Complementary Alternative Medicine 2

Question 1

What are the issues with assessing the effectiveness of acupuncture?

Answer 1

Blinding. It is difficult to use sham acupuncture needles to blind both practitioner and patient. Also difficult to use sham acupuncture locations especially if both practitioner/patient is aware of sites.

Question 2

Why is it difficult to assess chiropractic evidence?

Answer 2

Difficult to blind both parties even with placebo manipulations. So try comparative treatments such as physiotherapy.

Question 3

Why do people use complementary alternative medicine?

Answer 3

• Health promotion (general wellbeing),
• Belief that is will be more effective than conventional treatments
• Exhausted conventional options,
• Conventional options associated with side effects/risks,
• No conventional therapy available,
• Conventional approach emotionally/spiritually bereft,
• Feeling more in control

Question 4

What is medical pluralism?

Answer 4

• Adoption of more than one medical system (belief, behaviours or treatments)

Question 5

Are CAMs affective?

Answer 5

• Some may be effective (herbal remedies could contain active ingredients.
• Other factors can make a treatment appear effective, eg, diseases-associated, patient-focussed or CAM-based.
• Some clearly have no plausible scientific explanation.

Question 6

What are some of the ethical issues surrounding CAMs?

Answer 6

• Worries around effectiveness,
• Lack of regulation around practitioners/substances. Direct vs indirect harm.
• Make sure to balance patient choice against the first duty of a doctor.