Alternative Medicine Lack Of Evidence
Why Alternative Medicine Cannot Be Evidence-Based by M R Tonelli and T C Callahan
Below is a summary of the article published Acad Med. 2001 Dec;76(12):1213-20
The concept of evidence-based medicine (EBM) has been widely adopted by
orthodox Western medicine. Proponents of EBM have argued that complementary
and alternative medicine (CAM) modalities ought to be subjected to rigorous,
controlled clinical trials in order to assess their efficacy. However, this
does not represent a scientific necessity, but rather is a philosophical
demand: promoters of EBM seek to establish their particular epistemology as
the primary arbiter of all medical knowledge.
This claim is problematic. The methods for obtaining knowledge in a healing art must be coherent with that art's underlying understanding and theory of illness. Thus, the method of EBM and the knowledge gained from population-based studies may not be the best way to assess certain CAM practices, which view illness and healing within the context of a particular individual only. In addition, many alternative approaches center on the notion of non-measurable but perceptible aspects of illness and health (e.g., Qi) that preclude study within the current framework of controlled clinical trials.
Still, the
methods of developing knowledge within CAM currently have limitations and
are subject to bias and varied interpretation. CAM must develop and defend a
rational and coherent method for assessing causality and efficacy, though
not necessarily one based on the results of controlled clinical trials.
Orthodox medicine should consider abandoning demands that CAM become
evidence-based, at least as "evidence" is currently narrowly defined, but
insist instead upon a more complete and coherent description and defense of
the alternative epistemic methods and tools of these disciplines.
This is a summary. The full article is available at the web site of Academic Medicine.
If you have enjoyed this article, have a look at this rather different article on the same topic.
Copyright 2001, M R Tonelli and T C Callahan , Department of Medicine, Division of Pulmonary and Critical Care Medicine,
University of Washington School of Medicine, Seattle, Washington, USA.
