On Alternative Medicine
Oct 27, 2010

On Alternative Medicine

There is an interesting dichotomy regarding public opinion when it comes to alternative medicines. The perception of alternative medicines it seems is either one of largely disbelief where they are disregarded as valid medicine or alternatively people buy into them entirely believing not just in their results but their claimed mechanisms. I suspect neither view is correct and a more balanced and scientific approach to the field should be established. On the one hand, we cannot dismiss that some legitimate benefits from alternative medicine do exist. On the other hand, simply accepting point blank all of the dogma that goes along with these practices on insufficient evidence is not only invalid reasoning but actively obstructs an objective and rational analysis of their results and mechanisms that could lead to improvement and wider acceptance. Moreover, there is in this story an interesting analogy to the relationship between religion and science.

It should be established at the front that there can be legitimate benefits of many alternative medicines. People can and do have genuine and even normative physiological and psychological benefits from such medicine. We ignore the legitimacy of these benefits at our own detriment. At the same time, we should be highly skeptical of both the claimed mechanisms as well as the objective scale of the benefits. Acknowledging some benefits is very different from acknowledging all claimed benefits, and there is good reason to believe a large scale exaggeration of the claimed benefits exists and indeed some practitioners are easily seen to be charlatans.

We cannot conflate the benefits of alternative medicine with its proposed mechanisms. That a practice provides evidentially tangible benefits adds in no way to the claims of the mechanism nor to either the exclusivity or entirety of the technique. In general I find the claims of benefits - while still often exaggerated - to be a good order of magnitude easier to believe and indeed to demonstrate than their proposed mechanisms.

Take for example  the concept of Raiki energy healing over long distances. The claimed mechanism of a causal relationship between the actual actions performed and any benefit, perhaps through "energy" seem to be at best utterly unsupported by any scientific understanding of our physical world. Now as with most such things, there may indeed be genuine and perhaps even measurable benefits. However the mechanism may lie in psychological factors such as the placebo effect, the sense of comfort one finds from the idea that someone is helping you from afar and other possibilities.  I certainly don't wish to claim a specific mechanism for the point is that we should not maintain any claim on insufficient evidence.

What I propose is merely that we subject alternative medicine to the same degree of rationality and rigor as we do anything else. It does not deserve to be dismissed on its face nor does it deserve unconditioned acceptance. Of particular importance is divorcing the practices from the dogma that goes along with it that for the most part serves to distract from what is genuinely working and prevents rational inquiry.  That which works can be identified, embraced and improved on while that which doesn't can be rejected. Dogma, by its very nature, resists this kind of change. It should be noted that there is a possibility that some of this dogma actually is part of the mechanism. For example, having a firm belief that something outside of the physical realm will help you may be part of the mechanism (for example placebo) that actually does help you. However, this being the case does not prevent a study of the benefits and mechanisms and trying to improve them within the framework of rational inquiry not dogmatic tradition.

Sadly, there are difficulties in objectively studying many claims, both in results and in mechanisms. The benefits may be diffuse or intangible such as an increase to ones "wellbeing". The proposed mechanisms may be, sometimes by definition, outside of the realm of conventional physical, physiological or psychological understanding. However, simply because things are difficult does not mean there are not many objectives ways we can begin to approach these problems and make progress and improvements. Importantly, difficulties in scientific inquiry should not be replaced with merely belief on insufficient evidence.

I will conclude by noting that there is a strong parallel between this discussion between science and alternative medicine and the discussion between science and religion. In the latter case there is also a similar dichotomy in public opinion much like the alternative medicine case. Many atheists dismiss either directly or tacitly the possibility of genuinely spiritual or mystical experiences such as might arise from meditation. Many religious people who may well experience genuine and normative spiritual experiences attribute these experiences to divinity on insufficient evidence. The same two pronged approach about the veracity of the mechanisms of alternative medicine as different from the benefits remain true here where people usually either talk about the existential truth of a religion or about its benefits either individually or societally and likewise even if one could establish the latter it wouldn't imply the former. Likewise, there is an overabundance of dogmatic traditions that prevent free inquiry into so many subjects relating to religion of which many positive things could result.  Finally, a similar social stigma exists whereby religion is seen as outside the domain where our normal rational discourse applies, to its detriment.  The parallel is interesting, and I think is actually much stronger on many points than for the alternative medicine case. For example, questioning of religious practice is quite taboo unlike for alternative medicine. The usefulness of this comparison can be that if we acknowledge the wisdom, such as it is, as applied to alternative medicines we can apply it to religion.

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