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法律的困境:验证补充和替代医学以及证据范式的冲突。

Law's Dilemma: Validating Complementary and Alternative Medicine and the Clash of Evidential Paradigms.

机构信息

Faculty of Law, The University of British Columbia, Vancouver, BC, Canada V6T 1Z4.

出版信息

Evid Based Complement Alternat Med. 2011;2011. doi: 10.1155/2011/389518. Epub 2010 Sep 21.

Abstract

This paper examines the (in)compatibility between the diagnostic and therapeutic theories of complementary and alternative medicine (CAM) and a science-based regulatory framework. Specifically, the paper investigates the nexus between statutory legitimacy and scientific validation of health systems, with an examination of its impact on the development of complementary and alternative therapies. The paper evaluates competing theories for validating CAM ranging from the RCT methodology to anthropological perspectives and contends that while the RCT method might be beneficial in the regulation of many CAM therapies, yet dogmatic adherence to this paradigm as the exclusive method for legitimizing CAM will be adverse to the independent development of many CAM therapies whose philosophies and mechanisms of action are not scientifically interpretable. Drawing on history and research evidence to support this argument, the paper sues for a regulatory model that is accommodative of different evidential paradigms in support of a pluralistic healthcare system that balances the imperative of quality assurance with the need to ensure access.

摘要

本文探讨了补充和替代医学(CAM)的诊断和治疗理论与基于科学的监管框架之间的(不)兼容性。具体来说,本文研究了法定合法性与基于科学的卫生系统验证之间的关系,以及其对补充和替代疗法发展的影响。本文评估了验证 CAM 的竞争理论,从 RCT 方法到人类学观点,并认为虽然 RCT 方法可能有益于许多 CAM 疗法的监管,但教条地坚持将这种方法作为唯一合法化 CAM 的方法,将不利于许多 CAM 疗法的独立发展,这些疗法的哲学和作用机制在科学上无法解释。本文引用历史和研究证据来支持这一论点,主张采用一种监管模式,以适应不同的证据范式,支持多元化的医疗保健系统,在确保质量保证的必要性与确保获得服务的需求之间取得平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb45/2952302/c5c9e8ec68d2/ECAM2011-389518.001.jpg

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