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Talk:Complementary and alternative medicine

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Does not this article just duplicate Alternative medicine? Integrative, Alternative and Complementary Medicine all basically come under the same heading of Alternative medicine. Why not just improve the alternative medicine article?--Mr-Natural-Health 13:13, 19 Dec 2003 (UTC)

Agreed. This article is the same topic as the alternative health article. The two should be merged. RK 15:22, Dec 21, 2003 (UTC)

Waiting for 68.167.248.20 to do the merging as I have better things to do with my time. :)--Mr-Natural-Health 10:16, 23 Dec 2003 (UTC)

But..... alternative medicine is a term to distinguish traditional medicines and other systems, old or new, based on intuitive, or spiritual, or proto-scientific bases. Complementary medicine is mainstream allopathic medicine that allows for some alternative medicines, as long as they don't seem obviously counter-indicated, to be used side-by-side with allopathic medicine. And integrative medicine is medicine that looks at both allopathy and various alternative approaches with a critical eye and uses one or many approaches, but as a unified approach. There are differences between these things, and it looks like the WP articles and the way they redirect don't really reveal this subtelety (as well as giving air to scientistic complaints about these topics in a manner out of proportion with actual professional opinion, IMHO, btw....) Friarslantern 19:28, 24 September 2007 (UTC)

Since most biomedical journals discuss complementary and alternative medicine together, then you need a CAM page. However, there are big distinctions between complementary medicine and alternative medicine, therefore it is right to have separate pages for each branch, where these particulars can be discussed.Davwillev 13:49, 30 September 2007 (UTC)

This Article is mostly Irrelevant!

This article contains mostly irrelevant information and personal opinion which is simply wrong and cannot be supported with references.--Mr-Natural-Health 19:22, 23 Dec 2003 (UTC)

Comparing this page with its merge partner

IMHO this page has a few traits in its favor:

  • It's a quick introduction; its about a quarter of the size of the other page. It's handy to have a short introduction to such a broad topic.
You do not need an introduction to an introduction. Alternative medicine could be improved however, by separating the definiton from the overview section.--Mr-Natural-Health
  • This page attempts to highlight some common threads among CAM practices; of course the brevity results in a loss of important detail but its easier to absorb the detail if you start with an organizing framework, then flesh out the detail and the exceptions afterwards.
This page fails to highlight any common threads. What is there is either unnecessary, or just plain wrong.--Mr-Natural-Health
  • The taxonomy is the same one written by a center in the NIH; perhaps it could be improved, but again, all the detail about the various alternative methods are easier to understand as long as some sort of taxonomy is provided first.
No taxonomy is necessary. There are at least 4 possible classifications systems: Method of treatment, Therapeutic benefits, Medical Conditions benefited by, and Mode of Action for the Therapeutic Effects. Why is the method used in cam any better than anyone of these methods? The NIH is a fact, not a reason.--Mr-Natural-Health
  • This page introduces complementary medical therapies as well as alternative medical therapies.
Alternative medicine does a better job as is.--Mr-Natural-Health

I don't know what fits best within the wikipedia culture. In terms of satisfying the needs of a general reader, I can offer an opinion though. I would want to have this page be the basis for an introduction to the topic, and the other page provide the detailed look that people could really dive into once they are past the introductory phase. Whether that means a collection of pages, or just a single 30K page is something I would have to defer to others. In the absence of a consensus to the contrary, I'd probably do it as a collection of pages. I'll give it a shot sooner or later if someone doesn't beat me to it.

68.167.248.42 12:29, 24 Dec 2003 (UTC)
(Sorry, I don't have a login, and it would be pointless to get one just for this comment)

It is only a matter of time before this article is either deleted or redirected. So, take all the time that you want. Nothing written here needs to be merged with anything, as far as I am concerned.--Mr-Natural-Health 16:42, 24 Dec 2003 (UTC)~

There must be a history behind this all...

All I did in the 68.167.248.42 comment was read two articles and explained why I agreed with RK and whoever else that a merge rather than a redirect was appropriate. If all that Mr. NH can respond with boils down to "don't merge, just delete or redirect", there doesn't seem to be any real discussion taking place here. He is just being dismissive of the specific comments I made.

BTW, when I read this page, it didn't come across as irrelevant or personal opinion. Google led me to wikipedia as well as NCCAM and Mayo Clinic's CAM pages, and all three seem to treat the subject similarly. Perhaps it is precisely because it's similar to the NCCAM and Mayo that this page can be considered biased in some way, but when I read all of these pages I come away with the impression that the language used here is neutral without resorting to detailed pro and con sections.

A quick perusal of the discussion on the AM page points out the long (for wikipedia) history behind this topic. My comments don't have the benefit of or the baggage from participating in all of those earlier discussions.

68.167.254.136 02:43, 25 Dec 2003 (UTC)

I have already expressed my opnion. You are the one you objected. Now, do the merge or I will redirect once again. Seems simple enought to me.--Mr-Natural-Health 07:50, 25 Dec 2003 (UTC)

67.100.124.108 appears to have caused a considerable amount of damage. Even though Alternative medicine can be traced back to Sept 2001. 67.100.124.108 went about, apparently unchallenged and undetected, adding cross-links in numerous other articles like Health science and Medicine; all pointing to the wrong article which clearly should have been Alternative medicine. Actually in many cases no links should have been added at all as they are clearly inappropriate, illogical and amateurish. It would take a major amount of work to undo all this damage. Where were all these busybody editors when this damage was taking place? One can only marvel at this mess called Misplaced Pages!!!--Mr-Natural-Health 06:00, 27 Dec 2003 (UTC)

History vs. current state, and some potential points of agreement

Although you still haven't commented on the concrete points I made in the 68.167.248.42 comment, your point seems to be that the bigger issues of the long history it took to get alternative medicine in the state it is today, and the numerous cross-links to this CAM page overshadow any reason to discuss what is of value in this page or merge it into an integrated set of pages on alternative and complementary medicine. I disagree, but can at least understand your position given the tortuous history of the AM page.

When I look past the name calling and your apparent frustration, I can also agree that an attempt at a merge needs to be done by someone interested in doing it and sensitive to the careful crafting of the AM page. If the original author doesn't step up to that, or someone like yourself with a long involvement in the topic doesn't do it, I'll give it a shot.

I don't agree with the sense of urgency you have about either doing it now or turning it into a redirect; there are plenty of wikipedia examples where overlapping or parallel write-ups exist. Misplaced Pages seems to get better over time, with some progress made in hours and others taking weeks, months, or I guess in the case of AM, years. If this had been a case of vandalism, prompt action would be warranted, but this is obvious not applicable to this case, so I'd advocate a merge, and when I try, it'll be guided by the 68.167.248.42 comment.

The other thing I'll do for now is cross reference this discussion with Talk:Alternative medicine.

68.167.191.104 00:01, 28 Dec 2003 (UTC)

Seems simple enough to me. You objected, therefore you do the merge. And, I and everybody else on the planet will undo it tomorrow, if we object to it. Otherwise, I am sure that what is here will end up deleted sooner than later.

Of course, Misplaced Pages could easily end up history tomorrow too.--Mr-Natural-Health 04:21, 30 Dec 2003 (UTC)

By the way, I object to quackery in alternative medicine just as much if not more so than the science Geeks do. I just hate the medical scientism people more than I hate quacks. Just thought that you might want to know.--Mr-Natural-Health 04:27, 30 Dec 2003 (UTC)

External links

The purpose of Wiki is not to accommodate everyone's opinion on everything. Per Misplaced Pages:What Misplaced Pages is not:. Edwardian 06:47, 13 September 2005 (UTC)

- Please see related discussion at Talk:Alternative_medicine#External_links --GalaazV

Complementary and Alternative Medicine

Hi Edwardian - I noticed you removed the external link "Health Benefits of Mangosteen" in the subsection "Medicine that is somewhere between...". I put it back and moved it under subsection "Advocacy of Alternative Medicine". Also... if you consider this link spam, but not others which contain Google Ads, then you're not being objective. I actually looked at the other external links before adding the link on Mangosteen. There are 5 other external links just under the "Advocacy..." subsection which contain Google Ads (see the bottom of the page in some of them). The Mangosteen site is a helpful content site with lots of information about this fruit. Let's keep it. Thanks. User:FlipOne

Thank you for your comments. The "External links" section in Complementary and alternative medicine should contain general references to CAM, not references to specific CAM therapies. As long as it is not linkspam, specific information about Mangosteen should go under Mangosteen. If you want to tie-in CAM, then a reference to Mangosteen could be made in Herbalism. The same thing goes for the other links you mentioned, too, which I will try to address. Edwardian 20:58, 28 October 2005 (UTC)

Edwardian: (1) Why did you remove my comment? (2) There are more Ad-supported links (I found 3) on the page (including Quackwatch - see that Google search box at the upper right corner?). When you see a Google search box anywhere on a page, that means it's Ad-supported (they earn money from Ad clicks on the Google Search Results pages). When you see a banner Ad on top of a page, that of course means it's Ad-supported. You have to try your best to be fair and consistent, or your edit-contribitions will not be credible as you hope them to be. User:FlipOne (Re: on the Mangosteen content site removal)

I am placing your comments here because this page is a more appropriate page for us to have the discussion, and for others who come after us to view them. The Quackwatch link is appropriate to this page and does not contain overt linkspam. Regarding my credibility, I am not the one with an agenda to push inserting linkspam in a multitude of pages. Edwardian 21:35, 28 October 2005 (UTC)
Hi Edwardian: The Mangosteen website is a "pure content" site on the Mangosteen. You can see that the primary goal of the website is to educate readers on the benefits of Mangosteen, and just like countless external links at other wikipedia topics, the website is Google-Ad supported. It isn't "overt linkspam" as you call it. I hope you'll take a second look at the website and see for yourself. Please do. Thanks. User:FlipOne
As a new visitor to this discussion, it appears to me that you two are at cross purposes. Edwardian hasn't properly explained that his objection (in accordance with Wiki policy) is the link to a commecial product website in the first place, not whether or not that website contains further links, which is what User:FlipOne is arguing. --Red King 10:47, 29 October 2005 (UTC)

I have addressed this on FlipOne's userpage. Given that he has been spamming his link over numerous pages on the wiki I hope this user will sometime become productive. JFW | T@lk 21:37, 29 October 2005 (UTC)

Spam or not spam?

I added a link to the external link section on ayurveda: http://www.kahc.co.uk/ayurvedaarticles.html

However, this was removed and the reason was that it was considered spam.

I firmly believe that this link is NOT a spam. The organisation that owns the website provides information about and related to ayurveda, specifically Kerala Ayurveda. I believe that this is very much very adds to the value of the CAM page and it is better to provide a link than to just copy and paste from the site.

However, if you still think this site is a spam, then please add your comment to this.

I removed the link. A link to a description of Ayurveda would belong on that page, not on the CAM article. The link is in the Ayurveda article (which btw. could really use some cleaning up - all those external links can't all be relevant). When you add external links to the same website to multiple pages, it is usually called spam. Many wikipedians will take that as a sign that you are trying to promote a specific website rather than improving Misplaced Pages.
Rasmus (talk) 20:25, 8 December 2005 (UTC)

OK then. Didn't realise it was spam. I put this link on this cam page and the alternative page as well since they were both talking about similar things. However, this doesnt resolve the issue. Misplaced Pages advises that it is better to post a link to the page of the relevant topic than to copy parts of the page and post it on Wiki. What should you do then when you post a link, without having it referred to as spam? Guest, 9th Decmember 2005, 13:56 (GMT)

First you should verify that the information is relevant to the article. A rule of thumb is to consider how many other websites that exists that has similar relevancy. If there are many the link probably isn't relevant. In this case, the number of websites about some CAM-therapy is in the thousands. Links to general information about CAM, that is as high quality as the links already present, would be fine however.
Secondly, unless the link in question is to a relevant organization (like the International Association of Ayurveda practitioners or something like that), you should verify that the information isn't already in the article or in the other links; and it should be something that you couldn't easily add to the article (adding the information in your own words is fine - cut'n'pasting is violating copyright).
Thirdly, if you start out by creating an account and editing a few articles (except for the external links), you would have much less risk of being taken for a spammer. We try to be nice to newcomers, but unfortunately we get so many link-spammmers that a newcomer can easily be mistaken for one.
You can add a cleanup-tag by typing {{cleanup}}, or since this is only a section of the article, you might want to use {{cleanup-section}}. If you feel up to it, you might also want to be bold and do it yourself. There are also lots of hints on this page (for instance, you can automatically sign your posts by using ~~~~.
Rasmus (talk) 14:27, 9 December 2005 (UTC)

Ok. So, for example, the article on the site about "Holism and Ayurveda" is very specific and would be suitable on the Ayurveda page, but the page containing an index of ayurveda articles wouldn't be linked from this CAM article because there are too many sites out there containing a similar idea and it is not very specific to this CAM article. Got ya. Guest, 9the December 2005, 15:59 (GMT)

The information structure is important

For all of these related articles, this Complementary and alternative medicine article needs to be the highest level, with a link to Alternative Medicine and a redirect from Alternative Medicine to Complementary and alternative medicine. - a medical journal editor Healtheditor 16:34, 30 June 2006 (UTC)healtheditor

Separation of 'complementary and alternative medicine' article from 'alternative medicine' article

I have seperated these two articles as the 'CAM' article should (obviously!!!) be the parent article of both 'complementary medicine' and 'alternative medicine' articles. After doing this, I have removed all direct reference to CM in the AM article, and vice versa.

There is now room for the CAM article to be general, and the other two to be more specific, and it gives us scope to clearly define between AM and CM. The literature is out there for us to acheive this, but it will take time to accumulate this.Davwillev 20:55, 26 August 2007 (UTC)

There seems to be three disctinct concepts here which I believe each deserve their own articles: 1. Alternative Medicine (Medicine outside of the Conventional Medicine) 2. Complimentary Medicine (Medicine not quite conventional done in conjunction with Conventional Medicine) 3. Complementary and alternative medicine (A popular umbrella term).
I like the umbrella concept! Both alternative medicine and complementary medicine exists as separate concepts. Whereas, this complementary and alternative medicine article could take the umbrella prospective. That way the issue can be resolved once and for all. -- John Gohde (talk) 18:58, 18 November 2007 (UTC)
My thought is that the first two are the main articles; whereas the umbrella term should discuss the notable use and application of the term in the world. -- Levine2112 07:05, 1 October 2007 (UTC)

Restoration of long-standing redirect (and notice of RfC at alternative medicine)

Levine2112 reverted my restoration of the long-standing redirect with this edit summary: "I don't see any discussion or agreement to do this rather drastic action... please provide before redirecting again." Actually the original redirect which I restored was instituted after much discussion and merging of the articles and was a consensus decision by many editors. I agree that my restoration was rather bold, but it was only after the sudden appearance of a merge tag alerted me to the fact that a very small discussion by a couple editors who had not been parties to the original discussions was going on, and which should not have been going on at a "dead" article. The discussion should have occurred at the current alternative medicine article, where absolutely no discussion or suggestion of a merge had occurred and where no consensus had been formed to change the situation. I was just restoring the consensus situation.

The removal of the redirect had not been done properly and I restored it. It is a serious matter to revive a dead article without the input of the vast numbers of editors who had been involved in the original discussions and mergers. Otherwise I have no special burden one way or the other for or against a particular method for dividing this subject into several articles (which could of course be done) or consolidating it into one article (which was an overwhelming consensus decision). I am just upholding the consensus until a united majority of many editors decides to reverse the original decision. A small group should not to such a drastic thing. I will start an RfC on the matter there (the only proper place to do so, since all the significant editors have been working there) to get more input. Maybe it's time to do it. I don't care one way or the other, but until then the consensus decision should be protected and I will again restore the redirect. See you at the RfC. (I'll incorporate the link here when it's done.) -- Fyslee / talk 19:37, 1 October 2007 (UTC)


There should NOT be a redirect from the 'CAM' article to the 'alternative medicine' article as they are not the same. There needs to be scope to describe the difference between complementary medicine and alternative medicine, and this redirect will supress this. If there was an earlier consensus (which I do not see), then it was done by very few.Davwillev 08:35, 1 November 2007 (UTC)

If any article should be redirected, Alternative Medicine should be redirected to this fine article on CAM. The term "alternative medicine" is dated, while CAM is currently the preferred term. Furthermore, the entire style of this article is fresher than AM, which over the years has been pretty well hacked to death. It would be a good way to finally ditch all those discussion pages at AM, too. John Gohde 17:08, 6 November 2007 (UTC)

Sections to be Merged into the Alternative Meidicne Article

The term complementary and alternative medicine (CAM) is an umbrella term for alternative medicine and complementary medicine.

In order to write this article from an umbrella perspective, the following sections of it should be merged into the alternative medicine article.

Criticisms of the term

Some scientists reject the above classification and to varying degrees reject the term "alternative medicine" itself.

The following three commentators argue for classifying treatments based on the objectively verifiable criteria of the scientific method, not based on the changing curricula of various medical schools or social sphere of usage. They advocate a classification based on evidence-based medicine, i.e., scientifically proven evidence of efficacy (or lack thereof). According to them it is possible for a method to change categories (proven vs. nonproven) in either direction, based on increased knowledge of its effectiveness or lack thereof:

  • Marcia Angell, former editor-in-chief of the New England Journal of Medicine, states that "...since many alternative remedies have recently found their way into the medical mainstream cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."
  • George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA), and Phil B. Fontanarosa, Senior Editor of JAMA, state: "There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues—namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy."
  • Richard Dawkins, Professor of the Public Understanding of Science at Oxford, defines alternative medicine as a "...set of practices which cannot be tested, refuse to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine." He also states that "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

Other well-known proponents of evidence-based medicine, such as the Cochrane Collaboration and Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, use the term "alternative medicine" but agree with the above commentators that all treatments, whether "mainstream" or "alternative", ought to be held to standards of the scientific method. Oxford University Press publishes a peer-reviewed journal entitled Evidence-based Complementary and Alternative Medicine (eCAM).

Regulation

Jurisdiction differs concerning which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled health service or reimbursed by a private health medical insurance company.

In article 34 (Specific legal obligations) of the General Comment No. 14 (2000) on The right to the highest attainable standard of health of the Committee on Economic, Social and Cultural Rights (United Nations), it is stated that

Obligations to respect (the right to health) include a State's obligation to refrain from prohibiting or impeding traditional preventive care, healing practices and medicines, from marketing unsafe drugs and from applying coercive medical treatments

A number of alternative medicine advocates disagree with the restrictions of government agencies that approve medical treatments (such as the American Food and Drug Administration) and the agencies' adherence to experimental evaluation methods. They claim that this impedes those seeking to bring useful and effective treatments and approaches to the public, and protest that their contributions and discoveries are unfairly dismissed, overlooked or suppressed. Alternative medicine providers often argue that health fraud should be dealt with appropriately when it occurs.

In India, which is the home of several alternative systems of medicines, Ayurveda, Siddha, Unani, and Homeopathy are licenced by the government, despite lack of reputable scientific evidence. Naturopathy will also be licensed soon because several Universities now offer bachelors degrees in it. Other activities connected with AM/CM, such as Panchakarma and massage therapy related to Ayurveda are also licenced by the government now. Research into and licensing of these activities is carried out by the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH).

Support for alternative medicine

Alternative therapies provide some services not available from conventional medicine. Examples are patient empowerment and treatment methods that follow the biopsychosocial model of health .

Efficacy

Advocates of alternative medicine hold that the various alternative treatment methods are effective in treating a wide range of major and minor medical conditions, and contend that recently published research (such as Michalsen, 2003, Gonsalkorale 2003, and Berga 2003) proves the effectiveness of specific alternative treatments. They assert that a PubMed search revealed over 370,000 research papers classified as alternative medicine published in Medline-recognized journals since 1966 in the National Library of Medicine database. See also Kleijnen 1991, and Linde 1997.

Advocates of alternative medicine hold that alternative medicine may provide health benefits through patient empowerment, by offering more choices to the public, including treatments that are simply not available in conventional medicine:

"Most Americans who consult alternative providers would probably jump at the chance to consult a physician who is well trained in scientifically based medicine and who is also open-minded and knowledgeable about the body's innate mechanisms of healing, the role of lifestyle factors in influencing health, and the appropriate uses of dietary supplements, herbs, and other forms of treatment, from osteopathic manipulation to Chinese and Ayurvedic medicine. In other words, they want competent help in navigating the confusing maze of therapeutic options that are available today, especially in those cases in which conventional approaches are relatively ineffective or harmful."

Evidence-based medicine (EBM) applies the scientific method to medical practice, and aims for the ideal that healthcare professionals should make "conscientious, explicit, and judicious use of current best evidence" in their everyday practice. Prof. Edzard Ernst is a notable proponent of applying EBM to CAM.

Although advocates of alternative medicine acknowledge that the placebo effect may play a role in the benefits that some receive from alternative therapies, they point out that this does not diminish their validity. Researchers who judge treatments using the scientific method are concerned by this viewpoint, since it fails to address the possible inefficacy of alternative treatments.

Use of CAM as a complement to conventional medicine

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A major objection to alternative medicine is that it may be done in place of conventional medical treatments. As long as alternative treatments are used alongside conventional treatments, the majority of medical doctors find most forms of complementary medicine acceptable. Consistent with previous studies, the CDC recently reported that the majority of individuals in the United States (i.e., 54.9%) used CAM in conjunction with conventional medicine.

It is advisable for patients to inform their medical doctor when they are using alternative medicine, because some alternative treatments may interact with orthodox medical treatments, and such potential conflicts should be explored in the interest of the patient. However, many conventional practitioners are biased or uninformed about alternatives, and patients are often reluctant to share this information with their medical doctors since they fear it will hurt their doctor-patient relationship.

The issue of alternative medicine interfering with conventional medical practices is minimized when it is turned to only after conventional treatments have been exhausted. Many patients feel that alternative medicine may help in coping with chronic illnesses for which conventional medicine offers no cure, only management. Over time, it has become more common for a patient's own MD to suggest alternatives when they cannot offer effective treatment.

Criticism of alternative medicine

See also List of branches of alternative medicine for specific criticisms of different types of CAM

Due to the wide range of therapies that are considered to be "alternative medicine" few criticisms apply across the board, except possibly that of not being scientifically supported or even testable. Proponents of CAM typically address this basic criticism by arguing that it is a self-fulfilling prophecy: critics believe that there is no plausibility to CAMs because they find little or no proofs, while it is plausibility that should inform the scientific research for proofs.

Proponents of alternative therapy have an obligation to provide grounds for biological plausibility, such as sound theoretical or preclinical data, or for clinical plausibility, in the form of authentic, well-prepared case reports, in order to justify the investment of time and energy in exploring the merits of a novel anticancer therapy. But plausibility, not proof, should be sufficient to initiate the process.

In other words, proponents of CAMs argue that skeptics, in saying that theories or anecdotal and preclinical data do not constitute proof, merely state the obvious but do not actually engage in the evaluation of CAMs. Criticisms directed at specific branches of alternative medicine range from the fairly minor (conventional treatment is believed to be more effective in a particular area) to incompatibility with the known laws of physics (for example, in homeopathy). Critics argue that alternative medicine practitioners may not have an accredited medical degree or be licensed physicians or general practitioners and make sweeping claims without demonstrated expertise. This cannot always be considered a serious criticism, because unless a new system of medicine becomes established, it does not receive accreditation of any kind, except by its own professional organizations. This is the route homeopathy, ayurveda, siddha, unani, and naturopathy had to follow in those countries where it is now offered by accredited institutions. Proponents of the various forms of alternative medicine reject criticism as being founded in prejudice, financial self-interest, or ignorance. Refutations of criticism sometimes take the form of an appeal to nature.

Efficacy

Lack of proper testing

Although proponents of alternative medicine often cite the large number of studies which have been performed, critics point out that there are no statistics on exactly how many of those studies were controlled, double blind, peer-reviewed experiments, or how many produced results supporting alternative medicine or parts thereof. They contend that many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials; in contrast, conventional drugs reach the market only after such trials have proved their efficacy.

Some argue that less research is carried out on alternative medicine because many alternative medicine techniques cannot be patented, and hence there is little financial incentive to study them. Drug research, by contrast, can be very lucrative, which has resulted in funding of trials by pharmaceutical companies. Many people, including conventional and alternative medical practitioners, contend that this funding has led to corruption of the scientific process for approval of drug usage, and that ghostwritten work has appeared in major peer-reviewed medical journals. Increasing the funding for research of alternative medicine techniques was the purpose of the National Center for Complementary and Alternative Medicine. NCCAM and its predecessor, the Office of Alternative Medicine, have spent more than $200 million on such research since 1991. The German Federal Institute for Drugs and Medical Devices Commission E has studied many herbal remedies for efficacy.

Some skeptics of alternative practices point out that a person may attribute symptomatic relief to an otherwise ineffective therapy due to the placebo effect, the natural recovery from or the cyclical nature of an illness (the regression fallacy), or the possibility that the person never originally had a true illness. CAM proponents point out this may also apply in cases where conventional treatments have been used. To this, CAM critics point out that this does not account for conventional medical success in double blind clinical trials. CAM proponents, however, don't typically question conventional medical successes revealed in double blind clinical trials.

Safety

Critics contend that some people have been hurt or killed directly from the various practices or indirectly by failed diagnoses or the subsequent avoidance of conventional medicine which they believe is redundant.

Alternative medicine critics agree with its proponents that people should be free to choose whatever method of healthcare they want, but stipulate that people must be informed as to the safety and efficacy of whatever method they choose. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. Grapefruit seed extract is an example of quackery when multiple studies demonstrate its universal antimicrobial effect is due to synthetic antimicrobial contamination.

Delay in seeking conventional medical treatment

Those who have had success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics contend that therapies that rely on the placebo effect to define success are very dangerous. According to Lilienfeld (2002) "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as “opportunity cost.” Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative consequences.

Danger can be increased when used as a complement to conventional medicine

A Norwegian multicentre study examined the association between the use of alternative medicine and cancer survival. 515 patients using standard medical care for cancer were followed for eight years. 22% of those patients used alternative medicine concurrently with their standard care. The study revealed that death rates were 30% higher in alternative medicine users than in those who did not use alternative medicine (AM): "The use of AM seems to predict a shorter survival from cancer."

Associate Professor Alastair MacLennan of the Department of Obstetrics and Gynaecology in Adelaide University, Australia reports that a patient of his almost bled to death on the operating table. She had failed to mention she had been taking "natural" potions to "build up her strength" for the operation - one of them turned out to be a powerful anticoagulant which nearly caused her death.

To ABC Online, MacLennan also gives another possible mechanism:

"And lastly there’s the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they’re disappointed and they move on to the next one, and they’re disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they’ve seen the failure so often in the past".

Danger from undesired side-effects

Conventional treatments are subjected to testing for undesired side-effects (which may not, however, be revealed to the public in a timely manner), whereas alternative treatments generally are not subjected to such testing at all. However, any treatment — whether conventional or alternative — that has a biological or psychological impact on a patient may also have potentially dangerous biological or psychological side-effects. Nevertheless, attempts to refute this fact with regard to alternative treatments sometimes use the appeal to nature fallacy, i.e. "that which is natural cannot be harmful".

Homeopathy, however, is regarded as being safe in terms of such side effects since, according to known physics and chemistry, it cannot possibly have more effect on the patient than simple water does.

Danger related to self-medication

Similar problems as those related to self-medication also apply to parts of alternative medicine. For example, an alternative medicine may instantly make symptoms better, but actually worsen problems in the long run. The result may be addiction and deteriorating health.

Issues of regulation

Critics contend that some branches of alternative medicine are often not properly regulated in some countries to identify who practices or know what training or expertise they may possess. Critics argue that the governmental regulation of any particular alternative therapy does necessitate that the therapy is effective. The most sensible course in such a case could be to simply ensure that the sold treatment is not dangerous, but the problem would then remain to know if it does what its proponents say it does.

Sociological and psychological explanations for belief in CAM efficacy

There are both social/cultural and psychological reasons:

Social or cultural reasons:

  • the low level of scientific literacy among the public at large
  • an increase in anti-intellectualism and antiscientific attitudes riding on the coattails of new age mysticism
  • vigorous marketing of extravagant claims by the "alternative" medical community
  • inadequate media scrutiny and attacking critics
  • increasing social malaise (conspiracy theories) and mistrust of traditional authority figures - the antidoctor backlash
  • dislike of the delivery methods of scientific biomedicine.

Psychological reasons:

Request for Comments: merge proposal for complementary and alternative medicine articles

There's been a lot of activity and discussion about merging or keeping these pages separate. I found the discussion confusing, so I suggest that we focus the discussion here so we can make a decision.

Should we have three articles, or one?

  1. Complementary and alternative medicine
  2. Complementary medicine
  3. Alternative medicine
Option A
Merge all three into one article at Complementary and alternative medicine, and redirect the other two to that one.
Option B
Keep the three articles separate, using Complementary and alternative medicine as a WP:Summary style page, with the details mainly in each of the "main articles".

I don't feel strongly about it, but I support the merge idea, for these reasons:

  • Much information overlaps between all three articles, and especially between CAM and each of the separate branches. If we keep the articles separate, then there will be duplication and it will take effort to keep the info in sync, especially when there are sources quoted.
  • Complementary medicine and alternative medicine, as separate articles, would include many topics that fit within both, because in practice some of those methods overlap. An example would be that if someone has panic attacks, their regular doctor might suggest that in addition to medication, they learn meditation, or get a massage, or try yoga. So, because it's coming from a doctor, that makes those "complementary" rather purely "alternative", though many people might put them into the alternative article too. (those are just examples I made up on the spot, not intended to be specifics).
  • Since the CAM article name has the word "and" in the title, it already refers to both kinds.
  • When the NIH decided to study alternative medicine, they created the U.S. National Center for Complementary and Alternative Medicine (NCCAM). They initially named it "Office of Alternative Medicine" and later changed to the current name. However, even under the current name, they are still studying some forms of medicine that I think most of us would call purely "alternative". For example, on their webpage currently is a link to the results of a study to see if Shark Cartilage Supplement helps with Lung Cancer. Is that "alternative", or "complementary"? How would we decide which article would include that information?
  • The issues of research, scientific method, criticism, legal status, regulation, etc, interconnect for the three topics. By merging the article we can address them in one place.
  • In doing the merge, we could organize the article with sections for each where it's appropriate to separate alternative from complementary, but in situations where information may move from one to the other, the related references will easily move along with the text rather than needing to be moved between articles.

That's how I see it. I request comments from others so we can come to consensus and proceed with the content. As it is now there is a lot of confusion between the three articles. A definite decision one way or the other would make editing them easier for all of us. --Jack-A-Roe (talk) 05:11, 9 December 2007 (UTC)

  1. Alternative medicine--the risks of untested and unregulated remedies. Angell M, Kassirer JP. N Engl J Med 1998;339:839.
  2. Alternative medicine meets science. Fontanarosa P.B., and Lundberg G.D. JAMA. 1998; 280: 1618-1619.
  3. Simonyi Professorship web site
  4. A callous world. Richard Holloway. Book review Richard Dawkins A Devil's Chaplain. The Guardian, February 15, 2003.
  5. Dawkins, Richard (003). A Devil's Chaplain. Weidenfeld & Nicolson. {{cite book}}: Check date values in: |year= (help); More than one of |author= and |last= specified (help)
  6. The Cochrane Collaboration Complementary Medicine Field. Retrieved 5 August 2006.
  7. The HealthWatch Award 2005: Prof. Edzard Ernst, Complementary medicine: the good the bad and the ugly. Retrieved 5 August 2006
  8. "Complementary medicine is diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine." Ernst et al British General Practitioner 1995; 45:506.
  9. Evidence-based Complementary and Alternative Medicine
  10. COMMITTEE ON ECONOMIC, SOCIAL AND CULTURAL RIGHTS. General Comment No. 14 (2000) The right to the highest attainable standard of health : . 11/08/2000. E/C.12/2000/4. http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.en
  11. Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH)
  12. Vickers A. "Alternative Cancer Cures: "Unproven" or "Disproven"?" CA Cancer J Clin 2004; 54: 110-118. Online
  13. Michalsen A, Ludtke R, Buhring M. "Thermal hydrotherapy improves quality of life and hemodynamic function in patients with chronic heart failure." Am Heart J, 2003; 146 (4):E11. PMID 14564334
  14. Gonsalkorale WM, Miller V, Afzal A, Whorwell PJ. "Long term benefits of hypnotherapy for irritable bowel syndrome." Gut, 2003; 52 (11):1623-9. PMID 14570733
  15. Berga SL, Marcus MD, Loucks TL. "Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy." Fertility and Sterility 2003; 80 (4): 976-981 Abstract
  16. Kleijnen J, Knipschild P, ter Riet G. "Clinical trials of homoeopathy." BMJ, 1991; 302:316-23. Erratum in: BMJ, 1991; 302:818. PMID 1825800
  17. Linde K, Clausius N, Ramirez G. "Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials." Lancet, 1997; 350:834-43. Erratum in: Lancet 1998 Jan 17;351(9097):220. PMID 9310601
  18. Snyderman R & Weil AT. "Integrative medicine: bringing medicine back to its roots." Arch Intern Med 2002; 162:395-397.
  19. Cite error: The named reference Vickers was invoked but never defined (see the help page).
  20. Hoffer LJ (2001). "Proof versus plausibility: rules of engagement for the struggle to evaluate alternative cancer therapies". CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 164 (3): 351–3. PMID 11232135.
  21. Larkin M. "Whose article is it anyway?" Lancet, 1999; 354:136. Editorial
  22. Flanagin A, Carey LA, Fontanarosa PB. "Prevalence of articles with honorary authors and ghost authors in peer-reviewed medical journals." JAMA, 1998; 280(3):222-4. Full text
  23. CSICOP.org article on alternative medicine
  24. James Alcock PhD, Alternative Medicine and the Psychology of Belief, The Scientific Review of Alternative Medicine, Fall/Winter 1999 Volume 3 ~ Number 2. available online
  25. Ganzera M, Aberham A, Stuppner H. Development and validation of an HPLC/UV/MS method for simultaneous determination of 18 preservatives in grapefruit seed extract. Institute of Pharmacy, University of Innsbruck, Innrain 52, 6020 Innsbruck, Austria. J Agric Food Chem. 2006 May 31;54(11):3768-72. Abstract
  26. Takeoka, G., Dao, L., Wong, R.Y., Lundin, R., Mahoney N. Identification of benzethonium chloride in commercial grapefruit seed extracts. J Agric Food Chem. 2001 49(7):3316–20. Abstract
  27. von Woedtke, T., Schlüter, B., Pflegel, P., Lindequist, U.; Jülich, W.-D. Aspects of the antimicrobial efficacy of grapefruit seed extract and its relation to preservative substances contained. Pharmazie 1999 54:452–456. Abstract
  28. Sakamoto, S., Sato, K., Maitani, T., Yamada, T. Analysis of components in natural food additive “grapefruit seed extract” by HPLC and LC/MS. Bull. Natl. Inst. Health Sci. 1996, 114:38–42. Abstract
  29. Takeoka, G.R., Dao, L.T., Wong, R.Y., Harden L.A. Identification of benzalkonium chloride in commercial grapefruit seed extracts. J Agric Food Chem. 2005 53(19):7630–6. Abstract
  30. Risberg T, et al. Does use of alternative medicine predict survival from cancer? Eur J Cancer 2003 Feb;39(3):372-7
  31. ^ Beyerstein BL. Psychology and 'Alternative Medicine' Social and Judgmental Biases That Make Inert Treatments Seem to Work. The Scientific Review of Alternative Medicine/ Fall/Winter 1999 Volume 3 ~ Number 2
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