Dictionary:
alternative medicine |
A variety of therapeutic or preventive health care practices, such as homeopathy, naturopathy, chiropractic, and herbal medicine, that do not follow generally accepted medical methods and may not have a scientific explanation for their effectiveness.
| Answers Corp. Content: Alternative Medicine Encyclopedia |
| Encyclopedia of Public Health: Alternative, Complementary, and Integrative Medicine |
Conventional Medicine and Public Health
Traditionally, public health relies extensively on conventional (allopathic) medicine in its mission to prevent and treat disease. It accepts reductionistic methods to identify the origin of illness at the cellular and subcellular level, and then applies these principles in assessing and addressing risk factors in populations. This results in a three-tiered approach to the delivery of public health services: (1) primary prevention, which involves efforts to reduce exposure to risk factors for injury and illness; (2) secondary prevention, which involves the identification and control of disease in its early stages; and (3) tertiary prevention, which attempts to control the impact of existing illness and injury through prolonged treatment and rehabilitative services.
Paralleling the growth of technology-based medicine (and its effectiveness), however, has been a simultaneous rise in chronic illnesses that are resistant to current treatment modalities and very costly to society. Leading causes of morbidity in the early 1900s, such as trauma and infectious disease, have been supplanted by chronic conditions such as cancer, heart disease, and HIV (human immunodeficiency virus) infection. This requires the development of a new model of health care that is multidimensional and that recognizes all factors influencing health and illness. At a public health level, multidimensional problems require multidimensional interventions, which is the basis of the integrative medical approach.
Complementary and Alternative Medicine
In 1948, the World Health Organization (WHO) defined health as "a complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity." The public increasingly embraces "holistic" medicine when seeking treatment for chronic medical conditions. This philosophical shift has led to a sharp increase in the use of complementary and alternative medicine (CAM), defined as modalities (e.g., acupuncture, herbal therapy, massage therapy), employed in place of, or as adjuncts to, conventional medical therapies. Surveys reveal that almost half of the U.S. population turns to such modalities, with acceptance and use of CAM expanding during the 1990s. Studies showing that CAM use tends to be higher among patients with diseases (e.g., cancer, arthritis), that are often inadequately treated by conventional approaches may suggest an inherent dissatisfaction with Western medicine. Research suggests, however, that the public is actually turning to CAM because its doctrines parallel their own personal values and belief systems. For example, patients want physicians who regard them as whole persons—minds and spirits as well as bodies—and who believe in the healing power of nature. In fact, although CAM therapies are very diverse, ranging from well-established cultural traditions (e.g., Chinese traditional medicine) to quasi-allopathic modalities marginally supported by current science (e.g., chelation therapy), most share common underlying philosophies. These include a belief in the interconnectedness of mind and body and respect for the innate mechanisms of healing.
Integrative Medicine
Practioners of conventional medicine are justifiably proud of the achievements of their profession—most notably the diagnostic, pharmacological, and surgical advances of the twentieth century. Total reliance on such technologies, however, has led to the dismissal of CAM modalities as archaic or ineffective. The result has been increasing divisiveness between proponents and opponents of unconventional therapies.
The descriptive phrase "integrative medicine," coined in the late twentieth century, characterizes a new model of health care rooted both in conventional and alternative medicine. In the broadest sense, integrative medicine employs modalities drawn from all medical therapeutic paradigms, providing patients with individualized treatment plans optimized for their specific clinical situations. The underlying philosophy recognizes and relies upon the innate healing capacity of the human body and emphasizes the importance of the relationship between practitioner and patient in fostering this capacity.
While incorporating aspects of both conventional medicine and CAM, integrative medicine does not uncritically accept either without evidence of validity and efficacy. Additionally, in weighing both the benefits and risks inherent to any therapy, regardless of its origin, the integrative practitioner initially selects the least invasive, least toxic, and least costly interventions appropriate to the situation.
A cornerstone of the integrative model is the assertion that health and healing optimally occur when all factors that influence the organism are addressed. To quote Sir William Osler (1849–1919), "It is more important to know what sort of patient has a disease than what sort of disease a patient has." Therefore, although a patient presents specific symptoms, the integrative practitioner inquires into all lifestyle, psychosocial, and spiritual influences affecting quality of life. The ensuing treatment plan includes recommendations such as dietary change, increase in physical activity, and stress reduction in addition to any specific therapies. Positive coping skills such as biofeedback, yoga, prayer, meditation, and community involvement are promoted.
Although the breadth and depth of CAM is beyond the scope of this chapter, a few of the more recognized and researched modalities are listed below:
Fundamental to the integrative model is the therapeutic relationship between the patient and doctor. Practitioners recognize that they are not the source of healing, but the means by which patients discover, or rediscover, their innate capacity to regain health. Therapeutic modalities, whether conventional or alternative, are simply adjuncts to this process; patients must take responsibility for their own health and well-being. To this end, each therapeutic decision is the result of a consideration of all appropriate modalities, whether conventional or CAM. Patients are thus active partners in choosing therapies consistent with their values and philosophical beliefs.
Integrative Medicine and the Future of Health Care
No one denies the existence of a crisis in the delivery and financing of health care. The arrangement of unregulated fee-for-service practices, reimbursement through managed care, and costly defensive medicine has complicated rather than alleviated the burden of escalating chronic illness associated with an aging population. The ensuing national debate has focused upon repair of this system, rather than the creation of a new design.
An integrative approach to public health redefines the ideology of the system rather than attempting to repair the current model. It looks to equitable and universal access to health maintenance services, and focuses on disease prevention as well as on current treatments, which may not always be effective. Decisions regarding the provision of health care therefore do not simply originate from within the medical and reimbursement sectors, but become a social contract among individuals, providers, hospitals, academic institutions, corporations, communities, and governmental agencies. Individuals become accountable for the impact their behavioral choices have upon the community as well as on their own personal wellbeing. Health care providers and hospitals work to prevent illness as well as treat it, emphasizing accountability to the individual and the community over financial profit. Academic institutions develop programs that promote the synergistic training of students of medicine, nursing, pharmacy, and others involved in patient care. Corporations recognize the overall value of healthy employees and invest in individual and organized wellness programs. Communities acknowledge that health in not only the result of good medical care, but also of adequate housing, sanitation, and education. Finally, government serves as a safety net, ensuring access to medical care when all other resources fail, as well as enacting and enforcing legislation designed to protect both the individual and the health care system. Thus, the concept of integrative medicine encompasses not only the health of the individual, but of society as a whole.
(SEE ALSO: Chinese Traditional Medicine; Holistic Medicine; Prevention; Preventive Health Behavior; Preventive Medicine)
Bibliography
Astin, J. A. (1998). "Why Patients Use Alternative Medicine: Results of a National Study." Journal of American Medical Association 279(19):1548–1553.
Donnelly, W. J.; Spykerboer, J. E.; and Thong, Y. H. (1985). "Are Patients Who Use Alternative Medicine Dissatisfied with Orthodox Medicine?" Medical Journal of Australia 142(10):539–541.
Eisenberg, D. M.; Davis, R. B.; Ettner, S. L.; Appel, S.; Wilkey, S.; Van Rompay, M.; and Kessler, R. C.(1998). "Trends in Alternative Medicine Use in the United States, 1990–1997: Results of a Follow-up National Survey." Journal of American Medical Association 280(18):1569–1575.
Gaudet, T. W. (1998). "Integrative Medicine: The Evolution of a New Approach to Medicine and to Medical Education." Integrative Medicine 1(2):67–73.
Kaptchuk, T. J., and Eisenberg, D. M. (1998). "The Persuasive Appeal of Alternative Medicine." Annals of Internal Medicine 129(12):1061–1065.
Maizes, V., and Caspi, O. (1999). "The Principles and Challenges of Integrative Medicine." Western Journal of Medicine 171(3):148–149.
Rees, L., and Weil, A. (2000). "Integrated Medicine." British Medical Journal 322(7279):119–120.
Weil, A. (2000). "The Significance of Integrated Medicine for the Future of Medical Education." American Journal of Medicine 108(5):441–443.
— WILLIAM BENDA; ANDREW WEIL
| Britannica Concise Encyclopedia: alternative medicine |
For more information on alternative medicine, visit Britannica.com.
| US History Encyclopedia: Alternative Medicine |
Alternative medical practices have arisen in or have easily been transported to the United States, where social values and political infrastructure have encouraged many forms to flourish. The pervading American value placed in persons having autonomy with respect to making decisions over their own bodies; the skepticism toward any professional group having a monopoly on a given field; and Article 10 of the U.S. Constitution, which reserves to each state the exclusive power to set standards, make rules, and license practitioners in their jurisdictions, have enabled the public and small groups of unorthodox practitioners to shape laws that limit the powers of the dominant orthodox medical profession and protect the interests of alternative minority groups. In Europe and most other countries, licensure and medical policy are centralized, and alternative practitioners and their supporters must win one large battle to gain political recognition or face being marginalized. In the United States, alternative medical movements have been able to fight simultaneous battles in several states, winning some and using those successes to institutionalize, build followings, set standards, and continue their struggles in other jurisdictions.
Although alternative medicine has existed throughout the country's history, the greatest growth of alternative medical movements occurred during three eras, when more broad-based social ideologies nurtured the philosophical premises and political aims of such movements. These ideologies were Jacksonian Democracy (roughly the 1820s to the 1840s), populism (1880s–1910s), and New Age thought (1970s–1990s).
The Era of Jacksonian Democracy
President Andrew Jackson and many of his followers trumpeted the virtues of "the common man, " feared large centralized institutions, and had a distrust of professionals, particularly when the latter sought special privileges or exclusive rights based upon expertise to practice in fields traditionally open to those with or without formal training. Consistent with these beliefs, three large alternative medical movements arose during this time.
Samuel Thomson, a self-trained root doctor from New Hampshire, believed that all disorders were caused by obstructed perspiration. He argued that fever was the body's effort to eliminate disease and that orthodox physicians, with their bleedings, blisterings, and use of drugs like mercury, arsenic, and antimony, were jeopardizing the lives of patients and causing many deaths. Thomson believed anyone could treat disease using six classes of remedies consisting of botanical drugs and the steam bath, all designed to produce great internal heat, eliminate the cold, and allow the body to reestablish its natural balance. Thomson wrote a popular book, prepared kits of his medicine, sold individual rights to his practice, and encouraged followers to defeat or repeal medical licensure laws that restricted the practice of medicine to formally trained physicians. Although Thomson was antiprofessional, other alternative groups that employed a wider range of botanical drugs emerged, including Eclectic Medicine, which established schools, journals, and hospitals and won status for its practitioners as physicians.
The second major group of medical reformers, part of the so-called popular health movement, believed that physicians were largely unnecessary because most diseases could be prevented by individuals adopting healthy habits. The most prominent American lecturer and writer in this movement, Sylvester Graham, maintained that disease resulted from excessive stimulation of the tissues. Any food that caused too much stimulation had to be avoided, including tea, coffee, alcohol, pastries, and all fleshy meats. Graham also used the doctrine of overstimulation to warn of the powerful dangers of too much sexual energy. Eating meat, he argued, produced a heightened sex drive, which was health destroying. One of his innovations was a cracker that still bears his name, which was initially designed in part to discourage overstimulation of this type.
The most significant European import during this era was Homeopathy, a system of practice originated by the German physician Samuel Hahnemann. Brought to America in the 1820s, homeopathy encompassed two essential principles. The first principle was that the drug best able to cure a given illness would be that which could produce the symptoms of that illness in a healthy person. The second principle was that the smaller the dose, the more powerful the effect. One active part per hundred was shaken in a vial, and one part of that solution was mixed with another ninety-nine inactive parts, and so on, usually thirty times. By the end of the nineteenth century, homeopaths constituted 10 percent and the eclectics 5 percent of the physician and surgeon population in the United States.
The Era of Populism
Midwestern populism encompassed a distrust of large East Coast–controlled businesses and institutions, a belief that elites had gained too much power, and a sense that common people had too little say in shaping government and law in their own interests. As opposed to Jacksonian Democracy, many populists were not against creating laws governing the professions as long as the interests of competing groups were protected. In the 1870s and 1880s, new medical licensure laws were enacted; however, homeopathic and eclectic physicians were given the same rights as orthodox physicians. Challenging this hegemony were two groups—osteopathy and chiropractic.
Osteopathy was founded by Andrew Taylor Still, an apprenticeship-trained Midwestern physician. Still, who had practiced for a time as a bonesetter, believed that disease was the result of an obstruction or imbalance of the fluids caused by misplaced bones, particularly of the spinal column. These misplacements could be corrected through physical manipulation. He established an infirmary and school in Kirksville, Missouri, in 1892. Still's followers relatively quickly gained some measure of legal protection, established other colleges, and gradually expanded osteopathy's scope of practice to incorporate drugs and surgery. Eventually, D.O.s (doctors of osteopathic medicine) won equal rights along with M.D.s as full-fledged physicians and surgeons in every state and equal recognition by the federal government. As homeopathic and eclectic medicine faded after the beginning of the twentieth century, osteopathy became, and remained, the only equivalent professional rival of allopathic medicine, although the differences between the two groups have faded considerably.
Chiropractic appeared within a decade of the emergence of osteopathy and was founded in Davenport, Iowa, by Daniel David Palmer. Like Still, Palmer believed that diseases were due to misplaced bones. Many early chiropractors or D.C.s (doctors of chiropractic) were initially charged with practicing osteopathy without a license, but they demonstrated to courts and eventually legislatures that their diagnostic and treatment techniques were different. Unlike osteopathic physicians, who grew to encompass the full range of medical training and skills, chiropractors, despite the addition of some adjuncts, continued to center their activities on spinal manipulation and quickly became associated in the public mind with that technique, though osteopathy had historical priority.
"new Age" Thought
Fueled by America's continued participation in the Vietnam War and frustration with the perceived failure of government to produce meaningful change consistent with their own beliefs, a growing number of middle-class Americans in the 1970s shifted their attention from reforming society by legislative action to focusing on the potential for personal improvement. Drawing upon the rich traditions of other cultures, and often incorporating metaphysical and spiritual understandings of the basis and meaning of life, millions of Americans turned to a variety of disparate health beliefs and practices, including traditional Chinese and Ayurvedic medicine; crystals and scented candles; rolfing and other body treatments; imaging and other psychological interventions; alternative diets; herbs, vitamins, and other supplements; and a rediscovery of homeopathic and botanical remedies. By the end of the twentieth century, more money was spent by Americans on alternative practitioners and remedies than on visits to the offices of conventional primary care physicians.
This movement also reflected a growing frustration with the way orthodox medicine was practiced. Too little time was spent listening to patients, and while science had contributed to the treatment of acute diseases, many patients with chronic illnesses wanted more relief from their conditions than conventional physicians could provide. The number of alternative treatments that became available provided patients with new choices and new hopes. Experience by physicians with some of these modalities, and later research indicating value in some forms of alternative treatment, encouraged a growing number of conventionally trained physicians to incorporate these methods under the banner of "holistic" or "integrative" medicine. The continued popularity of these most recent forms of alternative medicine will, as in earlier periods, depend not only on the perceived efficacy of the respective practices over time but also on the broader social trends and ideologies that facilitated the emergence and growth of these practices.
Bibliography
Berman, Alex, and Michael A. Flannery. America's Botanico-Medical Movements: Vox Populi. New York: Pharmaceutical Products Press, 2001.
Gevitz, Norman. The D.O.'s: Osteopathic Medicine in America. Baltimore: Johns Hopkins University Press, 1991.
———, ed. Other Healers: Unorthodox Medicine in America. Baltimore: Johns Hopkins University Press, 1988.
Haller, John S. Medical Protestants: The Eclectics in American Medicine, 1825–1939. Carbondale: Southern Illinois University Press, 1994.
Kaufman, Martin. Homeopathy in America: The Rise and Fall of a Medical Heresy. Baltimore: Johns Hopkins University Press, 1971.
McGuire, Meredith. Ritual Healing in Suburban America. New Brunswick, N.J.: Rutgers University Press, 1988.
Moore, J. Stuart. Chiropractic in America: The History of a Medical Alternative. Baltimore: Johns Hopkins University Press, 1993.
Whorton, James C. Crusaders for Fitness: The History of American Health Reformers. Princeton, N.J.: Princeton University Press, 1982.
| Spotlight: alternative medicine |
From our Archives: Today's Highlights, March 1, 2005
| Columbia Encyclopedia: alternative medicine, |
| Health Dictionary: alternative medicine |
Medical practice or therapy that uses methods that have not been associated with the traditional, standard care most generally taught and executed by AMA-certified medical schools.
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Alternative medicine has been described as "any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain".[1]
Alternative medicine practices are often based in belief systems not derived from modern science. Alternative medicines may therefore incorporate spiritual, metaphysical, or religious underpinnings, untested practices, non-Western medical traditions, or newly developed approaches to healing.
If an alternative medical approach, initially regarded as untested, is subsequently shown to be safe and effective, it may then be adopted by conventional practitioners and no longer considered "alternative".
Alternative medicine is commonly categorised together with complementary medicine under the umbrella term 'complementary and alternative medicine' (CAM for short). Some scientists reject this and the above classifications and to varying degrees reject the term "alternative medicine" itself.
The following three commentators argue for classifying treatments based on the objectively verifiable criteria of the
Other well-known proponents of evidence-based medicine, such as the Cochrane Collaboration and Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, use the term "alternative medicine" but agree with the above commentators that all treatments, whether "mainstream" or "alternative", ought to be held to standards of the scientific method.[7][8][9] Oxford University Press publishes a peer-reviewed journal entitled Evidence-based Complementary and Alternative Medicine (eCAM).[10]
Some commentators maintain that some or all fields of alternative medicine are pseudoscientific, or contain significant pseudoscientific elements. In the late 20th century systematic investigation of the evidence-base proceeded, and at least one university department of alternative and complementary medicine was established, at the University of Exeter under Professor Edzard Ernst for this purpose.
Jurisdiction differs concerning which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled health service or reimbursed by a private health medical insurance company.
In article 34 (Specific legal obligations) of the General Comment No. 14 (2000) on The right to the highest attainable standard of health of the Committee on Economic, Social and Cultural Rights (United Nations), it is stated that
Obligations to respect (the right to health) include a State's obligation to refrain from prohibiting or impeding traditional preventive care, healing practices and medicines, from marketing unsafe drugs and from applying coercive medical treatments [11]
A number of alternative medicine advocates disagree with the restrictions of government agencies that approve medical treatments (such as the American Food and Drug Administration) and the agencies' adherence to experimental evaluation methods. They claim that this impedes those seeking to bring useful and effective treatments and approaches to the public, and protest that their contributions and discoveries are unfairly dismissed, overlooked or suppressed. Alternative medicine providers often argue that health fraud should be dealt with appropriately when it occurs.
In India, which is the home of several alternative systems of medicines, Ayurveda, Siddha, Unani, and Homeopathy are licenced by the government, despite lack of reputable scientific evidence. Naturopathy will also be licensed soon because several Universities now offer bachelors degrees in it. Other activities connected with AM/CM, such as Panchakarma and massage therapy related to Ayurveda are also licenced by the government now. Research into and licensing of these activities is carried out by the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH).[12]
Many people utilize mainstream medicine for diagnosis and basic information, while turning to alternatives for what they believe to be health-enhancing measures. However, studies indicate that a majority of people use alternative approaches in conjunction with conventional medicine.
Edzard Ernst wrote in the Medical Journal of Australia that "about half the general population in developed countries use complementary and alternative medicine (CAM)."[13] A survey released in May 2004 by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, 36% of Americans used some form of alternative therapy in the past 12 months, 50% in a lifetime — a category that included yoga, meditation, herbal treatments and the Atkins diet.[14] If prayer was counted as an alternative therapy, the figure rose to 62.1%. 25% of people who use CAM do so because medical professional suggested it.[15] Another study suggests a similar figure of 40%.[16] A British telephone survey by the BBC of 1209 adults in 1998 shows that around 20% of adults in Britain had used alternative medicine in the past 12 months.[citation needed]
The use of alternative medicine appears to be increasing. A 1998 study showed that the use of alternative medicine had risen from 33.8% in 1990 to 42.1% in 1997.[17] In the United Kingdom, a 2000 report ordered by the House of Lords suggested that "...limited data seem to support the idea that CAM use in the United Kingdom is high and is increasing."[18]
Increasing numbers of medical colleges have begun offering courses in alternative medicine. For example, the University of Arizona College of Medicine offers a program in Integrative Medicine under the leadership of Dr. Andrew Weil which trains physicians in various branches of alternative medicine which "...neither rejects conventional medicine, nor embraces alternative practices uncritically."[19] In three separate research surveys that surveyed 729 schools in the United States (125 medical schools offering an MD degree, 19 medical schools offering a Doctor of Osteopathy degree, and 585 schools offering a nursing degree), 60% of the standard medical schools, 95% of osteopathic medical schools and 84.8% of the nursing schools teach some form of CAM.[20][21][22] Accredited Naturopathic colleges and universities are increasing in number and popularity in the U.S.A. They offer the most complete medical training in complimentary medicines that is available today[citation needed]. See Naturopathic medicine.
In Britain, no conventional medical schools offer courses that teach the clinical practice of alternative medicine. However, alternative medicine is taught in several unconventional schools as part of their curriculum. Teaching is based mostly on theory and understanding of alternative medicine, with emphasis on being able to communicate with alternative medicine specialists. To obtain competence in practicing clinical alternative medicine, qualifications must be obtained from individual medical societies. The student must have graduated and be a qualified doctor. The British Medical Acupuncture Society, which offers medical acupuncture certificates to doctors, is one such example, as is the College of Naturopathic Medicine UK and Ireland.
The NCCAM surveyed the American public on complementary and alternative medicine use in 2002. According to the survey:[23]
Alternative therapies provide some services not available from conventional medicine. Examples are patient empowerment and treatment methods that follow the biopsychosocial model of health [25].
Advocates of alternative medicine hold that the various alternative treatment methods are effective in treating a wide range of major and minor medical conditions, and contend that recently published research (such as Michalsen, 2003,[26] Gonsalkorale 2003,[27] and Berga 2003[28]) proves the effectiveness of specific alternative treatments. They assert that a PubMed search revealed over 370,000 research papers classified as alternative medicine published in Medline-recognized journals since 1966 in the National Library of Medicine database. See also Kleijnen 1991,[29] and Linde 1997.[30]
Advocates of alternative medicine hold that alternative medicine may provide health benefits through patient empowerment, by offering more choices to the public, including treatments that are simply not available in conventional medicine:
Evidence-based medicine (EBM) applies the scientific method to medical practice, and aims for the ideal that healthcare professionals should make "conscientious, explicit, and judicious use of current best evidence" in their everyday practice. Prof. Edzard Ernst is a notable proponent of applying EBM to CAM.
Although advocates of alternative medicine acknowledge that the placebo effect may play a
role in the benefits that some receive from alternative therapies, they point out that this does not diminish their validity.
Researchers who judge treatments using the
A major objection to alternative medicine is that it is done in place of conventional medical treatments. As long as alternative treatments are used alongside conventional treatments, the majority of medical doctors find most forms of complementary medicine acceptable.[32] Consistent with previous studies, the CDC recently reported that the majority of individuals in the United States (i.e., 54.9%) used CAM in conjunction with conventional medicine.[citation needed]
It is advisable for patients to inform their medical doctor when they are using alternative medicine, because some alternative treatments may interact with orthodox medical treatments, and such potential conflicts should be explored in the interest of the patient. However, many conventional practitioners are biased or uninformed about alternatives, and patients are often reluctant to share this information with their medical doctors since they fear it will hurt their doctor-patient relationship.
The issue of alternative medicine interfering with conventional medical practices is minimized when it is turned to only after conventional treatments have been exhausted. Many patients feel that alternative medicine may help in coping with chronic illnesses for which conventional medicine offers no cure, only management. Over time, it has become more common for a patient's own MD to suggest alternatives when they cannot offer effective treatment.
See also List of branches of alternative medicine for specific criticisms of different types of CAM
Due to the wide range of therapies that are considered to be "alternative medicine" few criticisms apply across the board, except possibly that of not being scientifically supported or even testable. Proponents of CAM typically address this basic criticism by arguing that it is a self-fulfilling prophecy: critics believe that there is no plausibility to CAMs because they find little or no proofs, while it is plausibility that should inform the scientific research for proofs.
Proponents of alternative therapy have an obligation to provide grounds for biological plausibility, such as sound theoretical or preclinical data, or for clinical plausibility, in the form of authentic, well-prepared case reports, in order to justify the investment of time and energy in exploring the merits of a novel anticancer therapy. But plausibility, not proof, should be sufficient to initiate the process. [33]
In other words, proponents of CAMs argue that skeptics, in saying that theories or anecdotal and preclinical data do not constitute proof, merely state the obvious but do not actually engage in the evaluation of CAMs. Criticisms directed at specific branches of alternative medicine range from the fairly minor (conventional treatment is believed to be more effective in a particular area) to incompatibility with the known laws of physics (for example, in homeopathy). Critics argue that alternative medicine practitioners may not have an accredited medical degree or be licensed physicians or general practitioners and make sweeping claims without demonstrated expertise. This cannot always be considered a serious criticism, because unless a new system of medicine becomes established, it does not receive accreditation of any kind, except by its own professional organizations. This is the route homeopathy, ayurveda, siddha, unani, and naturopathy had to follow in those countries where it is now offered by accredited institutions. Proponents of the various forms of alternative medicine reject criticism as being founded in prejudice, financial self-interest, or ignorance. Refutations of criticism sometimes take the form of an appeal to nature.
Although proponents of alternative medicine often cite the large number of studies which have been performed, critics point out that there are no statistics on exactly how many of those studies were controlled, double blind, peer-reviewed experiments, or how many produced results supporting alternative medicine or parts thereof. They contend that many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials; in contrast, conventional drugs reach the market only after such trials have proved their efficacy.
Some argue that less research is carried out on alternative medicine because many alternative medicine techniques cannot be patented, and hence there is little financial incentive to study them. Drug research, by contrast, can be very lucrative, which has resulted in funding of trials by pharmaceutical companies. Many people, including conventional and alternative medical practitioners, contend that this funding has led to corruption of the scientific process for approval of drug usage, and that ghostwritten work has appeared in major peer-reviewed medical journals.[34][35] Increasing the funding for research of alternative medicine techniques was the purpose of the National Center for Complementary and Alternative Medicine. NCCAM and its predecessor, the Office of Alternative Medicine, have spent more than $200 million on such research since 1991. The German Federal Institute for Drugs and Medical Devices Commission E has studied many herbal remedies for efficacy.[36]
Some skeptics of alternative practices point out that a person may attribute symptomatic relief to an otherwise ineffective therapy due to the placebo effect, the natural recovery from or the cyclical nature of an illness (the regression fallacy), or the possibility that the person never originally had a true illness.[37] CAM proponents point out this may also apply in cases where conventional treatments have been used. To this, CAM critics point out that this does not account for conventional medical success in double blind clinical trials. CAM proponents, however, don't typically question conventional medical successes revealed in double blind clinical trials.
Critics contend that some people have been hurt or killed directly from the various practices or indirectly by failed diagnoses or the subsequent avoidance of conventional medicine which they believe is redundant.
Alternative medicine critics agree with its proponents that people should be free to choose whatever method of healthcare they want, but stipulate that people must be informed as to the safety and efficacy of whatever method they choose. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. Grapefruit seed extract is an example of quackery when multiple studies demonstrate its universal antimicrobial effect is due to synthetic antimicrobial contamination.[38][39][40][41][42]
Those who have had success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics contend that therapies that rely on the placebo effect to define success are very dangerous. According to Lilienfeld (2002) "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as “opportunity cost.” Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative consequences[2].
A Norwegian multicentre study examined the association between the use of alternative medicine and cancer survival. 515 patients using standard medical care for cancer were followed for eight years. 22% of those patients used alternative medicine concurrently with their standard care. The study revealed that death rates were 30% higher in alternative medicine users than in those who did not use alternative medicine (AM): "The use of AM seems to predict a shorter survival from cancer."[43]
Associate Professor Alastair MacLennan of the Department of Obstetrics and Gynaecology in Adelaide University, Australia reports that a patient of his almost bled to death on the operating table. She had failed to mention she had been taking "natural" potions to "build up her strength" for the operation - one of them turned out to be a powerful anticoagulant which nearly caused her death. [3]
To ABC Online, MacLennan also gives another possible mechanism:
Conventional treatments are subjected to testing for undesired side-effects (which may not, however, be revealed to the public in a timely manner), whereas alternative treatments generally are not subjected to such testing at all. However, any treatment — whether conventional or alternative — that has a biological or psychological impact on a patient may also have potentially dangerous biological or psychological side-effects. Nevertheless, attempts to refute this fact with regard to alternative treatments sometimes use the appeal to nature fallacy, i.e. "that which is natural cannot be harmful".
Homeopathy, however, is regarded as being safe in terms of such side effects since, according to known physics and chemistry, it cannot possibly have more effect on the patient than simple water does.
Similar problems as those related to self-medication also apply to parts of alternative medicine. For example, an alternative medicine may instantly make symptoms better, but actually worsen problems in the long run. The result may be addiction[citation needed] and deteriorating health.
Critics contend that some branches of alternative medicine are often not properly regulated in some countries to identify who practices or know what training or expertise they may possess. Critics argue that the governmental regulation of any particular alternative therapy does necessitate that the therapy is effective. The most sensible course in such a case could be to simply ensure that the sold treatment is not dangerous, but the problem would then remain to know if it does what its proponents say it does.
There are both social/cultural and psychological reasons:
Social or cultural reasons:
Psychological reasons:
Integrative medicine is a branch of alternative medicine which claims to limit itself to methods with strong scientific evidence of efficacy and safety[citation needed]. The main proponent of integrative medicine is Andrew T. Weil M.D., who founded the Program in Integrative Medicine at the University of Arizona in 1994 based on a phrase coined by Elson Haas, MD. It is claimed that responsible alternative health product providers who have had medical studies conducted on their products often publish these studies online.[citation needed].
