Against homeopathy--a utilitarian perspective

I examine the positive and negative features of homeopathy from an ethical perspective. I consider: (a) several potentially beneficial features of homeopathy, including non-invasiveness, cost-effectiveness, holism, placebo benefits and agent autonomy; and (b) several potentially negative features of homeopathy, including failure to seek effective healthcare, wastage of resources, promulgation of false beliefs and a weakening of commitment to scientific medicine. A utilitarian analysis of the utilities and disutilities leads to the conclusion that homeopathy is ethically unacceptable and ought to be actively rejected by healthcare professionals.     

HOMEOPATHY AND EXTRAORDINARY CLAIMS – A RESPONSE TO SMITH'S UTILITARIAN ARGUMENT

Kevin Smith's utilitarian argument against homeopathy 1 is flawed because he did not review and refute the relevant basic science literature on ultra‐high dilutions. He also failed to appreciate that allopathic medicine is based on a deductive‐nomothetic method and that homeopathic medicine is based on an inductive‐idiographic method, and thus that the implications for clinical research are very different. His misunderstanding of provings and of the holism of homeopathic medicine also demonstrated his failure to understand the history, philosophy and method of homeopathy. Finally, I questioned the value of introducing ethical judgment into an ongoing scientific debate.     

FOR HOMEOPATHY: A PRACTISING PHYSICIAN'S PERSPECTIVE

This article is a rebuttal to Kevin Smith's ‘Against Homeopathy,’ which was posted on 14 February 2011. 1 It contends that his argument rests entirely on the assumption that homeopathic remedies are nothing but placebos. His argumentation is good, but his assumption is false. Evidence is presented to show that the Law of Similars is plausible and that ultradilute remedies do indeed have biological activity.     

Advising Patients on the Use of Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is an area of great public interest and activity, both nationally and worldwide. Many alternative medical practices have existed for hundreds, even thousands of years. Patients and professionals are turning to CAM for a variety of reasons. Most have tried conventional medicine for a particular (usually chronic) medical condition and have found the results inadequate. Some are concerned over the side effects of conventional therapies. Some are seeking out a more “holistic” orientation in health care where they can address body, mind, and spirit. A continuing challenge will be how to address CAM services that are based on time, practitioner–patient interactions, and self-care, using modern standards of evidence, education, licensing, and reimbursement. For most CAM therapies, there is insufficient research to say definitively that it works and CAM research is especially limited in the area of cancer. Given that situation, the questions (but not answers) facing the medical practitioner are clear-cut. Should the practitioner await the definitive results of formal Phase III randomized clinical trials, or should the practitioner rely on limited data, seeking out evidence that makes physiological sense and small trials that seem to offer some benefit to the patient? When and at what point do you discourage, permit, or recommend an available alternative therapy? The answers are not simple. There may be differences of opinion and values among the patient, the practitioner, and the organizations that pay for a therapy. CAM areas should be approached with every patient who enters the office recognizing that there are precautions to consider when patients are using, or plan to use, such therapies. This paper presents a broad survey of what complementary and alternative medicine is from the perspectives of both the public as user and the conventional medical practitioner, as well as provides examples of issues pertinent to understanding and evaluating research in CAM. The past is back and the future will involve integration of modern and ancient ways.     

American acupuncture and efficacy: meanings and their points of insertion

By its very definition, efficacy's meanings remain fluid, their particularities contingent on context. The change seen as significant may occur on a symbolic level or through the removal of physical symptoms. It may address conditions of a social body. Some discussions differentiate between "healing" and "curing." Many of these meanings surface when examining what efficacy means in the practice of acupuncture in the United States. This complex phenomenon is possible largely because acupuncture draws on the qi paradigm on the one hand, allowing for the most ephemeral dimensions of experience to be included in considerations of efficacy. On the other hand, in the most material sense, acupuncture is also susceptible to being conceptualized as a device, independent of that same paradigm, allowing for the insertion of biomedical models and criteria. Pluralism within acupuncture itself intersects with, and even embodies, the medical pluralism of U.S. culture.     

生物医学工程的精要、责任和展望

作为工程学的直属分支,建立生物医学工程学科的主要目的不是为了开辟一个新的科学研究领域,而是为了借助工程学的方法来解决生物医学领域所面临的实际问题,以及借助工程师们所接受的专业训练、所拥有的专业知识、所具备的工作技巧来提高医疗服务的质量和效果。工程学与生物医学的结合已取得了一些具有里程碑性质的成果。在中低收入国家,例如中国,生物医学工程有责任保证合理使用专业技术,为低廉、可靠、有效的医疗服务提供支持。本文将根据可预见和不可预见的学科发展限制和困难,对学科发展的现实目标和责任进行严肃、冷静地讨论。     

The circle of the soul: the role of spirituality in health care

This paper examines the critical attitude of behavioral professionals toward spiritual phenomena, and the current growing openness toward a scientific study of spirituality and its effects on health. Health care professionals work amidst sickness and suffering, and become immersed in the struggles of suffering persons for meaning and spiritual direction. Biofeedback and neurofeedback training can facilitate relaxation, mental stillness, and the emergence of spiritual experiences. A growing body of empirical studies documents largely positive effects of religious involvement on health. The effects of religion and spirituality on health are diverse, ranging from such tangible and easily understood phenomena as a reduction of health-risk behaviors in church-goers, to more elusive phenomena such as the distant effects of prayer on health and physiology. Psychophysiological methods may prove useful in identifying specific physiological mechanisms mediating such effects. Spirituality is also a dimension in much of complementary and alternative medicine (CAM), and the CAM arena may offer a window of opportunity for biofeedback practice.     

Nutrition Facts in Multiple Sclerosis

The question whether dietary habits and lifestyle have influence on the course of multiple sclerosis (MS) is still a matter of debate, and at present, MS therapy is not associated with any information on diet and lifestyle. Here we show that dietary factors and lifestyle may exacerbate or ameliorate MS symptoms by modulating the inflammatory status of the disease both in relapsing-remitting MS and in primary-progressive MS. This is achieved by controlling both the metabolic and inflammatory pathways in the human cell and the composition of commensal gut microbiota. What increases inflammation are hypercaloric Western-style diets, characterized by high salt, animal fat, red meat, sugar-sweetened drinks, fried food, low fiber, and lack of physical exercise. The persistence of this type of diet upregulates the metabolism of human cells toward biosynthetic pathways including those of proinflammatory molecules and also leads to a dysbiotic gut microbiota, alteration of intestinal immunity, and low-grade systemic inflammation. Conversely, exercise and low-calorie diets based on the assumption of vegetables, fruit, legumes, fish, prebiotics, and probiotics act on nuclear receptors and enzymes that upregulate oxidative metabolism, downregulate the synthesis of proinflammatory molecules, and restore or maintain a healthy symbiotic gut microbiota. Now that we know the molecular mechanisms by which dietary factors and exercise affect the inflammatory status in MS, we can expect that a nutritional intervention with anti-inflammatory food and dietary supplements can alleviate possible side effects of immune-modulatory drugs and the symptoms of chronic fatigue syndrome and thus favor patient wellness.     

Headache Treatment with Pulsing Electromagnetic Fields: A Literature Review

Pulsing electromagnetic field (PEMF) therapy may be a viable form of complementary and alternative medicine. Clinical applications include the treatment of fractures, wounds, and heart disease. More recent applications involve treatment of recurrent headache disorders. This paper reviews available studies investigating PEMF for headache management. Possible mechanisms for effects (neurochemical, electrophysical, and cardiovascular) are discussed. The available data suggest that PEMF treatment for headache merits further study. Suggestions for future research are provided.     

Herbal medicinal products target defined biochemical and molecular mediators of inflammatory autoimmune arthritis

Rheumatoid arthritis (RA) is a chronic debilitating disease characterized by synovial inflammation, damage to cartilage and bone, and deformities of the joints. Several drugs possessing anti-inflammatory and immunomodulatory properties are being used in the conventional (allopathic) system of medicine to treat RA. However, the long-term use of these drugs is associated with harmful side effects. Therefore, newer drugs with low or no toxicity for the treatment of RA are actively being sought. Interestingly, several herbs demonstrate anti-inflammatory and anti-arthritic activity. In this review, we describe the role of the major biochemical and molecular mediators in the pathogenesis of RA, and highlight the sites of action of herbal medicinal products that have anti-arthritic activity. With the rapidly increasing use of CAM products by patients with RA and other inflammation-related disorders, our review presents timely information validating the scientific rationale for the use of natural therapeutic products.     

Two into One Won’t Go: Conceptual, Clinical, Ethical and Legal Impedimenta to the Convergence of CAM and Orthodox Medicine

The convergence of complementary and alternative medicine (CAM) and evidence-based medicine (EBM) is a prominent feature of healthcare in western countries, but it is currently undertheorised, and its implications have been insufficiently considered. Two models of convergence are described – the totally integrated evidence-based model (TI) and the multicultural-pluralistic model (MP). Both models are being incorporated into general medical practice. Against the background of the reasons for the increasing utilisation of CAM by the public and by general practitioners, TI-convergence is supported and MP-convergence is rejected. MP-convergence is epistemologically and clinically incoherent, and it cannot be regulated. It is also inconsistent with developments in the legal determination of the standard of care for both diagnosis/treatment and disclosure. These claims concerning MP-convergence are justified by the fact that science is not a member of the group of perspectives or world-views which postmodernism treats as equally valid, and this is especially important for healthcare.     

Healing across Cultures: Learning from Traditions

The health and wellness of an individual are reliant on the integrated effects of mind, body, and spirit. This triad is intricately set within a backdrop of the environment, our earth. Western cultures often disregard this holism, especially this fourth component, in its considerations of wellness as described by modern medicine. This practice is unlike that of many of the traditional cultures in the world. These cultures focus more on balance in the context of environmental respect. Varied cultures share remarkable similarities in their healing modalities, especially considering the relative isolation from one to another—evidence that there is truth to the healing knowledge they possess. We are not disconnected from the natural world in terms of health, but dependent and interconnected within ourselves and to everything around us. Social change is required to assure that the practice of modern medicine evolves to incorporate this integral aspect of health and wellness, and this can be done through partnerships with traditional healers.There is a growing demand for wellness and earthly responsibility. It is time to appropriately learn from age-old societies and their healing traditions for they do have answers we are seeking in sustainability and harmony, environmental stewardship and planetary respect, and holistic health. For thousands of years, our ancestors have known the secrets of long life—this knowledge needs to be preserved through the apprenticeship of future generations. We propose a collaboration that develops mutually beneficial learning partnerships combining modern medical knowledge with the wisdom of traditional healers around the world.     

The emergence of integrative medicine in Australia: the growing interest of biomedicine and nursing in complementary medicine in a southern developed society

In this article, I examine the process by which some biomedical physicians and nurses in Australia have come to adopt various alternative therapies in their regimens of practice, largely in response to (1) the growing interest on the part of many Australians in what is generally called "complementary medicine", and (2) a recognition that biomedicine is not particularly effective in treating an array of chronic ailments. Some Australian biomedical physicians and nurses have come to embrace "integrative medicine," which purports to blend the best of biomedicine and complementary medicine, and have even created an Australasian Integrative Medical Association and established integrative medical training programs and centers. I argue that the adoption of alternative therapies and the development of integrative medicine on the part of Australian biomedical physicians and nurses constitute another national manifestation of the co-option of complementary and alternative medicine.     

For my wellness, not just my illness: North Americans’ use of dietary supplements

Passage of the DSHEA in 1994 created a new “liminal” category for the FDA: dietary supplements are regulated as neither food nor drugs. However, there appears to be a significant disconnect between the “official” discourse surrounding dietary supplements and supplement users’ actual practices. Despite this discrepancy, and the inadequacy of surveys to capture the dynamics of pharmaceutical practice, there is little ethnographic information available on the ways that Americans think about or use dietary supplements. We offer some preliminary observations from a pilot ethnographic study of Americans’ use of dietary supplements in which we consider not only the reasons why people are using supplements, but how they are using them, and how their experimentation has been influenced by the information they seek and receive from a variety of sources. We illustrate how anthropological studies of supplement related practice can help us better understand Americans’ attraction to and use of dietary supplements, and suggest that anthropology can contribute to a more balanced perspective on supplement use—one that moves the study of supplements beyond surveys and randomized controlled studies of efficacy to considerations of patterns of use in context, user expectations, and measures of perceived effectiveness.     

The Third Therapeutic Revolution: Behavioral Medicine

Behavioral medicine—and one of its progenitors, biofeedback—are expanding as the Third Therapeutic Revolution, supplementing surgery and pharmacology in treating human illnesses. Parallel development of nonscience-based therapies is a part of the same revolution. Labeling their positive results as placebo effects hides a greater truth: faith and trust play an enormous role in therapy. The successes of both behavioral medicine and unorthodox complementary medicine are the result of thedebonafide effect(my Latin for from good faith). Readers are urged to adopt this better definition of the unexplicable and substantial good results of both the placebos in research and the ministration of unorthodox treatments.     

多巴胺与神经退行性疾病研究进展

多巴胺调控人类的情绪和认识能力,包括思想、感觉、理解、推理等,同时,它也在人类的运动功能中发挥重要作用。研究表明多巴胺的合成、储存、释放、降解和重摄取等失衡均与中枢神经系统的多种退行性疾病有密切联系,同时许多治疗疾病的有效药物也围绕多巴胺的研究而产生,如多巴胺替代疗法改善帕金森病的运动症状,多巴胺受体阻断剂可改善舞蹈病的运动症状以及调节多种疾病的精神症状,在临床上都取得了可喜的疗效。然而目前未发现与多巴胺代谢直接相关的基因突变,因此未来需要继续深入研究在神经退行性疾病中造成多巴胺代谢失常的机制,旨在为临床新药物靶点和新治疗手段的研发提供线索。     

NADP—苹果酸酶活性变化及其在CAM运行中的调节

ＮＡＤＰ－苹果酸酶是ＣＡＭ植物一种重要脱羧酶。实验结果表明,专一ＣＡＭ植物瓦松和兼性ＣＡＭ植物长药景天及露花其ＮＡＤＰ－苹果酸酶活性昼高夜低;５－８月,兼性ＣＡＭ植物长药景天和露花随着Ｃ３光合型向ＣＡＤ型转化,其中ＮＡＤＰ－苹果酸活活性逐渐升高。     

IS HOMEOPATHY REALLY ‘MORALLY AND ETHICALLY UNACCEPTABLE’? A CRITIQUE OF PURE SCIENTISM

In this short response we show that Kevin Smith's moral and ethical rejections of homeopathy 1 are fallacious and rest on questionable epistemology. Further, we suggest Smith's presumption of a utilitarian stance is an example of scientism encroaching into medicine.