Delegations from all 17 North American colleges, from the oldest (Palmer) and the largest (Life) to the smallest and newest (Bridgeport and Colorado), were joined by representatives from schools in 11 other countries - Australia, Brazil (2), Canada (2), Denmark, France, Italy, Japan (2), Korea, New Zealand, South Africa and the United Kingdom (4).
Others present represented proposed schools in Costa Rica and Mexico, accrediting agencies, examining boards and licensing authorities. Leaders of professional associations addressing the meeting included DCs: Jim Mertz, ACA president; Sid Williams, ICA past president; Tim St. Denis, president, Canadian Chiropractic Association; Laurie Tassell, president, Chiropractors' Association of Australia; and Michael van den Bos, president, Chiropractors' Association of South Africa.
The World Federation of Chiropractic (WFC) called this meeting, co-sponsored by the Association of Chiropractic Colleges (ACC) and the U.S. National Board of Chiropractic Examiners (NBCE), to seek consensus on the core beliefs and basic tenets of the philosophy of chiropractic, and how to teach them to chiropractic students. "Discord in our philosophical base," said WFC President Dr. Bruce Vaughan (from Hong Kong) as he opened the meeting, "underlies the discord in clinical approaches and political organization in the profession" and must be resolved.
As could be seen from this meeting, many new schools are opening throughout the world. Will they create a unified and stronger chiropractic profession or, like osteopathy, will they divide, fragment and weaken the profession?
"If we can agree on the basic philosophy of chiropractic as it has evolved, then there will be less reason for division, discord and factionalism," said Dr. Vaughan. "On behalf of the WFC, I call for harmony in our profession." In other opening remarks, Dr. Ken Padgett, ACC president, called for acceptance of the 1996 ACC "Paradigm of Chiropractic," agreed to by all North American college presidents.
Highlights of the program, co-chaired by Dr. David Koch, past president, Sherman College of Straight Chiropractic, and Dr. Reed Phillips, president, Southern California University of Health Sciences (formerly LACC), were:
• Attendance by and consensus from all factions within the chiropractic profession.
• The presentation of impressive, formal lectures on philosophy not only in chiropractic but also in complementary and alternative medicine, medicine, and science generally. Keynote addresses were on the role of philosophy in the healing arts by Kenneth Schaffner,MD,PhD, George Washington University; and complementary health care by Ian Coulter,PhD, RAND and UCLA.
Other lectures explored vitalism (David Peters,MD); the nervous system (Howard Vernon,DC); the therapeutic and nontherapeutic approaches to chiropractic (Joseph Keating, Jr.PhD, and Thom Gelardi,DC, respectively); the importance of belief in health care (Michael Goldstein,PhD); philosophical conflict between chiropractors and their patients (Jennifer Jamison,MD); and the philosophical basis of condition-centered (Marion McGregor,DC); vertebral subluxation-centered (David Koch,DC); and patient-centered (Meridel Gatterman,DC) care.
• Presentations by educational and professional leaders from all world regions on current content and methods of teaching philosophy in their chiropractic schools.
• A closing address by John Astin,PhD, from the University of Maryland, a major figure in the U.S. health care system's move toward integrated health care, confirmed renewed philosophical and scientific interest in the concept of vitalism and encouraging the chiropractic profession to engage the medical profession and others in a dialogue that would lead to a changed and improved philosophy of health care throughout the health care system.
Various speakers spoke of the new level of disenchantment with the limitations of the biomedical model, and the current move within health care to adopt the Professor George Engel's biopsychosocial model, which views health in physical, social, psychological and spiritual terms.
• A final day of workshops and discussion leading to the following new general consensus statements on philosophy in chiropractic education:
- A shared approach to health and healing, based upon a shared philosophy of chiropractic, is important for the identity and future of the chiropractic profession.
- Chiropractic is a unique discipline, but exists as part of a broader entity, the health care system. Accordingly, the discussion of philosophy as a discipline and the philosophy of health care, as well as specifically the philosophy of chiropractic, should be important components in every chiropractic curriculum.
- The philosophy of chiropractic should be taught and developed in a manner that is intellectually defensible in the discipline of philosophy.
- Principles from philosophical schools of thought that were discussed at some length at this meeting in the context of the philosophy of chiropractic included:
1. Other philosophical ideas that were presented at the meeting, but for which there was insufficient time for extended discussion included:
• American pragmatism
• Complexity theory
• Critical rationalism
• Post modernism
• Sociology of the professions
• Systems theory
1. Models of health care discussed at the meeting, and offered for consideration in chiropractic education, included the:
• Biopsychosocial model
• Condition-centered model
• Evidence-based model
• Patient-centered model
• Vertebral subluxation-centered model
With respect to the Association of Chiropractic Colleges' Paradigm of Chiropractic put before the meeting by the ACC, it is appropriate that the philosophy of chiropractic is presented as a core component of the foundation of the chiropractic paradigm of health. This philosophical foundation may be further understood in light of the above statements.
"It is timely and exciting that these statements support the ACC "Paradigm of Chiropractic," said WFC education committee chair and president of Life College West, Dr. Gerry Clum. "This ACC Paradigm forms the basis of a new common vision for the ICA, ACA and other chiropractic organizations in the United States, and has also been submitted to the World Federation of Chiropractic for approval as policy at its assembly in Paris next May."
The full lecture program, all papers and information on audiotapes may be downloaded from http://www.wfc.org and are also available from the WFC.