title: Decontextualized versus lived worlds: critical thoughts on the intersection of evidence, lifeworld, and values.
abstract: BACKGROUND
  Numerous studies and trials are conducted under the evidence-based complementary and alternative medicine (EBCAM) paradigm. Some individuals view the results generated by this approach as symbolic evidential proof of complementary medicine, and as representative of practice. Such evaluations are made even though the ability to capture and reflect clinical reality by the methods used is questioned. The effect of this type of research on complementary medicine researchers and practitioners has received minimal consideration, and this article explores this subject by critically reviewing the literature and theorizing the effects on the lifeworld and values of those embodied by EBCAM.
  
  
  METHODS
  This review accesses the discourse of various disciplines involved with, and commenting on, complementary medicine research. Collected literature is collated within specified limits, subjected to argumentation analysis, and synthesized within a critical theory methodology. Emergent themes are examined, and the effects of EBCAM on holistic researcher and practitioner lifeworld and values are theorized via the colonization framework of critical social theorist Jürgen Habermas.
  
  
  RESULTS
  The use of an evidence-based medicine research model to investigate complementary medicine practice is not well regarded by those who critically examine its use. Within a critical theory framework, the generation and application of research resulting from EBCAM is viewed as a philosophically incongruent process arising from a dominative discourse that can colonize lifeworld. This can result in a variety of pathological symptoms that may have a detrimental effect.
  
  
  CONCLUSIONS
  The application of EBCAM has the theoretical potential to damage complementary medicine culture, profession, and practice. Its ongoing use requires thought, attention, and careful revision, taking into account the lifeworld and values of researchers and practitioners. If this inclusive view can occur, knowledge generation with relevance to the whole of the professions could proceed.
authors.affiliation: University of New England School of Health, Armidale, New South Wales, Australia. hrchu@ndmctsgh.edu.tw
authors.forename: Jeff
authors.initials: J
authors.lastname: Flatt
mesh_terms: D001291:Attitude of Health Personnel; D035843:Biomedical Research; D000529:Complementary Therapies; D019317:Evidence-Based Medicine; D006801:Humans; D010684:Philosophy; D012945:Social Values; D013850:Thinking