Medical+Pluralism

toc = Medical Pluralism =

Definition
The existence of multiple healing systems and options within a society. Pluralism has always existed in health care systems; there have always been multiple practitioners to choose from and multiple ways of understanding health and healing. While the ideal pluralism suggests multiple healing options competing on a level playing field, in modern societies this is often not the case.

History
Origins and development in the United States In the west, orthodox medicine (@biomedicine) has enjoyed a hegemonic position for over a century, but "before the early 19th century, U.S. medicine was a shifting collection of coexisting options not rigidly or permanently defined: A broad spectrum of practitioners, diverse in social background and intellectual attainment" (Kaptchuk & Eisenberg 189 ). Professional care was not limited to today's mainstream biomedicine. Rather, botanical healers, midwives, apothecaries, bonesetters, inoculaters, and ethnic practitioners, such as Native American and slave doctors, provided to their immediate communities through alternative and complementary practices. Even with the Enlightenment’s goal of universalizing the benefits of science, the democratic fervor of the post-Revolution United States allowed alternative therapies to thrive with biomedicine looming.

In the early 19th century, "U.S. medical pluralism was a war zone" (Kaptchuk & Eisenberg 190). In 1847, the American Medical Association (AMA) was founded, in an attempt to protect orthodox medicine from "other" alternative therapies, combating any deviance with their Committee on Quackery (ref). Until recently, one of the medical community's main concerns was combating alternative therapies. An alliance with the government through the U.S. Food and Drug Administration secured biomedicine's elite status for years to come. Though the elitism of the modern U.S. medical system is exclusive, Charles Leslie, in his essay Medical Pluralism in World Perspective, reminds us:

"The triumph of modern medicine has been to improve care by applying scientific research and new forms of professional organization to biomedical problems. Since the last quarter of the 19th century this has led to effective knowledge for controlling and curing infectious diseases. and to the complex technology that characterizes the modern hospital. Efforts to increase the scope and to improve the quality of health care have sought to eliminate or severely restrict “irregular practices”, so that ideally local medical systems will simply become extensions of a nationally and internationally standardized medical system." (191).

In the 1960s, alternative medicines (anything other than mainstream biomedicine) started regaining respect after the period of "eclipse" that began when organized biomedicine's relationship with the state became stronger (Cant and Sharma, 1999). Medical professionals "no longer uniformly categorizes alternative medicine as deviant, marginal, fringe, fraudulent, and of little consequence. Rather, the profession has begun to realize that it is a cohabitant in what seems to be a postmodern medical network in which consumer preferences dictate the service profile" (Kaptchuk & Eisenberg, 189). The results of a survey conducted in 1990 and 1997, assessing the use of and expenditures for alternative medicine, showed an increase from 34 to 42 percent, confirming the increasing respect for "alternative" therapies.

Case Studies
FROM ALTERNATIVE TO COMPLEMENTARY: MODERN MEDICINE AND THE GLOBAL PERSPECTIVE- CASE STUDY

"In recent years reformers have drawn heavily on the example of the People’s Republic of China, where traditional Chinese medicine has been incorporated in the state sanctioned medical system. The idea is to consider “irregular medicine” in a more objective sociological manner. All medical systems can then be conceived of as pluralistic structures in which cosmopolitan medicine is one component in competitive and complimentary relationships to numerous “alternative therapies”. This way of conceiving the medical system opens the door to serious practical studies on how these therapies and their practitioners provide resources for health care planning. The argument is especially strong for developing countries where local medical systems are largely composed of indigenous practices and the immulation of costly institutional planning from industrial countries is culturally and economically inappropriate" (Leslie, 191).


 * ALTERNATIVE MEDICINE GOES MAINSTREAM**

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