Vitalism is a philosophical school of thought with a long and sometimes controversial history.1,2 It is a foundational principle of health professions such as acupuncture/traditional Chinese medicine,3,4 naturopathy,5,6 and chiropractic.1,7,8 Vitalism has multiple forms9 and varying versions of it have been described.10 No one definition is universally accepted.2 However, the core position of vitalism has traditionally been that living organisms are fundamentally different from non-living things. Essentially, the difference lies in the belief that organisms have a special life principle, energy, or force which non-living things do not have, and which cannot be detected, tested, or proven by the methods of positivist science.11 Many who work in this dominant paradigm of science consider only the material realm legitimate for investigation. They therefore reject vitalism because of its apparently non-material central principle.9,12 Yet vitalism lives on in some areas of science, philosophy, sociology, and, as will be addressed in this paper, chiropractic.13, 14, 15, 16, 17

Chiropractic was founded by Daniel David (D.D.) Palmer in 1895.18 Although he did not use the word “vitalism” in his definitive explanation of the profession, his use of vitalistic terms such as “life force”19(p32) established vitalism as a central part of the profession's philosophical foundations. Palmer posited that a universal intelligence gave order to the universe and that an innate intelligence (a portion of universal intelligence in each individual) ordered the function of the human body. Innate intelligence has been identified by some chiropractors as a vitalistic life force in humans,1,20, 21, 22 and vitalism has been a source of both guidance and controversy in chiropractic.23

Some chiropractors consider vitalism to be a fundamental and important aspect of their profession.24,25 They argue that it offers a sense of coherence for life, health, and practice in a technical world,26 and helps to distinguish chiropractic from materialistic biomedicine.27 Some chiropractors have suggested that vitalism be modernized into a new vitalism28 defined as “a recognition and respect for the inherent, self-organizing, self-maintaining, self-healing abilities of every individual.”29(p11) In addition, they proposed an extensive agenda to clarify, research, and operationalize this approach across multiple disciplines.29

In contrast, other chiropractors adopt a positivist approach towards vitalism.8 They reject it as a divisive, religious,30 retrograde, aberrant ideology31 and public health risk which “scares” policy makers.32 They claim that belief in vitalism excludes chiropractic from science33 and hinders the acceptance and progress of the profession.34 Supporters of this approach have argued that vitalistic chiropractic educators should be replaced35 and that vitalistic practitioners be reported to the authorities.31

However, the arguments on both sides of this issue have been based on opinions rather than on empirical research data.8 There is a lack of clear and in-depth understanding about vitalism in today's chiropractic profession. It was therefore decided to explore what chiropractors mean when they speak about vitalism. This paper reports a qualitative first part of a larger sequential mixed methods study which explored what meanings and value chiropractors attribute to vitalism. This first part informed the preparation of the content of subsequent quantitative and qualitative parts of the larger study which investigated the generalizability of the findings reported in this present study to a much larger sample of the profession. That additional research, including the question of value, will be reported on in other papers.