This is the question posed by Richard Harman, a retired mechanical engineer turned ‘healing touch’ practitioner, in the February issue of Kai Tiaki Nursing New Zealand. For those unfamiliar with Kai Tiaki, it is the publication of the New Zealand Nurses Organisation and is circulated to 44,000 nurses and healthcare practitioners around New Zealand. The full content of Richard Harman’s article is posted on his website. He writes:
“…take advantage of treatments, complementary to medical care, that can rapidly heal some chronic ailments. As someone who has become familiar with a number of natural health care practices, I strongly believe our health care services would benefit hugely if practitioners of natural health care (who could be regarded as healing specialists) were better integrated into “mainstream” health services…
The ability for full integration to reduce the backlog of chronically ill people would steadily improve our economy and well being. The low cost of complementary treatments, relative to medical treatments, and the work of the incoming healing specialists, could heal many more people for the same cost as at present. The savings could also be used to help fund the training of more healers, whose work would become a grass roots form of health care.”
He discusses the importance of auras and energy fields in maintaining health and suggests integrating the natural health care practises of energy healing and homeopathy and cites the ‘pioneering’ work of James Oschman and Bruce Lipton.
I’m going to take issue with just two* points. First up, on why the medical profession resists integrating medical and complementary therapies. Says, Richard Harman:
“The medical profession largely resists such integration on the grounds that many healers (to use their convenient name) are not medically qualified.”
No, the medical profession resists such integration because there is no reliable evidence that the treatments are effective. Just read Prof Edzard Ernst & Dr Simon Singh’s excellent book on the subject, ‘Trick or Treatment?‘.
And secondly, that clinical trials are ‘ineffective’ and they should not be required for complementary treatments. He states:
“However, too many complementary treatments have been “proved ineffective”, because medical trials are inappropriate for their subtle-energetic nature.
…One way to accelerate the process would be to delete the requirement for clinical trials of complementary treatments prior to their use with patients. The safety of the treatments, which have caused no deaths, and their unsuitability for medical trials could let their effectiveness record be accumulated while they are being used. That record would identify the most effective healers and treatments for each ailment.”
This argument makes me see red. How can a clinical trial be inappropriate? The whole idea behind evidence-based medicine is to remove all the biases and delusions we humans are capable of reading into things to find out if something is effective or not. It doesn’t matter if it homeopathy or drinking orange juice. It doesn’t matter how it works. What is important is that there is a measurable outcome. Time and time again, when cherry-picking and biases are removed, complementary treatments are found to be no more effective than placebo.
So back to the initial question: is it time to integrate medical and natural health care? I say no, but I think a better question would be, is it time to integrate placebo and medical health care? A recent publication by Kaptchuk et al [1] in the open access journal PloS One demonstrated the efficacy of prescribing placebo for irritable bowel syndrome. But what was really fascinating about this study is that the patients were told it was a placebo!
[1] Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, Singer JP, Kowalczykowski M, Miller FG, Kirsch I, Lembo AJ (2010). Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLoS One 5(12):e15591.
* Just two? But there were so many to choose from!
There are an argument—not the ones Richard Harman presents!—for having these ‘alternative’ practitioners brought in the fold. I doubt Harman would like them though:-
- they’d have to register, so that they’d be obligated to hold up to mainstream care standards. This was, for example, raised in response to case of a iridiologist treating a cancerous growth in the scalp in Nelson. I’ve two minds about it, but I can see the point.
- there is a move in the EU to have all remedies show their effectiveness.
Of course Harman’s suggestion rests on a double standard, which is what makes it ridiculous: to be regarded as essentially the same, but not to be held to the same standards. Doesn’t make any sense. If you want to a treatment be held with the same respect, you need the treatment to be held to the same standards.
Mind you, citing Bruce Lipman and “quantum physics”, in the manner he does, pretty much says he’s outside sound discussion. Then he goes on to ‘Energy healing and homeopathy’. Sigh
It’s depressing the extent this silliness is in New Zealand. Let’s hope the proposals for the Natural Health Products Bill help. (Hugely frustratingly, I never found time to contribute, esp. as I’ve written on this general issue several times.)