Volume 155, April 2016, Pages 73–81
CAM within a field force of countervailing powers: The case of Portugal
Highlights
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- CAM practitioners have acted as a source of power and a countervailing force.
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- The balance of power between CAM, the medical profession and the state is evident.
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- Biomedical power remains important in providing directions in the regulation of CAM.
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- The medical profession may be losing its hegemonic control over CAM legislation.
Abstract
This
paper examines the extent to which the position of the medical
profession and the state towards complementary and alternative medicine
(CAM) practitioners has changed since the late 1990s, taking Portugal as
a case study. Using Light's concept of countervailing powers, we
consider the alliances, interests, rhetoric and degrees of control
between these three actors over time, focussing particularly on the
extent to which CAM practitioners have acted as a countervailing force
in their relationship with the medical profession and the state. It also
brings to the fore the position of supra-state agencies concerning CAM
regulation. A critical discourse analysis was conducted on data derived
from a systematic search of information dating from the late 1990s up to
2015. Our analysis suggests that CAM has emerged as an active player
and a countervailing power in that it has had significant influence on
the process of state policy-making. The medical profession, in turn, has
moved from rejecting to ‘incorporating’ CAM, while the state has acted
as a ‘broker’, trying to accommodate the demands and preferences of both
actors while simultaneously demonstrating its power and autonomy in
shaping health policy. In sum, the history of countermoves of CAM, the
medical profession and the state in recasting power relations regarding
CAM regulation in Portugal has highlighted the explanatory value of
Light's countervailing power theory and the need to move away from a
professional dominance and corporatist approach, in which CAM has simply
been seen as subjugated to the power of the medical profession and the
state.
Keywords
- Portugal;
- Complementary and alternative medicine;
- Medical profession;
- State;
- Countervailing powers;
- Professions regulation;
- Policy process
Copyright © 2016 Elsevier Ltd. All rights reserved.
