Robert Seip

The purpose of this thesis is to provide a robust epistemological justification for Evidence Based Medicine (EMB), and thereby to demonstrate the epistemological short comings of Complementary and Alternative Medicine (CAM). CAM has received support from both philosophers, such as Rorty and Feyerband, and the Sociology and Anthropology of Medicine. The thesis will thus review both the internal coherence and the application of non-realist arguments, and counter non-realism with the realist epistemology and philosophy of science that is represented by C.S. Peirce’s pragmatism. Rorty and Feyerabend and others have developed radical forms of scientific antirealism in the latter 20th century. Subsequently, sociologists developed even more intractable forms of anti-realism, which they applied to the social study of science. This approach served to challenge the legitimacy of orthodox scientific practice (including EMB). A practical expression of this controversy was immediately identified in the question of the role of scientific authority in a democratic society. That question was immediately applied to the status of alternative medical systems and their legitimacy vis-a-vis EBM in terms of the controversy over what has come to be termed "medical pluralism": If scientific medicine has no particular authority, should other, medical systems, epistemically incompatible with EBM, be made available as well? The thesis will suggest that non-realism is in fact a marginal position within the philosophy of science. Scientists, medical researchers and medical practitioners may thus appeal to the philosophy of science in order to justify their authority in the face of challenges from CAM. However, it will be suggested that they are frequently ill-served by a reliance on a simplistic understanding of the philosophy of Karl Popper. An alternative will be proposed in the philosophy of C. S. Peirce. His pragmatism offers to medical research and medical practice a way of understanding and justifying the scientific process, a justification of realism in the face of non-realism, and a resource for the criticism of CAM and medical pluralism, as at once epistemologically ill grounded and potentially dangerous to patients and the general public.