As someone who spends a lot of time talking about the dangers of “alternative medicine”, I often get confronted with the following argument against banning such practices: “Worst case scenario, it doesn’t work. That’s harmless. Why take something away that people rely on and that makes them feel better about their health?“. The point I always try to make in response is that while drinking creative herbal teas while also taking your medicine certainly doesn’t harm you, there are many people in the world who view “alternative” medicine as a reliable source of advice. And this has dire consequences.
The latest story in the news that makes my point for me is that of a Sydney naturopath who is currently under inquiry because she prescribed a water-only diet to a breastfeeding mother to cure her child’s eczema. The child became severely malnourished and would have sadly died if the mother hadn’t come to her senses and brought him to the hospital just in time. Eczema is, of course, not fatal and very common among babies (up to 20% of children under the age of 1 are diagnosed with some form of dermatitis). While skin inflammation can be made worse by food allergies, there is of course no evidence whatsoever that eating itself has anything to do with getting a skin rash. On the other hand, it is one of the basics of common sense that not eating kills you. It’s equally common sense that babies are more delicate than adults and therefore that while an adult woman can probably survive for a few days on water only, a baby might be too small and fragile to pull through. The amazing thing is, the mother in question clearly knew this on some level, since she reportedly gave in and ate a little bit of watermelon for a few days. Yet, she was somehow so entrenched in her belief that naturopathy is a legitimate form of medicine that she still went against her most basic animal instincts and stopped eating and feeding her child. Her faith in naturopathy was really no different from the religious zeal that makes especially devout people around the world commit various forms of self-harm. What is especially heartbreaking is that there are a variety of very effective treatments of infant dermatitis. There are antihistamines, cortisone creams and immune-modulatory drugs that can really make a big difference on the condition if not treat it completely. Many of these things are available over the counter at most drugstores and are advertised daily on television. It would take someone who has completely abandoned the idea of rationality to believe that not eating would be a better idea than any of the science-based treatment options out there.
Further evidence that the mother had checked out of her analytical brain is that the naturopath whose advice she was blindly following had already been accused of manslaughter for prescribing a water-only diet to a patient of hers in 1987 (you’d think she would have learnt from that experience, but nevermind). The reason she was never convicted highlights what I believe is the central hypocrisy in the way we view alternative medicine. The defense successfully argued that she was giving advice as a friend, not as a medical professional – and the jury clearly agreed. Of course, that line of defense would have never worked if the naturopath had been instead a medical doctor, or a registered nurse, or a pharmacist, or a physician’s assistant, or a physiotherapist. People who are legitimate medical professionals have a responsibility to act as such even when they are off the clock because their position and qualifications means people will implicitly trust them. However, a naturopath holds no such influence and as such can freely give any kind of pernicious advice as a friend without the responsibility of being taken seriously. The issue being, of course, that there are some people who do take “alternative medical practitioners” seriously – and end up paying the price (as well as, presumably, a rather fat bill). The problem lies with the trappings we allow these people to have. Naturopaths sign themselves off as NMDs, which is only one tiny letter off from MD (the way medical doctors identify themselves). “Natural” remedies are on sale in pharmacies, right next to medicine that has had to go through many rounds of rigorous scientific testing in order to be sold to the public. We allow these individuals to advertise themselves as medical professionals, which means that some people buy into their nonsense. There are, fundamentally, two ways out of this mess.
Either we start seriously regulating alternative medicine as though it were real medicine, or we start putting emphasis on scientific literacy in schools and colleges around the world. The first option would undoubtedly be more satisfying in the short term (getting all the “miracle cures” to back up their claims before they can be sold in pharmacies would be really entertaining), but the second one is definitely most beneficial in the long term. In most countries around the world, science is taught very selectively to those who care. While in most colleges in America you have to take some kind of English or writing class, science is almost never compulsory – mainly because it is really, really hard. However, this churns out hundreds of thousands of high school and university graduates every year who have no understanding of the basic principles that make their bodies function. As such, these people are easy pray to the quackery of “alternative” doctors, especially when they are sick, or desperate, or sleep deprived and trying to cope with an infant with severe dermatitis. Knowledge, as always, would have been power.
While the story of this naturopath’s treatment is alarming, to generalize and imply what the vast majority of competent ones do treatment-wise is “quackery” is false. There are many physicians who prescribe harmful drugs and do worthless procedures, yet you would certainly not paint the entire profession as being filled with charlatans. Since properly prescribed pharmaceuticals are the third leading cause of death in the USA (106,000 deaths every year at a minimum), and there have been no deaths from any vitamin, mineral or herb in the last 25 years, it’s pretty obvious which profession has the best safety record when it comes to prescriptions.
No medicine is always harmless. Conventional medicine kills far more people than anyone wants to admit. Regulation in the form of licensing based on board exams and criminal background checks is already employed for MD’s, DO’s, ND’s, DC’s, and LAC’s among others. While you might expect a practitioner with a license to always choose evidence-based assessments and treatments, this is simply not the truth. People are subjective creatures regardless of training are susceptible to group think and delusion. Targeting the broad category of alternative medicine is not helpful for the patient. Not all alternatives are nonsense, and not all conventional practices have a firm basis. We need to establish a means of assessing practitioners regardless of degree/license and reporting the findings to the public. The goal would be to determine who actually practices based on evidence and who does not.