CAM

The work of Professor Ernst and his team at Exeter in the study of complementary medicine (CAM) is disappointing. Their obsessive search for ‘compellingly positive evidence’ of positive outcomes in specific disorders in response to specific treatments scratches the surface of a profoundly interesting and challenging phenomenon. It represents a kind of scientific tunnel vision.

For example, their ‘table of treatments which demonstrably generate more good than harm’ does not include homeopathy. And yet, the study of clinical outcomes at Bristol Homeopathic Hospital (United Bristol Healthcare Trust), in patients with a wide range of longstanding disorders responding poorly to conventional treatment and referred by their GPs or other specialists, shows an overall level of benefit of around 75%, often resulting in reduction or withdrawal of conventional medication.²

The familiarly dismissive argument that an uncontrolled study such as this yields no data of statistical significance deserving of serious attention, represents a severe case of what has been called ‘paradigm paralysis’.³ These are real results in really sick people. That they may be achieved by a package of care that includes a decent dose of non-specific effects, alongside whatever specific effects the homeopathic prescription may have, does not make them invalid, it makes them particularly interesting, and very important. In his James Mackenzie lecture,⁴ ‘Who Cares?’ David Haslam eloquently expounds the limitations of the prevailing medical paradigm of which the Ernst approach is a prime example.

Having met Professor Ernst a number of times I have no doubt of the earnestness and good intentions with which he and his team pursue their cause, but it is sad that the leader of such a potentially pioneering academic department is not prepared to be more of a ‘paradigm pioneer’.