A small case of cognitive dissonance

This recent commentary on a skeptic thread reveals how polarized thinking can be offered up as “balanced” reasoning:

"The following is a direct quote from the Dec. 6th issue of NEJM:

In recent weeks, over-the-counter cough and cold medications for children have received unprecedented attention from regulators, physicians, the media, and parents. This scrutiny represents a long-overdue reassessment of products that were purchased by 39% of U.S. households during the past 3 years. It also reflects an important evolution in the standard of evidence for medications used in children.

Over-the-counter cough and cold preparations include various combinations of antihistamines, decongestants, antitussives, and expectorants. There is no standard for describing these products; two products marketed similarly may have different types of ingredients. Consumers purchase about 95 million packages of such medication for use in children each year. Within the pediatric community, however, concern over the effectiveness and safety of such drugs has been growing for more than two decades.”

“I think there's a similarity here with some of the criticisms made of CAM products on this List. Not identical, nor perhaps as extensive, but similar; in particular market driven, and taking decades to rectify, while clearly taking advantage of citizen's vulnerabilities in the area of health care. Most notable perhaps is the much greater degree of harm caused here as compared to CAM treatments; much less of an effort to hold anyone accountable as compared to the reactions to lesser frequencies and/or degrees of harm when these occur from CAM; and, it seems to me, the much greater level of tolerance or permissiveness over a prolonged period toward direct harms from these cough and cold products as compared to problems occasionally reported from direct harms from CAM products.”

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Here are a few comments with respect to some of the cognitive dissonance noted in these remarks:

"Most notable perhaps is the much greater degree of harm caused here as compared to CAM treatments"

Imperfect though it may be this process seems to reflect a critical scrutiny not often observed in non evidence based modalities. These substances have real actions and as harms are measured, evaluated, and taken into account, there are mechanisms for change.

It appears to me that non evidence based approaches (homeopathy prevention for Malaria and AIDS, chiropractic for subluxations, nutrition schemes for cancer cures....) open doors for significant harms of their own. What critical mechanisms are in place to scrutinize them (The NCCAM hasn't seemed to have had much impact yet)?

"much less of an effort to hold anyone accountable as compared to the reactions to lesser frequencies and/or degrees of harm when these occur from CAM"

Not so sure about this. Accountability is critical, so is honesty and transparency in scientific endeavours. Pharmaceuticals & industry have lots of dirty laundry here. In the same vein though, "CAM" has been given huge leeway and liberty to ply all kinds of questionable practices and make a lot of $$ under a veneer of "science". This is significant harm.

"and, it seems to me, the much greater level of tolerance or permissiveness over a prolonged period toward direct harms from these cough and cold products as compared to problems occasionally reported from direct harms from CAM products."

This "direct" harm comparison is confusing. How do we compare a treatment with known effect (implying risk/benefit) with a placebo for example? If a placebo harms even one person, doesn't that have huge implications?

Anecdotally, we just referred a client’s dog to surgery for known disk herniations being treated with homeopathy and acupuncture...and this morning I talked to a new mother who refuses to vaccinate her child (doesn't "believe" in them)preferring the "immune boosting effects" of aromatherapy.

It seems harms loom heavy all over...