Quackery should be ducked

In suggesting why so called "Alternative and Complementary Medicine" might be appealing to consumers in this most scientific of all ages, a reporter from "New Yorker" magazine told me that in this "post modern" age people wanted more romance in the science they hear so much about. "You doctors are failing to understand that panaceas, reliance on traditional use and working with nature are irresistibly attractive concepts"!

If true such thinking features dangerous delusions as was brought home to me, yet again, in an email from a paediatrician this week who had just seen a nine year old girl with untreated autism whose parents had spent $40,000 on naturopaths and chiropractors who promised to cure their child. There is little in the way of protection for consumers from modern day quackery and, regrettably, some of our universities that should be champions of scientific truths are not helping the situation.

More than a third of our universities are allowing health care related pseudoscientific concepts to be presented to their students as if they represented good science, i.e. were supported by experimental evidence. The "disciplines" involved include Homeopathy, Iridology, Reflexology, Kinesiology, "Energy Medicine" and Aromatherapy. There is no scientific basis for any of these subjects. The ideology involved, which is more metaphysical than physical, represents an affront to scientific knowledge of physiology and pathology.

Although there is some evidence that some procedures involving Acupuncture and Chiropractic result in benefits in a limited number of conditions they do not cure the long list of diseases they claim to be able to treat. In some universities both are taught as if there was sound evidence for believing they could be used to treat a broad array of disease processes.

For some time there has been growing concern associated with the efforts of Chiropractors to extend their role in the health system beyond the evidence base they have for the treatment of musculoskeletal problems related to the back. Their peak body, The Chiropractor's Association of Australia (CAA) has a vision for Chiropractic becoming the major primary care discipline in the country.

Their belief in the suitability for Chiropractic to offer all embracing primary care stems from their continued support for their founder's concept of an "innate intelligence" that flows as energy up and down the spinal column controlling normal function of the body's physiological processes. "Subluxation" (not used in the common medical sense of visible collapse of spinal column integrity) interferes with this vital flow and is responsible for most diseases The CAA claims to be the protector of this intellectual knowledge.

Alarmingly many chiropractors are extending their use of manipulation of the spine and neck to the treatment of children with extraordinary claims for the ability of such treatment to cure Asthma, allergies, bed-wetting, Attention Deficit Syndrome, colic, fever and numerous other problems. One has sympathy for the considerable number of chiropractors who distance themselves from this nonsense now increasingly promoted to the community.

The regrettable decision of the Federal government to establish a national registration and self-regulation system for chiropractors, without a definition of an acceptable range of services, together with permission to call themselves "Doctors" has done nothing to protect consumers from this "quackery".

That some tertiary institutes should allow "pseudoscience' based coursesto be offered on their campuses is unacceptable, particularly when health care is involved. To do so is to lower the standards of tertiary Institutions in this country damaging what has been an enviable reputation for excellence in scientific research and application.

Good scientists working for such Institutions have every reason to be angered by a university's retreat from the primacy of scientific based approach to medicine. It is disturbing to see federal tax dollars spent on supporting non-science (nonsense) on our campuses and subsidising the rebate private health insurers provide for pseudoscience. This represents a waste of precious health care dollars and again provides a level of totally unjustified credibility.

With the above concerns troubling more and more of the scientific, medical and academic community the recent announcement by Central Queensland University that it would offer a Bachelor of Science (Chiropractic) degree run by a newly appointed head of school sympathetic to non-existing 'subluxation' catalysed the creation of a new organisation "The Friends of Science in Medicine" dedicated to countering the growth of antiscience, ironically and disturbingly flourishing in this most scientific of all ages.

In particular the organisation will strive "To reverse the trend which sees government funded tertiary institutions offering courses in the health care sciences that are not underpinned by convincing scientific evidence". Within four weeks of announcing the creation of the "Friends" more than 450 prominent scientists, clinicians, academics and consumer advocates have joined the association, a clear indication of the growing disquiet for this trend.

We are not targeting all non-conventional practices. We strongly support research that seeks evidence for any reasonable approach but such research needs to be justified on its merits as is true for all medical research. We accept that modern medicine itself has more to do to improve its effectiveness and to test the validity of many of its practices. It is the teaching of pseudoscience that we are tackling and firmly believe that universities, government and consumers should understand that the fundamental principles of science raised by the Friends of Science in Medicine, and shared by most consumers, are fundamental to our provision of sustainable, safe and effective, health care.