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The National Council Against Health Fraud (NCAHF) wants the Bush Administration to disclaim and reject the final report of the White House Commission on Complementary and Alternative Medicine ("CAM") Policy, because the Commission has failed in its mission. Its final report does not appropriately assess "CAM" methods, lacks objectivity, and was principally the opinions of Commission leaders who revised it without most of the members ever seeing the final edition. The report is an unqualified endorsement of so-called "CAM," a "New-Age" marketing term which falsely proposes that untested and unscientific methods of care are equivalent to evidence-based medical practices. Some members of the Commission objected to the methods and recommendations and issued a significant dissent, pointing out where the Commission had fallen short. The report went to the White House without the majority of the commissioners having seen the final copy.
The White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP) was established two years ago during the Clinton Administration to make recommendations "assuring that public policy maximizes the benefits to Americans of complementary and alternative medicine." Its report recommends expanded federal spending and other policy initiatives that would foster irrational methods, and encourage treatments that have already been proven ineffective, or have no established therapeutic value. Despite nearly two years of work, the Commission failed to conduct basic, reasonable activities such as such as defining the term "CAM" and justifying the inclusion or exclusion of various methods within its scope. Without this foundation, the Commission could not appropriately assess any areas for "benefit" as prescribed in its charter. This failure, will likely lead thousands of Americans to believe that untested, unproven, and possibly dangerous interventions are valid methods of health care.
"Complementary and alternative medicine" is an imprecise term that is inherently misleading. "Alternative" methods are best described as practices outside of scientific, mainstream health care that lack evidence of safety and effectiveness. At worst, these can be characterized as the unfounded opinions of individuals whose views typically clash with basic concepts of anatomy and physiology, research methodology, and/or science. Their methods are generally not covered by insurance plans for these reasons. "Complementary medicine" is not medicine at all, but a collection of adjunctive techniques that help patients face and manage stress, cope with physical and other aspects of illness, and provide care and comfort measures. In truth, there are no "alternatives" to objective evidence of benefit or safety.
NCAHF has examined the background and credentials of WHCCAMP's members. Most are philosophically aligned with the so-called "CAM" movement, and many have an economic interest in this area. The Commission lacked members with backgrounds that would qualify them as knowledgeable in evaluating and critiquing so-called "alternative methods." Additionally several members have backgrounds meriting media scrutiny. For example, some are associated with homeopathy, a discredited 18th century prescientific theory whose proponents suggest that a substance diluted to infinitesimal proportions, where no molecules of the substance are left, can transfer healing powers to water. Multiple clinical trials and simple common sense show this cannot and does not occur. Others have made absurd advocacy statements that pushing on an outstretched arm can allow a practitioner to diagnose hidden infections at distant sites and that this technique should be widely adopted as a standard of practice. Two independent appraisals of the members of the Commission appear at http://www.no-whccamp.org/.
The Commission's interim draft report recommends across-the-board "integration" of "CAM" into government health agencies and the nation's medical, medical education, and insurance systems. Without supporting evidence, the Commission falsely assumes and states that "CAM" is cost-effective. Established literature shows it is not. It further recommends that "CAM" methods be integrated into every aspect of our educational and health-care delivery systems, once again without any logical rationale. Additionally, its report does not identify a single "CAM" practice that should be considered improper. A paragraph-by-paragraph analysis of the draft recommendations of the Commission is posted to Quackwatch. An analysis of the final report will be posted when it is officially released.
The Commission advocates spending hundreds of millions of taxpayer dollars to promote unscientific beliefs that include treating cancer with herbal teas and coffee enemas, and manipulating supernatural forces to treat serious illnesses. The report blindly advocates that anything marketed as "CAM" should be taught in medical schools, included in health plans, and widely incorporated into government policies.
Such recommendations are a perversion of the trust placed in presidential commissions, an affront to medical science, and an assault on consumer protection. Without science-based safeguards, any scam artist with a far-fetched idea can open for business and bilk the public. The proper place for unproven and untested methods is in laboratories and clinical research studies, not in a large-scale unscientific, unsupervised experiment upon the American people. Any method that is plausible should be tested with well-designed clinical trials. The rest should be discarded. No health care method should be marketed, promulgated, or taught without proof that it is safe and effective.
The so-called "CAM" movement and the Commission report attempt to create a separate, parallel system of health care that is unjustified. Advocates of so-called "CAM" suggest that it is an independent method of "science" and cannot be evaluated by reasonable methods and objective measures. In fact, it is not science at all, but a compilation of non-scientific and pseudoscientific opinions, conjectures, and unfounded hypotheses presented to appear as if they were scientific by presenting them as if they resemble scientific work, while lacking in rigor, logical foundation, critical analysis, or a search for truth. "CAM" does not qualify as an "alternative" to evidence based research or medicine since the pervasive and recurrent theme of "CAM" is merely that of a series of opinions that are refuted by common sense, and overruled by data. NCAHF President Robert S. Baratz, MD, PhD, DDS states that, "the public must be protected from this alleged system of care. It is nothing more than an attempt to market unskilled and unscientific practices. Calling it a medical care system is misleading and untrue."
NCAHF Board member Timothy Gorski MD, said that "The Commission was set up to support and promote the fiction that 'CAM' is a reasonable substitute for medical science. The fact is that real medicine has always been 'integrative' in that it incorporates anything that works. The 'CAM' movement is an attempt to achieve politically what cannot be done scientifically and, if the Gordon Commission gets its way, by making the taxpayer foot the bill." Dr. Gorski also objected to the idea that "CAM" is a "kinder, gentler" form of medical care. "I don't consider needlessly sticking needles into people or giving them coffee enemas to be more caring or compassionate. In fact, given the diversity of religious beliefs in the United States, it's the height of arrogance for 'CAM' advocates to try to medicalize spirituality along New Age lines."
Dr. Baratz agreed, saying that, "Spirituality is quite important to many people and human existence, but it is a non-medical activity. By claiming that spirituality and 'healthy living' are unique to and a part of 'CAM,' Americans are sold the lie that 'CAM' has wide appeal and support. In fact, it does not. Removing these non-medical practices makes the alleged 'CAM' entity fall apart. What is left is a group of aberrant practices coupled with unsupported conjecture and speculation."
At the Eleventh Hour, the leadership of the Commission hijacked the report and rewrote sections in a blatant attempt to stifle significant dissent from several of its members. Even at this writing, before official release of the report by Secretary of HHS Tommy Thompson and The White House, the Commission's leadership is working aggressively to keep a minority report out of the final document. This minority report by several commissioners is ample testimony to both the weakness of the work of the Commission, its recommendations, and the concept of "CAM" in general. The actions of the leadership to try to prevent and circumvent the minority report merely reinforces these weaknesses, and highlights the lack of objectivity of the process. The leadership released the Commission "findings" more than a week ago, via a public relations firm, before the report was finalized or even seen by the majority of the Commissioners.
When viewed in a larger context, "CAM" and its proponents are part of a movement that routinely rejects rational thought and objective evaluation of its methods, most often because they will reveal that the treatment or method under scrutiny will be shown to be lacking and principally the work of profiteers who hide behind a curtain of "New Age" rhetoric and neo-vitalistic beliefs.
NCAHF believes that this Commission has failed in its mission. For a Commission of professionals with medical and other advanced degrees, its activities lacked scholarship and rigor. Instead of seizing an opportunity to critically examine "CAM" theories and practices and making a rational and reasoned report to the President, the Commission blindly advocates policies that are illogical and economically senseless. The value of any possible therapies that may have emerged from careful review and testing has been lost in a tidal wave of enthusiasm for anything merely bearing the label of "CAM."
NCAHF strongly suggests that the Commission's recommendations be rejected and repudiated by President Bush and members of Congress for the reasons elaborated above. Widespread adoption of unproven, disproven, and irrational methods will cost the American public billions of dollars and thousands of human lives. The WHCCAMP recommendations for implementation are premature by any standard, since scientific data do not exist to support them. Medical ethics dictate that before any medical practices are adopted or spread. studies done with scientific methodology, and adequate protections for humans must demonstrate their validity. Doing less would be a danger to the public and would remove safeguards that have evolved over centuries in the practice of rational and caring medicine.
The National Council Against Health Fraud is a consumer advocacy group founded more than twenty years ago to promote reliable health information.
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