Alternative therapies
=====================

* Paul C.S. Hoaken

The argument expressed in John Hoey's editorial, "The arrogance of science and the pitfalls of hope,"1 was disappointing and unconvincing. Surely there is more reason for medical scientists to be alarmed by the apparent toleration, even acceptance, of alternative medicine than their frustration because of inadequate research funding. Should we not be critical of evidence supported only by testimonials and the claims of commercial concerns? The scientific method, with its emphasis on disinterested investigation, careful analysis of data, conservative scepticism and consensual agreement, is the best method human beings have for approaching the truth.2

Hoey is incredibly naïve to think that there must be merit in alternative therapies because those with "a higher level of education" use them. Education (it is sad to admit) does not guarantee the ability to think critically and to use an informed scepticism in considering claims for the effectiveness of treatments.

It is misleading to refer to scientific medicine as "the establishment." This term connotes some rigid ideological position whereas the scientific method has revealed, not just in medicine, a continually changing reality through revisions and self-correction.

If patients are "taking control of the agenda" regarding their treatment, let them do so. But let us not dignify treatment that is completely unsupported by scientific evidence with a medical endorsement. The best physicians can do is to inform patients of the lack of valid evidence supporting claims for alternative treatments (with a few exceptions) and to try to instill in patients an enlightened scepticism. I recommend to many patients *The Wellness Letter* published by the University of California at Berkeley. Contrast the sceptical (not negative) attitude toward alternative treatments in this publication intended for the lay public with the *CMAJ* articles criticized by Ian Tannock and David Warr.3

This editorial would have been bad enough coming from any physician. Coming from the Editor of *CMAJ* it makes me sad and embarrassed to be a member of the Canadian Medical Association.

## Appendix 1

**[Editor's note:]** 

Owing to an editorial oversight, this letter was not published in 1999 as scheduled.

## References

1.  1. Hoey J. The arrogance of science and the pitfalls of hope [editorial]. CMAJ 1998;159(7):803-4.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6MzoiUERGIjtzOjExOiJqb3VybmFsQ29kZSI7czo0OiJjbWFqIjtzOjU6InJlc2lkIjtzOjk6IjE1OS83LzgwMyI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xNjIvNS82MzIuNC5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  2. Strahler AN. *Understanding science.* Buffalo (NY): Prometheus Books; 1992.
    
    

3.  3. Tannock IF, Warr DG. Unconventional therapies for cancer: A refuge from the rules of evidence? CMAJ 1998;159(7):801-2.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6MzoiUERGIjtzOjExOiJqb3VybmFsQ29kZSI7czo0OiJjbWFqIjtzOjU6InJlc2lkIjtzOjk6IjE1OS83LzgwMSI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xNjIvNS82MzIuNC5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)