Alternative medicine. A critique

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There is much ado these days about "alternative medicine". The term alternative medicine, as used in the modern Western world, encompasses any healing practice "that does not fall within the realm of conventional medicine". Commonly cited examples include chiropractic practice, herbalism, traditional Chinese medicine, meditation, yoga, bio feed back, hypnosis, homeopathy, acupuncture, and diet-based therapies. However, because these alternative techniques tend to lack evidence of efficacy, some have advocated defining it as non-evidence based medicine, or not medicine at all.

Criticisms of alternative medicine by mainstream physicians have been numerous and vigorous opposition describing it as "pseudo-science" based on "absurd beliefs" continues to be voiced. In fact in 1997, a letter to the United States Senate Subcommittee and Public Health and Safety, signed by four Nobel laureates and other prominent scientists, deplored the lack of critical thinking and scientific rigor in alternative medicine-supported research.

For example, Richard Dawkins, the well-known avowed atheist and professor of the Public Understanding of Science at Oxford University, defines alternative medicine as "that set of practices that cannot be tested, refused to be tested or consistently fail tests. There is no alternative medicine, there is only medicine that works and medicine that does not work."

Now, while I agree that clinical observations are certainly important in medicine, many times there is no way of really knowing if something is truly effective or not without double-blind studies. For example, a person may suffer local back pain and seek treatment for all other sorts of things. The person may indeed recover or be "healed" by any of these alternative medicines, but this in itself is not proof that any of these measures really works. You need clinical trials of statistically significant samples of a population with a controlled sample of people (who are not treated but are given a placebo) to see which of these treatments worked.

Indeed, much of what today is called alternative medicine is, at best, effective placebos, and, at worse, fraud, and I feel a professional and perhaps cultural obligation to speak out, even if I run the risk of being unfashionable.



In fact, from various studies we have learned that a placebo alone, which is believed to have no biological activity, will improve many conditions by at least a third and even reduce pain complaints by 30 per cent or more. From scientific studies of health and disease, we have long confirmed the power of the mind-body connection, and in some conditions, a person's belief can dramatically eliminate their symptoms.

We also know, from 100 years of experience, that popular perceptions of effectiveness are very unreliable. Even individual physician's perceptions of effectiveness are equally unreliable.

The former editor of the Journal of the American Medical Association (JAMA) once stated that "there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking". Some sceptics of alternative practices also point out that a person may attribute symptomatic relief to otherwise ineffective therapies due either to the natural recovery from or the cyclical nature of an illness, the placebo effect, or the possibility that the "patient" never originally had a true illness.

As for cancer therapy, a 1998 systemic review of studies assessing its prevalence in 13 countries concluded that about 31 per cent of cancer patients used some form of complementary and alternative medicine (complementary meaning alternative medicines in addition to traditional Western medicine). However, are view of the effectiveness of certain alternative medicine techniques for cancer treatment have found that that most of these treatments are not merely unproven but are in fact proven not to work.

A Norwegian multi-centre study examined the association between the use of alternative medicine and cancer survival. Five hundred and fifteen patients using standard medical care for cancer were followed for eight years. Twenty-two per cent of those patients used alternative medicine concurrently with their standard care. The study revealed that death rates were 30 per cent higher in alternative medicine users than in those who did not use alternative medicine. The use of alternative medicine seems to predict a shorter survival from cancer was the study's conclusion.

Among the explanations for the appeal of alternative medicines includes the low levels of scientific literacy among the public at large, vigorous marketing of extravagant claims by the "alternative" medical community and inadequate media scrutiny and attacking critics. The psychological reasons include the placebo effect and the will to believe. Moreover, many promoters of natural remedies over-hype and overprice the items they sell and outlandish claims about a product's ability to cure accompanied by an equally outlandish price seems all too common in recent days.

Unfortunately, we have seen too many patients who have been suffering from near fatal conditions, who have been treated with non-traditional medicine, and have waited too long to be treated properly at the cost of their lives. It is certainly ironical that in this era of astounding scientific advances, so many of us are still so unlearned and misinformed about matters relating to health. And so it will remain, I am afraid.

Additional information:

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