Expert consensus on “alternative health care” risks developed

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Posted 30 June 2021

A 17-member Canadian team has come to a consensus regarding: (a) how “alternative health care” should be defined, (b) ways it can harm patients directly or indirectly, and (c) its four major risk categories.

The team consisted of three physicians, four nurses, three pharmacists, two physiotherapists, one social worker, two lawyers (with expertise in harm, injury and case law), an epidemiologist, a naturopath and a chiropractor, each with at least 10 years of experience and an identified interest in “alternative health care.”

Their definition is:

The range of therapeutics that largely originate from traditions and theories distinct from contemporary biomedical science, and which claim mechanisms of action outside of those currently accepted by scientific and biomedical consensus.

The team distinguished direct harm from indirect harm:

  • Direct harm can result from: (a) prescribed (including self-prescribed) substances, (b) procedures, (c) reducing the effectiveness of, or causing detrimental effects from existing medical therapies, and (d) financial losses from paying for ineffective interventions.
  • Indirect harm can result from: (a) replacing established effective care, (b) delay of treatment or failure to diagnose a medical problem and disease progression, (c) accepting detrimental health advice beyond the scope of the practitioner’s abilities, educational preparation/training, and clinical experience, and (d) negative effects on personal finances (impacting budget available for other needs) and social impact of lost work productivity.

Reference:
Garrett B. and others.
A taxonomy of risk-associated alternative health practices: A Delphi study. Health and Social Care in the Community, May 26, 2021

Their discussion of types of harm is similar to William T. Jarvis’s 1997 discussion of how quackery harms cancer patients. The new paper provides illuminating examples in each of four categories of risks: (a) risks that have been identified across a broad range of alternative health care activities, (b) risks with complete alternative health belief systems, (c) risks with alternative physical manipulative therapies and interventions, and (d) risks with alternative herbal and nutritional interventions. It describes how higher, moderate, and lower risks should be distinguished.

Scott Gavura has provided a helpful summary of the consensus building process used by the authors of the paper and offers examples of specific harms discussed in the paper.
Reference:
Gavura S. The risks associated with alternative medicine. Science-Based Medicine, June 24, 2021

Professor William M. London believes the terms “complementary” and “alternative” should not be defined because they are marketing doublespeak that conceals how promoting non-validated or invalidated practices is unethical.
Reference:
London WL. Please don’t define “complementary and alternative health practices”! Science-Based Medicine, Oct 28, 2011

Source: Consumer Health Digest #21-25, June 27, 2021

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