Guest post by Derek Gray
Last week I listened to the CBC Radio program, Unreserved, hosted by Rosanna Dearchild. In her interview with indigenous doctor Marcia Anderson DeCoteau, I was a little shocked to learn that I may be an epistemic racist. I had to transcribe the controversial parts of the interview myself, as they conveniently left out the racism accusations from the website’s summary.
The interview starts out well enough. Dr. Anderson DeCoteau is very well educated and respected. She is a doctor of internal medicine, the Medical Officer of Health for Northern Manitoba, and an Assistant Professor at the University of Manitoba. She does make good points about how incorporating indigenous practices or allowing traditional rituals in combination with modern medicine can really help indigenous peoples feel more comfortable and open to modern treatments. However, she notes that she herself does not incorporate them. But then there are the problematic parts of the interview from both host and guest.
Dearchild, the host, makes a somewhat smug comment when she points out that there is scientific support for the practice of smudging:
We’re seeing things now like studies coming out saying that smudging literally clears the air of negative energy and these are things that we’ve been saying for generations, right, and so it’s common knowledge to our people. (Emphasis added)
Now, my understanding is that the scientific support is actually for the effect of negative ions in the air, which smudging apparently produces (never mind the established fact that breathing in the smoke of pretty much anything that is burning isn’t good for you.) Negative ions do have a significant body of research showing they can have an effect on depression or seasonal depression in high exposures. I am happy to be educated/corrected on this point, but it seems to me she needs to review her use of the word “literally.” No, there is no scientific evidence for “clearing the air of negative energy.” In fact, by the sounds of it, smudging is adding negative energy isn’t it?
That said, I actually think it’s not a bad idea to at least consider that over hundreds of years of trial and error that there are often natural treatments that do in fact have an effect, or lead researchers to examine, refine, or extract the key component of an herb for example. It would indeed be racist or discriminatory to dismiss indigenous claims out of hand. The point here though is that the confirmation of efficacy is made via modern science. And modern science can just as often discover that a natural or traditional treatment is bad for you. No indigenous knowledge could confirm one way or the other or distinguish between placebo and non placebo effects.
Dr. DeCoteau adds her thoughts about natural/traditional treatments in general:
I think that there are kind of two things. One is that, in the limited evidence that there is, there’s never been evidence of harm. So there’s been different studies in some european nations and asian nations and I’ve never seen one that showed any harm, because that’s the first kind of layer of concern.
If no evidence of harm is the best she can say; then, isn’t she admitting that she doesn’t actually know if the effect of traditional indigenous practices is real? Of course we know this thinking is false, and there is very real harm done by blind faith in some natural treatments. For one, it can lead patients to avoid getting modern treatments at critical times. Also it can have a negative effect when combined with modern medicine, reducing its effectiveness (check out my favourite alternative-medicine researcher Edzard Ernst’s latest article on this topic). But it gets worse. She leaves the rational listener confused and offended in the next bit:
And the second thing that I say, or have discussed, more recently too, is this concept of epistemic racism. And epistemic being from, you know, epistemology, knowledge systems, ways of knowing, and it’s the form of racism that says one knowledge system is superior to another, so, when it comes to this notion of evidence, or knowledge that’s produced by western science, to say that our healing methods have to be supported by western science or western evidence is to say that western knowledge is superior to indigenous knowledge and our knowledge can’t be valid or valuable unless there is western science saying it’s valid. And so we should reject that base assumption that western science is superior to indigenous knowledge and indigenous forms of science and instead look at indigenous knowledge on its own and through its own lens. So when our knowledge keepers and our elders and our healers have held knowledge that’s been passed on through generations, of effectiveness then we can believe that and we can rely on it. We don’t need a scientific study to say that that knowledge is valid. (Emphasis added)
Listening to this the first time in the car, my hackles were raised, and visions of William Lane Craig danced in my head. Did DeCoteau just accuse me of racism for thinking that the best way of trusting a treatment is the scientific method? Did she just call evidence a mere “notion”? After listening to this many times to transcribe it, my interpretation softened a little, but there are still problems: mainly this conflating of the concept of “knowledge” and “ways of obtaining knowledge.” If she is saying that western doctors should not immediately discount things (knowledge) that indigenous people have learned and refuse to study them, then yes I tend to agree with her on that count. There is undoubtedly a record of racism towards indigenous peoples in western hospitals. But I vigorously disagree with the idea that we should look at indigenous knowledge “on its own and through its own lens.” There are justifiable reasons to look at ancient practices for ideas but through the lens of modern scientific inquiry. Nothing will be gained by building a wall of separation and blindly trusting any “knowledge” merely because it has been passed down for hundreds of years. Asking for evidence is categorically not a racist discounting of indigenous knowledge – it’s just the only credible way of confirming its positive or negative effects. As a professor of health sciences, DeCoteau should know better.
The rest of the interview touches on whether or not there should be funding for supporting the inclusion of indigenous healing methods. I don’t have a fully formed opinion on that – as I mentioned earlier, I think there is room for the real calming and comfort effects that familiar ritual can have on a nervous patient.
I’ll end here to say that it is disturbing to hear from a university professor and someone directly responsible for the health of a large portion of Manitobans that the scientific method is somehow exclusively a “western” tradition and that by depending on it exclusively as a confirmation of knowledge is a form of racism.