Alternative Medicine: a Critical Review (2000)
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ALTERNATIVE MEDICINE: A CRITICAL REVIEW ' William T. Jarvis, Ph.D. Professor of Public Health & Preventive Medicine Loma Linda University Loma Linda, CA 92350 [email protected] All Rights Reserved, 2000 ABOlITPROFESSORWILLIAMJARVIS Degrees. Bachelor of Science, University of Minnesota-Duluth 1961. Majors: Health & Physical Education; Social Studies; Minor: Health Education. Master of Arts, Kent State University, 1968. Major: Health & Physical Education; minor: Sociology. Doctor of Philosophy, University of Oregon, Eugene, 1973. Major: Health Education; cognate: Sociology. HeallhPromotion Specialist. Taught school and community-based programs in physical fitness and healthful lifestyles. Personally, has run nearly 60,000miles since beginningin 1965, and is an avid tennis player. Enjoys a seasonal residence in an alpine region of British Columbia where he engages in winter sports and outdoor activities. ConsumerHealth Educator. &amines questionable health practices, and the products and services that support them. Compares claims with available evidence of safety and efficacy and issues buyer beware messages when appropriate. In addition to specific information on controversial issues, the consumer health field includes consumer protection law, regulatory policies, marketing strategies, and human vulnerability. Professor Jarvis employs an epidemiological model to define, map, and analyze questionable health behavior and the public health problems of health misinformation, fraud, and quackery. ResearchMethodologist. Teaches epidemiological and biomedical research methods. Has provided a laboratorywhere proponents of unusual diagnostic and/or treatment methods may explain their ideas and demonstrate their practices before students who are challenged to design studies that would test the procedures in question. Believes that most proponents of questionable healthcare have become convinced of the value of their practices because of personal experiences in settings where they have failed to apply proper controls for the clinical illusions that can fool competent, honest, and well-meaning healthcare. Encourages the open-mindedness that is essential for scientific progress, but decries empty•mindedness--ie, the failure to have learned fromstudying the pitfalls that have befuddled clinicians and patients in the past. Teaches that no profession or culture--east or west--owns scientific methodology which consists of valid and reliable ways of te�ting ideas in the natural world; these yield intellectual productswhich become the beliefs of science; beliefs open to challenge, but which ..stand until new evidence based upon better methodology is forthcoming. HeallhPhilosopher. Examines ancient cosmologies, ethnic and religion-based belief systems, and ideas that underlie behaviors that have health outcomes. Believes that diverse cultural beliefsystems are admirable fortheir sincere attempts to make sense of reality and mankind's place in the scheme of things, but that such systems were limited by prescientific notions about cause and effect and crude technology. Knowledge is progressive and change inevitable, but human nature has remained relatively unchanged. Present Pooition, Membershipsand Consultant Pooitioos(Partial listing) 1. Professor of Public Health & Preventive Medicine, Loma Linda University School of Medicine; Professor of Health Promotion & Education, LLU School of Public Health; secondary appointment, LLU School of Dentistry. 2. Co-founder, past president, and member of Board of Directors of the National Council Against Health Fraud, Inc., a nonprofit, voluntary health agency which combats health misinformation, fraud and quackery. 3. Member,Subcommitt ee on Alternative& ComplementaryM ethodsof CancerManagement, American Cancer Society. 1986-98; advisor 1998 to the present. 4. Member of California Attorney General's Task Force on Health Fraud. Aids in the reporting, investigation, and prosecution of consumer protection law violators in California. 5. Board of Advisors, American Council on Science & Health which promotes balanced evaluations of the impact of science and technology upon the environment and human health. 6. Editorial Staffof Nutrition Fo1wn, a timely publication dealing with controversial nutrition topics. 7. Co-chairman, Subcommittee on Paranormal Health Claims of the Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP), which examines faith healing, psychic surgery, alleged healing miracles, etc. 8. Consultant to the Council on Scientific Affairs, American Dental Association for 1984, 1995, 1996, 1997, and 1998. 9. Consultant to the National Associationfor Chiropractic Medicine, an organization of reform-minded practitioners who rejectunscientific chiropractic theories, restrict their practices to rational treatment modalities for neuro-musculoskeletal conditions, and do not believe chiropractic to be an alternative "system" to medicine. 10. Honorary member of board of directors, Children's Health Is a Legal Duty (CHILD). Opposes laws that exempt parents who fail to provide medical care to their children from prosecution on the basis of religious belief. 11. Member, Council for Scientific Medicine, and contributing editor to Tiie Scientific Review ofAlternative Medicine, a publication dedicated to the scientific, rational evaluation of unconventional medical claims. Publications and Presentations ** More than 125 publications dealing with consumer health issues including the: - American Medical Association's Reader's Guide to ''Aitemative" Health Methods (AMA, 1993); - trade book The Health Robbers (Prometheus Books, 1993); . college textbook ConsumerHealth: A Guide to Intelligent Decisions, 6th Edition (Brown & Benchmark, 1997); _ American Dietetic Association's 1995 position paper on nutrition misinformation (1 Am Diet Assoc, 1995:95:705-7; - editor of the NCAHFNewsletter from 1978 through 1998. ** Nearly 300 presentations before professional gatherings at the state, regional, national and international levels on topics such as nutrition-related quackery, chiropractic, cancer quackery, alternative/complementary medicine, etc. Opinions expressed do ,wt necessarily reflect theJXJSitions of any organizaJion wiJh which he is asscxiaJed. ALTERNATIVE MEDICINE: A Critical Review A critical examination of alternative medicine approaches, including chiropractic and "paranormal-based" health treatments. Conflicts between alternative therapies and standard medicine, as well as patient rights and reliable sources of health information are emphasized. LEARNING OBJECTIVES 1. Define key terms used in reference to alternative medicine. Quackery allopathy Standard medicine vitalism Traditional medicine animism Eastern vs Western science / medicine monism Alternative medicine Complementary medicine Integrative medicine 2. Explain how quackery became "politically correct" in the 1990s. 1970s: Extent of questionable health behavior by American adults. 1980s: Congressional studies that identifiedquackery as the number one problem harmful to elderly consumers. Extent of questionable health behavior 1990s: American flirtation with quackery seen as marketing opportunity rather than social problem. Three forces driving the alternative medicine movement: economic; personal experience; ideologic 3. Describe historical facts (founder or foundation thereof, time and point of origin), theories, and practices of a variety of alternative and complementary health care systems. (Goal: to match origins, theories, and practices) Anthroposophical medicine "healing crisis" Ayuvedic medicine "detoxification" Chiropractic doctrine of correspondences Homeopathy Naturopathy Traditional Chinese Medicine 4. Describe important concepts from the psychology of deception. The physiology of deception The purpose of deception Two basic types of deception Different Kinds of Quacks Different Kinds of Users 5. Describe characteristic thinking patterns that have been observed in alternative practitioners. 6. Explain why alternative practitioners succeed despite the questionable nature of their procedures. 7. Point out how patients can be systematically deceived by dubious practitioners. Staging Taking control of the situation The invented disease The "yet" disease "What's better" How to avoid blame One-sided coin trick Patient subversion & recruitment Myths and wisecracks 8. Identify important cautions patients of alternative practitioners should understand. At your own risk Alternative providers not held to rational medical standards of conduct Compensation may be reduced Dangerous notions Financial exploitation ALTERNATIVEMEDICINE; A CriJicalReview, William T. Jmis, PhD, All Rights Reserved, March, 2000. 1 GLOSSARY Terms that describe the actions and behaviors associated with quackery. Allopathy 1 Therapy with remedies that produce effects differing from those of the disease treated. Compare homeopathy.1 Rootedin ancient theorythat hypothesized four humors(black bile, yellow bile, blood, phlegm), fourconditions (hot, cold, wet, dry) and balancing by "opposites"; eg, fever (hot) due to excess blood,therefore, cool by blood-letting. Coined by homeopathy inventor Hahnemann to describe medical practices of his day (c. 1810). 2 A system of medical practice making use of all measures proved of value in the treatment of disease. Alternative A propositionor situation offering a choice between two or more things only one of which may be chosen. Alternative medicine Any medical practice or intervention that (a) Jacks sufficient documentation