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Alternative Medicine Biologically-based
Biologically-Based Alternative Medicines
Table of Contents
Biologically-Based Alternative Medicines
II. What are biologically based alternative medicines?
A. Ionic Foot Bath: A specific example
B. Chelation Therapy:
C. Why are they so popular?
III. Anecdotal Evidence
IV. Misunderstanding Statistics
V. Confirming Evidence
VI. Misunderstanding Coincidence and Chance
VIII. Placebo Effect
X. Who cares?
By: Patrick Mayfield
This chapter will discuss biologically based alternative medicines, also known as complimentary medicines or CAM (due to the preference for some individuals to use alternative medicines in conjunction with traditional methods), but first a brief overview of alternative medicines and the importance of this topic will be discussed. According to the Merriam-Webster Dictionary, alternative medicines are "any of various systems of healing or treating disease, not included in the traditional medical curricula taught in the United States and Britain". (Alternative Medicine, n.d.). Alternative medicines are often defined as "that which has not shown to be consistently effective" (Bratman & Steven, 1997). The National Center for Complementary and Alternative Medicine (NCCAM) describes CAM as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine," ("What is," 2010). The NCCAM further differentiates "complimentary" medicine as being used along with conventional methods and/or medicines, and "alternative" medicine as being used as a substitution for conventional methods and/or medicines ("What is," 2010).
Alternative medicines are a large and ever growing business worldwide. Surveys have shown that CAM use increased by 25% between 1990 and 1997 (Eisenberg et al., 1998). According to the National Health Interview Survey, non-vitamin and non-mineral natural substance use has risen to 17.7% in adults in 2007, (as citied in, "What is," 2010). Furthermore, non-vitamin and non-mineral natural substance use has increased in adults 2.3% from 36% to 38.3%. The most common non-vitamin and non-mineral natural substance used in 2002 was Echinacea and in 2007 was fish oil/omega 3 (as citied in, "What is," 2010). Many people turn to alternatives because of enticing claims, prices, and ignorance. Salespersons prey on the innocent souls who do not have enough knowledge about the scientific method and how many mistakes there are to make in thinking. However, alternative medicines do not just affect wallets, alternative medicines could affect a person’s health, and not in the way, they claim. That is to say, many alternative medicines make extraordinary claims about health, but in all actuality, most do not live up to those claims in the slightest. People can get their hopes up that these cheaper medicines with little or no scientific evidence will have the same effect or better as scientifically proven methods.
Most alternative medicines do not have any scientific evidence backing their claims. There is also little or no scientific research being conducted on biologically based alternative medicines. Compared to the amount of research that traditional medicines go through there is a large difference. This creates a problem if people are choosing or even trusting alternative medicines over scientifically evidence based medicines. Furthermore, prices on alternative medicines are not as good of a deal, as they seem. Medicines proven by science take years upon years of research and testing to develop a safe and reliable product approved by the FDA. This process takes extreme amounts of funding. Many alternative medicines do not go through this process, hence, one possible reason why they are cheaper, but with cheaper prices, you lose quality assurance. Prices on alternative medicines have actually been increasing quickly over the years. In seven years from 1990 to 1997 the cost for alternative medicine services increased by 45.2%, with 27 billion dollars being spent on alternative medicines (MacLennan, Wilson, & Taylor, 2002).
Many questions rise from this discussion. Why are so many people taking a risk on alternative medicine? How has alternative medicine become such a large business? Finally, why do so many people, know so little, about alternative medicines and their consequences? In this chapter, biologically based alternative medicines will be presented and explained. The claims of the practitioners of these medicines will be explained and the evidence for such claims will be examined. The reasons why people believe that biologically based alternatives medicines will actually work, and why they choose to spend so much money on them, will be considered. Finally, this chapter will cover the business side and the regulation, or lack thereof, of biologically based alternative medicines.
II. What are biologically based alternative medicines?
Biologically based alternative medicines are medicines that are not supported by scientific evidence, and that are alternative treatments using natural substances (i.e. ginkgo biloba) or natural therapies (i.e. dieting or ionic detox). The NCCAM has labeled biologically based alternative medicines as "biologically based practices." This section of CAM includes, according to the NCCAM, botanicals, animal-derived extracts, vitamins, minerals, fatty acids, amino acids, proteins, prebiotics, and probiotics, whole diets, and "functional foods." ("What is", 2010). Some other examples are, but not limited to, Chinese food therapy, chelation therapy, orthomolecular medicine, naturopathy, urine therapy, diet therapy, and ionic footbaths.
by Ano Lobb via Flickr:Creative Commons
Many of these medicines are well known, (i.e. vitamins and minerals), however, some biologically based alternative medicines are not well known. Brief descriptions of the not so well known medicines are included as follows. Botanicals are also known as herbalism, herbal supplements, or more simply, herbs (e.g. see figure 4). An example of an animal-derived extract would be surfactants, or a substance that greatly reduces the surface tension of a liquid. Surfactants can also be synthetic, but in terms of animal-derived, they are typically organically extracted lavage fluid or minced lungs from cows, pigs, and humans (Seger & Soll, 2009). Animal-derived surfactants are oftend used for the curing of certain respiratory ailments or diseases that have a deficiency of surfactants within the lining of the lungs (Seger & Soll, 2009). Vitamins and minerals along with botanicals are perhaps the most frequently used alternative medicines. Prebiotics are considered to be food ingredients that are not digestible but help bacteria and microorganisms in the digestive system grow and become more active (Gibson & Roberfriod, 1995). Probiotics are actual living microorganisms or bacteria that improve the microbial balance within the organism (Fuller, 1989). A whole diet is the use of a diet that contains only non-processed whole foods. Functional foods are foods that demonstrate a benefit to the body other than providing nutrients and that, which improves health and well-being (Roberfroid, 2000). Chinese food therapy is part of traditional Chinese medicine, and it is simply the practice of using natural foods instead of medicines (Pitchford, 2002). Chelation therapy (e.g. see figure six) is an effective treatment for lead poisoning and other heavy metal poisonings; however, CAM practitioners often use it as a cure for cancer and other health issues. Orthomolecular medicine also known as megavitamin therapy is the practice of using dietary supplements, vitamins, and engaging in a particular diet to obtain "optimum health" (Pauling, 1968). Naturopathy is the practice of using natural substances for cures instead of conventional medicine. Naturopathics typically will try and not use any conventional medicine. Urine therapy is another alternative medicine in which one engages in drinking their own urine and/or massaging their own urine into their skin for medicinal purposes (Carroll, 2003). Diet therapy is described as the use of special diets. There are several diet therapies, including but not limited to, Gerson therapy, Pritikin diet, Ornish diet, the Mediterranean diet, and macrobiotic diets. The Gerson therapy is a specific macrobiotic diet. The Pritikin diet is a low-fat diet that emphasizes eating mostly vegetables, fruits, and grains. The Ornish diet is another low-fat diet that is completely vegetarian. The Mediterranean diet emphasizes low consumption of red meats; moderate consumption of fish, dairy, poultry, and red wine; and high consumption of fruits, vegetables, and olive oil. Ionic footbaths (e.g. see figures 7 and 8) are said to pull toxins out of your body through your feet by the processes of osmosis, diffusion, ionization, and electrolysis (A Major Difference, 2010). All of these therapies, supplements, diets, and medicines have multiple uses and are often used in replace of or complementary to conventional medicines.
Biologically based alternative medicines are used for a variety of different ailments, diseases, health problems, and dieting. Ionic footbaths have been used to cure everything from kidney disease and liver disease to being poisoned by metals and other chemicals. Chelation therapy, which is actually effective for the treatment of heavy metal poisoning, is being used to treat other diseases such as, atherosclerosis, cancer and heart disease. Dietary supplements, vitamins, and minerals as well as orthomolecular medicine are used on a wide array of illnesses including the common cold, the HIV virus, as well as depression. Certain diet therapies are often used to treat cancer and cardiovascular disorders.
A. Ionic Foot Bath: A specific example
by live w mcs via Flickr:Creative Commons
The ionic foot bath or detox is also a popular biologically based alternative medicine. The ionic foot bath is said to emit a low charge into the water of the footbath to electrodes that are connected to metal plates sitting in the water. According to ionic foot bath proprietors, water is broken down into separate molecules by the process of electrolysis leaving extra negative hydrogen molecules that are then absorbed through the feet by the process of osmosis (A Major Difference, 2010). These hydrogen molecules then pick up toxins within the body and help body’s natural process of detoxification become easier. However, this is not the only version of the story. Many ionic foot bath websites, practitioners, and salespersons have their own version of how the ionic footbath works, similar to others but with added information or a different spin. Another website describes the process a little bit differently, where positive and negative ions can both be produced in the water (Ionic Foot Detox, 2004). When positive ions are pumped into the water hydrogen gas is produced and is released from the bath into the environment with an abundance of negative ions left to remain in the water. When negative ions are pumped into the water, oxygen gas is produced in the water and positive ions remain in the water. These changes in positive and negative ions within the water are supposed to neutralize charged particles within the water, (but the toxicity of these particles is not specified) and thus these neutralized particles are magically pulled out of the body through whatever part of the body is in the water via osmosis and diffusion (Ionic Foot Detox, 2004).
Proponents for the ionic bath use different "scientific" sources that supposedly support their claims. Unfortunately, at least for those who spent thousands of dollars and wasted many an hour on ionic foot baths, there is no scientific evidence that supports any benefits of the ionic footbath. There are articles used by the proponents of the ionic foot bath that are made to look scientific, that use scientific language, and that are claimed to be "scientific". However, there is no clear use of the scientific method, random assignment, controlled studies, or replication of studies, in any of these articles. An article citied as a "peer-reviewed article" on majordifference.com entitled "Ionization Therapy: Modern Technology Applied to an Ancient Problem (Ionization Therapy, 2002)," is in the journal called "Explore! For the Professional", this journal is a CAM journal and is only reviewed by CAM reviewers. In fact, the article mentioned is written by a "staff writer", the name of the author is not even given. Perhaps best of all is that an advertisement for ionic foot baths is included at the bottom. In fact, many of the articles that are used in support or as evidence for ionic footbaths are only remotely related or very general to the process. For example, on ionicfootdetox.com they have a section labeled "Links to Scientific Studies and Related Articles," and yes, there are scientific articles but they are so general they cannot be taken as evidence for the claims of the ionic foot detox. One of the articles they link is that of the research of Neils Bohr on electricity and another one of the articles they mention is an article on membrane channels and osmosis. It looks scientific, it even says "Nobel Prize" on it to mislead people into thinking it’s prize winning science, but in reality this is just information on two scientists who have won the Nobel Prize, and information on how membrane channels work, there is no research, there is no study, there is no evidence. For articles that include a study, most of the studies lack enough information to be deemed an experimental article. Another linked article on the ionic foot detox website cannot be considered scientific research or scientific evidence, the "study" they link is on biological being in the water after a detox. This "study" has many problems, they did not use a randomized clinical trial, nor do they use a double blind study method, so the placebo effect could be an explanation. The "study" only had a sample size of 12, they conducted this research in Mexico (site unknown), this "study" was not published in any medical journal and is written more like a memo than a journal article, and finally the researchers’ credentials are in question as well. These are just a few examples of what is incorrect in the "study".
Such studies as previously mentioned cannot be replicated on the information given, and the validity or reliability statistics of such studies is non-existent. Most studies only use a small sample, which is very interesting because one would expect it to be very easy to recruit participants because are many people with ailments, diseases, and pain that the ionic footbath is supposed to help. One would think many of these participants would volunteer if only given free access to the ionic footbath process. An interesting point to make is that these research problems and lack of research that have been described for the ionic footbath go for most, if not all, alternative medicines to date. Although, research in the field is growing with the advent of the NCAAM and various other organizations, evidenced based research published in a respected peer reviewed article is still extremely lacking.
B. Chelation Therapy:
Studies involving chelation therapy are another good example of claims of evidence that actually end up being insubstantial. As previously mentioned, the use of chelation therapy for treating cardiovascular disease is incorrect and not an intended use. The correct use of chelation therapy involves the treating of heavy metal poisoning. Chelation therapy as an alternative medicine is said to have great success in treating not only cardiovascular diseases but also cancers, strokes, and various illnesses related to having diabetes. According to a Cypher report, 86% of 19,000 cases reported by physicians using chelation showed positive signs of improvement (Carroll, 2003). However, these studies were merely self-reports from the physicians about various case studies. The physicians gave these case studies to the Cypher report individually with none containing a control group. Therefore, all of the 19,000 reports, although large in number, are powerless and hold no weight in arguing for the evidence that chelation supposedly helps cure cardiovascular disease and other vascular diseases (Carroll, 2003). The case studies also contained no random assignment to groups due to not having a control group and being a case study. The physicians could very well be biased in their reporting of these cases. A double blind study would be necessary to tease this bias out of the relationship. It would obviously make sense for the doctors to want and expect chelation therapy to work. After all, if you were potentially harming your patient by using a method of treatment for an unintended use that is not backed by solid evidence, you would want to be right. You would also want it to work if you care about your patients; most doctors genuinely want their patients to get better.
There are often other motives for not adequately seeking evidence for or against the use of chelation for curing diseases other than heavy metal poisoning. Advocates for chelation therapy often claim that the costs of conducting experiments are extremely high (Carroll, 2003). They are correct, conducting experiments on medication and therapies is very high but it is necessary and the risks are too great not to. Conventional medicine goes through rigorous testing for a reason. It should be in the best interest of everyone to do so, but unfortunately when money is involved that is not always the case. Another motive would be that related to the conspiracy theories. Conspiracy theories can be found about a large number of things, and medical practice is not ignored. Currently, the most popular conspiracy theory about conventional medicine is that the large pharmaceutical companies with help from the government are trying to eradicate and/or preventing alternative medicines from gaining acceptance. Conspiracy theorists claim that the reason for a lack of evidence for alternative medicines is due to the large companies and the government making it too hard for experiments to take place. Even further, conspiracy theorists propose that even when experiments are conducted, large companies and the government make it impossible for research to be published and when it is published, the research is attacked without warrant and therefore never materializes to the public. These conspiracies however are ungrounded and rarely have much truth to them.
A new disturbing trend is the use of chelation therapy for children diagnosed with Autism (Carroll, 2003). The theory that some vaccinations for children contain mercury and are poisoning children is what operates this different use of chelation. The belief that mercury is often found in vaccinations and is leading to the onset of autism in children is extremely unfounded and causing much harm to parents of autistic children and the perception of vaccinations. There is no scientific evidence that vaccinations contain mercury, and there is no scientific evidence that links mercury poisoning directly to the onset of autism in children, and therefore no evidence that vaccinations containing mercury are causing children to be autistic. Believing in such a misguided idea is harmful to parents who are quick to blame and blinded by various mistakes in thinking and judgment. Forgoing important scientifically evidence based vaccinations not only puts young children at high risk, but it also feeds into the conspiracy. For many people, only hearing the words "vaccinations", "poisoning", and "autism", in the same breath can cause an association between the words that will likely change perceptions about vaccinations for the worse. Conspiracy theories are often created, maintained, and believed by many of the thinking fallacies that will be discussed in the following paragraphs.
C. Why are they so popular?
We have briefly discussed what alternative medicines are, and more specifically what biologically based alternative measures are, what they are used for, and finally what they actually do, or the evidence for the benefits of these alternative medicines (or lack thereof). However, we have not yet discussed why we are talking about them in the first place. Why then are alternative medicines so popular and gaining popularity every year? Why are people putting so much belief, trust, hope, and resources (i.e. money, time, and effort) into these alternative medicines? Why are people increasingly using alternative medicines over conventional medicines and ignoring the fact that conventional medicines are evidenced based and most alternative medicines are not? There are many possible answers to these questions, which will be laid out in detail below.
Are people fools? Well, perhaps, but it is much easier to be a fool than one would think because there are many factors in play that lead someone into being fooled, including ones own mind. Perhaps a large reason as to why so many people are turning to alternative medicines is because they are desperate. Conventional medicines are never 100% effective. Have they proven to be more effective than alternative medicines? Yes. However, they cannot work all the time due to the wide range of factors that can affect the effectiveness of the medicine. This statement alone provides more support for the argument that alternative medicines lack evidence of efficacy and therefore need substantial research to support the proposed benefits. If conventional medicine, with all of its scientific and clinical research, cannot be 100% or even 80%, or sometimes even less than 50% effective, then how is it reasonable for alternative medicines to say that they are and yet not have any evidence to support alternative medicines? That is an extraordinary claim that must be proved by extraordinary evidence, and extraordinary evidence they do not have.
Alternative medicines claim to be just as effective as conventional medicines. They are supposed to heal diseases like cancer, heart disease, kidney disease, HIV, and a host of other ailments. Conventional medicine is compared to alternative medicine as an unnatural, toxic, solution to the problem, whereas alternative medicines are promoted as the healthier, more natural, safe choice. The problem with this argument is that these claims are high and lofty. For these claims to be correct, a huge body of research, rivaling that of conventional medicine, will need to be produced. This research will have to be scientific, utilizing the scientific method to test testable and falsifiable hypotheses about alternative medicines and practices. Once this research is conducted, we could get a view of the efficacy of alternative medicine and compare it to that of conventional medicine. However, to date, alternative medicines lack substantial evidence for their efficacy, and they research that they do report is rarely scientific in nature and cannot be taken seriously.
Those who promote biologically based alternative medicines make extraordinary claims about the benefits and efficacy of their medicines. Many of these medicines are said to cure various diseases, rid one of pain, remedy sickness, and fix chronic ailments such as cancer, hepatitis, liver disease, and many others. The problems with making such claims are that they are ungrounded and lack the necessary random clinical trials that would lend support for such claims. As Michael Shermer (2002) states, "The moral is that the more extraordinary the claim, the more extraordinarily well-tested the evidence must be." Conventional medicine does not make extraordinary claims but rather rational claims that it can test and provide rational evidence for support. So then, when a conventional medicine does not work for a particular person, they often become desperate, especially if many conventional medicines have failed. They turn to alternative medicines that promise something greater, but this promise is quite empty handed most of the time.
People also tend to use biologically based alternative medicines for a number of other reasons including but not limited to low use of a rational thinking style, thinking fallacies, placebo effect, rumors, and a host of other thinking errors. The proprietors of alternative medicines also lend a hand for fooling people into not only using their product but also thinking that there is evidence or research backing their claims. Many proprietors also like to dress their medicines up with scientific language, authority, and anecdotes that make it hard for people to see through the pseudoscience and recognize that there is no real science behind CAM practices. These errors in thinking and rationale make it hard for persons to be skeptical about CAM therapies. Without learning about such fallacies and possible ways to correct for them, a person does in fact have a hard time not being fooled. Therefore, to educate the masses, and of course the readers of this chapter, it will be good to discuss these fallacies as our skeptical ancestors have done before us (e.g. Kida, 2006; Shermer, 2002; Sagan, 1996). A good place to begin the discussion on thinking fallacies and irrational thinking would be anecdotes. Anecdotes can be found everywhere, have been, and still are very prevalent in most cultures today. Anecdotes could be considered as one of the main fallacies that trouble people’s ability to think scientifically and be skeptically.
III. Anecdotal Evidence
Anecdotes are just stories about past experiences. People use anecdotes to explain phenomena every day. It is so prevalent because it is very easy to use an anecdote. People love to hear stories. The people that walk the earth today all came from decedents who lived in storytelling societies (Kida, 2006). It is in our history, it is commonplace, and we are used to it. We are also very social creatures, and stories are a very sociable activity (Kida, 2006). Stories are also more entertaining than statistics because they can influence our emotions and they can paint a picture. It is hard to paint a picture with statistics. Many times, we hear stories from those that we come into frequent contact with, we hear them from people we know, often people we trust and this only serves to make the stories even more compelling. Therefore, for these reasons we devote more attention and interest to a story or a personal account than we would statistics. Perhaps we should just face the truth; to most people statistics are boring. Most media outlets such as 20/20 or Dateline and other news stations report more anecdotal evidence, stories, rather than scientific research and statistics (Kida, 2006). People are more interested in stories so these news shows will have higher ratings if they include more stories than hard evidence.
How does this relate then to biologically based alternative medicines? If you have a person who has recently begun taking herbal supplements, such as ginkgo biloba, to cure headaches, as opposed to a conventional medicine in ibuprofen or aspirin, and their headaches have been less frequent than before. This person may then believe that the ginkgo biloba is actually working, even though there is no scientific evidence that include a randomized clinically trial utilizing a double blind method that supports the efficacy of ginkgo biloba, and it is probably just a case of the placebo effect. This person then goes on to promote ginkgo biloba out of innocence and ignorance. He or she wants other people to benefit, like he or she had, from ginkgo biloba. This person professes the benefits of using ginkgo biloba for headaches with her story. Many people are willing to believe this because they may know this person well and trust their advice. People are also much more willing to accept this anecdote as true, rather than research ginkgo biloba’s efficacy. Another problem with giving more credence to anecdotes rather than scientific research is the fact that anecdotes are much easier to manipulate (Kida, 2006). Thomas Kida, gives an excellent example of this in his book
Don’t Believe Everything you Think: The 6 Basic Mistakes we Make in Thinking
. He describes James (The Amazing) Randi who is a well known skeptic and debunker. James Randi told a studio audience on a talk show that he had seen orange v-shaped flying objects overhead while driving to the studio. Immediately people began to call the talk show to explain that they too had seen the orange v-flying objects and many of them actually added new information to the account that James Randi had never mentioned. The interesting part is that the whole story was made up by Randi and demonstrated how easy it is to create a fake testimonial and even garner support for it from outside sources. Finally, since most CAM therapies do not report much scientific evidence and the evidence they do report cannot be considered relevant or valid due to methodology, even if they did research it they would be led astray or would give up without finding the truth. A person telling a story may seem compelling but the most compelling evidence of all lies in scientific inquiry and statistics. Michael Shermer (2002) states that, "ten anecdotes are no better than one and a hundred anecdotes are no better than ten.
IV. Misunderstanding Statistics
Furthermore, many people do not understand statistics and therefore do not use them to make decisions because many people think that statistics are too hard. We also know that people do not understand science and the scientific method very well. A study in 1997 found that most Americans, less than one fifth, fall below an adequate level of civil scientific knowledge (Miller, J., R. Pardo, & F. Niwa, 1997, as citied in "Science and Technology", 2004). Even more concerning, a 2001 National Science Foundation study found that two thirds of Americans do not know enough knowledge about the scientific method to give an accurate explanation of how it works. Only 43% of Americans answered a question about how an experiment works correctly, and only 57% answered a question about probabilities correctly (as citied in, "Science and Technology", 2004). One would think that judges would probably have a good understanding of the scientific method; however, Gatowski et al. 2001 surveyed 400 judges and found that the majority of judges lacked the necessary scientific literacy proposed by the Daulbert criterion. Only 5% of the 400 judges could give a correct definition of falsifiability, and only 4% demonstrated an understanding of an error rate. These statistics give us an idea of how little the public knows about statistics and the scientific method, and even science in general, and it is easier to understand how people can take pseudoscience and pseudoscientific evidence as real science and real evidence. When asking undergraduates about statistics, what is heard quite often? Statistics are too hard. This is discouraging because in earnest, everyone should have some level of statistical knowledge, and yet this is not the case. Statistics should be understood by the public more than what is currently understood. Perhaps a lack of promotion of statistics or a lack of promotion of teaching statistics in secondary schools is to blame. Teaching general knowledge about statistics is very important because statistics from scientific research offer evidence that is more reliable.
V. Confirming Evidence
Confirming evidence is a well-documented fallacy and is simply the fact that we like confirming evidence rather than disconfirming evidence. People like to be right. We do not even have to have to have a preconceived notion or judgment on the subject to be biased against disconfirming evidence. This changes how we seek and accept information. If we have a bias for confirmatory evidence, we will ignore information that does not fit with our belief or idea, and even if we do not have an idea, yet we will use information that confirms our hypothesis. Michael Shermer mentions this in his book:
Why People Believe Weird Things
, as "theory influences observation." He gives an example of Columbus believing that he was in Asia when he was actually in the New World and started labeling various plants that which he had knowledge of being in Asia (Shermer, 2002). We get more of a boost to our self-esteem when we are correct than when we are incorrect. It is a natural tendency for humans to be attracted to confirming information (Kida, 2006). If we have certain beliefs, we like to maintain those beliefs by allocating more attention to information that supports those beliefs rather than those that may disconfirm our beliefs (Kida, 2006). If we think about this in terms of biologically based alternative medicines we can easily see where this becomes a problem. If we already have been duped by other thinking fallacies and believe that certain biologically based alternative medicines work, then we will most likely take the easier route and find evidence that confirms this belief. It is good for our self-esteem to do so. We will ignore contradictory evidence and it will continually become harder to let go of our beliefs. If a conventional medicine has failed us, it makes us even more vulnerable to fall into this fallacy. A person in this situation might say, "Well the conventional method didn’t work, so let’s try this alternative method it will probably work." This person has already set up the belief that the CAM method will work, and will subsequently find evidence to support this belief. These beliefs can persist even when the misses far outnumber the hits, even when there is a large volume of contradictory evidence based on scientific research. Anecdotes can also further help these beliefs, because believing in someone’s anecdotal evidence will set up the belief and therefore make it more likely that we would include confirmatory evidence and ignore disconfirming evidence.
VI. Misunderstanding Coincidence and Chance
Another fallacy described in Thomas Kida’s (2006) book is the fact that people do not fully understand coincidence and chance and therefore do not appreciate its role in our life. We tend to focus on the here and now and we are wired to think in terms of cause and effect. We do not like to think that chance plays a much greater role in our life than what we actually allow ourselves to believe. The world seems safer if we can attach a cause to every effect rather than something being determined by chance. Therefore, we typically see coincidences as evidence. Those who use biologically based alternative medicines and claim that they work could merely be falling in to the trap of believing that the alternative medicines are actually working and curing their ailment when in reality it could be something of a coincidence. That is perhaps a person with cancer had been trying all of the conventional methods first and had no progress, and then finally switched to a multivitamin herbal supplement. She started to see improvement a short time after taking the supplement. This could be explained by something other than the supplement actually working. The cancer could have begun to go into remission when starting to take the multivitamin supplement. Spontaneous remission although rare is actually a documented phenomenon (Challis & Stam, 1990). This could be just a coincidence but the person with cancer has attributed it the herbal supplement with no evidence to support that assumption.
Oversimplification is another thinking problem outlined by Kida that we deal with everyday. Because we must sort through an overwhelming amount of information constantly, we simplify things by relying on other people’s experiences or anecdotal evidence, as well as, information that can be recalled upon more easily. However, when we do this we often only pay attention to the first pieces of memory that comes to our mind and therefore do not pay attention to all of the information at hand before making a decision (Kida, 2006). Some information is just easier to come up with than other information, for instance, Thomas Kida gives a great example of this in his book. He poses the question, "Is it more likely that a word starts with the letter k, or that a word has k as its third letter?" He goes on to explain that most people choose the former because that it is easier for us to think about words that start with the letter k (Kida, 2006). If an event is more detailed than other events, or sensational, we tend to be able to recall it more readily than a mundane event. Some events are more salient than other events and those salient events are easier to recall. Much of the time, heuristics work, they typically allow us to make a good enough decision. Since heuristics make our daily lives possible, and allow more efficiency we use them constantly and rely heavily upon them. The problem is we tend to rely on them far too often and use them to generalize far too often.
If we look at this fallacy in terms of using biologically based alternative medicines, we can see that this fallacy can help to perpetuate many of the other fallacies, and vice versa. If we are considering a biologically based alternative medicine, we may skip the heavy reading of researching the medicine and its efficacy for an anecdotal story or someone else’s experience, because it is more efficient and more simple. Proprietors of the medicine will be quick to give you anecdotal evidence. We may also use stereotypes to judge whether the proprietor of the medicine can be trusted. If the person looks like a doctor or a nice person then we will accept that this person, even though we do not know them at all, can be trusted. Many of us do not want to spend the time or simply do not have the time to get to know the person enough to make that judgment. This person could have far different characteristics than the stereotype that we have decided to place them under, and yet, we go on believing this is so. Here we can see how one fallacy can perpetuate another, because our confirming bias will cause us to seek out or pay attention to information that fits the stereotype that we have chosen (Kida, 2006). Many times the proprietors of these alternative medicines are lost themselves, and do not know the pseudoscience they are meddling in, let alone the harmful effect that they might be causing to the people they are selling the therapy to.
VIII. Placebo Effect
The placebo effect plays a huge role in the use of CAM therapies and medications as well as the reported efficacy of CAM. The placebo effect happens when a person believes a treatment will help them, takes a treatment that actually has no effect at all or minimal effect, and simply the act of going through the process of the treatment causes the person to think they have gotten better. People report actually getting better and studies have shown that in certain cases people really do get better (De La Fuente-Fernández, et al., 2001). However, for many treatments that have little evidence and effect it is not the treatment themselves that are healing patients, it is the belief and hope in the patients and the knowing and preparing for therapy that helps them. For a patient who knows that he or she will receive treatment, a treatment that is supposed to help, will often prepare, unknowingly, by releasing certain chemicals in the brain such as dopamine. Parkinson’s patients’ brains will often release dopamine in the onset of treatment (De La Fuente-Fernández, et al., 2001). The placebo effect is a well-documented phenomenon in not only psychology research but also medical research as well (Hawkins, 2010; Irizarry, et al., 2005; Oken, 2008). Therefore, people who turn to biologically based alternative medicines or any CAM therapies for that matter can be "healed" or helped by something as simple as the placebo effect. Perhaps it is simply that the patients or people who use alternative medicines are misattributing their getting better to the alternative medicines when it is actually a placebo effect. The placebo effect can be very confusing to these people because it is not a physical substance; it is all in their heads. They take an alternative medicine and they feel better. It is hard to convince such persons of the placebo effect because most laypersons do not understand the placebo effect and most doctors do not recognize its power. Therefore, the placebo effect is yet one more reason why people believe in the healing powers of alternative medicines regardless of the lack of evidence for them.
Most CAM practices are a form of pseudoscience. That is they try to act like science, they dress their evidence and anecdotes up like science, they talk like science, but they are far from science. Many CAM therapies use scientific language to confuse and trick people. As previously mentioned in this chapter, Ionic footbaths are as pseudoscientific as they come. Proprietors of the ionic footbaths use a lot of scientific jargon to confuse people into thinking that it is actually science. They use words like osmosis, electrolysis, diffusion, and ionization to sound scientific. However, many of these words are not used correctly in the first place, or they are used out of context, or sometimes even generalized to something unrelated. For example, the new concepts of creation-science or intelligent design sound scientific, but they are not in the least bit. Proponents of these ideas would need scientific research, experimental evidence, and replication to call their ideas science (Shermer, 2002). Creation-science is nothing more than pseudoscience with the word "science" slapped on the end of it. Yes, it is a free country, but is it not wrong to claim to be something you are not? Laypersons, whom do not have the knowledge or experience in science or scientific jargon, will not take the time to research such ideas to see if they really are science. Most laypersons would accept the pseudoscience for science because they use a heuristic or it sounds like science to them. Statistics separates pseudoscience from real science.
X. Who cares?
Some of you who are reading this may get to this point in the chapter and wonder, I do not use CAM, and how does this affect me? Or perhaps, who cares what people use because it is their choice. Yes, that statement is correct; it is a person’s choice. However, it is important to educate people how to make good decisions. With all of the thinking fallacies mentioned and many more not mentioned, and the proprietors actions of creating and professing pseudoscience and confusing and taking advantages of the masses with the motivation to sell product and own a thriving business, it is somewhat an obligation to the scientific community to, at the very least, give the public a chance to become educated on the scientific method and rational thinking as well as the opportunity to make an educated decision. If in fact a person, after hearing both sides of the argument, still chooses to use non-scientific, non-evidence based practices, then that is their choice.
Many people may think that if other people use CAM therapies that it does not affect them. It may not affect you directly but it does affect you indirectly. For example, research has shown that more than 34.4 billion dollars is spent on CAM practices each year (Eisenberg et al., 1998). If this 34.4 billion dollars was spent improving, developing, and researching conventional evidence based medicine, who knows what progress we could make. The government has set up the NCAAM and various other entities and is funding their research on CAM practices. Should government spending be used on unproven CAM practices? Another problem is the use of CAM for diseases such as HIV, Hepatitis C (Standish, et al. 2001; CAM and Hepatitis, 2009). If people are forgoing the use of conventional medicine for HIV and using herbal supplements instead, this poses a serious problem. These people are taking a great risk with their lives.
In summary, what biologically based alternative medicines are, the different types of biologically based alternative medicines, how popular they are becoming and what biologically based alternative medicines are used for has been discussed. What these alternative medicines are supposed do and what they actually do have been discussed, as well as, a host of thinking fallacies and how they are related to biologically based alternative medicines. The bottom line is, unless CAM or biologically based alternative medicines gains an exponential amount of scientific research with statistics showing a reasonable efficacy, it is too dangerous and too fallacious to choose alternative medicines over conventional medicines.
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