The contested reality of acupuncture effects: measurement, meaning and relations of power in the context of an integration initiative in Norway
With the current health policy of evidence-based medicine, efforts to introduce new therapies in public health care are inevitably linked to the necessity of providing evidence for the therapies’ efficacy. By focusing on differences between patients’ viewpoints as to what counts as the effects of acupuncture and the outcomes measured by physicians in a study, I discuss the contested reality of effects in the context of an initiative aimed at the integration of acupuncture in a public hospital in Norway. In the analysis, I draw on ethnographic data from fieldwork at an acupuncture clinic where patients with rheumatoid arthritis (RA) were offered acupuncture as part of a pilot clinical study, which was the first step in an integration attempt. Applying Pierre Bourdieu’s concept of symbolic power, I discuss the power dimensions implicit in the evaluation of medical therapies and integration processes. To conclude, I suggest that for actors interested in the integration of acupuncture and other forms of alternative and complementary medicine, it seems a necessary step to recognise the need for better measures to counteract the illegitimate consequences of biomedical authority when plans for integration are designed.