Alt Med - Introduction (1 of 20)

Note: the following is drawn largely from quackwatch.org and from this blogger's distance education course entitled "Alternative Medicine and Physical Therapy". Other sources will be cited with links as appropriate.

Definitions

"Alternative Medicine" (aka Complimentary, Integrative or Holistic) may be defined in two ways. Correctly employed, it refers to methods that have equal value for a particular purpose (i.e. two antibiotics capable of killing a particular organism). However, when applied to unproven methods, the term can be misleading because methods that are unsafe or ineffective are not reasonable alternatives to proven treatments.

There are two other definitions that need to be presented when discussing "Alternative Medicine":

1. Quackery, which is the promotion of an unproven product or service
2. Fraud, which is the intentional perversion of truth for gain

Essentially, all promoters of "Alternative Medicine" are practicing quackery. However, not all are guilty of fraud.

Background

The "Alternative" movement is part of a general societal trend toward rejection of science as a method of determining the truth. For example:

• 20% of Americans believe the sun revolves around the earth
• 50% of Americans do not believe in evolution
• 50% of Americans say we depend too much on science and not enough on faith

This movement also embraces the post-modernist doctrine that science is not necessarily more valid than pseudoscience and that there is no objective reality. Scientific medicine (which is mislabeled as allopathic, conventional or traditional) is viewed as but one of a vast array of healthcare options. It portrays itself as a beleaguered minority fighting a self-serving, monolithic "Establishment".

The "New Age" movement is intimately entwined with the "Alternative Medicine" movement. This movement is a decentralized Western social and spiritual movement that seeks Spiritual Truth and the attainment of the highest individual human potential. Besides "Alternative Medicine", the "New Age" movement combines aspects of cosmology, astrology, various religious practices, nature and environmentalism. It utilizes such activities as channeling, holistic health treatments, meditation and crystal healing. Belief in reincarnation, UFOs, crop circles and other "unsolved mysteries" is common.

Some comments regarding a common synonym for "Alternative Medicine", namely "Holistic Medicine". This term is erroneously used to portray "traditional" medicine as focusing only on the "parts" and minimizing the "whole". This is essentially a "straw man" argument. Looking at the "whole" person is important in medicine and is good if science is accepted in doing so. After all, we are more than the sum of our parts and there is a strong connection between the mind, brain and body.

Examples of the language of "Alternative Medicine" include the following:

• "Vitalism" - This is the concept that bodily functions are due to a vital principle or "life force" distinct from the physical forces explainable by the laws of physics and chemistry. The "energies" postulated by vitalists cannot be measured by scientific methods.

• "Quantum Mechanics" - This term is erroneously used to support unscientific concepts of "energy fields" and/or the above-stated "life force". There may be such fields or forces but, until the scientific method supports them having an effect on us, there is no reason to believe. There is a legitimate science of Quantum Mechanics and it is involved with exciting research in the area of atomic and sub-atomic particles and energy.

Answers to some common questions

What's wrong with "Alternative Medicine"? Treatments probably are ineffective, outside of the placebo effect. It may deny the patient effective treatment. There are increased risks of harm since safety has not been effectively evaluated.

Why are some people apparently helped by "Alternative Medicine"? Many medical problems are self-limiting. Correlation between improvement and the application of treatment does not necessarily mean one "caused" the other. The setting and the patient/practitioner interaction may reinforce the placebo effect.

What is the placebo effect? It is an apparently beneficial result of inactive therapy that occurs because of the patient's expectation that it will help. In fact, this effect is very strong, prevalent and growing.

Is it ethical to use the placebo effect? Since virtually every medical treatment has some placebo effects, it is unavoidable. However, most reputable practitioners agree that it is unethical to administer a treatment that is known to have only a placebo effect.

What has science done for us? We would not have the benefits of living in the modern world, such as:

• Electricity
• Plastics
• Flight
• Modern agriculture
• Modern medicine, safety and hygiene
• Technological innovations of a wide variety
• Ever-expanding knowledge of our world and universe

Science

Science may be defined as "the systematic knowledge of the physical/material/natural world gained through observation and experimentation". Science necessarily assumes that supernatural powers do not exist, or if they do exist, they do not interfere with our natural world.

A term closely related to science is skepticism. From the Introduction page of Skeptic magazine, skepticism is "a provisional approach to claims. It is the application of reason to any and all ideas — no sacred cows allowed. In other words, skepticism is a method, not a position. Ideally, skeptics do not go into an investigation closed to the possibility that a phenomenon might be real or that a claim might be true. When we say we are 'skeptical,' we mean that we must see compelling evidence before we believe". It is not cynicism, which is "an attitude of scornful or jaded negativity, especially a general distrust of the integrity or professed motives of others".

A further clarification is needed regarding skepticism. Many people who deny scientific results call themselves skeptics (i.e. climate change skeptics, evolution skeptics, etc.). They are not "skeptics", they are "deniers".

The methods of science are simply called the Scientific Method. This systematic and objective process involves observation and experimentation. The first step is to define a question to be answered. This is followed by observations and the gathering of information and resources. From this activity, an hypothesis is formed. The experiment is then conducted and data is collected. The data is then analyzed and interpreted. Conclusions are drawn and the results are published. Others then have the opportunity to repeat the experiment and either confirm or refute the previous conclusions.

There is a hierarchy in the quality of scientific studies and there are several scales used in the scientific community to differentiate study quality. Following is a good example of such a scale:

1. Highest: Well-designed, randomized controlled trials (RCTs) and prospective (looking ahead) studies, with double-blinding (patient and evaluator do not know what is being administered) and a placebo group. Most pharmaceuticals must meet this highest standard to be approved for patient use.
2. Cohort Studies: These are non randomized but prospective. Subjects who presently have a certain condition and/or receive a particular treatment are followed over time and compared with another group who are not effected by the condition under investigation. This level also may include poorly-designed RCTs. For ethical reasons, this level may be the highest possible (i.e. studying the effects of smoking).
3. Case-Controlled Studies: A retrospective (looking back) examination of exposures to suspected risk or protective factors in relation to an outcome that is established at the beginning of the study.
4. Case-Series: Poorly-designed Cohort and Case-Controlled Studies.
5. Lowest: Anecdotal evidence (non-scientific observations or studies); also includes animal and bench research

The vast majority of "Alternative Medicine" research involves the above-stated levels 4 and 5, with no independently-accepted positive studies at level 1.

Science is not perfect but is constantly developing more useful, accurate and comprehensive models and methods. It is self-correcting, with new evidence leading to new conclusions. With "Peer Review", bad studies can be exposed.

Final remarks

There is the reality that, in today's society, science is constantly fighting the influences of economics, politics, religion and a wide variety of other special interests. In light of this situation, it may be difficult for the layperson to make an informed opinion on the value of an "Alternative Medicine" treatment. However, this blogger encourages those with an open mind to do appropriate research before entering into that unscientific world.

If you disagree with this blogger regarding the value of true science, I ask you what is your alternative tool for finding the truth?

Note

This post is the first in a series discussing "Alternative Medicine". Subsequent postings will present information regarding a variety of commonly-used "Alternative Medicine" practices.