What is Traditional, Complementary, and Integrative Medicine: An Operational Typology (Part I, Conceptual Foundations)

Background: This work, the first in a series of four linked articles, presents the conceptual foundations of an operational typology of the field of Traditional, Complementary, and Integrative Medicine (TCIM). While the TCIM field is very broad, encompassing a large and disparate range of therapeutic systems, knowledges, practices, products and devices not currently falling within biomedicine’s standard of care—no international standard currently exists for classifying these health care approaches. Methods: Operational typologies are theoretically informed classification tools that subdivide larger constructs (in this case, TCIM) into meaningful subcategories. The typology is theoretically predicated upon a detailed analysis of the World Health Organization’s (WHO)’s definitions of traditional, complementary, and Indigenous traditional medicine. The WHO definitions are widely cited, have global applicability, and are inclusive enough to account for a wide range of non-biomedical therapeutics. To further support the typology’s theoretical foundations, this article engages scholarly perspectives related to the aforementioned domains, drawn from the fields of medical sociology and anthropology. Results: The WHO definitions point to four key conceptual domains upon which the typology is designed: (1) historical factors; (2) paradigmatic and cultural features; (3) knowledge transmission modes; and (4) health systems contexts. Sociological and anthropological perspectives critically interrogate the TCIM construct in light of Biomedicine’s global dominance and draw attention to the paradigmatic underpinnings of diverse complex medical systems and therapeutic hybridities. More specifically, this article elaborates upon the ontological polarities of ecocentrism/anthropocentrism, vitalism/mechanism, holism/reductionism, and salutogenesis/pathogenesis, which deeply inform the typology’s design. Conclusion: Readers will find the typology itself presented in the second article of the series, followed by third and fourth articles discussing the typology’s applications.