Ethics in Medicine

Letter to the Economist

Kristen Sparrow • June 22, 2011

Just for the sake of completeness, I will post my letter to the Economist here. I didn’t get it in in a timely fashion because of my last Spain trip in May, but I’ll “publish” it here instead. It is in response to the Economist articles about Alternative Medicine, here and here.
Sir:I was amused and bemused by the full-throated condemnation of alternative medicine as no more than placebo in the May 21st Economist.. I can only address the acupuncture literature, since that is my area of interest and expertise. The author makes no mention whatsoever of the significant number of reputable acupuncture studies done on animals to delineate physiological pathways involved in acupuncture(no placebo there). Nor did he mention numerous fMRI studies done on acupuncture subjects, nor of the exhaustive studies performed on knee osteoarthritis nor of the extensive studies funded by the German insurance companies which lead to their including acupuncture as a covered benefit. Nor did he mention that the British NHS has recently included acupuncture as a first line treatment for back pain because “they want to fund only treatments that work.”
Placebos will always be with us both in traditional and alternative medicine, but without irony he mentions that fake surgery for the knee (it was actually arthroscopy) was no better than the real thing, but somehow never admits the obvious that surgery itself may be quite a powerful placebo. He also stated that Ernst, in debunking alternative medicine is addressing “a serious public-health problem.” “Conventional medicines must be safe and effective before licensed for sale.” In the last decade alone, Vioxx and Prozac, as the most egregious examples, were on the market for years and it took quite a bit of morbidity and mortality before the problems came to light or were even admitted.
There is nothing courageous, new, nor noteworthy in attacking alternative medicine. The fact is that acupuncture research is poorly funded, with no huge lobbying or industrial backing, since it is currently not easily scalable so remains unattractive to corporate interests. Admittedly, acupuncture’s mode of action has not been adequately explained and the results not yet entirely reproducible. The same could be said of some traditional modes of therapy. But patients seek safe treatment options, and vote with their feet. This fact alone seems to enrage some critics.

(For more information about my practice please click here.)