Terminology of alternative medicine
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Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.
Terms for alternative medicine
The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and
The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to
Complementary or integrative medicine
Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a
CAM is an abbreviation of the phrase complementary and alternative medicine.[18][19] The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries."[20]
Other terms
Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the era of modern medicine. The 2019 WHO study defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness."[20]
Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine.
Definitions of alternative medicine
Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of
Challenges in defining alternative medicine
Terminology has shifted over time, reflecting the preferred branding of practitioners.
Prominent members of the science
Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo.[5][17][43][44] It has been said that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",[34] and that the very idea of "alternative" treatments is paradoxical because any treatment proven to work is by definition "medicine."[45]
Different types of definitions
Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.
An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM),
Evidence-based definitions distinguish alternative medicine based on its provision of therapies that are unproven, unvalidated, or ineffective and support of theories with no recognized scientific basis.[66] These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but are not based on evidence gathered with the scientific method.[8][22][12][13][54][67] Exemplifying this perspective, a 1998 editorial co-authored by Marcia Angell, a former editor of The New England Journal of Medicine, argued that:
It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.[22]
This line of division has been subject to criticism on the grounds that not all forms of standard medical practice have adequately demonstrated evidence of benefit,[n 5][68][69] and that most conventional therapies, if proven to be ineffective, would not later be classified as alternative.[59] Another definition is that alternative medicine refers to a diverse range of related and unrelated products, practices, and theories ranging from biologically plausible practices and products and practices with some evidence, to practices and theories that are directly contradicted by basic science or clear evidence, and products that have been conclusively proven to be ineffective or even toxic and harmful.[n 3][37][70][5]
Proponents of an
Australia
The public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym "CAM" for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.[77]
Denmark
The
- Treatments performed by therapists that are not authorized healthcare professionals.
- Treatments performed by authorized healthcare professionals, but those based on methods otherwise used mainly outside the healthcare system. People without a healthcare authorisation are [also] allowed to perform the treatments.[78]
Other terms
Allopathic medicine
Allopathic medicine or allopathy is a
Use of the term remains common among homeopaths and has spread to other alternative medicine practices. The meaning implied by the label has never been accepted by conventional medicine and is still considered pejorative by some.[84] William Jarvis, an expert on alternative medicine and public health,[85] states that "although many modern therapies can be construed to conform to an allopathic rationale (e.g., using a laxative to relieve constipation), standard medicine has never paid allegiance to an allopathic principle" and that the label "allopath" was "considered highly derisive by regular medicine."[86]
Many modern science-based medical treatments (antibiotics, vaccines, and chemotherapeutics, for example) do not fit Samuel Hahnemann's definition of allopathy, as they seek to prevent illness, or remove the cause of an illness by acting on the cause of disease.[87][88]
See also
Notes
- ^ The Final Report (2002) of the White House Commission on Complementary and Alternative Medicine Policy states: "The Commissioners believe and have repeatedly stated in this Report that our response should be to hold all systems of health and healing, including conventional and CAM, to the same rigorous standards of good science and health services research. Although the Commissioners support the provision of the most accurate information about the state of the science of all CAM modalities, they believe that it is premature to advocate the wide implementation and reimbursement of CAM modalities that are yet unproven."[7]
- ^ a b "[A]lternative medicine refers to all treatments that have not been proven effective using scientific methods."[8]
- ^ a b c d "Complementary and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed."[21]
- ^ a b "It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work... speculation, and testimonials do not substitute for evidence."[22]
- ^ a b c "The phrase complementary and alternative medicine is used to describe a group of diverse medical and health care systems, practices, and products that have historic origins outside mainstream medicine. Most of these practices are used together with conventional therapies and therefore have been called complementary to distinguish them from alternative practices, those used as a substitute for standard care. ... Until a decade ago or so, "complementary and alternative medicine" could be defined as practices that are neither taught in medical schools nor reimbursed, but this definition is no longer workable, since medical students increasingly seek and receive some instruction about complementary health practices, and some practices are reimbursed by third-party payers. Another definition, practices that lack an evidence base, is also not useful, since there is a growing body of research on some of these modalities, and some aspects of standard care do not have a strong evidence base."[26]
- ^ "An alternative medical system is a set of practices based on a philosophy different from Western biomedicine."[27]
- ^ "CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[28]
- ^ The BMA used the term non-conventional medicine instead of alternative medicine.[47]
- ^ The Office for Alternative Medicine, part of the National Institutes of Health, was renamed NCCAM in 1998.[60]
- ^ "Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients";[71] "Evidence based medicine, whose philosophical origins extend back to mid-19th century Paris and earlier, remains a hot topic for clinicians, public health practitioners, purchasers, planners, and the public. British centres for evidence based practice have been established or planned in adult medicine, child health, surgery, pathology, pharmacotherapy, nursing, general practice, and dentistry; the Cochrane Collaboration and Britain's Centre for Review and Dissemination in York are providing systematic reviews of the effects of health care".[71]
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External links
- Terminology of alternative medicine at Curlie