Альтернативная медицина

Альтернативная медицина
АМ, дополнительная и альтернативная медицина (CAM), дополнительная медицина, неортодоксальная медицина, интегративная медицина (IM), дополнительная и интегративная медицина (CIM), медицина нового века, псевдомедицина, нетрадиционная медицина, неортодоксальная медицина, альтернативная медицина
Претензии	Альтернативы научно обоснованной медицине

Альтернативная медицина — это любая практика, целью которой является достижение целебного эффекта медицины, несмотря на отсутствие биологической достоверности , проверяемости , повторяемости или доказательств эффективности. В отличие от современной медицины , которая использует научный метод для проверки возможных методов лечения посредством ответственных и этических клинических испытаний , получая повторяемые доказательства либо эффекта, либо его отсутствия, альтернативные методы лечения находятся за пределами основной медицины. и не возникают в результате использования научного метода, а вместо этого полагаются на свидетельства , анекдоты , религию, традиции, суеверия , веру в сверхъестественные « энергии », псевдонауку , ошибки в рассуждениях , пропаганду, мошенничество или другие ненаучные источники. Часто используемые термины для соответствующих практик — это Нью Эйдж медицина , псевдомедицина , неортодоксальная медицина , целостная медицина , маргинальная медицина и нетрадиционная медицина , мало чем отличающаяся от шарлатанства .

Некоторые альтернативные практики основаны на теориях, которые противоречат устоявшейся науке о том, как работает человеческое тело; другие обращаются к сверхъестественному или суеверному, чтобы объяснить их эффект или его отсутствие. В других странах такая практика правдоподобна, но ей не хватает положительной вероятности результата с соотношением риска и выгоды . Исследования альтернативных методов лечения часто не соответствуют надлежащим протоколам исследований (таким как плацебо -контролируемые исследования, слепые эксперименты и расчет априорной вероятности ), что приводит к неверным результатам. История показала, что если метод доказал свою эффективность, он в конечном итоге перестает быть альтернативой и становится основной медициной.

Большая часть воспринимаемого эффекта альтернативной практики возникает из-за веры в ее эффективность, эффекта плацебо или из-за того, что вылеченное состояние разрешается само по себе ( естественное течение болезни ). Это еще больше усугубляется тенденцией обращаться к альтернативным методам лечения в случае неэффективности лекарств, и в этот момент состояние будет худшим и, скорее всего, самопроизвольно улучшится. В отсутствие этой предвзятости, особенно в отношении заболеваний, которые, как ожидается, не улучшатся сами по себе, таких как рак или ВИЧ-инфекция , многочисленные исследования показали значительно худшие результаты, если пациенты обращаются к альтернативным методам лечения. Хотя это может быть связано с тем, что эти пациенты избегают эффективного лечения, некоторые альтернативные методы лечения являются активно вредными (например, цианидом амигдалина отравление или намеренное употребление перекиси водорода ) или активно мешают эффективному лечению.

Сектор альтернативной медицины — это высокодоходная отрасль с сильным лобби. и сталкивается с гораздо меньшим регулированием использования и маркетинга непроверенных методов лечения. Дополнительная медицина ( CM ), дополнительная и альтернативная медицина ( CAM ), интегрированная медицина или интегративная медицина ( IM ), а также целостная медицина пытаются объединить альтернативные практики с практиками основной медицины. Практики традиционной медицины становятся «альтернативными», когда используются за пределами их первоначальных условий и без надлежащего научного объяснения и доказательств. Альтернативные методы часто позиционируются как более « естественные » или « холистические », чем методы, предлагаемые медицинской наукой, которую иногда пренебрежительно называют « большой фармацией сторонники альтернативной медицины ». На изучение альтернативной медицины были потрачены миллиарды долларов, при этом положительные результаты были незначительными или отсутствовали вовсе, а многие методы были полностью опровергнуты.

Определения и терминология

Смотрите также: Терминология альтернативной медицины.

Марсия Энджелл : «Не может быть двух видов медицины – традиционной и альтернативной».

Термины «альтернативная медицина» , «дополнительная медицина» , «интегративная медицина», « холистическая медицина» , «натуральная медицина» , «неортодоксальная медицина» , « маргинальная медицина» , «нетрадиционная медицина» и нового века» «медицина используются как взаимозаменяемые, имеющие одно и то же значение и почти синонимы в большинстве контекстов. Терминология со временем изменилась, отражая предпочтительный брендинг практикующих специалистов. Например, отдел Национальных институтов здравоохранения США , изучающий альтернативную медицину, в настоящее время называемый Национальным центром дополнительного и интегративного здравоохранения (NCCIH), был создан как Управление альтернативной медицины (OAM) и был переименован в Национальный центр дополнительного и альтернативного здравоохранения. Медицина (NCCAM) до получения нынешнего названия. Терапию часто называют «естественной» или «холистической», неявно и намеренно предполагая, что традиционная медицина является «искусственной» и «узкой по своему охвату».

Значение термина «альтернатива» в выражении «альтернативная медицина» не в том, что это эффективная альтернатива медицинской науке (хотя некоторые сторонники альтернативной медицины могут использовать расплывчатую терминологию, чтобы создать видимость эффективности). Также можно использовать свободную терминологию, чтобы предположить, что дихотомия существует, хотя ее нет (например, использование выражений «западная медицина» и «восточная медицина», чтобы предположить, что разница представляет собой культурное различие между азиатским Востоком и европейским Запад, а не в том, что разница между доказательной медициной и методами лечения, которые не работают).

Альтернативная медицина

Альтернативная медицина в общих чертах определяется как набор продуктов, практик и теорий, которые, как полагают или воспринимаются их пользователями, оказывают целебное воздействие медицины. которых но эффективность не установлена ​​научными методами , или чья теория и практика не являются частью биомедицины , или чьи теории или практика прямо противоречат научным данным или научным принципам, используемым в биомедицине. «Биомедицина» или «медицина» — это та часть медицинской науки, которая применяет принципы биологии , физиологии , молекулярной биологии , биофизики и других естественных наук к клинической практике , используя научные методы для установления эффективности этой практики. В отличие от медицины, альтернативный продукт или практика не возникают в результате использования научных методов, а могут быть основаны на слухах , религии, традициях, суевериях , вере в сверхъестественные силы, лженауке , ошибках в рассуждениях , пропаганде, мошенничестве или других ненаучных источниках.

Некоторые другие определения направлены на определение альтернативной медицины с точки зрения ее социальной и политической маргинальности по отношению к основному здравоохранению. Это может относиться к отсутствию поддержки, которую альтернативные методы лечения получают от ученых-медиков в отношении доступа к финансированию исследований , сочувственного освещения в медицинской прессе или включения в стандартную медицинскую учебную программу . Например, широко используемый Определение, разработанное NCCIH США, называет его «группой разнообразных медицинских систем, методов и продуктов здравоохранения, которые обычно не считаются частью традиционной медицины» . Однако эти описательные определения недостаточны в наши дни, когда некоторые традиционные врачи предлагают альтернативные методы лечения, а вводные курсы или модули могут предлагаться как часть стандартной медицинской подготовки бакалавриата; Альтернативную медицину преподают более чем в половине медицинских школ США , и американские страховые компании все чаще готовы предоставлять возмещение за альтернативные методы лечения.

Дополнительная или интегративная медицина

Дополнительная медицина (КМ) или интегративная медицина (ИМ) – это когда альтернативная медицина используется вместе с основным функциональным лечением, полагая, что она улучшает эффект лечения. Например, можно считать, что иглоукалывание (прокалывание тела иглами для воздействия на поток сверхъестественной энергии) повышает эффективность или «дополняет» научно обоснованную медицину при одновременном использовании. Значительное лекарственное взаимодействие, вызванное альтернативными методами лечения, может сделать лечение менее эффективным, особенно при лечении рака .

Некоторые медицинские организации проводят различие между комплементарной и альтернативной медициной, включая Национальную службу здравоохранения Великобритании (NHS), Исследования рака в Великобритании , и Центр США по контролю и профилактике заболеваний (CDC), последний из которых заявляет, что « дополнительная медицина используется в дополнение к стандартным методам лечения», тогда как « альтернативная медицина используется вместо стандартных методов лечения».

Дополнительные и интегративные вмешательства используются для снижения утомляемости у взрослых онкологических больных.

Дэвид Горски описал интегративную медицину как попытку привнести лженауку в академическую научно-обоснованную медицину. скептики, такие как Горски и Дэвид Колкухун, называли это уничижительным термином « шарлатанство ». Роберт Тодд Кэрролл описал интегративную медицину как «синоним «альтернативной» медицины, которая в худшем случае объединяет смысл с бессмыслицей. , не оправдывает" Роуз Шапиро раскритиковала сферу альтернативной медицины за ребрендинг тех же практик, что и интегративная медицина.

CAM — это аббревиатура фразы «дополнительная и альтернативная медицина» . (ВОЗ) о традиционной и дополнительной медицине за 2019 год В Глобальном отчете Всемирной организации здравоохранения говорится, что термины «дополнительная и альтернативная медицина» «относятся к широкому набору методов здравоохранения, которые не являются частью собственной традиционной или традиционной медицины этой страны и не полностью интегрированы. в доминирующую систему здравоохранения. В некоторых странах они используются как синонимы традиционной медицины».

Экзамен по интегративной медицине, проводимый Американским советом врачей по специальностям. включает в себя следующие предметы: мануальная терапия , биополевая терапия , иглоукалывание , двигательная терапия, экспрессивные искусства, традиционная китайская медицина , аюрведа , местные медицинские системы , гомеопатическая медицина , натуропатическая медицина , остеопатическая медицина , хиропрактика и функциональная медицина .

Другие условия

См. Также: Традиционная медицина.

Традиционная медицина (ТМ) относится к определенным практикам в культуре, существовавшим еще до появления медицинской науки. Многие практики НМ основаны на «холистическом» подходе к болезням и здоровью, в отличие от научно-обоснованных методов традиционной медицины. В докладе ВОЗ за 2019 год традиционная медицина определяется как «сумма знаний, навыков и практик, основанных на теориях, верованиях и опыте, присущих различным культурам, объяснимым или нет, используемых для поддержания здоровья, а также для профилактики диагностика, улучшение или лечение физических и психических заболеваний». При использовании за пределами исходной обстановки и при отсутствии научных доказательств практики НМ обычно называют «альтернативной медициной».

Холистическая медицина – это еще один ребрендинг альтернативной медицины. В этом случае слова баланс и холизм часто используются наряду с дополнительным или интегративным , претендуя на более полный учет «целого» человека, в отличие от предполагаемого редукционизма медицины.

Challenges in defining alternative medicine

Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo. Journalist John Diamond wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", a notion later echoed by Paul Offit: "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends."

Types

See also: List of forms of alternative medicine

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods. Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.

Unscientific belief systems

"They told me if I took 1000 pills at night I should be quite another thing in the morning", an early 19th-century satire on Morison's Vegetable Pills, an alternative medicine supplement

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.

	Proposed mechanism	Issues
Naturopathy	Naturopathic medicine is based on a belief that the body heals itself using a supernatural vital energy that guides bodily processes.	In conflict with the paradigm of evidence-based medicine. Many naturopaths have opposed vaccination, and "scientific evidence does not support claims that naturopathic medicine can cure cancer or any other disease".
Homeopathy	A belief that a substance that causes the symptoms of a disease in healthy people cures similar symptoms in sick people.	Developed before knowledge of atoms and molecules, or of basic chemistry, which shows that repeated dilution as practiced in homeopathy produces only water, and that homeopathy is not scientifically valid.

Traditional ethnic systems

Ready-to-drink traditional Chinese medicine mixture

Acupuncture involves insertion of needles in the body.

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world. Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.

Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition.

	Claims	Issues
Traditional Chinese medicine	Traditional practices and beliefs from China, together with modifications made by the Communist party make up TCM. Common practices include herbal medicine, acupuncture (insertion of needles in the body at specified points), massage (Tui na), exercise (qigong), and dietary therapy.	The practices are based on belief in a supernatural energy called qi, considerations of Chinese astrology and Chinese numerology, traditional use of herbs and other substances found in China, a belief that the tongue contains a map of the body that reflects changes in the body, and an incorrect model of the anatomy and physiology of internal organs.
Ayurveda	Traditional medicine of India. Ayurveda believes in the existence of three elemental substances, the doshas (called Vata, Pitta and Kapha), and states that a balance of the doshas results in health, while imbalance results in disease. Such disease-inducing imbalances can be adjusted and balanced using traditional herbs, minerals and heavy metals. Ayurveda stresses the use of plant-based medicines and treatments, with some animal products, and added minerals, including sulfur, arsenic, lead and copper(II) sulfate.	Safety concerns have been raised about Ayurveda, with two U.S. studies finding about 20 percent of Ayurvedic Indian-manufactured patent medicines contained toxic levels of heavy metals such as lead, mercury and arsenic. A 2015 study of users in the United States also found elevated blood lead levels in 40 percent of those tested. Other concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities. Incidents of heavy metal poisoning have been attributed to the use of these compounds in the United States.

Supernatural energies

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.

	Claims	Issues
Biofield therapy	Intended to influence energy fields that, it is purported, surround and penetrate the body.	Advocates of scientific skepticism such as Carl Sagan have criticized the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.
Bioelectromagnetic therapy	Use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in an unconventional manner.	Asserts that magnets can be used to defy the laws of physics to influence health and disease.
Chiropractic	Spinal manipulation aims to treat "vertebral subluxations" which are claimed to put pressure on nerves.	Chiropractic was based on the belief that manipulating the spine unblocks the flow of a supernatural vital energy called Innate Intelligence, thereby affecting health and disease. Vertebral subluxation is a pseudoscientific entity not proven to exist.
Reiki	Practitioners place their palms on the patient near Chakras that they believe are centers of supernatural energies in the belief that these supernatural energies can transfer from the practitioner's palms to heal the patient.	Lacks credible scientific evidence.

Herbal remedies and other substances

Main article: Herbal medicine

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods. Examples include healing claims for non-vitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng. Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products. It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.

A chiropractor "adjusting" the spine

Religion, faith healing, and prayer

See also: Shamanism

	Claims	Issues
Christian faith healing	There is a divine or spiritual intervention in healing.	Lack of evidence for effectiveness. Unwanted outcomes, such as death and disability, "have occurred when faith healing was elected instead of medical care for serious injuries or illnesses". A 2001 double-blind study of 799 discharged coronary surgery patients found that "intercessory prayer had no significant effect on medical outcomes after hospitalization in a coronary care unit."

NCCIH classification

The US agency NCCIH has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy. None of these energies have any evidence to support that they affect the body in any positive or health promoting way.

1. Whole medical systems: Cut across more than one of the other groups; examples include traditional Chinese medicine, naturopathy, homeopathy, and ayurveda.
2. Mind-body interventions: Explore the interconnection between the mind, body, and spirit, under the premise that they affect "bodily functions and symptoms". A connection between mind and body is conventional medical fact, and this classification does not include therapies with proven function such as cognitive behavioral therapy.
3. "Biology"-based practices: Use substances found in nature such as herbs, foods, vitamins, and other natural substances. (As used here, "biology" does not refer to the science of biology, but is a usage newly coined by NCCIH in the primary source used for this article. "Biology-based" as coined by NCCIH may refer to chemicals from a nonbiological source, such as use of the poison lead in traditional Chinese medicine, and to other nonbiological substances.)
4. Manipulative and body-based practices: feature manipulation or movement of body parts, such as is done in bodywork, chiropractic, and osteopathic manipulation.
5. Energy medicine: is a domain that deals with putative and verifiable energy fields:
   • Biofield therapies are intended to influence energy fields that are purported to surround and penetrate the body. The existence of such energy fields have been disproven.
   • Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in a non-scientific manner.

History

Main article: History of alternative medicine

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery. Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments. In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s. This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine. At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine. By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".

An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health).

Medical education

Mainly as a result of reforms following the Flexner Report of 1910 medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic. Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine, and engaging in complex clinical reasoning (medical decision-making). Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Exceptionally, the School of Medicine of the University of Maryland, Baltimore, includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration). Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD). All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Examination (USMLE).

Efficacy

Edzard Ernst, an authority on scientific study of alternative therapies and diagnoses and the first university professor of CAM, in 2012

There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved. Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias, marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.

The Scientific Review of Alternative Medicine points to confusions in the general population – a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category.

Edzard Ernst, the first university professor of Complementary and Alternative Medicine, characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Ernst has concluded that 95% of the alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis. According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.

As of 2005, the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.

Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment. Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin.

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.

Cancer researcher Andrew J. Vickers has stated:

Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven".

Perceived mechanism of effect

Anything classified as alternative medicine by definition does not have a proven healing or medical effect. However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to the alternative treatment.

How alternative therapies "work":
a) Misinterpreted natural course – the individual gets better without treatment.
b) Placebo effect or false treatment effect – an individual receives "alternative therapy" and is convinced it will help. The conviction makes them more likely to get better.
c) Nocebo effect – an individual is convinced that standard treatment will not work, and that alternative therapies will work. This decreases the likelihood standard treatment will work, while the placebo effect of the "alternative" remains.
d) No adverse effects – Standard treatment is replaced with "alternative" treatment, getting rid of adverse effects, but also of improvement.
e) Interference – Standard treatment is "complemented" with something that interferes with its effect. This can both cause worse effect, but also decreased (or even increased) side effects, which may be interpreted as "helping". Researchers, such as epidemiologists, clinical statisticians and pharmacologists, use clinical trials to reveal such effects, allowing physicians to offer a therapeutic solution best known to work. "Alternative treatments" often refuse to use trials or make it deliberately hard to do so.

Placebo effect

A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the nocebo effect, when patients who expect a treatment to be harmful will perceive harmful effects after taking it.

Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect. However, reassessments found the study to have flawed methodology. This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered.

All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful. David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine. Almost none have performed significantly better than a placebo in clinical trials. Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.

Regression to the mean

A patient who receives an inert treatment may report improvements afterwards that it did not cause. Assuming it was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result.

Other factors

There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias, and misleading wording of questions. In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson and Peter C. Gøtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding." Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment.

Use and regulation

Appeal

Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the post hoc, ergo propter hoc fallacy.

In a 2018 interview with The BMJ, Edzard Ernst stated: "The present popularity of complementary and alternative medicine is also inviting criticism of what we are doing in mainstream medicine. It shows that we aren't fulfilling a certain need-we are not giving patients enough time, compassion, or empathy. These are things that complementary practitioners are very good at. Mainstream medicine could learn something from complementary medicine."

Marketing

Alternative medicine is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma".

The popularity of complementary & alternative medicine (CAM) may be related to other factors that Ernst mentioned in a 2008 interview in The Independent:

Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. "People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives." At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth.

Paul Offit proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking". Promoting alternative medicine has been called dangerous and unethical.

Friendly and colorful images of herbal treatments may look less threatening or dangerous when compared to conventional medicine. This is an intentional marketing strategy.

Social factors

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism. Related to this are vigorous marketing of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics. Alternative medicine is criticized for taking advantage of the least fortunate members of society.

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments. Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine. Medical doctors are also aggressively marketing alternative medicine to profit from this market.

Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative therapies to avoid the adverse effects of conventional treatments.

Prevalence of use

According to research published in 2015, the increasing popularity of CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.

In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.

In Latin America, inequities against BIPOC communities keep them tied to their traditional practices and therefore, it is often these communities that constitute the majority of users of alternative medicine. Racist attitudes towards certain communities disable them from accessing more urbanized modes of care. In a study that assessed access to care in rural communities of Latin America, it was found that discrimination is a huge barrier to the ability of citizens to access care; more specifically, women of Indigenous and African descent, and lower-income families were especially hurt. Such exclusion exacerbates the inequities that minorities in Latin America already face. Consistently excluded from many systems of westernized care for socioeconomic and other reasons, low-income communities of color often turn to traditional medicine for care as it has proved reliable to them across generations.

Commentators including David Horrobin have proposed adopting a prize system to reward medical research. This stands in opposition to the current mechanism for funding research proposals in most countries around the world. In the US, the NCCIH provides public research funding for alternative medicine. The NCCIH has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies. As of 2011, the NCCIH's sister organization in the NIC Office of Cancer Complementary and Alternative Medicine had given out grants of around $105 million each year for several years. Testing alternative medicine that has no scientific basis (as in the aforementioned grants) has been called a waste of scarce research resources.

That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia. A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%.

In the United States

In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices. Thirty-one states have child-abuse religious exemptions.

The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. According to a national survey conducted in 2002, "36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine." Americans spend many billions on the therapies annually. Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain. In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons". In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004. More than 70% of the hospitals offering CAM were in urban areas.

A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize". Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least "sort of scientific", when it is not at all scientific. In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies. "Therapeutic touch" was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.

Prevalence of use of specific therapies

The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism (19%), breathing meditation (12%), meditation (8%), chiropractic medicine (8%), yoga (5–6%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and visualization (2%).

In Britain, the most often used alternative therapies were Alexander technique, aromatherapy, Bach and other flower remedies, body work therapies including massage, Counseling stress therapies, hypnotherapy, meditation, reflexology, Shiatsu, Ayurvedic medicine, nutritional medicine, and yoga. Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.

According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.

In palliative care

Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. "From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable." The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."

Regulation

Further information: Regulation of alternative medicine and Regulation and prevalence of homeopathy

Health campaign flyers, as in this example from the Food and Drug Administration, warn the public about unsafe products.

The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine. Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.

Regulation and licensing of alternative medicine ranges widely from country to country, and state to state. In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs, and half or more of the American alternative practitioners are licensed MDs. In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.

Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The U.S. Food and Drug Administration (FDA), has issued online warnings for consumers about medication health fraud. This includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.

Risks and problems

The National Science Foundation has studied the problematic side of the public's attitudes and understandings of science fiction, pseudoscience, and belief in alternative medicine. They use a quote from Robert L. Park to describe some issues with alternative medicine:

Alternative medicine is another concern. As used here, alternative medicine refers to all treatments that have not been proven effective using scientific methods. A scientist's view of the situation appeared in a recent book (Park 2000b)":

Between homeopathy and herbal therapy lies a bewildering array of untested and unregulated treatments, all labeled alternative by their proponents. Alternative seems to define a culture rather than a field of medicine—a culture that is not scientifically demanding. It is a culture in which ancient traditions are given more weight than biological science, and anecdotes are preferred over clinical trials. Alternative therapies steadfastly resist change, often for centuries or even millennia, unaffected by scientific advances in the understanding of physiology or disease. Incredible explanations invoking modern physics are sometimes offered for how alternative therapies might work, but there seems to be little interest in testing these speculations scientifically.

Negative outcomes

See also: List of herbs with known adverse effects

According to the Institute of Medicine, use of alternative medical techniques may result in several types of harm:

• "Direct harm, which results in adverse patient outcome."
• "Economic harm, which results in monetary loss but presents no health hazard;"
• "Indirect harm, which results in a delay of appropriate treatment, or in unreasonable expectations that discourage patients and their families from accepting and dealing effectively with their medical conditions;"

Interactions with conventional pharmaceuticals

Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems. An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death.

To ABC Online, MacLennan also gives another possible mechanism:

And lastly there's the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they're disappointed and they move on to the next one, and they're disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they've seen the failure so often in the past.

Side-effects

Conventional treatments are subjected to testing for undesired side-effects, whereas alternative therapies, in general, are not subjected to such testing at all. Any treatment – whether conventional or alternative – that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative therapies sometimes use the appeal to nature fallacy, i.e., "That which is natural cannot be harmful." Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.

An exception to the normal thinking regarding side-effects is homeopathy. Since 1938, the FDA has regulated homeopathic products in "several significantly different ways from other drugs." Homeopathic preparations, termed "remedies", are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength", and their alcohol concentration may be much higher than allowed in conventional drugs.

Treatment delay

Alternative medicine may discourage people from getting the best possible treatment. Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as opportunity cost. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative outcomes. Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.

Unconventional cancer "cures"

There have always been "many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as 'unproven,' suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown." However, "many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective.... The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."

Edzard Ernst has stated:

any alternative cancer cure is bogus by definition. There will never be an alternative cancer cure. Why? Because if something looked halfway promising, then mainstream oncology would scrutinize it, and if there is anything to it, it would become mainstream almost automatically and very quickly. All curative "alternative cancer cures" are based on false claims, are bogus, and, I would say, even criminal.

Rejection of science

There is no alternative medicine. There is only scientifically proven,
evidence-based medicine supported by solid data
or unproven medicine, for which scientific evidence is lacking.
— P.B. Fontanarosa, JAMA (1998)

Complementary and alternative medicine (CAM) is not as well researched as conventional medicine, which undergoes intense research before release to the public. Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not. Funding for research is also sparse making it difficult to do further research for effectiveness of CAM. Most funding for CAM is funded by government agencies. Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable. The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet. Even with the little research done on it, CAM has not been proven to be effective. Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Even those with positive results can be better explained as resulting in false positives due to bias and noisy data.

Alternative medicine may lead to a false understanding of the body and of the process of science. Steven Novella, a neurologist at Yale School of Medicine, wrote that government-funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate." Marcia Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with. It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position are George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA) and the journal's interim editor-in-chief Phil Fontanarosa.

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the United States Senate's Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)

Neil deGrasse Tyson:
Q: What do you call Alternative Medicine that survives double-blind laboratory tests?
A: Regular Medicine.

In March 2009, a staff writer for The Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.

Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The Demon-Haunted World: Science as a Candle in the Dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment. Barrett has pointed out that there is a policy at the NIH of never saying something does not work, only that a different version or dose might give different results. Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch. Grounds for opposing alternative medicine include that:

• Alternative therapies typically lack any scientific validation, and their effectiveness either is unproven or has been disproved.
• It is usually based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud.
• Methods may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.
• Research on alternative medicine is frequently of low quality and methodologically flawed.
• Treatments are not part of the conventional, science-based healthcare system.
• Where alternative therapies have replaced conventional science-based medicine, even with the safest alternative medicines, failure to use or delay in using conventional science-based medicine has caused deaths.

Many alternative medical treatments are not patentable, which may lead to less research funding from the private sector. In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy – also a disincentive for manufacturers to fund scientific research.

English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain, defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests." Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.

CAM is also often less regulated than conventional medicine. There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients. CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine, and it is often described as an issue of non-maleficence.

According to two writers, Wallace Sampson and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.

In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this."

Harriet Hall criticized the low standard of evidence accepted by the alternative medicine community:

Science-based medicine has one rigorous standard of evidence, the kind [used for pharmaceuticals] .... CAM has a double standard. They gladly accept a lower standard of evidence for treatments they believe in. However, I suspect they would reject a pharmaceutical if it were approved for marketing on the kind of evidence they accept for CAM.

Conflicts of interest

Some commentators have said that special consideration must be given to the issue of conflicts of interest in alternative medicine. Edzard Ernst has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject. Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions. David Gorski contrasts evidence-based medicine, in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions. Harriet Hall writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials.

Use of health and research resources

Research into alternative therapies has been criticized for "diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." Research methods expert and author of Snake Oil Science, R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense." A commonly cited statistic is that the US National Institute of Health had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective.

See also

• Alternative therapies for developmental and learning disabilities
• Conservation medicine
• Ethnomedicine
• Gallbladder flush
• Psychic surgery
• Siddha medicine

Библиография

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• Даунинг А.М., Хантер Д.Г. (2003). «Подтверждение клинических рассуждений: вопрос перспективы, но чьей точки зрения?» . Мануальная терапия . 8 (2): 117–119. дои : 10.1016/S1356-689X(02)00077-2 . ПМИД   12890440 .
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• Ганн И.П. (декабрь 1998 г.). «Критика книги Майкла Л. Милленсона « Требование медицинского совершенства: врачи и подотчетность в век информации, и ее актуальность для CRNA и сестринского дела ». Журнал ААНА . 66 (6): 575–582. ISSN   0094-6354 . ПМИД   10488264 .
• Хэнд, WD (1980). «Народная магическая медицина и символизм на Западе». Магическая медицина . Беркли: Издательство Калифорнийского университета. стр. 305–319. ISBN  978-0-520-04129-5 . ОСЛК   6420468 .
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• Клиника Мэйо (2007). Книга клиники Мэйо по альтернативной медицине: новый подход к использованию лучших натуральных методов лечения и традиционной медицины . Парсиппани, Нью-Джерси: Time Home Entertainment. ISBN  978-1-933405-92-6 .
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• Стивенс, П. младший (ноябрь – декабрь 2001 г.). «Магическое мышление в дополнительной и альтернативной медицине» . Скептический исследователь .
• Тонелли М.Р. (2001). «Границы доказательной медицины». Респираторная помощь . 46 (12): 1435–1440, обсуждение 1440–1441. ПМИД   11728302 .
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Всемирная организация здравоохранения

• Ориентиры для обучения традиционной/дополнительной и альтернативной медицине
• Центр ВОЗ в Кобе; Бодекер, Г.; и др. (2005). Глобальный атлас ВОЗ традиционной, дополнительной и альтернативной медицины . ВОЗ. ISBN  978-92-4-156286-7 . Краткое содержание.

Журналы

• Обзор альтернативной медицины: журнал клинической терапии . Сэндпойнт, Айдахо: Thorne Research, гр. Идентификатор NLM 1996 г.: 9705340. Архивировано 12 июня 2018 г. в Wayback Machine.
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• Исследования в области дополнительной медицины
• Журнал альтернативной и дополнительной медицины, Нью-Йорк: Мэри Энн Либерт, ок. 1995 год
• Научный обзор альтернативной медицины (SRAM). Архивировано 22 августа 2010 г. в Wayback Machine.