Prof Walach: what lies ahead for research into SCAM?

Prof. Harald Walach and his work have been regular topics on this blog (e.g. here, here, and here). Walach has served as the editor of Forschende Komplementärmedizin / Research in Complementary Medicine for 20 years and is now retiring from this post. On this occasion, he just published an EDITORIAL looking both back and ahead on research into so-called alternative medicine (SCAM). Here are the last paragraphs of his piece:

What lies in store? We do not know. “Hidden is the future before me, I am wondering what my destiny will bring,” sings Lensky in Tschaikowsky’s opera Eugen Onegin, and this is a good description of our current situation, not only in medicine, but also politically. If I have one wish for the future of CAM, for the future of our journal, then it is to keep the fire ablaze and uphold the hope of change that has been at the source of its founding and is still empowering many in the field. The field of medicine, but also the world, needs examples of visions and visionaries. The landscape will change. While the beginning of the field and the journal was a decidedly German-speaking, central European enterprise, we have now seen the extension of the field.

China has entered the scene with enormous manpower, a venerable tradition, and a huge amount of experience, research, and funding. Other countries, Iran for instance, are discovering the sources of traditional medical approaches. It might well be the case that those who forget that the world does not end at the rim of the Mediterranean and of the Atlantic will be left behind. It has always been a decisive element of CAM research that it bridged countries, nations, polities, and worldviews. The ISCMR, Consortium, and European Congress for Integrative Medicine (ECIM) conferences probably had as attendees more researchers from outside Europe and the US than from their host countries. Africa is only slowly beginning to enter the scene. The future will be less Euro- and Western-centric than the beginning of CAM, I am quite sure. The Western model of healthcare and economic growth through single pharmacological inventions is not sustainable worldwide and in the long run, apart from the fact that it is conceptually ill-founded. Thus, our hope very likely lies in broadening our view: thinking about other systems of medicine, other approaches, whole-systems thinking. This is actually very similar to our beginning. Every end is a beginning, every beginning is an end, Oscar Wilde used to say.

Apart from the abundant use of platitudes, there are several statements that might deserve a comment:

• The beginning of the field and the journal was a decidedly German-speaking, central European enterprise. Yes, the journal started as a predominantly German publication, yet the field was never mostly German/ central European. SCAM always included many modalities that originated from China, the US, and other non-European countries. Neither was the research into these areas ever dominated by German-speaking investigators.
• China has entered the scene with enormous manpower, a venerable tradition, and a huge amount of experience, research, and funding. This is true – but is it a good development? On this blog, I have often written about the fact that research from China is notoriously unreliable or even fabricated. As the quantity of such work is about to totally overwhelm SCAM research, this is a most concerning development, in my view.
• It has always been a decisive element of CAM research that it bridged countries, nations, polities, and worldviews. I would say that this is not something that characterizes SCAM research. It is a hallmark of any research. And considering my last point, it might soon no longer apply to SCAM. As we are being flooded with unreliable Chinese SCAM research, Chinese dominance might soon stifle criticism of SCAM.
• The Western model of healthcare and economic growth? As far as I can see, the model of economic growth is fast being adopted by non-Western counties.

So, what is the future of SCAM and SCAM research? Like Walach, I don’t know. But contrary to Walach, I hope for something entirely different. I hope that the stupidly short-sighted notion of two types of research and two types of healthcare can eventually be abandoned. In the end, there can only be one type of science – the one that understands itself as critically testing hypotheses by trying to prove them wrong – and only one type of medicine – the one that does more good than harm.