The Ship of Theseus and the North Star
The Ship of Theseus and the North Star
The Problem: Evolving While Maintaining Coherence
Since I began studying chiropractic in 1997, I've watched the profession return repeatedly to the same arguments. The faces change, but the questions remain the same: what do chiropractors do? What is chiropractic? What role should Innate Intelligence play in how we understand the profession? Over time, that repetition has made me wonder whether the argument itself is pointing to something deeper. Instead of asking which side is correct, I have come to think we’re asking the wrong question. Before deciding whether chiropractic should change or stay the same, perhaps we should first ask what it is we're trying to preserve. As a result, I’ve become less interested in deciding which faction of chiropractic is correct and more interested in a different question: How does a profession continue learning without losing itself?
Note: This isn't an attempt to define chiropractic once and for all. At its heart, this essay is about identity. More specifically, it's an attempt to think carefully about how professions preserve their identity while continuing to learn.
How can a profession continue learning without losing the identity that made it worth preserving in the first place?
The phrase "art, science, and philosophy" has been part of chiropractic for generations. The challenge is that those three words can mean very different things to different people.
Science evolves through evidence and revision.
Art evolves through experience, skill and clinical judgment.
Philosophy ideally evolves through reasoning and reflection.
The difficulty comes when philosophy is treated as fixed doctrine rather than as a framework for asking questions. Once that happens, disagreements become less about evidence and more about identity. On the other hand, if philosophy is abandoned entirely, the profession risks becoming just a collection of techniques with no unifying purpose.
Something that often gets overlooked: growth can be mistaken for assimilation.
For example, if chiropractors become more knowledgeable about:
- Nutrition
- Exercise physiology
- Neuroscience
- Endocrinology
- Psychology
- Immunology
…it doesn't necessarily mean they're becoming physicians. It could simply mean they're becoming better chiropractors who understand the context in which they practice. Concern arises if expanding knowledge is accompanied by a shift away from the profession's core competencies and scope.
A profession can broaden its understanding of human health while remaining centered on what it uniquely contributes. The question is where that center lies.
- What do chiropractors do?
- What is chiropractic for?
Every long-lived profession seems to have three layers:
- An internal map (how practitioners understand themselves)
- A translation layer (how they explain their work to patients, policymakers, researchers and other professionals)
- An external map (how society understands what the profession contributes)
The internal map doesn't have to become identical to the external one. But the translation layer must be robust enough that people can reliably understand what value the profession offers, even if they don't adopt its conceptual framework.
Rather than asking practitioners to give up deeply held philosophical commitments, the profession could invest more in developing a shared language for communicating across those different maps. That wouldn't resolve every disagreement, but it could make the profession more intelligible to the wider healthcare system without requiring everyone to think exactly the same way.
The North Star Question
This begs the question: "How do we evolve and yet keep our North Star?"
Every institution that lasts for centuries must solve some version of it.
The question isn't whether to change. Everything changes. The question is what must never change and what must always change?
To dig deeper, we must distinguish between identity, principles and implementation.
- Identity answers: Who are we?
- Principles answers: Why do we exist?
- Implementation answers: How do we fulfill that purpose today?
I think chiropractic has often confused implementation with identity. Is the adjustment the identity? Or is it the primary implementation of a deeper identity? Those are different questions. Likewise, is understanding neuroscience a change in philosophy? Or is it simply a better understanding of the same phenomena?
Observations outlive explanations
From sea navigation’s reliance on fixed stars to astronomy’s shift from geocentrism to heliocentrism to scurvy’s eventual explanation as a micronutrient deficiency, the observation was correct even when the explanation was dead wrong. History is full of cases where observations endured even after explanations changed.
- Astronomers observed planetary motion long before Newton.
- People used aspirin before prostaglandins were discovered.
- Semmelweis reduced infections before germ theory.
The North Star is not a destination. It's an orienting reference. You never arrive at Polaris. You continually orient yourself by it.
That may be a better metaphor for philosophy than seeing philosophy as a finished body of propositions.
If every chiropractic college disappeared tomorrow and you had to rebuild the profession from scratch in 2126, what absolutely could not be lost?
Not techniques. Not equipment. Not terminology. Not historical arguments.
What would have to survive for people 100 years from now to still call it chiropractic?
The answers to that question may be our North Star.
The Ship of Theseus Problem
Should the profession be worried about being “swallowed” by the medical model?
I think I am more worried about identity drift than medicine. Medicine isn't the danger because it's medicine; it's the danger because a profession can slowly become something else without realizing it.
- That happens to universities.
- It happens to churches.
- It happens in corporations.
- It happens in political parties.
Not necessarily through a hostile takeover. Usually through incremental adaptation, that, over time, changes the institution's center of gravity.
Ironically, the opposite danger also likely exists. An institution can become so committed to preserving its current expression of its identity that it mistakes the vessel for the essence.
There's a thought experiment called the Ship of Theseus. If every plank of a ship is replaced over time, is it still the same ship? In the reverse, if none of the planks are ever replaced, can the ship survive the ocean? The answer is probably no.
Imagine this old “ship” sailing throughout the ocean…
- The destination (North Star) remains the same.
- The navigation principles remain the same.
- The sails, rigging, hull and instruments change continuously.
If you refuse to replace the sails, you sink. If you forget where you're sailing, you drift. Both are existential failures.
Perhaps the profession's real work over the next decade isn't deciding whether to become more evidence-based, more philosophical, more neurological or more integrative. It may be identifying, with unusual clarity, what is essential and what is contingent.
If that distinction is widely understood, evolution becomes less threatening because people know what they're protecting.
If that distinction is unclear, then every proposed change feels like an attack on the profession itself.
A North Star doesn't tell you exactly which tack to take in today's wind. It tells you how to know whether, despite changing winds, you're still headed in the right direction.
Chiropractic as an Institution
To take it a step further, maybe we need to decide whether chiropractic is an institution or an organization. An organization has a defined governance structure, leadership and authority. For example:
- A hospital
- A university
- A professional association
- A corporation
An organization can make decisions that are binding on its members.
Institutions are sustained by:
- Shared narratives
- Norms
- Traditions
- Educational systems
- Licensing
- Professional culture
- Public legitimacy
They’re emergent rather than centrally controlled.
Organizations solve problems through leadership. Institutions solve problems through culture.
No single entity can decide:
- What chiropractic is
- What chiropractors believe
- How every chiropractor practices
- What every college teaches
The American Chiropractic Association can't do that. Neither can the International Chiropractors Association. Neither can an accrediting body, licensing board or college. Each has influence, but none has complete authority over the profession.
That makes chiropractic much more like an institution.
If chiropractic is an institution, then no president of an association is going to "save chiropractic." No new strategic plan will either. The institution evolves because thousands of chiropractors, educators, researchers, regulators and patients gradually change what they reinforce over time.
Institutions usually have what sociologists call institutional logics.
Institutional logics theory is a sociological idea that explains how broader belief systems (like norms, values and symbols) shape what people and organizations think and do. It also looks at how organizations handle situations where multiple logics exist at the same time, sometimes causing conflict.
Essentially, the underlying beliefs that define what counts as legitimate.
Chiropractic has multiple competing institutional logics. Corrective care, pain care, vitalistic and primary care expansion.
- Corrective care logic: chiropractic restores normal spinal function.
- Pain-care logic: chiropractic treats musculoskeletal disorders.
- Vitalistic logic: chiropractic facilitates the body's self-regulating capacity.
- Primary care expansion logic: chiropractic should broaden its scope to meet more healthcare needs.
Each of those leads to different educational priorities, research agendas, clinical practices and policy goals. That's not merely disagreement about technique. It's disagreement about what the institution is fundamentally for.
An organization can tolerate quite a bit of internal diversity because leaders can set direction.
An institution is more vulnerable when there isn't enough shared culture to maintain internal cohesion. If different parts of the institution are pulling toward fundamentally different ends, there isn't a central authority that can simply resolve it.
Chiropractic is an institution, but it has not fully institutionalized its core identity. Meaning this: chiropractic exists as a profession, but it has not yet fully stabilized what counts as its shared center, purpose or defining logic.
Institutions become durable when their identity is stable enough that individual leaders, schools or factions can come and go without threatening the whole.
Medicine has gone through enormous changes over the last century (new specialties, technologies, evidence standards), but people still broadly recognize what medicine is. Nursing has evolved substantially while retaining a recognizable identity. Chiropractic, by contrast, is still actively debating foundational questions that many older professions settled, or at least learned to manage, decades ago. It’s still negotiating its core identity in a way that makes strategic adaptation especially challenging.
Institutions endure not because they resist change, but because they have a durable center of gravity that helps them absorb change without losing themselves. For chiropractic, the enduring challenge may be less about finding that center than about articulating it in a way that enough of the profession recognizes as worth preserving, even while disagreeing about many other things.
To take this a step further, why do professions develop identities at all?
Identity isn’t merely tradition, it’s an adaptation. Professions need stable identities because society can’t repeatedly renegotiate what every profession is. If every generation had to rediscover medicine from scratch, healthcare would collapse. Identity lowers uncertainty.
Another step leads us to, what makes identities drift?
Bad people? Conspiracies? Usually incentives. Research funding, insurance, education, licensure, technology, economics and patient expectations are all forces that slowly move institutions.
Metaphysics, Evidence and Category Confusion
Back to our North Star…
How can we define something metaphysical in the physical realm?
Philosophers sometimes distinguish between:
- Ontology: what exists
- Epistemology: how we know
- Methodology: how we investigate
If Innate Intelligence or Universal Intelligence is intended as a metaphysical concept, then expecting it to be directly measurable by physical methods creates a category mismatch. Science is well suited to investigating observable phenomena and testable hypotheses. Metaphysical concepts often serve a different role: they provide an overarching way of interpreting reality rather than functioning as empirical measurements.
The challenge is that when metaphysical claims are presented as empirical claims, people naturally ask for empirical evidence. Conversely, when empirical findings are expected to validate or invalidate metaphysical beliefs, the discussion can become confused because the two are operating under different standards.
Many enduring professions and traditions have navigated this by distinguishing between their philosophical foundations and their empirical work. For example, medicine has ethical commitments that are philosophical rather than experimentally derived, yet it relies on empirical methods to evaluate treatments. Those ethical commitments don't become scientific hypotheses simply because they guide practice.
That distinction might also help explain why chiropractic has found it difficult to reach consensus. If some practitioners understand concepts like Innate Intelligence primarily as metaphysical principles and others interpret them as literal physiological mechanisms, they may appear to use the same words while meaning quite different things.
Historical context
Early chiropractic emerged during a period when discussions of vitalism, philosophy, religion and science were much more intertwined than they are today. As scientific norms evolved over the twentieth century, the profession inherited language that different generations have interpreted in different ways.
What role do Innate Intelligence and Universal Intelligence need to play for chiropractic to remain recognizably chiropractic?
There are several possible answers:
- They are indispensable metaphysical foundations
- They are historical metaphors pointing toward the body's capacity for organization and adaptation.
- They are philosophical “short cuts” that orient clinical thinking.
- They are claims about reality that should be treated as empirically testable.
Each answer leads to a different vision of the profession.
Historical Note: These Fault Lines Are Not New
Excerpt from a 1934 Letter from Loran M. Rogers, DC to Hector Lamont, DC
“We are trying to unite the Chiropractic profession. However, we have found that it is impossible to unite them so long as we have someone like B.J. Palmer driving the wedge of dissention to prevent National unity.”
The 1934 quote is interesting because it shows that the fault lines are not new. They were present while many of the founders were still alive. That suggests the disagreements aren't simply the result of modern evidence-based practice or functional medicine…they're woven into the profession's history.
Both sides in these early debates could plausibly argue they were trying to preserve chiropractic, but they had different ideas of what preservation required. One emphasized cohesion and institutional unity; another emphasized guarding the profession's distinctiveness, even at the cost of internal conflict. Those are different strategic philosophies, not merely personal disagreements.
The disagreement may not be about whether these concepts are important, but about what kind of concepts they are. Conversations can end up talking past one another because participants are operating with different assumptions about what counts as explanation, evidence or meaning.
So rather than asking, "Can we define the metaphysical in the physical?" another question could be:
Can a profession have a metaphysical North Star while using empirical methods to evaluate its clinical practices?
History suggests that professions and institutions can integrate philosophical commitments with empirical inquiry, provided they're clear about which questions belong to which domain and don't expect one domain to do the work of the other.
For example, the legal profession is built entirely on the separation of laws of nature (empirical facts) and norms of justice (philosophical principles).
When these boundaries fail, professions falter. The strongest institutions treat philosophy as the compass (defining the direction and the boundaries) and empirical inquiry as the engine (providing the power, the data and the real-world mechanics).
Scientists often describe a phenomenon using the conceptual tools available to them and later generations reinterpret the same observations using new models. Sometimes the original explanation turns out to be wrong while the observation was sound. Sometimes the observation itself doesn't hold up. Sometimes both change.
If the North Star of chiropractic is that the nervous system plays a central role in organizing human function, then every new generation has the opportunity to ask, "What tools and methods allow us to understand that more clearly?" The methods can evolve while the orienting question remains the same.
Whether one views this through a vitalistic lens (Innate Intelligence) or a contemporary neurophysiological one (proprioceptive input, sensorimotor integration, autonomic regulation), the clinical task remains the same: use hands-on skill to improve the nervous system’s ability to organize function. This shared commitment turns philosophy into a practical clinical North Star rather than a source of division.
Let’s end where we began…
- What does a chiropractor do?
- What is chiropractic?
The chiropractor attempts to create conditions in which the patient's own organizing capacity can express itself more effectively and assists the body's capacity for self-organization by influencing the nervous system through skilled manual care.
Healing does not come from without; it comes from within. The healer is merely the facilitator.
What do I believe chiropractic’s North Star actually is?
