Funding Magic: Alternative Medicine

One of the most alarming trends is the global rise in tax-payer funded magic, particularly in developed countries¹. No, this is not a joke, in nations such as Australia and America there has been an increase in government-funded research and care programs into supplements, complementary and alternative medicine (also known as SCAM, a term coined by the fellows at Science Based Medicine). But before I delve into this further, I should define a few terms, reflect on the general problems of giving SCAM’s both attention and money, then give you some specific examples and why they are particularly problematic.

Supplements- multivitamins/minerals and other nutrients or dietary ingredients in capsule/tablet form (i.e. vitamin C and glucosamine).

Complementary and alternative medicine- health carepractices based on the idea of vitalism, an unproven concept that living organisms are sustained by a mystical force different and more powerful than established chemical and physical forces. CAM encompasses practices including (but not limited to) reflexology, homeopathy, naturopathy, acupuncture and traditional Chinese medicine.

You know what they call alternative medicine that’s been proved to work? Medicine.”

–Tim Minchin.

To start off with, the S in SCAM, or supplements, do have a place in conventional, proven, science/evidence-based medicine. This is what sets it aside from CAM. Any textbook on medicine will tell you that adequate nutrition including correct vitamin and mineral levels, are essential to regular physiological functioning. Severe deficiencies in vitamins and minerals can cause problems such as scurvy² and rickets³. However, here is where the claims and advertising of supplements causes problems. People are being urged to routinely use products such as multivitamins and minerals, despite no existing evidence for a benefit. Now of course there are exceptions such as pregnant women being encouraged by clinicians to take folic acid⁴, but I am not talking about these sorts of cases, but rather the generalist approach to taking supplements. Additionally, the paucity of warnings against taking certain supplements can be dangerous particularly to certain people.  Just like with anything, dose maketh the poison, and vitamins/minerals are no exception. Pregnant women are at risk of overdosing on vitamin A (causing severe birth defects) and therefore are generally recommended to not take supplements with vitamin A in it. The real question you have to ask yourself and your GP is- why am I taking this supplement and do I need it? Even if it is a supplement like vitamin C that is unlikely to cause harm, are you happy with your potential placebo burning a hole in your wallet? Research into the physiological effects of vitamins and minerals, particularly in certain populations, is important, but you don’t want to keep flogging a dead horse with funding thoroughly debunked nonsense like mega-dosing with vitamin C for various ailments.

Now onto the magic that is CAM. All of the big players in the CAM field such as homeopathy, reflexology, iridology, naturopathy and acupuncture have been thoroughly debunked. Any positive effects people believe they get are pure placebos. In fact, some even carry risks beyond burning another hole in that wallet of yours, such as adverse health effects. The details of my premise have been collated and investigated so well that I won’t waste space going into much here (interested readers are directed to Dr. Paul Offit’s book “Do You Believe in Magic: The Sense and Nonsense of Alternative Medicine”). If you make claims that either have been scientifically tested to be wrong, are not falsifiable (and therefore not scientific in the first place, hence irrelevant to health care) or are pseudoscientific⁵, then you should not receive money from the public to either do research or to provide a service such as medical care.

The first recent example I want to show you arises from an article in the Australian newspaper The Herald Sun about the Olivia Newton John Cancer and Wellness Centre. Now, first off I have to say that the idea of having another medical building with a focus on tackling cancer is fantastic, especially since risk of developing cancer increases significantly with age⁶, and Australia has an ageing population⁷. No, my problem lies with her asking for government funding for magical therapies such as acupuncture. Now don’t get me wrong, what seems to be her overall idea is pleasant- massages, nice music and relaxation for cancer patients to make them feel more comfortable. However the use of acupuncture to treat pain resulting from cancer is still controversial, and generally, most (if not all) published findings are either highly biased, use poor statistics to reach poorer conclusions, or just conclude that more research is required. Also, for me the final nail in the coffin for the idea comes from the fact that the basis of acupuncture principles stems from the mystical concept of chi and meridian lines; neither of which are have been shown to exist. If a treatment is based on a non-existent concept, a field where no outstanding or scientifically significant published findings exist, then it should not be government funded. This I not the same as experimental medicine, I should point out, since it is based in science and evidence-based medicine.

Another example is the government funding of a homeopathy clinic in Balmain, Australia. At least here Dr Andrew McDonald is requesting for an investigation from the Ministers for healthcare and Medical Research. This is a fantastic example of funding magic. There is even less evidence for homeopathy (also a core part of naturopath training) as there is with acupuncture; in fact I would go so far as to say that there is no evidence for homeopathy. No, wait, I will take it a step further; there is no scientific plausibility^8-10 for homeopathy to work in any way, shape or form, beyond a placebo affect. Taxpayers and governments alike should not suffer as fools for funding woo woo.

Finally is the case of research funding for SCAM’s. Here I will focus on the CAM part, using the Royal Melbourne Institute for Technology (RMIT) and their government-funded chiropractic program. In 2011, RMIT won the Bent Spoon Award for “for having a fundamentalist chiropractic education program  and for endorsing the practice by targeting children and infants in their on-campus paediatric chiropractic clinics”. Aside from possible use for mechanical back pain interventions, chiropratic is essentially quackery. VIC skeptics have written well on the RMIT chiropractic clinic and program, so I won’t bore you with repeating the details you can read here. However, I will say that by government funding of such programs and clinics, they give their thumbs up and endorsement of such quackery. This is the sort of thing that diminishes the reputation of such an institute.

The fight against quackery, woo woo and crankery can feel like an uphill battle, with the victims being the public (confused over mixed messages and understanding what their money is funding), legitimate researchers who miss out on additional funding (when it is diverted to magic) and the reputations of educational, health care and research establishments. If you are concerned about the penetration of SCAM’s into the aforementioned areas, then I would urge you to write to your local member of parliament, or for those outside Australia, your equivalent.

References:

1. Coulter ID and Willis EM. The rise and rise of complementary and alternative medicine: a sociological perspective. MJA, 2004, 180:11:587-9.
2. Carpenter KJ. The Discovery of Vitamin C. Ann Nutr Metab 2013, 61:259-64.
3. Pettifor JM. Nutritional rickets: deficiency of vitamin D, calcium, or both? Am J Clin Nutr 2004, 80:6:17255-95.
4. Talaulikar V and Arulkumaran S. Folic acid in pregnancy. Ob, Gyn Reproduct Med 2013, 23:9:286-88.
5. http://plato.stanford.edu/entries/pseudo-science/
6. http://www.who.int/mediacentre/factsheets/fs297/en/
7. http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features10March%202009
8. http://theness.com/neurologicablog/index.php/tag/homeopathy/
9. http://www.sciencebasedmedicine.org/homeopathy-and-plausibility/

10. Smith K. Homeopathy is unscientific and unethical. Bioethics 2012, 26:9:508-12.