complementary and alternative medicine: science, pseudoscience, and ethics martin donohoe, md, facp...

Download Complementary and Alternative Medicine: Science, Pseudoscience, and Ethics Martin Donohoe, MD, FACP Karen Adams, MD, FACOG

Post on 23-Dec-2015

213 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • Slide 1
  • Complementary and Alternative Medicine: Science, Pseudoscience, and Ethics Martin Donohoe, MD, FACP Karen Adams, MD, FACOG
  • Slide 2
  • Outline What is CAM? What is CAM? Philosophies of CAM and Western medicine Philosophies of CAM and Western medicine Recognizing Quackery, Pseudoscience and Bogus Discoveries Recognizing Quackery, Pseudoscience and Bogus Discoveries Risks and Benefits of Herbal Remedies Risks and Benefits of Herbal Remedies Why Herbs are Not Regulated Why Herbs are Not Regulated Conclusions and Recommendations Conclusions and Recommendations
  • Slide 3
  • What is CAM? Any health care intervention not offered by traditional Western physicians Any health care intervention not offered by traditional Western physicians E.g., chiropractic, massage, acupuncture, homeopathy, distance healing, therapeutic touch, Reiki therapy, aromatherapy, herbs/nutraceuticals
  • Slide 4
  • CAM Some are recommended by physicians for certain conditions or people: Some are recommended by physicians for certain conditions or people: Chiropractic, massage, acupuncture, aromatherapy Proven benefit e.g., acupuncture for certain types of chronic pain, chemotherapy-induced nausea and vomiting; guided imagery to reduce stress of surgery in children and adults Proven benefit e.g., acupuncture for certain types of chronic pain, chemotherapy-induced nausea and vomiting; guided imagery to reduce stress of surgery in children and adults
  • Slide 5
  • No Such Thing as CAM Good medicine Good medicine Scientific Evidence-Based Quality Control Peer Reviewed Humanistic and Caring
  • Slide 6
  • No Such Thing as CAM Bad Medicine Bad Medicine Non-scientific Poor or No Quality Control Non-Peer Reviewed Impersonal, Uncaring
  • Slide 7
  • CAM is Not Unique in Its Emphasis on: Humanistic health care Humanistic health care Empathy and Compassion Empathy and Compassion Emphasis on healing the mind and body / recognizing the powerful links between the two Emphasis on healing the mind and body / recognizing the powerful links between the two
  • Slide 8
  • CAM is Not Unique in Its Emphasis on: Care involving family, friends, religious practitioners Care involving family, friends, religious practitioners Care emphasizing the whole patient or the provider-patient relationship Care emphasizing the whole patient or the provider-patient relationship
  • Slide 9
  • CAM Versus Western Medicine These attributes are the characteristics of quality medicine and public health, yet have been co- opted by the CAM movement
  • Slide 10
  • Dont get sCAMmed by CAM Some CAM is without benefit, some harmful Some CAM is without benefit, some harmful Therefore, it is important to be able to recognize quackery, pseudoscience and bogus discoveries Therefore, it is important to be able to recognize quackery, pseudoscience and bogus discoveries
  • Slide 11
  • How Quackery Harms Economic harm individual costs Economic harm individual costs Direct harm Direct harm Medical e.g., cyanide toxicity from laetrile, electrolyte imbalances from coffee enemas, quadriplegia from cervical spine manipulations Psychological e.g., unjustified guilt, distortion of perspective
  • Slide 12
  • How Quackery Harms Indirect harm: Indirect harm: E.g., delay in seeking care Harm to Society: Harm to Society: Perpetuates pseudoscience, puts other contemporary and future patients at risk
  • Slide 13
  • Warning Signs of a Bogus Scientific Discovery The discoverer pitches the claim directly to the media The discoverer pitches the claim directly to the media The discoverer says that a powerful establishment is trying to suppress his/her work The discoverer says that a powerful establishment is trying to suppress his/her work The scientific effect involved is always at the very limit of detection The scientific effect involved is always at the very limit of detection Evidence for a discovery is anecdotal Evidence for a discovery is anecdotal
  • Slide 14
  • Warning Signs of a Bogus Scientific Discovery The discoverer says a belief is credible because it has endured for centuries The discoverer says a belief is credible because it has endured for centuries The discoverer has worked in isolation The discoverer has worked in isolation The discoverer must propose new laws of nature to explain an observation The discoverer must propose new laws of nature to explain an observation
  • Slide 15
  • Characteristics of Pseudoscience Indifferent to facts Indifferent to facts Looks only for evidence supporting hypothesis Looks only for evidence supporting hypothesis Indifferent to criteria of valid evidence Indifferent to criteria of valid evidence Relies heavily on subjective validation Relies heavily on subjective validation Depends on arbitrary conventions of human culture, rather than on unchanging regularities of nature Depends on arbitrary conventions of human culture, rather than on unchanging regularities of nature
  • Slide 16
  • Characteristics of Pseudoscience Avoids putting its claims to meaningful tests Avoids putting its claims to meaningful tests Often contradictory Often contradictory Deliberately creates mystery where none exists, sometimes by omitting important details Deliberately creates mystery where none exists, sometimes by omitting important details Does not progress Does not progress Attempts to persuade with rhetoric, propaganda and misrepresentation Attempts to persuade with rhetoric, propaganda and misrepresentation
  • Slide 17
  • Characteristics of Pseudoscience Appeals to false authority, emotion, sentiment, or distrust of established facts Appeals to false authority, emotion, sentiment, or distrust of established facts Extraordinary claims and fantastic theories Extraordinary claims and fantastic theories Often described by an invented vocabulary of words with ambiguous meanings Often described by an invented vocabulary of words with ambiguous meanings Relies on anachronistic thinking Relies on anachronistic thinking Appeals to vanity, fear, magical thinking or desperation Appeals to vanity, fear, magical thinking or desperation
  • Slide 18
  • Characteristics of Pseudoscience Relies on anecdotes and testimonials Relies on anecdotes and testimonials Products often claim to be effective against a wide range of unrelated diseases Products often claim to be effective against a wide range of unrelated diseases Quick, dramatic results promised for one- time therapies; frequent re- treatments/maintenance treatments required for ongoing therapies Quick, dramatic results promised for one- time therapies; frequent re- treatments/maintenance treatments required for ongoing therapies $
  • Slide 19
  • Characteristics of Pseudoscience Disclaimers couched in pseudo-medical jargon Disclaimers couched in pseudo-medical jargon Claims that Western Medicine is dangerous Claims that Western Medicine is dangerous Practitioners advise, Dont trust your doctor Practitioners advise, Dont trust your doctor
  • Slide 20
  • Characteristics of Pseudoscience Claims of no side effects Claims of no side effects Products claimed to be natural usually are not Products claimed to be natural usually are not
  • Slide 21
  • Misconceptions re Cancer
  • Slide 22
  • Slide 23
  • Ban Dihydrogen Monoxide? Iowa junior high school student science fair project Iowa junior high school student science fair project 100 adults surveyed at State Fair 100 adults surveyed at State Fair
  • Slide 24
  • Would you sign a petition to ban dihydrogen monoxide? 1. It can cause excessive sweating and vomiting 2. It is a major component in acid rain 3. It can cause severe burns in its gaseous state 4. It can kill you if accidentally inhaled 5. It contributes to erosion 6. It decreases effectiveness of automobile brakes 7. It has been found in tumors of terminal cancer patients
  • Slide 25
  • Ban Dihydrogen Monoxide? Results Results 90 yes 8 Get away from me kid! I dont sign petitions. 2 Are you kidding - that is water!
  • Slide 26
  • One Reason Why Pseudoscientific Beliefs are Common: Public Education is in Disarray U.S. Schools ranked lowest among western nations, particularly in science U.S. Schools ranked lowest among western nations, particularly in science funding, infrastructure decaying funding, infrastructure decaying 1/4 of U.S. Schools have no library 1/4 of U.S. Schools have no library 1/4 of schools use textbooks from the 1980s or earlier 1/4 of schools use textbooks from the 1980s or earlier
  • Slide 27
  • Geographic Ignorance Percent of US teens unable to locate the following on a map: Percent of US teens unable to locate the following on a map: United States 11% Pacific Ocean 29% Japan 58% United Kingdom 68%
  • Slide 28
  • Pseudoscientific Beliefs Percentage of Americans who believe at least to some degree in these phenomena 19761997 Astrology17% 37% Astrology17% 37% UFOs24% 30% UFOs24% 30% Reincarnation 9% 25% Reincarnation 9% 25% Fortune-Telling 4%14% Fortune-Telling 4%14%
  • Slide 29
  • Ignorance/Pseudoscientific Beliefs Half of US citizens do not believe in evolution and do believe that humans and dinosaurs coexisted (2007) Half of US citizens do not believe in evolution and do believe that h

Recommended

View more >