I recently had a conversation with friends about the role of placebo effect in alternative medical “therapies” such as acupuncture, Reiki And homeopathy. My friends readily acknowledged that such therapies had no scientific basis, but they believed they had a role to play in modern medicine – precisely because of the placebo effect.
After all, my friends said, if you feel better after, say, an acupuncture or Reiki session or after taking a homeopathic “remedy” for a cold, who cares except that placebo effect at work?
And to some extent, I agree. If you want to waste your money and time on treatments that are really nothing more than “sugar pills” and magical thinking – and you are fully aware that that’s all they are – then sure, go ahead and do it.
But of course, it’s not that simple. Because alternative therapies are not without danger.
Certain alternative medicines (yes, like conventional medicines) can lead to dangerous side effects. Such therapies may also prevent people from obtaining an accurate diagnosis and/or treatment for a medical condition requiring evidence-based care.
Avoiding hard truths
And this can be a very serious matter, as clearly shown an article on this subject which was published online last week in Wired by Alan Levinovitzassistant professor of philosophy and religion at James Madison University and author of “The Gluten Lie: And Other Myths About What You Eat.” »
Levinovitz writes:
When faced with the possibility of a troubling diagnosis, people often prefer to avoid the hard truths. (Yale University neurologist Dr. Steven) Novella tells the heartbreaking story of one of his patients, suffering from ALS. After the first diagnosis, the man left the office, unable to come to terms with the idea of suffering from an incurable degenerative disease, likely to kill him within five years. He chose instead to consult a naturopath, who taught him redeeming news: conventional and narrow-minded medicine had misdiagnosed him. It wasn’t ALS, the naturopath explained, but rather chronic Lyme disease, which could be treated with holistic, all-natural supplements.
Nearly a year later, seriously degenerated, the man was back in Novella’s office. He had wasted countless hours and thousands of dollars on false hope. Now he was ready to listen, but with much less time to prepare for the reality of what awaited him and a spirit broken by disappointment. Research suggests that this is not just an anecdote. Studies outside Norway, JapanAnd Korea reported higher mortality rates and lower quality of life for cancer patients following complementary and alternative medicines.
(A disturbing variation on this story occurs when Homeopaths Without Borders heads to underdeveloped countries after natural disasters (like the 2010 Haiti earthquake) to distribute their “treatments” to unsuspecting people – people who may not then realize that they must seek conventional treatment for their injuries or injuries. diseases.)
An ethical dilemma
As Novella explains to Levinovitz, the recent upsurge in “integrative” medicine — the addition of alternative medicine to conventional medical practices — presents an ethical dilemma for doctors.
“We decided in the medical community that it was misleading to prescribe placebos,” Novella says. “So why would it be acceptable to send someone to a homeopath who prescribes them sugar pills?”
Another “serious negative effect” of alternative treatments, he adds, is that they change patients’ perceptions of traditional doctors.
“The patient, who does not correctly interpret the placebo effect, will be convinced that he feels better because the principles of acupuncture are true,” explains Novella. “So when they get cancer, maybe that’s who they’ll turn to first.”
Traditional medicine
There are, of course, many reasons why alternative medicine stubbornly persists despite its quackery. This is partly due to marketing (alternative medicine, like conventional medicine, is a multibillion-dollar-a-year industry – often involving the same large companies) and partly to the public’s lack of scientific knowledge, including how to to interpret scientific evidence. .
But traditional medicine is also to blame, as Levinovitz’s article makes clear:
Novella readily acknowledges the flaws in our current healthcare system. The government doesn’t fund enough research, meaning companies have a disproportionate influence on the development of new drugs. Overworked doctors don’t have enough time with their patients, forcing them to make difficult diagnoses without taking enough time to answer questions and comfort them. Physicians, especially surgeons, often have an unnecessarily gruff and dismissive bedside manner. Reimbursement tends to reward actions. The list of faults he mentions is endless.
But Novella says recognizing the flaws in our health care system doesn’t mean abandoning rigorous standards in medicine.
Novella is particularly troubled by the fact that a degree from a naturopathic school – where there is no agreed standard of care — counts toward board certification in integrative medicine. As he points out, naturopaths, like the one who misdiagnosed his patient’s ALS as chronic Lyme disease, adopt homeopathysometimes like a cure for autism. They are also open to chelation treatment And fear of vaccines. “We need to make a lot of changes,” he admits. “But as Paul Krugman says, when the public believes in magic, it’s spring for charlatans.”
You can read Levinovitz’s article on the Wired website.
