Alternative Cancer Treatments & Medical Tourism: People & Power

I saw this excellent documentary on Aljazeera English exploring the alternative cancer therapy clinics, many based in Tijuana, Mexico. Interestingly many of these fee-for-service clinics offer treatments unlicensed elsewhere such as Laetrile, and Sono-photo-dynamic Therapy (which certainly looks like an application of techno-mumbo-jumbo, but I’d be interested in other thoughts on the effectiveness of this therapy).

Cancer Sell – People & Power – Al Jazeera English

SPDT

I think the most worrying aspect is the commercial sales pressure applied by these clinics to vulnerable people. If ever you need a good argument for Evidence Based Practice, this is it.

Bernie

Science and Non-Science!

Well we are back into a new term here, and the trend in advertising to equate scientific and non-scientific ideas seems to be as strong as ever here in Canada in the new year. Interestingly, I saw a television advertisement last Friday for a new hospital information system being employed in Canada (Ontario I believe). The advertisement made a point to explain how the system incorporated patient information from both modern medicine, alternative Eastern medicine and natruropathic medicine.

Now this public affirmation of all encompassing healthcare struck me as interesting and I have long been trying to get my head around what naturopathic medicine actually is. I have read a variety of literature on the subject and still find it rather a confusing area, and have come to the conclusion it does not seem to be a scientific endevour. It is of specific interest to us nurses here in BC as naturopaths are one of the few listed health professions (including physicians) who are explicitly identified as being able to give orders to nurses under our professional regulations:

Section 7: Restricted Activities that Require an Order

Health professionals authorized to give orders to registered nurses under the Regulation are dentists, midwives, naturopaths, nurse practitioners, physicians and podiatrists.

(CRNBC 2011)

I must admit I have always found this rather puzzling, as to why naturopaths were selected but not other alternative health practitioners,  and the rationale for this seems to be rather arbitrary.

If we take a look at the statement of the Canadian Association of Naturopathic Doctors they state:

“Naturopathic medicine is a distinct primary health care system that blends modern scientific knowledge with traditional and natural forms of medicine. The naturopathic philosophy is to stimulate the healing power of the body and treat the underlying cause of disease. Symptoms of disease are seen as warning signals of improper functioning of the body, and unfavourable lifestyle habits. Naturopathic Medicine emphasizes disease as a process rather than as an entity.”

This seems not really that different than modern medicine, other than the limitation of focus to primary healthcare. However, reading further we find that  their natural/traditional interventions are based on a range of some decidedly dubious practices, including homeopathy (which despite what many advocates will tell you, is well established as bunk, and neither its theoretical basis or the empirical evidence of its effectiveness stand up to scrutiny).

It seems naturopathy attributes illness to the violation of “natural laws” suggesting that standard medical practices merely treat or suppress symptoms. Naturopathy has some other rather non-scientific ideas in that it does not accept the germ theory of illness, or more worryingly support vaccinations (see http://www.cand.ca/Position_Papers.papers.0.html?&L=0).

Scientific practices have a clearly stated and straightforward underpinning philosophy. We can consider science as:

“Science is the pursuit of knowledge and understanding of the natural and social world following a systematic methodology based on evidence.”

(UK Science Council, 2011)

Philosophically we can resort to the “problem of induction,” and related epistemological arguments to question the nature of evidence, but what is the rationale for blending scientific and non-scientific practices? This seems a very weird thing to want to do in the first place, a bit like saying I believe in chemistry and vodooo to explain the nature of matter, or lets blend astrophysics and astrology to explain the function of the solar system. I know there is this desire to be holistic, but it seems to publicly support disciplines that seem to have a catch-all basis, with rather vague and mystical rationales should be something we should seriously question, especially when dealing with publicly funded healthcare.

This view is growing very untrendy in my profession, and I know Roger and I are likely to be considered dinosaurs in this perspective as the adoption of postmodern notions of holistic being (although we prefer the term “old tuskers”). So I ask, should we be concerned with this trend for non-scientific alternative health practices being increasingly equated with science and evidence based practices? Scientific knowledge may well be flawed, but this all-inclusive approach seems to reflect more of a politically “right-on”stance rather than reflect a real interest in the quality of public healthcare. Its one thing if you or I want to go and pay for a round of crystal therapy if we wish to, but buying into services (with public money) that are popular but have no established utility seems a dubious undertaking in these times of economic woe. Certainly some traditional and alternative health practices have value, but exploring alternative health practices to establish their value using well established scientific methods for evidence based practice  would seem to make more sense for public health care.

All this writing has made my arm ache, now where did I leave my Q-Ray bracelet…

Bernie

CRNBC (2011) Scope of Practice for Registered Nurses. Retrieved from https://www.crnbc.ca/Standards/ScopePractice/Pages/Default.aspx  on 12/01/2012

UK Science Council. (2009). What is Science? | www.sciencecouncil.org Retrieved 8/25/2011, 2011, from http://www.sciencecouncil.org/content/what-science