After Canadian lawmakers proposed legislation in 2008 to better enforce existing regulations of the supplement industry, Canadians mounted significant public protest, including an online petition ...that garnered more than 24,000 signatures and 8585 comments over several months. In this article, we offer a rhetorical analysis of a randomized sample of those comments to track the range of topics and arguments advanced by signatories against the legislation. We identify five primary topics that recur throughout the dataset, freedom, choice, health, greed, and nature, which in turn furnish sixteen core arguments that together illuminate the signatories' primary concerns about potentially losing access to supplements. Ultimately, the topics and arguments reveal deep and persistent public anxieties not only about individuals’ health but also about their agency and autonomy. This study both provides insight into why people reject government oversight of health in favor of alternative, natural health interventions and illustrates the utility of qualitative analysis of public commentary about health and health policy in texts such as petitions, public comment periods, and social media responses, all of which are rich sites of discourse that merit further study from both scholars, policy-makers, and health researchers and practitioners.
During the 1990s, an unprecedented number of Americans turned to complementary and alternative medicine (CAM), an umbrella term encompassing chiropractic, energy healing, herbal medicine, homeopathy, ...meditation, naturopathy, and traditional Chinese medicine. By 1997, nearly half the US population was seeking CAM, spending at least $27 billion out of pocket. Bounding Biomedicine centers on this boundary-changing era, looking at how consumer demand shook the health care hierarchy. Drawing on scholarship in rhetoric and science and technology studies, the book examines how the medical profession scrambled to maintain its position of privilege and prestige, even as its foothold appeared to be crumbling. Colleen Derkatch analyzes CAM-themed medical journals and related discourse to illustrate how members of the medical establishment applied Western standards of evaluation and peer review to test health practices that did not fit easily (or at all) within standard frameworks of medical research. And she shows that, despite many practitioners' efforts to eliminate the boundaries between "regular" and "alternative, " this research on CAM and the forms of communication that surrounded it ultimately ended up creating an even greater division between what counts as safe, effective health care and what does not.At a time when debates over treatment choices have flared up again, Bounding Biomedicine gives us a possible blueprint for understanding how the medical establishment will react to this new era of therapeutic change.
How and why the idea of wellness holds such rhetorical—and harmful—power.In Why Wellness Sells, Colleen Derkatch examines why the concept of wellness holds such rhetorical power in contemporary ...culture. Public interest in wellness is driven by two opposing philosophies of health that cycle into and amplify each other: restoration, where people use natural health products to restore themselves to prior states of wellness; and enhancement, where people strive for maximum wellness by optimizing their body's systems and functions. Why Wellness Sells tracks the tension between these two ideas of wellness across a variety of sources, including interviews, popular and social media, advertising, and online activism. Derkatch examines how wellness manifests across multiple domains, where being well means different things, ranging from a state of pre-illness to an empowered act of good consumer-citizenship, from physical or moral purification to sustenance and care, and from harm reduction to optimization. Along the way, Derkatch demonstrates that the idea of wellness may promise access to the good life, but it serves primarily as a strategy for coping with a devastating and overwhelming present.Drawing on scholarship in the rhetoric of health and medicine, the health and medical humanities, and related fields, Derkatch offers a nuanced account of how language, belief, behavior, experience, and persuasion collide to produce and promote wellness, one of the most compelling—and harmful—concepts that govern contemporary Western life. She explains that wellness has become so pervasive in the United States and Canada because it is an ever-moving, and thus unachievable, goal. The concept of wellness entrenches an individualist model of health as a personal responsibility, when collectivist approaches would more readily serve the health and well-being of whole populations.
Communities across Canada are increasingly developing food charters, with at least 22 regional charters published in Ontario alone. As a rhetorical genre, food charters are persuasive actions that ...articulate not only the kind of food system to which a community aspires, but also the kind of community that it aspires to be. We argue that Ontario’s food charters play an important role in constituting a sense of community identity and values through the rhetorical action of the genre itself. We analyze how this is accomplished through two rhetorical features, the naming of community and the listing of community priorities, showing how these features simultaneously obscure and reveal ideological tensions and logical incongruities within each community’s vision for its food system. Our analysis illustrates how the genre of the food charter both responds to and shapes the diverse, possibly conflicting values that inform food policy and food security initiatives in Ontario, and it offers insight into how the genre itself may inadvertently constrain the action it is intended to perform.
Public health promotion of “local food” Derkatch, Colleen; Spoel, Philippa
Health (London, England : 1997),
03/2017, Letnik:
21, Številka:
2
Journal Article
Recenzirano
This article explores how the recent and growing promotion of local foods by public health units in Ontario, Canada, rhetorically interpellates the “good” health citizen as someone who not only takes ...responsibility for personal health but, through the consumption and support of “local food,” also accepts and fulfills her responsibilities to care for the local economy, the community’s well-being, and the natural environment. Drawing on Charland’s concept of constitutive rhetoric, we analyze a selection of public health unit documents about local food to develop a textured account of the complex, multifaceted forms of health citizenship they constitute. Our analysis reveals that, despite their appeals to environmental sustainability and community well-being, these materials primarily characterize the ideal health citizen as an informed consumer who supports the interests of the neoliberal state through individualized lifestyle behaviors, consuming goods produced and distributed through private enterprise. By exhorting individuals to “buy local,” public health discourse therefore frames responsible health citizenship principally in consumerist terms that constrain the range of available options for citizens to engage in meaningful action vis-à-vis their food systems.
This article examines professional boundary work in a set of medical journal theme issues about complementary and alternative medicine (CAM). Whereas these journals claim as their collective goal to ...bridge and blur boundaries between mainstream and alternative medicine, this article identifies and describes two chief rhetorical strategies through which the journals instead bolster and even expand those boundaries. These two strategies, constituting and categorizing, appear central to the demarcation of biomedical boundaries vis-à-vis CAM.
In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The "gold standard" method, the randomised, controlled trial (RCT), imbues ...medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM.