Complementary and Alternative Medicine Law and Regulation Criticized

Complementary and alternative medicine law and regulation, particularly with respect to dietary supplements, has been labeled a "futile effort costing taxpayers tens of millions of dollars a year."

Writes Robert Bazell, Chief science and health correspondent for NBC News in "Ignoring the failures of alternative medicine: The U.S. spends millions testing popular supplements. It's a futile effort:"

"Last week's study showing that the widely touted and sold supplement DHEA does nothing to slow the effects of aging was only the latest major piece of research with powerfully negative results from the National Institutes of Health Center for Complimentary and Alternative Medicine. Previous placebo-controlled trials proved the uselessness of St. John's Wort for depression and saw palmetto for enlarged prostates, shark cartilage for cancer, echinacea for the common cold and glucosamine plus chondroitin sulphate for arthritis.

But it doesn't matter much -- few seem to care."

But many do. The NBC chief overlooks all the rigorous clinical trials that have brought the public closer to understanding which complementary and alternative medicine (CAM) therapies have efficacy, which are safe, and which fail these tests. In addition, such trials inform malpractice law and other legal rules governing holistic health and alternative medicine, making it easier for patients and physicians (and other health care providers as well as hospitals alike) to try to predict, understand, and self-regulate as consumers increasingly ask for, and even demand, inclusion of alternative therapies.

The chief's passion is evident in statements such as: "The NIH launched its office of Complementary and Alternative Medicine (CAM) in 1991 in response to the public's huge interest in finding ways around mainstream medicine. At first, those heading the effort brought dubious credentials. Much of the research ranged from mediocre (meaningless animal studies) to laughable (passing magnets over sore knees)."

Do magnets work or not? Since many individuals and companies tout success with magnets, and electromagnetic fields obviously affect the body, this is an important research question. Dismissing the research as "laughable" surely does not advance scientific truth. And to which animal studies is the chief referring, and why does he label them "meaningless?"

"Almost all the research has come to the same conclusion: the stuff doesn't work" is certainly overbroad. One only need go to the NCCAM website, and to PubMed, to search for the literature for specific trials on various therapies. This information is also contained in the 2005 Report on Complementary and Alternative Medicine by the Institute of Medicine.

Even the example of acupuncture - which the article suggests has been "already proven effective in China" - is not entirely accurate. Acupuncture research has suggested the efficacy of certain acupuncture points--taken in isolation from the practice of traditional oriental medicine--for specific problems (such as, for example, relief of nausea from chemotherapy, as agreed by a National Institutes of Health (NIH) Consensus Panel). But that limited victory for claims of acupuncturists is far from suggesting that acupuncture as a whole has been "proven effective," and many of the trials were in the U.S., not China.

Admittedly, the Dietary Supplements Health Education Act of 1994 has been controversial, particularly among medical doctors who agree that proponents of complementary and alternative medicine have too many unproven claims. But that is not the whole story, and ethically speaking, there is something to be said for consumer autonomy and informed health care choices.

With respect to the health correspondent's line of argument, conclusions should not drive the data; if we want to honor the rigors of scientific method, it is the data that should drive the medical conclusions. And particularly when evaluating complementary and alternative medicine, and the law regulating CAM therapies, it is important to be honest.