ID: 1055468
Student Number
1055468
Name of lecturer
Val Pennacchio
Assignment Title
“Discuss your understanding of the main
philosophical schools of thought and methods of
reasoning relevant to the practice of chiropractic”
Module Number/Name
Year 2: Philosophy Studies
Word Count
1630
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ID: 1055468
Introduction
Chiropractic, and with it, some would say inseparably, ‘Chiropractic
Philosophy’ originated with D.D. Palmer. From its early days Chiropractic
developed and evolved through the influence of its key thinkers. Most notably
B.J. Palmer, the son of the developer, but also through the influence of
Chiropractors taught by D.D. Palmer, particularly Fitz, Howard, Langworthy
and Smith who all developed their own ‘tweaks’ to that which Palmer had
taught them; doing so, however, without collaboration for the most part
(Johnson, 2010).
The Palmers, father and son, engaged in many battles, on both personal and
professional grounds. Likewise the profession has not broken away from its
early tradition of tension and factionalism to this day, despite its maturity of
more than a century of providing care to patients worldwide. It is fair to say
that Chiropractic Philosophy has been controversial since its beginnings
(Biggs et al, 2002), both within and external to the profession. Despite
philosophical differences, today, delivery of education for Chiropractors is
largely regulated and meets internationally recognised standards, affording
portability of Chiropractic qualifications globally, but there are differences in
education delivery, in that education providers are often clearly defined by
their philosophical stance, which in turn produces significant differences in the
attitudes of graduates in line with the college they attended (Biggs et al,
2002).
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However when surveying the philosophical views of Chiropractors it is easy to
see they are, by and large, a heterogenous group, a ‘broad church’. Shaping
the internal development of Chiropractic Philosophy, over time, were the
external influences of colliding world views, e.g. vitalism vs mechanism or
holism vs reductionism (Senzon, 2011) and “internal politics linked often to
personal ambitions and rivalries” (Copland-Griffiths, 1991 p 138).
It is beyond the scope of this essay to explore all of the forces that shaped
Chiropractic-Philosophy by considering the dominant established influences
upon its early proponents, or the political drives which shaped Chiropractic’s
development since inception. The essay will however, endeavour to describe
how key concepts such as Vitalism, Materialism. Holism, Reductionism,
Naturalism, Therapeutic Conservatism, Humanism, and Critical Rationalism
have emerged as forces which shaped, and continue to define, that which
Chiropractors consider as their personal philosophical orientation.
A Chiropractor’s philosophical stance is undoubtedly important, for as
Seaman (1998) states: “When applied to Chiropractic, philosophy demands
that we examine our concepts about subluxation/joint complex dysfunction
and methods of Chiropractic care for the purpose of disposing in-correct
concepts and methods”; a view that proponents from all philosophical
perspectives in Chiropractic might accept, albeit with differing opinions about
what might be disposed of.
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Vitalism & Materialism
D.D. Palmer was undoubtedly, philosophically, a vitalist. Palmer conceived
that the various systems of the human body were mediated by impulses,
facilitated by the body’s ‘innate intelligence’; which was considered to be
driven by a ‘universal intelligence’. Palmer’s philosophical stance was in line
with the long tradition of vitalist practitioners in health disciplines who believed
that all living organisms are sustained by a vital life-force which is distinct
from, but moreover more powerful, than physical and chemical forces
(Coulter, 1999). Vitalist ideas can be seen in western culture in the concept of
Vis Medicatrix Naturae and Pneuma articulated by the Greeks, in Chi as
understood and promoted in Chinese medicine and philosophy, and in Prana
as expressed in the Upanishads of the Rishis of India (Oddo, 2012).
Diametrically opposed to vitalism are those views held by proponents of
materialism, who would not consider that there is an ‘innate intelligence’ or
any transcendental force driving life. Instead, in a reductionist manner, all
phenomena is seen as simply ‘matter’ and in clinical terms, such philosophy
applied to diagnosis and treatment would manifest in an altogether
mechanistic hypothesis of disease, and mechanistic approach to delivering
treatment.
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Holism & Reductionism
Philosophically, Holism views the ‘whole’ as more than the sum of its parts
(Coulter, 1999). Holism is embodied in many contemporary health disciplines
in the context of understanding expressed in the Biopsychosocial Model,
proposed by Engel in 1977, which considers the complex inter-relationship of
biological, psychological and sociological factors when seeking to understand
the manifestation of physical or mental pathologies (Adler, 2009). Importantly,
holism argues against the reductionist approaches followed in other health
care disciplines, maintaining that the ‘whole’ is not only distinct from its parts
but also that the ‘whole’ influences its parts and that individual parts cannot be
understood without considering their interdependent nature within the ‘whole’
(Coulter, 1999).
Chiropractic, since its inception, has assumed a holistic position towards the
delivery of patient care, one which is also completely compatible with its
vitalist philosophical origins. Reductionism would seek to reduce the causes
of disease to physiological disturbances in line with the biomedical view of
illness (Andersen, 2001).
Naturalism
Coulter (1999) states that: “For (D.D.) Palmer, the healer heals as nature
heals, in accordance with nature’s laws. Compelling the body to do its own
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healing with its own forces”. Palmer profoundly believed that the body had a
natural capacity to heal itself without the interference of drugs or surgery,
which he saw as potentially removing the symptoms but not the cause
(Coulter, 1999). Naturalism is increasingly popular today, owing perhaps to
the increased awareness of iatrogenic illness as a consequence of
involvement with allopathic medical interventions, which causes people to
consider conservative and natural health interventions. In the naturalist
paradigm Chiropractic finds itself in harmony.
Therapeutic Conservatism
In Therapeutic Conservatism Chiropractic also finds accord. Chiropractic is
inherently conservative, believing that the best care often involves the least
amount of intervention necessary, with any treatment taken being
concentrated upon facilitating the body’s own capacity to heal (Coulter, 1999).
Therapeutic Conservatism not only compels the healer to deliver as little
intervention as possible, but it also empowers and entreats the patient to be
very much engaged in their own recovery (Coulter, 1999). The therapeutic
working alliance which can be formed by such an approach is one which has
far reaching positive benefits because, in the very least, the patient must
assume a level of responsibility for their own health which is often abdicated
in models of health care which could be dehumanising through their
hierarchical stance, positioning the healer as the expert dispensing inflexible
recommendations, or curative medications, as a primary route to wellness.
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Therapeutic conservatism, in its Chiropractic expression, is not just embedded
in original Chiropractic philosophy but also, on some level, finds expression in
Chiropractic care delivered by those in the profession who embrace a more
‘medically’ orientated philosophical stance and indeed is often the dictate of
professional regulators of the profession.
Humanism
Humanist philosophy views the individual in context of their immutable rights
and holds that they should be held in respect for the expression of their
individuality (Coulter, 1999). Humanist philosophy has permeated
psychological and health science in contemporary society. Humanist
approaches to health care requires the health practitioner to actually care for
their patients, rather than simply ‘treat’ them (Coulter, 1999). This philosophy
therefore assumes a very patient-centred treatment approach which also
elicits the patient’s working alliance with the practitioner, requiring the patient
to be active in partnership with the healer – therefore in accord with
interdependent approach assumed also in Therapeutic Conservatism.
Critical Rationalism
The philosophical stance adopted by Critical Rationalists is that all
phenomena can be understood through the use of reason or rationality, reliant
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upon scientific investigation of data collected by the five senses (Coulter,
1999) to draw ‘temporary’ conclusions through testing various hypothesis, by
various scientific means. They are temporary conclusions as it is thought that
on-going growth in understanding will add to, or refute, these initial
conclusions, therefore advancing understanding. These views were
propounded by Karl Popper (1969), an influential force in the development of
Critical Rationalism within science, who held that criticism was the life blood of
rational thought and that all knowledge is fallible, and all knowledge may be
advanced further, a position highly critical of dogmatism (Coulter, 1999).
Critical Rationalist philosophy holds that the methods of science are equally
applicable to health and the natural sciences, accepting that the biological and
social sciences inform the knowledge base for clinical practice (Coulter,
1999). Critical Rationalism has influenced the contemporary education of
Chiropractors, which now includes considerable education in basic science as
well as that of Medicine (Coulter, 1999).
Rationalist philosophy may often be applied in science to bestow a veneer of
seemingly logical analysis, when in fact the reality of its validity in given
situations is less so. In his seminal work, The Structure of Scientific
Revolution (1962), Thomas Kuhn questioned the ‘history of science’, asserting
that it was altogether less rational than it was portrayed and he suggested that
science had had two periods; normal and revolution. During periods of normal
science, scientists do not challenge the existing paradigm but instead apply it
to a wide field of research. He suggested that eventually, as no single
paradigm can resolve all research questions then new rival paradigms would
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emerge. Interestingly Kuhn suggested that in transitioning to a new paradigm
from an existing one, then the scientist would go through a process of
‘conversion’ (Coulter, 1999).
Kuhn and others challenged the movement of logical positivism and its later
derivation, logical empiricism, which aimed at defining a strict definition of
validity and meaning (Polanyi, 1969) and had emerged as dominant
influences on scientific philosophy in the early twentieth century. Two decades
after the peak dominance of such thinking, Polyani (1969) states that: “it has
become clearer year by year that this aim was unattainable”.
Conclusion
Chiropractic was founded upon vitalistic philosophical beliefs, congruent with
the philosophical views embraced in Holism, Naturalism, Humanism and
Therapeutic Conservatism. Over time a diverse spectrum of opinion, shaped
by various other schools of philosophical thought, such as Critical Rationalism
and Logical Empiricism, as well as by dominant personalities within the
profession, came to influence and divide Chiropractors perception of how
Chiropractic should be defined and indeed practiced; in much the same way
that these philosophical influences also divided public perception of science
and health care in general. A universally accepted definition of Chiropractic
Philosophy does not exist, although a dominant one, in accord with
Chiropractic’s founding principles and philosophy does exist and it will be
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interesting to observe how continuously evolving public perception of science
and health care, which is increasingly holistic in tone, will influence the
Chiropractic profession in the future.
Word Count (1630)
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References
Adler, R. (2009). Engel's biopsychosocial model is still relevant today. Journal
of Psychosomatic Research. 67 (1), 607-611.
Andersen, H. (2001). The history of reductionism versus holistic approaches
to scientific research. Endeavour. 25 (4), 153-156.
Biggs, D., Mierau, D. and Hay, D. (2002) Multiple Authoring. Measuring
philosophy: a philosophy index. Journal of Canadian Chiropractic Association.
46 (3), 173-183.
Copland-Griffiths, M. (1991) Dynamic Chiropractic Today. p. 138. Thorsons
Publishing Group
Coulter, I. (1999) Chiropractic: A Philosophy for Alternative Health Care. pp.
8-43. Butterworth-Heinemann
Johnson, C. (2010). Reflecting on 115 years: the chiropractic profession's
philosophical path. Journal of Chiropractic Humanities. 17 (1), 1-5.
Oddo, T. (2012) The Early History and Philosophy of Chiropractic: The life
and Work of D.D. Palmer. p. 66. Amazon Print
Polanyi, M. (1969) Knowing and Being. p. 73. The University of Chicago
Press
Seaman, D. (1998). Philosophy and Science versus Dogmatism
in the Practice of Chiropractic.
http://www.chiro.org/ChiroZine/ABSTRACTS/Science_vs_dogmatism.shtml
(accessed October 16, 2015)
Senzon, S. (2011). Constructing a philosophy of chiropractic: evolving
worldviews and postmodern core. Journal of Chiropractic Humanities. 18 (1),
10-23.
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Bibliography
Haavik. H. (2014) The Reality Check. Haavik Research
Koch. D. (2008) Contemporary Chiropractic Philosophy. Roswell Publishing
Company
Morter. M. (2001) The Soul Purpose. Dynamic Life, LLC
Seaman, D. and Soltys. J. (2013). Straight chiropractic philosophy as a barrier
to Medicare compliance: a discussion of 5 incongruent issues. Journal of
Chiropractic Humanities. 20: 19-26.
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