The University of Edinburgh, UK.
Health (London). 2022 Mar;26(2):244-262. doi: 10.1177/1363459320931916. Epub 2020 Jun 7.
Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM's growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM's 'publics', however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public's effort to legitimate CAM within the UK's National Health Service: the campaign to 'save' Glasgow's Centre for Integrative Care (CIC). Campaigners skilfully intertwined 'experiential' knowledge of the value of CIC care with 'credentialed' knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance.
在当代卫生系统中,关于补充和替代医学(CAM)的资金和监管的争论中,合法性问题显得尤为突出。CAM 的普及程度不断提高,这通常被描绘为临床、国家和科学合法性与更广泛的公众合法性之间潜在的冲突。然而,在对 CAM 的合法性进行研究时,CAM 的“公众”往往被置于次要地位,而只是作为他人合法化努力的晴雨表。本文将重点介绍英国国民保健制度中一个公众为使 CAM 合法化所做的努力:为“拯救”格拉斯哥综合护理中心(CIC)而开展的运动。活动家们巧妙地将 CIC 护理价值的“经验性”知识与最佳临床和管理实践方面的“认证”知识交织在一起。他们这样做的方式既务实又纯粹,既改革又对立。我们认为,合法化是一种协商性的实践,而不是一种稳定的状态,是由各种公众在更广泛的医疗保健治理中参与知识生产和决策制定的矩阵时所承担的劳动。