Cutting complementary medicine courses from universities would dilute the quality of the education available and threaten safe practice but have no impact on demand for it, according to academics writing in the Medical Journal of Australia (MJA) today.
In an emphatic response to recent comments by Friends of Science in Medicine (FSM), a body that is committed to stemming the spread of “pseudoscience” in medicine, the authors accuse some in the medical orthodoxy of trying to stifle divergent views.
Writing in the MJA in March, two founding members of FSM, Alastair MacLennan, a professor of obstetrics and gynaecology at the University of Adelaide, and Robert Morrison of Flinders University, wrote: “Pseudoscientific courses sully the genuinely scientific courses and research conducted at the same institutions. Their scientists and students should be concerned by any retreat from the primacy of an experimental, evidence-based approach in science and medicine.”
In today’s retort, Stephen Myers, a Professor of Complementary Medicine and Director of the Natural Medicine Research Unit at Southern Cross University, and coauthors warn that there is “great danger for the public if complementary medicine practice is allowed to develop outside mainstream education”. It would undermine “safe practice and critical appraisal”.
Among the coauthors is Kerryn Phelps, former President of the Australian Medical Association, and Adjunct Professor in the Faculty of Medicine, School of Public Health at the University of Sydney.
“Science sets out to rigorously eliminate bias, not to assert it,” they write. “The arguments mounted for the closure of complementary medicine courses in Australian universities by the Friends of Science in Medicine in a recent editorial … are highly emotive and, while having a gloss of superficial reasonableness, they do not stand up to critical review.”
Professor Myers said that complementary medicine was a broad field that could not be described with generalisations. It was important, he added, to distinguish the major professional and university-based disciplines of traditional Chinese medicine, chiropractic, osteopathy and naturopathy from “fringe practices, and the actions of rogue or unqualified practitioners”.
Two “comprehensive reviews” of complementary medicine practice and training in Australia over the past 15 years — one on traditional Chinese medicine and the other on naturopathy and Western herbal medicine - had both supported the movement of these professions into a university setting, “just as earlier reviews had done for chiropractic and osteopathy”, Professor Myers said.
“It is not melodramatic to point out that if the Friends of Science in Medicine were to succeed in their stated aims, they would achieve a dystopia — a medical ‘1984’ where only one way of knowing the body in health and illness is permitted in public discourse.”
But John Dwyer, President of FSM and Emeritus Professor at the University of New South Wales, said Professor Myers had misrepresented the position of his organisation: “A look at our website makes it clear we strongly support research into currently alternative approaches if they are credible and there is sufficient evidence to warrant science dollars being used to settle the question of efficacy.
“It is pointless to argue about who is right and who is wrong, who should be believed and who should not,” he said. “That is the whole point of our approach, to subject claims to proper scientific scrutiny, as science excels in determining impartially whether these supposed treatments are effective or not.
“The fact that many complementary and alternative medicines have been scientifically examined and found to be ineffective bears out our concerns, and no amount of assertion, declaiming, authoritative pronouncement, no matter whether it comes from exponents of complementary medicine or FSM is relevant in the face of good scientific research findings published in respected journals.
“The criticism of FSM for putting a forceful point of view on the need for scientific research sits very oddly with those who base their belief in many complementary and alternative medicines on the dogmatic pronouncement and descriptions uttered by sole individuals who have invented various medicines, often centuries ago, and who are still blindly followed to this day, despite centuries of scientific discovery and advancement in medicine.”
In a separate article in today’s issue of MJA, Paul Komesaroff, a Professor of Medicine at Monash University, and coauthors wrote that the views in the March editorial by FSM “exceed the boundaries of reasoned debate and risk compromising the values that FSM claims to support”.
Professor Komesaroff said that while there was now an extensive evidence base for complementary therapies, the concept of evidence-based medicine was highly contested within Western medicine itself.
It was not appropriate, he said, for doctors or scientists with a particular view of medicine to impose those views on the whole community.
“It is important that those who seek to be friends of science do not inadvertently become its enemies. We call on the members of FSM to revise their tactics and instead support open, respectful dialogue in the great spirit and tradition of science itself”.