Chinese Medicine in Taiwan

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understanding of what integration of Chinese and Western medicine means, including scientification of Chinese medicine, complementary usage of Chinese medicine in biomedical health care system, and remaining zhongyi in the core but not rejecting the employment of biomedical tools if needed, etc.

2.1.5 Chinese medicine in Taiwan

After 1945, the Chinese Nationalist government continued its policy on Chinese medicine in Taiwan. Chinese medicine was allowed to coexist with Western medicine but at the same time it was pushed towards modernization and scientification. Under American influence after the Second World War, the practice of biomedicine has been the main stay of the healthcare system.

The practice of Chinese medicine was officially recognized in 1956. Chinese Medicine Education Act passed in the same year provided a legal ground for establishing research and educational institutions of Chinese medicine. It aimed to overall modernization of Taiwan‟s health system.

Although the act gave the same status to both medical systems, “the path [of Chinese medicine]

to respectability and acceptability among the general public, academic and healthcare professionals has been arduous” (Chen, Shum, & Hsieh, 2002, p.303).

In terms of education, before the late 1960s, all Chinese medical practitioners acquired their education through apprenticeship and self-study. The development of institutionalized Chinese medical education has been led by College of Chinese Medicine (established in 1958 in Taichung, now China Medical University), which since 1966 has offered the formal professional training and the medical degree of Chinese medicine (Chi et al., 1996). Modernization of Chinese medicine and integration of Chinese and Western medicine have been the unwavering guiding

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principles of the medical curriculum in China Medical College since its establishment. To date, Taiwan has five major institutions offering undergraduate and post-graduate programs and conducting different kinds of research projects (Chen, Shum, & Hsieh, 2002).

In terms of licensing, under the Western medicine-dominated health care system, the licensing system has also “contributed to the secondary role of Chinese medical practitioners in providing health care” (Chi et all, 1996, p. 1330). According to Chi et al. (1996), there are five types of Chinese medical practitioners in Taiwan: Chinese medicine physician (CMP), Chinese medicine pharmacist (CMPharm), Chinese medicine registered nurse (CMRN), Chinese medicine nurse (CMN), and Chinese medicine physician‟s aid (CMPA).

However, only the first two categories, CMP and CMPharm, are official titles. There are no separate examinations for CMRN, CMN and CMPA. CMN yet can take a licensure examination for Western medicine nurses thus becoming CMRN. Until 2010, there have been two systems of licensing CMP: Chinese Medicine Physician License Exam (CMPLE) and Chinese Medicine Physician Special License Qualifying Exam (CMPSLQE). The former exam can be taken only by physicians with medical degrees in Chinese medicine. The latter licensure system has been offered for physicians who have acquired their education in the traditional way of apprenticeship and self-study. The CMPSLQE includes two levels of examination: Qualifying Examination and Special License Examination. Only by passing both can one obtain the CMP license (Chi et al., 1996). However, the CMPSLQE will be suspended in 2011 (Qualifying Examination was held for the last time in 2008 and Special License Examination will be concluded in 2011) because, according to the Taiwan‟s Ministry of Examination, the CMPSLQE has had its historical meaning but does not correspond to modern professional standards:

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Considering that the traditional private training of the doctors of Chinese medicine did not fit well with the social demands for independently arrived professional assessment and official accreditation, the Special Examination for Doctors of Chinese Medicine has been set up as a provisional means to approve the credentials of doctors of Chinese medicine.

The Examination has its historical function. However, as the formal education system has begun to offer structured Chinese medical instruction with results becoming steadily in tune with the social expectations and professional standards, the need for the Initial Qualifying and Special Examinations for Doctors of Chinese Medicine has decreased over time. (Ministry of Examination, 2005)

In sum, nowadays Taiwan is acknowledged as a medically plural society where both biomedicine and Chinese medicine are officially recognized healing practices. Western medicine yet dominates the orthodox establishment of health care system (Hsu et al., 2007; Kleinman, 1980; Lew-Ting, 2005). For example, in 2008, Taiwan had 3,160 clinics and 22 hospitals of Chinese medicine, compared unfavorably with 10,326 clinics and 493 hospitals of Western medicine (Department of Health of Republic of China, 2009). Nonetheless, even though the science-based Western medicine has a more predominant voice in the orthodox establishment, Chinese and folk medicine have still been widely practiced by local people (Wu, 1982; Chan, 2005). This situation thus results in the uniquely dual health care system.

The aim of this part of the literature review is to illustrate the sociohistorical background of present dialogue between Western and Chinese medicine which has been taking place since the nineteenth century. In fact, these discussions are still taking place nowadays.

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Several statements must be made before continuing further with the literature review. First, I acknowledge the invaluable input of postmodernism and Foucauldian theory as major players in the paradigmatic changes in social sciences and intellectual history at large. The critique of objective knowledge and empiricism has provided a new perspective for understanding the world, including medicine, by allowing scholars to see it as a cultural phenomenon. Second, in this study, I make extensive references to the irreplaceable anthropological scholarship of Chinese medicine.

However, I distance from the understanding of Western science and medicine as a universal, modern and progressive entity and Chinese medicine as a traditional and local system. Instead, I will follow social actors and their own understandings about traditional and modern, xiyi and zhongyi, and about the integration of both. Third, although this study is placed under the context of globalization, the literature review suggests that patterns and processes of globalization vary place to place. Therefore, I refrain from adopting any of the aforementioned perspectives towards globalization of Chinese medicine to Taiwan‟s context. I will engage in an exploratory and interpretive qualitative study in order to acquire an understanding of the phenomenon.