As most of us know, the use of so-called alternative medicine (SCAM) can be problematic; its use in children is often most problematic:
- There are hardly any SCAMs that have been shown to work for paediatric conditions.
- Most SCAMs can cause considerable harm to children.
- Some might even amount to child abuse.
- Most SCAM practitioners lack adequate training to treat children.
- Many SCAM providers offer dangerous advice to parents.
- Parents are sometimes unable to differentiate between nonsense and medicine.
- Informed consent can present a trick subject when treating children.
In this context, the statement from the ‘Spanish Association Of Paediatrics Medicines Committee’ is of particular value and importance:
Currently, there are some therapies that are being practiced without adjusting to the available scientific evidence. The terminology is confusing, encompassing terms such as “alternative medicine”, “natural medicine”, “complementary medicine”, “pseudoscience” or “pseudo-therapies”. The Medicines Committee of the Spanish Association of Paediatrics considers that no health professional should recommend treatments not supported by scientific evidence. Also, diagnostic and therapeutic actions should be always based on protocols and clinical practice guidelines. Health authorities and judicial system should regulate and regularize the use of alternative medicines in children, warning parents and prescribers of possible sanctions in those cases in which the clinical evolution is not satisfactory, as well responsibilities are required for the practice of traditional medicine, for health professionals who act without complying with the “lex artis ad hoc”, and for the parents who do not fulfill their duties of custody and protection. In addition, it considers that, as already has happened, Professional Associations should also sanction, or at least reprobate or correct, those health professionals who, under a scientific recognition obtained by a university degree, promote the use of therapies far from the scientific method and current evidence, especially in those cases in which it is recommended to replace conventional treatment with pseudo-therapy, and in any case if said substitution leads to a clinical worsening that could have been avoided.
Of course, not all SCAM professions focus on children. The following, however, treat children regularly:
- acupuncturists
- anthroposophical doctors
- chiropractors
- craniosacral therapists
- energy healers
- herbalists
- homeopaths
- naturopaths
- osteopaths
I believe that all SCAM providers who treat children should consider the above statement very carefully. They must ask themselves whether there is good evidence that their treatments generate more good than harm for their patients. If the answer is not positive, they should stop. If they don’t, they should realise that they behave unethically and quite possibly even illegally.
13 Responses to Position Statement From The Spanish Association Of Paediatrics Medicines Committee Concerning The Use Of Alternative Medicine And Pseudo-Science In Children
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Quite a few doctors registered by the GMC are acting unethically in promoting un-evidenced SCAM practices – and the GMC is going to regulate physician assistants!
What they will get up to heavens knows.
Sigh.
Basically the GMC will only act if a SCAM doctor kills someone. And patients would literally rather die than complain about their SCAM doctor.
I don’t think this is entirely true: I have been an expert witness in 2 GMC cases of SCAM doctors where nobody died.
the GMC will react to any complaint by patients. but there you are right: they rarely complain.
I didn’t know that, and stand corrected. In these 2 cases, did the patients suffer any harm?
not major harm; in both cases, there were multiple complaints; in one case, there also was a complaint from a doctor who felt his patient was badly treated.
Isn’t the demand to practice evidence based medicine only in the medical treatment of child’s diseases a difficult issue because most of the medications in babies and children is an off label use? I know pediatricians who prescribe proton pump inhibitors to the newborn against three-month colics regularly….
yah….how about universal application of this “statement”? Why limit it to CAM?
“Conclusions and Relevance This study found associations between the use of acid-suppressive medications and antibiotics during the first 6 months of infancy and subsequent development of allergic disease. Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit.”
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2676167
absolutely!
but, as you might have noticed, this blog is about SCAM.
C’mon Edzard
I believe that you maintain that science based medicine is the standard to which all other is measured.
If that is true, how can science based medicine not be part of the conversation ?
You insistence on focusing only on SCAM is a cop out…. a smoke screen.
in the same way that vegetables are part of a balanced diet, yet they are rarely discussed on a blog about bakery.
But you have passed judgement on homeopathy.
In a court of law, there is a advocate for the defense and the plaintiff.
You tip the scales.
you’re taking tosh!
in a court of law, if it had to decide about the efficacy of homeopathy, the judge and jury would look at the evidence for and against homeopathy; nothing to do with anything else.
Congratulations, you are the ultimate “spin doctor”