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The
Press
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Researchers
have found acupuncture can lower blood pressure, though
the effect was produced by stimulating a point that
was not supposed to effect the heart.
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The
press is the major vector for the spread of "CAM" through
its uncritical reporting and misrepresentation. Several times
a year in most newspapers, a novice reporter claiming skepticism
consults an "alternative" practitioner, often an acupuncturist,
and reports that some chronic aggravation improved. Not reported
is the fact that controlled trials show the method is not
effective. Nor does the article follow up on how often or
how much the symptom recurs over the next year or five. These
are facts most physicians must have and must divulge before
obtaining informed consent for a procedure.
Political pressures, not public need or scientific
validity, were behind the rise of chiropractic, acupuncture,
and other methods.
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The
July 3, 1998, San Jose Mercury News bore a small Washington
Post article about rural China's 70% infestation rate by various
parasites, most commonly worms, resulting in malnutrition,
decreased intelligence, and general weakening of the workforce.
The article was buried on page DD5. The previous week's acupuncture
article was on page 1B, complete with half-page photo. This
kind of editorial treatment is typical.
So
where are acupuncture and moxibustion when we need them? The
worm infestation above apparently does not respond to "AM."
The failure of traditional Chinese medicine in China and its
maximum 18% usage there is a testimonial to modern biomedicine's
success. But this is assumed not to interest the public; at
least it seems not to interest the press.
The typical "AM" article highlights a few advocates, but presents
the scientific view in two paragraphs -- usually in the middle
or toward the end of the article. The pseudoscience view usually
gets the last word.
Power
Politics
Traditionally,
a distinguishing feature of quacks has been this: If they
cannot prove their claims scientifically, they use the popular
press and lobby for special privilege in legislatures. Seven
states have passed "access to medical treatment" (AMT) bills.
These allow any licensed practitioner to practice any method
within the legal scope of practice -- proved or not -- on
any patient, provided "informed consent" is obtained. Regulatory
boards, organized medicine, and public-service agencies oppose
such bills. (Even now the Texas board is considering liberalizing
regulations on aberrant practices to conform to policies resembling
AMT bills.)
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Former
chiropractor John Badanes debunks one chiropractic belief
that legs of differing lengths should be, and can be,
"corrected."
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Pressure
groups from the "CAM" community support these policies and
contribute funds toward their passage. Political pressures,
not public need or scientific validity, were behind the rise
of chiropractic, acupuncture, and other methods.
So
the braid of the "AM" movement is complex and strong and will
always lurk in our backgrounds, even if all human misery and
disease were to be conquered. For now it grows into the interstices
of scientific and ethical medicine's weaknesses and is fertilized
by imagined faults. The movement has advanced socially and
politically.
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The European Community is about to consider removing
many worthless "AM" methods from lists for reimbursement.
The same disenchantment may occur here in a few years.
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According
to Prof. Edzard Ernst of Exeter University, the fascination
with "AM" has peaked in the United Kingdom, and classes are
poorly attended. The European Community is about to consider
removing many worthless "AM" methods from lists for reimbursement.
The same disenchantment may occur here in a few years. Yet
we can learn from "AM's" existence and social successes. We
can study misinterpretation of events and the formation of
beliefs, increase our understanding of social movements, and
perhaps tease out small kernels of benefits -- even if only
psychological -- in some methods.
The
challenge here is for us to increase our abilities to observe,
measure, record, analyze, and reason, and not to allow the
holes in our reality-sieve widen until we have lost our grip
on it. 
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