May 06 2009
Those who advocate for strict scientific standards in medicine are often asked, “what’s the harm” of someone pursuing unconventional medicine? If people want to engage in a little hope, even if it’s a false hope, it might make them feel better and it won’t cause any harm.
Often the questioner assumes that the unscientific remedies are themselves harmless. This is not always a reasonable assumption. Some unscientific treatments are directly harmful, or carry a non-trivial risk. But that is not the limit to the harm that can be caused by pursuing such remedies.
For me the biggest harm of unscientific medicine is that it fosters a distruct of science-based medicine and practitioners and faith in bizarre notions of health and illness and in treatments that do not work. Someone who feels that acupuncture helpe their back pain may then rely upon it when they get cancer.
Homeopathic treatments (real ones, not products labeled homeopathic but containing real drugs) are certainly harmless. They have no side effects because they have not effects – they are just water and sugar pills. Most homeopathic dilutions are such that chances are not a single molecule of the “active” ingredient remains behind. Or, more acurately, the original assortment of molecules that can be found in all water are there, but that’s it. Homeopathy is literally nothing but pure magical thinking.
But homeopathy can still kill. Thomas Sam, a homeopath, and his wife, Manju Sam, are standing trial in an Australian court for manslaughter by gross criminal negligence. They allowed their 9 month old child to die from complications of severe eczema. According to reports, their daughter, Gloria, was healthy at birth. But at 4 months old she developed a skin rash, which became progressively worse. Sam decided to treat the eczema with homeopathic treatments – which means not to treat it at all. He sought advice from other homeopaths and naturopaths.
He also refused to follow the advice of the child’s pediatrician to take her to skin specialist to get more aggressive treatment. As a result Gloria’s eczema worsened. Her skin became thin and cracked, resulting in infections, and eventually septicemia and death. Standard medical treatments could have saved her right up until days before her death. This seems to be a case of ideology trumping common sense, evidence, and all reason.
This sad case is an extreme example, but it is not an isolated case. Similar cases occur with adults, in which case there is no legal issue of neglect. The website whatstheharm.net documents the stories of many similar cases. Because of my blogs and podcast I also receive many e-mails from family members who are standing by helplessly while a loved-one slowly dies from a treatable disease because they are enthralled by an unscientific practitioner and their claims.
Some defend unscientific practices by saying that they should be used in addition to science-based medicine rather than instead of it. I agree that this is a safer option – forgoing all science-based medicine is the most extreme and dangerous approach. But that does not mean that the “integrative” approach is safe or reasonable. In practice those who are ideologically dedicated to treatments that cannot be supported by evidence or basic science seek or prescribe such treatments first, delaying access to proven therapies.
There are also other sources of indirect harm. Expending resources of time, money, effort, and emotion on treatments that do not work reduce the resources available for treatments that do work. Also I find that unscientific therapies are often accompanied by gross misinformation about biology and medicine. They also thrive, as I stated above, on mistrust of science-based medicine.
No matter how promoters try to sugar coat it, unscientific treatments are harmful to the system and to individuals. Occasionally, as with the case of Gloria Sam, we hear of a dramatic example. But the harm from unscientific health claims are not limited to these media-friendly cases.
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