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Feb112012

Modern medicine is not "Western medicine"

Earlier I made the argument that modern values should not be called "Western values". The case for not calling modern medicine "Western medicine" is even stronger. There are two basic ways of thinking about the evolution of medicine, the historical and the methodological, and in neither case is "Western" an appropriate adjective.

The "Father of Paediatic Medicine" (he was not Western)Using the historical perspective, we talk about traditional medicines and modern medicine. Traditional medicines were a diverse set of health practices with a strong regional basis, so it is fair to talk about Indian traditional medicine, Chinese traditional medicine, Aboriginal traditional medicine and so forth. Western traditional medicine was one of these regional practices, and involved practices such as blood-letting, prayer and a bunch of (mostly lethal) herbal treatments. Modern medicine grew out of an algamation of the best practices of all of these traditional medicines, while discarding the worst practices of each.

The centre of modern medicine has shifted over time: it certainly has not always been "Western". Indeed, western Europe was the backwater of medicine for thousands of years - while European doctors were prescribing leeches for every condition the Islamic world was pioneering medicine that we would truly call modern. The foundations of modern paediatrics, pharmacy, surgery and ophthalmology were all set in the Islamic world, drawing on traditions from Greece to Egypt, from Persia to India. Western traditional medicine has probably contributed less to modern medicine than most other traditional medicines. In the 19th century it could be argued that the most advance occured in continental Europe, and in the 20th century in the Anglo-American world, but today modern medicine is truly a global endevour, and the research community is the most international of professions. To call modern medicine "Western medicine" is to cherry-pick that moment in time when the Western world was the leader, ignoring all that came before it and has developed since. Visiting a hospital in China, Ghana, Peru or America you will see the same techniques, philosophy and equipment, making modern medicine "global medicine".

Alternatively, we can talk about medicine using the methodological perspective. Here there have been two major approaches to medicine, the faith-based approach and the evidence-based approach. In general, traditional medicinal practice is based on faith in the effectiveness of the medicines. Western traditional medicine is no different - the use of prayer as a standard healing technique is an obvious example of faith, but equally the adherance of physicians to blood-letting for a thousand years despite all the patients it killed was a sign of faith in the technique, rather than a constant reapprasial of its success. Likewise other traditional medicines are a mismash of techniques, some that work well, some that do nothing and some that can be fatal, but all diligently implemented as the knowledge is transmitted whole rather than critically analysed.

The evidence-based approach to medicine is radically different. It takes hypotheses from tradition or new research, and then simply puts them to the test. If they work they stay, if they fail they are discarded. If anything, the ability to discard failed techniques is the most important aspect of evidence-based medicine, and the key distinction between modern medicine and traditional medicines. Modern medicine continually gets better because it is open to any new ideas but it throws away the ones that don't work. "Alternative medicines" do not throw away techniques that have been proven not to work, so the stagnant approach maintains both harmless voodoo approaches and harmful treatments.

So modern medicine at its best is pure evidence-based medicine, willing to take in any treatment from any tradition, so long as it passes a scientific test. Scientific enquiry is not uniquely Western, it is the shared inheritance of the world and was developed as a global endevour. To call science "Western" is to have a parochial view of science, taught as a school subject where the home-grown heroes are the only figures worth mentioning. We don't call evidence-based engineering "Western engineering", so why do people insist on calling evidence-based medicine "Western medicine"? We don't let self-trained self-proclaimed "alternative engineers" erect skyscrapers, so why do we allow "alternative healers" to treat patients in genuine need?

Reader Comments (1)

I would take PepperMint to that vet.

February 14, 2012 | Unregistered CommenterLydia

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