This dissertation explores the question of how the legitimacy of different approaches to
healing is socially and culturally constructed. Questions about the legitimacy of what has
come to be called "Complementary and Alternative Medicine" or CAM have come to the
forefront of both health policy and public discourses as the popularity of these non-biomedical
approaches to healing has grown. The dissertation used an ethnographic
approach to explore the complex issues related to the legitimation of CAM. This
interdisciplinary research focused on the field of cancer treatment since a significant
proportion of cancer patients use both conventional and unconventional treatments and
since treatment decisions have important consequences. Fieldwork was undertaken in the
Lower Mainland area of British Columbia over a period of three years. A total of 45 in-depth
individual interviews were done with 17 cancer patients, six oncologists, three
nurses who specialize in cancer care, and 11 professionals involved in CAM, including
practitioners of traditional Chinese medicine, naturopathy, chiropractic, healing touch,
and psychospiritual counseling. Eight people participated in more than one interview. A
focus group with seven cancer patients was done to supplement the interviews.
Participant-observation was done in a variety of relevant settings including a committee
considering how to integrate CAM with conventional medicine, a healing group for
patients, and public lectures, conferences, and events. Textual material from public media
was analyzed. The dissertation uses the results of the fieldwork, particularly the
experiences of patients, to formulate a model that elucidates the processes whereby
emerging cultural models are linked with personal experience to form situated meanings
about legitimacy that take root through social practices. The dissertation argues that
underneath the growing use of CAM lie important changes in the way people are thinking
about the nature of the body, the nature of health and healing, and relationships between
patients and health care providers. In addition, the use of CAM is associated with the
adoption of epistemologies that undermine the hegemony of scientific rationality. The
implications of these findings for health care policy, practice, and research are discussed.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/15053 |
| Date | 11 1900 |
| Creators | Fryer, Margaret L. |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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