Contesting the Rule(s) of Medicine: Homeopathy's Battle for Legitimacy

This essay examines the political, economic and ideological elements at work in a battle over authoritative knowledge in the field of biomedicine. The orthodox medical establishment is facing a challenge to its historical position of dominance from an array of alternative therapies. As one of the leading forms of alternative medicine, homeopathy is seeking legitimacy but faces significant opposition from the scientific and medical community. The Canadian public and other social organizations are lobbying for medical pluralism and more access to alternatives. In this essay the author examines this contest and evaluates the nature of the ideological debate between homeopathy and the medical establishment historically and in the contemporary period. Cet article examine les elements politiques, economiques et ideologiques qui sont presents dans les conflits portant sur les connaissances qui font autorite dans le domaine de la medecine conventionnelle. Le corps medical orthodoxe voit sa position historique dominante confrontee par une gamme de therapies paralleles. A titre d'une des formes les plus reconnues de medecine parallele, l'homeopathie recherche la legitimite mais est tres opposee par la communaute scientifique et medicale. Le public canadien et d'autres organismes sociaux demandent un pluralisme medical et un meilleur acces aux medecines paralleles. Dans cet article, l'auteure examine ce conflit et evalue la nature du debat ideologique entre les defendeurs de l'homeopathie et le corps medical du point de vue historique et actuel. Science is an inherently political arena. Contrary to the notion advanced by some members of the scientific community that science is an apolitical, factual enterprise, humanist scholars of science recognize the socially constructed nature of scientific enterprise. They point to the elaborate interplay of economic, institutional and ideological factors that establishes what is sanctioned as scientific knowledge in our society versus what will be relegated to the status of folklore, mysticism or quackery. In contemporary Canadian society legitimate scientific knowledge falls within a fairly narrow range. In so far as there is a modern orthodoxy that has usurped the place traditionally held by religion, it is science. The institutions that we entrust with knowledge production are scientific, and the technologies we use to solve problems are scientific. The alliance of Western medicine with modern science - which we call biomedicine - is so intimate that it is almost inconceivable to imagine a successful heretical challenge to biomedicine without a concurrent crisis in science as a whole. (Wolpe 1133) The structures of science narrowly define what lies within the range of accepted opinion. The boundaries of the hegemony are securely policed by the scientists and policy-makers who are the official gatekeepers of knowledge. For a scientific break-through to be acknowledged as such, it must be legitimated. This involves the affirmation of various social institutions and actors. Yet despite the rhetoric about "eureka" moments, in fact, new initiatives in the field of science and medicine are treated with great scepticism. Many of the most cherished of today's scientific principles and medical practices were treated as heresies when they were first introduced, while countless innovations have never succeeded in overturning established practice. When a new approach is developed it faces a battle for legitimacy. Groups engaged in a competition over dominant knowledge systems use a number of means to gain advantage over their opponents, including political lobbying, mobilization of resources and ideological legitimization (Zald and McCarthy). Ideology can be defined as a set of ideas that shapes our understanding about what is natural, rational, and legitimate (van Dijk; Eagleton; Steuter). Ideologies are used by social groups to justify their own positions and to marginalize and discredit their rivals. …