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Why do I care?

May 26, 2011

Why should anyone care about science-based anything? Why do I care? This is an important question to consider, in particular for those of us who are passionate about the subjects of science-based medicine, public health, pseudoscience, medical quackery and the like. I thought it was important for me to address up front as I begin my blogging journey. After all, does it really matter what quackery someone gets caught up in if it makes him or her feel better? Is it any of my business? Why should I care? What’s the harm? For a quick answer to that last question take a few minutes to peruse this website. Ultimately this is an issue that matters because people matter. People matter and many have been harmed and many more will be harmed in the future, as you already know if you clicked on the link above, by unscientific thinking about scientific issues, particularly when it comes to their health. This is why I believe this issue to be so important, it is at times a matter of life or death and even when it’s not, the stakes are frequently still very high.

The first question I am often asked by friends and family who wonder why this stuff is so important to me is … you guessed it…what’s the harm? I have already pointed to the link above which offers many examples of how people who put their trust in alternative practitioners, alternative medicine, and pseudoscience have been physically harmed, some even having lost their lives. To simplify the discussion we can separate this physical harm into two categories, direct harm done by unsafe, unproven medical treatments and indirect harm done when those convinced of the efficacy of unproven treatments ignore science-based treatments that actually carry benefit. This alone is cause for us to rage against the many forms of pseudoscience and quackery foisted on unsuspecting patients, often desperate for a cure after deciding that scientific medicine has failed them; however, if we focus only on physical harm and loss of life we would be missing much of the picture here. We must also consider other indirect harms such as the psychological harm inflicted on those offered miracle cures only to find out later that they have been sold the proverbial snake-oil. Add to that the friends and family left to deal with a lack of closure after a loved one’s final days, weeks, or months that could have provided that closure were spent under the misguided understanding that a particular brand of miracle cure was sure to take affect any day and restore him to perfect health. There are families torn apart by an ailing loved one’s decision to forgo science-based treatments for woo-based ones despite family members’ pleadings. There is the financial burden that is so often felt by those who utilize expensive complementary and alternative medicine (CAM) that can for some end up as unbearable as their physical burdens. The financial issue is an important one as it extends to the many more benign forms of CAM, pseudoscience, and quackery from plastic bracelets offering to improve ‘well-being’ to fad diets, to the supplement industry. People deserve to be informed and to the have the opportunity to make informed decisions when fraudsters attempt to separate them from their hard earned cash. Many are the ways in which those involved in CAM, and all manner of pseudoscience and quackery hurt the marks, I mean patients, they service. While the above is not an exhaustive list it seems quite clear that there are many answers to the question “what’s the harm?”.

Does it really matter what quackery someone gets caught up in as long as he or she feels better? This is another question I am often asked that at its most basic seems to be a reference, often unknowingly on the part of the question asker, to the placebo effect. There is a lot of interesting research and fascinating information to study when it comes to the placebo effect that is beyond the scope of this post. Suffice it to say at this point that, at the very least, any appeal to the placebo effect as a reason not to object to CAM ignores important ethical issues for doctors, and other health care professionals who have obligation not to lie to patients about treatments. Moreover, I find that many who ask this question oversimplify the placebo effect to some magical mind-body connection that allows one’s thoughts to physically heal the body, ignoring differences in the way the term is used from one situation to the next and assuming that feeling better is being better, an assumption that is far from the simple truth.

There are varying estimates about the use of CAM across, Canada, the United States, and the rest of the world. Changing definitions of what constitutes CAM (Does considering prayer in CAM use surveys really give us an accurate picture of patient use of CAM?) along with the agendas of those reporting such surveys make it difficult to be confident in attempts to pin down current CAM use to specific percentages of the population. That being said, it is clear that credulous mainstream media, and the explosion of the internet and the use of a Google university education by self-styled experts, among other factors are serving to misinform the public about the safety and efficacy of so-called complementary and alternative medicine (CAM) leading many people to pursue a host of treatments for which efficacy and safety are not well understood, or even worse, treatments that are known not to work, to be unsafe, or both. Regardless of your view on the frequency of CAM use I submit to you that one unnecessary death is too many.

As long as there are those looking to misinform the public and push unproven, and/or unsafe treatments on those who don’t know better someone needs to sound the alarm. Why shouldn’t I care? As stated in the introductory post of this blog, I believe this is an issue that should be of importance to those whose passion it is to pursue a career in medical research or in clinical medicine. It is never too early for me as an undergraduate to begin learning about the issues I may face as professional and I firmly believe that the issues of CAM, pseudoscience, and medical quackery is an important one. We may not all choose to pursue every area of interest with the same intensity but that doesn’t mean we should ignore them or pretend they are not there. I cannot speak for all undergraduate students but I know that the further I get in my education and the closer I get to the goal of medical school the more those I know expect me to be able to discuss issues of science and health with them. Of course, they know I am far from an expert and trust me, they know better than to mistake my ranting for professional advice, but they do expect that I will know more than they do. Given that issues of CAM and all manner of controversial forms of medical treatment, pseudoscience, and quackery are often the hot button topic of the day, I want to know what’s out there and at the very least where to direct those who have questions to find responsible, science-based, information to help them in making informed decisions.

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From → General, General CAM

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