Re: Alternative medicine (was Ethics)

Lee Daniel Crocker (lcrocker@calweb.com)
Thu, 2 Jan 1997 18:31:39 -0800 (PST)


I must apologize for allowing my emotional reaction to some of the
postings here interfere with the effective communication of the point
I was trying to argue. It began with a claim that "medicine is not
science", to which I took issue, explaining the scientific foundation
of medicine. Others then took issue with some of the aspects of
modern medicine as practiced in the US (with which I agreed), and
promoted alternatives (with which I do not agree).

The assertion I have been trying, but failing, to make, is just this:
The fundamental nature of most modern allopathic medicine is science,
and the fundamental nature of most "alternative" medicine is quackery.
I stand by that basic assessment, and I will try to explain.

It is always dangerous to generalize about people. One cannot begin
every sentence with "I'm sure there are a few counterexamples, but the
majority of group X, or the primary founders/directors/speakers of
group X, or most members of group X I have met..." So it is important
to identify what defines the group, what gives it its identity. Then
one can draw conclusions about the group from its nature, without
having to rely on individual examples that can be too variable.

The nature of allopathic medicine is science. Doctors collect and
share data about diseases, perform experiments with treatments and
diagnoses, encourage others to verify their results, publish articles
in peer-reviewed and refereed journals, submit themselves to public
criticism of their ideas, postulate new ideas and other explanations
for their results, change their recommendations with new data, and
willingly admit their ignorance when insufficient data are available.
There are some things that get in the way: the expensive FDA approval
process discourages less-profitable medicines. The AMA cares more
about the health of its members' bank accounts than patients. But
these problems are well known, many are working to fix them and
others, but the nature of the business is still the same: when facts
slap them in the face, they eventually listen. Because despite the
bureacratic obstacles and mental prejudices, the methods themselves
are scientifically sound, and the epistemology used to update the
methods is sound.

The nature of most alternative medicines is mysticism. Authorities
are revered over results--the older the authority, the better. Pretty
but unobservable ideas like the acupuncturist's flow of "chi" and the
sub-molecular "vibrations" of the homeopath are espoused despite
centuries of lack of evidence, and the inability to measure or test.
They write books and sell them in popular bookstores without submitting
them for review. They sell supplements in health food stores with
lots of personal recommendations, anecdotes, analogies, and other
flawed reasoning as sales techniques. They appear on talk shows to
promote their wares and to ridicule--perhaps appropriatley--some part
of modern medicine, hoping that the audience with thereby think that
any alternative is superior. They claim to cure everything, and to
have "fundamental" knowlege. When science proves them wrong, they
simply incorporate some part of it into their mythology in an attempt
to keep it alive, the way chiropractors finally capitulated on the
germ theory of medicine when they no longer had any choice.

Again, these are generalizations, but every time I go into a health food
store and read glowing endorsements on a label, or turn on Oprah and
hear some quack telling us not to immunize our children, and a doctor
on the panel quietly acknowleging when asked that "yes, science doesn't
know everything"--as if that were a negative--the nature of the two
businesses are confirmed in my mind.

The choice to employ a specific method of reasoning has consequences.
And since life and death depend on the consequences of medical advice
and treatment, that choice is far more important than irrelevant factors
like the practitioner's personality or motives, licensing authorities,
professional affiliations, the esthetic qualities of the arguments, or
one's personal prejudices.

Since all organic diseases sometimes cure themselves, and the mind has
powerful effects on the body, anything one does will cure some people.
But the methods of science can isolate those cases from the results of
real treatments. A child with a ruptured spleen can choose either the
scientifically verified method of surgery, or the older authoritative
method of prayer. There are no guarantees either way, but odds are he
will survive in the first case and die in the second. A woman with
headaches may well find comfort and ease of pain with acupuncture. But
if they were caused by a brain tumor, her delay in seeking reponsible
diagnosis could kill her.

Because actions have consequences, the people who take those actions
are responsible for them, and may properly be judged for their choices.
In the absence of other information, I judge a modern doctor to be a
scientist, and I judge an alternative practitioner to be a charlatan,
even when the acupuncturist happens to make the pain go away, and the
doctor loses a patient on the table. Until the fundamental nature of
those occupations and their methods of reasoning change, I will
continue to do so.