The Committee for the Advancement of Scientific Skepticism (CASS) at the Centre for Inquiry Canada, in an effort to educate the public about the roles of critical thinking and the philosophy of skepticism, has produced a series of articles we have entitled “What is Skepticism?” Over four weeks we will be presenting them on Skeptic North and welcome your comments and discussion.
In this final entry in CASS’s series What is Skepticism, Dr.Claire Trottier and Dr. Behzad Elahi discuss the transition of a medical treatment from alternative to mainstream and the conditions under which this transition occurs. This article first appeared in Full Comment, a blog of the National Post, on August 21, 2010.
A Skeptic’s View of Alternative Medicine
Alternative medicine is gaining popularity in Canada, especially for the treatment of chronic conditions. Many treatment modalities are endorsed by practitioners of alternative medicine: from nutritional supplements, to acupuncture, to magnetic bracelets. It is important to examine scientifically if these treatments works, and in so doing, we can see how skeptics examine the claims of alternative medicine.
For a skeptic, it is important to constantly remain open to new ideas; being skeptical does not mean dismissing ideas outright. Skepticism means carefully investigating claims to determine if they are biologically plausible, and if they are supported by evidence. When a reproducible effect is found for a new therapy, it becomes accepted as part of medicine. Incorporating new evidence is how medicine works – which is why treatments and practices change so often. Our current understanding of ulcers is a perfect illustration of the flexibility of science-based medicine.
Medical theory used to state that ulcers were caused by stress. In 1982, two Australian scientists discovered that a bacteria was in
fact responsible. There was some early resistance in the scientific community upon publication of these results. However, once these finding were reproduced, the medical community accepted this evidence. Ulcers are now successfully treated with antibiotics, and a 2005 Nobel Prize was awarded to Barry J. Marshall and J. Robin Warren in recognition for these important findings.
The American government has poured hundreds of millions of dollars annually into the study of alternative therapies through their National Center for Complementary and Alternative Medicine (NCCAM) (the 2009 budget was 121 million dollars). In collaboration with the alternative medical community, the studies undertaken at the NCCAM have not shown any evidence of efficacy for most of the treatments studied. Gingko biloba on cognitive function: no effect. Echinacea for prevention and treatment of colds: no effect. Acupuncture for back pain: no effect. In 2009, the Associated Press investigated the NCCAM and found that after a total of $2.5 billion in research funding, no new advances in medicine had been identified.
There are occasions where there are tenuous links between alternative theories and real science. Most alternative nutritional supplements are ineffective, and some have been found to contain high levels of pesticides and trace amounts of heavy metals. However, the use of certain supplements is well-supported by science: folic acid supplements prevent neural tube defects, and many physicians recommend vitamin D supplements during the winter. These supplements are not alternative, they are part of mainstream science and medicine. What sets these therapies apart from alternative supplements is that they are supported by reproducible evidence and make biological sense.
Magnets have long been believed to have healing powers, and this idea is still very popular in alternative medicine. The magnetic bracelet is a good example; it supposedly produces a magnetic field that relieves inflammation. These bracelets have been studied, and no evidence has been found to support their use. However, specific uses of magnetic fields have shown promise in depression, and a technique called Transcranial Magnetic Stimulation is currently being studied as a possible treatment. Science and medicine do not reject the potential of magnetic fields for affecting biology. The distinction between evidence and unproven pseudoscientific claims lies at the heart of skepticism.
A skeptic must have an open mind, examine biological plausibility, and review the evidence before coming to a conclusion. Skeptics are careful to avoid being swayed by personal testimonials and anecdotes. The former editor of the Journal of the American Medical Association, George Lundberg, said it best when he argued that alternative medicine does not exist: “there is only scientifically proven, evidence-based medicine supported by solid data, or unproven medicine, for which scientific evidence is lacking”. When it comes to health, skeptics separate the wheat from the chaff and only support therapies that have been shown to work.
Claire Trottier has a Ph.D. in Microbiology and Immunology, and is currently working in biomedical science education as a Postdoctoral Fellow. She is a CFI science adviser and lives in Montreal, Quebec.
Behzad Elahi grew up in Iran in an intellectual family of skeptics and physicians. He received his M.D. degree from Tehran University of Medical Sciences, Iran in 2005. Since 2008 he has been working on his PhD in University of Toronto, department of Neurology and Neurosurgery. Behzad holds Canadian Institute of Health Research (CIHR)scholarship in the field of dystonia and has grown special interest in brain plasticity and movement disorders especially Parkinson’s disease and dystonia.
About the Committee for the Advancement of Scientific Skepticism (CASS) and the Centre for Inquiry Canada (CFI): CASS is a national, fast response team which critically engages with scientific, technological and medical claims made in public discourse. We address factual inaccuracies and misinformation in public debates by promoting evidence-based science. CASS is a subset of CFI. CFI is the leading freethought organization in Canada promoting reason, science, secularism and freedom of inquiry. CASS can be followed on Twitter @CFICASS, or on Facebook on the CASS fan page.