model becomes strong, legal definition of medical practice would be expanded to include unorthodox systems of medicine. If the paradigm shift model is the most supported, there will be a problem of how to distinguish those alternative therapies that possibly trigger a paradigm shift and are worth legalizing from those that do not. Nevertheless, it is not easy to determine to what extent alternative therapies should be legalized on the basis of efficacy, to what extent the technical adoption model can be applied, to what extent therapeutic activity should have proven theoretical explanation as in the paradigm shift model or biomedicine model, and to what extent the current health care system should be open to non-biomedical schemes as in the specialization model. The most practical solution for now would appear to be for biomedical professionals and practitioners of alternative therapies to acknowledge that the basis of their legitimacy argument is varied. A temporary standard for efficacy and safety, as well as a standard level of knowledge of both biomedical and alternative theory required for its practice, should be set out for each individual therapy.