Friday, June 17, 2011

Atwood on CAM in the American Medical Association Journal of Ethics, and AANP's Response to AMA's 2009 SOPP

here, I cite from a recent piece regarding ethics, CAM and modern medicine [see 001., below]; then from the AANP's response to criticism by the AMA [see 002., below]:

001. Kimball C. Atwood, MD rites in "'CAM' Education in Medical Schools—A Critical Opportunity Missed" (also as pdf) (2011-06) [my musings are in bold]:

"the medical school classroom should seek to foster a rigorous, skeptical habit of mind [...]';

hear, hear.

"a problem common to 'complementary and alternative medicine' (CAM) courses in U.S. medical schools [though is that] they are uncritical and promotional [credulous to the extreme!].  This is unfortunate because the topic [of CAM] offers an ideal opportunity to discuss scientific skepticism, other critical thinking skills, accurate information, the history of medicine, medical practice ethics, human studies ethics, and linguistic integrity -- all of which are basic to professionalism and excellence in modern medicine [...]";

hear, hear.

"[such CAM things as] qi cannot, by dint of its Chinese pedigree, claim immunity from scientific scrutiny. Nor is such scrutiny even concerned with that pedigree: what makes qi unworthy of being taken seriously in science or medicine is that it is undetectable, unmeasurable, and unfalsifiable. The same can be said for many other beliefs found in CAM, no matter their geographical or ethnic origins: the human energy field, craniosacral rhythms, chakras, the four humors, chiropractic subluxations, vitalism, psychokinesis, similia similibus curantur, water memory, homunculi represented on the eyes, ears, and feet, and more. A scientific dismissal of qi no more belittles Chinese culture or people than a dismissal of humoral theory belittles European culture or people [...] ";

now, some may argue that qi is vitalism, other that qi is a form of animism or animatism.  Often, it's even spiritism.  The dismissal of qi, is, like the dismissal of humoral Galenic archaicism, actually historical fact TOO.

"in reality, the emergence of modern medicine and its discarding of prescientific myths were the result of scientific discoveries [...] it was the discovery of such principles as chemical thermodynamics and Avogadro’s number and the development of the basic medical sciences, that refuted vitalism, homeopathy, humoral theory, miasma theory, the doctrine of signatures, and other prescientific myths that persist today as CAM beliefs [...]";

hear, hear.

"[the term] 'allopathic' was coined circa 1800 by Samuel Hahnemann, the inventor of homeopathy [...] the term was not accurate even at the time, and certainly does not describe modern medicine [...]";

no it doesn't.  I've often said that calling modern medicine allopathy is akin to calling modern chemistry alchemy.

"'complementary' and 'alternative' are themselves euphemisms, designed not by those who would exclude them but by their apologists, to distract from less flattering adjectives. An honest term for most practices covered by the term CAM would be 'implausible medical claims' [...]";

but truthful labels upon nonsense harm its marketing!  In order to judge something broadly implausible, it actually requires a broadly educated and ACTIVE intellect in the modern sense.

"modern medicine is [...] distinguished by its reliance on science. The principles of biology, chemistry, anatomy, physiology, and pharmacology do not vary according to location, nor does the capacity of science to follow evidence wherever it may lead, whether to new discoveries or to discrediting long-held opinions [...]";

that's why scientific-skepticism is the most rebel-punk-kick-ass of attitudes.

"the preponderance of evidence shows that the effects of CAM treatments, with the exceptions of a few biological substances, are not distinguishable from those of placebos [...]";

not to the believers, unfortunately.

"[skeptically speaking] logical fallacies, including the appeal to tradition ('five thousand years of Chinese history'), are common in CAM advocacy. Astrology is far older than acupuncture, but astrology is not valid. Others fallacies illustrated in the case scenario are the ad populum ('qi is widely accepted as legitimate'), the straw man (Michael appears to accuse Sophia of belittling Chinese culture, people, or history when she was doing nothing of the sort), the argument from ignorance and the argument from authority ('a concept that I wouldn’t expect anyone who hasn’t grown up in the culture to appreciate'), special pleading ('it's impossible to subject that kind of complexity to controlled trials'), the ad hominem ('who are you to decide what constitutes evidence?'), and the tu quoque ('keep an open mind before you disregar...)."

such metacognition is antithetical to sectarian unreflective dogmatism!!

002. the State of Alaska hosts the 2009 AMA SOPP paper on naturopathy here.  And I'm fascinated that naturopathy, in all this time, HAS NOT -- by-any-means-of-the-term adequately -- ADEQUATELY addressed the criticisms therein.  Karen Howard of the AANP stated in "April 2011: The AANP Meets the AMA":

"on May 10, AANP President Carl Hangee-Bauer, ND, and I will meet with the American Medical Association (AMA) at their Chicago headquarters, along with other nine professions [...] to discuss the reality of modern day inter-professional collaboration [...]";

ah, of-the-professions claim

"in 2009, the AMA targeted naturopathic medicine in its Scope of Practice Partnership (SOPP), an effort to restrict non-MD and DO providers from enhancing their scope of practice to meet the level of their training [...]";

ah, the persecution claim.  I've read that document, and it is, in my view, ACCURATE.  Now, if NDs are allowed to practice to the full extent of their training, which for instance labels homeopathy a clinical science and the science-ejected scientific -- therein it is mistraining -- WOE TO PROFESSIONAL STANDARDS and FAIR TRADE.  Result: licensed falsehood.

"the AANP, in response to their inaccurate misrepresentation of ND education and training [...]";

oh, snap!  The science frauds are accusing the more rigorous organization of misfeasance.  Talk about living in cloud cuckoo land and the reversal of all values.

"despite AMA opposition, AANP State Affiliates continue to gain ground, increasing scope and gaining licensure laws. Why? [...]";

my opinion: ignorant lawmakers and a gullible public and 'ye old lacking-in-scruples naturopathy'.

 "committed volunteer NDs are relentless in their efforts to educate legislators on their education and training [...]";

now, a long time ago, a certain AANP document:

From naturocrit

misrepresented naturopathy and set me down that rabbit hole.  Don't trust their representations: miseducation and education are the same thing in naturopathyland.  That's why they can name their school's "division of health science" and universities of "health science" when actually hugely NOT.

 "our academic institutions and the CNME adhere to federal and state accreditation standards that mirror that of allopathic medicine [...]";

the 'A' word, because naturopathy is so fused with homeopathy.  If allopathic medicine was the medicine of 1800 [and it certainly isn't modern medicine], then this isn't something to brag about.

 "NDs all over the country, in licensed and unlicensed jurisdictions, maintain a commitment to the highest standards of the professionalism [...]";

The misrepresentation of homeopathy is merely one sign of naturopathy's knowledge, commerce and therein professionalism problems.  E.g, here are five NDs that incorrectly label homeopathy "scientific" [from my Appendix I.05.p. which is AANP NDs T-Z]: 

Tessler, N. (ND Bastyr 1983, DHANP AANP) states "homeopathy is an advanced natural healing science" [vsc 2011-01-17]; Thoring, T.C. (ND Bastyr 1999) states "is naturopathic medicine scientific? Yes [...] many of the individual therapies of naturopathic medical practice have been scientifically validated [...including] homeopathy" [vsc 2011-01-10]; Tweedle, A. (ND CCNM) states "naturopathic medicine is primary medical care that integrates modern medical science [etc....] health is restored using therapies from the sciences [...including] homeopathy [...] naturopathic physicians [...] are extensively trained in modern medical science" [vsc 2011-02-02]; Vandekerkhove, A. (ND BINM) states "naturopathic physicians are trained in the conventional medical sciences [...] they use therapies from the sciences [...including] homeopathy" [vsc 2011-02-02]; White, L.H. (ND UBCNM) states "naturopathic doctors (NDs) [...] are educated in the conventional medical sciences [...] they treat disease and restore health using therapies from the sciences [...including] homeopathy" [vsc 2010-08-07).

"evidence of that is reflected in our licensing laws and bills that require all licensed NDs to have graduated from CNME approved schools and pass the NPLEX";

hmmmm. The NPLEX falsely labels homepathy a "clinical science".  What does the NPLEX guaranteed: institutionalized falsehood.

"carrying an active license to practice naturopathic medicine is indeed a badge of honor. It demonstrates commitment to your patients, commitment to continuing education and providing quality care, and commitment to advocating for laws that enable NDs to serve the primary care and prevention needs of at-risk populations across the country.";

hmmmm. I see licensed falsehood, which, where I come from, ain't honorable.  Like Oregon's OBNM nonsense, now with a ".gov" stamp.
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