Ijaz Nadine
Department of Law and Legal Studies, Carleton University, 1125 Colonel By Drive, Ottawa ON K1S 5B6, Canada.
Soc Sci Med. 2022 Oct;311:115310. doi: 10.1016/j.socscimed.2022.115310. Epub 2022 Aug 26.
This work presents a neo-Gramscian theorization of therapeutic hegemony and subalternity, deployed with reference to the practice of homeopathy in North America by two increasingly-professionalized but unorthodox health occupational groups: Homeopaths and Naturopaths. Despite both occupations' contemporary sociopolitical subordination to dominant biomedicine, the continent's Homeopaths have been less successful in their professionalization efforts, owing partly to homeopathy-their primary therapeutic modality-being widely considered incommensurable with biomedical science. For Naturopaths, who increasingly align themselves with biomedical evidentiary norms, homeopathy represents but one among several central therapeutic modalities. Using survey (n = 588) and interview (n = 31) data from an empirical case involving Homeopaths and Naturopaths in Ontario, Canada-a jurisdictional outlier in which both groups are regulated by the state-the author employs the theory of therapeutic subalternity to illuminate the internal struggles faced by homeopathy-practising occupations in a biomedically-dominant context. Despite their regulated standing, Homeopaths' negative media characterization and ongoing lack of access to third-party insurance reimbursement contribute to ongoing frustration among practitioners, expressed as displaced envy toward the province's more elite, homeopathy-practising Naturopaths. However, while most Naturopaths express appreciation for homeopathy's clinical merits, many appear increasingly reluctant to use or discuss the practice to prevent compromise to their profession's therapeutic legitimation.
本文提出了一种关于治疗霸权和次等地位的新葛兰西理论,并参照北美顺势疗法的实践进行阐述。北美有两个日益专业化但非正统的健康职业群体:顺势疗法从业者和自然疗法从业者。尽管这两个职业在当代社会政治层面都从属于占主导地位的生物医学,但该大陆的顺势疗法从业者在其职业化努力中不太成功,部分原因在于顺势疗法——他们的主要治疗方式——被广泛认为与生物医学科学不相容。对于越来越认同生物医学证据规范的自然疗法从业者来说,顺势疗法只是几种核心治疗方式之一。作者利用来自加拿大安大略省一个涉及顺势疗法从业者和自然疗法从业者的实证案例的调查数据(n = 588)和访谈数据(n = 31)——这是一个司法上的异类,两个群体都由该州监管——运用治疗次等地位理论来阐明在生物医学占主导地位的背景下,从事顺势疗法的职业所面临的内部斗争。尽管顺势疗法从业者具有受监管的地位,但他们在媒体上的负面形象以及持续无法获得第三方保险报销,导致从业者持续感到沮丧,表现为对该省更精英的、从事顺势疗法的自然疗法从业者的错位嫉妒。然而,虽然大多数自然疗法从业者对顺势疗法的临床优点表示赞赏,但许多人似乎越来越不愿意使用或讨论这种疗法,以避免损害其职业的治疗合法性。