Alternative Medicine
A Site Map
of the Debate
| CUTTING EDGE | |
|
Alternative Medicine
A Site Map of the Debate | |
|
( |
|
About half of people in a typical family doctor's practice, to judge from a recent survey, are using some form of alternative medicine in addition to - or in exclusion of - what that doctor would recommend. About half of them aren't even telling their doctors about it. Meanwhile, there is precious - if any - solid evidence of effectiveness for the vast and diverse range of interventions that fall under the rubric of "alternative" or "complementary" or "unorthodox" medicine.
Why this should be the case is interesting, but in this debate we ask a narrower question. Is it even possible to establish effectiveness for any of these treatments according to the principles of evidence-based medicine, as generally accepted by the medical professions of the United States and Great Britain, the two home countries of the majority of BioMedNet's members?
There are suggestions that it should be possible. Both the worldwide Cochrane Collaboration, a network of biomedical researchers who prepare systematic reviews of medical studies, and the National Center for Complementary and Alternative Medicine, a division of the U.S. National Institutes of Health, have taken up the mantle of examining alternative medicine from a scientifically critical point of view. However, an editorial published in September 1998 in the New England Journal of Medicine observed that of 30 grants awarded by the NIH center five years earlier, "none was a controlled clinical trial that would allow any conclusions to be drawn about the efficacy of an alternative treatment."
"There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work," concluded NEJM editors Marcia Angell, and Jerome Kassirer in that editorial. "Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional medicine."
Our debate addresses the question that follows from that bold statement: Exactly which treatments should be tested, and how? A broadly diverse panel, representing advocates of alternative medicine, critics and (we hope) neutral parties, grappled with this and related questions over five days. Interestingly, news about HMS Beagle's online debate leaked out while the selected panel was deliberating. As a result, we received some unsolicited opinions, which we include here as a basis for continuing debate. If you also would like to respond, send us feedback.
Our SponsorThe Lindesmith Center is a policy research institute founded in 1994 that focuses on broadening the debate on drug policy and related issues. The center houses a library and information center; organizes seminars and conferences; acts as a link between scholars, government, and the media; directs a grants program in central and eastern Europe; and undertakes projects on special topics such as methadone policy reform and alternatives to drug testing in the workplace. The guiding principle of the center is harm reduction, an alternative approach to drug policy and treatment that focuses on minimizing the adverse effects of both drug use and drug prohibition. Particular attention is focused on analyzing the experiences of foreign countries in reducing drug-related harms.
Andrzej Krauze is an illustrator, poster maker, cartoonist, and painter who illustrates regularly for HMS Beagle, The Guardian, The Sunday Telegraph, Bookseller, and New Statesman.
