I recommend Simon Singh’s book Trick or Treatment
~In your opinion, is it just a placebo effect, or is energy really at work?
When it comes to energy based therapies, there is NO scientific evidence that this stuff does anything. It is important not to confuse ideas like ‘Well maybe one day we will understand it, and then we can test it.’ This is a mistake. If an alternative therapy works, then the results will show up under repeated double blind controlled replicated experimentation. Once a pattern is shown, then we can try to find the mechanism. But if there is no pattern (i.e. nothing happens) then it doesn’t matter how mystical the claims are…there is no evidence it works and it shouldn’t be sold as if it does unless such evidence can be demonstrated.
~Should people who practice this type of healing be allowed to continue?
I think serious consideration should be given to ensuring that people who charge for health services should all be under some regulatory and legal framework. These people are in the health business, which claims a service provided and charges very well in return. So if, for instance, someone sells homeopathic anti-malarials. Everything they sell should be labeled as having no evidence that it works (unless there is independent, up to date, and rigorous evidence to suggest otherwise), that their product is the chemical equivalent of water (because it is water), and the consumer takes it under the full knowledge that any benefit would purely be placebo. Same for the claims of energy field practitioners. Similarly, if the alternative health professional encourages someone to come off their evidence based medicine, and that person gets sick or dies, then their needs to be some culpability. If they want the aura of medicine, they are more than welcome to the malpractice claims as well.
~Does it not matter if it’s physically evident or a placebo, as long as the person finds relief?
Yes, I think it does matter.
1) Do we want an honest or a dishonest relationship between a health practitioner (I use the term loosely) and their patient or not? In other words for someone to claim that homeopathy can help with AIDS, or that Reiki practitioners can a) sense energy fields, and b) cure diseases, the practitioner has to be either ignorant of the lack of evidence for these claims, or lie to their patient to convince them that it is not just a placebo. So to encourage placebo treatments is to encourage practitioner’s (who are in a position of trust) to purposefully, or in ignorance, mislead patients who may or may not be suffering from a serious illness.
2) All medical interventions and fake treatments can have a placebo impact. The question is not a placebo or no placebo, but whether there exists a net physiological improvement or not that goes beyond placebo. Do we want to encourage or discourage the financing, public understanding etc.. of evidence based medicine which has cured and continues to cure some of the worst ravages of disease, chronic illnesses, or do we want to go back to the dark ages where any crackpot or charlatan can hang a sign on their door an make any outrageous claim for profit? By pretending that placebo is good enough we ignore the real health benefits that are available and require public support for advancement. Remember there are limited finances (both individual and government) for medical treatments. For every dollar that is spent on a placebo, that dollar is lost from the advancement or provision of a real medical treatment or potential breakthrough.
3) Placebos can delay or distract from the treatment of the real cause of the problem. So while we can convince ourselves for some period of time that something is working as the symptoms are perceived to be managed, all the while an underlying cause that may be serious can be progressing (eg. cancer). Furthermore, some alternative practitioners can encourage patients to trade a demonstrated effective medication for a placebo. This can be dangerous or fatal. We have a century of accumulated evidence for what causes disease from germ theory, to environmental impacts, genetic disorders, immunization, etc.. Medical sciences do not have all the answers but the scientific process is the best we have for finding those answers, alternative or not.
4) Alternative medicine can be expensive, ongoing (gotta love those chronic conditions), and ineffectual. If we wouldn’t accept the placebo argument for someone who convinces us that our car is running better after charging us to place a magnet over it (But hey, if he is happier with his car, then isn’t it okay?), why would we use this argument for that which is most precious to us, our health. This issue goes beyond individual rights to be tricked, because it has societal implications with regards to funding, and individual implications with regards to health. Fraudulent claims are fraudulent claims.
~Have you had personal experiences with this?
My wife was encouraged by a medico to try acupuncture. She refused and pissed of the medico. But because she refused and insisted on further examination to identify the cause of the problem and not just rest on the symptoms (i.e. headaches), a physio found the source and by addressing the source enabled real relief in weeks. The acupuncture course was expected to take far more time, did not involve diagnosing the problem, and would have cost the tax payer far more. Why, because the underlying causes were not being addressed, which would have exacerbated with time in my wife’s case. Alternative therapies can be dangerous because they convince the patient they are doing something, when they may be doing nothing. This wastes time and can distract from real and potentially serious underlying causes of the problem, and the seeking out of effective remedies.
~Are there certain practices that you consider legitimate and others quackery? (ex: Neurologist is legit, while a massage therapist is a flake).
It all comes down to whether the claim hasn’t been substantiated by rigorous controlled trials. An unsubstantiated claim, should never be a claim, it’s just a hypothesis and should be presented as such. At which point it is at the stage for testing, not the stage for administration to a patient. As has been said, there is no such thing as alternative medicine. There is just medicine that works and medicine that doesn’t. Neither the practitioner nor the patient can distinguish the difference unless their own biases are removed from the testing of the claim (eg. large scale, double blind, controlled replicated studies…for which the results are then compared with other similar studies to see if outcomes are consistent)... After multiple appropriate tests, then we can start to approximate truth, and then we can weigh up the risks and benefits of the treatment relative to other treatments. Before this time it is quackery to claim that if you do X it will cure Y without sufficient evidence.
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