Medicine, Philosophy and ‘Alternative Medicine’

Last week I recommended a book, Hippocratic Oaths: Medicine and its Discontents by Raymond Tallis (Publisher: Atlantic Books, 2004) The author, a doctor and a philosopher, makes a scathing attack on the nanny state interfering with NHS medicine, spending vast quantities on ‘improvements’ that do not stand up to examination in the light of day. He correctly points out that each successive government feels honour-bound to introduce improvements which just disrupt things and lower the quality of medical care. With all this I concur and applaud loudly.

Unfortunately the good doctor then goes on to trash alternative and traditional medicine. He does so in the predictable formulaic way that I have encountered over the last two decades. Let’s look at some of this criticisms. We welcome criticism because by answering criticism we can know ourselves better and improve.

Criticism 1 : Tallis makes the point that there is no convincing scientific evidence that alternative medicine actually works better than suggestion.
My response: What Tallis should be asking is not what works better than suggestion but why it works at all. In particular if suggestion is so powerful, how should scientific doctors utilise it? If alternative therapies work better than orthodox ones in some cases and ‘suggestion’ is the key, doctors better learn how to use ‘suggestion’ creatively and they had better learn it quickly.

Criticism 2: Alternative medicine spuriously offers ‘personal significance’ as an important part of the way it views medicine.
My response: It’s not only alternative practitioners who have recognised the importance of personal differences in the way we deal with diseases. It’s scientific geneticists who have also recognised that different diseases may need different treatments in different type of people because each person has a different genome.

Criticism 3: Homeopathy has neither biological basis nor physical basis for its action
My response: Why then do eminent physicists such as Capra (The Turning Point) devote large segments of their books to homeopathic medicine?

Criticism 4: Alternative Medicine relies on anecdotal evidence (stories of successfully treated cases) to further its cause. Tallis compares this to the marketing technique of a snake-oil selling ‘huckster’.
My response: While not wishing to accuse my eminent colleague of hypocrisy, I would like to draw his attention to some of his own writing. While deploring the use of anecdotal evidence by practitioners of alternative medicine himself, he is not averse to using some personal anecdotes taken from his time as a young doctor in Nigeria. He uses these anecdotal descriptions of the horror of what can happen when one eschews scientific medicine for ‘traditional medicine’. I have no problem with this as these anecdotes make a valid point. I do have a problem with him reserving the right to use anecdotes himself but denying this right to others.

Tallis also makes the point of how ignoring sage medical advice can be disastrous for a whole country. His attack on the South African government’s attitude to the catastrophic spread of AIDS in that country is totally justified. When a powerful body such as a government ignores science and scientifically proven treatment and favours obscure and highly controversial views about a major illness, they deserve all the criticism they get. His attitude to the MMR inoculation and how its ‘dangers’ were hyped by the media at huge financial cost to us all, is also appropriate.

Conclusion: Orthodox scientific, ‘alternative’ and ‘traditional’ medicine all have their place. In life-threatening conditions (or conditions where there is a risk of irreversible damage) only conventional scientific medicine should be used. In many other conditions however, holistic alternatives can be tried in conjunction with orthodox tests and monitoring procedures. This is why alternative medicine is best practised by fully qualified doctors. Even ‘traditional medicine’ has its place but it is best used for psychological and psychosomatic problems rather than in the treatment of life-threatening infections such as HIV/AIDS where the advocation of its use by irresponsible governments has had disastrous results.