Thursday, January 19, 2006

A verbal spanking from Jacob

My remarks on alternative medicine evidently pushed some buttons. Jacob of Family Medicine Notes commented on yesterday’s post: "You are joking right? These people are doing research. I don't get why you would discount something just because it is not mainstream big-pharma funded. If a well-researched alternative to the traditional treatments turns out to be effective - I would call this SCIENCE .. and your knee-jerk rejection of all things "integrative" to be the pseudo-science. Shame on you!"
Wow. Where to begin. Jacob reminds us that research is being done. I acknowledge and applaud high quality research in CAM. Note the proviso high quality. If, for example, the large NIH sponsored placebo controlled chelation therapy trial demonstrates benefits for patients with coronary artery disease I’ll accept chelation as something that works. Mainstream or not the real distinction is between health claims which have been scientifically proven to work and those which have not.

Other notions proffered for “research” are, in my considered opinion, exercises in pseudoscience---attempts to validate claims that have been debunked and have no biologic plausibility. What’s the point of looking for clinical effects of energy fields undetectable by instruments of physicists and Star Wars forces left behind in water after active ingredients are diluted out?

A strict empiricist might object to my requirement of biologic plausibility, but I maintain a line must be drawn. Otherwise we might as well burn the chemistry and physics books and study every claim that comes along. Why stop with Therapeutic Touch, Homeopathy and Reiki? Let’s go on down the slippery slope and fund studies of astrology, telekinesis and shamanism. And while we’re on the subject of energy medicine why not resurrect Franz Mesmer’s theory of animal magnetism? If only we do enough research his claims will surely be validated. (Discredited in the 18th century, Mesmer would likely be on faculty at a medical school today).

But it’s not so much the research I criticize as the uncritical promotion of baseless methods. Jacob thinks I'm pseudoscientific. Is it pseudoscientific to be skeptical, ask questions or require proof? Having now elaborated on the basis for my objections I hope Jacob and other readers will not regard my opinions as knee-jerk. Finally, I’m afraid I’m missing Jacob’s point about big-pharma funding---it hasn’t entered into my opinions on pseudoscience.

If it seems I’m beating the drum on pseudoscience, I have a distinct purpose: exposure. People who expect institutions of medical education and health care to be based on rigorous science and intellectual integrity need to know what’s going on. Or maybe I’m just full of negative energy.


Moof said...

I find it disturbing that one of our local hospitals has begun to offer Reiki to their inpatients. At the very least, having Reiki "practitioners" wandering the hallways offering their services daily to anyone and everyone lends a tacit medical approval to its place in serious medicine.

I know more and more people who are turning to these alternative "medicines" in place of seeing a physician ... and I think that as this class of "touchy-feely" pseudo-science gains momentum, that the trend could become pronounced.

That said, I think that the reason the general public is so keen on that sort of thing is because the pseudo-scientific "medicines" are more in the business of connecting with people on an emotive level than they are on a medical level. To counter this, serious medicine may have to try a bit harder to relate to more than just the physical aspects of illnesses.


R. W. Donnell said...

Thank you for your comments. There are different levels of promotion of pseudoscience. There are many examples where the "mainstream" lends tacit or passive approval to bogus methods. This can have the same adverse effect as active promotion, likewise all too common.

I totally agree with you that serious medicine needs to pay more attention to the "whole person" (much as I hate to use that phrase since it's been hijacked by the pseudoscience crowd).

mchebert said...

Science is not a set of theories and suppositions, as alternative medicine advocates would have us believe. Science (and medicine) is a method of inquiry. If you ask logical questions and perform studies according to scientific standards, your results ARE valid science.

Thus, chiropractors, or advocates of magnet therapy, can enter mainstream medicine. All they have to do is prove what they have to say. The doctor who first proposed that peptic ulcers were infectious in origin was laughed at, but then he went out and proved his theory. Now no one is laughing.

I cannot stand people in science who give the "you don't give us any respect" baloney. Want respect? Prove your methods are correct using valid scientific methods, and you have it. If you refuse to do so, don't expect people who have devoted their lives to evidence-based medical care to turn their backs on their system to embrace alternative medicine.

You give people respect no matter who they are. Ideas are another matter, and do not deserve respect if they have nothing to back them up.

Orac said...

Credulous acceptance of nonscientific and pseudoscientific "ethnoscience" is running rampant. For example, there was an event at the Newark Museum that promoted uncritical acceptance of everything from "alternative medicine" that might have value (herbalists) to all sorts of superstitious, religious, and unscientific ideas, such as Chi, energy medicine, ying/yang, and African "divination" based on a person's "spirit encased in a physical body." These pseudoscientific and religious ideas were given the term "ethnoscience."

"Ethnoscience"? Give me a break. It's just like "intelligent design" creationism advocates trying to redefine what science is in order to get their religious idea counted as "science."