Feminist Interventions in Biomedical Discourse: An Analysis of the Rhetoric of Integrative Medicine
Willard, Barbara E., Women's Studies in Communication
The growing integrative health care community has produced a rhetorical text stressing personal empowerment, egalitarian relationships, and medical knowledge based on one's bodily experiences. This article examines the rhetoric of best-selling books and PBS documentaries promoting integrative medicine. A metaphor analysis of the rhetoric suggests that integrative medical practitioners perform a feminist intervention in biomedical discourse having the potential to significantly alter health care practices in the U.S.
Medical discourse is a contested, open-ended text, fraught with competing rhetorics and systems of meaning. Patterns of discourse in medical practice, for instance, may disempower women, especially during times of crisis (Birke, 2000). Some, however, may empower women as participants in their own health care and enable their informed decisions about appropriate treatment. Because feminist rhetorical critics scrutinize discourse that creates and sustains injustices inherent in social structures, they have the potential to reveal this kind of variation in the symbolic construction of illness.
Women are the primary consumers of health care because they live longer than men, their reproductive system typically requires medical intervention, and they are more likely to care for others' health (Boston Women's Health Book Collective [BWHBC], 1998; Lorber, 1997; Nettleton, 1995; Weisman, 1998). Feminist activists and theorists maintain that despite women's disproportionate use, Western medical establishments suffer communicative and psychological shortcomings, and therefore fail to provide satisfactory care to women (BWHBC, 1998; Fisher, 1994; Lorber, 1997; Northrup, 1994, 2001). The women's health movement gained visibility in the 1970s with the publication of the book Our Bodies,
Ourselves (BWHBC, 1971). This movement criticized the inaccessibility of medical discourse and emphasized the need for straightforward medical knowledge about the female body and women's empowerment over their own health care. As a result, many women turned to complementary and alternative medicine (CAM) because of increased personal attention from doctors, the perception of patient empowerment, and a sense of participative decision making in determining healing approaches (Astin, 1998; Lupton, 1994; Nahin, 1999; Scott, 1998a). Recently, The Journal of the American Medical Association reported that CAM therapy use was more common among women (49%) than men (38%) (Eisenberg, et al., 1998). Other recent research has found similar patterns of CAM usage among women and men (Astin, 1998; Barnes, Powell-Griner, McFann, & Nahin, 2004).
Practitioners of CAM, also called integrative medicine, are typically M.D.s, trained at traditional medical universities, who have integrated alternative medical modalities (e.g. acupuncture, meditation, homeopathy) into their practice. This approach to medicine is seen as a health care option that addresses and overcomes the communicative and psychological weaknesses of traditional Western medicine (BWHBC, 1998; Northrup, 1994, 2001). The rhetoric used in traditional Western medicine is typically identified as biomedical discourse. Biomedicine is defined by Columbia University medical professor Daniel Eskinazi (1998) as medical practice that focuses on the "molecular, physiological and pathological mechanisms believed to form the basis of biological processes" (p. 1622). Biomedicine generally places an emphasis on interventions that treat biological pathologies as opposed to preventing illness or creating the conditions of health.
Critics of the biomedical model characterize it as overly mechanistic and maintain that biomedical practitioners view the body as an object to be repaired (Scott, 1998b; Weitz, 2001). This view, critics claim, results in a mind/body dualism and physical reductionism that overlooks psychological and social causes of illness (Birke, 2000; Lupton, 1994; Nettleton, 1995; Rios & Simpson, 1998). …