Short abstract:

This paper examines forms of epistemic authority enacted in naturopathic and acupuncture consultations. Analysis highlights how the discourses, techniques and technologies practitioners use effectively syncretize biomedical and 'refused knowledge' such that they lend each other legitimacy.

Long abstract:

The contested epistemic authority of biomedicine is receiving increased attention in STS, where complementary and alternative medicine (CAM) is often invoked as the quintessential challenger of biomedicine’s legitimacy. However, studies of CAM itself remain relatively scarce in STS, and the basis of CAM’s own epistemic authority, and how this may also be changing, is not well understood. Assessing when and how CAM challenges or aligns with scientific and biomedical epistemologies requires empirical analysis of specific cases of practice within this diverse field. This paper draws from a study that examines the forms of knowledge and evidence produced and applied in practice by two groups of CAM practitioners – naturopaths and acupuncturists – in Australia. Data were gathered by audio-recording practitioner-patient consultations and interviewing practitioners before and afterwards about their knowledge practices. The analysis highlights the range of discourses, techniques and technologies that enact epistemic legitimacy within the consultations. Biomedicine’s authority is rarely explicitly challenged in these spaces, and in various ways it is reinforced through practitioners’ engagement with standard biomedical testing and diagnoses and mimicry of biomedical repertoires. At the same time, traditional CAM paradigms and practices are woven through the consultations, effectively syncretizing biomedicine and 'refused knowledge' (Crabu et al. 2024) such that they lend each other legitimacy. The paper builds on emerging frameworks that identify modes of knowledge legitimation within contested epistemic domains, uncovering the modes that operate in these CAM clinics.