The Freedom of Ignorance: Health Freedom, What is it and Do We Want it?
When policy around how herbal remedies, alternative medicines, supplements and all sorts of other practices outside the mainstream of medical practice is discussed the concept of “Health Freedom” inevitably comes up. It’s not always couched in that term but the idea is that people should be free to choose whatever method of healthcare that they wish.
Sounds good right? Who wants to impinge in someone’s freedom to make their own decisions? Isn’t that what living in a free country is all about? Personal autonomy, the right to take action unfettered by how someone else thinks I should run my life. That’s how I want to live, why should I want to take that away from others?
Well, I don’t. But the notion of freedom has always come with a caveat (several actually), that is – it is inherently restricted by ignorance. Is someone who is uninformed about the actual state of affairs truly free?
That’s what those who speak out about alternative medicine are actually trying to achieve. We aren’t attempting to “defend our turf” or “squelch the competition” we are attempting to inform the public about the true underpinnings of these therapies and point out they they are either unsupported by science or have in fact been disproved.
As has been noted before, a majority of New Zealanders are unaware that Homeopathic medicines do not contain any active ingredient and yet many people think they are scientifically proven.
Education was also the intent of the co-ordinated Sciblogs rebuttal to the poorly conceived and executed series on alternative therapies printed by the Herald earlier this year. (see here, here, here and here)
Policies that are aimed at restricting access to herbal or alternative medicine usually are doing so from the aspect of quality control. Does the remedy or practice have good evidence of efficacy, is it safe? These are the questions that we should be asking about every medical practice, not just those in the “alternative” (or complementary, or integrative, pick your marketing phrase of choice) camp.
Unfortunately is is not in the interests of those pushing alternative modalities to undergo strict evidence based testing so the issue is re-packaged from a quality control issue to a “freedom” issue.
Similar tactics are seen in arenas outside the medical realm. In biology the evolution vs creationism/intelligent design “debate” is framed as “Academic Freedom” as is the debate around climate change. This is not a coincidence. Whether or not these decisions are made consciously or not there has been convergence on the “Freedom” aspect of these cases for a reason, people respond to it. We are jealous of our freedom, and rightly so, freedom forms the basis of our society.
But as I alluded above, freedom is not an absolute and unalloyed good under all circumstances. It comes up against restrictions in all sorts of ways, some epistemological (as in the case of whether a choice is really free if the person is not aware of all the factors affecting that choice) and some are practical (as in should we allow freedom to include the freedom to sell harmful products?).
Conclusion
The natural/alternative remedies debate is not, at it’s heart, about freedom at all. Rather it is about education and quality control. We should subject all medical practices to the same rigorous examination regarding safety and efficacy. Long term “after market” monitoring should also factor into this equation to catch those practices that looked good in the necessarily limited testing that they are subjected to prior to being rolled out to the general public but may still have safety problems.
In this way we should be able to serve the public’s health interests and avoid false choices about freedom.
thing that gets me is the WILFUL ignorance – those who choose to be deceived and deluded by the woo. I have met plenty of them who are coherent, lucid, educated and still swear by arnica for everything.
For many of them it seems to me that they are using alternative treatments as some sort of political statement. They would be better off pulling on their birkenstocks, wearing a smileyface badge and shouting out that they are gonna stick it to the Man…
A couple of interesting points there, a distinction between people who are simply uninformed and will immediately see the craziness when it’s explained and those who either don’t want to know or know but rationalise the knowledge away. Two different groups who require different approaches, I’m hoping most are in the first group.
Second is the reason people use alternative medicine, often it is claimed that it is a dissatisfaction with mainstream medicine that turns people to the
dark sidealternatives, when motivations line up better with personal philosophy. In fact there is a survey done recently (I’ll have to look it up) that shows even those who use altmed are satisfied with regular medicine too. Conventional medicine and doctors didn’t drive them away.Thanks
Being a practitioner of alternative [I prefer "complementary"] medicine, mainly acupuncture, I am always interested to learn from the postings that challenge alternatives on the basis of poor science and weak support form well-designed studies. Problem is, many modalities are difficult to study using the gold standard of double blind, so we are left with, mostly, outcome compilations. This brings me to look at how the mind affects outcomes, for, even in traditional hard-core Western medicine, physicians will tell you that remedy is assisted, and even potentiated, by the patients’ belief in what they are doing. And let’s not ever forget the will to live [and heal]. I remember when my mother was in hospital with severe Staphlococcus aureus pneumonia. She was questioning her physician, and asked him, “Can this illness kill me?”, to which he replied, “Yes”, but that she had three factors working in her favor. The first- her desire to get well. Second, the love and support of all her loved ones present at the hospital [there were many]. Third, the best that he, the physician, and the hospital staff could bring to bear on curing her disease. And he said that he named these in order of importance from most to least. Interesting doctor…..
So, what are we to conclude from all this? I appreciate that there are posts encouraging freedom of choice, so what of education? I understand that in the UK, it used to be that any practitioner was required to post their credentials in their place of business, and that it was then up to the potential patient to do verification as to authenticity and legitimacy. And woe be to the practitioner who posted falsely. And one can certainly find flaws in this system. But what of freedom?
One of the US Founding Fathers, I think it was Thomas Jefferson, said that the price of freedom is eternal vigilance. He was speaking of the nation, but couldn’t this also apply to every aspect of our lives?
It’s useful to me for perspective to remember that medical mistakes, aka iatrogenic error, is one of the largest, if not the largest, causes of death in Western society.
I exhort all who come to me for help to pay attention- learn all that they can about any considered modality- then to move cautiously so as to make informed choices, and to seek practitioners who follow the maxim- First- Do No Harm.
I welcome hearing from any and all.
Proper education only makes sense. If people dont know what they can realistically expect, they are more likely to be dissatisfied…