thoughts on alternative medicines

[mr friendly guy]

Ok, I couldn't fit exactly what I wanted to say in the title, so I had to cut it down.

In the homeopathy thread, essentially Faram pointed out an example of natural selection, where idiots would take homeopathy - all part of natural selection in action. However since its nothing more than a placebo pretending to be something else other than a placebo its also fraud.

My question is, when someone takes an alternative medicine which is clearly quackery (for this purpose lets ignore those ones which have some anecdotal evidence and deserves a proper clinical trial to decide whether it really works), should we just shrug and watch natural selection in action, or do we need to do something about combating the practioner of said quackery. Or do we do both?

[Zero]

Natural selection seems like an amazingly pathetic reason to let someone die. Besides, isn't intelligence primarily believed to be a learned action? If it is, natural selection won't eliminate it, and saving people from their stupidity won't improve the gene pool.

All of that aside, it's blatently immoral to let anyone die if there's no danger to you in preventing it. Natural selection is a process, and shouldn't effect our sense of right and wrong. That's like saying that it's wrong to try and get into space, because gravity fights us in that reguard. Processes simply have ought to have no bearing on what's considered right or wrong.

[Lord of the Abyss]

Everbody makes mistakes; smart people learn from them, but they aren't immune. Dead people, on the other hand don't learn anything. Frankly, if someone makes a bad choice that kills them, they aren't necessarily stupider than average; they just had the bad luck to pick a mistake that was lethal.

Now if you try to warn them and they don't listen, and the "treatment" fails and they still don't listen; that's foolishness or stupidity. At that point, I'd walk away with a clean conscience. I tried, and if they won't listen to me or learn from experience, there's little I can do anyway.

[Faram]

Natural selection seems like an amazingly pathetic reason to let someone die. Besides, isn't intelligence primarily believed to be a learned action? If it is, natural selection won't eliminate it, and saving people from their stupidity won't improve the gene pool.

Have you meet, seen or heard a homeopathy advocate?

Last time I saw one on TV he was a diehard lunatic that thought that homeopathy is superior to modern medicine in all ways shapes and forms.

I am not going to go out of my way to help that sort of morons. Neiter am I going to argue with a lunetic that belives homeopathy is superior, because it is as productive as arguing with a dihard religious nutcase.

Let those fools use their "superior" alternative threatment.

[mr friendly guy]

Now if you try to warn them and they don't listen, and the "treatment" fails and they still don't listen; that's foolishness or stupidity. At that point, I'd walk away with a clean conscience. I tried, and if they won't listen to me or learn from experience, there's little I can do anyway.

That's a good point. But how many times can legitimate medical associations warn people before unfounded attacks start coming in against the medical profession - eg they are afraid of the superiority of alternative medicine because it will ruin business etc. The thing is, warning someone also has a cost involved in that alternative medicine advocates will retaliate by launching attacks against you.

[Guardsman Bass]

My question is, when someone takes an alternative medicine which is clearly quackery (for this purpose lets ignore those ones which have some anecdotal evidence and deserves a proper clinical trial to decide whether it really works), should we just shrug and watch natural selection in action, or do we need to do something about combating the practioner of said quackery. Or do we do both?

It depends on some conditions. If the practitioner is using the practice to commit fraud, then we should attempt to prosecute him/her. This is pretty difficult; note the con man on TV infomercials hawking his book Natural Cures They Don't Want You to Know About. He spouts all kinds of fraudulant claims, and seems to have gotten away with it.

The other condition should be if the product that is being sold has been determined to be dangerous to its users. Since we're assuming that the quackery of the medicine has been determined, most likely we can also tell at least some of the conditions in which it might be dangerous. If the practitioner does not take this into account, prosecute away.

Other than that, you ought to discourage the use of quackery, but you can't really do anything about it.

[Lord of the Abyss]

Now if you try to warn them and they don't listen, and the "treatment" fails and they still don't listen; that's foolishness or stupidity. At that point, I'd walk away with a clean conscience. I tried, and if they won't listen to me or learn from experience, there's little I can do anyway.

That's a good point. But how many times can legitimate medical associations warn people before unfounded attacks start coming in against the medical profession - eg they are afraid of the superiority of alternative medicine because it will ruin business etc. The thing is, warning someone also has a cost involved in that alternative medicine advocates will retaliate by launching attacks against you.

Thing is, they do that anyway. Homepaths often warn against the evils of "allopathic" medicine. Medical frauds in general bad mouth real medicine. Scientologists warn against real psychology and psychiatric drugs. Faith healers often encourage people to throw away medicine.

Really, backing down from these people never solves anything. Frankly, the only real solution is for the government to crack down on this sort of medical quackery.

[wolveraptor]

Which would quickly be interpreted as an attack on freedom of ideas.

[Broomstick]

My question is, when someone takes an alternative medicine which is clearly quackery (for this purpose lets ignore those ones which have some anecdotal evidence and deserves a proper clinical trial to decide whether it really works), should we just shrug and watch natural selection in action, or do we need to do something about combating the practioner of said quackery. Or do we do both?

I guess I'd let the principal of "First, do no harm" be the guide here.

As an example, if someone has terminal cancer (just as an example) and they think sipping some sort of herbal concoction eases their pain (for this example, assume no nasty side effects) or helps them sleep I'm not going to say jack, because it's not causing any harm and the placebo effect might actually ease their suffering.

On the other hand, I'd definitely oppose an insulin-dependent diabetic throwing out their insulin in favor of some herbal "tea" that supposedly will cure them.

And this is where the homeopathy question can get difficult - you're dealing with, essentially, distilled water and sugar pills. If a mother thinks putting a few drops of one of these "remedies" helps her active children settle down at night (and I know one such) I don't think there's any harm being done and I just don't feel like arguing the point. On the other hand, I can't condone use of such "remedies" for, say, a virulent infection that really needs some antibiotics.

[Zero]

If people are defrauding other people into refusing proper medical treatment in favor or lies and bullshit, how can you see it as even vaguely alright to just let that shit continue, or go on?

[Broomstick]

Go back and re-read my post.

Never did I say I'd condone fraud or replacing legitimate medical care... what I said was if using the "alternative remedy" did no harm I wouldn't bother arguing.

If you stop and think about it, replacing a real treatment with a fraud IS harm, and thus I would not support it.

Otherwise ... letting someone seriously ill sip their "special tea" is no more harmful than us feeding my dying father-in-law fudgesicles. At that point, it certainly wouldn't hurt him any worse than his disease, and provided emotional comfort.

Plenty of people use herbs and other questionable stuff in addition to legit medicine, it's not always an "all or nothing" choice here.

But hucksters and frauds... I've dissected and cursed at plenty of snake-oil schemes on this forum, and I'll gladly do so again.

[Zero]

Oh, I wasn't talking to you. I actually liked your oppinion on this matter better then the majority of those expressed so far. The notion of allowing such things for personal comfort, but not allowing them to cause harm seems so blatently obvious, but it startles me when people propose that we should allow people who believe in such treatments to die in the name of natural selection.

[WyrdNyrd]

Here's an example of how even non-harmful "alternative" "medicines" can be considered harmful:

Stealing time. By offering false hope, quackery steals the most precious thing terminal cancer patients have -- the best use of what little time that they have left. The notion that terminal patients have nothing to lose by turning to quackery is dead wrong. Most people faced with a life-threatening disease can make a reasonable psychological adjustment. Those who face reality experience five classical stages: denial, anger, bargaining, depression and acceptance. Those who accept their fate are in the best position to use their remaining time wisely.

In the ABC-TV special "Who Will Love My Children" Ann Margret played an impoverished Iowa mother with cancer who spent her last few months finding homes for her ten children. I know of two similar cases. Quacks discourage people from making the difficult adjustment by reinforcing their denial. Such people usually die unprepared because preparation for death is an admission of failure.

This is just the one point I recalled from a long and detailed argument against cancer-treatment quackery found on the excellent Quackwatch site.

[weemadando]

There was a study reported on ABC NewsRadio last week regarding Homeopathy treatments that showed that "the treatment worked any better than a placebo."

BBC News

I'll take the word of a peer reviewed publication such as the Lancet over a shit-spouting money-grubbing fuck-bag who just wants to line their pocket, has no understanding of medicine and most likely doesn't REALLY care about my wellbeing.

[mr friendly guy]

Whats most damning about that article is this statement from the Society of Homeopaths

"It has been established beyond doubt and accepted by many researchers, that the placebo-controlled randomised controlled trial is not a fitting research tool with which to test homeopathy."

Clearly they are beyond the mortal ken of "conventional" medicine that they don't even have to summit to the same evaluation methods as conventional medicine.

Come to think of it, I should have placed a poll. Can a mod please please add these options on

What to do in regards to alternative medicines quackery

1. Its fraud - prosecute the fakes

2. If someone stupid enough to try it despite warnings, its natural selection in action.

3. I want the best of both worlds - lets do both.

[mr friendly guy]

2. If someone stupid enough to try it despite warnings, its natural selection in action.

.

I will better phrase that one better as
2. If someone is stupid enough to try it despite warnings, its natural selection in action - sit back and let them learn / suffer from their own stupidity.

[DPDarkPrimus]

2. If someone stupid enough to try it despite warnings, its natural selection in action.

.

I will better phrase that one better as
2. If someone is stupid enough to try it despite warnings, its natural selection in action - sit back and let them learn / suffer from their own stupidity.

I disagree, to a point. While I'm all for idiots getting their due, these medicial scams aren't just hurting/killing people... they're making bastards rich. And I'm very much against people profitting on the sale of products that will not do what is promised and will lead to the purchaser's harm/death.

[Broomstick]

"Most people faced with a life-threatening disease can make a reasonable psychological adjustment. Those who face reality experience five classical stages: denial, anger, bargaining, depression and acceptance. Those who accept their fate are in the best position to use their remaining time wisely.

Having buried my share of family and friends (three of 'em just this year) I disagree that the "five classical stages" apply universally, or even commonly. I've seen too many rational, clear-eyed-facing-reality people go down into the final darkness alternating between fear and anger, with a side order of desparation.

Those emotions are, of course, the very reason the terminally/chronically/seriously ill are so vulnerable to false hope.

[brianeyci]

My question is, when someone takes an alternative medicine which is clearly quackery (for this purpose lets ignore those ones which have some anecdotal evidence and deserves a proper clinical trial to decide whether it really works), should we just shrug and watch natural selection in action, or do we need to do something about combating the practioner of said quackery. Or do we do both?

I saw a passing reference in another thread that you are a physician, and you probably know more about the subject matter than everybody on the board combined anyway. What do you mean when you say "combating"? Do you mean some sort of ad campaign or organized movement to inform people about quacks?

Anyway, my opinion for what it's worth is live and let live, except in a situation where serious complications or death can arise. For example, homeopaths as long as they dillute their poisons and don't start feeding their crap to children, it is someone's choice to go see one. However for chiropractors, I seem to remember neck manipulations leading to lawsuits about strokes, so I would warn someone about that. For fence-sitters (ones which help in certain situations) like massage therapy, I would tell them the specific situation that the treatment would work in. For example, for accupuncture, I would not summarily dismiss it, but recommend it only for things like muscle pain. Lastly I would suggest alternatives, because some people turn to alternative medicine because they have no choice.

As for the jihad against alternative medicine, if it were to go ahead somehow, it would have to be very specific, targetted against a specific type of alternative medicine and not just attempting to group them all together, and also be straightforward enough that most people can understand. However, like you said there can be retaliation, and unless there is specific proof that something is going badly enough to seriously harm someone, there's no reason to do attack ads.

An alternative are ads promoting general physicians. I saw an ad on television promoting naturopaths. Why not ads promoting conventional medicine. The naturopath ads were bragging about 7 years of post-secondary education, as being able to be primary care providers which seemed disingenious to me. I am sure real doctors and conventional medicine can do much better. You guys set broken bones, pull bullets out of people's guts, and I'm pretty sure your academic credentials are far superior to anything the opposition can brag about. Conventional medicine also has insulin, tylenol, and things people take for granted all the time. I would say that any campaign to promote conventional medicine would have to promote it rather than attack alternative medicine, and have ads like the one I saw on television for naturopathy.

Brian

[Darth Wong]

One thing people are ignoring here is the fact that for many people, conventional medicine does jack shit to solve their problems, or may even exacerbate them. The gold standard for damaging conventional medicine is female hormone therapy and hysterectomies: medical "solutions" which are virtually handed out like candy bars even though they are extremely powerful and (in the case of hysterectomies) absurdly invasive procedures.

The problem is not that conventional medicine doesn't work; it generally does its job as advertised. But it simply isn't designed to deal with certain things, most notably long-term chronic conditions of ill health. Meet enough people with health problems and eventually you'll run into someone who has this story: "I felt horrible, and could barely get out of bed in the morning, and I kept throwing up, but the doctors did some blood tests and said that I'm fine." This is not an unusual story; is it any wonder that people eventually get frustrated?

Add to that the suspicion people have that the medical industry wants to addict you to pharmaceutical drugs rather than genuinely trying to make you healthier (quite frankly not an unfounded fear), and it's really no wonder that people get desperate and will try anything, even to the exclusion of what their doctor is recommending.

if there's a failure here, it's been the erosion of public faith in medicine over the last 20 years, and I personally think that the industry has no one to blame but itself, and particularly the drug companies.

[Zero]

I will better phrase that one better as
2. If someone is stupid enough to try it despite warnings, its natural selection in action - sit back and let them learn / suffer from their own stupidity.

Why is something being natural selection seen as having any reference to morality, or righteous action? I could say it's natural selection in action to let someone drown, too, but that doesn't mean I wouldn't be a complete prick for doing so. Natural selection is a process, not a moral guideline.

[mr friendly guy]

I saw a passing reference in another thread that you are a physician,

Just to clarify, I am a doctor, but not a physician. I know the terms get used interchangeably, but a physician is a medical specialty, ie they deserve the adjective specialist in describing their job.

and you probably know more about the subject matter than everybody on the board combined anyway.

Since alternative medicines wasn't a requirement of my course, I know about as much as I occasionally read in regards to them. The news about how the Lancet (a respected medical journal) advocates conventional medicine take a more active role in criticising homeopathy caught my attention.

What do you mean when you say "combating"? Do you mean some sort of ad campaign or organized movement to inform people about quacks?

I am thinking in terms of how much to combat it? For example

1) occasionally criticise in papers, on the news etc

or

2) fund an ad campaign

or

3) advocate that laws against fraud be used against such practitioners is they can't show their treatment does what its claimed.

Anyway, my opinion for what it's worth is live and let live, except in a situation where serious complications or death can arise. For example, homeopaths as long as they dillute their poisons and don't start feeding their crap to children, it is someone's choice to go see one. However for chiropractors, I seem to remember neck manipulations leading to lawsuits about strokes, so I would warn someone about that.

While I do find some alternative medicines somewhat interesting reading, the issue is also one of fraud and standards. For example a doctor who doesn't actively harm, but fails to use proper treatment can be sued, especially if the patient suffers negative consequences. Your proposal would hold alternative practitioners to a different standard - ie they cannot be held accountable for not using proper treatment, only accountable if they actively harm.

For fence-sitters (ones which help in certain situations) like massage therapy, I would tell them the specific situation that the treatment would work in. For example, for accupuncture, I would not summarily dismiss it, but recommend it only for things like muscle pain. Lastly I would suggest alternatives, because some people turn to alternative medicine because they have no choice.

To avoid lumping alternative medicines into the same category, I did specify early on - ones which have been shown to be definitely quackery. For example the theory behind homeopathy sounds dodgy in the extreme, and the fact clinical studies don't seem to support it only makes it look worse.

Things like acupuncture have some anecdotal evidence which to me warrants closer look at. I am not saying it works, but I think it is "worthy" of a clinical trial. In fact if any one wants to start a thread discussing it, I can share a bit of my knowledge on how it supposedly works - and no, its not because of the flow of chi.

As for the jihad against alternative medicine, if it were to go ahead somehow, it would have to be very specific, targetted against a specific type of alternative medicine and not just attempting to group them all together, and also be straightforward enough that most people can understand.

Well the Lancet is certainly advocating more criticism against homeopathy.

However, like you said there can be retaliation, and unless there is specific proof that something is going badly enough to seriously harm someone, there's no reason to do attack ads.

I think you are reversing the burden of proof here. Its up to alternative medicines to show that their treatment works (ie does as claimed). It may be harmless, but it doesn't do as advertised, its fraud. The question is, should conventional medicine get worked up enough over it to do something about it?

An alternative are ads promoting general physicians. I saw an ad on television promoting naturopaths. Why not ads promoting conventional medicine. The naturopath ads were bragging about 7 years of post-secondary education, as being able to be primary care providers which seemed disingenious to me. I am sure real doctors and conventional medicine can do much better. You guys set broken bones, pull bullets out of people's guts, and I'm pretty sure your academic credentials are far superior to anything the opposition can brag about. Conventional medicine also has insulin, tylenol, and things people take for granted all the time. I would say that any campaign to promote conventional medicine would have to promote it rather than attack alternative medicine, and have ads like the one I saw on television for naturopathy.

Brian

I work in the public health system, and I assume like Australia, Canada has "free" healthcare. I am paid by the government to take care of patients who get admitted under the team (currently that would be in the coronary care unit). I get paid regardless of whether we are overflowing or no one comes through (which never happens of course). While there certainly is a lot of people trying alternative medicines, when someone has a heart attack, they are not going to go to their naturopath. They come to the public or private hospitals.

I admit alternative medicines may take some business from say GPs, but from the public hospital system, I very much doubt it. The issue however isn't a matter of business or promoting conventional medicine, that's a red herring. My view on someone refusing treatment because they want to try quackery is no different than my view on JW refusing blood transfusion - I think you are silly, but I am not going to waste the effort trying to "force" you.

The issue is 1) if some medicines are clearly fraudulent (even if not directly harmful, although they can be indirectly harmful if someone chooses not to seek proper help) and 2) that such practitioners without regulation are held to a separate standard- see point 1).[/quote]

[mr friendly guy]

I will better phrase that one better as
2. If someone is stupid enough to try it despite warnings, its natural selection in action - sit back and let them learn / suffer from their own stupidity.

Why is something being natural selection seen as having any reference to morality, or righteous action? I could say it's natural selection in action to let someone drown, too, but that doesn't mean I wouldn't be a complete prick for doing so. Natural selection is a process, not a moral guideline.

Well I do have options 1 and 3) if you don't like option 2.

But I will play devil's advocate. As a general rule morality trumps natural selection when its a physical limitation, eg someone who cannot swim. I feel sympathetic if someone gets thrown off a boat and can't swim, and since I can, I will try to save them.

When the limitation is due to stupidity, the sympathy is significantly less. Unlike physical limitations, you have more control over stupidity (ie you can choose to learn and choose to think).

For example, this board discusses the Darwin Awards which are awared to people who prevent themselves from reproducing secondary to stupidity (usually by getting themselves killed). Among threads which have been started included a moron who refused to fasten his seatbelt because he perceived a right to refuse it - and died in a car crash because of it and a robber who tried to rob a gunstore full of customers, and was shot dead by the customers.

Some people who go for non clinical proven alternative medications aren't quite at the same end of the spectrum compared to the above examples. However there is an aspect of stupidity there (if we ignore those who go for fraudulent treatments because of desperation). For example - homeopathy where you dilute the chemical so much it does nothing, or naturopathy where something is "natural" its automatically better. If you have a modicrum of reasoning ability, such premises sound ridiculous. In that case, I could argue

1) you cannot force people to do something against their will

2) since 1) is true, it follows that you cannot save people from themselves if they do not want you to

3) after you have explain why some alternative medicines are quackery, you have done all you can and hence discharge whatever moral responsibility - to go further and to try forcing them will create an even greater moral problem

4) why bother any more

5) attribute the phenomena to stupidity and natural selection

[Pezzoni]

I don't think that the said quacks should be allowed to prey on the weak and vulnerable... People who may be so desperate for a 'cure' they'll try anything, eventually being conned out of the their money.
At the same time, those who don't wish to try 'real' medicine should be welcome to take whatever quackery they wish. When it doesn't help them, it's their fault.

Of course, the above should be limited to adults making their own decisions... Not the typical 'Jehovas Witness' medical scenario, where parents refuse proper medical treatment for their dieing children, as they consider it against their religion. (Although this is prevented in the UK generally, by the courts taking parentage of the said child).

[Guardsman Bass]

The problem is not that conventional medicine doesn't work; it generally does its job as advertised. But it simply isn't designed to deal with certain things, most notably long-term chronic conditions of ill health. Meet enough people with health problems and eventually you'll run into someone who has this story: "I felt horrible, and could barely get out of bed in the morning, and I kept throwing up, but the doctors did some blood tests and said that I'm fine." This is not an unusual story; is it any wonder that people eventually get frustrated?

In these kinds of cases, especially the psychosomatic style illnesses, the attractiveness of alternative medicine is increased because it, at least, seems to work if you believe it will.