Abstract
Medical pluralism does not only mean the presence of multiple therapies but also the variety of health discourses and norms. By analysing the rhetoric of active participants in the Estonian health field, we portray the diverse discourses in defining and positioning complementary and alternative medicine (CAM) in relation to biomedicine (BM). On a scale of attitudes, five different positions of CAM and BM emerge. Both ends of the spectrum dominantly represent a system-level view characterized by distinct categories, opposition, and labelling. In between, integrative positions focus more on an individual’s personal needs by combining and “taking the best out of” all available knowledge systems. The presence of these competing discourses poses several challenges for health communication. Meanings offered by CAM-related health approaches are increasingly visible and influential as unlicensed health workers and laypeople contribute more to public communication due to the openness of social media. On the other hand, critics of CAM and proponents of scientific thinking have mobilized to set boundaries to defend the authoritative position of scientific medicine. Our analysis suggests that using system-level categories supports polarization, which could lead people to seek alternative explanations based on their individual experiences, and thus feeding distrust towards medicine and doctors.
Highlights
Medical pluralism does mean the presence of multiple therapies and the variety of health discourses and norms
complementary and alternative medicine (CAM) has occasionally been criticized by sceptics because of its anti-scientific and potentially dangerous nature (Lewis, 2019; Cano-Orón, 2019)
We ask the following: how are CAM and BM depicted by diverse spokespeople and in different contexts? How does boundary work manifest in communication? The overview of these depictions helps in discussing some challenges for health communication and highlights some warning signals regarding the potentially increasing polarization of representations of CAM and BM
Summary
Medical pluralism does mean the presence of multiple therapies and the variety of health discourses and norms. Recent decades have witnessed increasingly diverse health-related opinions and expert positions in the mass media (Kline, 2006; Briggs & Hallin, 2016), a greater presence of “lay experts” (Prior, 2003), as well as networks of people sharing their experiences online (Griffiths et al, 2012). This increasing diversity in the context of health has been depicted as postmodern fragmentation and the emergence of microcultures (Thompson & Troester, 2002). Despite the pluralism at the individual level, critique and warnings have been raised at the public level, following the logic of “boundary work” (Gieryn, 1983), so that “the contestation of expertise is perhaps nowhere more pronounced than in the field of health and well-being” (Vuolanto et al, 2020: 509)
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