Adams Jon, Hollenberg Daniel, Lui Chi-Wai, Broom Alex
School of Population Health, University of Queensland, Brisbane, Australia.
J Manipulative Physiol Ther. 2009 Nov-Dec;32(9):792-8. doi: 10.1016/j.jmpt.2009.10.006.
This article argues for the importance of examining the phenomenon of integrative health care in broader social and historical contexts. The authors examine mainstream approaches to identify patterns of integrative medicine and criticize them for their neglect of clashes among different philosophical paradigms and the wider social contexts that govern health care in practice. The authors outline a framework and highlight the values of a critical social science perspective in deepening our understanding of recent transformations in health care practice and issues surrounding biomedicine and complementary/alternative medicine (including chiropractic, naturopathy, massage, acupuncture/oriental medicine, etc) and traditional medicine. A critical social science perspective pays special attention to complex power relations, inclusionary/exclusionary strategies, and interprofessional dynamics in medicine. Drawing upon recent research findings, the authors illustrate how such a perspective reveals the intricacies and tensions that surround the integration of different paradigms of health care practice. The authors summarize the importance of situating integrative health care in structural contexts and affirm their commitment to a critical social science approach.
本文主张在更广泛的社会和历史背景下审视综合医疗保健现象的重要性。作者研究了主流方法以识别整合医学模式,并批评它们忽视了不同哲学范式之间的冲突以及在实际医疗保健中起支配作用的更广泛社会背景。作者概述了一个框架,并强调了批判性社会科学视角在深化我们对医疗保健实践近期转变以及围绕生物医学与补充/替代医学(包括整脊疗法、自然疗法、按摩、针灸/东方医学等)和传统医学的问题的理解方面的价值。批判性社会科学视角特别关注医学中的复杂权力关系、包容/排斥策略和跨专业动态。作者借鉴近期的研究结果,说明了这种视角如何揭示围绕不同医疗保健实践范式整合的复杂性和紧张关系。作者总结了将综合医疗保健置于结构背景中的重要性,并申明他们对批判性社会科学方法的坚持。