Dr Oppel replies

While Dr Bell rightly points out that the current scientific literature is not perfect, his letter contains a number of statements and misconceptions that require rebuttal. 

My article focused on the perils of accepting cherished beliefs at face value and teaching them as though they were fact.

Dr Bell first charges me with being on a “crusade against non-pharmaceutical and non-surgical therapies.” This is somewhat puzzling as I have long held that any therapy, no matter its type or origin, should be accepted as good medical practice once it has been shown to be safe and effective.

Dr Bell then proposes that traditional medical beliefs must be true be­cause “the price of failure is… death.” Such a view does not explain why when long-held “traditional” medical views—no matter what their cultural origin—are finally put to the test, a dismal picture results. For example, traditional European herbal remedies like echinacea and gingko, despite centuries of use, fall flat when put through properly designed trials. 

To be sure, the use of such things, be they herbs, acupuncture, bloodletting, or therapeutic touch, can give a sense of hope and empowerment, and often play an integral cultural role. But that does not mean they are truly beneficial medical treatments. 

The US National Institutes of Health has spent hundreds of millions of dollars investigating therapies that evolved in precisely the manner described by Dr Bell. No compelling evidence of new valid therapies has yet been uncovered (to confirm, search the NIH ClinicalTrials.gov website listing trials funded and the results obtained. Go to http://clinicaltrials.gov, click on Search for Clinical Trials, select Advanced Search, and in the Lead Sponsors field, type “NCCAM” [National Center for Complementary and Alternative Medicine]).

It is not arrogance, but humility, that allows us to come to grips with the fact that while there may be traditional knowledge to be prized and accepted, there is also a great deal of traditional misconception—including our own. Showing respect for cultural beliefs is not, and should not be, synonymous with taking things at face value.

Dr Bell’s concern about blind trust in the current scientific “database” is well taken, but it does not apply to my article. We know there are a lot more ways to get things wrong without proper scientific scrutiny, and it is incumbent on us to test medical claims before assuming their validity—or teaching them to schoolchildren. 

That does not mean that we will automatically get the right answer in every case, but to give free passes on the basis of religious significance, long-term use, or cultural or political deference would be a regressive step that would be more likely to serve patients poorly and miseducate the public.
—Lloyd Oppel, MD
Chair, Allied Medicine Committee

Lloyd Oppel, MD, MHSc, FCFP(Em). Dr Oppel replies. BCMJ, Vol. 53, No. 8, October, 2011, Page(s) 392 - Letters.

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