Kaptchuk T J, Eisenberg D M
Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, W/K-400, Boston, MA 02215, USA.
Ann Intern Med. 2001 Aug 7;135(3):189-95. doi: 10.7326/0003-4819-135-3-200108070-00011.
Medicine has become interested in unconventional healing practices, ostensibly because of recent demographic research that reveals a thriving medical market of multiple options. This essay presents a historical overview of medical pluralism in the United States. Consistent evidence is examined suggesting that unconventional medicine has been a persistent presence in U.S. health care. Despite parallels with the past, the recent widespread interest in alternative medicine also represents a dramatic reconfiguration of medical pluralism-from historical antagonism to what might arguably be described as a topical acknowledgment of postmodern medical diversity. This recent shift may have less to do with acknowledging "new" survey data than with representing shifts in medicine's institutional authority in a consumer-driven health care environment. This essay is an introduction to a discussion of a taxonomy of contemporary U.S. medical pluralism, which also appears in this issue.
医学已经开始关注非传统的治疗方法,表面上是因为最近的人口统计学研究揭示了一个有着多种选择且蓬勃发展的医疗市场。本文对美国医学多元主义进行了历史概述。经审视的一致证据表明,非传统医学在美国医疗保健领域一直存在。尽管与过去有相似之处,但最近对替代医学的广泛兴趣也代表了医学多元主义的巨大重构——从历史上的对立到可以说是对后现代医学多样性的一种表面认可。这种最近的转变可能与承认“新的”调查数据关系不大,而更多地与在消费者驱动的医疗保健环境中体现医学机构权威的转变有关。本文是对当代美国医学多元主义分类法讨论的引言,该分类法也刊载于本期。