Elsevier

Social Science & Medicine

Volume 63, Issue 7, October 2006, Pages 1771-1783
Social Science & Medicine

The drive for legitimation in Australian naturopathy: Successes and dilemmas

https://doi.org/10.1016/j.socscimed.2006.04.021Get rights and content

Abstract

Whereas naturopathic physicians have either “licensure” or state-mandated “registration” in 13 US states and four Canadian provinces, naturopaths in Australia have thus far failed to obtain “statutory registration” in any political jurisdiction, despite the fact that chiropractors and osteopaths have done so in all Australian states and territories, and acupuncturists and Traditional Chinese Medicine practitioners have done so in the state of Victoria. Ironically, naturopathy and various other complementary medical systems are taught in many public tertiary institutions. This essay presents an overview of the development and the current socio-political status of naturopathy in Australia and its redefinition in some contexts as “natural therapies” and “natural medicine” or even as the major component of complementary medicine. It also examines reasons why the Australian state has come to express an interest in naturopathy along with other complementary medical systems.

Introduction

Whereas various professionalized heterodox medical systems, such as osteopathy, chiropractic, and acupuncture, have been the focus of a modest amount of historical and social scientific research in various Anglophone countries, particularly the United States, Canada, Britain, and Australia, naturopathy as a professionalized heterodox medical system has received relatively little attention in these settings. I, along with Cody (1999) and Whorton (1986), Whorton (2002), have given some attention to the historical development and socio-political status of naturopathy in the United States and Eliane Gort and David Coburn (1988) and Boon (1997), Boon (1998) have touched upon various aspects of naturopathy in Canada (See Baer (1992), Baer (2001)). In comparison to North America, naturopathy in Australia has been the subject of very little historical and social scientific research. Based upon both archival and ethnographic research that I conducted during my stint as a visiting senior lecturer at Australian National University in 2004, I present an overview of the development and current socio-political status of naturopathy “down under” and its redefinition in some contexts as “natural therapies” or “natural medicine” as a broad category within the larger rubric of “complementary medicine.”

In comparison to the United States where naturopathic physicians have achieved “licensure” or state-mandated “registration” in 13 states, the District of Columbia, and Puerto Rico, and in Canada where they have achieved “licensure” in four provinces, naturopaths have failed to achieve “statutory registration,” the rough counter-part to the former legal processes, in any Australian political jurisdiction. In contrast, chiropractors and osteopaths obtained “statutory registration” in all Australian states and territories beginning in the early 1980s and acupuncturists and Traditional Chinese Medicine practitioners obtained statutory registration in the state of Victoria in 2000.

This essay also examines reasons why the Australian state has come to express an interest in and has provided limited support for naturopathy and various other complementary medical systems. For example, naturopathy and some other complementary medicine systems are now taught in various public tertiary institutions. While naturopathy in Australia has enjoyed some degree of increasing legitimation, it also faces the danger of loosing its distinctive identity and becoming conflated with broader entities referred to as “natural therapies,” “natural medicine,” or even “complementary medicine.”

Section snippets

The regulatory process in Australia

Health policymakers in Australia have tended to delineate three forms of regulation for health occupations in Australia, namely self-regulation, statutory registration, and co-regulation (NSW Health Department, 2002, pp. 16–19). Self-regulation theoretically involves various occupational groups establishing and maintaining their own standards and codes of practice, education, training, and disciplinary action. Co-regulation theoretically occurs when the state and occupational groups share the

The development of naturopathy and natural therapies in Australia

Australian naturopathy appears to have drawn from both British and American naturopathy and became initially intricately intertwined with both osteopathy and chiropractic. Like in other countries, naturopaths function as the ultimate therapeutic eclectics. They regard disease as a response to bodily toxins and imbalances in a person's social, psychic, and spiritual environment: germs are not the cause of disease per se but rather are parasites that take advantage of the body when it is in a

The drive for statutory registration on the part of naturopaths and natural therapists

In their drive for professionalization and legitimacy, complementary practitioners often emulate biomedicine by pursing some form of state-mandated recognition and/or accreditation, even one internal to the occupational group. Heterodox practitioners around the world have a long history of conducting intense campaigns to obtain state-sponsorship and have found support among sympathetic politicians and other patrons. In the struggles between rival medical systems, the state, which holds the

Government spending for complementary medicine and research

The federal government began formal recognition of complementary medicine training programs other than chiropractic and osteopathy in 1992. It implemented the National Health Training Packages that include standard qualification titles, such as Advanced Diploma of Naturopathy or Advanced Diploma of Western Herbalism. The Australian state has gone further than perhaps any other government in a developed society in terms of supporting public education in complementary medicine, not only

The interest of the Australian state in complementary medicine

Despite the fact that Australia has a plural or dominative medical system that is dominated by biomedicine, other medical systems, including naturopathy, persist and thrive, albeit often under precarious and tentative conditions. Indeed, biomedicine's dominance over rival medical systems has never been absolute in any society, developed or developing. In advanced capitalist societies, the state, which primarily serves the interests of the corporate class, must periodically make concessions to

Conclusion

While complementary practitioners, including naturopaths but particularly chiropractors and osteopaths, have indeed improved their legitimacy within the context of the Australian dominative medical system, this development has not seriously eroded biomedical domination. As Willis (1988, p. 176) observes, “Practitioners of complementary care modalities have been so far unsuccessful in gaining access to the hospital system, either public or private.” Conversely, biomedical dominance has been

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