VITALISM and distinguishes the profession from allopathic medicine .( 45 ) The belief that health comes primarily from within each individual and that vitalistic chiropractic can facilitate this process ( 48 ) can offer a sense of coherence and self-sufficiency in a world dominated by technological medicine .( 26 ) Regardless of the marked differences in the viewpoints of positivistic and vitalistic chiropractors , these viewpoints share one thing . Both sides of the discussion are based on opinions which have not been informed by relevant research .
A MAJORITY UNDERSTOOD VITALISM AS THE CHIROPRACTIC CONCEPT OF INNATE INTELLIGENCE ; AS A TRADITIONAL FORM OF VITALISM INVOLVING A LIFE PRINCIPLE ; AS A GUIDE TO A GOOD , MORAL , AND HEALTHY LIFE ; AND AS AN IMPORTANT ESSENCE OF THE IDENTITY OF CHIROPRACTIC . A MINORITY SAW VITALISM AS AN OBSOLETE AND UNSCIENTIFIC DOCTRINE WHICH SHOULD NOT BE PART OF CHIROPRACTIC .
The value of vitalism in chiropractic
Allopathic biomedicine and its derivative biopsychosocial medicine focus on the treatment of disease .( 49 , 50 ) Perhaps because of this focus , and their lack of attention to health , these approaches have struggled to effectively address the current global prevalence of non-communicable lifestyle-related conditions such as obesity , cancers , and cardio-vascular , chronic respiratory , and diabetes Type-2 conditions .( 7 , 51 , 52 ) In contrast , rather than the treatment of disease , vitalistic chiropractic has been linked to the promotion of health , wellness , and healthy lifestyles .( 52 , 53 ) It may be that vitalistic chiropractic could offer approaches that are useful in addressing this prevalence of lifestylerelated conditions .( 21 , 25 ) However , the precise meaning of vitalism to the broader profession and its possible value in chiropractic have not been clear .( 40 )
Research on vitalism in chiropractic
A recent study has explored the meaning and value of vitalism in chiropractic . ( 7 ) Two research questions were posed . The first asked what chiropractors mean when they speak about vitalism . The second asked what value do chiropractors believe that chiropractic thinking and practices based on vitalism might offer in addressing the current global prevalence of non-communicable lifestyle-related conditions .
This exploratory sequential mixed methods study involved three phases of data collection .( 7 ) The first phase used semi-structured interviews of 18 key informant chiropractors from eight countries to explore the research questions . The findings of this first phase were then used in the development of an 82-question online survey which enabled data collection for Phases II ( composed of closed-ended questions ) and III ( composed open-ended questions ) of the study . Chiropractor members of the Chiropractors ’ Association of Australia ( CAA ) and the New Zealand Chiropractors ’ Association ( NZCA ) were invited to complete the survey . The 307 responses which remained after data cleaning exceeded the calculated minimum sample size of 226 and represented 9.6 % of CAA members and 16.8 % of NZCA members . Synthesis of data collected from all three phases indicated that vitalism had several meanings for study participants . A majority understood vitalism as the chiropractic concept of innate intelligence ; as a traditional form of vitalism involving a life principle ; as a guide to a good , moral , and healthy life ; and as an important essence of the identity of chiropractic . A minority saw vitalism as an obsolete and unscientific doctrine which should not be part of chiropractic .
Similarly , a majority of participants felt that chiropractic care based on vitalistic thinking and practices could offer substantial value towards dealing with the prevalence of non-communicable lifestyle-related conditions .( 7 ) Accordingly , a vitalistic practice model composed of chiropractic adjustive care combined with healthy lifestyle advice emerged from the data . In contrast , the non-vitalist participants offered a manipulative therapy practice model for the treatment of musculoskeletal pain . Overall , the study findings revealed a marked division on most issues between the pro-vitalism and anti-vitalism participants . Very few participants placed themselves in the space between these two groups .
Conclusion
Vitalism arose from ancient origins and has formed a core principle of chiropractic . Its influence has been retained in the profession and is a source of controversy . Recent research found that a majority of the chiropractic participants strongly identified vitalism with the foundational chiropractic principle of innate intelligence . A majority of participants also believed that vitalistic chiropractic could offer great value to the profession and those it serves . A minority of study participants held opposite views and was strongly against vitalism in chiropractic . The challenge for the chiropractic profession is to carry out the research needed to explore the operationalisation of vitalism in chiropractic practice and the possible benefits and risks of that .
REFERENCES
1 . Thornhill JT . A vitalism ethos and the chiropractic health care paradigm . J Chiropr Humanit [ Internet ]. 2020 [ cited 2021 Oct 15 ]; 27 :[ 59-81 pp .]. Available from : https :// www . sciencedirect . com / science / article / abs / pii / S1556349920300048 DOI . org / 10.1016 / j . echu . 2020.10.004 .
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