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Questionable Gate-keeping: Scientific Evidence for Complementary and Alternative Medicines (CAM): Response to Malcolm Parker

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Abstract

The more popular complementary and alternative medicine (CAM) has become, the more often it is demanded that the integration of CAM should be limited to those approaches that are scientifically proven to be effective. This paper argues that this demand is ethically and philosophically questionable. The clinical legitimacy being gained by CAM and its increasing informal integration should instead caution against upholding the biomedical framework and evidence-based medicine as conditions of acceptance. Patients’ positive experiences with CAM deserve a truly scientific exploration of non-biomedical conceptualizations of health and illness. It is also problematic to request scientific evidence when there is proven resistance against CAM in research institutions, under-funding and a lack of suitable research methodologies. This is even more so, when much conventional medicine is not practiced with the same level of evidence as demanded from CAM.

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References

  1. Silenzio, V. M. B. (2002). What is the role of complementary and alternative medicine in public health? American Journal of Public Health, 92, 1562–1564.

    Article  PubMed  Google Scholar 

  2. Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S., Van Rompay, M., et al. (1998). Trends in alternative medicine use in the United States, 1990–1997. Results of a follow-up national survey. Journal of the American Medical Association, 280, 1569–1575.

    Article  PubMed  CAS  Google Scholar 

  3. World Health Organization. (2002). WHO traditional medicines strategy 2002–2005. Geneva: World Health Organization.

    Google Scholar 

  4. Snyderman, R., & Weil, A. T. (2002). Integrative medicine: Bringing medicine back to its roots. Archives of Internal Medicine, 162, 395–397.

    Article  PubMed  Google Scholar 

  5. Callahan, D. (2002). Introduction. In D. Callahan (Ed.), The role of complementary and alternative medicine. Accommodating pluralism (p. vii–x). Washington DC: Georgetown University Press.

    Google Scholar 

  6. Angell, M., & Kassirer, J. P. (1998). Alternative medicine – The risks of untested and unregulated remedies. The New England Journal of Medicine, 339, 839–841.

    Article  PubMed  CAS  Google Scholar 

  7. Fontanarosa, P. B., & Lundberg, G. D. (1998) Alternative medicine meets science. Journal of the American Medical Association, 280, 1618–1619.

    Article  PubMed  CAS  Google Scholar 

  8. Ernst, E. (1996). The ethics of complementary medicine. Journal of Medical Ethics, 22, 197–198.

    PubMed  CAS  Google Scholar 

  9. Komesaroff, P. A.(1998). Use of complementary medicines: Scientific and ethical issues. Medical Journal of Australia, 169, 180–181.

    PubMed  CAS  Google Scholar 

  10. Gruner, J. (2000). Complementary medicine, evidence based medicine and informed consent. Monash Bioethics Review, 19, 13–27.

    Google Scholar 

  11. Ernst, E., & Cohen, M. H.(2001). Informed consent in complementary and alternative medicine. Archives of Internal Medicine, 161, 2288–2293.

    Article  PubMed  CAS  Google Scholar 

  12. Kopelman, L. M. (2002) The role of science in assessing conventional, complementary, and alternative medicines. In D. Callaghan (Ed.), The role of complementary and alternative medicine. Accommodating pluralism (p. 36–53). Washington DC: Georgetown University Press.

    Google Scholar 

  13. Ernst, E., Cohen, M. H., & Stone, J. (2004). Ethical problems arising in evidence based complementary and alternative medicine. Journal of Medical Ethics, 30, 156–159.

    Article  PubMed  CAS  Google Scholar 

  14. Parker, M. (2007). Two into one won’t go: Conceptual, clinical, ethical and legal impedimenta to the convergence of CAM and orthodox medicine. Journal of Bioethical Inquiry, 4(1), doi:10.1007/s11673-007-9031-z (this issue).

  15. Clark-Grill, M. M. (2004). Reclaiming the full story of human health: The ethical significance of complementary and alternative medicines. Doctoral Thesis, University of Otago.

  16. Lyng, S. (1990). Holistic health and biomedical medicine. A countersystem analysis. Albany: State University of New York Press.

    Google Scholar 

  17. Nordin, I. (2000). Expert and non-expert knowledge in medical practice. Medicine, Health Care and Philosophy, 3, 297–304.

    Article  CAS  Google Scholar 

  18. Willis, E., & White, K. (2004). Evidence-based medicine and CAM. In P. Tovey, G. Easthope, J. Adams (Eds.), The mainstreaming of complementary and alternative medicine (p. 49–63). London: Routledge.

    Google Scholar 

  19. Astin, J. A. (1998). Why patients use alternative medicine. Journal of the American Medical Association, 279, 1548–1553.

    Article  PubMed  CAS  Google Scholar 

  20. Fisher, P., van Haselen, R., Hardy, K., Berkovitz, S., & McCarney, R. (2004). Effectiveness gaps: A new concept for evaluating health service and research needs applied to complementary and alternative medicine. Journal of Alternative and Complementary Medicine, 10, 627–632.

    Google Scholar 

  21. Hocquard, T. J. (2002). Fibromyalgia: An opportunity to explore the human experience of disability, and the implication for rehabilitation. New Zealand Family Physician, 29, 380–382.

    Google Scholar 

  22. Malterud, K. (2002). Understanding the patient with medically unexplained disorders – A patient-centred approach. New Zealand Family Physician, 29, 374–379.

    Google Scholar 

  23. Murdoch, C. (2002). The fruits of unbelief. New Zealand Family Physician, 29, 383–384.

    Google Scholar 

  24. O’Connor, B. B. (2002). Personal experience, popular epistemology, and complementary and alternative medicine research. In D. Callaghan (Ed.), The role of complementary and alternative medicine (p.54–73). Washington DC: Georgetown University Press.

    Google Scholar 

  25. Mason, S., Tovey, P., & Long, A. F. (2002). Evaluating complementary medicine: Methodological challenges of randomised controlled trials. British Medical Journal, 325, 832–834.

    Article  PubMed  Google Scholar 

  26. Long, A. F., Mercer, G., & Hughes, K. (2000). Developing a tool to measure holistic practice: A missing dimension on outcomes measurement within complementary therapies. Complementary Therapies in Medicine, 8, 26–31.

    PubMed  CAS  Google Scholar 

  27. Lukoff, D., Edwards, D., & Miller, M. (1998). The case study as a scientific method for researching alternative therapies. Alternative Therapies, 4, 44–52.

    CAS  Google Scholar 

  28. Kiene, H.(2001). Komplementäre Methodenlehre der klinischen Forschung: Cognition-based medicine. Berlin: Springer.

    Google Scholar 

  29. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L. V., et.al. (1997). Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. The Lancet, 350, 834–843.

    Article  CAS  Google Scholar 

  30. Shang, A., Huwiler-Müntener, K., Nartrey, L., Jüni, P., Dörig, S., Sterne, J. A. C., et. al. (2005). Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet, 366, 726–732.

    Article  Google Scholar 

  31. Frass, M., Linkesch, M., Banyai, S., Resch, G., Dielacher, C., Löbl, T., et. al. (2005). Adjunctive homeopathic treatment in patients with severe sepsis: A randomized, double-blind, placebo-controlled trial in an intensive care unit. Homeopathy, 94, 75–80.

    Article  PubMed  CAS  Google Scholar 

  32. Bell, I. R., Lewis, D. A., Brooks, A. J., Schwartz, G. E., Lewis, S. E., Walsh, B. T., et. al. (2004). Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology, 43, 577–582.

    Article  PubMed  CAS  Google Scholar 

  33. Vandenbroucke, J. P., & de Craen, A. J. M. (2001). Alternative medicine: A “mirror image” for scientific reasoning in conventional medicine. Annals of Internal Medicine, 135, 507–513.

    PubMed  CAS  Google Scholar 

  34. Vandenbroucke, J. P. (2002). Alternative treatments in reproductive medicine. The vexing problem of “seemingly impeccable trials...”. Human Reproduction, 17, 2228–2229.

    Article  PubMed  Google Scholar 

  35. Morreim, E. H. (2003). A dose of our own medicine: Alternative medicine, conventional medicine, and the standards of science. The Journal of Law, Medicine & Ethics, 31,222–235.

    Article  Google Scholar 

  36. Haynes, B., & Haines, A. (1998). Barriers and bridges to evidence based clinical practice. British Medical Journal, 317, 273–276.

    PubMed  CAS  Google Scholar 

  37. Naylor, C. D. (1995). Grey zones of clinical practice: Some limits to evidence-based medicine. The Lancet, 345, 840–842.

    Article  CAS  Google Scholar 

  38. Kenny, N. P. (1997). Does good science make good medicine? Incorporating evidence into practice is complicated by the fact that clinical practice is as much art as science. Canadian Medical Association Journal, 157, 33–36.

    PubMed  CAS  Google Scholar 

  39. Bauchner, H. (1999). Evidence-based medicine: A new science or an epidemiologic fad? Pediatrics, 103, 1029–1031.

    Article  PubMed  CAS  Google Scholar 

  40. Cranney, M., Warren, E., Barton, S., Gardner, K., & Walley, T. (2001). Why do GPs not implement evidence-based guidelines? A descriptive study. Family Practice, 18, 359–363.

    Article  PubMed  CAS  Google Scholar 

  41. Knottnerus, A., & Dinant, G. J. (1997). Medicine based evidence, a prerequisite for evidence based medicine. British Medical Journal, 315, 1109–1110.

    PubMed  CAS  Google Scholar 

  42. Culpepper, L., & Gilbert, T. T. (1999). Evidence and ethics. The Lancet, 353, 329–331.

    Article  Google Scholar 

  43. Rosser, W. W. (1999). Application of evidence from randomized controlled trials to general practice. The Lancet, 353, 661–664.

    Article  CAS  Google Scholar 

  44. Van Weel, C., & Knottnerus, J. A. (1999). Evidence-based interventions and comprehensive treatment. The Lancet, 353, 916–918.

    Article  Google Scholar 

  45. Stevenson, F. A., Barry, C. A., Britten, N., Barber, N., & Bradley, C. P. (2000). Doctor–patient communication about drugs: The evidence for shared decision making. Social Science and Medicine, 50, 829–840.

    Article  PubMed  CAS  Google Scholar 

  46. Eskinazi, D. P. (1998). Factors that shape alternative medicine. Journal of the American Medical Association, 280, 1621–1623.

    Article  PubMed  CAS  Google Scholar 

  47. Hufford, D. J. (2003). Evaluating complementary and alternative medicine: The limits of science and of scientists. The Journal of Law, Medicine & Ethics, 31, 198–212.

    Article  Google Scholar 

  48. House of Lords’ Select Committee on Science and Technology Complementary and Alternative Medicine. (2000). London: The Stationary Office.

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Clark-Grill, M. Questionable Gate-keeping: Scientific Evidence for Complementary and Alternative Medicines (CAM): Response to Malcolm Parker. Bioethical Inquiry 4, 21–28 (2007). https://doi.org/10.1007/s11673-007-9035-8

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