Jane McCredie: Turning faith into science

THERE hasn’t been a lot of middle ground in the fiery debate about Australian universities offering courses in the various branches of alternative medicine.

On one side stand the Friends of Science in Medicine — 400 or so doctors and scientists lobbying universities to abandon degrees in “quackery”. On the other, a mass of outraged practitioners and their clients.

The FSM says almost one in three Australian universities now offer courses in complementary and alternative medicine (CAM), including traditional Chinese medicine, chiropractic, homeopathy, naturopathy, reflexology and aromatherapy.

Dr Ray Myers, acting head of the School of Health Sciences at RMIT, defended his university’s CAM programs against the scientific attack.

Chiropractic and osteopathy were two areas taught in which clinical research was limited, he told The Conversation, but the program incorporated the “best available evidence”, while also promoting further clinical research.

I have no argument with the university researching these widely used treatments, but the comments do rather beg the question of whether something should be taught as “health science” to future practitioners if the evidence for it is limited.

And I’m not the first to raise the concern that the provision of science degrees in these areas could give consumers an unrealistic, and potentially dangerous, expectation about the level of evidence underlying the treatments.

When we start talking about that key issue of evidence, we come up against the enormous, and I suspect growing, distrust of science among many in our community.

Here’s one woman commenting on The Conversation article: “I just find this issue oppressive for a number of reasons. It reeks of censorship. It’s fascist and elitist. Are we really going to let a bunch of elitists dictate our philosophy? Are we also going to let them determine our choice of healthcare or education? If we relinquish the ‘peoples’ knowledge of herbs then we lose something intrinsic, something not quantifiable, a history, a history that includes our culture and our connection to nature…”

Things that are not quantifiable may indeed hold great value for us, but is a science degree their natural home?

At its most fundamental level, this is a debate between science and faith, and the two simply don’t speak the same language. Science has about as much chance of undermining the tenets of faith as does the reverse.

Many practitioners and consumers of complementary therapies, angered by the FSM attack, seem to believe it is the blinkered vision of scientists that is at fault.

One acupuncturist, for example, repeatedly argued that the placebo effect was irrelevant when it came to assessing the efficacy of acupuncture because the interaction with the therapist was the intervention.

His conclusion? Once the “tainted” evidence provided by placebo-controlled trials was excluded, what was left was “an overwhelming mountain of case-study evidence spanning billions of patients stretching across a history thousands of years long”.

I’m not sure anybody has ever tracked down the origin of the quote: “The plural of anecdote is not data”, but it would seem to apply here (even when the claimed number of anecdotes is in the billions).

Of course, even the most scientifically minded hold beliefs we might struggle to explain in strictly rational terms and, like faith, science can cling to old truths and be hostile to new ways of thinking about the world.

But that is only science at its worst. At its best, the discipline carries a willingness, even a desire, to be proved wrong. And that is where it breaks ranks with faith and the faith-based professions.

There is an argument for including the study of alternative medicine in mainstream health science degrees — practitioners need to be in a position to talk to their patients about the risks and benefits of these extremely popular offerings.

But teaching faith-based practice as part of a “science” degree seems to me the equivalent of physics departments offering a BSc (Astrology).

Jane McCredie is a Sydney-based science and medicine writer.

Posted 6 February 2012

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