Saturday, February 19, 2011

The TCM vs. Western medicine debate -- a philosophical and political debate?

Recently, Andy Ho, a senior writer with the Straits Times (ST), wrote a series of opinion pieces questioning the validity of alternative medicine as a form of medical treatment. Unsurprisingly, this series of opinion pieces stirred up a debate in the ST Forum pages over the validity of alternative medicine as a form of medical treatment, especially with Ho's most recent piece that labelled acupuncture (and by extension, traditional Chinese medicine in general?) as a "placebo treatment".

While this debate over the validity of traditional Chinese medicine (TCM) as a form of medical treatment is interesting in itself, what I find more interesting are the possibly underlying issues, philosophical and political, that are involved in this debate. These are the issues that this post will focus attention on. As such, this post will not be taking a stance as to whether TCM, or alternative medicine in general, is a valid and reliable form of medical treatment.

Philosophical/epistemological issue: what should qualify as valid knowledge?

As some of you all may already know, there is a sub-field within the study of philosophy that looks at what should qualify as valid or certain knowledge.

And one main divide in this sub-field would perhaps be the divide between empiricism and rationalism. Proponents of the former generally argue that only what can be observed by the senses should qualify as valid knowledge while proponents of the latter are more sceptical about sensory data since such data can be "false" (for example, optical illusions) and instead argue that valid knowledge should be knowledge that is congruent with reason.

Another significant divide in this sub-field would be the divide between positivism/scientism and non-positivism/scientism. Essentially, proponents of the former argue that only knowledge that is congruent with scientific reasoning or that can be scientifically proven should qualify as valid knowledge. In contrast, the proponents of non-positivism/scientism is of the stance that although scientific knowledge may indeed be a form of valid knowledge, it is not the only form of valid knowledge; knowledge derived from other sources or methods may be just as valid.

Evidently, the latter divide is relevant with regards to this debate over the validity of TCM, or alternative medicine in general, as a form of medical treatment vis-a-vis Western medicine, in that the general impression perhaps that while Western medicine is scientifically proven, the former is however not as scientifically proven. And thus, to those who abide by the stance of positivism/scientism, this will imply that TCM, or alternative medicine in general, is not as valid or reliable a form of medical treatment as Western medicine. On the other hand, as can be seen from the letters written in to the ST Forum to defend TCM, there are those who will argue that although TCM may not be as scientifically proven, this does not however imply that it is not a valid or reliable form of medical treatment.

Of course, while there are similarities between the positions adopted in the "positivism/scientism versus non-positivism/scientism" and "Western medicine versus alternative medicine" debates, I suppose that one main difference is however that the latter is not just a theoretical debate but involves people's health and lives.

Political/cultural issue: rise of the non-West?

As was mentioned earlier, the general impression is perhaps that while Western medicine, which generally has its roots in Western societies, is scientifically proven, TCM, or alternative medicine, is however not as scientifically proven. The former is thus regarded as the dominant mainstream model of medical treatment while non-Western medical knowledge or treatment is regarded as "alternative medicine".

The process by which the above impression was created was, according to the postcolonial theorists, a highly political one. Essentially, it may be argued that along with their political colonisation of non-European territories in the past, the European/Western colonialists also colonised the minds of those living in those territories. This means that along with colonisation, traditional forms of knowledge, including medical knowledge, and cultures in the colonised terrorities were relegated to a non-dominant, if not inferior, position vis-a-vis Western knowledge and culture. And as postcolonial theorists may argue, the legacy and aftermath of this process is still felt today and efforts should be made to reverse it.

In light of the above, the increased push to have non-Western forms of medical treatment be recognised as an equally valid model of medical treatment besides that of Western medicine may be seen as part of the effort to reverse the dominance of Western knowledge and culture set in place during the colonial period. Of course, this push to reverse Western dominance is especially relevant in recent times, in light of the economic and political rise of non-Western powers such as China and India (interestingly enough, to the best of my knowledge, when talking about "alternative medicine", people are usually referring to traditional Indian or Chinese medical treatments and not really traditional African medical treatment).

Here, it is worthwhile to pause and think for a while: if it is recognised that Western and non-Western medicine are different but equally valid models of medical treatment, would they be complimentary or competing models? Or would they be just different models?

Moving on, so far it would seem that , for at least the foreseeable future, Western medicine will retain its dominant "mainstream" position but who knows what the future may hold?


That is all I have to say for now. Hopefully, what I have written above has shed new or a different light on the issue in question and provoked some thought in you all.


chillycraps said...

I think there is a deep-seated preference in favour of western medicine, that is very institutionalised. Just the fact that TCM practitioners can't issue medical certificate already tells a lot.

angry doc said...

Chiropractic and homeopathy have "Western" roots, yet they see supporters in our local population.

I suspect that the "cultural" divide that sees people supporting alternative medicine is not just an issue of race or east-vs-west, but also one of distrust of "establishment".

angry doc said...

Ha, I think chillcraps' post just proved my point!

Certainly the alternative medicine establishment (no, that's not an oxymoron) is trying to market itself under the banner of "health freedom" - sod the science, let the consumers decide!

Anonymous said...

What about the main difference between "Western" and traditional Chinese medicine: the rigorous tests and trials that are required for a (western) drug to pass before it is allowed to even be licensed for use?

I wouldn't dismiss the efficacy of certain types of traditional medicine, but given a choice, I would almost always choose the "Western" option simply because I have greater confidence in what the drug actually contains (i.e. an isolated compound as opposed to a mixture of unknowns in a herbal root), how it was manufactured (as opposed to questionable preservation methods employed in traditional medicine), its consistent quality and dosage, its safety, efficacy and contraindications.

TCM may have its merits but there is no reason why it should be exempt from scientific scrutiny.

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