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The
growth of alternative medicine and its insurgence into the realms of the
biomedical system raises a number of questions about the nature of
evidence. Calls for 'gold standard' randomised controlled trial evidence,
by both biomedical and political establishments, to legitimise the
integration of alternative medicine into healthcare systems, can be
interpreted as deeply political. In this paper, the supposed objectivity
of scientific, biomedical forms of evidence is questioned through an
illumination of the multiple rhetorics embedded in the evidence-based
medicine phenomenon, both within biomedicine itself and in calls for its
use to evaluate alternative therapeutic systems. Anthropological notions
of evidence are constructed very differently from those of biomedical
science, and offer a closer resonance with the philosophy of alternative
medicine. Examples are given of the kinds of evidence produced by
anthropologists researching alternative medicine. Ethnographic evidence of
'what works' in alternative medicine includes concepts such as
transcendent, transformational experiences; changing lived-body
experience; and the gaining of meaning. It is proposed that the promotion
of differently constructed modes of evidence can be used to legitimise
alternative medicine by widening the definition of what works in therapy,
and offering a critique of what people feel is lacking from much of
orthodox medical care.
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