Clinical Reasoning and Decision-Making in Homeopathy: an Interpretative Phenomenological Analysis

Abstract

Aim: The aim of this study was to examine homeopathic practice as a lived phenomenon. This thesis explores the interior of clinical practice. Background: Homeopathy is a globally practiced discipline in the arena of complementary and alternative medicine. Despite sustained practice it is epistemically contentious, yet little is known about the reasoning and decision making practices of its practitioners, what actually happens in practice. Methods: Using interpretative phenomenological analysis, participants were extensively observed, recorded and interviewed. Data were coded, categorised and analysed. Results: Themes representing the sources and forms of reasoning were generated. Practice is underpinned by theory, core texts and clinical authority. Beyond these sources of authority, practice is guided by clinical experience, by praxis and professional wisdom. Clinical reasoning does not exclusively depend on knowledge; it is performed between practitioners and their patients, built upon a therapeutic relationship. Discussion: This thesis enhances knowledge and understanding of clinical reasoning practice. It raises pedagogical and philosophical questions about how clinical practice can be interpreted and understood. It also argues that questions about forms of evidence for disciplines including homeopathy need to consider the diverse goals and preferences of patients and health professionals alike. Conclusions: Research into the lived experience confirms that homeopathic clinical reasoning is highly complex, driven by multiple sources of evidence.