ilw
06-10-2007, 12:13 AM
The dilemmas at the heart of 'alternative medicine'
All forms of ineffective treatment, 'alternative' or otherwise, pose real dilemmas that are usually neglected.
The definition dilemma
Once any treatment is shown beyond doubt to be effective, it ceases to be 'alternative' and becomes just like any other part of medical knowledge. That means that 'alternative medicine' must consist entirely of unproven treatments.
The lying dilemma
Suppose that a treatment owes all its effectiveness to the placebo effect, e,g. homeopathy (even Peter Fisher almost admitted as much). But in some people, at least, the placebo effect is quite real. It may be a genuine physical response, though one that does not depend in any activity of the drug, or other treatment.
If the placebo effect is real, it would be wrong to deprive patients of them, if there is nothing more effective available. For example, if terminal cancer patients say they feel better after having their feet tickled by a 'reflexologist', why should they not have that small pleasure?
If the foregoing argument is granted, then it follows that it would be our duty to maximise the placebo effect. In the absence of specific research, it seems reasonable to suppose that individuals who are susceptible to placebo effects, will get the best results if there treatment is surrounded by as much impressive mumbo jumbo as possible.
This suggests that, in order to maximixe the placebo effect, it will be important to lie to the patient as much as possible, and certainly to disguise from them the fact that, for example, their homeopathic pill contains nothing but lactose.
Therein lies the dilemma. The whole trend in medicine has been to be more open with the patient and to tell them the truth. To maximise the benefit of alternative medicine, it is necessary to lie to the patient as much as possible.
As if telling lies to patients were not enough, the dilemma has another aspect, which is also almost always overlooked. Who trains CAM practitioners? Are the trainers expected to tell their students the same lies? Certainly that is the normal practice at the moment. Consider some examples.
The training dilemma
If feet tickling makes patients feel better, it might be thought necessary to hire professional feet ticklers who have been trained in 'reflexology'. But who does the training? It cannot be expected that a university will provide a course that preaches the mumbo jumbo of meridians, energy lines and so on.
A good example is acupuncture. It is often stated that one of the best documented forms of 'alternative medicine' is acupuncture. Certainly the act of pushing needles into to your body elicits real physiological responses. But recent experiments suggest that it matters very little where the needles are inserted. There are no 'key' points: it is the pricking that does it. But its advocates try to 'explain' the effects, along these lines.
"There are 14 major avenues of energy flowing through the body. These are known as meridians".
The energy that moves through the meridians is called Qi.
Think of Qi as "The Force". It is the energy that makes a clear distinction between life and death.
Acupuncture needles are gently placed through the skin along various key points along the meridians. This helps rebalance the Qi so the body systems work harmoniously.
I suppose, to the uneducated, the language sounds a bit like that of physics. But it is not. The words have no discernable meaning whatsoever. They are pure gobbledygook. Can any serious university be expected to teach such nonsense as though the words meant something? Of course not. Well so you'd think, though a few 'universities' have fallen for this, to their eternal shame (e.g, Westminster, Thames Valley, Salford, Central Lancashire, Lincoln: see below for more).
http://www.dcscience.net/quack.html
Alternative medicine is something which pisses me off quite a lot in much the same vein as religion and it seems to be on the rise (to the extent that there are university courses teaching it and NHS funding is being pissed down the drain on it). Another recent example of its rise was the panorama programme which talked a lot of bullsh*t about electrosensitivity (http://www.badscience.net/?p=414) and has caused various schools to start withdrawing wifi and i believe missing opportunities for enhancing the teaching they provide. They've even got jasper carrott scaremongering ffs (http://video.google.com/videoplay?docid=1815884563738845754).
Its all gone too far, the article quoted above is by Dr Colquhoun
This week, for example, Professor David Colquhoun FRS - one of the most eminent scientists in the UK - has been forced to remove his quackbusting blog from the UCL servers where it has lived for many years, after complaints from disgruntled alternative therapists.
To me this is so incredibly arse-backwards, his website is being forced offline by people selling witch doctor remedies!
Generally I think the reason it annoys me so much is probably because my dad has started going in for it more and more and despite the fact that he has a medical degree (dentistry) he completely fails to see just how little sense most of it makes, it causes (good natured) arguments nearly every time i see him.
Are there any believers here? Or anyone else who gets seriously peeved by it like me.
Also I'd like to recommend www.badscience.net to everyone too btw, its a blog by a doctor who writes in the guardian newspaper. The focus is on bad medical science, but it does discuss other scientific subjects and has links to other websites on the net. All very educational and engagingly written
All forms of ineffective treatment, 'alternative' or otherwise, pose real dilemmas that are usually neglected.
The definition dilemma
Once any treatment is shown beyond doubt to be effective, it ceases to be 'alternative' and becomes just like any other part of medical knowledge. That means that 'alternative medicine' must consist entirely of unproven treatments.
The lying dilemma
Suppose that a treatment owes all its effectiveness to the placebo effect, e,g. homeopathy (even Peter Fisher almost admitted as much). But in some people, at least, the placebo effect is quite real. It may be a genuine physical response, though one that does not depend in any activity of the drug, or other treatment.
If the placebo effect is real, it would be wrong to deprive patients of them, if there is nothing more effective available. For example, if terminal cancer patients say they feel better after having their feet tickled by a 'reflexologist', why should they not have that small pleasure?
If the foregoing argument is granted, then it follows that it would be our duty to maximise the placebo effect. In the absence of specific research, it seems reasonable to suppose that individuals who are susceptible to placebo effects, will get the best results if there treatment is surrounded by as much impressive mumbo jumbo as possible.
This suggests that, in order to maximixe the placebo effect, it will be important to lie to the patient as much as possible, and certainly to disguise from them the fact that, for example, their homeopathic pill contains nothing but lactose.
Therein lies the dilemma. The whole trend in medicine has been to be more open with the patient and to tell them the truth. To maximise the benefit of alternative medicine, it is necessary to lie to the patient as much as possible.
As if telling lies to patients were not enough, the dilemma has another aspect, which is also almost always overlooked. Who trains CAM practitioners? Are the trainers expected to tell their students the same lies? Certainly that is the normal practice at the moment. Consider some examples.
The training dilemma
If feet tickling makes patients feel better, it might be thought necessary to hire professional feet ticklers who have been trained in 'reflexology'. But who does the training? It cannot be expected that a university will provide a course that preaches the mumbo jumbo of meridians, energy lines and so on.
A good example is acupuncture. It is often stated that one of the best documented forms of 'alternative medicine' is acupuncture. Certainly the act of pushing needles into to your body elicits real physiological responses. But recent experiments suggest that it matters very little where the needles are inserted. There are no 'key' points: it is the pricking that does it. But its advocates try to 'explain' the effects, along these lines.
"There are 14 major avenues of energy flowing through the body. These are known as meridians".
The energy that moves through the meridians is called Qi.
Think of Qi as "The Force". It is the energy that makes a clear distinction between life and death.
Acupuncture needles are gently placed through the skin along various key points along the meridians. This helps rebalance the Qi so the body systems work harmoniously.
I suppose, to the uneducated, the language sounds a bit like that of physics. But it is not. The words have no discernable meaning whatsoever. They are pure gobbledygook. Can any serious university be expected to teach such nonsense as though the words meant something? Of course not. Well so you'd think, though a few 'universities' have fallen for this, to their eternal shame (e.g, Westminster, Thames Valley, Salford, Central Lancashire, Lincoln: see below for more).
http://www.dcscience.net/quack.html
Alternative medicine is something which pisses me off quite a lot in much the same vein as religion and it seems to be on the rise (to the extent that there are university courses teaching it and NHS funding is being pissed down the drain on it). Another recent example of its rise was the panorama programme which talked a lot of bullsh*t about electrosensitivity (http://www.badscience.net/?p=414) and has caused various schools to start withdrawing wifi and i believe missing opportunities for enhancing the teaching they provide. They've even got jasper carrott scaremongering ffs (http://video.google.com/videoplay?docid=1815884563738845754).
Its all gone too far, the article quoted above is by Dr Colquhoun
This week, for example, Professor David Colquhoun FRS - one of the most eminent scientists in the UK - has been forced to remove his quackbusting blog from the UCL servers where it has lived for many years, after complaints from disgruntled alternative therapists.
To me this is so incredibly arse-backwards, his website is being forced offline by people selling witch doctor remedies!
Generally I think the reason it annoys me so much is probably because my dad has started going in for it more and more and despite the fact that he has a medical degree (dentistry) he completely fails to see just how little sense most of it makes, it causes (good natured) arguments nearly every time i see him.
Are there any believers here? Or anyone else who gets seriously peeved by it like me.
Also I'd like to recommend www.badscience.net to everyone too btw, its a blog by a doctor who writes in the guardian newspaper. The focus is on bad medical science, but it does discuss other scientific subjects and has links to other websites on the net. All very educational and engagingly written