Bounding Biomedicine: Evidence And Rhetoric In The New Science Of Alternative Medicine

Hardcover | April 21, 2016

byColleen Derkatch

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During the 1990s, an unprecedented number of Americans turned to complementary and alternative medicine (CAM), an umbrella term encompassing chiropractic, energy healing, herbal medicine, homeopathy, meditation, naturopathy, and traditional Chinese medicine. By 1997, nearly half the US population was seeking CAM, spending at least $27 billion out of pocket.

Bounding Biomedicine centers on this boundary-changing era, looking at how consumer demand shook the health care hierarchy. Drawing on scholarship in rhetoric and science and technology studies, the book examines how the medical profession scrambled to maintain its position of privilege and prestige, even as its foothold appeared to be crumbling. Colleen Derkatch analyzes CAM-themed medical journals and related discourse to illustrate how members of the medical establishment applied Western standards of evaluation and peer review to test health practices that did not fit easily (or at all) within standard frameworks of medical research. And she shows that, despite many practitioners’ efforts to eliminate the boundaries between “regular” and “alternative,” this research on CAM and the forms of communication that surrounded it ultimately ended up creating an even greater division between what counts as safe, effective health care and what does not.

At a time when debates over treatment choices have flared up again, Bounding Biomedicine gives us a possible blueprint for understanding how the medical establishment will react to this new era of therapeutic change.

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During the 1990s, an unprecedented number of Americans turned to complementary and alternative medicine (CAM), an umbrella term encompassing chiropractic, energy healing, herbal medicine, homeopathy, meditation, naturopathy, and traditional Chinese medicine. By 1997, nearly half the US population was seeking CAM, spending at least $27 ...

Colleen Derkatch is assistant professor of rhetoric in the Department of English and vice chair of the Research Ethics Board at Ryerson University in Toronto, Canada.
Format:HardcoverDimensions:264 pages, 9 × 6 × 0.9 inPublished:April 21, 2016Publisher:University Of Chicago PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:022634584X

ISBN - 13:9780226345840

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Extra Content

Table of Contents

Acknowledgments
Introduction

CAM Enters Biomedicine
Rhetoric at the Fringes of Medicine
Mapping Biomedical Boundaries
Analyzing a Rhetorical Moment
Preview of Chapters

1 Evidence, Rhetoric, and Disciplinary Boundaries
Biomedicine’s Shifting Terrain: From Intuition and Experience to “Evidence”
Quantitative Evidence and Jurisdictional Control
Medical-Professional Strategies of Exclusion

2 Patrolling Professional Borders
Constituting the Medical Profession
Peer Review as Professional Self-Regulation
Categorizing Complementary and Alternative Medicine
CAM à la Carte

3 Scientific Methods at the Edge of Biomedicine
Idealizing Evidence: Scientific Methods and CAM Research
Idealizing Research: The Genre of the Randomized Controlled Trial Report
Method as a Boundary Argument
Efficacy as a Boundary Object

4 Precincts of Care in CAM Research
Models of Clinical Practice
Regulating Rhetorical Interaction
Purifying Placebo Effects
Patient Choice across Medical Models
Dietary Supplements and Patient Agency

5 Professional Borders in Popular Media
The Newsweek Special Report as a Biomedical “Discourse Moment”
Reporting the New Science
“Does it Really Work?” Constructing Biomedicine in the Media
Mapping Boundaries of Expertise in Newsweek
Displaced Stories about CAM and CAM Research

Conclusion: Boundaries as Entry Points
Notes
Works Cited
Index

Editorial Reviews

“Derkatch’s Bounding Biomedicine is a valuable rhetorical analysis of how the boundary between conventional and alternative medicine has been drawn, patrolled, and renegotiated. Focusing on the moment in 1998 when the Journal of the American Medical Association and its eleven associated journals published special issues on complementary and alternative medicine, Bounding Biomedicine offers a deeply textured account of how two incommensurable frames of medical practice met. Derkatch’s book sets a new standard for research in medical rhetoric.”