The Threat of Pseudoscience to National Healthcare
By: Thomas Liang
Introduction
Currently, there are still forms of pseudoscience that exist in modern medicine. In particular, there is an ongoing debate of whether alternative medicine should be implemented into the national healthcare system. Thus, there are three main reasons why alternative medicine should not be implemented in national healthcare. First, it is not adequately supported by strong scientific evidence; second, almost all medical professionals are trained in allopathic medicine, and are therefore unfamiliar with alternative methods; finally, patients have autonomy and reserve the right to seek additional treatments independently.
Standard medicine, formally known as allopathic medicine, refers to the Western medicine that we are familiar with in our modern lives. Alternative and complementary medicine (CAM), according to the American Cancer Society, are products, practices, and treatments that deviate from the scope of standard medicine (2021). Furthermore, alternative medicine aims to replace standard medical care, whereas complementary therapies (hence the name) are applied in conjunction with conventional medical treatments. Examples of popular CAM treatments include homeopathy, acupuncture, dietary supplements, and faith healing (National Cancer Institute 2021).
The public consensus around CAM is somewhat divided. However, unlike allopathic medicine, alternative and complementary treatments often lack the scientific basis and evidence to support their claims. Not only are the treatments ineffective, but they may also negatively interfere with normal medical treatment. On the other hand, some complementary methods have been studied and deemed effective in certain instances. Overall, CAM may provide some new insights to the medical community, but for the sake of patient safety, it is imperative that all forms of medicine must be thoroughly tested, rigorously analyzed, and concur with the current literature.
Lack of Scientific Evidence
CAM treatments are often rejected by the scientific community due to its lack of scientific and empirical evidence. Conventional medicines, in contrast, undergo intensive research with multiple inspections and carefully designed trials. All allopathic medicines demonstrate their efficacy through “double-blind randomized controlled trials,” before they are federally approved and released to the public (Tabish 2008). CAM remedies, on the other hand, do not experience such a rigorous regulation process, and thus may pose unknown dangers and potential benefits. However, as the number of CAM participants increases over time (Ventola 2010), more research has been conducted surrounding the potential risks and benefits of CAM. One particular study from Jacobsson et al. (2009) found that CAM substances were associated with a variety of adverse reactions.” Eleven of which resulted in a fatal outcome (e.g. death, brain trauma). While other studies have suggested some surprising benefits of CAM, more research is needed to fully understand the field.
CAM critics also argue that it is pointless to classify medicines as conventional and alternative, claiming that there are only two types of medicine - treatments that work and treatments that do not (Tabish 2008). Moreover, all medicines must be “scientifically proven, evidence-based medicine supported by solid data or unproven medicine” (Tabish 2008). CAM therapies may indeed have some unforeseen benefits, but until they too are held to the “strict standards of the scientific method,” they certainly shall not be considered as part of mainstream medicine.
Discrepancies in Medical Training
The large majority of medical professionals are trained in allopathic medicine, and are therefore quite unfamiliar with CAM. Due to the largely unscientific nature of CAM, many physicians, in particular, have voiced their objections. A survey study revealed that the majority of physicians (61%)
discouraged CAM therapies due to their lack of knowledge “about the safety or efficacy of CAM treatments” (Milden and Stokols 2010). Around 81% of respondents also vouched for more CAM education, while preferring to stick solely with conventional medical treatments for the time being. Although most physicians expressed a general openness towards CAM, the implementation of such practices are primarily challenged by the respondents’ familiarity with CAM treatments and their “therapeutic validity”, as well as their institutional concerns about non-standard medical treatments (Milden & Stokols 2010). Another study from Patel et al. confirmed these findings: Most physicians were in favour of increasing their knowledge of CAM, but were quite unaware of available evidence-based resources on CAM (2017).
This lack of apprehension and dubious attitude towards CAM is not limited to physicians, but reflected across other medical professions as well, such as nurses. Chang and Chang (2015) found that most nurses (66.4%) had positive attitudes towards CAM, but 77.4% did not have a strong understanding of the associated risks and benefits. Furthermore, nearly half of the respondents reported feeling uncomfortable when discussing CAM treatments with their patients (Chang & Chang 2015). As a result, the researchers stated that this lack of knowledge explained why nurses are unable to effectively communicate the validity of CAM to their patients.
Overall, when comparing the perspectives of nurses and physicians on CAM, there is an optimistic outlook, but institutional concerns and lack of familiarity strongly discourage the implementation of CAM practices into national healthcare.
Patient Autonomy
Patient autonomy usually refers to the “principle of respect” that allows patients to make their own decisions about which healthcare treatments they would and would not like to receive (Entwistle et al. 2010). This allows patients to exercise freedom and choice in regards to how they would like to be
medically treated. Therefore, in terms of CAM, patients should absolutely reserve the right to seek out additional, non-conventional medicines as they see fit. However, these external treatments will not be encompassed as part of the national healthcare system for safety concerns. Tabish (2008) agrees that patients should be able to choose whatever kind of healthcare they want, but must understand the safety and efficacy of whatever method they choose. In addition, CAM products are often easier to find and access compared to conventional medicines. Dietary supplements, for example, are commonly found in pharmacies and drug stores. Services, such as acupuncture, chiropractic, and faith healing, can be easily found at individual clinics. There are also many CAM practitioners who hold an independent practice and specialize in homeopathy, naturopathy, traditional Chinese, or Ayurvedic medicine (Ventola 2010). Despite the increased use of CAM, the current literature ultimately demonstrates that there is no motive to implement it into standardized healthcare, as most participants of CAM exercise their patient autonomy and explore these alternative treatments independently anyway.
Counter-arguments
The growing usage of CAM therapies have encouraged scientists and researchers to further investigate whether alternative and complementary medicines truly provide any possible benefits.
For context, CAM proponents claim that alternative and complementary therapies have significant advantages that are absent in conventional medicine. The basis of CAM is built on holistic care, viewing and treating the entire body as one system (Tabish 2008); in contrast, Western medicine typically specializes the body into its organ systems, treating each of them individually. In addition, CAM greatly emphasizes a “natural” and “safe” approach to medication, which is appealing to many patients (Ventola 2010).
When used in conjunction with allopathic treatments, however, some complementary medicine practices have proven to benefit certain patients (American Cancer Society 2021): Acupuncture and
massage therapy may alleviate mild pain and nausea as well as decrease levels of stress and anxiety. Prayer and practicing spirituality may help patients cope with emotional turmoil from cancer, while yoga and tai chi have been shown to improve general strength and coordination. Similarly, a study from Oh et al. (2010) explored the use and perceived benefits of CAM treatments in Australian cancer patients: they found that 90% of surveyed participants reported benefit from their CAM treatments, whereas 8% of CAM users felt no benefit and 2% were unsure. The three most commonly reported perceived benefits were an improved quality of life, improved immune function, and reduced symptoms and side effects, respectively (Oh et al. 2010).
In response to these popular counter-arguments, it is important to understand and analyze the trends exhibited by CAM supporters. First, the studies who have illustrated the potential benefits of CAM are patient survey-based in nature. This means that the “benefits” may not actually be scientifically sound, but are rather self-perceived benefits reported by CAM users. Thus, this is a common case of the placebo effect in action (Tabish 2008) as many of these perceived benefits have minimal documented scientific reasoning behind it.
Next, it is imperative to realize that “natural” remedies are not necessarily safe; likewise, “unnatural” medicines are not always dangerous. One of the most compelling examples of an “unnatural” drug is the vaccine. In short, vaccines, when used against infectious diseases, are composed of parts of a certain inactivated virus, bacteria, and genetic code. This sophisticated action of removing, decoding, and manipulating genetic information is certainly not a practice found in Mother Nature, yet vaccines are one of humanity’s most powerful weapons against disease. In fact, Dr. Edward Jenner, in 1716, created the first smallpox vaccine by inoculating a young boy with cowpox disease, a relatively harmless virus to humans. A few days later, Dr. Jenner injected the boy with smallpox, but no disease ever developed, demonstrating the effectiveness of the vaccine.
In summary, although certain CAM treatments have valid benefits, sufficient evidence and meticulous examination is crucial to distinguish between truth and falsehood.
Conclusion
The scientific method is one of the most powerful tools that humanity has at its disposal to truly understand how our world works. It becomes even more useful when we apply it to fields that affect our health and wellbeing, especially medicine. As a result, pseudoscience and misinformation threaten the dignity of the scientific method, and undermine our fundamental values of reason, experiment, and analysis.
One of the most relevant applications of this theme is the use of alternative and complementary medicines in healthcare. As such, CAM treatments should not be implemented into the national healthcare system due to therapeutic uncertainty and risk as well as severe unfamiliarity among medical professionals. Patients, however, shall reserve their right to exercise autonomy and choose which healthcare interventions they’d like to receive. Finally, the identification of pseudoscience is important, especially in the field of healthcare, because it directly affects the wellbeing of all patients. To ensure the safety of everyone, the scientific community must enforce the rigorous standards of the scientific method upon all forms of medicine - conventional or alternative. Further research must be conducted towards CAM to fully leverage its potential benefits while remaining vigilant of any adverse side effects.
Works Cited
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