Australasian Science: Australia's authority on science since 1938

A Dose of Science

By Rob Morrison

Alternative health practices pirate the terminology and titles of real science to gain credibility, but it is what their practitioners do, not what they say, that gives the game away.

The federal budget contained an overdue recommendation for the Chief Medical Officer to assess several complementary and alternative medicines (CAMs) to determine those that are not evidence-based and should no longer receive taxpayer-funded rebates for treatments. Listed were homeopathy, reiki, aromatherapy, ear candling, crystal therapy, flower essences, kinesiology and rolfing. It follows the British government’s decision to cease funding the teaching of these CAMs in British universities.

The CAM community’s response included the challenge that many medical treatments are not evidence-based, so other non-evidence-based treatments must be equally valid.

Some medical practitioners choose to go against the scientific underpinning of their discipline – even incorporating CAMs in their work – but renegades do not represent medicine any more than they do in other professions.

It is also true that much of medicine is not strongly evidence-based. But there is a big difference between medical practitioners trying possible treatments that orthodox science suggests should work, and CAM practitioners categorically asserting that their treatments will work despite scientific evidence that they do not – and cannot without overthrowing the sciences of chemistry, physics and physiology.

The difference between these approaches can itself be referenced back to the scientific method. A medical practitioner, faced with an ailment of unknown cause and for which treatments are uncertain, often suggests trying some medicine.

Rosacea is an example. Called the “curse of the Celts” and “adult acne”, this reddening of facial skin brings misery to its sufferers. Its cause is a mystery. Various hypotheses suggest allergy, skin mites, heredity, food sensitivity, metabolic disorders and more. These are reasonable proposals, as science requires a hypothesis to test. Initial testing may then involve prescribing antihistamines, miticides, dietary changes, cortisone cream or something else, each suggested by what we know of physiology and pharmacology through orthodox science.

This is not recommending haphazard, ambiguous treatments on the basis of mystical or dogmatic “theories”. It starts a logical, experimental process of finding a treatment that improves the condition and may reveal its cause.

In the scientific method, observation leads to a hypothesis. This is tested by experiment, results are interpreted and a conclusion published. Others confirm it, helping to build a theory that combines countless experimental results, explains the mechanism behind them all and allows accurate predictions. Germ theory, the theories of evolution, immunity and many more have been built in this way, creating new disciplines within science and advancing medicine’s ability to prevent and treat disease.

The development of penicillin encapsulates the process. Observing that mould infecting a culture dish caused bacterial colonies to decline led to a hypothesis that the mould contained something that killed bacteria. Experiments showed that it did, supporting the factual hypothesis, and analysis then demonstrated how it did, validating the subsequent explanatory hypothesis. It advanced the germ theory of disease, clarifying distinctions between bacterial and viral infections and medicines effective against each.

That progression is a scientific one. Medical practitioners groping at the initial stages and trying to make observations that link cause and effect may be early in the process but they are not defying it.

But CAMs, especially more extreme CAMs, start at the wrong end – with a theory. Whether it is the subluxations of chiropractic, the meridians of acupuncture or the mystical forces of reiki and other CAMs, the starting point is a detailed theory, often delivered as the pronouncement of an individual or the alleged wisdom of some ancient or obscure civilisation, but there is a fundamental flaw – factual hypotheses that form the building blocks of real scientific theories are lacking, have never been put to the test or have been shown by systematic experimentation to be invalid. Observations, such as they are, are selective, often partisan, and cite popularity and anecdotes as evidence rather than establishing real evidence by testing hypotheses based on those observations.

CAM theories also defy other tenets of orthodox science by defying established physical and chemical laws and ignoring requirements that natural rather than supernatural influences should be assumed, that Ockham’s Razor should be wielded, and that explanations conflicting with well-established science must be treated with great skepticism – requiring more, not less, scientific research for their validation.

Rob Morrison is a Professorial Fellow at Flinders University. A scientist by training, he is one of the founders, and current Vice-President, of Friends of Science in Medicine.