The Problem With Alternative Medicine
I’ve got no objection to people who want to use complementary, alternative, holistic, wholefood sorts of therapies, as long as they can afford to spend their money on them and haven’t been conned into thinking that serious scientific tests have shown them to be worthwhile.
After all, these are now generally termed complementary medicines; they used to be referred to as alternative medicine. Why the change? Simply because if you give people the placebo as well as the tested medicine, they are much more likely to get better. If you give people just the ‘alternative’ (the homeopathy, or whatever), there’s no guarantee people will actually get better, and they might possibly get worse, with serious consequences.
It’s just not safe or sensible to treat these as an alternative to conventional medicine. The problem is that they might work for some people; the problem is in determining whether that is regression to the mean (i.e. most of the time, people aren’t ill; take an ill person and leave them for an amount of time, and if it’s not a serious illness, they will generally get better, irrespective of whether or not they have been given medicine), whether it’s to do with the placebo effect, or whether there has actually been some benefit. Anecdotally, people tend to assume that it’s the therapy which is the cause of the person getting better. Scientific studies are yet to bear this out.
So while I don’t have a problem with someone wanting to use a homeopathic remedy where, in order to get one molecule of active ingredient, the user would need to drink the equivalent of more than all the water in the world, I do have a problem with someone believing that this should be used instead of traditional (read: proven) medicine.
You can do all the bile chanting you want, but don’t ever think it should be used instead of proper medicine.
Otherwise you’ll get sad cases like this one:
A couple whose baby daughter died after they treated her with homeopathic remedies instead of conventional medicine have been found guilty of manslaughter. Gloria Thomas died aged nine months after spending more than half her life with eczema.
The skin condition wore down her natural defences and left her completely vulnerable when she developed an eye infection that killed her within days of developing.
Obviously Gloria Thomas is one of the victims here: the poor little child died unnecessarily; she spent most of her short life in discomfort because of the eczema. But her parents, who presumably believed they “acting for the best” are also victims. They were led to believe that homeopathy was better, that there was somehow something wrong with conventional medicine. And because of that, they are responsible for their daughter’s death.
Of course they are far from blameless — they specifically ignored advice given to them by doctors — but I find it difficult to believe that they were doing this out of spite; but they allowed their unsupported beliefs to be responsible for the suffering and death of their daughter.
But the fault doesn’t just lie with them. The fault also lies with the people who spend time suggesting that these ‘alternative’ or ‘complementary’ medicines actually have any benefit beyond the placebo effect [begin edit for clarity] where this has not been backed up by any properly rigorous scientific study, particularly if they are advertised in such a way as to imply they are better or safer than conventional therapies [/end edit]
And the problem is that people (in particular people in the media) are allowed to put forward suggestions that conventional medicine may be dangerous (depending on what it is, it may be, but not being treated adequately is likely to be more dangerous), or perpetuating myths such as the MMR vaccine being associated with autism. They are allowed to put forward these suggestions, and then when as a result of this, children get measles and die, they do not face any consequences.
Irrespective of the fact that they might think they are giving people good advice, they aren’t. And if they dole out poor advice or misinformation — whether it’s because they don’t know better (because they haven’t checked it out properly) or because they are seeking to deliberately mislead — they need to be held accountable.
Should parents be forced to give their kids the MMR jab? I’d say no. I don’t think it’s right to force parents to give their children particular vaccinations. While I have some sympathy for the “if you’ve not been vaccinated, you don’t get to attend state schools” idea, I’m still wary about this — surely those people who have been vaccinated won’t be at risk, so they are only risking killing their own children anyway?
I can understand why parents would have been wary about MMR, after the scare. What I can’t understand is those parents who think “ooh, autism is bad, therefore me no give vaccine” without considering what the vaccine is actually for. If you’re worried, and you’re a responsible parent, you ought to at the very least look into it. And if you do that, the evidence will push you overwhelmingly towards giving the MMR jab.
And if you’re not capable of doing that, I can sympathise with (without fully supporting) the view that maybe you’re not a responsible enough parent to be in charge of your child’s vaccinations. If you’d rather ignore all the evidence based medicine, then you might as well focus on the bile chanting…
Phil says:
June 7th, 2009 at 10:06 am
“surely those people who have been vaccinated won’t be at risk” I’m not sure. But I think actually they would be. vaccines aren’t 100% guarantee. If you have multiple unvaccinated kids become contagious, there is a much greater likelihood of vaccinated kids getting infected. Also of mutation of the viruses into vaccine resistant strains. Which would be very bad!
paul canning says:
June 7th, 2009 at 10:25 am
Back in the 90s I worked with a therapist friend on testing whether any therapies would help relieve AIDS symptoms. Our biggest problem was the impossibility of getting funding or any support to test them.
I could see that some of them did help and this makes sense as much conventional medicine is derived from nature. This is why drug companies send people out to indigenous peoples to find new therapies.
But the system for ‘proving’ the efficacy of a substance is radically bent against the ability of alternative therapies to do that as it is so expensive, even simple blood tests – we had to do this by cheating.
The Goldfish says:
June 7th, 2009 at 11:41 am
You’re throwing a lot of different threads together here.
Thing is that we don’t know all alternative medicines are hopeless. It’s just that where something has an effect beyond placebo, it ought to be provable. As Paul points out in his post, clinical trials are expensive and haven’t been conducted for every alternative therapy. Obviously, there are lots of cases where folk have attempted to prove something with double blind placebo trials, failed and come up with excuses (I think it’s safe to say that homeopathy really is nonsense).
Science is applied doubt Jack. Personally, having been subjected to all manner of different “therapies” as a teenager, I think most of it probably is nonsense and I think much of it is exploitative and dangerous nonsense. But I can’t say for sure that everything that’s not currently provided by the NHS falls into the same category. I don’t have the evidence (just as I don’t have any evidence that any of it works).
Also, the placebo has a significant, if largely unspoken, role in conventional medicine. It is possible that the vast majority of people who benefit from SSRI antidepressants (prozac and family) are benefiting from the placebo effect rather than the chemical effects of the drug. Most drugs we take may work partially on placebo. It’s not like the placebo renders something a complete waste of time.
Finally on MMR, as Phil points out, there’s the matter of herd immunity. In order for a vaccination program to protect all those who are vaccinated, the vast majority of any given population must be vaccinated. Vaccinated children are safer, but the presence of large numbers of unvaccinated children puts everyone at risk.
That having said, I think we’d do much better to have a proper public information campaign than forcing people to do anything.
Forgive the long comment, in a somewhat pedantic state of mind today.
JackP says:
June 7th, 2009 at 12:05 pm
@Paul, @Goldfish:
I have clarified post above to try and make it more clear that it’s people who recommend stuff which hasn’t been scientifically tested over stuff which has which is my main objection.
This anti-science agenda must stop: it’s killing people. What about Daniel Hauser, who has cancer believed treatable with chemo?
And I’m not disputing that the placebo effect can be very beneficial. It probably sounds dismissive to someone who doesn’t understand the placebo effect, but there have been trials where the placebo effect has made people better even when you’ve actually been giving treatment that ought to make them slightly worse…
And it’s because something ‘no better than placebo’ may well be beneficial, that I don’t object to people using complementary therapies. It might, or it might not, benefit them. But as long as they are taking the therapies which have been proven to work as well, where’s the harm?
It’s the idea of it being an alternative, an ‘instead-of’ which I think is dangerous.
I should have mentioned it, but this post was inspired by yesterday’s – the reading material was making me think ‘poor decisions based on lack of understanding can cost lives’. Which brought me back to Daniel (who I then forgot to mention in the original article) and gloaria.
Anyway, I’m pleased I’ve come up with something which has stirred up a few opinions
Nick says:
June 8th, 2009 at 2:20 pm
I don’t often comment on this as I believe it’s up to the individual to take responsibility for their own health and to research all methods of treatment before starting anything (complimentary or allopathic). Even though I’m happy with my views I don’t believe it’s my right to expect others to agree or submit. I think your main point about using complementary therapy exclusively is valid, I prefer to chop and change with whatever therapy I think works – the health of the patient is valid. However, I think the tone of your post and the examples you use come across as biased.
It’s important to remember, as others have commented, that generally the research for western medicines comes from (or is funded by) the companies that have a vested interest in their commercial success. Side effects do exist and are not necessarily documented before the therapy is released for public consumption (simply because they’ve not been found). I’m more inclined to trust my multidisciplinary complimentary practitioner’s many years of proven experience, over a drug with a list of side effects on the side of its packet. Also, unless it’s good for PR, these companies have no motivation to promote anything other than their own drugs. The last time I checked out American TV it seemed to have a drug for all kinds of minor ailments, things that eg. eating more fruit or fibre would sort out.
Your statement that all parents who educate themselves about the MMR vaccine would give it to their children comes across as naive (sorry I looked for another word, but couldn’t find one). Even educated people disagree. I fully support your right to have a view, but I think we’ve all got to recognise our roles as impromtu opinion leaders and frame our views in a way that leaves people to make their own minds up (what I hope I’m doing here). I also agree with you that nobody should ever have a therapy forced on them, however I understand that position gets tricky with children, maybe that’s for another comment.
I’m not trying to offend, I’m just trying to get some balance. I believe people need to take responsbility for their health, but I also believe the way these issues are discussed on blogs and in the media is critically important.
Phew, I’m glad to get that out. Sorry it turned out to be quite long. I think I’ll leave you to continue the conversation while I get back to what I should be doing…
Nick says:
June 8th, 2009 at 2:23 pm
D’oh, “the health of the patient is valid” should be “the health of the patient is paramount”. Sorry about that, too many things going on…
JackP says:
June 8th, 2009 at 7:03 pm
@Nick – sorry if the examples came across as biased – however it was those specific examples which inspired the post, rather than the other way around!
It’s an interesting point re: funding ffor research. But there are a lot of companies making a lot of money from alternative therapies too – if they want to be given more credit they should maybe pay for some research too.
And I accept that ‘even educated people disagree’ — that’s half the fun — but I do feel the evidence for MMR is overwhelmingly in favour, particularly in comparison with the risks of not being vaccinated.
Oh, and no offense taken…
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June 12th, 2010 at 8:44 pm
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