bias
Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Placebo
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
The present study was conducted to evaluate the effect of date palm on the sexual function of infertile couples. It was designed as a double-blind, placebo-controlled clinical trial conducted on infertile women and their husbands who referred to infertility clinics in Iran in 2019.
The intervention group was given a palm date capsule and the control group was given a placebo. Data were collected through female sexual function index and International Index of Erectile Function.
The total score of sexual function of females in the intervention group increased significantly from 21.06 ± 2.58 to 27.31 ± 2.59 (P < 0.0001). Also, other areas of sexual function in females (arousal, orgasm, lubrication, pain during intercourse, satisfaction) in the intervention group showed a significant increase compared to females in the control group, which was statistically significant (P < 0.0001).
All areas of male sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) significantly increased in the intervention group compared to the control group (P < 0.0001).
The authors concluded that the present study revealed that 1-month consumption of date palm has a positive impact on the sexual function of infertile couples.
In an attempt to explain the rational for this study, the authors state that, since ancient times, date palm has been used in Greece, China and Egypt to treat infertility and increase sexual desire and fertility in females. Rasekh indicated that Palm Pollen is effective in sperm parameters of infertile men. Administering date palm to male rats and measuring the sexual parameters of rats showed an improvement in their sexual function. Studies on animals have shown its effect on the parameters of semen analysis in male animals and increasing hormones.
So, the trial was what might call a ‘long shot’, even a very long one. But that does not render its findings less interesting. If the results could be confirmed, they would certainly have considerable significance.
But can they be confirmed?
I have some doubts.
Two things are remarkable, in my view.
- The study only had subjective endpoints.
- There was as good as no placebo effect in the control group.
How can this be?
One explanation might be that the verum and the placebo capsules were easily identified by their taste of other features. This would then lead to many patients being ‘deblinded’; in other words, the patients on verum would have known and expected to experience an effect, while the patients on placebo would have also known and be disappointed thus not even experiencing a placebo response.
This might be an apt reminder for trialists to include a check of the success of blinding in their list of outcome measures.
Bioenergy (or energy healing) therapies are among the popular alternative treatment options for many diseases, including cancer. Many studies deal with the advantages and disadvantages of bioenergy therapies as an addition to established treatments such as chemotherapy, surgery, and radiation in the treatment of cancer. However, a systematic overview of this evidence is thus far lacking. For this reason, German authors reviewed and critically examined the evidence to determine what benefits the treatments have for patients.
In June 2022, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness, and potential harm of bioenergy therapies including the following modalities:
- Reiki,
- Therapeutic Touch,
- Healing Touch,
- Polarity Therapy.
From all 2477 search results, 21 publications with a total of 1375 patients were included in this systematic review. The patients treated with bioenergy therapies were mainly diagnosed with breast cancer. The main outcomes measured were:
- anxiety,
- depression,
- mood,
- fatigue,
- quality of life (QoL),
- comfort,
- well-being,
- neurotoxicity,
- pain,
- nausea.
The studies were predominantly of moderate quality and, for the most part, found no effect. In terms of QoL, pain, and nausea, there were some positive short-term effects of the interventions, but no long-term differences were detectable. The risk of side effects from bioenergy therapies appears to be relatively small.
The authors concluded that considering the methodical limitations of the included studies, studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.
Energy healing is as popular as it is implausible. What these ‘healers’ call ‘energy’ is not how it is defined in physics. It is an undefined, imagined entity that exists only in the imagination of its proponents. So why should it have an effect on cancer or any other condition?
My team conducted 2 RCT of energy healing (pain and warts); both failed to show positive effects. And here is what I stated in my recent book about energy healing for any ailment:
Energy healing is an umbrella term for a range of paranormal healing practices. Their common denominator is the belief in a mystical ‘energy’ that can be used for therapeutic purposes.
- Forms of energy healing have existed in many ancient cultures. The ‘New Age’ movement has brought about a revival of these ideas, and today energy healing systems are amongst the most popular alternative therapies in the US as well as in many other countries. Popular forms of energy healing include those listed above. Each of these are discussed and referenced in separate chapters of this book.
- Energy healing relies on the esoteric belief in some form of ‘energy’ which is distinct from the concept of energy understood in physics and refers to some life force such as chi in Traditional Chinese Medicine, or prana in Ayurvedic medicine.
- Some proponents employ terminology from quantum physics and other ‘cutting-edge’ science to give their treatments a scientific flair which, upon closer scrutiny, turns out to be but a veneer of pseudo-science.
- The ‘energy’ that energy healers refer to is not measurable and lacks biological plausibility.
- Considering its implausibility, energy healing has attracted a surprisingly high level of research activity. Its findings are discussed in the respective chapters of each of the specific forms of energy healing.
- Generally speaking, the methodologically best trials of energy healing fail to demonstrate that it generates effects beyond placebo.
- Even though energy healing is per se harmless, it can do untold damage, not least because it significantly undermines rational thought in our societies.
As you can see, I do not entirely agree with my German friends on the issue of harm. I think energy healing is potentially dangerous and should be discouraged.
Have you ever wondered how good or bad the education of chiropractors and osteopaths is? Well, I have – and this new paper promises to provide an answer.
The aim of this study was to explore Australian chiropractic and osteopathic new graduates’ readiness for transition to practice concerning their clinical skills, professional behaviors, and interprofessional abilities. Phase 1 explored final-year students’ self-perceptions, and this part uncovered their opinions after 6 months or more in practice.
Interviews were conducted with a self-selecting sample of phase 1 participant graduates from 2 Australian chiropractic and 2 osteopathic programs. Results of the thematic content analysis of responses were compared to the Australian Chiropractic Standards and Osteopathic Capabilities, the authority documents at the time of the study.
Interviews from graduates of 2 chiropractic courses (n = 6) and 2 osteopathic courses (n = 8) revealed that the majority had positive comments about their readiness for practice. Most were satisfied with their level of clinical skills, verbal communication skills, and manual therapy skills. Gaps in competence were identified in written communications such as case notes and referrals to enable interprofessional practice, understanding of professional behaviors, and business skills. These identified gaps suggest that these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.
The authors concluded that this small study into clinical training for chiropractic and osteopathy suggests that graduates lack some necessary skills and that it is possible that the ideals and goals for clinical education, to prepare for the transition to practice, may not be fully realized or deliver all the desired prerequisites for graduate practice.
Their conclusions in the actual paper finish with these sentences, in the main, graduate participants and the final year students were unable to articulate what professional behaviors were expected of them. The identified gaps suggest these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.
In several ways, this is a remarkable paper – remarkably poor, I hasten to add. Apart from the fact that its sample size was tiny and the response rate was low, it has many further limitations. Most notably, the clinical skills, professional behaviors, and interprofessional abilities were not assessed. All the researchers did was ask the participants how good or bad they were at these skills. Is this method going to generate reliable evidence? I very much doubt it!
Imagine, these guys have just paid tidy sums for their ‘education’ and they have no experience to speak of. Are they going to be in a good position to critically evaluate their abilities? No, I fear not!
Considering these flaws and the fact that chiropractors and osteopaths are not exactly known for their skills of critical thinking, I find it amazing that important deficits in their abilities nevertheless emerge. If I had to formulate a conclusion from all this, I might therefore suggest this:
A dismal study seems to suggest that chiropractic and osteopathic schooling is dismal.
PS
Come to think of it, there might be another fitting option:
Yet another team of chiro- and osteos demonstrate that they don’t know how to do science.
This randomized clinical trial (RCT) tested whether acupuncture is effective for the prevention of chronic tension-type headaches (CTTH). The researchers recruited 218 participants who were diagnosed with CTTH.
- The participants in the intervention group received 20 sessions of true acupuncture (TA group) over 8 weeks. The acupuncture treatments were standardized across participants, and each acupuncture site was needled to achieve deqi sensation. Each treatment session lasted 30 minutes.
- The participants in the control group received the same sessions and treatment frequency of superficial acupuncture (SA group)—defined as a type of sham control by avoiding deqi sensation at each acupuncture site.
The main outcome measure was the responder rate at 16 weeks after randomization. Followed-up was 32 weeks. A responder was defined as a participant who reported at least a 50% reduction in the monthly number of headache days (MHDs).
The responder rate was 68.2% in the TA group (n=110) versus 48.1% in the SA group (n=108) at week 16 (odds ratio, 2.65; 95%CI, 1.5 to 4.77; p<0.001); and 68.2% in the TA group versus 50% in the SA group at week 32 (odds ratio, 2.4; 95%CI, 1.36 to 4.3; p<0.001). The reduction in MHDs was 13.1±9.8 days in the TA group versus 8.8±9.6 days in the SA group at week 16 (mean difference, 4.3 days; 95%CI, 2.0 to 6.5; p<0.001), and the reduction was 14±10.5 days in the TA group versus 9.5±9.3 days in the SA group at week 32 (mean difference, 4.5 days; 95%CI, 2.1 to 6.8; p<0.001). Four mild adverse events were reported; three in the TA group versus one in the SA group.
The authors concluded that the 8-week TA treatment was effective for the prophylaxis of CTTH. Further studies might focus on the cost-effectiveness of the treatment.
“Our study showed that deqi sensation could enhance the effect of acupuncture in the treatment of chronic TTH, and the effect of acupuncture lasted at least 6 months when the treatment was stopped,” said co-investigator Ying Li, MD, PhD, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Why am I not convinced?
Assuming that all the findings are correctly reported, the study does not at all show that the treatment was effective. It merely demonstrates that those patients who knew that were receiving TA told the researcher that they improved more than those who knew they has sham acupuncture. The difference in outcomes is not in the least surprising: patients’ knowledge of having had the verum leads to a placebo effect and to social desirability (patients giving the researchers positive responses simply because they were thankful for being looked after). Patients’ knowledge of having had the sham treatment leads to disappointment and thus worse outcomes.
But this is not the only reason why I am skeptical about this study. The authors claim they achieved deqi at every treatment. That is 20 treatments in 110 patients or 2 200 deqis! I think someone might be telling porkies here. Deqi cannot reliably be elicited on every single occasion. I, therefore, feel that perhaps the authors of this trial were a bit more than generous when writing up their study, and I am reminded of the recent report claiming that more than 80% of clinical trial data from China are fabricated.
One of my recent posts prompted the following comment from a chiropractor: “… please don’t let me stop you…while we actually treat patients“. It was given in the context of a debate about the evidence for or against chiropractic spinal manipulations as a treatment of whiplash injuries. My position was that there is no convincing evidence, while the chiropractor argued that he has been using manipulations for this indication with good results. Here I do not want to re-visit the pros and cons of that particular debate. Since similar objections have been put to me so many times, I want rather to raise several more principal points.
Before I do this, I need to quickly get the personal stuff out of the way: the comment implies that I don’t really know what I am talking about because I don’t see patients and thus don’t understand their needs. The truth is that I started my professional life as a clinician, then I went into basic science, then I went back into clinical medicine (while also doing research), and eventually, I became a full-time clinical researcher. I have thus seen plenty of patients, certainly enough to empathize with both the needs of patients and the reasoning of clinicians. In fact, these provided the motives for my clinical research during the last decades of my professional career (more details here).
Now about the real issue that is at stake here. When offered by a clinician to a scientist, the comment “… please don’t let me stop you…while we actually treat patients” is an expression of an arrogant feeling of superiority that clinicians often harbor vis a vis professionals who are not at the ‘coal face’ of healthcare. Stripped down to its core, the argument implies that science is fairly useless because the only knowledge worth having stems from dealing with patients. In other words, it is about the tension that so often exists between clinical experience and scientific evidence.
Many clinicians feel that experience is the best guide to correct decision-making.
Many scientists feel that experience is fraught with errors, and only science can lead us towards optimal decisions.
Such arguments emerge regularly on this blog and are constant company to almost any type of healthcare. The question is, who is right and who is wrong?
As I indicated, I can empathize with both positions. I can see that, in the context of making therapeutic decisions in a busy clinic, for instance, the clinician’s argument weighs heavily and can make sense, particularly in areas where the evidence is mixed, weak, or uncertain.
However, in the context of this blog and other discussions focused on critical evaluation of the science, I am strongly on the side of the scientist. In fact, in this context, the argument “… please don’t let me stop you…while we actually treat patients” seems ridiculous and resembles an embarrassing admission of having no rational argument left for defending one’s own position.
To put my view of this in a nutshell: it is not a question of either or; for optimal healthcare, we obviously need both clinical experience AND scientific evidence (an insight that is not in the slightest original, since it is even part of Sackett’s definition of EBM).
One of my previous posts was about a press release announcing a ‘WORLDWIDE DECLARATION’, and I promised to comment about the actual declaration. This post firstly reproduces this document and secondly provides a few comments on it. Here is the document:
DEFINITIONS
Traditional, complementary and integrative healthcare (TCIH) refers to the respectful collaboration between various systems of healthcare and their health professionals with the aim of offering a person-centred and holistic approach to health.
ABOUT US
We represent a worldwide community of users and health professionals of TCIH with a large diversity of backgrounds and experiences with a common commitment to the advancement and
promotion of TCIH.
THE HEALTHCARE WE DESIRE
• Focuses on the whole person, including physical, mental, social and spiritual dimensions
• Is patient-centred and supports self-healing and health creation
• Is participative and respects individual choices
• Is evidence-based by integrating clinical experience and patient values with the best available research information
• Respects cultural diversity and regional differences
• Is an integral part of community and planetary health
• Uses natural and sustainable resources that are respectful of the health of our planet
• Integrates traditional, complementary and biomedical practices in a supportive and collaborative manner
We appreciate the benefits of conventional / biomedicine. At the same time we recognize its limitations, including:
• The insufficient therapeutic options that biomedicine provides, especially for chronic / non-communicable diseases (NCDs)
• Frequent side effects of biomedical treatments and rising antimicrobial resistance
• Fragmentation of care from increased specialization and the limits of a disease-based model
We are inspired by countries that are successfully integrating TCIH into their healthcare systems. However, we are concerned about:
• Countries that prevent, limit or undervalue the practice of TCIH
• Uninformed or unbalanced media reporting of TCIH
• Insufficient public funding of TCIH research
• Risk of reduced availability of TCIH and unregulated practices in some countries
OUR CALL TO ACTION
All countries
• Ensure full access to TCIH as part of the right to health for all
• Include TCIH into national health systems
• Provide accreditation of TCIH healthcare professionals in accordance with international training standards to ensure high quality care
• Ensure access and safety of TCIH medicines through specific regulatory pathways
• Fund research on TCIH and disseminate reliable information on TCIH to the public
All healthcare professionals
• Foster respectful collaboration between all healthcare professions towards achieving a person-centred and holistic approach to healthcare
_____________________________
And here are my comments.
- “TCIH”: in the realm of so-called alternative medicine it seems popular to create a new name for the subject at hand; this one is yet another one in a long line of innovations – sadly, it is as nonsensical as most of the previous ones.
- Person-centred and holistic approach to health: all good healthcare has these qualities.
- We represent a worldwide community: really? Who exactly are you then, and what is your ligitimization?
- Whole person, including physical, mental, social and spiritual dimensions: all good healthcare has these qualities.
- Patient-centred and supports self-healing and health creation: all good healthcare has these qualities.
- Respects individual choices: all good healthcare has these qualities.
- Evidence-based: either they do not know what this term means or they are deliberately misleading the public.
- Integral part of community and planetary health: all good healthcare has these qualities.
- Natural and sustainable resources that are respectful of the health of our planet: like Rhino horn and similar ingredients of TCM products?
- Insufficient therapeutic options that biomedicine provides: yes, conventional medicine is far from perfect, but adding something even less perfect to it cannot improve it.
- Frequent side effects of biomedical treatments and rising antimicrobial resistance: yes, conventional medicine is far from perfect, but adding something even less perfect to it cannot improve it.
- Full access to TCIH as part of the right to health for all: the ‘right to health for all’ means the right to the most effective therapies not the right to the most bizarre quackery.
- Accreditation of TCIH healthcare professionals: giving respectability to every quack would not render healthcare better or safer but worse and more dangerous.
- Access and safety of TCIH medicines through specific regulatory pathways: regulating access to unproven treatments is nothing less than a recipe for disaster.
- Research on TCIH: yes in some areas, research might be worthwhile, but it must be rigorously testing TCIH and not promoting it uncritically.
- Disseminate reliable information on TCIH to the public: thank you! This is my main aim in writing the ~2500 posts on this blog. Yet I do often get the impression that this gets disappointingly little support – and frequently the exact opposite – from enthusiasts of TCIH.
If you go on Twitter you will find that chiropractors are keen like mustard to promote the idea that, after a car accident, you should consult a chiropractor. Here is just one Tweet that might stand for hundreds, perhaps even thousands:
Recovering from a car accident? If you have accident-related injuries such as whiplash, chiropractic care may provide relief. Treatments like spinal manipulation and soft tissue therapy can aid in your recovery.
In case you don’t like Twitter, you could also go on the Internet where you find hundreds of websites that promote the same idea. Here are just two examples:
There is no question, chiropractors earn much of their living by treating patients suffering from whiplash (neck injury caused by sudden back and forth movement of the neck often causing neck pain and stiffness, shoulder pain, and headache) after a car accident with spinal manipulation.
Why?
There are two not mutually exclusive possibilities:
- They think it is effective.
- It brings in good money.
I have no doubt about the latter notion, yet I think we should question the first. Is there really good evidence that chiropractic manipulations are effective for whiplash?
When I was head of the PMR department at the University of Vienna, treating whiplash was my team’s daily bread. At the time, our strategy was to treat each patient according to the whiplash stage and to his/her individual signs and symptoms. Manipulations were generally considered to be contra-indicated. But that was about 30 years ago. Perhaps the evidence has now changed. Perhaps manipulation therapy has been shown to be effective for certain types of whiplash injuries?
To find out, I did a few Medline searches. These did, however, not locate compelling evidence for spinal manipulation as a treatment of any stage of whiplash injuries. Here is an example of the evidence I found:
In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). This review aimed to update the findings of the Neck Pain Task Force, which examined the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. Its findings show the following: Evidence from 15 evaluation studies suggests that for recent neck pain and associated disorders grades I-II, cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises.
But this is most puzzling!
Why do chiropractors promote their manipulations for whiplash, if there is no compelling evidence that it does more good than harm? Again, there are two possibilities:
- They erroneously believe it to be effective.
- They don’t care but are in it purely for the money.
Whatever it is – and obviously not all chiropractors would have the same reason – I must point out that, in both cases, they behave unethically. Not being informed about the evidence related to the interventions used clearly violates healthcare ethics, and so does financially not informing and exploiting patients.
I reported about the activities of Eurocam before (see here) and I was distinctly underwhelmed with this quackery lobby group. Now they have published a press release about a ‘worldwide declaration’ in favor of integrated medicine. Here is my translation of the press release (I will comment on the actual declaration at a later stage):
With a declaration, Eurocam and the European Federation of Homeopathic Patient’s Association, among others, call for an open scientific discourse, more research funds, and more promotion of young researchers in the field of integrative medicine. The declaration is supported by the German Central Association of Homeopathic Physicians and the Homeopathy Research Institute (HRI), among others. Integrative medicine combines conventional and complementary elements in health care for the benefit of patients. The goal is patient-centred and holistic health care. Already 130 organisations have committed themselves to these goals in the medical care of the population in the Declaration.
Integrative medicine integrates complementary and conventional methods
In addition, the Declaration advocates health care that takes the whole person into account in its psychological, mental, social and spiritual dimensions. Integrative medicine in the sense of the Declaration is patient-centred and supports the body’s own regulatory abilities. In addition, it is participatory and respects individual decisions with regard to medical care. It is committed to the evidence of medical procedures, which is based on experience, patient preferences and research findings. It incorporates cultural diversity and regional differences as well as the concepts of community health and planetary health. Integrative medicine uses natural and sustainable resources and integrates complementary and conventional medical procedures.
Integrative medicine: Opportunities especially for chronic diseases and side effects
The supporters of the Declaration see opportunities for integrative medicine above all in chronic and non-communicable diseases, as well as in the frequent side effects of conventional therapies and increasing antibiotic resistance. Conventional medicine is characterised by fragmentation and divisional thinking within medical care, as well as by the increasing specialisation of the health professions. The holistic view of the patient is thus left out. Against this backdrop, the Declaration advocates anchoring integrative medicine as a legal entitlement in health care and integrating it into national health care systems. International training standards should be adapted with integrative medicine in mind, and research projects should be promoted. At the same time, balanced and high-quality patient information is needed.
________________________________
This press release requires a few short comments, in my view:
- “Integrative medicine combines conventional and complementary elements in health care for the benefit of patients.” Anyone who cares to research for longer than 10 minutes will find that very often the complementary elements are unproven and disproven treatments.
- “The goal is patient-centred and holistic health care.” By integrating unproven and disproven treatments into routine care, medicine cannot become more patient-centred but must get less effective and more expensive.
- “The Declaration advocates health care that takes the whole person into account in its psychological, mental, social and spiritual dimensions.” Any good healthcare aims at doing this.
- “Individual decisions with regard to medical care” are respected in all forms of healthcare.
- “Side effects of conventional therapies and increasing antibiotic resistance” are regrettable phenomena and much research is going on to minimize them. So-called alternative medicine (SCAM) has not yet been shown to offer a single solution to these problems.
- “The holistic view of the patient is left out” in conventional medicine. One of the most popular fallacies with SCAM advocates is the strawman fallacy.
I find the text almost comical. It reveals thought processes that lack even the most fundamental rules of logic. One really does get the impression that it had been written by people who are deplorably naive, misinformed, and quite frankly stupid.
All healthcare professionals have an ethical obligation to be truthful and act in the best interest of the patient by adhering to the best available evidence. Providing false or misleading information to patients or consumers is thus a breach of medical ethics. In Canada, the authorities have started taking action against nurses that violate these ethical principles.
- A nurse has been suspended for asking a co-worker to create fake vaccine records.
Now it has been reported that a former registered nurse in West Kelowna has been suspended for four weeks after giving a vulnerable client anti-vaccine information and recommending “alternative pseudoscience” treatments.
According to the terms of a consent agreement posted on the B.C. College of Nurses and Midwives site, Carole Garfield was under investigation for actions that happened in September 2021. The college claims that Garfield contacted the client when she was off duty, using her personal mobile phone and email to give information against the COVID-19 vaccine and recommending so-called alternative medicine (SCAM). The exact nature of the “pseudoscience modalities” Garfield recommended to the client was not listed in the college’s notice.
Garfield’s nursing licence was cancelled back in April, according to the college’s registry. It’s unclear how exactly the four-week suspension will be applied. In addition to her month-long suspension and a public reprimand, Garfield is not allowed to be the sole nurse on duty for six months. She will also be given education about ethics, boundaries, and client confidentiality, as well as the province’s professional nursing standards. “The inquiry committee is satisfied that the terms will protect the public,” read a statement from the college.
In my view, it is high time for professional bodies to act against healthcare professionals who issue misleading information to their patients. In the realm of so-called alternative medicine (SCAM), issuing false or misleading information is extremely common and causes untold harm. Such harm would be largely preventable if the professional bodies in charge would start acting responsibly in the best interest of patients. It is high time that they follow the Canadian example!
