Book Reviews > Borderland Practices: Regulating
Alternative Therapies in New Zealand By Kevin Dew
This new book that examines the changing nature of 'orthodox' and 'alternative'
practice. The author looks at recent medical history from a social scientist's
perspective and asks how primary health care can be regulated when the
boundaries between what is orthodox and what is alternative are continually
Every day thousands of New Zealanders consume an array of vitamin pills or
visit alternative therapists of one kind or another. Doctors themselves may
prescribe or administer 'alternative' remedies such as St John's Wort or
acupuncture. What is going on in primary health care?
Modern societies regulate medical care to maintain patient safety, but where
there has been regulation there has also been limitation. Medical practice has
become more standardised and controlled, and some therapeutic practices have
been deemed acceptable while others have not. Medical doctors who have ventured
too far down the 'alternative' path have been struck off, and therapies such as
homeopathy are excluded from state funded care.
Kevin Dew argues that terms such as 'science', 'unorthodoxy' and
'incompetence' have tended to change in meaning over time and place. Some of the
challenges to orthodox medicine in the twentieth century, such as chiropractic
and acupuncture, are now accepted practice. The New Zealand health reforms
attempted to define a 'core' of health services that would be validated by
science and provided to everyone, but solutions to the problems varied with the
different patient populations seen by practitioners. And what were once
acceptable concepts and practices in orthodox medicine are unacceptable now.
reforms have led to efforts to develop formulae that will guide the therapeutic
actions of medical practitioners, but individual practitioners make their own
judgements about patient care. How the delivery of care is regulated and funded
are questions that don't go away, and the author concludes his discussion of
these issues by looking at three possible models of regulation. These models
take into account relations between medical knowledge, the role of the
practitioner and the role of the profession in policing what practitioners,
whether orthodox or alternative, are allowed to do.
Kevin Dew is a senior lecturer *In the Department of
Public Health at the Wellington School of Medicine and Health
Sciences, University of Otago. He has co edited Health and Society
in Aotearoa New Zealand with Peter Davis, and Sociology of Health in
New Zealand with Allison Kirkman.
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