Alternative Medicine (copied from DH)

[Lixivium]

Alternative Medicine is, according to the Wikipedia article on the topic (here), "encompasses any healing practice that does not fall within the realm of conventional medicine". This does not include, for example, drugs in development by scientists that ought to work by scientific theories, but does include acupuncture, homeopathy, biofeedback, naturopathy, herbal medicine and the like.

The thing is, millions of people are using a variety of treatments that have almost no effect beyond the placebo effect. There are a limited number of ones that work beyond that - I've heard about acupuncture being able to stimulate the nervous system in some way, but by and large the entire realm of alternative medicine is pseudoscience at best, dangerous at worst.

I, of course, am against the entire concept - I believe that things should be tested before they are used on a person.

There are a variety of deaths and injuries resulting from relying upon alternative medicine (SOURCE).

I was wondering if there are any proponents of Alternative Medicine on here. I was further wondering if I could engage them in argumentation about the validity of using alternative medicine at all.

Okay so the whole reason I even joined Proving Grounds was that I really wanted to make a particular post on this topic in Debate Hall, but I couldn't . I will make a more comprehensive post about this later. In the mean time, most of DH seems to be solidly against the concept of alternative medicine; what do the Proving Grounds people have to say about this topic?

 

[Faithkeeper]

Do we assume that the things said in the debate hall thread have already been brought up here, or do we start anew?

I think you can assume stuff in DH has already been stated. Feel free to quote them if you wish.

[Note: I highly recommend you read the debate hall topic (http://www.smashboards.com/showthread.php?t=229118) beforehand so you can better know points that have already been presented and don't repeat things.]
EDIT:

I agree with much of what has been said: There is potential danger in alternative medicine, and it should be thoroughly investigated to test its safety. Much of the alternative medicine does very little at all and can even be harmful. Uncertain doses of alternative medicine can present a dangerous situation if overdosed. Yet there is an added advantage of alternative medicine that most posters seem to brush aside or overlook: the power of the placebo effect.

Multiple posters said that often alternative medicine did little more than have the power of the placebo effect, yet my question to them would be: Why is this a problem?

The power of the placebo effect is undeniable, placebos have been effectively used on patients suffering from these conditions:

* ADHD:adult,[121] child[122]
* Amalgam fillings: attributed symptoms (inert "chelation" therapy)[123]
* Anxiety disorders[124][125]
* Asthma (water aerosol inhalant)[126]
* Asthma[127][128]table 1
* Autism: language and behavior problems[129][130]
* Benign prostatic enlargement[131]
* Binge eating disorder[132]
* Bipolar mania[133]
* Chronic fatigue syndrome[134]
* Cough[135]
* Crohn's disease[136]
* Depression (Light treatment; low red light placebo)[137]
* Depression[138][139][140][141]
* Dyspepsia and gastric motility[142]
* Epilepsy[143]
* Erectile dysfunction[144]
* Food allergy: ability to eat ill-making foods[73] p. 54
* Gastric and duodenal ulcers[73][145][119]
* Headache[146]
* Heart failure, congestive[147]
* Herpes simplex[148]
* Hypertension: mild and moderate[149][21]
* Irritable bowel syndrome[150][151]
* Migraine prophylaxis[152]
* Multiple sclerosis[153]
* Nausea: gastric activity[154]
* Nausea: chemotherapy[155]
* Nausea and vomiting: postoperative (sham acupuncture)[156]
* Pain[157][158]
* Panic disorders[159]
* Parkinson’s disease[160][161]
* Pathological gambling[162]
* Premenstrual dysphoric disorder.[163]
* Psoriatic arthritis[164]
* Reflux esophagitis[165]
* Restless leg syndrome[166]
* Rheumatic diseases[167]
* Sexual dysfunction: women[168]
* Social phobia[169]
* Third molar extraction swelling (sham ultra-sound)[7][8]
* Ulcerative colitis[170]
* Vulvar vestibulitis[171]

(source= http://en.wikipedia.org/wiki/Placebo)


I think there is little debate in whether or not the placebo is effective, so why not apply this to alternative medicine? If an individual has convinced themselves that an alternative medicine will work, (which individuals obviously have, given alternative medicine's relative prevalence) why not make sure these alternative medicines are safe and then harness the power of the placebo effect?

"Expectation is a powerful thing," says Robert DeLap, M.D., head of one of the Food and Drug Administration's Offices of Drug Evaluation. "The more you believe you're going to benefit from a treatment, the more likely it is that you will experience a benefit."

While for the general populous, conventional medicine should be recommended due to the fact it is undoubtedly more effective in a neutral setting, I think (tested and proven safe) alternative medicine (as a placebo) is a rather viable option to those who wish it.

Additional sources:
http://www.fda.gov/fdac/features/2000/100_heal.html

 

[Lixivium]

I think you can assume stuff in DH has already been stated. Feel free to quote them if you wish.

Edit:

While for the general populous, conventional medicine should be recommended due to the fact it is undoubtedly more effective in a neutral setting, I think (tested and proven safe) alternative medicine (as a placebo) is a rather viable option to those who wish it.

Well, I suppose the challenge is to educate people about these alternative drugs without losing the power of the placebo effect.


Suppose a patient comes into a doctor's office and asks about an alternative drug: "is ____ effective for my ____?"

Do you take the time to explain to them what it means for a drug to not be significantly better than a placebo? Can you say in good conscience that a drug "works" just because it elicits the placebo effect? If they walk away with the impression that a drug works as well as conventional medicine when it is really acting through placebo, is that ethical or honest?

The other catch is in "tested and proven safe". There is virtually no medication, traditional or alternative, that is without side effects; even ibuprofen can cause or worsen stomach ulcers. Alternative/herbal medicines may seem more innocuous than conventional medicine but they can have significant interactions with other drugs:

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

This study highlights the significant effects of St. John's Wort on drug metabolism, and keep in mind most other alternative/herbal drugs are not subjected to these kinds of studies by their very definition. I have a feeling most practioners and marketers of alternative medicine are not going to take the time to sit down with someone and figure out how they'd have to alter their drug regimen in order to take St. John's Wort.

 

[Faithkeeper]

Suppose a patient comes into a doctor's office and asks about an alternative drug: "is ____ effective for my ____?"

Do you take the time to explain to them what it means for a drug to not be significantly better than a placebo? Can you say in good conscience that a drug "works" just because it elicits the placebo effect? If they walk away with the impression that a drug works as well as conventional medicine when it is really acting through placebo, is that ethical or honest?

I was really speaking towards cases where the individual refused conventional medicine like:

Debbie Benson
Age: 55
Fort Bragg, California
Died (cancer)
July 15, 1997
She had a deep distrust of traditional medicine, so she sought out naturopaths and other alternative practitioners for her breast cancer. It raged out of control and she died.

Marcia Bergeron
Age: 57
Quadra Island, British Columbia, Canada
Died (poisoning)
December 26, 2006
She distrusted conventional medicine, so she decided to self-medicate using pills purchased from a Canadian online pharmacy. What she didn't know was the pharmacy was not actually Canadian and the pills were tainted with toxic heavy metals.

From http://www.whatstheharm.net/alternativemedicine.html originally posted by aeghrur in the Debate Hall topic.
When a patient refuses to take conventional medicine, (Which they have the constitutional right to do. [In the united states]) I could say in good conscious that alternative medicine works. In saying this, not only would I be telling the truth (due to the placebo effect), but I could be saving a life and further strengthening the placebo effect by saying it does work. This quote supports my statement:

New findings show that the placebo effect - in which patients given an inactive treatment believe it can cure - is most powerful when a trusted physician enthusiastically offers a patient a new therapy. In a study of more than 6,000 patients being given experimental treatments for asthma, duodenal ulcer, and herpes, two-thirds improved

"Could an enthusiastic physician and a believing patient create a clinical improvement in a patient?" said Dr. Ronald Glaser, a virologist at Ohio State University Medical School. "That question has haunted drug studies. But there may well be a psychological effect with a significant biological outcome, if you extrapolate from data showing that psychological factors like stress can affect viruses like herpes. It's definitely one possible explanation."

______________________________________________​

The other catch is in "tested and proven safe". There is virtually no medication, traditional or alternative, that is without side effects; even ibuprofen can cause or worsen stomach ulcers. Alternative/herbal medicines may seem more innocuous than conventional medicine but they can have significant interactions with other drugs:

http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

This study highlights the significant effects of St. John's Wort on drug metabolism, and keep in mind most other alternative/herbal drugs are not subjected to these kinds of studies by their very definition. I have a feeling most practioners and marketers of alternative medicine are not going to take the time to sit down with someone and figure out how they'd have to alter their drug regimen in order to take St. John's Wort.

These are all good points, and I do not disagree. I actually already addressed my thoughts on this in my first post:

I agree with much of what has been said: There is potential danger in alternative medicine, and it should be thoroughly investigated to test its safety. Much of the alternative medicine does very little at all and can even be harmful. Uncertain doses of alternative medicine can present a dangerous situation if overdosed.

I suppose in a perfect world, one could effectively turn alternative medicine into conventional medicine by identifying its active ingredient and so on. Yet I do not see this perfect world in our near future, because when one alternative medicine makes the jump to conventional, mistrust of conventional medicine will inevitably replace it with a new form of alternative medicine. I see no easy solution in this matter, but for the cases of individuals who refuse conventional medicine, I see little other option than what I suggested in my first post.

 

[Lixivium]

Yet I do not see this perfect world in our near future, because when one alternative medicine makes the jump to conventional, mistrust of conventional medicine will inevitably replace it with a new form of alternative medicine. I see no easy solution in this matter, but for the cases of individuals who refuse conventional medicine, I see little other option than what I suggested in my first post.

That's actually a good point. I acknowledge that alternative medicine will never go away, it is a multi-billion dollar market not because all its practitioners have hoodwinked everyone, but because there is a DEMAND for it. People want "alternatives", they want to believe something could work at a level outside the rational, empirical world.

This irrationality is probably hardwired into the human brain evolutionarily. {Source} Even if we think it's counterproductive and just plain wrong, we have to deal with it.

But, there was once a South Park episode that made fun of John Edward and "Crossing Over." In that episode, the argument he made on his behalf was the same as yours: that even if he was an outright huckster, he was naking people feel better; essentially, that the ends justify the means.

And yet charging people for a service you are not actually providing is by definition fraud - certainly legally wrong, and I would argue morally wrong as well. By endorsing alternative medicine, it would be difficult to avoid giving people false or unsubstantiated hope and driving them even further against conventional medicine. If it worked by some miracle, they would proceed to try to convert others to their beliefs, even though they had no rational basis for it. Philosophically, I don't see that as being worthwhile of asking physicians to compromise their principles and ethics.

 

[Faithkeeper]

And yet charging people for a service you are not actually providing is by definition fraud - certainly legally wrong,

I definitely see your point, although I don't think it is really fraud, based on the concept that I am prescribing the treatment that would fix the ailment.

...and I would argue morally wrong as well.

Morally, in cases where a patient won't take conventional medicine, my personal beliefs place a higher value on saving their life than being completely clear. (I think I would be deceptive but honest, and while I am not fond of deception, I am less fond of a death I could have prevented)

By endorsing alternative medicine, it would be difficult to avoid giving people false or unsubstantiated hope and driving them even further against conventional medicine. If it worked by some miracle, they would proceed to try to convert others to their beliefs, even though they had no rational basis for it.

It is completely acceptable for me to tell a patient after they have been treated that the alternative medicine did absolutely nothing and it was all in his or her head, is it not?

Philosophically, I don't see that as being worthwhile of asking physicians to compromise their principles and ethics.

The majority of physicians do not necessarily think it is unethical. Actually, this study suggests the opposite:

A recent national survey of 679 physicians, funded in part by NCCAM, found that about half the physician respondents prescribed placebo treatments on a regular basis. Most (62%) said they think the practice is ethical.

Sources:
http://abcnews.go.com/Health/ColdandFluNews/Story?id=6099708&page=1
http://nccam.nih.gov/research/results/spotlight/102408.htm
http://www.bloomberg.com/apps/news?pid=20601124&sid=ahaD1J6VIA.o&refer=home

 

[Lixivium]

t necessarily think it is unethical. Actually, this study suggests the opposite:

Prescribing a placebo is not considered alternative medicine. It's a little different to give someone a sugar pill vs. saying "go get your spine adjusted."

 

[Faithkeeper]

Prescribing a placebo is not considered alternative medicine. It's a little different to give someone a sugar pill vs. saying "go get your spine adjusted."

My entire point has been focused around using alternative medicine as a placebo. I don't see the difference between a sugar pill and alternative medicine. Both are harmless [or would be, given the clarifications I gave in previous posts] inactive treatments, used to heal people.