Alternative Medicine Essay
The widespread use of alternative medicine nowadays has driven scientists to study it and understand the reasons of the high demand for unconventional treatment. According to Zollman C, and Vickers A. (1999), complementary and alternative medicine (CAM) can be defined as therapeutic and diagnostic disciplines which are exogenous of the institutions where modern methods of treatment are exist and taught. Eisenberg D. (1993), defines CAM as “medical interventions which are commonly not taught at medical schools and not generally provided at hospitals in the US”. These two definitions are not fully satisfactory because, firstly, some forms of CAM which were tested by scientists and appeared to be safe and effective and found a place in conventional medical mainstream. Secondly, CAM is not about medical intervention, which means impacts of taken drugs. The majority of CAM is based on psychology, spirituality, sociology and traditional Chinese medicine (TCM), which make trials difficult. However, despite the fact that conventional medicine is scientific based and proven by science, many people still use alternative medicine instead or as a compliment to the modern one. Research shows that the majority of the patients at an Accident and Emergency department used to refer to some forms of CAM. (Waterbrook A.L, 2008).
Other studies show that over the period of the last 20 years an increase in interest in CAM was observed. Approximately 30% of the UK population (Ernst, 1996) and almost the same in the USA (Kuhn, 1999, Wooton and Sporber, 2001) have used alternative medicine. Referring to these sources it is seen that the demand for CAM remains high nowadays; however, the importance here is not to evaluate the reasons why people still use alternative medicine but to prove or disprove the outweighing advantages of CAM over conventional medicine. The key point is to understand what there is about CAM that differentiates it from modern health care. It is argued that individuals to date embrace CAM because it meets consumer needs and provides health care without any side effects, curing an illness completely not just minimizing the pain for a short period. However, despite the popularity of CAM, the effectiveness cannot be fully trusted and thoroughly tested, whereas, conventional medicine is based on science study and research and scientifically proven.
The aim of this essay is to compare and contrast two approaches of medical health care and to prove that advantages of modern medicine outweigh those of alternative methods of treatment in many aspects and to show that CAM has many disadvantages which have been revealed during surveys. First of all, it is better to learn the history and some forms of unconventional medicine to have background knowledge on it. While modern medicine developed due to science evolvement, CAM always existed from many centuries ago till these days. It takes roots from traditional Chinese medicine (TCM)found on herbal remedies also including psychological, spiritual aspects in their treatment. In contrast to modern medicine, TCM focuses not solely on disease but also on maladjustment of human body and whole functioning process. The most commonly used forms of CAM are herbal therapy, health food and vitamins consumption, massage, relaxation techniques, chiropractic, acupuncture and placebo (Sutherland L.M, 1994). According to the type of treatment they provide, CAM practitioners can be put into four groups, although there is no defined way of classification for unconventional treatment. The first, psychological and spiritual group comprises faith healers, mystics providing paranormal healings and those who use specific methods affecting human psychology such as hypnosis, mental imaging and laughter therapy.
Those, who advice herbal remedies, vitamin and multivitamin supplements and particular diets like macrobiotic diet, are in the second, nutritional group. The drug and biologic category includes highly trained specialists in the drug, various chemicals and vaccine use. It can be injections to improve the immune system, injections of animal live cells and homeopathy. The fourth group consists of chiropractors, touch and massage therapists and acupuncturists, where treatment involves some physical forces. There are also other treatments which are problematic or incapable of being classified, such as iridology, aroma therapy and the identification of internal illness by examination of the eye iris (Rubel A, Murray R, 1992). Increasing popularity of CAM and reasons driving people to choose unconventional medicine as a compliment to conventional one or instead of it can be clearly explained. First of all, some people refuse from modern health care because of dissatisfaction with it or with the physicians, particularly when a prognosis offering no hope for a patient is announced or when a patient experiences revulsion or painful effects of treatment. Dissatisfaction with health care provider is also can be one of the reasons of using CAM.
Studies at University of Limpopo revealed that patients were disappointed with attitudes of doctors. They claimed that physicians did not provide sufficient time for consultation, some of which were only 10 to15 minutes. In addition, it is argued that health care providers behaved as if they were cognizant of everything and often not explaining about illness and not providing information about treatment (Ogunbanjo G, 2008). This might be the reason of disappointment and stimulating people to seek alternative treatments. On the contrary, approach of homeopaths was likely to be preferred by patients. According to the research done by professor Gboyega Ocunbanjo at University of Limpopo (2008), relationship between patient and CAM practitioner played more crucial role what than type of treatment was used. Homeopaths supported patients not only physically but morally, they spent more time on discussion of the problem than mainstream medicine doctors did, relationship was person-to-person, rather than patient and physician (Ogunbanjo G, 2008). Consequently, the patients felt themselves more independent and respected by practitioners and made further visits. However, results of this study revealed no potential advantage of CAM, but only psychological aspect of it.
It showed significance of relationship between CAM practitioner and patient and moral support given by homeopaths, missing any proofs on real treatment of alternative medicine. Other studies also showed that reasons of switching to CAM depended more on personal belief in paranormal, extra-sensory and spirituality rather than dissatisfaction with conventional medicine. Survey held by Custers K et al (2009), exposed that preference of CAM was based more on paranormal belief among general public than attitudes towards science. Many CAM practitioners prevailed that alternative therapies disobey severe restrictions of reductionist research. They state that their services are individualized, natural, taking into account mental and social aspects, rather than just the symptoms of illness, and justify a radical change in the approach of surveys. However, these arguments are built on misinterpretations, and often dealing with the obstacles requires giving the meaning of the research question and afterward obtaining optimal research equipment which corresponds it. For instance, randomized controlled clinical trials are the least prejudiced approach for discovering a genuine answer, if some form of CAM is aimed to be tested for effectiveness (Ernst E, 2000).
Still the central question occurs there designed to establish the future role of the CAM in the mainstream health care. Each form of CAM must be tested by scientists, because some of them are harmless but others not and some are effective, whereas others can be pure placebos and even dangerous for human health.In 1992, an Office of Alternative Medicine was established in the National Institutes of Health to test unconventional remedies. Results were no comforting, because 28 methods of treatment out of 30 research grants that the office gave have had outcome in “final reports” in 1993 (National Institutes of Health, 1992). However, probably after six years Medline search found that only 9 of the 28 research grants were published. Five of them were in two journals which are not in the list of the 3500 journal titles in Countway library of Medicine’s collection (Chou C.K, McDougall J.A, Ahn C, Voru N, 1997). None of the remained four alternative remedies was tested by clinical trial that would allow making any summary on the efficacy of a complementary treatment (Reid S.A, Duke L.M, Allen J.B, 1998).
Another research hold by Ernst E (2000), revealed the failure of more than 100 different alternative therapies recommended for treatment of asthma. Ideology of CAM intentionally disregards biologic mechanism, often discredits modern science and bases on ancient practices and herbal remedies which are in some way considered being at the same time more effective and less hazardous than modern methods of treatment. Before 20th century, majority of herbal remedies were botanicals, obtained from plants. For instance, purple foxglove was discovered to fight edema, the opium poppy to be helpful for cough, pain and diarrhea, and cinchona bark to reduce fever. However, human cost for taking therapies with botanicals was great, because, firstly, they had negative impacts on human body, causing another illness. Secondly, doses of botanicals were random, due to unknown amount of active components (Angell M, 1998). More significant, most of herbal remedies did not work at all, and some even were dangerous or might cause death. One could only distinguish between advantageous and ineffective or toxic botanicals through anecdotes received by word of mouth (Angell M, 1998). The beginning of the 20th century brought dramatic changes to human healthcare due to huge advance in medical science.
The foundation of methods of the identification and purification of the active components in botanicals made their efficacy and safeness greater. After morphine was released from opium poppy, digitalis from the purple foxglove and quinine from cinchona bark, treatment became effective without harming human body and other functions (Angell M, 1998). Further of medical advances are remarkable. As example, treatments with heparin, aspirin, beta-adrenergic blockers and thrombolytic agents have decreased mortal rate from myocardial infarction; nucleoside analogues and a protease inhibitor combination can repel the origins of AIDS in people with HIV; childhood leukemia in most cases can be cured by a cocktail of cytotoxic drugs. In addition, the beginning of the 21st century was the key period of invention of vaccines fighting many epidemic scourges, such as poliomyelitis, measles, diphtheria, hepatitis B and some forms of pneumococcal pneumonia, including the foundation of efficient antibiotics curing many other health problems (Coppes et al, 1998). To support these statements, it is seen that United States has experienced dramatic increase in the life expectancy of the country, approximately by three decades.
Partly, the reason for that is better sanitation and living standards, but mostly, due to advances in health care (Coppes et al, 1998). One may state that conventional medicine also based on anecdotes, which are published in peer-reviewed journals. However, these case reports are completely different from the anecdotes of CAM. Journals publishing about modern medicine are reviewed and assessed by experts. Hence, they describe well-structured new opening in a defined terms. If, for instance, a journal received paper of a patient’s recovery from pancreas cancer after taking rhubarb diet, publishers would demand documentation of illness and its scope. They would ask for other patients, who did not regain after rhubarb diet, and might propose trying testing the method on other diseased people. After the results of these and other requirements are satisfactory, journal might publish a case report – not as an announcement of a treatment, but as a suggestion of a hypothesis that ought to be tested in a formal clinical trial. In contrast to modern medicine, anecdotes about unconventional treatments lack such documentation and peer-reviewing as they are usually published in magazines and books for public reading (Angell M, 1998). Angell M, (1998) argues that herbal remedies may also be sold without any knowledge of their mechanism of action.
According to DiPoalo and his colleagues’ report (1998), herbal mixture named PC-SPES, where PC stands for prostate cancer and spes is the Latin word for “hope”, has sufficient estrogenic activity. Estrogens are defined as a group of any steroid hormone, which activate changes in female reproductive system, after which female secondary sexual typical features develop in human (http://dictionary.reference.com/browse/estrogen, 2011). Despite this, PC-SPES is still sold as helping patients’ immune system, who have prostate cancer which is disobedient to estrogen treatment (Alternative Medicine Digest, 1997). Consequently, a lot of men receiving PC-SPES have taken uncertain quantity of hormonal treatment without being informed. Complementary and alternative medicine is not always cheap and may even require more expenditure than conventional medicine. Researches in 1984 estimated that patients’ annual expenditure on unconventional health care was 10 billion dollars in the US (Subcommittee on Health and Long-Term Care of the Select Committee on Aging, 1984) and the results of the surveyin 1997 showed 1.6 billion pounds annual expenditure in the UK on CAM (White A, Resch K, Ernst E, 1997).
According to Eisenberg et al (1998), 1990s research results estimated that number of visits to CAM practitioners in the US was 425 million, whereas number of call on to conventional health care providers was 388 million in the same year. Annual expenditure on CAM was approximately $ 13.7 billion, in compare to $12.8 billion spent annually on whole hospitalizations in the US in 1990. Another survey held in the US in 1997 considered out-of-pocket expenditure on alternative medicine to be $27 billion which was equal to out-of-pocket expenditure for all modern medicine services (Eisenberg et al, 1998). Indeed, some forms of alternative medicine are more expensive than modern health care. One reason for that might be individual approach of the practitioners towards patients. Homeopaths may receive high fees from patients visiting them. Second reason can be increasing belief in CAM among people, which drives them to use it more and try other alternative remedies. Individuals start to receive herbal treatments, consult homeopaths and visit CAM practitioners very regularly, including them into their lifestyle, which is costly in the long-run.
To conclude, it is seen that CAM has many disadvantages in compare to conventional medicine, which depends on science and study research. First of all, most forms of CAM failed clinical trials as being hazardous, ineffective and some even being able to cause death in particular cases. Secondly, botanicals such as opium poppy and purple foxglove helped to cure cough and edema, respectively, at the same time destroying human body due to content of active toxic components. In addition, CAM is based on anecdotes, which are received by word of mouth or published or books for public reading. It cannot be fully trusted, because of not being tested or failure in formal clinical trials. One cannot be sure in efficacy of alternative medicine, as the case with PC-SPES, which despite containing great amount of estrogens is sold to prostate cancer diseased people till these days. Ultimately, research revealed that annual expenditure on CAM was higher than for conventional medicine in the UK and the US. In contrast, modern medicine is scientifically proven and provides only those treatments which passed clinical trials.
The treatments are published only in peer-reviewed journals and are not announced as a cure, but are suggested as possible treatment. Conventional medicine can be trusted and it shows real treatment. The most significant advantage of conventional health care is the increase in the life expectancy of people due to advance in medicine. Also, illnesses which had no cure in the past, like child leukemia, heart related diseases and most forms asthma can be treated now. Therefore, there should be no alternative to modern medicine, because advantages of it are clear, while there is still discussion on unconventional medicine. Some forms of CAM might be used as compliment to conventional medicine, but not as alternative to it. People should be more informed about CAM and its inefficiency to provide effective and safe health care as modern medicine does.