What is the Harm of Alternative Medicine?

Yesterday fellow Sciblogger Grant posted about homeopathic medications in pharmacies and questioned the legitimacy of reputable organisations selling such patent snake oil. The comments to this entry reveal one of the most frustrating aspects of speaking out against unscientific medicine and can be summarised thusly: “I’m far too sophisticated to be taken in by this stuff myself but other people seem to like it and if it doesn’t work then what’s the harm?”.

This attitude is ever present and comes from a reasonable starting point i.e. everyone is entitled to their own opinion and it’s not my job to save them from themselves. I can totally get behind that, usually. When it comes to ineffective medications of the alternative variety however this impulse though understandable is misguided and I’d like to put down a few reasons why I think so, some are speculative but I think the possibility of harm is great enough that they deserve to be considered.

For a start there may well be direct harm caused by using alternative remedies. As there is little to no regulation of these medications then no proof of safety or efficacy is required for sale. Witness the Zicam debacle last year regarding a “homeopathic” cold medication.

Further more the possibility for indirect harm (as multiply alluded to by Grant) may be significant. In case your imagination is not up to the task I will outline a few ways this may be the case. For instance the underlying principles of something like homeopathy are no only unscientific they are in direct contradiction of the last 200 years of scientific understanding. If they are used as the basis of reasoning about health then the results can be more dire than someone getting a bad nights sleep (in the case of the homeopathic sleep aid Grant used as an example).

Use of these therapies for minor ailments by the “worried and wonky well” may increase the possibility they they will be used for more serious health issues where the results could be deadly.

Look no further than the position statement of the WHO regarding the use of homeopathy in the treatment of Malaria and AIDs (among other things). The consequences of such thinking could be incalculable in terms of human suffering and spread of disease. But what’s the harm, right?

Additionally it is one thing for adults to make an informed choice for themselves based on available evidence filter through their particular world view but what about when this choice id forced on their children? The recent case of parents being found guilty of manslaughter over giving homeopathic remedies to their sick daughter is a terrible reminder that sometimes it is innocent children that pay the price for people’s gullibility. But, you know, what’s the harm?

When ostensibly professional medical providers such as pharmacists sell demonstrably irrational treatments they lend credibility to them that the average person uses to base decisions on. I mean the wouldn’t sell it if it didn’t work, right?

So while I understand the commitment to individual autonomy and freedom of choice that leads to the “What’s the Harm?” question, I fail to see how this means that fraudulent therapies must be let off the hook simply because there is a demand for them.

This has been a more vitriolic post than I normally write but what’s the point of a blog if you can’t vent once in a while?

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  1. I have put together a short list of resources and examples to illustrate the potential harm of a wide variety of alternative medicine interventions. Such negative outcomes are not difficult to find,and while they are rare for most CAM practices, the benefits are often little to none, so even minimal risk is unjustifiable.

    http://www.skeptvet.com/index.php?p=1_21_What-s-The-Harm-

  2. Quite true, all medical practices have some inherent risk. We decide on appropriate treatments based on the risk assessment against the potential for benefit. When it comes to low probability treatments as promoted by CAM any risk, even indirect, isn’t justifiable.

    Awesome resource too! Thanks.

  3. http://coffeelovingskeptic.com/?p=711 – A bit of a beginner’s guide. It’s such a huge area of contention, especially trying to part facts from fiction.

    • Thanks for the, uh, advertising?
      Joking, networking and sharing resources is fine.
      Read your article, not bad. I did find the high praise of placebo slightly concerning, I think there are at least two entities referred to by the phrase “Placebo Effect”. One is simply the catch-all of difference between improvement in studies between the starting condition and end point for the placebo group. This includes poor study design, statistical effects, blinding issues, regression to the mean, reporting bias etc.
      Then there is the physiologic effect that people assume is happening due to this difference, this part I find troublesome. There has been a big push lately to recognise the placebo effect as a valid component of objective medicine. So much so that even skeptics are buying the hype. I have to assume you’ve read this article at Science Based Medicine but I’ll put it here for readers.

      The coverage of Homeopathy is kind of incomplete by just stating there’s nothing in it. Medicines classified as Homeopathic merely have to consist of ingredients found in the Homeopathic Pharmacopoeia. The level of dilution is not (necessarily) a restriction, the comment by Peter Harrison goes some way toward addressing this but only covers accidental contamination. Low dilutions used as a purposeful part of manufacture should also be taken into account (ie the Zicam example above).

      Other than that, good standard arguments there. Really there isn’t much new ground to be covered so that’s no criticism. Keep it up, certainly there is a need for good writing out there and I’m only occasionally up to the task.

      • Here’s a recent post by Dr Steven Novella that touches on these points again.

        http://theness.com/neurologicablog/index.php/well-it-worked-for-me/

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