–OpEd-
SÂO PAULO — Earlier this spring, Thiago Celso Andrade Reges was arrested in the Brazilian state of Ceará for illegal practice of medicine, after having worked in several hospitals in the region.
He had previously gone to court in Brazil to get a validation of his Bolivian diploma, which turned out to be false. The Regional Council of Medicine of Ceará (Cremec) suspended his professional license and opened an internal investigation.
Easy question: why arrest someone who commits fraud by impersonating a doctor? I imagine the answer should not generate great disagreement among readers: it put people’s health and lives at risk. Fake doctors don’t have adequate training, and they prescribe medicines and treatments, and issue diagnoses, which are not reliable. There is no reason to assume that their advice is based on a scientific background, or on the best knowledge available in the medical field.
But there’s more to it than that. The case raises another intriguing question: would not the practice of “alternative medicine” be just as responsible for putting the lives and health of patients at risk as the practice of medicine without a degree?
An intellectual subterfuge
For those who don’t know the answer, here are some tips: The first is that alternative therapies are based on far-fetched theories about things that don’t exist: areas on the head, or on the ear, which, by stimulation, can solve physical and emotional problems; chakra alignment; vital energy and memory of water; body meridians; mysterious energies emanating from the hands; water “energized” by “new” states of matter, etc. The list goes on, with no end in sight.
In bonafide science, different fields of research learn and teach each other, generating a cohesive system.
Illusory, theoretical ideas end up being a characteristic not only of alternative medicine practices but of pseudoscience in general, as the philosopher of science Mario Bunge argues: in bonafide science, different fields of research learn and teach each other, generating a cohesive system.
The concepts of “energy,” for example, are adequately quantified in physics, chemistry, biology and engineering. On the other hand, the mechanism by which the planets would generate different personality traits – as claimed in astrology – and the supposed energies emanated by water to be able to be located using the rhabdomancy, only exist as an intellectual subterfuge.
Still a regular practice
The second reason: they all have a weak or non-existent base of reliable evidence on efficacy and safety. Some have studies showing supposed positive results that are just the result of confounding factors, biases in data analysis, difficulty in conducting the clinical trial with blinding, problems in patient randomization and/or lack of adequate comparison with a placebo. Note, too, that if the evidence base for these practices were good, it would not be necessary to call them “alternatives.”
Scientifically speaking, everything that is diagnosed and prescribed under the guise of the “alternative” is as (little) reliable as what is recommended by any individual who is practicing medicine without ever having studied the subject.
But a good part of “alternative medicine” is practiced on a regular basis, without facing any problems with the law. Some modalities are in charge of holders of a medical degree – which, at least, opens up the possibility for the professional, at the absolute minimum, to recognize when it is time to stop fooling around and start treating the patient seriously. Others are authorized by professional councils in fields such as biology.
A cost/benefit analysis
The Federal Council of Medicine itself recognizes homeopathy as an authentic medical specialty; and we, as Brazilian society, pay for the application of several of them, since they are offered through the Unified Health System (SUS).
Public funding of these practices, which obviously put patients’ health at risk (such as strokes caused by chiropractic, ozone therapy amputations, and death from otitis after opting for homoeopathic treatment), still violates the principle of the good administration of public resources: if the budget is limited – it is – then management must prioritize what is best to fulfil the purposes of the application of the resource. In this case, that means promoting and funding practices supported by good evidence.
It’s a simple matter of cost/benefit analysis.For those who are still not convinced, just leave medicine and look at other areas of science to make the absurdity of this funding more evident: what would the population think about the use of public resources to finance research and practices of “alternative physics”? Or to argue, for example, that it is not necessary to design constructions based on the good application of Newton’s Laws in engineering?
But what is at risk is not the stability of our buildings, but people’s lives.
There would be homes falling all around the city. With alternative medicines, the logic is the same. But what is at risk is not the stability of our buildings, but people’s lives.
