“Because it is assumed that disease labels may change but diseases themselves are universal, few question whose diagnostic instruments or labels should be valorized in clinical research protocols.”
(p. 671)

The utility of RCTs in determining the effectiveness in treatments pre-supposes the categorization of conditions and symptoms.

Conditions that are categorized as a single disease in a (Western) biomedical context are understood as multiple distinct diseases in the Tibetan medical context, and vice-versa.

“Here the question that is seldom asked is: ‘whose outcomes count?’” (p. 673)

RCTs assume that the evidence from a trial is incontrovertible and not open to interpretation.

Tibetan and western doctors center different data and create different evidence when looking at the effectiveness of a treatment.

When there is disagreement between paradigms about whether a treatment “worked” or not, the House (Western medical practice) determines who is right.

[I]t is generally assumed that reliable remedies can be reduced to a few basic active ingredients that can be evaluated singularly for their effectiveness.” (p. 673)

RCTs like those required by the NCCAM are often incompatible with the treatments in Tibetan medicine, which might include many carefully prepared ingredients.

Western science is deeply invested in the idea that physiological processes like disease and the compounds that affect / alleviate them are discrete and can be isolated.