Monday, September 10, 2012

Complementary and Alternative Medicine

The James Randi Educational Foundation (JREF) has made it its mission to expose what it considers to be fraudulent or misleading behaviour by people in positions of influence and power. In his most famous cases, Randi turned his own attention to faith healers, and in particular Peter Popoff.

Recently the JREF has focused on practitioners of complementary and alternative medicine (CAM). This has become a hot topic in the UK, where healthcare is publicly funded through the National Health Service (NHS). Despite vocal opposition by the British Medical Association, many medical practices now offer alternative treatments such as acupuncture or homeopathy and homeopathic hospitals have been founded in London, Liverpool and Bristol.

The British government currently provides financial support for alternative therapies amounting to around £4 million per year (source The British Homeopathic Association), and many argue that this is a good deal in terms of the perceived benefits. There is significant celebrity endorsement of CAM, and Prince Charles has been particularly outspoken on the issue. There exists, however, no credible scientific and statistically significant evidence that CAM works any better than placebo (as reported exhaustively by Dr. Ben Goldacre in his Bad Science blog).

Many people would say that it is an individual's right to believe what they like, and even if these beliefs turn out to be based on untruths they may still be sources of comfort, especially in times of distress (a relativistic point of view). The placebo effect is powerful and little understood and therefore it could also be argued that it is beneficial to allow or even encourage people to maintain their existing beliefs, particularly in relation to their own health. This does sound somewhat patronising, however, and is suggestive of willful support of public ignorance.

In the article below, Dr. Steven Novella (member of the JREF and clinical neurologist at Yale University School of Medicine) proposes that CAM should be considered not just to have no medical merit but to be actively dangerous to public health. He discusses a real life situation in which a woman with a cancerous growth decided to consult a practitioner of alternative rather than conventional medicine.
Is It Dangerous to Believe in CAM?

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