Modern western science as a standard for traditional Chinese medicine: A critical appraisal

Journal of Law, Medicine and Ethics

Volumn 31, Issue 2, 2003, Pages 213-221

  Fan, Ruiping ^a,b,c,d  

^a CITY UNIVERSITY OF HONG KONG   (Hong Kong)

^b Baotou Coll Med in Inner Mongolia   (Mongolia)

^c Grad Sch Chinese Acad Social S   (China)

^d RICE UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CHINESE MEDICINE; CLIMATE; CONFERENCE PAPER; EMOTION; HERBAL MEDICINE; HUMAN; MEDICAL PRACTICE; PHILOSOPHY OF MEDICINE; STANDARD; TRADITIONAL MEDICINE; WESTERN HEMISPHERE; ARTICLE; CHINA; CULTURAL ANTHROPOLOGY; CULTURAL FACTOR; HEALTH CARE AND PUBLIC HEALTH; HEALTH PERSONNEL ATTITUDE; HISTORY; PATIENT CARE; PHILOSOPHY; PHYSICIAN; SCIENCE;

HEALTH CARE AND PUBLIC HEALTH;

ATTITUDE OF HEALTH PERSONNEL; CHINA; CROSS-CULTURAL COMPARISON; HISTORY, 20TH CENTURY; HISTORY, 21ST CENTURY; HISTORY, ANCIENT; HUMANS; MEDICINE, CHINESE TRADITIONAL; PATIENT CARE; PHILOSOPHY, MEDICAL; PHYSICIANS; SCIENCE; WESTERN WORLD;

EID: 0038732373     PISSN: 10731105     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2003.tb00082.x     Document Type: Conference Paper

References (23)

1. The World Health Organization has defined three types of health systems to describe the degree to which traditional medicine/complementary and alternative medicine is an officially recognized element of health care. "In an integrative system, TM/CAM [traditional medicine/complementary and alternative medicine] is officially recognized and incorporated into all areas of health care provision.... An inclusive system recognizes TM/CAM, but has not yet fully integrated it into all aspects of health care, be this health care delivery, education and training, or regulation.... With a tolerant system, the national health care system is based entirely on allopathic medicine, but some TM/CAM practices are tolerated by law." See World Health Organization, WHO Traditional Medicine Strategy 2002-2005 (Geneva: WHO, 2002): at 8-9, available at 〈http://www.who.int/medicines/library/trm/trm_strat_eng.pdf〉.
2. Ian Holliday categorizes four different forms of relation between modern scientific medicine and traditional Chinese medicine based on his research on the East Asian countries: integration (nondiscrimination and fusion, such as mainland China), equalization (nondiscrimination and separation, such as South Korea and Taiwan), subjugation (discrimination and fusion, such as Japan), and marginalization (discrimination and separation, such as Hong Kong and Singapore). See I. Holliday, "Traditional Medicines in Modern Societies: Learning from East Asia," Journal of Medicine & Philosophy, 28, no. 3 (2003) (forthcoming). The dual standard integration which I support may be similar to Holliday's "zone of balanced health care development."
3. Unless otherwise stated, all the figures and other information in this section are from the public homepage of the State Administration of Traditional Chinese Medicine, at 〈http://www.satcm.gov.cn/lanmu/zonghe_xinxi/ tongji_zhaibian.htm〉 (last visited June 14, 2003). Unfortunately, most of the information offered there is in Chinese. The information I used in this article was translated into English by myself.
4. See the homepage of the Ministry of Health of the People's Republic of China, at 〈http://www.moh.gov.cn/statistics/digest01/ty1-1.htm〉 (last visited June 14, 2003).
5. My position in the rest of this section was formed primarily from my investigation of the traditional Chinese medical practice in Beijing and my hometown (in Inner Mongolia) in July 2002. Regarding recent discussions and debates about the manner of traditional Chinese medical practice and the direction of its development, readers can easily find a huge number of essays in the recent issues of relevant Chinese newspapers and journals, especially Zhongguo Yiyao Xuebao (Chinese Medicine and Pharmacy), Jiankang Bao (Health), Yixue yu Zhexue (Medicine and Philosophy), and Shanghai Yiyao Xuebao (Shanghai Journal of Chinese Medicine and Pharmacy).
6. Officially, Chinese administrations on traditional Chinese medicine clearly support double diagnosis (shuangchong zhenduan), but have no stated position on double therapy. There are no statistics available regarding what percentage of traditional Chinese medical physicians conduct double therapy without a justifiable reason. My investigation finds that the practice is quite common. Undeniably, in addition to the influence of the monostandard, there is another important cause for double therapy: economic incentive. The government's long time rigid control of health care prices has caused a ridiculous phenomenon in medical practice in recent China: physicians' overprescription. This phenomenon has made double treatment all the more appealing in the traditional Chinese medical circle. Health care has been taken as welfare service and its price is set low by the government. Physicians cannot charge any payment for their consultation with patients except for a nominal amount of registration fees. This forces physicians to "do" something on the patients in order to get payments (for their hospitals and themselves), such as performing experimental and machinery examinations, procedures, operations, and - very importantly - prescribing drugs to make a profit from the difference between the wholesale and retail prices of the drugs. Many Chinese hospitals obtain almost 50 percent of their income by "selling" drugs to patients. This circumstance puts traditional Chinese medical hospitals in an even worse situation than modern scientific medical hospitals - the traditional hospitals have to sell more drugs to have their ends meet because they usually do not have as advanced modern technological equipment to bill patients for using as modern scientific medical hospitals do. Moreover, since traditional Chinese medical drugs are usually set at a lower price than modern scientific medical drugs, traditional Chinese medical physicians' prescribing modern scientific medical drugs is financially inevitable.
7. Many people still believe that the Yellow Emperor's Internal Medicine was compiled much earlier than the Eastern Han dynasty. Here 1 simply follow Yuqun Lao's well-grounded argument of fixing the time of its compilation in the Eastern Han dynasty. See his Qihuang Yidao (The Way of Chinese Medicine) (Taipei: Hongye Wenhua Shiye Youxiangongsi, 1993): at 55-80.
8. See, e.g., Z. Wei and L. Nie, Zhongyi Zhongyao Shi (A History of Traditional Chinese Medicine) (Taipei: Wenjin Press, 1994): at 332-36.
9. The current debate still takes place around the issue of whether traditional Chinese medicine is science. Those supporting the existence and development of traditional Chinese medicine take pains to argue that it is science. Due to the value-laden character of the concept of science, no one dares to risk one's position by arguing that traditional Chinese medicine is not science, though it is effective.
10. See J. Liang, Zhongguo Gudai Yizheng Shilue (A Short History of the Chinese Medical System) (China: Inter Mongolia People's Press, 1995): at 172.
11. The information in this paragraph and the next is primarily from H. Zhao, Jindai Zhongxiyi Zhenglunshi (History of the Debate Between Traditional Chinese Medicine and Modern Scientific Medicine in the Modern Time) (Hefei: Anhui Science & Technology Press, 1989): at 86-91, 111-17, 122-31.
12. The information in this paragraph is primarily from B. Ma, X. Gao, and Z. Hong, Zhongwai Yixue Wenhua Jiaoliushi (The History of Medical Cultural Communication Between China and Foreign Countries) (Shanghai: Wenhui Press, 1993): at 576-82.
13. Id. at 577.
14. Id. at 582.
15. See, e.g., Friedrich Engels, Dialetik der Natur (Chinese), trans. Zhong gong zhong yang Makesi Engesi Liening Sidalin zhu zuo bian yi ju (Chinese Communist Party Central Committee's Bureau of the Compilation and Translation of the Works of Marx, Engels, Lenin, and Stalin) (Beijing: People's Press, 1971).
16. For a very useful English introduction to traditional Chinese medicinal herbs, see L. Yanchi, The Essential Book of Traditional Chinese Medicine, vol. 2 (New York: Columbia University Press, 1998).
17. For a useful summary of such research projects and their outputs, see State Administration of Traditional Chinese Medicine, ed., Jianguo 40nian Zhongyiyao Keji Chengjiu (The Scientific and Technological Achievements of Traditional Chinese Medicine in the First Forty Years of the People's Republic of China) (Beijing: Chinese Medical Classics Press, 1989): at 586-654.
18. For a very helpful English introduction to the channel system according to traditional Chinese medicine theory, see Yanchi, supra note 16, at vol. 1, Chapter 4.
19. For an excellent book on such research projects and problems, see L. Chengzhong, Linchuang Jingluo Xianxiangxue (Clinical Channel Phenomenology), (Dalian: Dalian Press, 1994).
20. For all the figures and other information in this paragraph, see the homepage of the State Administration of Traditional Chinese Medicine, under the entry of Zhongyiyao Wushinian Dashiji 1949-1999 (Significant Events of Traditional Chinese Medicine in 1949-1999), at 〈http://www.satcm.gov.cn/ lanmu/zonghe_xinxi/tongji_zhaibian.htm〉 (last visited June 14, 2003).
21. For these important views, see some well-known works of Thomas Kuhn and Paul Feyerabend. See, e.g., T. Kuhn, The Structure of Scientific Revolutions (Chicago: University of Chicago Press, 1970); P. Feyerabend, Against Method (London: Verso, 1978).
22. For these important views, see some well-known works of Thomas Kuhn and Paul Feyerabend. See, e.g., T. Kuhn, The Structure of Scientific Revolutions (Chicago: University of Chicago Press, 1970); P. Feyerabend, Against Method (London: Verso, 1978).
23. For a brilliant exploration of the role of randomized clinical trials in relation to complementary and alternative medicine, see K.F. Schaffner, "Assessments of Efficacy in Biomedicine: The Turn Toward Methodological Pluralism," in D. Callahan, ed., The Role of Complementary and Alternative Medicine (Washington, D.C.: Georgetown University Press, 2002): at 1-14.