Bounding Biomedicine: Evidence and Rhetoric in the New Science of Alternative Medicine

253 Pages·2016·3.24 MB·English

by  Colleen Derkatch

Bounding Biomedicine

Bounding Biomedicine
Evidence and Rhetoric in the New Science of
Alternative Medicine
colleen derkatch
The University of Chicago Press
Chicago and London
Colleen Derkatch is assistant professor of rhetoric in the Department of English and
vice chair of the Research Ethics Board at Ryerson University in Toronto, Canada.
The University of Chicago Press, Chicago 60637
The University of Chicago Press, Ltd., London
© 2016 by The University of Chicago
All rights reserved. Published 2016.
Printed in the United States of America
25 24 23 22 21 20 19 18 17 16 1 2 3 4 5
isbn- 13: 978- 0- 226- 34584- 0 (cloth)
isbn- 13: 978- 0- 226- 34598- 7 (e- book)
doi: 10.7208/chicago/9780226345987.001.0001
Library of Congress Cataloging-in-Publication Data
Derkatch, Colleen, author.
Bounding biomedicine : evidence and rhetoric in the new science of alternative
medicine / Colleen Derkatch.
pages ; cm
Includes bibliographical references and index.
isbn 978-0-226-34584-0 (cloth : alk. paper)—isbn 978-0-226-34598-7 (e-book)
1. Alternative medicine—United States—History—20th century. 2. Alternative
medicine—Research—United States—History—20th century. 3. Medicine—
United States—History—20th century. I. Title.
r733.d4393 2016
610.28—dc23
2015029053
♾ This paper meets the requirements of ansi /niso z39.48- 1992
(Permanence of Paper).
For Isla and Nathan,
“just for.”

“[I]f you who are reading this article do not know what rational thinking
means, you are beyond help.”
rudolph happle, “The Essence of Alternative Medicine:
A Dermatologist’s View from Germany”
“[Q]uackery never prospers, for if and when it does, it becomes termed medi-
cine instead.”
roy porter, Quacks: Fakers and Charlatans in English Medicine

Contents
Acknowledgments xi
Introduction 1
CAM Enters Biomedicine 2
Rhetoric at the Fringes of Medicine 5
Mapping Biomedical Boundaries 8
Analyzing a Rhetorical Moment 12
Preview of Chapters 17
1 Evidence, Rhetoric, and Disciplinary Boundaries 21
Biomedicine’s Shifting Terrain: From Intuition and Experience
to “Evidence” 24
Quantitative Evidence and Jurisdictional Control 29
Medical- Professional Strategies of Exclusion 35
2 Patrolling Professional Borders 44
Constituting the Medical Profession 47
Peer Review as Professional Self- Regulation 53
Categorizing Complementary and Alternative Medicine 55
CAM à la Carte 62
3 Scientific Methods at the Edge of Biomedicine 68
Idealizing Evidence: Scientific Methods and CAM Research 72
Idealizing Research: The Genre of the Randomized Controlled
Trial Report 81
Method as a Boundary Argument 88
Efficacy as a Boundary Object 94
4 Precincts of Care in CAM Research 106
Models of Clinical Practice 110
Regulating Rhetorical Interaction 113
Purifying Placebo Effects 122
Patient Choice across Medical Models 131
Dietary Supplements and Patient Agency 138