Dec 12 2011

Fighting CAM – In Australia

One thing that I notice when the issue of so-called complementary and alternative medicine (CAM, although some of my colleagues add the “s” from “so-called” to make is SCAM) is brought up in the media is that many misconceptions will be cited as fact, often by both sides, although far more by the pro-CAM side. CAM advocates seem to rely almost entirely on misconceptions and factual errors.

In Australia recently an ABC program aired that was highly critical of CAM, and now CAM advocates are firing back. The latest exchange was initiated by a group of 34 Australian physicians who are campaigning against pseudoscience in medicine. This is something that should not be controversial, but amazingly there is a large number of practitioners (although a minority) that stand  up to defend pseudoscience in medicine. They report:

Emeritus Professor of Medicine at the University of New South Wales John Dwyer says some courses previously offered at Southern Cross were more “magic” than science.
“We were off to a bad start with Southern Cross University when their founding Professor of Health and Nursing was teaching for years Healing Touch therapy; quite extraordinary nonsense.”

Good for him and his colleagues – we need more professionals who are not afraid to point out that the CAM emperor has no clothes.

Defending nonsense we have:

Professor Iain Graham from Southern Cross University’s School of Health yesterday defended his university, saying the use of alternative therapies, such as homeopathy, can be traced as far back as ancient Greece.

The Argument from Antiquity

I have to give the standard caveat that professor Graham may have been misquoted or misrepresented, but he was quoted making the same argument in a different piece as well. Taken at face value, we have a misstatement of fact combined with a logical fallacy. He probably (if I am being generous) did not mean to state that homeopathy can be traced back to ancient Greece, just that some CAM therapies can. Homeopathy was invented by Samuel Hahnemann about 200 years ago.

But I wonder what CAM modalities he had in mind. Chiropractic? About 100 years. Therapeutic touch? A few decades. Acupuncture is a complex question, but what passes for acupuncture today is less than 100 years old. Perhaps he was thinking about blood letting or trepanation.

It is true, however, that some basic concepts, like the notion of a life energy, can trace it roots to ancient Greece, and other ancient cultures. However, such notions are pre-scientific nonsense. Scientists abandoned the notion of life energy over a century ago because there is no evidence that such a force exists (and there still isn’t) and after figuring out all the basic processes of life there was essentially nothing left for the alleged life force to do.

For some reason, however, professor Graham believes that antiquity in science is a virtue – the “argument from antiquity” logical fallacy. The unstated assumption is that if an idea has survived for hundreds or thousands of years it must be legitimate. This is demonstrably false. Galenic medicine (blood letting, purging, etc. based on the notion of the four humours) survived for thousands of years, and yet it was based on complete an utter primitive nonsense. In fact its tendrils still exists – there is still blood letting, cupping (which is just another form of blood letting) and similar practices going on in the world. It was replaced in the West because of the advent of science in medicine – a trend that Graham apparently wants to reverse.

The Argument from Popularity

Graham’s second swing and a miss is this:

“Eighty per cent of Australians seek alternative therapies,” Prof Graham said.

“Obviously orthodox medicine is not working for everyone,” he said.

I highly doubt that the 80% figure is correct. Most such figures are highly inflated by including all sorts of practices in the CAM category, like exercise, eating organic food, and sometimes prayer is included. US surveys show the percentage of CAM use is around 1/3, but this is mostly things like massage and chiropractic manipulations. Homeopathy is around 3-4%, and acupuncture 6-7%. In fact, only manipulation and massage were in the double digits.

This is all marketing deception – create a false category (CAM), pad it out with commonly used methods, and then claim that the extreme fringes are therefore getting more popular. I don’t know how Graham got to 80% (I doubt such methods are that much more popular in Australia) but it is close to one survey from 2007 that found that 69% of Australians used one of the 17 most popular forms of CAM in the last year. However, they included in their list: martial arts, yoga, massage, meditation, and taking multivitamins. I am not sure what taking multivitamins says about the popularity of homeopathy, but apparently professor Graham thinks that is significant.

In any case – I will grant that CAM as a marketing concept has been somewhat successful, and even that it has gained popularity recently (although not as much as advocates would have you think). That is entirely irrelevant, however, to the question of whether or not any particular CAM modality is science-based and appropriate for a university curriculum (the question at hand).

Universities are supposed to be thought-leaders, to have intellectual standards that rise above the mere notion of popularity. They are supposed to uphold academic standards of scholarship, and in scientific disciplines of high standards in science. It is therefore very odd and disturbing to defend a university policy based upon popularity. Should we allow surveys of public opinion to determine whether or not we teach creationism or astrology in our universities?


These same two arguments keep coming up in the defense of CAM, despite the fact that they are factually dubious and logically fallacious. That, however, is the nature of CAM – it is an intellectually dubious enterprise. We need more professionals like John Dwyer who are not afraid to say so.

In the comments to the above article another very common CAM canard was presented. Commenter “shotinfo” wrote:

According to articles published in both the British Medical Journal and the New England Journal of Medicine, between 85% and 90% of all mainstream medical drugs and procedures have never been scientifically proven to either work or be effective.

I love the fake references – of course no such articles in BMJ or NEJM exist, and no references were offered, but it certainly makes the fake factoid sound legitimate. I have already discussed this issue in detail. The bottom line is that surveys of medical practice find that about 78% of them are reasonably evidence-based. Yet again we have a factual misstatement used to support a logical fallacy (tu quoque). All medical practice should strive to be more science and evidence-based. Pointing out the deficiencies in one discipline does not justify deficiencies in another.

The commenter, however, also misses the real point of criticism of CAM. Mainstream medicine is based upon a culture and institution of science, and a science-based standard of care. The execution of this standard is flawed, but the principle is clear. CAM is not based on a science-based standard. It, in fact, seeks to subvert and even remove the science-based standard of care. And CAM proponents live in a culture of pseudoscience, not legitimate science.

We need to keep pointing this out – and the defenders of CAM will keep making our point for us by quoting the same factual errors and logical fallacies over and over again.

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