Clinical Benchmark: Vitalism

The meaning and value of vitalism in chiropractic

Abstract: Vitalism has a long history of guidance and controversy in the chiropractic profession, yet there is little clear understanding of its meaning or value in chiropractic. This study therefore sought to answer two research questions. The first asked what chiropractors mean when they speak about vitalism. The second asked what value do chiropractors believe that chiropractic thinking and practices based on vitalism might offer in addressing current global prevalence of non-communicable lifestyle-related conditions. 

This study used a constructivist approach, a predominant research stance of descriptive phenomenology, and a mixed methodology design of exploratory sequential qualitative and quantitative research methods. In Phase I data collection, semi-structured interviews of 18 key informants from eight countries explored the research questions. 

Phase I findings informed the development of an 82-question online survey which was used for data collection in Phase II (composed of closed-ended questions) and Phase III (composed of open-ended questions). Phases II and III explored the generalisability of the findings of Phase I to a wider sample of the profession. Chiropractor members of the Chiropractors’ Association and Australia (CAA) and of the New Zealand Chiropractors’ Association (NZCA) were invited to participate in the survey. Data from a total of 307 respondents were analysed. This represented 9.6% of CAA members and 16.8% of NZCA members. 

Synthesis of data from all three phases revealed that participants attributed multiple meanings to vitalism. To a majority, vitalism meant innate intelligence, a traditional form of vitalism, a guide to a good life, and an essence of the identity of chiropractic. To a minority, vitalism meant an obsolete and unscientific doctrine. To a smaller minority, vitalism meant a neo-vitalism. These differences of opinion presented a marked division over vitalism within the sample. Very few participants occupied the middle ground between the pro- and anti-vitalism groups. A majority of participants believed that chiropractic thinking and practices based on vitalism could offer great value in addressing prevalence of non-communicable lifestyle related conditions. To address this prevalence, the majority proposed a vitalistic practice model composed of chiropractic adjustive care and healthy lifestyle advice. A minority proposed a non-vitalistic practice model of manipulative therapy for the treatment of musculoskeletal pain. 

This study’s findings offered the first empirical data concerning the meanings and value that a sample of chiropractors attributed to vitalism. Future research could explore the potential of this knowledge to add value to the profession’s activities. 

Indexing Terms: Vitalism, health, non-communicable disease, non-communicable disorder, chiropractic, philosophy.

Cite: Richards DM. The meaning and value of vitalism in chiropractic [Thesis]. Asia-Pac Chiropr J. 2021;1.3. URL


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