Epistemological challenges to integrative medicine: An anti-colonial perspective on the combination of complementary/alternative medicine with biomedicine

摘要

The ideal of combining biomedicine with traditional, complementary and/or alternative medicine (CAM) is now widespread in global healthcare systems. Called integrative medicine (IM) or integrative healthcare (IHC), biomedicine and CAM are being combined in myriad healthcare settings; select medical curricula are incorporating CAM while new 'integrative'physicians are graduating; and widescale health policy on CAM is being created by such organisations as the World Health Organization (WHO). While the IM trend is fast developing, little theory has been applied to examining the epistemology of this new health phenomenon and if, in fact, integration between divergent health paradigms is possible. Drawing on an anti-colonial analysis of new IM settings in Canada, we suggest that fundamental challenges exist to integrating biomedicine and CAM that have been largely ignored in the push for integration. They are: (a) the devaluing of non-biomedical health knowledges; (b) accepting only biomedical evidence; and (c) the creation of a biomedical monolithic worldview.As a part of paradigm appropriation and assimilation, we trace these challenges to the colonial devaluation of Indigenous knowledge. We argue that an anticolonial analysis of IM provides the 'missing link' to understanding the fundamental processes through which biomedicine appropriates CAM, and the reasons it continues to do so.