Complementary/Alternative Medicine: Engulfed by Postmodernism, Anti-Science and Regressive Thinking
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Complementary/alternative medicine: engulfed by postmodernism, anti-science and regressive thinking Complementary and alternative medicine political structures. 9 According to this line of set of assumptions, use different (CAM) has become an important topic for thought, fundamental philosophical issues theoretical explanations, embrace a public health. Its use is on the increase; in determine which therapy is effective or safe. different philosophy, pose different the US and Germany, for instance, about The ‘Western medical system’, is only one of questions and use different language … two-thirds of the general population now use several approaches, and not necessarily the than medicine’. 15 CAM. 1,2 Health authorities across the globe best. 10 In the past, it is argued, conventional now feel the need to deal with the medicine repeatedly got it wrong, so why The new ‘holistic paradigm’ includes implications of such widespread use. More should it be right today? 11 ‘Biomedically ‘concepts of psychosomatism, than half of all WHO member states now trained experts’, it is claimed, ‘ignore most of consciousness and energy’. 16 According to have a national office for CAM and 43% the aspects that advocates of alternative some, the meaning of illness and health is support an expert committee on the therapies draw on as evidence of therapeutic neglected by conventional medicine to its subject. 3 This high level of attention seems effectiveness’. 7 They are convinced that peril: ‘sometimes, illness is the patient’s best justified but must be guided by clear ‘there is no such a thing as The Evidence, just friend’. 17 The multidimensionality of life, and thinking. Worryingly this is often not the competing bodies of evidence’. 7 our existence means that the research tools case. In this article, I will attempt to clarify of science are too limited to generate the confusions that CAM is often plagued by. Double standards meaningful insights — ‘the round problems The scientific method is viewed as too of CAM’ do not fit ‘into the square holes of CONFUSIONS narrow to be able to capture CAM in all its the scientific method’. 18 The dilemma, some Postmodernism complexity. 8,12,11 ‘Scientifically constructed CAM enthusiasts insist, is ‘how to prove Post-modern ideas have infiltrated CAM. evidence for an alternative therapy’, CAM scientifically something which does not fit Science’s quest for truth is seen as a enthusiasts argue, ‘only works when the the framework of scientific belief’. 13 For those politically motivated ‘struggle for power’, in therapy has mutated into a medicalised who only have a hammer (conventional which the ‘societal approach is pitted version and divested itself of its alternative scientists) the world consists only of nails. 12 against reductionism’. 4,5 The claim is that philosophy’. 7 ‘The narrowness of … science Modern medicine is deemed to be in a crisis, ‘CAM poses huge challenges not only to the has become apparent, so full of fact and and only a shift of paradigms can save us dominance of biomedicine, but also to the empty of meaning’. 13 ‘Orthodox medicine from it. 12,11 fruits of dominance — status and power in should consider abandoning demands that Evidence-based medicine is seen as a decision making about health care and the CAM become evidence-based, at least as ‘fashion’ obsessed with linear thinking which livelihood of physicians’ 6 or that CAM poses ‘evidence’ is currently narrowly defined, but is ‘antithetical’ to CAM and ignores ‘the a ‘threat ... to the long-standing hegemony insist instead upon a more complete wisdom of tradition’. 4 ‘A full analysis presents of biomedicine in the West’. 7 In order to fend description and defence of the alternative a level of complexity that tends to overwhelm off this threat, conventional medicine is said epistemic methods and tools of these its methodology’. 17 Whenever conventional to ‘attack the medical competition, show no disciplines’. 14 Evidence-based medicine, it is clinical trials produce negative results intellectual tolerance, and only take those claimed, is inapplicable to CAM because it concepts such as: ‘quantum theory’, prisoners, who can be converted’. 4 does not necessarily represent the dominant ‘entanglement’, ‘chaos theory’, and ‘fuzzy or preferred logic of [CAM] practitioners’, 4 logic’ are quoted to imply that CAM works Anti-science and is viewed as ‘a new paradigm in after all. 7,19 If this fails, it is argued that Many enthusiasts of CAM are overtly anti- orthodox medicine’ representing ‘a ‘knowledge from randomised clinical trials scientific, believing that subjecting CAM to hegemonic cultural movement generated as would be of little use in therapeutic practice’. 4 scientific testing misses the point and fails to a continuation of the ascendency of medical account for its cultural diversity. Measuring dominance’. 4 Terminology Chinese philosophy with a ‘Western’ The CAM literature is rife with terminology yardstick, for instance, is seen as a travesty Paradigm shift such as vitalism, energy, balance, toxins and to pluralism. 8 Scientists, it is claimed, do not A shift to a new paradigm is therefore detoxification, and immune- recognise that their own way of reasoning is required: 11 boosting. 4,6,8,10,12,15,18,19 These words are usually not a value-free endeavour but culturally couched in pseudo-scientific language. 20 For constructed and deeply embedded in larger ‘... chiropractors begin with a different the lay person, such discussions seem to be 298 British Journal of General Practice, April 2009 Essay based on scientific facts providing easily primary care providers under the ‘new ‘Whenever a proponent of a understood and superficially plausible paradigm’ 15 are not a ‘conundrum’ but controversial empirical claim counters explanations for therapeutic approaches. Lay represent a concept the value of which can criticisms of the evidence by reference audiences are therefore misled to believe that be scientifically determined. Based on the to a ‘paradigm shift’, it is time to put on such terminology signifies good science. data available to date, it is impossible to one’s hip waders. To the extent that deny that the results are far from ‘paradigm’ just means a new theoretical Politics convincing. 28,29 Anatomy, physiology, and view, it prevails because of — not in Legislative efforts and tax payers’ money are pathology are not ‘Western medical spite of — sound evidence. The rise of currently directed towards regulating CAM systems’, they are generalisable truths that quantum mechanics is frequently professions. But regulation is not primarily apply to all humans. To call scientific referenced as the paradigmatic example an instrument for increasing the credibility of medicine ‘Western’ or ‘reductionist’ is of paradigm shift. But the discoverers of CAM providers, it must foremost ensure the discriminating and reminiscent of calling quantum mechanics did not have to safety of the public. Regulation of nonsense Einstein’s discoveries ‘Jewish physics’. 30 philosophically argue their opponents must result in nonsense. Public funds have Cancer patients may long for ‘practitioners into making a paradigm shift before been spent on publishing a UK patient with a different understanding of their quantum phenomena were accepted. guide 21 which avoids addressing efficacy disease and treatment, than those offered The proponents merely presented ever- and is instead a promotional booklet for within the conventional healthcare system’. 31 increasing amounts of solid evidence. unproven treatments. 22 A report This language does not render the nurturing To the extent that ‘paradigm shift’ is commissioned by the Prince of Wales to of false hopes in vulnerable patients less used to describe something about the influence UK health policy claims that huge unethical, and should not distract from the social and historical process of how amounts of money could be saved if the fact that cancer patients foremost want to be research is done, it has little legitimate NHS adopted CAM treatments routinely. 23 cured. A cure requires effective treatments role in discussions of evidential quality. The report was aimed at politicians, and not a ‘meaning’. 32 ‘Healing’ that fails to heal 32 Most other uses are so vague that no without expertise in health economics, most is dangerous. significant meaning can be attached’. 35 of its contents might appear unreasonable. 24 There is no alternative to the scientific method for evaluating the value of medical Specifically writing about CAM, Andrew CLARIFICATIONS interventions, even though some may think Vickers stated that: For over 15 years, I have struggled with this that ‘the science of biomedicine ... [is] level of confusion, tried to understand what perceived as old-fashioned and rejected in ‘... paradigms might well have a useful lies behind the misunderstandings and favour of the quantum and chaos theories of conceptual role in some fields of discussed the issues with advocates of modern physics’. 7 Advocating research to discourse; it has yet to be argued that CAM. Sadly it seems that the degree of investigate the ‘phenomenology of the lived this is the case in complementary confusion has not significantly decreased. body using more creative methodologies to medicine research … Reference to On the contrary, I fear that deal with processes, in both the researcher paradigms leads to crude misunderstandings are sometimes and the researched, such as intuition, generalisations rather than useful, deliberately perpetuated. somatic perception, bodily imagination and detailed analysis … The paradigm Whether homoeopathy (or any other CAM sensation’ does not mean anything. 33 Such moves from being an explanation for the modality) is effective cannot depend on what anthropological or sociological studies at nature of scientific change, to becoming concept of knowledge we happen to favour. best inform us about patients’ and the ‘bogeyman’: a packaging of Neither is a ‘quantum perspective’ 25 likely to therapists’ ‘beliefs about health, illness and nebulous fears and animosities into a generate a meaningful answer to this the body, and about the nature of the healing discrete entity which no-one can see question.