|Title||Mapping the epistemological diversity of Chinese medicine; a Q methodology study|
The diversity of medical practice has been widely documented in ethnographic and historical studies; what remains is to map out that diversity. In this research how such diversity manifests is elicited through asking practitioners their perspectives of how biomedicine influences their Chinese medicine practice. This starting point is chosen since the global dominance of biomedicine inevitably impacts, to varying degrees, on Chinese medicine practices. Q methodology, a unique combination of quantitative and qualitative methods (that challenges such divisions) is chosen for its ability to attain and describe a wide diversity of different subjective perspectives on a topic. Furthermore, this method allows these to arise from the data without a priori definition by the researcher. However, whilst looking at subjective opinions it is not interested in who said what, but rather what is being said about the topic. For subjectivity is seen to be forged in the social milieu; what is of interest is how such opinions group. Acknowledging that Chinese medicine today is not, of course, contained within Chinese borders, international perspectives are sought. The commonly accepted view that the two medical systems, biomedicine and Chinese medicine, used together lead to greater clarity of the whole is challenged, on epistemological grounds, drawing on theories of knowing found in the Chinese medicine literature. Six distinct practices of Chinese medicine were found and described using the term enactment. It is proposed that practitioners can access the differing inter-subjectively formed Chinese medicines using the patient body as a boundary object. Through capturing the richness and complexity of various points of view this research can identify points of both conflict and consensus that can offer directions for future practice, education and particularly clinical research design. It offers a contribution to the Q methodology literature through applying method assemblage in the analysis of factors. Thus, the neutral zone is rendered as important in understanding the narrative of the factor as are the points of most and least agreement.