Archive for April, 2010

Friendly take on alt-med


The latest issue of Humanitie is now out, and with it the twin columns of the Friendly Humanist and the Not-Quite-So-Friendly Humanist.  Note to readers who have the magazine itself:  a slight editorial hiccup this issue has our columns switched – Mike’s article is attributed to me, and mine to him.  The following is my contribution.  You can read Mike’s here.

Having complementary and alternative medicine (“CAM”) as the topic of this column puts me in a dilemma.  How can I put a friendly spin on a collection of beliefs and practices that go against science and reason?  These are cornerstones of the humanist ethic.

Let’s take a very quick look at what we’re talking about.  First, the proposed mechanisms are ridiculous:  “like cures like”, chakras, chi, etc.  Second, the denigration of real medicine – of real science – that seems to inevitably accompany promotion of CAM is ignorant and dangerous.  It causes people to waste time on CAM treatments before seeking real medical advice, and makes room for even more dangerous nonsense, such as the deadly anti-vaccination paranoia.  Instead of being friendly, maybe I should be recommending that we ban all CAM practitioners from hawking their snake oil to a vulnerable public.

The only real advantage to most CAM treatments is that clients get very detailed and personal consultations.  If you’ve read about the placebo effect, you understand that our social mammal-brains are positively affected by that sort of one-on-one attention, whether or not it’s accompanied by real medicine.  It gives an air of gravitas to the water (or hand-waving or needles in the skin or whatever magical elixir is being peddled).  This encourages the brain to do its thing:  for example, reducing the sensation of pain, or soothing an inflammation.

And there lies something promising.  You see, these actual, real benefits of CAM have nothing to do with the magical beliefs of the practitioners (and clients).  In fact, even real doctors could harness this capacity for self-improvement.  If only they weren’t run ragged by overstretched health budgets, they might have time to give the same sort of deep, personal consultations.

So here’s what I’ve come up with:  the friendliest proposal I can honestly support.

Since alternatives to medicine act to erode public confidence in real science and medicine, and since this is already hurting the public health through (for example) the resurgence of vaccine-preventable diseases, let’s tax them.  The high tax on cigarettes helps pay for the damage they do to the public’s health.  Similarly, a hefty tax on CAM treatments could help pay for the damage they do to the public’s health.  We could use that money to train and hire more people to practice real medicine.

The more front-line medical staff we have, the more time each can dedicate to personalised consultations, maximising the placebo benefit of simply having the attention of an expert.  And because people would have more satisfying and effective interactions with real medicine, this would reinforce rather than erode people’s confidence in a scientific approach to knowledge and healing.

How about that!  I found something positive in that pool of intellectual chaff that is euphemistically called “complementary and alternative medicine”, and I’ve managed to lay out a plan for incorporating it into a real medicine.  All without asserting that CAM practitioners should all be tossed in the sea for polluting the arena of public discourse with misinformation and ignorance.  That was pretty friendly of me, don’t you think?