U.S.A. The development of Western medicine has improved and lengthened lives all over the world. However, not everyone believes in vaccines and antibiotics. Instead, they turn to complementary and alternative medicine (CAM) for their cures, despite the fact that scientists continually show that these methods are not as effective, -and sometimes not at all effective,- compared to Western medications.
The result is a growing anti-vaccination movement that destroys herd immunity, which normally works to protect those who cannot be vaccinated, including the elderly or other immunocompromised people. Therefore, it is important for everyone who is able to be vaccinated.
Surgical oncologist and science writer Dr. David Gorski, though he is an outspoken critic of CAM, uses peer-reviewed research to logically explain, in a manner a general audience can understand and enjoy, why a particular CAM claim is wrong. Here, he gives us an overview of what CAM is, where it came from and in contrast, what science-based medicine is. If interested, you can read more on his blog here.
Many of your articles are written in opposition to complementary and alternative medicine (CAM). First off, what exactly does this term refer to?
NCCAM (the National Center for Complementary and Alternative Medicine) defines CAM as “using a non-mainstream approach together with conventional medicine.” But what does “non-mainstream” mean? To me it means unscientific and unproven. As the cliché goes, by definition alternative medicine is medicine that has either not been shown to work or shown not to work. CAM involves combining alternative medicine with “mainstream” science-based medicine. I like to refer to this as “integrating” pseudoscience and quackery with science-based medicine, because it’s true.
How, if at all, has this type of medicine played into the anti-vaccination movement?
Absolutely. The vast majority of alternative medicine ranges from mildly to rabidly antivaccine.
What caused this movement and have there been repercussions?
Many of the arguments of today’s antivaccine movement are very similar to the arguments used 150 years ago: “toxins” in the vaccines, unknown compounds, fear of contamination, and the like. Today, there is the additional trumped up fear that vaccines somehow cause autism, even though they don’t.
Many discussions of alternative medicine reference the fact that it is “natural” and relies on methods used throughout history. Is this true; how did the initial ideas about alternative medicine originate?
This is called an appeal to antiquity, the argument that just because a treatment is old there must be something to it; it must work. It’s such a common argument that skeptics consider it a fallacy, at least in science and medicine. In any case, most of the ideas about alternative medicine have their roots in prescientific ideas, such as vitalism (the idea of a “life force”) and other forms of magical thinking. Alternative medicine also flourishes because humans are pattern-forming animals. We confuse correlation with causation all the time, and are unaware of placebo effects, which leads us to conclude that various remedies work when they don’t.
Overall, is a belief or use of CAM dangerous or harmless to society? Does it have an effect on ongoing medical or scientific research?
It is not without harms. It harms patients who use it instead of effective therapies. It also wastes the money of patients who use it with effective therapies, and it siphons dollars from legitimate scientific research.
In contrast to CAM, what is science-based medicine?
Science-based medicine is evidence-based medicine that takes science into account. The problem with EBM is that it places the randomized clinical trial above all other forms of evidence. This is appropriate when the therapies being tested have some plausibility, but when the therapies being tested are scientifically highly implausible (like acupuncture) or impossible (homeopathy), then all clinical trials pick up is noise and bias, which is why you can always find a “positive” trials of homeopathy. However, for something like homeopathy to work, several basic tenets of chemistry and physics that rest on very solid foundations of theory and evidence would have to be not just wrong, but spectacularly wrong. This is possible, but highly unlikely. For such tenets to be shown to be wrong would require a body of evidence of at least the same quality and quantity as the body of evidence that supports them. Clinical trials alone are not enough to do that, unless they reliably show “miraculous results,” such as curing stage IV pancreatic cancer. Even in such a case, the results would be enough to make us question whether our understanding of such tenets is complete, not to overturn them.
Dr. David Gorski is the Medical Director of the Alexander J. Walt Comprehensive Breast Center at the Barbara Ann Karmanos Cancer Institute in Detroit and Associate Professor of Surgery at the Wayne State University School of Medicine.