Many
serious diseases are not detectable in their early stages. When
symptoms do appear, the attempted cures may be painful, disabling or
mutilating and most certainly will be costly. If the patient endures the
toxicity of chemotherapy, or the disfigurement of surgery and radiation
and the treatment fails, then he and his family are left with the terrible
anxiety attendant to the continued presence and possible progression of a
devastating disease.
In this circumstance, the need for hope is all-powerful. It
understandably drives the patient and his family to seek some sort of
"alternatives". These desperate and vulnerable people
become fair game to the medical charlatans who offer "all natural,
safe treatments that heal."
To the fearful patient, healing and curing are one and the
same. A high level of intelligence does not guarantee that the patient
will recognize the false promise implied by the use of the word
"heal". In most cases, questioning of the practitioner will
reveal that the word "heal" is used in a spiritual or
metaphorical sense rather than a physical one.
Charlatans often claim that their therapy stimulates either
the "immune system" or some "innate" ability of the
body to heal itself. Thus, the charlatan avoids responsibility when the
treatment fails by shifting responsibility for the failure onto the
patient - a despicable thing to do to someone already facing the trauma of
a devastating illness.
Alternative medical treatments flourish because cures for
many diseases do not exist and because responsible physicians will not
offer false hope of medical miracles. The widespread popularity of
alternative treatments is directly related to the inadequacy of many
standard treatments; the impatient physician who answers questions
brusquely, evasively or not at all; the scientific illiteracy of the
public; the desperation of patients; and most significantly, the
willingness of sociopaths in our society to take advantage of
vulnerable patients.
Alternative treatments encompass a broad spectrum of remedies
whose effectiveness has never been proven. Remedies can involve ancient
mystical rites from the Far East, the invoking the help of various Gods,
the purging of "poisons" with enemas and the injection of extracts from human body fluids, live animal cells,
animal tissues, industrial chemicals, raw herbs, escharotics, and gaseous
ozone. Homeopaths administer water which they say they have treated to
make it "remember the vital essence of some active substance" it
once contained but no longer does.
One hallmark of quackery is that practitioners treat patients
according to the particular system they favor rather than the distinct
clinical conditions of the patient. Proponents will claim their treatment
heals everything from cancer to AIDS. Although they will defend the
practices of others, rarely if ever will one practitioner recommend some
other form of treatment as more efficacious for a particular patient's
condition. The alternative practitioner projects a variety of appealing
images of himself to win the confidence of medical consumers.
For example, As the " Healer", he plays the role of
a selfless, caring physician who has no interest in making money. His
"grateful patients" then eagerly follow his script whenever
there is a legal challenge to his practices. They ignore questions
about his credentials and his inept pseudoscience. They swear that their
"regular" doctors said, "there was no hope" but still
recommended the "cutting, burning or poisoning" treatments of
orthodox medicine. They state that these recommendations were all proven
wrong when they were "healed" by the treatment of the
alternative practitioner.
As the" Scientist", he poses as a superior
researcher whose " medical success" is based on his
understanding of the healing arts of the "ancients" coupled with his knowledge of
modern medical science. To blunt the impact of the rebuttals he knows his
claims will provoke, he assures his "flock" that his concepts
are so advanced that, like those of all great scientists in the past, they
are not understood by orthodox scientists and so are repudiated.
As the "Concerned Citizen" he recruits a cadre of
wealthy and prominent laymen (industrialists and Congressmen) as
supporters. Regardless of why they mistrust
established science and medicine, these people forcefully promote their
"protégé's" interests by lobbying government agencies, raising
money, publishing "Newsletters" advertising his treatment and
instigating letter writing campaigns that characterize his critics as
being against Freedom of Choice and therefore un-American.
No one characteristic signals the presence of fraud in
medical treatment, but anyone who reviews the bases for the claims can
detect it if they understand a few basic principles about evaluating
evidence.
Alternative remedies fall into two categories:
1) Substances" which are
said to affect cellular functions like the immune system (e.g.,
Laetrile, 714-X, Antineoplastons, Hydrogen peroxide, Ozone, Hydrazine
sulfate). The mechanisms by which these treatments supposedly work have
been published, and can be scientifically evaluated.
2) Mystical practices which are used "to call up the
patients latent healing powers" (e.g. Chi, homeopathy, acupuncture,
chiropraxis, visualization, meditation, faith healing, Kirlian auras,
numerology, gem therapy and Kabalah). There is no way to prove that
these powers exist and can cause healing, so their acceptance depends
entirely on the patients' willingness to blindly believe testimonials.
Charlatans depend heavily on
patient testimonials as "proof" that their therapies work. However,
they know that just offering a new treatment will boost a patient's
spirits, cause an increase in appetite and even reduce the perception of
pain. These subjective improvements are not proof that a treatment works.
Proof comes with supporting and concomitant evidence. It is
the consistency and predictability with
which patients respond to a treatment that is significant. Any
unpredictable improvement that occurs sporadically may not be due to the
treatment itself and therefore cannot be claimed as proof of its efficacy.
Every scientist lives with the challenge," PROVE
IT!" To do so, he knows he must present data that supports his
conclusions and can be independently reproduced by other scientists.
What is relevant in proving the curative value of any treatment is not the
reputation of its proponent, the persuasiveness of his theory, the
eminence of his political supporters, the anecdotes of his patients or the
lack of confidence that layman may have in the medical establishment.
It is whether the treatment can be shown to work in rigorously controlled,
objectively interpreted independent clinical trials.
The design of a valid clinical trial must include knowledge
of the biology of normal tissue, the cause of the disease, the variations
of the disease process in different tissues, the biochemical changes which
mirror the diseases progress and the means by which investigators can
evaluate the effect of the treatment.
Clinical researchers must know the chemical composition,
tissue specificity, metabolism, toxicity and excretion rates of each of
the substances being used so he can integrate this into the patients
clinical history and experiences with other medications. Finally each
patient must be closely followed for a significant period of time after
the treatment ends, so all the significant after effects can be noted. Only after all these conditions are fulfilled can a valid
conclusion be reached about the efficacy of the treatment.
In September l990, the NIH Office of Technology
Assessment published a review of the wide variety of alternative medical
treatments offered in the U.S. for a disease like cancer (ie. Burzynski,
Gold, Gerson, Burton, Gonzalez, Revici and others). Although these
treatments were entirely different from each other, proponents claimed
they evoked the same degree of "healing" in patients. What
was of great significance in this was the
fact that nowhere in all their claims of support for these treatments, was
there mention of their having personally tested and verified the efficacy
of any of the treatments they endorsed.
In l992, "true believers" in Congress created the
Office of Alternative Medicine at the NIH. Its mandate, they said,
was the verification of the effectiveness of alternative treatments.
As was pointed out earlier, any appropriately designed clinical trial must
contain the means to show that a given treatment might be worthless.
Perhaps this is why no attempt has as yet been made by the OAM to
clinically evaluate the effectiveness of any alternative treatment.
But independent investigators here and abroad have done so.
In well-designed and controlled trials of various alternative remedies
(hydrazine sulfate, chelation therapy, laetrile and others)
researchers obtained results which clearly demonstrated that those
treatments were worthless. Predictably, those conclusions were rejected by
those who used these treatments.
They charged that the test substances were given incorrectly,
that antagonistic drugs were given to negate the effectiveness of the
treatment and that the clinical data was incorrectly interpreted. All
this, they charged, proved that the Medical, Pharmaceutical and Insurance
establishments were engaged in a conspiracy to keep their "safe,
effective and inexpensive" new treatments from reaching the public.
Most people are outraged when they discover that they have
been victims of fraud. Strangely, this is not the case with
those who have been duped into spending huge sums for worthless
alternative treatments. They are either too embarrassed by their
gullibility to admit it, either to others or to themselves, or they
rationalize "gratitude" for the brief respite that the treatment
seemed to provide their deceased loved ones. Often they remain among
the most adamant proponents of the failed cure.
An examination of medical history illustrates the price
patients are willing to pay for hope, even
when the hope is false. In his "Medical Essays" (Boston
l883) Oliver Wendell Holmes wrote:
There is nothing that men will
not do to recover their health and save their lives. They have submitted
to being half drowned in water, choked with gases, buried to their chins
in earth, seared with hot irons, crimped with knives, had needles thrust
into their flesh, had fires kindled on their skin, and swallowed all
sorts of abominations. Then they pay for all this as if scalding were a
privilege, blisters a blessing and leeches a luxury. What more can be
asked for as proof of their sincerity?
To expose the fraud in the sale of
"hope", health care professionals must learn about the claims
being made for alternative medical treatments. With that knowledge
they can teach the truth to patients that ask. Having the assurance that
they are getting the best care possible from a knowledgeable professional
who understands their needs and is honestly trying to to solve their
clinical problems is the only way to keep patients out of the hands of
medical charlatans.
Patients considering alternative therapies for serious
medical illness must demand evidence. They must ask the practitioners
exactly what they are promising. They must ask what recourse they have if
the promised "healing" doesn't
occur, and must insist on accountability from the practitioner. If
patients could be persuaded to demand evidence and accountability for the
effectiveness of an alternative treatment, there would be fewer victims of
medical fraud.
About the Author
Saul Green, Ph.D., is a highly
regarded cancer researcher and a recognized expert in biochemistry,
immunology, and nutrition. He is retired from the Sloan Kettering
Institute in New York City. Dr. Green is an experienced consultant on the
analysis of alternative medical treatments, and has given lectures and
made TV appearances on this subject.
Among Dr. Green's noteworthy research accomplishments are the
first isolation of Tumor Necrosis Factor from the blood of experimental
animals, and the first identification of a similar protein in the serum of
normal human blood. He has advised and directed the establishment of
cancer research programs, interferon production and purification
procedures from human cells, and the isolation and purification of
naturally occurring Biological Response Modifiers.
Dr. Green is the author of over 40 technical publications. He
is a charter member of the Council for Scientific Medicine, a board member
of the National Council Against Health Fraud, an advisor to the American
Council on Science and Health, and a member of the Alternative and Complementary Methods Advisory Group of
the American Cancer Society.
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