Non-pharmacological interventions: Questioning the validity and ambitions of the concept
Berna, Fabrice
Non-pharmacological interventions: Questioning the validity and ambitions of the concept - 2025.
32
In France, many terms are used to describe therapeutic practices that are not, or only partially, integrated into conventional medicine. The term non-pharmacological intervention (NPI) has recently gained in visibility in France, being presented as a “new paradigm.” In this article, we offer a critical analysis of this concept. Our analysis highlights the rigorous participatory approach that led to the development of the Non-Pharmacological Intervention Society (NPIS) model. It shows that the term NPI does not strictly correspond to a theoretical concept, and that its definitional criteria lack precision. Validating NPIs as drugs—when they are defined by precisely what they are not (drugs)—amounts to applying an interpretative framework based on a foreign epistemological category, implying a logical contradiction and a possible methodological dead end. The NPIS model does not constitute a paradigmatic shift in Kuhn’s sense, as it builds on the epistemological framework of evidence-based medicine. The concept of NPI appears rather as a structuring regulatory framework designed to evaluate and integrate certain NPIs into conventional medicine. Its utility is pragmatic and contextual, addressing an overarching need to structure and legitimize NPIs. It represents an attempt to institutionalize NPIs within the existing biomedical paradigm. It represents a political and methodological strategy, not an epistemological revolution. Its exacting scientific standards create a risk of systemic exclusion for certain interventions it claims to integrate. Finally, given the stated aim of combating misinformation in health care, we examine the relevance of the NPI concept in light of its conceptual vagueness.
Non-pharmacological interventions: Questioning the validity and ambitions of the concept - 2025.
32
In France, many terms are used to describe therapeutic practices that are not, or only partially, integrated into conventional medicine. The term non-pharmacological intervention (NPI) has recently gained in visibility in France, being presented as a “new paradigm.” In this article, we offer a critical analysis of this concept. Our analysis highlights the rigorous participatory approach that led to the development of the Non-Pharmacological Intervention Society (NPIS) model. It shows that the term NPI does not strictly correspond to a theoretical concept, and that its definitional criteria lack precision. Validating NPIs as drugs—when they are defined by precisely what they are not (drugs)—amounts to applying an interpretative framework based on a foreign epistemological category, implying a logical contradiction and a possible methodological dead end. The NPIS model does not constitute a paradigmatic shift in Kuhn’s sense, as it builds on the epistemological framework of evidence-based medicine. The concept of NPI appears rather as a structuring regulatory framework designed to evaluate and integrate certain NPIs into conventional medicine. Its utility is pragmatic and contextual, addressing an overarching need to structure and legitimize NPIs. It represents an attempt to institutionalize NPIs within the existing biomedical paradigm. It represents a political and methodological strategy, not an epistemological revolution. Its exacting scientific standards create a risk of systemic exclusion for certain interventions it claims to integrate. Finally, given the stated aim of combating misinformation in health care, we examine the relevance of the NPI concept in light of its conceptual vagueness.
Réseaux sociaux