Comments from the Head to Head debate in the Irish Times

Should alternative medicine be integrated into the health system?

71% YES

29% NO

THE PUBLICS COMMENTS AGAINST INTEGRATION

I couldn't agree more with Dr. Brian Hughes' assessment of the need to keep alternative medicine (i.e. medicine that doesn't work but looks as if it does) out of our mainstream health services. We have worked for years to develop a health service committed to evidence-based practice. Alternative medicine seeks to have us embrace treatments on the basis of anecdote and testimonial.
Mike Ireland

It's good to finally see this debate. The media have allowed the alternative medicine industry to propagate false claims and squeeze money from an uninformed public. The Irish Times has been just as uncritical as every other media outlet. A recent Health supplement printed without challenge the ridiculous claim that reiki is explained by quantum mechanics. Genuine science is unfortunately confined to a single weekly page. Alternative medicine is the greatest health rip-off in this country and yet The Irish Times is not covering it.
David H Ireland

The element of alternative medicine that attracts considerable attention is that of herbal and nutritional therapies. But there is a potential for risk with such items. People often acquire the items from what are called health-food shops or from sites on the internet. Such sources rarely if ever can offer any quality assurance beyond the well-meaning but vague sales pitches from the manufacturers. Individuals who purchase such items have no independent evaluation regarding ingredients or possible adverse interactions with a prescription medication the person may be taking. Alternative treatment is sought by those who are trying to avoid the very high price of many prescription medications, and the deadly long waiting time to see a Doctor. It is truly a sad state of affairs when we are told to consider it a good thing that waiting times have been reduced to months instead of years. People will be better served when the cost and delays of conventional treatment are significantly improved, and they do not have to rely on choices that may be of no benefit.
Dan Ireland

Practitioners of so-called 'alternative' and 'complementary' medicine are one of three things: liars, charlatans, or ignoramuses. To be fair, most are probably just ignorant.

I have investigated alternative medicine in scientific papers. In almost every case, the evidence is either severely flawed or indicative of the fact that 'alternative' medicine is quackery of the highest order. Even where a paper does indicate some value to an 'alternative' treatment, a conflicting paper is generally published within a month or so.

Practitioners of 'alternative' medicine often point to the effectiveness of placebos in alleviating illness, and argue that their nonsense thus deserves equal treatment to mainstream medicine. What they ignore is that placebos only cure about 10% of patients. Would you trust a doctor or guru who said that a treatment they recommend has a 10% success rate?
Chris McCrohan Ireland

Taxpayers money should not be wasted on alternative treatments unless they are scientifically proven to deliver real health benefits
sean Ireland

This is a silly question. Only therapies that have demonstrable beneficial effects should be funded in the health system. Once an alternative therapy has been shown to be effective it is no longer classified as alternative and any good doctor will recommend it. The real question is: Should therapies that have not been shown to be effective be funded by the health system? Why not post that as a survey now and see what results you get? (Not to mention therapies that have been shown not to be effective.)
Brian Mulligan Ireland

Whilst modern medicine cannot treat and cure all diseases and ailments, this fact cannot be used to justify the use of spurious alternative therapies that lack evidence for their effectiveness and exploit the sufferers of such ailments. Desperation or dissatisfaction does not change the fact that , with the possible exception of acupuncture, alternative therapies are ineffective, costly and pointless. There is no justification for using tax payers money out of ignorance and desperation.
Keith Ireland

Integrating "Complementary" and "Alternative" medicine into our Health System would be like integrating Intelligent Design into our Education System.
sean Ireland

The health system should use evidence-based medicine: medicine that has been shown to work in rigorous, impartial experiments. If this includes placebos then that's all well and good.
David Ireland

The instant an 'alternative' medical procedure/therapy/treatment can be scientifically proven to have benefits, this becomes 'traditional' medicine. Placebo effect already is part of traditional medicine (any time your GP listens to you). Funding of 'alternative' medicine is a big mistake, and I'd hate my tax money going to fund those loonies.
Alfonso Ireland

The public are protected by law from many kinds of dishonesty and dubious practice. But for some reason, when it comes to somebody's health, there isn't a scrap of legislation to say that you can't tell a sick person whatever on earth you want to, regardless of whether or not it's actually any good for them. The alternative medical industry urgently needs to be regulated for the good of the public's health before more people like Paul Howie and Jacqueline Alderslade are conned into an early grave (http://historical-debates.oireachtas.ie/D/0602/D.0602.200505110015.html)
Robin Hilliard Ireland

Pushkar at top of page should note that herbal medicines are often potent, do have side effects and can dangerously interact with other medications. Having read Ruth Cloherty's article I consulted the website of the organisation she is referenced as directing. much on it would concern me, but consider this one example. She offers a diploma in Clinical Iridology where this is claimed as an "invaluable tool (that) will help you to form a diagnosis" and is also "a useful tool in measuring success, as effected (sic) parts of the eye will change as health is restored". (Conditions diagnosed by iridologists relate to all parts of the body. In fact I am not aware of claims that they diagnose eye problems per-se). The iris does not change except in rare occular disease. It is a better indicator of identity than fingerprints. FAQ's on the site indicate that one is fit to practice following completion of a diploma. Iridology is a nonsense that can diagnose nothing and has been systematically discredited. The course lasts 5 weekends over 6mths, costs €1,600 and releases "graduates" into society deluded that they can diagnose. This kind of reprehensible activity hardly lends credence or confidence to Ms. Cloherty's plea that alternative practitioners can in any sense complement a scientifically driven, evidence based approach to health and medicine.
Paul O'Donoghue Ireland

The question here essentially comes down to should we allow our health system to use methods which are unproven. If a new scientific treatment is proposed it would need to be thoroughly tested to verify that it worked and to identify any damaging side-effects. The same standards should be applied to alternative therapies. If their effects can be proved then that's great, they become scientific fact and can obviously be used in a modern health system. However, to allow patients to be cheated by selling unproven medicines and techniques, which could even prove harmful, would be nothing less than malpractice. Any supposed health treatment must be tested and proven before its use should be allowed or sanctioned by our health system.
Kathryn Ireland

We don't need alternatives to medicine in our health service. So called "alternative medicines" are simply not effective. Todays medicines are scientifically proven to be effective where as these snake oil peddlers proudly shy away from the rigorous double blind trials that all real medicines must undergo.

We need a health service in this country that works for everyone. Currently we have nothing resembling such an ideal. The problem lies with the management of patients and the time that our scarce and overworked doctors and nursing staff can spend with a patient. Any quack rubbing what ever he decides on a whim is a cure can obtain results because he gives the illusion that they are more interested than a burnt out detached doctor who cannot emotionally reassure a patient than some self deluded confidence trickster.

This is a problem that can be hopefully solved be spending money on staff to properly reward them for their hard work, attract new carers and ensure that our sick are cared for with real medicine. Don't waste tax payers money on this nonsense, if the snake oil worked big pharma would have take notice. Indeed the government continue to tell us about Ireland's growing vibrant research sector, wouldn't it be better to spend money researching the wild claims of these alternatives before subjecting our most vulnerable to them?
Kevin Ireland

Ruth Cloherty states "The healthcare system will be crippled if we don't integrate the most effective complementary and alternative practices such as acupuncture, osteopathy and nutritional therapy". Quite the opposite - once the door is opened for non-evidence based medicine, the tax payer will forever be paying for treatments that do not work. Chiropractic is a classic example of a nonsense health care idea which has gained respectability in many countries due to accreditation and folding it into the mainstream. There are some positives of course, many chiropractors will discard the absurd basis of chiropractic and actually treat muscular ailments using proper, evidence based techniques. But all this does is to create confusion - who can tell if a chiropractor these days is one who has had training in how to help with muscular or skeletal problems, or one who thinks that bad sublexations are causing your asthma and a quick check of your leg length will show why your spine is bent. Quackery abounds, and giving nonsensical practices a way into respectability is a dangerous road.
Gordon Ireland

It is sad that at the outset of the 21st century, with so many of the problems facing us in the coming decades only solvable by willpower informed by the rigours of science, that so many people are turning to pseudoscientific and indeed anti-scientific trash spouted by populist demagogues. Even if many of the practices promoted seem innocent in and of themselves, I fear it bodes ill for the future of the species. It is time that homeopaths, nutrition quacks and the various other forms of pseudo-scientists promoting themselves in the field of medicine, among others, should be seen for what they are. Another correspondent put it quite squarely; they consist of a small nucleus of liars and charlatans, cushioned by a comfortable supply of the ignorant. The intellectual mildew of ¿post-modernist¿ relativism spreading from our universities has a lot to answer for. Fair dues to Brian Hughes and his ilk for speaking up.
Donough Ireland

haven't we got enough problems with the health service without opening it up to crackpots, airheads and quacks who are profiteering on other peoples misery. I want science based on empirical evidence, not mythology dressed up as "alternative"
Mike Ireland

I would hope that if I was ill then my treatment would be based on rigorously conducted, preferably double-blind trials, and that my carers would have time to explain what was going on and treat me as a patient not just another case.Perhaps nice smells (aromatherapy) and foot massage (reflexology) could ease the stress but I think I would rather listen to a Bach CD (not paid for by the taxpayer). Incidentally The British Medical Journal's excellent 'Clinical Evidence' demonstrate that a lot of accepted treatments in mainstream medicine don't pass stringent tests either. The point is however for the medical profession to remain constantly critical of their therapies. That is something CAM practitioners don't and daren't do.
Mike Blade Ireland

No proof, no integration. It's as simple as that. Twenty or more centuries of quackery and bloodletting have taught us that delusional treatments, based on unsystematic observation and crazy theories can persist for centuries.
Jan Willem Nienhuys Netherlands

So it seems that ancient mysticism and anti-science still holds sway in Ireland. Amazing,it seems some 70% of your population wants to introduce quack medical and snake oil into the practise of real medicine. Ireland will not be alone in this, aside from the witch-doctor countries of Africa, etc. Russia includes homeopathy in its mainstream medical courses. No doubt medical treatment in Russia is streets ahead of that in backward Western Europe? :) Or maybe the proposal is just another Irish joke to amuse people in other countries with the simple minded backwardness of the Paddies? When I read of such stupidities I am really, truly glad that my ancestors emigrated to Australia. Fred Thornett, Hobart, Tasmania
Fred Thornett Australia

As Richard Dawkins, Professor of the Public Understanding of Science at Oxford says, alternative medicine is a "...set of practices which cannot be tested, refuse to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine....There is no alternative medicine. There is only medicine that works and medicine that doesn't work."
Stephen Ireland

If an alternate medicine can be proven to be effecatious, then it becomes ipso-facto mainstream medicine. If its effecacy cannot be proven, then it shouldn't even be called medicine. "Alternate" in this context is therefore unnecessary - and misleading.
Eric Fiesley Australia

"Alternative" medicine is not medicine. It does not adhere to the same stringent standards that real medicine does e.g. properly controlled scientific studies which show strong evidence of effectiveness. So-called "alternative medicine" therapies have simply not been proven to work and should not be integrated into the health system. Any therapy/treatment that was properly shown to work would be picked up by mainstream medicine and would therefore cease to be "alternative".
Terry Kelly Australia

You simply cannot be serious. Alternative medicines have no evidence basis at all. Perhaps you should consider the effect of such a silly proposition on how people view your country.
Bill Australia

If the AltMed group want to be included, just prove their claims and we will call it "medicine." What could be simpler?
Joe United States

Any medicines that are proven to be effective are already integrated into the health system. Alternative medicines are those that have been proven NOT to be effective and are of psychological benefit only.
Wil Trondl Mexico

The only medicine that should be integrated in the health system is medicine that works. And therefore you need evidence, EVIDENCE and E V I D E N C E! And most of the alternative does not live up to this criterion. It will be thrown away money. People should realize that immortality and eternal youth are unattainable goals for any kind of medicine.
Rik Delaet Belgium

As soon as one of the alternative "therapies" can win the paranormal challenge on randi.org I’d say yes. There’s no proof of homoeopathy, reiki etc. being more effective than placebo so far. So why waste the money?
Georg Germany

I totally agree with Dr. Hughes. When CAM practitioners claim that " scientific evidence " has been found, do simply ask for the studies they rely on. Most of them are ill-founded or supported by firms that make those CAM therapies like Boiron in France. Secondly, I do agree to that accepting this integration would sort of letting the wolf penetrate the sheep hut. Many people will believe that CAM can cure even serious diseases thanks to that " scientific " label. We have to be very cautious with that wave of postmodernism insinuating in our lifes. If I feel ill, I don't rush to see a physician right away. It is most of the time benign and after a few days I am back on my feet. What is the use of spilling money for something that cures by itself ?
Minon Phillip Belgium

Enda, Ireland, if alternative medicine is valid there is a simple procedure that all conventional medicine must pass that eliminates the bias you speak of - double blind testing. As to the issue of adverse reactions to drugs, that is an argument for more rigorous testing of medicine and the establishment of its benefit, not less. You destroy your own argument unless you claim that alternative medicine should be supported because it is inert placebo only.
Stephen Ireland

I think that there is a risk to integrated uncontrolled medicine.
KAMPS F. Belgium

Diana, Netherlands, there are many people in the world alive to day who never took an antibiotic and never took homeopathic potions. What exactly does that prove?
Stephen Ireland

Despite the commonly held idea that it is the 'traditionalists' within health who are arrogant, it strikes me as almost unbelievable that anyone, with a shred of insight, would suggest that they know if a therapy/medication works on the basis of simply using it. Surely even at the most basic levels of analysis it is clear that all sorts of factors are at work when it comes to health from psychological factors, time factors, physical factors, perceptual factors etc etc. Only a great degree of hubris (or honest ignorance) would allow someone say that they are capable of discerning what is 'working' and what isn't when they are taking a medication/treatment. Health researchers take it for granted that they cannot do this and require carefully sculpted research methods to tease out what's doing work and what is not. Surely it is not too much to ask for CAM proponents to acknowledge this?
Michael Ireland

I read the IT today and my head cold was gone by lunchtime. I'm convinced that reading the IT must have curative powers. Many people read newspapers every day and get better. What more evidence do you need? Clearly we are drawing on psychic energies of the power of the word. Of course it's not possible to test this in your double-blind scientific trials - to even suggest this shows your ignorance of the workings of mystic energy. Your imperialistic western chauvinistic science is simply incapable of accommodating holistic quantum healing understanding. yada yada yada... You know studies on prayer have shown a greater affect than those on homeopathy (and in those, not even a statistically significant effect).
Stephen Ireland

There is no anger Mark Ellison, there is simply amazement that a population who underwent an even remotely scientific education could reconcile the theory of Homeopathy with known science. If Homeopathy were correct, that water can retain an impression of the substance previously mixed with it, even when massive dilution has insured that not even a molecule of the substance could remain, then our understanding of the nature of physics would be fundamentally incorrect. Nobel prizes would be thrown around left right and centre. But where are the studies that prove it to be true? Nowhere. Not one.
Stephen Ireland

The argument here is not whether some people feel good sometimes when they take or partake in CAM. We get that. The question is why they do. We know that there are psychological and physical reasons which more than adequately explain why people get relief from pain, skin conditions, inflammation, mood problems etc. People who support CAM seem unwilling to accept that there may be reasons other than the CAM for the improvements they see. They believe they are impervious to being fooled. They took 'A' and got 'B' so A caused B ... never mind that C,D,E,F,G and H were all busily working away ... we don't want to know about them at all! A caused B ... QED!
Mike Ireland

There is no such thing as alternative therapy, quite simply there are therapies that work and there are therapies that don't. Any therapy, CAM or allopathic, that works will lend itself to standard research methodology of some sort. (There's no point expecting a therapy that requires a therapist to be present such as Physio or Psychology to be tested with a double blind placebo study. It won't work) To make things even more confusing there are protocols inside a therapy that work and those that don't. For example, the efficacy rates for a lot of standard treatments used in PT or physiotherapy (such as TENS and ultrasound) are very questionable. Indeed, the efficacy levels that are required by most medical staff as they look at accepted therapies would not be accepted for a CAM therapy. Quite simply, for a new kid on the block the bar is higher. Physicians (in general) are much more comfortable referring someone to an established therapy and therapist than to a CAM therapy, even if efficacy has been shown to be higher in good peer revied journals. We should also be wary of dismissing the strength of a placebo effect. As a psychophysiologist, I am much more interested in the third (approx)of the population who manifest the effect of a drug without the drug being present than I am in researching the people who manifest with the drug present. Trouble is getting a grant/money for decently researching the effect. If we could figure out what is going on in the part of the population who do not seem to need the drug maybe researchers could disseminate the information.
Daren Ireland

There is no such thing as "alternative" medicine. Medicine has been shown to work in double blind scientific studies. Alternatives do not become medicine until proven to work.
Dave Smith United States

Homeopaths are just people who didn't pay attention during Inorganic Chemistry classes.
Donna Smith United States

As consumers of health care products, we must insist that EBM and sCAM be subjected to identical (high) standards of evidence pertaining to efficacy and safety. sCAM actively tries to dodge scrutiny because its proponents either know that they don't have a case, or they simply don't understand science and the importance and consequences of evidence. sCAM has to prove its worth in exactly the same way that EBM does - anything else is naïve apologism. If a sCAM modality proves its worth on a level playing field then by all means embrace it - but then it's no longer sCAM but EBM. Either medicine works, or else it doesn't. There's no middle ground. Why, for instance, anyone in any society wants to continue wasting time and money on such paranormal scams as homeopathy, which has had 200 years to prove its worth and has failed without exception, is beyond me and only explicable by cognitive dissonance, ignorance and outright dishonesty. Throwing good money after bad is simply irrational and a waste of everybody's time and money. Let the sCAM community provide evidence that their stuff has acceptably safe and consistent effects beyond placebo before public money is wasted on it. Otherwise we might as well spend taxpayer's money on voodoo and alchemy.
Anders W. Bonde Denmark

First of all, I think it makes no sense whatsoever to use the term "alternative medicine" to describe such a variety of ideas, claims and alleged medical treatments. Secondly, to say that using herbs and other forms of nature's bounty is contra traditional medicine is absurd. Western medicine is largely built on experimentation with nature but the key difference is the scrutiny applied. To simply pick a berry from a bush and apply it to some disease or medical condition is not only irresponsible but could prove fatal. This is why the scientific method has proven to be our most effective tool in discovering what can truly benefit our species - and countless other species. Traditional medicine employs science to test its ideas. Why would we allow alternative medicine practitioners to bypass this crucial step? When we get to the heart of the matter it's often money that fuels these issues. The AM practitioners are lazy - they don't want to go through the rigorous learning and methodology of REAL medicine. Their ideas and their minds simply don't have what it takes to make it in the real world and so they create a fictitious one where charlatans are placed on equal ground with the physicians who have done all the work. This latest resurgence of anti-science and the fad that is alternative medicine is dangerous. It is largely through marketing gimmicks and our desire to be anti-establishment that it has gained such a stronghold within society. And then there's this bizarre fondness for "ancient" ideas - as if they hold some form of wisdom lost through the ages. This is just another example of how humans delude themselves in thinking the mysterious past was somehow better than the mundane present. Or that the intriguing Eastern side of the world holds some kind of magic lost to our consumer driven, rational societies. The key to deciding what should be included in our health system is the EVIDENCE in favour of a particular treatment. As humans, our curiosity and inquiring minds afford us an infinite supply of adventure. If there are better medical treatments out there, we'll most definitely discover them, and if they hold up to our tests, we'll add them to our knowledge base. But until then, we are risking lives and putting all of civilization in jeopardy if we do otherwise. Europe, more than most places, should know the dangers of this issue. See Roy Porter's book "Quacks" and review your history before making such an important decision. Better yet, check out The Scientific Review of Alternative Medicine at www.sram.org and the Committee for Skeptical Inquiry at www.csicop.org . My bet is that most people voting in this poll are doing so without reading the comments posted or putting much thought into what the consequences of their actions will mean. If people just took the time to educate themselves about all sides of the issue, we wouldn't make so many mistakes in life - both as individuals and as a global community.
Amanda United States

"Alternative Medicine" is, for the most part, a sham, relying on people's ignorance and on the placebo effect. Research has shown that some 30 to 60 percent of people respond positively to placebo medicines and treatments, although such "medicines" may be nothing more than sugar pills and the treatments worthless. To incorporate such nonsense into the healthcare system would give "Alternative Medicine" a legitimacy it doesn't deserve.
Harry Murphy United States

I can't even make sense of this. Should medicine that has not been tested be integrated into the medical system? How is that even a question? Test it. Find the stuff works. Then integrate that into standard health care practice. How could anyone argue for any other process?
Mike Planck United States

Remember the additives to petrol that would make your car run better? They were tested and found useless, yet lots of drivers swore by them, probably because knowing they had paid for a product to save fuel for example made them drive more carefully. Only double-blinded tests can separate the chaff from the wheat. I suggest CAM is renamed "PUM" for Probably Useless Medicine. Niels Hovmöller, Stockholm
Niels Hovmoller Sweden

Perhaps Dr Brian Hughes is on to something... Maybe the general public is too stupid to think for themselves and so your government (with all of its wisdom, integrity, and honesty) should allow only one choice of health care for the people of Ireland......to protect the public (of course!)
Brian Woods United States