Alternative Medicine – Sincerity no substitute for evidence

HOW many readers have gone to dinner parties and listened to otherwise intelligent people assert that alternative medicine can be just as effective as mainstream, scientific medicine? Generally, the argument is that alternative medicine, in all its many forms, is just another complementary and legitimate form of healing. Critical thinking, hypothesis.

by James Allan, The Australian

Reposted from:
http://www.theaustralian.news.com.au/story/0,25197,24187185-21147,00.html

So homeopathy, acupuncture, echinacea – even aromatherapy, magnetic resonance zones or anything with the word holistic in front of it – gets elevated to the same plane as chemotherapy, antibiotics or vaccines for mumps or measles. And this goes hand in hand with rather disdainful comments about sceptics of such alternative treatments not being open-minded and not being tolerant of competing world views.

So those who think alternative medicine is bogus are close-minded and intolerant. Well, that may be why I think it’s bogus, but why should you?

What is one to make of this sort of embrace of a tolerance that says all beliefs are equally valid and worthy, which implies that sincerity of feeling is what really counts?

I suppose the more mischievous among us would begin by noting that this sort of tolerance is often more selective than many of its proponents pretend. Strong beliefs in favour of the efficacy of homeopathy or iridology or the latest natural herb are frequently propounded by those in the chattering middle classes, many of whom would look aghast at anyone who held firm religious convictions. As far as the latter is concerned, a thorough-going scepticism grounded in a scientific world view is the order of day. That and a fair bit of tut-tutting about how dull-witted you’d have to be to actually believe that stuff.

But mention echinacea or homeopathy, or even astrology or more bizarre notions such as recovered memory syndrome, and the mantra for these same chardonnay-sipping people becomes the rather fashionable one that there are other, deeper truths out there that empiricism and a scientific world view cannot show us.

A more fundamental response to the embrace of irrationality starts with a few facts. In reply to the Monty Pythonesque question, “What has testing and appeals to hard evidence and the scientific world view ever done for us?”, the answer would go on and on and on. Our televisions, microwaves, CD players and cars are its products. So are our jet trips overseas. As are the world’s vastly more productive farming practices that manage to feed more than six billion people. Yes, even nuclear weapons are its progeny.

But then pacemakers, antibiotics, various public health measures, inoculations, modern surgery techniques and more have nearly doubled average life expectancy in the past century. The scientific world view has made life better for humans as a whole than at any other time in our comparatively short history.

Nor is it true that this scientific world view – the one that has delivered untold benefits to mankind – is compatible with or complementary to the mystical, anti-evidence world view underlying the embrace of such notions as homeopathy. (And did you know that homeopathy rests on diluting substances to a ratio of about one atom per universe and on metaphors such as that the almost pure water you take remembers the now gone substance?)

It seems almost churlish at these dinner parties to point out that alternative treatments rely on the placebo effect – that most people for most illnesses simply get better on their own (whether they take nothing, a sugar pill or unbelievably diluted water) – and on the deep-seated desire many have to want to believe something is working. And it seems churlish to ask why it is that these new age complementary medicines cannot produce results under double-blind drug trial conditions.

Here’s a simple fact. When it comes to the empirical, causal world in which we live, not all beliefs (no matter how sincerely and passionately held) are equally valid. Science starts from the commonsense premise that there is an “out there” beyond our senses, one that imposes outcomes and answers on humans, however we may have been socialised. The world is not simply what we wish or think it to be.

Any trendy postmodernist who may pretend that basics such as gravity, say, are social constructs is easily dealt with. Give him the Jeremy Bentham test. Take him up any tall building and ask him to jump. He won’t. He believes in a real, external world like the rest of us (outside the odd university English department, at any rate).

So you see, however many times some people may mistakenly repeat it, it is simply not true that you are more open-minded if you embrace alternative views that implicitly require you also to reject the discovered laws of physics and to put away the demand for hard, cold, testable evidence. More gullible? Yes. More open-minded? Not a chance.

Uttering terms such as complementary or competing world views is no substitute for evidence and empirical testing. Likewise, reading a product described as natural should not automatically send shivers of desire down your spine; such a description tells you nothing about whether it is good or bad. Hemlock is natural and it kills people. Fluoridation, hip replacements and braces are all highly unnatural and very good indeed.

No one likes to be rude at a fun dinner party or to risk social isolation by calling someone an idiot. But next time you find yourself seated beside a smart, well-paid enthusiast for the benefits of alternative medicine, you may just gently point out to him that if he gets cancer, he’d be better off opting for chemotherapy than for some equally valid, equally legitimate, non-traditional, world-view treatment.

James Allan is Garrick professor of law at the University of Queensland.

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