Nov 28 2012
One of the core fictions of “complementary” or “integrative” medicine is that they are primarily offered in addition to science-based medicine and only to fill gaps in what SBM can offer. The original marketing label used to promote treatments that are not adequately supported by evidence , “alternative medicine,” was a bit more accurate in that at least it acknowledged that such treatments were being offered instead of SBM (the fiction being that they are a viable alternative, rather than just health fraud and pseudoscience). The switch to “complementary” and “integrative” did not reflect an evolving philosophy or practice, just an evolving marketing strategy.
Today proponents are likely to reassure the right people – journalists, regulators, and academics – that their offerings are not meant to replace proven therapies, but to complement them (the best of both worlds). (Mark Crislip is fond of pointing out that this is like mixing cow pie with apple pie. It doesn’t make the cow pie palatable, but it does ruin the apple pie.) However, behind closed doors practitioners of unscientific medicine generally prescribe their favorite pseudoscience instead of science-based treatments.
For example, Alice Tuff from Sense about Science investigated 10 homeopathic clinics in the UK.
In the consultations, Alice explained that she was planning to join a 10-week truck tour through Central and Southern Africa and that the anti-malarial drugs her doctor had prescribed made her feel queasy.
The results – all 10 homeopathy clinics offered homeopathic treatments for malaria protection, and none of them suggested this be done in addition to standard treatment. None of them referred Alice back to her medical doctor for further advice (in which case she could have been offered science-based alternative malaria treatments that she may have tolerated better). Only two homeopaths took a personal medical history.
Homeopathic vaccines are an excellent test case for the ethics of so-called CAM. In order to accept CAM one has to, in my opinion, disregard core scientific principles, or profoundly misunderstand them. It is therefore not surprising that proponents of CAM would generally not recommend science-based treatments, and may even advise against them. The more savvy practitioners understand that in order to get a foot in the door they need to publicly take the “integrative” approach, but this is often not what happens in practice.
Schmidt and Ernst surveyed chiropractors and homeopaths for their advice on the MMR vaccine. After gathering the data they disclosed that this was for research and offered them the opportunity to withdraw their responses. The results are below:
We contacted 168 homoeopaths, of whom 104 (72%) responded, 27 (26%) withdrawing their answers. We contacted 63 chiropractors, of whom 22 (44%) responded, six (27%) withdrawing their responses. No general practitioners responded. The table shows that only a few professional homoeopaths and a quarter of the chiropractors advised in favour of the MMR vaccination. Almost half of the homoeopaths and nearly a fifth of the chiropractors advised against it.
Only 3% of the homeopaths advised getting the vaccination, while 40% specifically advised against it. Meanwhile, 25% of chiropractors advised for and 19% against getting the vaccine. As interesting is the fact that more than a quarter of each withdrew their responses – indicating a desire to conceal their true beliefs and practice from the public.
In reaction to this study the Society of Homeopaths put out an official statement saying they do not advise against vaccines – but again, we are just seeing the disconnect between the public face and practice behind closed doors. This seems to represent a deception inherent in non-science-based practice.
As if it needs to be said yet again on this site – homeopathy is an unscientific philosophy based upon superstitious notions invented over 200 years ago. Homeopathic pills and potions typically are diluted beyond the point where any active ingredients remain. Not only do physics, chemistry, and biology dictate that homeopathic treatments cannot work, when studied clinically they in fact do not work. Specifically the scientific evidence does not support the claim that homeopathy is effective in preventive infectious illness and is a suitable alternative to proven vaccines.
In addition to offering an ineffective treatment in place of perhaps the safest and most effective medical intervention ever devised, vaccines, proponents of unscientific alternatives have a huge motivation to attack their competition. They therefore often make common cause with the anti-vaccine movement, as evidence by the fact that 40% of the homeopaths in the above study (that allowed their advice to be known) specifically advised against vaccination.
It is not difficult to find sites on the web both attacking vaccines and promoting an alternative, such as homeopathy. This is partly a product of scientific illiteracy, but also just brand competition. If you are selling an alternative it is in your interest to criticize the competition.
In some cases the conflict between homeopathy and vaccination takes on a legal dimension. A recent court case in Australia involves divorced parents fighting over whether or not to vaccinate their child. The mother is against vaccines, stating:
She told the court that she adhered to a ”simple and healthy way of life”, that included eating organic food, using non-toxic cleaning products and sending the child to a Rudolph Steiner school where the toys were made from natural products such as wool, wax and silk.
Most parents at the school focused on ”building up the immune system of the child through homeopathics”, she told the court.
We see here the alliance of anti-vaccine sentiments, the naturalistic fallacy, and homeopathy.
The father and the girl’s stepmother took her to get vaccinated after she contracted whooping cough at age five. They were further concerned over risks posed to their newborn from their unvaccinated sibling. This led the mother to sue in court to keep her daughter from being vaccinated by her father. The news report of the case further reveals:
A doctor in homeopathic medicine told the court that homeopathic vaccination was safe and effective, whereas traditional vaccination had short- and long-term risks, including a link to ADHD and autism.
Apparently it is not difficult to find a homeopath who will testify to blatant pseudoscience in the courtroom.
It is apparent that there is a real and meaningful conflict between science-based medicine and what is offered by some as an alternative (interventions not adequately based on science) – how could there not be? The notion of “complementary” or “integrative” medicine is a marketing fiction, a political necessity for proponents of nonsense. In practice proponents of unscientific alternatives largely oppose science-based interventions, or will at least happily jump on the bandwagon of any criticism or denial of mainstream medicine, while falsely promoting treatments that are not supported by basic science or evidence of effectiveness.
This all gets filed under the category of “what’s the harm” of believing in and promoting medical pseudoscience.
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