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Analysis

Postmodernism and Medicine

POSTMODERN PROMOTION OF
ALTERNATIVE MEDICINE*
Dnal P. OMathna

OSTMODERNISM IS BOTH A PHILOSOPHY AND A CUL-

tural movement. The philosophy is sometimes impenetrable, at other times incomprehensible, apparently
deliberately so. One philosopher put it this way: Postmodernism is long on attitude and short on argument . . .
[and] remains conveniently ill-defined.1 Regardless,
many postmodern catch-phrases have caught on as popular sound-bites: Create your own reality. Question
authority. If it works for you, thats all that matters.
Find yourself within. Theres no right answer. It
doesnt seem to matter what these slogans mean, or if
they mean anything. Many in society have drifted into
accepting postmodernism without ever hearing the term
or knowing what it entails. The growing acceptance of alternative medicine within the healthcare system stands
as a prime example of how a nebulous philosophy like
postmodernism can have significant practical effects. It
stands as testimony to the fact that beliefs have consequences, as the following true story demonstrates.
A woman in her thirties awakens one morning with
severe abdominal pain. The intensity of the pain itself
makes it difficult for her to get out of bed. She takes
some painkillers and tries to sleep, but the pain persists.
She gets more and more worried, so she calls her doctor.
A nurse answers and courteously inquires about her
symptoms and recent activities.

The nurse tells the woman there is nothing seriously


wrong with her. She doesnt need to see the doctor, nor
take any medication. Instead, she has an opportunity to
explore her body and the meaning of her pain. The real
source of her problem is her stress and anxiety about the
pain. She needs to get in touch with her inner self and
be enlightened by what her body can tell her. She should
take two or three days to relax and focus on herself, and
all will be well. In fact, this could be a turning point in
her life if she learns more about herself and how to listen
to her body.
Not impressed by what the nurse tells her, the
woman insists on talking to someone else. She eventually gets an appointment with the doctor who discovers
a huge growth on her ovary and recommends immediate
surgery. The growth is very fragile, bursting immediately
upon removal. If it had burst while inside her, the consequences could have been much worseserious infection, at least, and possibly death. After surgery, the pain
disappeared and has not recurred.
Incidents like this occur as a direct result of postmodern thinking. The nurse had accepted some of the
new approaches to health and healing widely promoted
today, even in academic institutions.
*Revised and updated version of Postmodern impact:
health care. In: The Death of Truth. McCallum D, ed. Minneapolis, MN: Bethany; 1996:5884.
This account, told to the author by the victim, involves
postmodern ideas, but also malpractice. No suggestion is being
made that postmodernism or alternative medicine necessarily
leads to malpractice. The story still exemplifies the dangers of
adopting postmodern beliefs in health care.

Dnal P. OMathna is Professor of Bioethics and Chemistry at Mount Carmel


College of Nursing, Columbus, Ohio. Queries to the author should be sent to him
at Mount Carmel College of Nursing, 127 South Davis Avenue, Columbus, OH
43222, or by e-mail to domathuna@mchs.com.
THE SCIENTIFIC REVIEW OF ALTERNATIVE MEDICINE

Vol. 4, No. 1 (Spring/Summer 2000)

22

OMathna: Postmodern Promotion of Alternative Medicine


More than eighty nursing schools teach Therapeutic
Touch, one particular alternative therapy to be discussed
below. The majority of U.S. medical schools include
courses in alternative medicine, with very little critical
analysis incorporated.2 Hospital wellness programs include many alternative therapies, like Tai Chi, yoga,
Qigong, and meditation. How could this happen in an
era of evidence-based medicine and validated outcomes?
Part of the answer lies in the postmodern arguments
used to promote alternative medicine to a society increasingly accepting of postmodern ideology.

ALTERNATIVE MEDICINE AND POSTMODERNISM


Postmodernism is not the source of the ideas underlying
alternative medicine. Rather, postmodernism is the vehiclea Trojan horse bringing dubious alternative therapies to prominence and acceptability in hospitals and
on campuses today. Modern medicine has long known
the claims and views of much of alternative medicine,
but rejected them for solid scientific reasons.
Alternative medicine has been defined so broadly that
it includes legitimate and effective approaches to health,
such as diet, exercise, and relaxation techniques. Such
broad definitions tend to obscure the boundary between
the acceptable and the absurd. Proponents of alternative
medicine cannot demonstrate objectively that many of
their therapies work. But in a postmodern environment,
demonstrable effectiveness becomes irrelevant, and in addition, unsubstantiated theories like those often used in alternative medicine cannot be freely critiqued in the postmodern atmosphere of total acceptance of all possibilities.
Postmodernism rejects many of the ways by which a
worldviewor a medical therapycan be assessed and
judged. Bad research, therefore, carries as much weight
as properly structured and controlled studies. Likewise,
with the postmodern denial that truth even exists, arguments against an alternative therapy carry no more
weight than the cries of one religion against another. Almost anything can gain credibility because scientific
methodology is declared nothing more than a cultural
biasnamely that of western Europe.

PARADIGM SHIFT
Postmodernism calls for a radical restructuring of the
way we think. Postmodernists argue that reality is not as
rigid as we once thought. They claim that the idea of objective reality is just a metaphor to help us communicate.

23

Such a view of reality is compatible with alternative


medicine in a way modernism never was. Rather than
seeking to find the truth, postmodernism claims everything (or nothing) is true. Brugh Joy, MD, calls attention
to different views people have and concludes: The
shocker here is not that these people embody particular
contradictions but the more basic fact that no belief systems actually represent reality; they are only structured
ideas created out of a small part of the human minds potential.3 Once people stop trying to discover reality and
accept the existence of multiple realities, Joy sees powerful consequences: At this level of consciousness we can
create anything we desire.4
Dolores Krieger, cofounder of Therapeutic Touch
(TT), admits that this new way of viewing reality has
benefited TT and led to widespread interest in it.5 Jean
Watson, former president of the National League for
Nursing, in a talk entitled Postmodern Nursing, called
for a radical rethinking about health and healing
which would turn our ideas upside down.6 Deepak
Chopra, the best-selling health guru, calls for a completely new worldview which will give us the makings
of a new reality.7 A naturopath trying to bring alternative medicine into managed-care plans claims, We need
to change the way we look at reality.8
This change in worldview falls in line with the paradigmatic retransformation and coming revolution of
the New Age movement.9 This movement has given
credibility to alternative medicine because of their many
common concerns. While the content of alternative
medicine theories is not necessarily postmodern or New
Age, it is much more compatible with postmodernism
than modernism. Three postmodern arguments are frequently used by promoters of alternative medicine. After
listing them, we will examine each in more detail.
1. Alternative medicine proponents cast doubt on
the findings of biochemical medicine, arguing
that it is merely an outgrowth of a Western (modernist) mentality which is materialistic, maledominated, and cold.
2. Criticisms of alternative medicine are primarily
power-posturing by the medical establishment
over cultures marginalized by Western society.
3. Objective, rational, experimental data as the basis
for accepting the value of a therapy may be replaced with a new basis: personal experience.
Rejection of the Medical Model

Postmodernism rejects modernismthe inheritor of the


age of Enlightenment. Medicine in the modernist era

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THE SCIENTIFIC REVIEW OF ALTERNATIVE MEDICINE

has focused on the physical aspects of health and illness.


It is reductionistic in its assumption that the more we understand about the bodys biochemical reactions, the
better we can promote health and cure illness. From this
comes a focus on testing biological fluids or tissues in diagnosing illnesses, and taking hi-tech scans and images.
Good health is restored by adjusting abnormal chemistry
or surgically correcting the ailing tissues. Promoters of alternative medicine critique and reject or downplay the
value of the biochemical model of medicine.
At times, modern medicine has overemphasized the
physiological aspects of health and underappreciated the
contributions of peoples emotional, mental, relational,
and spiritual dimensions. Interactions with the modern
healthcare system often result in only cold, inhumane experiences.10 In addition, people get angry at modern medicine when their high expectations are not met. These
frustrations make people more willing to listen to extravagant claims. Postmodernism has an antiestablishment
aspect that makes alternative medicine seem attractive.
One nurse uses TT to move from a world of technology, mechanistic reductionistic language, and the
machinery of curing back to the art of caring.11 A
well-known teacher of Reiki, a Japanese life-energy
therapy, implies that turning to physicians for help can
be unhealthy. The primary message you received was to
go to the outside for healing and surrender to someone
else your power for restoring your own health. In that
process, you could easily experience a sense of loss of
your own life power, resulting in feelings of helplessness,
depression, and defeat.12
In the words of an Australian nurse-naturopath, reductionist medicine results in continued disease, dependence on management with drugs and surgery (control over nature being a fundamental need of patriarchal
science), poor quality of life, and tremendous cost to patient and community.13 Scientific answers are no better
than others as they simply reflect a scientific paradigm
which is male dominated, exclusive, authoritarian, linear,
and rigid.14 Postmodernists do not envision reforming
modernist paradigms. Such paradigms require (indeed
on a subconscious level they beg) to be overthrown.15
Postmodernism also promotes a back to the good
old days mentality. Proponents of alternative medicine
claimtruly enoughthat they derive insight from ancient traditional medicines. In their attempts to reject
modern medicine, many proponents claim that human
life was healthier when it was more natural and less civilized.16 The postmodern reshaping of history supports
this claim even though it goes against well-substantiated historical facts to the contrary.17

Chopra, for instance, uses this postmodern analysis to


his advantage by making use of both sides of the argument
on this point. He claims that people in the past lived to
great old ages because they worked hard and had less
stressful lives.18 But elsewhere in the same book, to bolster
his assertion that people should pamper themselves with
the therapies he promotes, he claims that previous generations lived less fulfilling lives and died younger because
of the severity of their living conditions.19
Alternative medicines postmodern proponents
paint modern medicine as an enterprise characterized
by uncaring chrome, concrete, and stainless steel. Alternative medicine postures itself as the soothing, wise
hand of the ancients.
The postmodern critics do have some valid points.
The medical community is well aware that medicine has
drifted away from some of its humanitarian and spiritual
roots. But these criticisms are not enough to justify a
wholesale rejection of modern medicine. While science
can lead to dehumanization, materialism, and impersonal interactions, this is not inevitable. In addition, we
ought not forget the dark side of the not-too-recent past.
Increased longevity and health in much of Western society attests to the many benefits of applying scientific
principles to medicine and public health. Uncritically
replacing well-established scientific reasoning with intuitive ancient wisdom will not benefit peoples health.
The Voice of the Marginalized

Postmodernists often claim to speak on behalf of a marginalized or oppressed group. When talking on postmodern nursing, Jean Watson emphasized how the medical model had marginalized nursing and its caring
model. Other nurses find common ground with alternative therapists in their similar marginalization: To
maintain its dominant position, orthodox medicine subordinated its essential counterpart, nursing, and excluded or limited the natural therapies, constructed as
fraudulent competitors.20 In postmodernism, beliefs are
socially constructed, not rationally established and supported. The rejection of any therapy is not viewed as an
evidence-based decision, but a power play. Watson
claims that important knowledge about health care has
been systematically excluded from human consciousness by biases of the modern era.21 Westerners do not
commonly believe that life energy fields sustain everything only because modern researchers have marginalized this view.22 Similarly, Ayurvedic medicine has supposedly been suppressed due to centuries of foreign rule
in India.23 Yet today 75% of the preparations recom-

OMathna: Postmodern Promotion of Alternative Medicine


mended by Ayurvedic practitioners in India, fifty years
after achieving independence, were modern pharmaceutical drugs.24
A common reply to calls for scientific validation of
alternative therapies is to claim that alternative medicine is being victimized by a double standard. A panel of
healthcare professors at the University of Colorado was
convened to evaluate research on TT. They concluded
there is not a sufficient body of data, both in quality and
quantity, to establish TT as a unique and efficacious
healing modality.25 They recommended that the practice not be taught for another twenty years until sufficient evidence had been established to validate it. The
dean of the nursing school claimed, We would like to
imagine our whole lives are rational and science-based,
but only 15% of medical interventions are supported by
solid scientific evidence.26 Similar statements continue
to be made about medical practice.27,28,29,30
The postmodern argument is that therapies are
being marginalized by holding them to a standard that
even conventional therapies do not achieve. Postmodernists claim that therapies are not accepted or rejected
based on scientific evidence, but rather on whether a
therapy fits in with the dominant paradigm in medicine.
Whether true or not, the response to this claim should
be the promotion of evidence-based medical and nursing
practice. Accepting all therapies, regardless of evidence,
or dismissing the scientific approach to health-care decisions, will expose patients to ineffective and potentially harmful therapies.
Before responding to this claim, however, its accuracy must be evaluated. Postmodern openness to all
views of reality undermines the importance and necessity of evaluating claims. The claim that only 15% of
medical decisions are evidence-based refers to a 1978
Office of Technology Assessment report.31 The person
who originally made the statement has admitted that it
was an off-the-cuff remark based on a 19601961 British
survey of nineteen physicians.32 His statement was intended to challenge others to find better evidence about
how physicians make clinical decisions. Researchers
have responded to this challenge and evidence-based
medicine and nursing have advanced significantly in the
intervening decades. Recent studies have found that the
majority of physicians clinical decisions can be supported by scientific evidence.33,34
Using 1960s data to make judgments about 1990s
practice is inappropriate. This type of postmodern response distracts peoples attention from evaluating the
evidence. Instead, people grow sympathetic to the underdog and more inclined to reject the conclusions of

25

the establishment. Postmodern ideology thus outweighs physical evidence. An influential nursing textbook recommends accepting TT as a way to celebrate
the diversity among us. . . . Therapeutic Touch is rooted
in Eastern philosophy. Because of our Western culture
orientation, we search for research to explain its effects.
To the Eastern mind, if it works, one doesnt need research to prove how it works. The Eastern mind doesnt
care how it works, only that it does.35 No mention is
made of how we know it works.
Postmodern ways of thinking about science and
medicine menace public health. Chopra revels in this
state of affairs when he says that once a person has accepted the Ayurvedic way of thinking, he will no longer
be bound by societys notions of what you should be
doing, saying, thinking, or feeling.36 Snake oil, miracle
cures, bloodletting, and the like will flourish when any
form of medical care is not required to demonstrate the
validity of its claims.
Reliance on Experience

Chopra places a higher priority on experience than


reason. You sometimes see Prana defined as life force
or life energy, but what is more important than a definition is to get experiential knowledge of it.37 In the instructions accompanying some of his exercises he states:
In the three related procedures given here, you will experience the effortless way that intentions can get fulfilled, bypassing the ego and the rational mind.38
Postmodern alternative medicine promoters argue
that therapies should not be evaluated on the basis of objective evidence or quantitative results. Rather, they say,
individual experience should be the judge. Krieger encourages her readers: Therapeutic Touch works. . . . You
can do it; everyone who is willing to undertake the discipline to learn Therapeutic Touch can do it. You need
only try in order to determine the truth of this statement
for yourself. So, I invite you: TRY.39
Although Krieger claims that experiential knowledge is the key to assessing this therapy, every quack
healing method ever devised has those who claim it
worked for them.40 Anecdotal reports are well known of
people levitating while meditating or shamans curing
cancer. But strangely, when these events are brought
into the laboratory, the feats cannot be replicated.
Theres even a name for this: the shyness phenomenon.
Anecdotal evidence plays a role in suggesting new developments in clinical practicethis is why case reports
remain valuable to cliniciansbut anecdotal evidence
alone falls short of the standards of modern health care,

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THE SCIENTIFIC REVIEW OF ALTERNATIVE MEDICINE

in spite of postmodern objections that this only reveals


prejudice.
Experiencing benefits after taking a therapy does not
necessarily support the effectiveness of the therapy. The
placebo effect is powerful and ubiquitous, which is part of
the reason why high-quality clinical trials are complicated and time-consuming. But experience is not without
value. We do need to experience some things before we
can understand and appreciate them. We probably have
to play a few rounds of golf before we can understand why
some people love it so much. If personal experience were
the best way to know if a therapy worked, we would end
up trying out untested, harmful therapies on ourselves. If
fortunate, we would only waste our time and money on
ineffective therapies. We need some prior evaluation of
potential therapies so that we experiment with only the
relatively safe and effective ones.
The task of evaluating medical therapies and products falls to a number of government agencies and professional organizations. While the broader marketplace
is governed by the premise, let the buyer beware, the
health marketplace should be governed by the
premise, let the seller beware.41 Consumer protection
laws exist because of this belief. Few would argue that
medicine should not be regulated when the dangers of
bogus therapies are so great. However, accepting regulation of health-care practices and remedies requires
giving over a certain amount of personal authority to the
government. We decide not to experience everything for
ourselves, but to let someone else test things and then we
accept their advice.
Postmodern rejection of all forms of authority and
their suspicion of government and law leads alternative
medicine proponents to rejection accountability for
their own therapies. Dana Ullman, president of the
Foundation for Homeopathic Education and Research,
rejects health-care regulation for these reasons: It is sad
that in this land of freedom some people seek to protect
others from making their own decisions in health care.
Hopefully as we approach the 21st century and as more
and more countries experience glasnost and perestroika, America will re-commit itself to real freedom
and real democracy.42
The consequences of this approach to health care
were borne out in a court case in which a homeopathic
midwife was accused of reckless conduct while assisting
a birth in Maine.43 The baby began breathing immediately after birth, but then started to gasp. The midwife
pushed a pellet of homeopathic laurocerasus into the
babys mouth believing this would correct the breathing
problem. Within ten minutes a squad arrived and placed

an oxygen mask over the babys mouth. The midwife


had the mask moved aside for a few seconds to give a
homeopathic liquid call Natures Rescue. This liquid
contained 27% alcohol, and was believed to focus the
babys energy.
A neonatologist testified that it was inappropriate
medical care to give a pellet, a liquid, or alcohol to a distressed newborn. The judge concluded that the defendants conduct created a substantial risk of serious bodily
injury to the baby. However, both a homeopathic family
physician and a homeopathic nurse practitioner testified
that the midwife acted according to standard homeopathic
practice. Because the defendant was not trained in medicine, she could not be held to medical standards. The
judge found the midwife not guilty of reckless conduct
since her alternative medicine training left her unaware
of the dangers of her actions. Although ignorance of the
law is no defense, it appears that ignorance of medicine
is a good defense for those dabbling in medical areas!
Self-help books promote the idea that we should all
decide everything about our health for ourselves. But
with so many things to know and understand about
health care, how can a person decide what is reliable? By
law, advertisements may not be false or misleading, but
popular literature isnt regulated. William Jarvis points
out that the public is at a major disadvantage when
faced with false and unproven remedies in books, magazines and newspaper articles, lectures, audio and video
cassettes, talk show appearances, etc. The financial interest of promoters is often disguised in such communications.44 High costs are paid for the postmodern right
to determine your own reality through personal experience. As a result of this broad rejection of authority, billions of dollars are being wasted, harm is being done, and
people are being diverted from proven, helpful therapies.

CONCLUSION
Postmodernism erects barricades against criticism of alternative medicine. Part of postmodernism is the rejection of an objective reality. Science is based on the pursuit of the most accurate description and explanation of
an underlying reality postmodernists claim does not
exist. Little wonder the two approaches collide. Ironically, postmodern proponents of alternative medicine
retain their interest in scientific studies, but only to the
extent that they support their preconceived beliefs.
When the results dont match their expectations, the
scientific paradigm is critiqued. By attempting to discredit the possibility of unbiased, repeatable, and con-

OMathna: Postmodern Promotion of Alternative Medicine


trolled studies, they resist pressure to demonstrate the effectiveness and safety of the therapies they endorse.
While postmodern ideology is abstract and academic, it has practical consequences. Promoting therapies
in the name of diversity leaves no way to reject any
therapy. Including coursework promoting unproven and
potentially unsafe therapies is unjustified given the overwhelming amount of information students need to digest. Information should be provided about commonly
used alternative therapies, but it should be taught in the
context of how to evaluate claims of efficacy. Healthcare providers promoting unproven therapies just because they are in vogue, or financially lucrative, is selling
health-care professionals short.
An understanding of postmodern arguments will assist concerned health-care providers in responding effectively when they are used to promote alternative therapies. People often have to be reminded of how valuable
science is in determining efficacy and safety. Postmodernism is a house of cards built on the ever-shifting sands
of multiple realities. The winds of reason are needed to
bring it down to earth. Patients health will benefit when
providers base their therapy recommendations on the
best scientific evidence available, not the latest popular
philosophy.

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41. Ibid., 1576.


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