PHILOSOPHY JOURNAL

by William M. Decken, D.C. Associate professor of clinical science Chair of philosophy department.

Article 8 Creating a Culture: Pragmatism and Chiropractic Don’t Mix

The common idea about chiropractic expressed pragmatically is that IT WORKS.

Pragmatically, chiropractic works because D.D. Palmer adjusted Harvey Lillard and his hearing returned. Chiropractic works because people come into our offices all week long and leave feeling better. These are examples of observable, practical outcomes and embraced as the totality of the chiropractic profession by many people both within and outside the profession.

Pragmatism is an indigenous American philosophical theory that explains both meaning and truth in terms of applying ideas or beliefs to the performance of actions that have observable, practical outcomes. The pragmatic theory of truth promises a convergence of human opinions upon a stable body of scientific propositions that have been shown to be successful principles for human action (1).

While many in the health care field in general are quite content to overlook Harvey Lillard’s experience, it certainly appears that there has been a convergence of human opinion upon a stable body of neurological science leading some to conclude that our “procedure” is an effective action to take for alleviating lower back pain.

The study of pragmatic theory might give us greater insight into the allopathic approach to health and healing. The question, though, is this: just how reliable is pragmatism as a criterion of truth, especially in describing chiropractic? Before answering, let us reflect on our practices again. In order for the proposition, “Chiropractic works because our adjustments result in the reduction, elimination or removal of back pain,” to be true, it would have to work all the time. We know that it does not. People sometimes leave our offices without feeling better or feeling no change at all.

What if Lillard’s hearing had not returned? If D.D. Palmer had utilized only pragmatic thinking he might have abandoned his pursuit, concluding that his theory (not yet named chiropractic) did not work, and therefore we would not be chiropractors today (2). In fact, historically we know that D.D. Palmer’s second deaf patient did not have the same results as Lillard.

Perhaps one hundred percent success is not a necessity. If not, what percentage of the time would it have to work in order to satisfy this criterion for truth? How much observational time would be required to determine whether or not chiropractic worked? Answering these questions seems to be in line with scientific methods and perhaps consistent with allopathic thinking.

Restating the proposition such that “Chiropractic works because the chiropractic adjustment removes an interference to the vital force that unites the intelligence and matter” would be a more accurate statement. However, this would not satisfy the pragmatic theory of truth because it is not based on a stable body of scientific propositions, but rather on a deductive premise. Furthermore, while our reasoning may cause us to conclude that chiropractic is practical — the result being an improved ability to adapt, express and live — our adjustments do not always have easily measurable outcomes within the confines of traditional scientific studies.

It is imperative that we, as a profession, be involved in thinking about and researching the science, art and philosophy of chiropractic if we desire to serve more people more effectively. The need for us to strike a balance between these three aspects of the profession demonstrates the weakness of pragmatism when used alone.

The chiropractic profession today is more recognized, readily accepted and embraced by society than it has ever been before. Is it because of legislation that makes it possible for us to practice without the fear of going to jail? Is it because of legislation that makes it possible for chiropractic to be included in health insurance laws? Is it because of the development of accredited education and licensing exams? Is it because chiropractic works and people want it? (I am defining “works” as improved expression of what a created being is capable of when free of interference caused by vertebral subluxation.) Or is it due to a combination of the above?

I submit that it would be inaccurate to attribute the success of chiropractic to any one of these possibilities. The meaning of chiropractic will not be validated by the observable performance of the profession. Chiropractic increased in stature before accreditation, before licensing, before insurance and before its philosophical tenets were fully developed.

When I was a boy, I did my best to do what my parents told me simply because they were my parents. As I matured and learned why certain things were to be done and other things were not, I began to feel a greater sense of ownership in what I decided my behaviors would be.

It has been said that with age comes wisdom, and with wisdom comes understanding. Our collective wisdom as a profession has grown as we have “aged” in chiropractic because of our practical experience and rational thought with regard to the philosophy, science and art of chiropractic. We should, therefore, have a greater understanding of why we are doing what we do and why we see what we see in our offices. We should not fall prey to believing that it is only the measurable that matters.

More than 2,000 years ago a young Greek artist named Timanthes studied under a well-respected tutor. After several years, the teacher’s efforts seemed to have paid off when Timanthes painted an exquisite work of art. Timanthes became so enraptured with the painting that he spent days gazing at it. One morning when he arrived to admire his work, he was shocked to find it blotted out with paint. Angry, Timanthes ran to his teacher, who admitted he had destroyed the painting.

“I did it for your own good,” the teacher said. “That painting was retarding your progress.” Timanthes heeded his teacher’s lesson and later produced the Sacrifice of Iphigenia, which is regarded as one of the finest paintings of antiquity.

There is a strong parallel here for chiropractic. We risk jeopardizing our progress as a profession if we focus solely on the educated means by which we have positioned the art and science of chiropractic as a force to be reckoned within the health care field. Likewise, our progress will be limited if we simply sit back and admire the philosophy of chiropractic without examining it and challenging it for completeness.

The World Federation of Chiropractic held a conference on philosophy in Fort Lauderdale in 2000. There it was suggested and discussed by the attending chiropractic leaders and academicians that the vitalistic component of the philosophy of chiropractic is what causes it to be set apart from other healing arts. The inescapable conclusion is that the philosophy of chiropractic is an essential component in chiropractic education. With this fact in view, it is truly puzzling to contemplate the anemic philosophical offerings of some of our educational institutions though the addition of philosophy clubs and courses at chiropractic colleges is cause for hope.

Sherman College of Straight Chiropractic has always striven to keep chiropractic philosophy in equal balance with the science and art. Is it fair to say the fruit of Sherman’s labor is now being realized and it is important for us (the entire college community) to remain actively involved in the analysis, promotion and continued development of the philosophy of chiropractic? I’d like to think so.

Some of the educated forces in chiropractic are promoting only the mechanistic or material side of vertebral subluxation and its correction, while leaving out the vitalism. In 1995 the Association of Chiropractic Colleges (ACC) put forth a new chiropractic paradigm, with which all chiropractic colleges at that time agreed. Subluxation was central to its thesis. Today, some are suggesting that the term “subluxation” be replaced with functional articular lesions (3). This terminology is suggested even as its proponents comment that we do not exactly know what happens when the spine is adjusted. The term is offered because it will enable more effective research of the material aspect of spinal adjusting.

Is this an attempt to apply only the pragmatic theory of truth? Vertebral subluxation, with both its material and immaterial component, is unique to chiropractic. Together, these components contribute to the positive effect that adjustments have in the lives of people we care for.

If we are to contribute to the transformation of an allopathic culture into a life-enhancing culture, the chiropractic profession must be clear and direct in how it collectively expresses the wisdom and understanding it has gained. As doctors of chiropractic, we are blessed to have an understanding that there is more going on than just the observable linear relationships associated with the adjustment. Pragmatism alone, without a combination of other stronger criteria of truth, just doesn’t work.

1. Dictionary of Philosophical Terms and Names, www.philosophypages.com.
2. Strauss, Chiropractic Philosophy, 1991, p. 21 (paraphrase).
3. Winterstein, J.F., Outreach, National University of Health Sciences, Vol. 19, No. 3, Oct/Nov 2003.


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