Medical epistemology or medical knowledge based on philosophy cannot be considered separate from medical metaphysics. The epidemiologic epistemology of EBM, which is the study of the causes, prevalence and control of diseases in a population correlates well with orthodox medicine’ s physiologic theory of disease. However, it may not be coherent with other theories of disease and healing. Thirdly, there is a requirement for potential alternative methods of generating medical knowledge in CAM (Tonelli & Callahan 2001). The methods of obtaining knowledge in a healing art such as CAM must the art’ s underlying understanding and theory of illness.
Therefore, disciplines such as complementary and alternative medicine (CAM) that diagnose and treat illnesses on non-measurable but detectable differences between individuals such as Qi, cannot be based on EBM since it cannot fulfil all its requirements for optimal clinical practice. Hence, “ the method of EBM and the knowledge gained from population-based studies may not be the best way to assess certain CAM practices” (Tonelli & Callahan 2001, p. 1213) which take into consideration illness and healing within the context of a particular only.
Currently, however, the methods of developing knowledge within CAM have limitations, are subject to bias and different interpretations. It is essential that CAM should develop a rigorous alternative epistemic framework of knowledge and method based on its philosophy if it hopes to be accepted as a valid medical discipline by orthodox practitioners. According to Long (2002), monitoring the achievement of desired outcomes of research is essential. The effects of a CAM intervention are of three types: those arising from the philosophy and practice of health and healing, factors from the relationship between the patient and the practitioner, and the factors resulting from the interventions used to enhance the healing process.
This delineation of effects is relevant to conventional medicine also. For the full effect of a CAM discipline to be recognized, the measurement of all three types of outcomes is required.
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