The first part of this episode is available to all listeners. To hear the whole thing, become a paid subscriber here.
Philosopher and medical ethics professor Arianne Shavisi joins us to discuss why alternative medicine isn’t the answer to a patriarchal healthcare system—and why in many ways it’s even worse. We get into the common misconception that alternative medicine is feminist, how alternative medicine differs from scientific medicine, the role of values in people’s attraction to alternative medicine, and more. Behind the paywall, we discuss why true patient autonomy and informed consent are impossible in alternative medicine, her thoughts on how to improve scientific medicine so that people aren’t drawn to worse alternatives, how she responds to claims that criticizing alternative medicine means discounting “non-Western” cultural knowledge, and more.
Arianne Shahvisi is a Kurdish-British writer and academic philosopher. She studied astrophysics and then philosophy at the universities of Cambridge and Oxford, and now teaches applied philosophy at the Brighton and Sussex Medical School, where her research focusses on gender, race, migration, and health. She writes regularly for the London Review of Books, and her essays have also appeared in the Guardian, the Independent, and the Economist. Her first book, Arguing for a Better World: How Philosophy Can Help Us Fight for Social Justice, was published by Penguin in 2023.
Resources and References
Contains affiliate links to Bookshop.org, where I earn a small commission for any purchases made.
Christy’s second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for extended interviews and more
Arianne’s paper “Medicine is Patriarchal, But Alternative Medicine Is Not the Answer”
More about Arianne at the University of Sussex
Arianne’s book, Arguing for a Better World: How Philosophy Can Help Us Fight for Social Justice
Christy’s online course, Intuitive Eating Fundamentals
Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: We're going to talk about your important critiques of alternative medicine that I'm really excited for people to hear. But before we do, I'd love to know just a little bit about what got you interested in this subject.
Arianne Shahvisi: So I think it was a few years ago now. I wrote the paper that we're going to be talking about back in 2017. And at that time, I was spending a lot of my research time thinking about feminism, thinking about philosophy of feminism. And I'd heard from various different people that they somehow felt that feminism was connected to alternative medicine. And I found this sort of proposed connection surprising because it seemed to me that there was something deeply unfeminist about alternative medicine. And so I suppose that's what made me want to dig in a little bit more on that connection and try to at least explain my thoughts about this.
Christy Harrison: And did it come from any sort of personal experience you had had with alternative medicine or not so much?
Arianne Shahvisi: No. So I don't have any personal experiences of alternative medicine, but I certainly have negative experiences of scientific medicine. And many of the people that I was talking to, friends, other academics, and I'm talking about women here, women academics, women friends, also had these negative experiences with what we would call scientific or conventional medicine. And so I do have those personal experiences. I had had a different response to that, the response of feeling like conventional medicine needed to do better. Whereas some friends and, as I say, other scholars working in this area seem to have decided that the best thing to do was to look elsewhere.
Christy Harrison: Yeah. I'm curious if that has anything to do with your background. Cause you have a science background, right?
Arianne Shahvisi: Yeah, I think it probably does have something to do with my background. And I think maybe one of the things we can talk about today is people's relationships to science. I'm very fortunate in that I have had lots of access to science, I've had lots of opportunities to learn. So I've ended up being a very scientifically literate person. My first degree was in physics, and that was within a natural sciences course. So I got to take lots of other sciences, too. So I feel reasonably confident engaging with scientific literature, reading scientific papers, kind of adjudicating scientific claims when I read them in the media. So definitely I think that's an important piece of background information in terms of perhaps why my relationship to medicine as a feminist might differ from another person's.
Christy Harrison: You have a PhD in the philosophy of science, right? Can you share a little bit about what that focuses on, what that entails?
Arianne Shahvisi: Yeah, I do. So my PhD was actually on looking at the very early conditions within the universe. So it's like a cosmology PhD, essentially. So quite far away from this kind of work. But definitely studying philosophy of science makes you think very carefully about what science is. So one of the very common definitions of science is that you put forward a hypothesis that is falsifiable. So the idea being that another person or group of people can come along and there are ways in which they could attempt to demonstrate that your hypothesis is wrong. Because that's such an important part of science.
And obviously, if after a certain period of time nobody has succeeded in demonstrating through evidence that your hypothesis is wrong, then that hypothesis tends to be adopted. Thinking quite hard about what the hallmark of science is, evidence is clearly a really important part of it. And philosophers of science are very concerned with these questions, what constitutes science? Where are the boundaries of science? And that was something I was thinking about quite deeply within my thesis as well.
Christy Harrison: And then you moved into the philosophy of feminism. I'm curious how that differed from the sort of hard science background that you had.
Arianne Shahvisi: Yeah, so it was quite a big change. I mean, the reason for the change was simply that once I had my training in philosophy, I felt capable of tackling other questions. It's quite a transferable set of skills. And there are lots of things in the world then and now that make me very angry, that I feel need greater attention, problems that need to be solved. And my research took a turn towards gender, race and migration and all sorts of issues that relate to those three. The skill set, as I say, is very similar. So it's still the same kind of skills of analysis and trying to find firm definitions of concepts that are used casually in everyday life, like science, like gender, like race. That's an important part of the work of a philosopher, regardless of which area of philosophy you work within.
Christy Harrison: Many of my listeners here are feminists who've also been pulled in by the promises of alternative medicine in many cases because they weren't being served by conventional healthcare. And I myself had that experience as well many years ago. And many of us have now come to question alternative medicine. That's one of the reasons for being of this podcast is that I went through this whole journey of really buying into diets and supplements and all these different things, and then came to question it when it just me down a path of increasingly disordered eating. And I realized that the genesis of some of my problems was actually disordered eating itself.
I have multiple chronic conditions that persist, but I think they were made worse by all of that sort of wellnessy stuff and alternative medicine kind of approaches that I was taking. And so now I'm kind of looking at it through a critical lens. And also have a degree as a dietitian and master's of public health nutrition. So I was trained in research methods. I finally of understood how to read a study, but previously as a health journalist, I did not understand how to read a study and was just relying on abstracts most of the time and then talking to the "experts," the people who had done the studies or others in the field and kind of relying on their interpretation. And it's really nice to now be able to dig in and understand it myself.
But anyway, I have gone through this whole journey and I think many people listening have gone through some similar experiences of coming to question alternative medicine. But I feel like I haven't heard anyone other than you talking about it in this way, articulating how alternative medicine is actually antithetical to feminism. So I'd love to get into that and maybe to start, we could talk about why people think alternative medicine is feminist in the first place.
Arianne Shahvisi: Yeah, it's a really great question. So I think lots of people who turn to alternative medicine do so primarily because they have had really negative experiences with scientific or conventional medicine. And the major theme of that dissatisfaction is not being treated with respect and not feeling autonomous in that interaction. Clearly, medical professionals hold an enormous amount of power by virtue of the fact that they can make people well. There's no greater power in the world than that. And of course, there are huge information dipoles.
So going into an interaction with a medical professional, they hold all of that information, and patients tend to hold less information and in many cases very little information. And then there's plenty of evidence that that's a differential experience. So there will be lots of people who are having those kinds of negative experiences. So they're going into an interaction with a healthcare professional, they're feeling disempowered by it. They're feeling as though the decisions that they're making, the choices that are being offered and not giving them the autonomy that they need. So that's a universal experience for lots of people from lots of different social identity groups.
But we have plenty of evidence to show that women are having A much harder time. Women are not being listened to. They're not being listened to, they're not feeling listened to, they are not having reports of their pain taken seriously. They're not getting the expensive but important physical tests requested that are needed in order to properly diagnose what's going on. These are not just general statements I'm making. There are multiple studies which demonstrate that women are less likely to be given painkillers even when their pain scores are the same as the pain scores for men. So when they're asked by a medical professional, on a scale of one to 10, how would you rate this pain? Were they giving the same scores? That's not being matched by the same dosage of painkillers. And in many cases they're not being given painkillers at all.
So there's a real sense in which this isn't something that women patients are inventing. There is a real sense in which women are not being listened to. Their reports are not being taken seriously when they attempt to describe things about their own bodies. And then on the other hand, you have other areas of medicine which are being kind of over medicalized. So there's almost an under medicalization where women are being told, "Oh, I don't know if this thing you're experiencing is really a medical problem, could it be a sort of psychological thing or could it be that you're just leading a particular kind of lifestyle" or something and then you get over medicalization. So areas like pregnancy and childbirth are the kind of classic examples where things which needn't be so medicalized are heavily medicalized. And this is often a way of the medical profession exercising greater control over what they consider to be a high risk scenario.
So basically making it easier for themselves, but in the process making the experience much more difficult and in some cases traumatizing for their women patients. So you've got this mix of really quite negative experiences. And I have to say, we should trust the reports of women when they tell us this is happening. But even over and above that, we have these kind of independent evidence bases for this. But even over and above that, we have these kind of independent evidence bases for this.
Christy Harrison: Just a flag for listeners. Your paper, "Medicine is patriarchal, but alternative medicine is not the answer," that has a great catalog of these studies, if people are interested.
Arianne Shahvisi: Yeah. And since, it was written in 2017, published in 2018, and a number of years have passed since so I've written a little bit on this since then, that there are more examples. They keep coming in. So this is not a problem that is going away. It's very much a live issue. I'm sure many of your listeners will be hearing this conversation and going through their own mental catalog of experiences. So then you have this group of people who don't feel listened to, who are in pain, who are unwell, right? So we're talking about patients. We're not just talking about people not being listened to, which will be bad enough. We're talking about people not being listened to, who are suffering. And obviously they want to be listened to. And more than that, they want their problems to be solved.
So we can all agree this is a feminist issue when a particular group of you, in the same way that this is also an issue of race, because we can also think about this in terms of race. The very same sorts of evidence that we see that demonstrate that women are having less positive experiences in their healthcare interactions, we see the same sorts of things in relation to people of color, the same kinds of evidence there. And of course, thinking intersectionally, women of color are having a very bad time with these two kind of axes of a sort of epistemic injustice, right? Of not being listened to on two counts, in ways that interact in complex ways.
There are specific issues that have been observed in relation to, for example, black women's experiences of, say, obstetric care in the U.S. There's plenty of evidence there as well. So this is an issue of race. This is an issue of gender. So it's clearly a feminist issue. And the question, of course, then is, what do we do next? What do we do about this? And the decision about what to do next is most of the time made entirely at the individual level. It would be great if we were all better organized and we could be working together to push for change here. And I hope that at some point in the future we'll see more organizational, and there are, of course, organizations that are trying to work to combat this kind of thing.
But the decision is, in the first instance, made at the individual level. So a person is faced with having to make a plan, what am I going to do? Am I going to go back to that doctor who doesn't listen to me, who makes me feel disrespected, who implies that I'm making things up, who is making it really hard for me to access diagnostic tests and medications? And it may not be as well worked out as that. It may just be, "I felt awful today when I saw my doctor and I already feel awful because I'm suffering with this medical problem. So what do I do now?"
And what we see then is lots of people feeling like greater liberation, greater autonomy lies in breaking outside the medical paradigm. That the problem is the medical paradigm and the power it holds. And clearly, feminists criticize power. Power is the major site of injustice. Power is the thing we want to struggle against. The medical establishment is clearly powerful. And so I think alternative medicine begins to look like the place where liberation and autonomy lie. A place that is aligned with anti-establishment values. A place that perhaps is safer for women, safer for people whose values are feminist values, anti-racist values, environmentalist values. And so I think that's why the two end up being connected.
Christy Harrison: Yeah, that makes so much sense. And your argument, I think, is so powerful in that you unpack why that's not the case on multiple levels. I'd love to start with your definition of alternative medicine.
Arianne Shahvisi: Sure, yeah, I'll give a short version. Obviously it's spelled out in much more detail within the paper. So the first thing to say is that alternative medicine is generally not well defined. So it's often when people are writing about alternative medicine, a definition is often given operationally, which is to say that rather than giving a definition in the sense that you would find in a dictionary, instead people will simply list the sort of things they mean. So they'll list a set of therapies that we would all commonly associate with alternative medicine. So what I was seeking to do in the paper, if my analysis was going to succeed at all, was to be really clear on what it was that I meant.
And so the definition that I came up with, which I still stand by, I think it still holds up, is that alternative medicine refers to those therapies which don't have proven effects beyond placebo. So that's one part of the definition. And that don't posit any mechanism, or they posit a mechanism that's implausible with respect to known science. So those two parts are really important here. So no proven effects beyond placebo. Because where you've got that, where you've got proven effects beyond placebo, it then looks like, "Fine, we might not know what the mechanism is, but we just need to do more research and that's presumably going to take us in the right direction."
And so that's a really important part of it is having that efficacy. So it's actually likely to work for most people. And then the mechanism is really important because mechanisms are how we understand why medicine works. And typically, the journey of a new therapy, which may start its life as a form of alternative medicine and end up as a form of scientific medicine, the start of that journey is that you notice that something works. You're like, "Oh, when we use this medicine or when we use this kind of surgery or treatment, we notice that people's health improves." And that's gotta be beyond placebo, because we know that placebo works.
So if you give a cohort of patients a sugar pill and you tell them the sugar pill is an effective therapy, if you convince them that this is the case, if they feel confident that this is the case, then you can get like 30% in some cases of the effect of a proven effective medicine, which is big. That's quite a substantial improvement that you might see in somebody's levels of pain or something like this. But what we typically do once we suspect that something works, is we go and we look for the mechanism. So we want to know, why does it work? What's it doing? Which part of the body is it operating on?
And you need to know this kind of thing as well. Cause this can help with things like dosages. So the finer details of how you're going to use that therapy, having the mechanism can be helpful with that. So just to reiterate that definition of alternative medicine, then, is a form of therapy that doesn't have proven effects beyond placebo, and where there's no proposed mechanism, or there is a proposed mechanism, but it's implausible with respect to known science. So I think taking those two together probably covers the sorts of medicines or therapies that we'll be talking about today.
Christy Harrison: You give an example in the paper of homeopathy, which I think is a good example of a physical mechanism that's implausible with respect to known science, because it relies on this idea that water has a memory and that you can dilute things to infinitesimally small levels and they will have actually more power somehow by being diluted. And it just doesn't make any sense, given everything we know from established science and other areas of science.
Arianne Shahvisi: Yeah, precisely. So homeopathy is a great example of this. Water does not have a memory. There is no area of science that has told us this. The idea that something can become more powerful by becoming less concentrated, just again, doesn't work with our notions of science. Science isn't something where you can pick and choose because it's a coherent account of the world. So if you throw a ball and you expect it to come back down to the ground again, which I imagine everybody does, that's because of gravity, right? And that's part of our scientific picture of the world. And that expectation demonstrates that we agree with this conception of the world.
Our expectations are built around what science has told us. You add milk to your coffee and the milk molecules spread through the coffee and it becomes more uniform over time. The opposite doesn't happen. You don't put milk in your coffee and it stays in a little bubble in one corner of the coffee. So these expectations we have of the world show that we're all scientific thinkers, right? We have these experiences of the world. They're grounded in scientific explanations which are not too difficult for us to follow if someone cares to explain them to us. You can't then pick and choose.
You can't say, well, yes, of course, I expect the milk to travel through my coffee and become uniform because of diffusion. The concentrations of milk will be very concentrated in one area at one time and then it will spread and be evenly concentrated throughout the coffee. Well, you can't believe that and believe in homeopathy, right? Because as I say, you can't pick and choose science. We live in a kind of coherent universe. We have no reason to believe that that is not the case. We can't just have little pocke of it where we suspend all the scientific knowledge that we carry about with us in the rest of our lives. So it's just not acceptable to have that belief and have all these other beliefs, right? There's a clash there.
Christy Harrison: That's so interesting. And I feel like people do suspend that disbelief or whatever, right? People do invest in something like homeopathy that doesn't have a good explanation given all the other scientific knowledge we have, even really baseline scientific knowledge like that. Why is that? Do you have any sense of why people are able to cut off or do cut off from that knowledge and try to pick and choose?
Arianne Shahvisi: Yeah, it's a really difficult question, actually. There's probably lots of different reasons for that. I think the main one is probably reasonably low scientific literacy, which I think is something we're probably going to come back to again and again. And when you were describing your own experiences, you described having that ability ultimately to read and adjudicate scientific papers. Now, that's an ability that most people do not have. Now, you don't need to be able to do that to know that homeopathy is not going to be consistent with the other beliefs that you have.
I think that probably the main thing to say here is people are desperate, so we kind of have to put ourselves into, and it's not too difficult to do so, and as you say, you've been on a journey yourself. Many of your listeners will have been too, but may still be on that journey in various different ways. You become desperate, you begin to look for anything that might be the answer. And I think, to be perfectly honest with you, when your body feels like it's rebelling against you, when you are suffering and in pain for long periods of time, your trust in the universe, I think, just begins to wane to some degree. So I think you find yourself in a very desperate state. You need to be helped. You need to get better. And getting better can become, rather than something that you feel medicine can help you with, it somehow becomes an act of faith.
I think we have to acknowledge the unusual psychological state that severe, chronic, untreated, apparently unsolvable illness puts people in. And I think it's unreasonable perhaps to expect in that state that people will be doing their very best scientific thinking. So that's one aspect of it. Another is that our interactions with health professionals within conventional medicine are very trusting a lot of the time. So although it is in principle possible to ask for the mechanism of something and have it carefully explained to you, in most cases by the medical professional, there's rarely time for this to happen in practice, so it rarely does.
So most people believe that the doctor knows what's going on, has everything in hand, and there's simply no reason to dig any further, right? They're going to do what they're going to do. It's just a waste of everybody's time for you to dig in, and you may not really be very interested. The primary interest of a patient is in getting better, right? That curiosity about mechanism might not be there. And so I think that carries over as well into the alternative medicine encounter where somebody is trusting the practitioner to get it right, and they're not necessarily asking those sorts of questions, so the mechanism might not really be on their mind. That's not how we are expected to be patients, either in the conventional medicine context or in the alternative medicine context.
So I think there's maybe a question here about how do we behave as patients and for all that we can criticize the medical establishment and should we also might want to reflect on what we can do and I'm not blaming any individual patient, but we might want to look collectively as a society at what being a patient means and the sorts of questions that are asked, the sorts of knowledge that we expect to be able to train people to have as standard.
Christy Harrison: Yeah, that's such a good point because people in that patient provider context, no matter if it's alternative medicine or conventional medicine. I did this certainly, and even, still feel myself doing this despite the knowledge that I have and the different stance that I have now. Because now I think I look at a relationship with a provider as this person's going to offer me what they have to offer and I'm going to decide whether that makes sense for me and jibes with what I know about my body and my experience of healthcare thus far and all the research that I've done and the scientific knowledge that I do have about my various conditions and stuff. And I'm going to talk with them about it and maybe go back and forth or maybe get a second opinion and then I'm going to critically analyze what they have to say basically and use that to support my well being and maybe change providers if I need to, if I can, if that's available to me.
But I think even now when I have that attitude, I still find myself falling back into sometimes, "They know best. I need to please them, I need to respect their authority." All of that. Which was so unquestioned for me the rest of my life and with the experiences of alternative medicine that I had and alternative, conventional, whatever it was, I think I was just so trusting and was just expecting them to give me what I needed. And if I felt disillusioned by a certain provider, I would go to a different provider, but I would still have that same attitude of okay, this is the person, this is who I'm going to listen to rather than trying to filter it through my own analysis. Still sometimes I have that trouble and struggle.
Arianne Shahvisi: Yeah, and I think that's the ideal, what you've described, but I think most people are very far from that ideal. And as you say, you struggle to do what you know would be best And I think it varies as well with the healthcare system that you're interacting with. So I assume you're interacting with a largely privatized healthcare system, where I think this idea that you're paying in some way and therefore you ought to investigate your options and make sure you're getting the best outcome for yourself, which even then, I think very few people are actually doing that. But it does make sense, it seems rational within that kind of system.
I'm based in the UK, where we have a national health service, and so I have never paid for any healthcare, but that comes with other aspects to it. So there's a feeling of intense gratitude when I see a medical professional. So in all my interactions with the service, and I've heard other people say this as well, I feel grateful. I feel like they're doing their best with limited resources. Even if the option that I've been offered isn't ideal, I should accept it because that's what they can offer. And there are probably good reasons why I'm not being offered this other thing that I've read about online, so there are all these other elements that can come into it.
So it will depend quite strongly on which healthcare system a person is operating within. And within a privatized context, it will also come down to things like affordability. There are those sorts of elements that can be at play here that can make a person even more willing to simply defer to the medical professional. And that can be a very complex interaction there. There's a lot of emotion, obviously, that happens in that space.
Christy Harrison: Yeah. And one thing I've heard from other people and have experienced to some extent myself, I'm not in a national healthcare system and have that kind of gratitude, but the gratitude of finally finding a provider who seems to get it and who's empathetic and who listens and who is going to investigate. That in and of itself is so powerful. And the gratitude for finding that can be so powerful that it can sort of cloud our judgment of what they do after that. It can make us kind of stick with providers, especially with alternative medicine, but even conventional providers too, maybe taking an approach that we don't ultimately benefit from.
Arianne Shahvisi: It's a relationship, isn't it, ultimately? And I think, as with any human relationship, it's going to be thick with all sorts of other considerations and people will not necessarily feel that it's the right thing or the decent thing for them to advocate for themselves or cause disagreement or doubt somebody. This idea of asking for a second opinion, I think I certainly think of it, and many of my friends think of it as almost an act of disrespect to the medical professional and that might be even more complicated if the medical professional is a woman and you know what it's like to be disrespected as a woman professional who ought to be respected. So there can be lots of elements to it, I think, that can make that what should be straightforward, or we would hope to be straightforward, feel like quite a fraught interaction.
Christy Harrison: Absolutely, yeah. I mean, one of those other considerations I think that we touched on a little bit is values. And you wrote that although many scholars think that disenchantment with scientific medicine is a bigger motivator for people to choose alternative medicine than necessarily the belief that alternative medicine is going to be effective, other researchers have found that a commitment to feminism, environmentalism, or other value systems is actually the biggest driver of alternative medicine use. And I think that's really interesting and kind of speaks to the relational nature of it. That you want to choose someone who aligns with your values, that you feel like you're going to be seen as a whole person or whatever in this other system. Can you talk a little bit about why values seem to play at least a major role, if not the biggest role, in people's attraction to alternative medicine?
Arianne Shahvisi: Yeah, so it's a mix of push and pull factors, obviously. And there are lots of push factors. We've discussed those already. Dissatisfaction with the medical establishment on various different levels. But, there are these pull factors. There's this feeling that greater autonomy awaits. I think there's a sense in which people's understanding of feminism sometimes goes via a rejection of whatever they deem to be closely associated with patriarchy. And on some level, that kind of makes sense. But I think it's too simplistic. I think that's where it goes wrong. So you can see how it works in this context.
So medicine has this long history of treating women and people of color and women of color especially, disrespectfully, exploitation, epistemic injustice, not listening to people, not believing people. And I say it's a long history, I mean it's a present reality as well. This hasn't gone away. It hasn't stopped. And so, in the title of the paper, I say, "Medicine is patriarchal." I'm actually not doubting that side of things. Medicine is patriarchal. There's lots of ways in which that can be spelt out in more detail. You can look at the workforce and you can look at where most of the power and money lies, and it's men. Even though women make up a greater share of medical practitioners, you can look at the experiences of women patients.
There's multiple levels on which saying medicine is patriarchal, I think, is a justifiable thing to say. Then what do you do with that? Right? And this is true for lots of areas of society where we identify patriarchy within a particular service or area of practice. We say it's patriarchal, then what do we do with that piece of information? And I think what's happening here is people thinking, well, if it's not medicine, and this is where the oversimplification comes in, so medicine's patriarchal. And then here's this other thing, which is not conventional medicine, so this must be not patriarchal.
Now, of course, that doesn't work, right? It doesn't work that if you say something is patriarchal, then the things that are not that thing are not patriarchal. They might also be patriarcha. Or they might not be patriarchal, but they might be problematic in other ways that are as bad as patriarchy. And I think that's kind of what's going on here. And so this is why you get people who strongly identify with feminism, strongly identify with environmentalism. So that's a slightly different thing in that one of the things that lots of alternative therapies work hard to do in bringing in a kind of customer base is talk about medicine as being harmful, toxic, unnatural, impure. So all of these sorts of words, that it pollutes the body and perhaps pollutes the environment more generally.
Some of these things might be justifiable. But the ultimate claim is that alternative medicine is more coherent for a person who cares about the environment, who is worried about climate crisis, is certainly worried about their own body and the effects of pollutants on their health. And it's a strange argument, really, because the argument seems to go something like this. It seems to be, well, look, conventional medicine uses pharmaceuticals, and pharmaceuticals are chemicals, and chemicals are polluting in certain ways, and therefore they're sort of artificial and toxic, and they can cause these sorts of issues. Which is setting aside the fact that they can be extremely beneficial and they can make people better. But that's the picture that's presented.
And the argument seems to go, alternative medicine doesn't involve any pharmaceuticals, it doesn't involve any chemicals, it doesn't involve things that actually are chemically active in any way. Therefore, it's great, it's pure, it's not going to cause any harms. And what seems to be lost in that is that if it doesn't contain things that are chemically active, how on earth is it going to operate on the body in order to make you better? Because that's what you need to do. You need to have something that interacts with the cells of your body, with the chemicals, the hormones, whatever else within your body and makes a change. That's what we need things to do.
On closer inspection, the argument just implodes. There's this idea that environmentally speaking, these pure therapies are, and of course, not all of them, you would expect to be linked to chemicals. Some of them are obviously linked to kind of manipulations of the body and things like this.
Christy Harrison: But supplements and things like that are actually chemicals, but they're sort of framed as not being chemicals or herbs or things like that. Substances like that are in our bodies too, are 100% chemicals. Literally. That's what we're all made up of. But this sort of chemophobia comes in where it's framed as these chemicals are these bad toxic things. And then there's this other class of things that's just natural substances or plant medicine or whatever.
Arianne Shahvisi: Yeah. And it's about language, isn't it? There's a distinction that's being made and repeated over and over again and being believed that in fact just makes no sense whatsoever between what is natural and what is chemical. So some of this is about values. Some of this is about people who are concerned with bodily purity or environmental purity and also concerned with feminism and thinking, "Well, conventional medicine is patriarchal. The other ones are liberatory. The alternatives are alternative in the sense of being alternative to patriarchy," rather than what they are, in fact, which is alternative to science. Which is a different thing. That is not the same thing.
And so I think this is why you end up with people who are trying to lead a life which in every domain adheres as closely as possible to a particular value system might find themselves drawn to alternative medicine on the grounds that they think it's feminist.
Christy Harrison: Yes. Well, that's really helpful explanation. And I want to dig in now to your argument that in fact, it is not feminist and it is in many ways antithetical to feminism. You write that despite being chosen in reaction to the shortcomings of scientific medicine, alternative medicine can't actually offer greater patient autonomy and may be even more likely to be exploitative. And this is largely because of the issue of informed consent, which you say is impossible in alternative medicine. So I'd love to talk about that. Why can't we give true informed consent to alternative medicine interventions?
Arianne Shahvisi: So informed consent requires
