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Boundary objects in complementary and alternative medicine: Acupuncture vs. Christian Science

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  • Owens, Kellie

Abstract

Nearly four in ten American use complementary or alternative medicine (CAM) each year. Even with a large number of patients, CAM practitioners face scrutiny from physicians and biomedical researchers who, in an era of evidence-based medicine, argue there is little evidence to support CAM treatments. Examining how CAM has or has not been integrated into American health care is crucial in understanding the contemporary boundaries of healthcare systems. An analytical tool from science and technology studies, boundary objects, can help scholars of medicine understand which practices become integrated into these systems. Using a comparative analysis based on archival and interview data, this paper examines the use of boundary objects in two alternative medical practices – acupuncture and Christian Science. While boundary objects alone cannot explain what health practices succeed or fail, juxtaposing the use of boundary objects by different CAM groups identifies the work boundary objects do to facilitate integration and the conditions under which they “work.” I find that acupuncturists' use of sterile needles as a boundary objects assists in their effective integration into U.S. healthcare because needles are both a symbol of biomedical prowess and a potentially unsafe device requiring regulation. Christian Scientists' use of the placebo effect as a boundary object has not succeeded because they fail to acknowledge the different contextual definitions of the placebo effect in biomedical communities. This comparative analysis highlights how context affects which boundary objects “work” for CAM practices and theorizes why alternative health practices succeed or fail to become integrated into healthcare systems.

Suggested Citation

  • Owens, Kellie, 2015. "Boundary objects in complementary and alternative medicine: Acupuncture vs. Christian Science," Social Science & Medicine, Elsevier, vol. 128(C), pages 18-24.
    • Handle: RePEc:eee:socmed:v:128:y:2015:i:c:p:18-24
    DOI: 10.1016/j.socscimed.2014.12.020
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    References listed on IDEAS

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    1. Baer, Hans A. & Jen, Cindy & Tanassi, Lucia M. & Tsia, Christopher & Wahbeh, Helen, 0. "The drive for professionalization in acupuncture: A preliminary view from the San Francisco Bay area," Social Science & Medicine, Elsevier, vol. 46(4-5), pages 533-537, February.
    2. O'Neill, Arthur, 1994. "Danger and safety in medicines," Social Science & Medicine, Elsevier, vol. 38(4), pages 497-507, February.
    3. Kim, Jongyoung, 2006. "Beyond paradigm: Making transcultural connections in a scientific translation of acupuncture," Social Science & Medicine, Elsevier, vol. 62(12), pages 2960-2972, June.
    4. Paul R. Carlile, 2002. "A Pragmatic View of Knowledge and Boundaries: Boundary Objects in New Product Development," Organization Science, INFORMS, vol. 13(4), pages 442-455, August.
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    Cited by:

    1. Fleming, Mark D. & Safaeinili, Nadia & Knox, Margae & Hernandez, Elizabeth & Brewster, Amanda L., 2023. "Between health care and social services: Boundary objects and cross-sector collaboration," Social Science & Medicine, Elsevier, vol. 320(C).
    2. Dowrick, Anna & Kelly, Moira & Feder, Gene, 2020. "Boundary spanners: Negotiating connections across primary care and domestic violence and abuse services," Social Science & Medicine, Elsevier, vol. 245(C).

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