Jonas Wayne B, Eisenberg David, Hufford David, Crawford Cindy
Samueli Institute, Alexandria, VA 22314, USA.
Forsch Komplementmed. 2013;20(1):65-72. doi: 10.1159/000348284. Epub 2013 Feb 25.
Medical practices that reside outside the mainstream medical structures have existed for centuries, often waxing and waning in prominence and use for various reasons. Recently, there has been a resurgence in interest and use of such practices in the USA generally referred to under the label of 'complementary and alternative medicine' (CAM). In this article we summarize some of the highlight events that punctuated this resurgence over the last 20 years. As in the past, social forces affecting these trends circulate around power, resources, and scope of practice. However, a prominent feature of this dynamic is a discussion about the role of science and 'evidence-based medicine' in addressing pluralistic healthcare-related practices. In the early years of this period, attempts to formulate the place of CAM practices as they relate to epistemology, nonconventional assumptions about health and healing, and the complexity of understanding 'whole systems' were discussed and often examined. Less attention is being paid to those core assumptions in more recent times. The focus now seems to be on how CAM practices can be judiciously and effectively 'integrated' into mainstream medicine. Examples of how this dynamic is evolving are described.
存在于主流医学结构之外的医疗实践已经存在了几个世纪，由于各种原因，其知名度和应用往往有起有落。最近，在美国，这类实践的兴趣和应用再度兴起，通常被贴上“补充和替代医学”（CAM）的标签。在本文中，我们总结了过去20年中标志着这种复兴的一些重大事件。和过去一样，影响这些趋势的社会力量围绕着权力、资源和实践范围展开。然而，这种动态变化的一个突出特点是关于科学和“循证医学”在处理多元化医疗相关实践中的作用的讨论。在这一时期的早期，人们讨论并经常审视将补充和替代医学实践在认识论、关于健康和治愈的非传统假设以及理解“整体系统”的复杂性方面的地位进行阐述的尝试。近年来，对这些核心假设的关注较少。现在的重点似乎是如何将补充和替代医学实践明智而有效地“整合”到主流医学中。文中描述了这种动态变化是如何演变的例子。
