Dangerous Practitioners
Supplementary, Complementary and Alternative Medicine

This is a modified version of a presentation I gave as part of a forum on alternative medicine, held in conjunction with the Australian Skeptics 2003 National Convention.

Here is the introduction slide for my presentation. Put your mouse over it to see what happened when I pressed "Next".

When?

There are three times when alternative medicine and its practitioners can be dangerous. These are before having medical treatment, after having treatment, and instead of real treatment. A good example of this danger can be seen from this book, which is a training manual for Contact Reflex Analysis. This book is an encyclopaedia of quackery, as it appears to contain a method of diagnosing and then treating every ailment known to man (and even some which are unknown). I was originally going to give it the benefit of the doubt tonight as I thought that in my first glance through it I had noticed that the book admitted that there is no cure for paraplegia, but a closer reading shows that it in fact does have a suggested cure for the sort of total paralysis caused by spinal cord defects that so befuddles conventional medicine. It is interesting to note that this book is supposed to be based on over forty years of research, but the new edition has a completely different set of potions and cures for all the diseases and ailments. It seems that the authors have had a falling out with their previous suppliers of herbs and spices …

The alternative world is riddled with "one cause, one cure" forms of quackery like CRA, Clark's zappers, cancer curers, autism curers and so on, but the industry is not prepared to do anything about these. Surely, if they want to be taken seriously they would want the charlatans and quacks out of business, but they are either ignored or defended. When anyone dies as a result of quackery, such as the death of Mitchell Little caused when naturopath Reg Fenn convinced his parents that a magical machine could cure a heart defect, there is either silence from the industry or condemnation of the authorities for attacking the practitioners. But let a real doctor make a mistake …

What?

Let's now look at what the alternative medicine industry has to say about safety, quality and effectiveness. The quotes below were made by officials of the Complementary Healthcare Council, a body which represents the participants in the industry.

When the government suggested that it was deceptive to include the words "drug free" on the label of potions with pharmacological effects, the reaction of the industry was:

Passage of TGR Amendment No.401 through the Senate would be a denial of our democratic right for responsible and commonsense information on complementary medicines.
http://www.iahf.com/asia/drugfree.html

When changes to advertising rules were suggested, this was going to cause much distress.

The advertising review has removed a lot of previously prohibited claims and introduced a system which allows a wider range of claims so long as they are balanced, truthful and not misleading. However, many claims that have been accepted for ten or more years are no longer acceptable and there is a real danger that many multi-component products will be lost as industry has 4 years to comply with the new requirements.
http://www.iahf.com/vit_trade/20001015.html

So here you see the industry admitting that for at least ten years its members have been making claims that are unbalanced, untruthful and misleading and instead of promising to clean up the act they want more than four more years to stop lying.

And the last policy statement from the Complementary Healthcare Council:

The main objective of the CHC position is to get out of the pharmaceutical paradigm that is crippling the industry and denying consumers' access to products that are freely available in other comparable countries.
http://www.iahf.com/vit_trade/20001015.html

There are two possible interpretations of the expression "pharmaceutical paradigm". One is that it is the paradigm which says that products should be thoroughly tested and be shown to work before they are sold to the public. The other is that science should be relevant to research and the pursuit of knowledge. It says much that following these principles might result in "crippling the industry".

Why?

Now let's get on to why alternative medicine practitioners are dangerous. The first reason is that there is no need or even desire to prove that anything works. Anecdote is good enough. If someone says that something worked once somewhere then that is good enough to justify selling the stuff to anyone. There is also no guarantee of quality. As the Pan Pharmaceuticals fiasco showed, comments from the alternative medicine industry indicated no concern about the shoddy manufacturing practices at Pan but instead treated the affair as an attack on alternative medicine. The attitude of the industry towards any attempt at regulation of packaging or advertising claims shows that deceit is acceptable, as does the continual quoting of long-refuted lies such as the number of "needless deaths" in hospitals. It seems impossible to find an example of a case where anyone from within the alternative medicine industry has ever supported government action against really outrageous quackery, and in fact there is a total rejection of any form of regulation or even investigation. The reaction to the NSW Dwyer committee is a good example of this, where the committee was established to root out rubbish like cancer quackery. The response from the industry was never "I can prove that this works" but instead consisted almost totally of ad hominem attacks on the members of the committee.

The Therapeutic Goods Administration oversees the manufacture, sale and distribution of medical products and things claiming to have therapeutic or pharmacological properties. There are two levels of approval – "registration", which requires evidence of safety, quality, and efficacy, and "listing", which only requires quality and safety. Both are required to have truthful labelling. Just for reference, I will quote what the TGA says. You will see that most complementary medicines can be sold without any proof that they work.

"Products assessed as having a higher level of risk (prescription medicines, some non-prescription medicines and medical devices) are evaluated for quality, safety and efficacy. Once approved for marketing in Australia these products are included in the ARTG as 'registered' products and are identified by an AUST R number.

"Products assessed as being lower risk (many non-prescription medicines including most complementary medicines and low risk medical devices) are assessed for quality and safety. Once approved for marketing in Australia, these products are included in the ARTG as 'listed' products and are identified by an AUST L number".

Summary

To summarise, the dangers of unregulated alternative medicine are to your health, from untested medications, to your life, from avoiding proper treatment, to your wealth, from fraud and theft, to your family, from losing you, to your children, from increased risk of disease through the opposition to vaccination, and to society, by returning to the dark ages and belief in magic.

To finish up, I will return to the question "Why?" again, but this time I want to turn it inwards to explain why I am concerned about quackery. Last weekend I spent time in the Museum of Melbourne participating in the Great Australian Science Show. While I was in the museum I had my photograph taken standing next to an iron lung. I do not want to live in a world where such things are ever required, and I don't want my children, or anyone else's children, to live in an age where medicine is nothing but superstition and its practitioners are sorcerers.