Sunday, June 15, 2014

The Eastern Medicine Revolution? Not Quite

"The Eastern Medicine Revolution?" These were the words emblazoned across the screen behind Dr. David L. Katz, founding director of the Yale-Griffin Prevention Research Center, as he discussed the growing popularity of holistic integrative medicine on a recent edition of the Katie Couric Show. The conversation centered on the opening of Cleveland Clinic's Chinese herb therapy ward in January of this year, the first of its kind at a major US hospital. Dr. Katz argued—convincingly, I might add—that some instances where "alternative" medicines are criticized for lack of sufficient supporting evidence are more attributable to the profit motive driving drug development than to any lack of efficacy. Citing the case of coenzyme Q10, Dr. Katz explained that financial incentives drastically bias medical research against alternative medicines, which often cannot easily be patented for marketing and thus less often receive sufficient funding for extensive research and regulatory approval.

Not all "eastern medicines," however, are created equal in the eyes of many, and while Dr. Katz's argument lands a powerful blow to the general portrayal of holistic medicine as quackery, it would be a mistake to conclude that money can tell us the whole story.  This is especially true in the case of traditional Islamic medicine.  On the rare occasion that Islam can be discussed independent of the political rhetoric surrounding Muslims, terrorism, and immigration in Europe and the United States, Islamic medicine rarely exists in popular media without the word "medieval" preceding it.  While describing the study of Islamic medicine or even defining the concept of holistic medicine are challenging and important topics, the question I hope to explore here is whether the conventional medical establishments of the United States and Europe are ready to begin embracing even the possibility of traditional Islamic medicine representing an alternative treatment option, as they increasingly have for traditional Chinese therapies.  My answer is no, they are not quite prepared for such a step.

Why the United States and Europe are NOT ready to embrace the possibility of traditional Islamic medicine as an option:

In addition to the challenge of profit motive demonstrated by Dr. Katz, traditional Islamic medicine faces the same difficulty encountered by nearly all understandings of illness originating outside the conventional biomedical model: the patronizing categorization as "beliefs" as opposed to knowledge.  While anthropologists have generally understood knowledge and beliefs as complimentary, health professionals tend to view the terms as contrasting, with "beliefs" connoting ideas that are irrational, erroneous, and obstructive to health.  As such, the very terms used within public health discourse often exclude Islamic medicine from serious consideration, along with other traditional forms of holistic medicine.

There also exist obstacles that are unique to Islamic medicine, however, as the portrayal of Islam and Muslims by medical writers is hardly neutral.  A review of medical literature from 1966 to 2005 revealed recurring latent biases, including notions that Islamic tradition is a barrier to modernity, that being an observant Muslim poses health risks, and that "Islam" represents a problem for healthcare delivery.  Even historic examinations of Islamic medicine frequently reduce "positive" elements to mere transmissions of Greek, Jewish, or Christian thought.  Such messages build on a long history of orientalist representations of Muslim societies as deficient and dehumanized Others, a phenomenon famously examined by Edward Said, to which medical discourse is no exception.  Nowhere is this more apparent, perhaps, than in depictions of Arabs and Muslims in psychodynamic literature post-9/11, during an era of suspicion and hostility toward Muslims and of military interventions in Muslim-majority countries by Europe and the United States.

Thus, to fully comprehend Islamic medicine's exclusion from the conversation around alternative medicine in the West, let alone from the conventional medical establishment, we must look beyond questions of research funding and evidence-based medicine.  While important, these issues speak little of the relationship between knowledge production and geopolitical power that are behind persisting orientalist narratives around Muslims and Islam in medical literature.  Until American and European health professionals and academics are prepared to critically address these narratives, Islamic medicine is unlikely to be included in any "Eastern medicine revolution" that may be underway.

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