Monday, July 9, 2007

Complementary/alternative medicine and relative harm

A recent comment thread on a skeptical list touched on the concept of complementary and alternative medicine (CAM) and relative harm. This commentator noted that the low incidence of harm from the practice of CAM paled in comparison to the horrors of other human activities such as alcoholism, poor diets, religious dogma, and smoking. The general conclusion being that efforts should therefore be more focused on these problems rather than the more “benign” CAM medical practices.

While these types of comparisons may seem to make sense- most of us want to address humanities problems in some way- we need to look a little deeper before we let the CAM modalities run amok over the medical landscape.

Implying that CAM modalities are comparatively benign and can thus be allowed as a legitimate choice in medicine begs the question; because they are benign; then they are benign. In addition, there is a bit of over-reporting of the facts in claiming that CAM is, when compared with major social ills, an insignificant harm. Although not the major point, if one wants to go there, history is replete with examples to the contrary.

The crucial issue here is that critical thinking has allowed for solid and palpable progress in many areas of human endeavor. The progress in modern medicine is due in large part to utilizing this skill to derive effective modalities from the realm of science- a discipline that has given us the closest picture of the true nature of things we have as of yet.

This was my response to the “CAM is benign ploy”:

“If you take into account the significant harm non-science based medical practices have wrought throughout history using combinations of ineffective and often harmful therapies, the importance of minimizing the bubbling cauldron of ignorance in medicine today becomes ever more urgent- even if these therapies “appear” harmless compared to demonstrably effective medicine.

Without the self critical, self correcting methodology of science, modern medicine stands to become another recent socio-cultural phenomenon- a postmodern paper tiger. Conflagrating consumer “choice” in medicine together with the gory details of humanities frailties, socio economic missteps, religiosity, and often schizophrenic behavior misses an important point. That is, where critical thinking has flourished; it has been possible to better navigate reality as it is.

Freedom of choice brings with it a huge responsibility; especially regarding others. Add to this the fact that freedom of choice in medicine is further tempered with society’s demanding expectation (for the most part) that it provide the most effective practice possible- no matter what a person “believes”.

To date science provides the clearest roads to this end. Unlike religion, politics, or cultural roots, science reflects universal realities (i.e., you breath oxygen, are structurally bipedal, and communicate using a complex recursive language). In kind, scientific medicine strives to derive knowledge and treatments based on these truths. Not a religion or cultural dogma, it can flex, bend, and change- based on expanding scientific understanding.

If medicines imposed science based limitations are removed, society will again be open to a plethora of competing false realities among which the placebo- that ghostly deception- reins supreme. Indeed, this type of medical “anarchy” silences the all important need for honest discourse. Instead of a place where human touch, emotional acknowledgment, and real communication can truly thrive- even under the harsh light of reality- a thick fog of magic, dogma, and ideological suggestion would smother any effective medical progress, and turn even simple human behavior against itself.”

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