As The Complementary Medicine Debate Continues, Patients Lose

Editor's Choice
Main Category: Complementary Medicine / Alternative Medicine
Also Included In: Public Health;  Clinical Trials / Drug Trials
Article Date: 17 Apr 2008 - 12:00 PDT

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In an editorial published in BMJ Clinical Evidence, complementary medicine (CM) expert Professor Edzard Ernst writes that patients are continuously and seriously being misled by the debate over complementary medicine's efficacy. Ernst believes that arguments, as presented by two different and somewhat hostile attitudes that influence evidence about the practice, leave unanswerable the fundamental question concerning complementary medicine - Does it generate more harm than good?

Complementary medicine includes several practices, the most popular of which are acupuncture, homeopathy, spinal manipulation, and herbal medicine. One side of the debate argues that there is no scientific evidence that can support CM, while the other side believes that scientific evidence cannot be applied to CM.

Ernst writes that skeptics of complementary medicine are particularly good at ignoring evidence that is related to the field. Of the extant thousands of clinical trials and hundreds of systematic reviews, it is not common to see mainstream journals publishing positive findings, which lead many to believe that there is not much serious research investigating complementary medicine or that the practice is harmful or useless.

On the other side of the debate is the camp that supports complementary medicine. When researchers come to conclusions that are not in line with their beliefs, these proponents are quick to point out that there is no place for scientific evidence in complementary medicine.

"The loser in these everlasting quibbles and debates is, of course, the patient," writes Ernst. "If they listen to the 'there is no evidence' argument, they might not benefit from those forms of CM that are beneficial. If they follow the 'science does not apply' notion, they might end up receiving treatments that generate more harm than good."

It is apparent to Ernst that it is the "almost insatiable hunger of patients" for complementary medicine that has driven the importance of CM, not the eagerness of doctors, the interests of scientists, or the attention of politicians. In addition, because CM is usually unavailable through the National Health Service, patients are spending £1.6 billion in Britain every year to purchase complementary medicine products - and the effects of these are often uncertain.

Ernst concludes that, "Change is necessary, and positive change is best achieved if we begin to produce reliable information specifically for lay people."

Complementary medicine and evidence: like fire and water?
Edzard Ernst
BMJ. (April 2008)
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Written by: Peter M Crosta

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