Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

Once again, practitioners will use the report to help validate invalid treatments. And, once again, patients will be persuaded that it is worth spending their money and risking their health on bogus treatments. For example, those who have seen a preliminary version of the report state that the WHO views homeopathy as a valid form of treatment for diarrhoea. Globally, over a million children die each year of diarrhoeal diseases, and an increased use of homeopathy would only make the situation worse. India’s National Rural Health Mission is already showing signs of advocating homeopathy to treat diarrhoea, and the WHO report would only give credibility to this foolhardy policy.

The future of alternative medicine

The Scottish distiller Thomas Dewar once said: ‘Minds are like parachutes. They only function when open.’ On the other hand, the New York Times publisher Arthur Hays Sulzberger stated: ‘I believe in an open mind, but not so open that your brains fall out.’

Of course, Dewar and Sulzberger both had a point, and their views were combined in a lecture in Pasadena in 1987, when the great American physicist Carl Sagan explained how science should treat new ideas:

It seems to me what is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same time a great openness to new ideas. If you are only skeptical, then no new ideas make it through to you. You never learn anything new. You become a crotchety old person convinced that nonsense is ruling the world. (There is, of course, much data to support you.) On the other hand, if you are open to the point of gullibility and have not an ounce of skeptical sense in you, then you cannot distinguish useful ideas from worthless ones. If all ideas have equal validity then you are lost, because then it seems to me, no ideas have any validity at all.

Throughout this book we have tried to strike a balance by being open to all forms of alternative medicine and all their respective claims, while submitting each one to the ordeal of testing. In general, the key test has been the clinical trial. Pioneered 250 years ago by James Lind and then refined over the course of the next century by Alexander Hamilton, Pierre Louis and many others, the clinical trial remains a beautifully simple, yet powerful, mechanism for getting to the truth. Indeed, Pierre Louis’ description of a clinical trial still holds true today:

For example, in any particular epidemic, let us suppose five hundred of the sick, taken indiscriminately, are subjected to one kind of treatment, and five hundred others, taken in the same manner, are treated in a different mode; if the mortality is greater among the first than among the second, must we not conclude that the treatment was less appropriate, or less efficacious in the first class than in the second?

Having sought to be both open-minded and sceptical, and having relied on all the best available evidence, our broad conclusion is fairly straightforward. Most forms of alternative medicine for most conditions remain either unproven or are demonstrably ineffective, and several alternative therapies put patients at risk of harm.

There will always be new research that will add to our knowledge, and it is possible that alternative treatments that currently appear in effective might turn out to offer a significant benefit. However, while writing this book during the course of 2007, there have been major new studies that have only further undermined the credibility of alternative medicine. One of the most important was published in the British Medical Journal under the title ‘Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial’. The researchers gave advice and exercise to 352 patients, and then one-third received nothing else, one-third received real acupuncture, and one-third received sham acupuncture via the stage-dagger needles described in Chapter 2. The researchers concluded: ‘Our trial failed to show that acupuncture is a useful adjunct to a course of individualised, exercise based physiotherapy for older adults with knee osteoarthritis.’ This conclusion was reinforced by Eric Mannheimer’s analysis of all the latest data, also published in 2007. These results were a serious blow for acupuncturists, who have argued that acupuncture for knee osteoarthritis was their most effective intervention. This particular treatment was even singled out for a special mention when the Prince of Wales addressed the WHO in 2006. It now seems that the jewel in the acupuncturists’ crown is fake.