Beyond Medical Pluralism

Communicative Positioning of Biomedicine and CAM in Estonia

Abstract

Medical pluralism does not only mean the presence of multiple therapies but also the variety of health discourses and norms. By analysing the rhetoric of active participants in the Estonian health field, we portray the diverse discourses in defining and positioning complementary and alternative medicine (CAM) in relation to biomedicine (BM). On a scale of attitudes, five different positions of CAM and BM emerge. Both ends of the spectrum dominantly represent a system-level view characterized by distinct categories, opposition, and labelling. In between, integrative positions focus more on an individual’s personal needs by combining and “taking the best out of” all available knowledge systems. The presence of these competing discourses poses several challenges for health communication. Meanings offered by CAM-related health approaches are increasingly visible and influential as unlicensed health workers and laypeople contribute more to public communication due to the openness of social media. On the other hand, critics of CAM and proponents of scientific thinking have mobilized to set boundaries to defend the authoritative position of scientific medicine. Our analysis suggests that using system-level categories supports polarization, which could lead people to seek alternative explanations based on their individual experiences, and thus feeding distrust towards medicine and doctors.