For most of its existence, chiropractic has been sustained by pseudoscientific ideas such as subluxation and innate intelligence which are not based on solid science. Some chiropractors have been criticized for having an anti-immunization stance, despite the consensus of public health professionals on the benefits of vaccination, which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic. The American Medical Association called chiropractic an “unscientific cult” and boycotted it until losing an antitrust case in 1987.Chiropractic is said to have developed a strong political base and to have sustained demand for services; researchers Cooper and McKee report that it has gained more legitimacy and greater acceptance among physicians and health plans in the U.S. for the treatment of some musculoskeletal conditions and the principles of evidence-based medicine have been used to review research studies and generate practice guidelines. Traditional (or straight) chiropractic still assumes that a vertebral subluxation interferes with the body’s “innate intelligence”, a vitalistic notion ridiculed by the scientific and healthcare communities. Other chiropractors want to separate themselves from the traditional vitalistic concept of innate intelligence – John W Reggars wrote in 2011 that chiropractic was at a crossroads, and that in order to progress it would need to embrace science; in his view, the promotion of chiropractic as a cure-all was both “misguided and irrational”.
Chiropractic’s early philosophy was rooted in vitalism, spiritual inspiration and rationalism. A philosophy based on deduction from irrefutable doctrine helped distinguish chiropractic from medicine, provided it with legal and political defenses against claims of practicing medicine without a license, and allowed chiropractors to establish themselves as an autonomous profession. This “straight” philosophy, taught to generations of chiropractors, rejects the inferential reasoning of the scientific method, and relies on deductions from vitalistic first principles rather than on the materialism of science.
However, most practitioners currently accept the importance of scientific research into chiropractic, and most practitioners are “mixers” who attempt to combine the materialistic reductionism of science with the metaphysics of their predecessors and with the holistic paradigm of wellness; a 2008 commentary proposed that chiropractic actively divorce itself from the straight philosophy as part of a campaign to eliminate untestable dogma and engage in critical thinking and evidence-based research.
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