Conventional Medicine is that medicine which is officially promulgated by various mainstream national and international medical organizations. The "opposite" is Alternative medicine.
Attempted Consensual Definition
The Conventional moiety in this definition of Medicine points to the absolute requirement of a prior convention existing between practitioners and a regulating body. However, the merits of the conventional concept are close to nil since this is only an ad-hoc , operational definition required only by virtue of a logical need to accomodate Alternative medicine. Conventional medicine is really only medicine (and nothing else), as much as alternative medicine is medicine (no mainstream-dissident attributes added). There is a growing consensus between dispensors and receivers of medical care that only the patient's best interest should apply to the most general, acceptable definition, complete with attributes, of medicine per se.
The issue of protection of either patients (if naive and under pressure from quacks), or the biomedical and drug industry (under pressure from the 15 billion dollar per year and growing alternative market) is already addressed by the caveat emptor principle of liberal economies. The issue of scientific control of the medical offer is in balance with the principle of reciprocity in regulation, aka quies custodiet ipsos custodes (who controls the controllers). Therefore, it has been argued (although not peremptorily) there is only one medicine - that medicine which is best for a given case at a given moment in time. Indeed, if regarded in context, the sum total of alternatives depends on the mainstream as much as it depends on some intrinsic variability, and the central tendency is such that the alternatives integrated over time yield zero.
This article is a stub, created to help resolve an issue in Alternative medicine. Depending upon how the issue is resolved, this stub will either be expanded or deleted.
The Conventional medicine (CM) vs. Alternative medicine Outstanding Debate: (AM)
Request for comments
21 critical, disputed and operational issues to be addressed in the definition of CM vs AM :
- (01). mainstream (central tendency) vs. variability (complementarity .) Legislators found it useful to coin "Complementary and Alternative Medicine'' (CAM) for the purpose of advanced billing codes (ABC). This leads to confusion between CM (complementary medicine) and CAM (complementary and alternative medicine) ;
- (02). art vs science (see alternative medicine talk page discussions here). Probably the old distinction between Western Medicine and Oriental Medicine and all de-relativization and politically correct issues have a place here ;
- (03). regulated over free (board-endorsed or "dissident"). Yet another case for more litigation in the medical litigation industry;
- (04). experimental vs magisterial (amico Plato sed magis amico veritas )
- (05). statistical vs. individual (cohorts vs anecdotal case studies: FDA regulates medical practice exclusively with clinical studies, which clearly say nothing for a given individual who may as well die as an acceptable collateral damage; on the other extreme you would perhaps not dismiss as anecdotal evidence an exotic and obscure drug which clearly cured your terminal cancer.)
- (06). touching the patient vs remaining distant (clearly a tendency exists of replacing cases in all their complexity with numbers. Also see the hysteria about not touching kids in order to hunt possible pedophilia in medical personnel - a case for abusus non tollit usum ?);
- (07). caveat emptor vs quies custodiet ipsos custodes (see at CM text)
- (08). biomedicine vs clinical experience, intuition and even feelings (in mainstream medicine the difference between good and bad doctors is still in this dilemma )
- (09). lawful vs illegal (see Good Samaritan Acts - are novices and laymen entitled or tolerated to dispense medical care if and when needed ? ). Also, is the government allowed to practice medicine without a license? The WVA Bill SB439, introduced by Senator Prezioso of Marion County and Senator Minard of Harrison County has already passed the Senate HHR Committee on February 19, 2004. It is expected to pass the Senate floor and House committees. Indeed, the WVA Bill will remove physicians' ability to exercise individual judgment for their patients, by forcing them to grant medical exemptions for only "commonly accepted practices." This is tantamount to the government practicing medicine without a license.
- (10). proven vs accepted (this seems to be a non-starter, since being foolproof by design does not a dilemma make. However, the issue is serious, since there are AM practices which are proven and not accepted, and there are proven CM practices which do not work. See the British Pharmacopoea who was duly proven - and only thirty years later again proven to contain 78% useless drugs. Moreover, AM practices so new that no expert has even started to design clever experiment protocols for validation, would never make it into the debate. Thomas Kuhn must feel vindicated (for the record, he maintained, against Karl Popper that a whole generation must disappear before a scientific paradigm has a chance to live :)
- (11). falsifiability vs. credibility (Incidentaly, Karl Popper, in a trend-setting epistemologic effort, determined that the main attribute of a good scientific theory is not its credibility, but, and cunningly, its falsifiability (see his famous "Logik der Forschung - Logic of Scientific Research"). Indeed, the more degrees of liberty a theory has in rejecting the (null ) hypothesis, the better that theory fits into a pattern of advancing knowledge. Ad absurdum, a non-falsifiable theory does not even deserve the name of theory. The Popper epistemologic criteria seem to have been forgotten by most medical regulation bodies, who require credentials first of all, perhaps in the epidemiological context of aggressive marketing.
- (12) admissibility and confessio delicti. More than 50 % of the arbiters paid by the FDA to independently assess a new medical drug or procedure are also players for our field day. Most of them are now known to have a direct financial interest in the object of their "independent" judgement (USA today published data - with the puerile admission that "there are - hold on your laugh - simply not enough numbers of highly esteemed experts to be employed"... :). Of course, this means nothing in principle for the logical content of our article here, but practically, does hardly qualify FDA as a tax-paid federal low-bias regulator. Moreover, research of big science is sometimes so pushed for by the interests of markets that criminal procedures are pulled out from Pandora's box. The yearly published top 100 confessed corporation criminals pleading guilty always contains the big fives of the drug industry. The combined figure for fines paid, sometimes as high as 500,000,000 USD each, is five orders of magnitude higher than the research budget for AM. Even the operational costs of the clinically dead Office Of Alternative Medicine is five figures below. It's really simple to see how this happens: Whoever worked in medical financial management like myself, would confirm that it is of course more profitable to include such high costs (which still compare so unfavorably with profits) under the research budget items, and to perpetuate the confessio delicti policies in the process. Last, but not least, the very process of new drug admission is biased by design, since marketing companies took over experimental design as if design drugs meant design procedures to validate them. A priori, AM is still too far from CM to be contaminated by the new procedures.
- (13) myth of safety and myth of freedom of the press issues: By our benevolent dictator Jim's own example (you know where, item # 1), you can't say anywhere in Wiki that corporations are criminals, even if they are. (Click here for a list of top 100 corporate criminals pleading guilty and fined as much as USD 500,000,000). Need not add that in excess of 100,000 people die each year in the USA as a direct consequence of side effects from FDA-endorsed drugs. Recently even the highly publicized FDA procedures are bypassed in the name of "Patriot Acts I and II" so that known dangerous vaccines might be sold and innoculated in a soon-to-become-mandatory nation-wide procedure. (It already happened in Gulf War I - for all but the French troops there - and except for the French, 78% of GW I veterans are now disabled as a direct consequence.) These are hard facts one can hardly ignore, especially when writing about CM vs. AM. These facts, and others, clearly throw the myth of consumer protection in conventional medicine over board, by any standard. Also, by the published admission of the very CM board-edorsed doctors who have a legal obligation to hunt witches in the AM, we have this paradox: if one counts the victims of CM vs victims of AM, up to four orders of magnitude burst into anyone's eyes. Quite an interesting paradox from the hight of my own clinical experience. Reminds me of the safety obsessions in Sweden where the government compulsively evacuated the eskimos in an area of the remote north in order to avoid death from some meteoric or comet desintegration alert, only to find that helicopter medevac accidents increased the risk of mortality for the population thus "protected" some ten thousand times. As always, highly paid independent statistical, epidemiological and even medical experts determined that such risks were indeed acceptable in the general direction of Aristotle's actual vs. potential debate. Hmm. Talk about work in progress...
All these should perhaps be weighted against the time-proven golden standard: patient's best interest. Now, having said all that, to me, as a seasoned, senior and indeed old practicing medical doctor (and after my declaration of bias towards our benevolent dictator) the single most important fact about conventional medicine for the 21st American Century, is that it still exists. Sincerely, irismeister 11:03, 2004 Feb 19 (UTC)
Highly POV-alert-prone positions
(these NEED not be discussed - left out by me on purpose )
- 14. What people happen to believe is NOT a matter of objective fact, my own belief (and Jim's own belief) in stating this notwithstanding :)
- 15. Drugging America Down to Death articles - inflammatory, needs not be quoted even as a POV;
- 16. "Wisdom is finding alternatives".
- 17. Species survival issues. Nothing lasts for ever;
- 18. Licensure and re-licensure (procedures whereby boards make sure money is cut away from those who no longer reinforce big industry);
- 19. Big science is no longer science. Drug industry now funds medical universities;
- 20. "There isn't much left, your honor:)" Oldies and goldies - retired MDs encouraged to become alternative practitioners (when no financial security pressures exists for them any longer);
- 21. Barrett is a proven quack paid by the drug industry for busting quacks!
References
- Jason Lazarou, Bruce H. Pomeranz and Paul N. Corey, "Incidence of adverse drug reactions in hospitalized patients: A meta analysis of prospective studies," Journal of American Medical Association, April 15, 1998, 279(15): 1200-05.
This study found more than 100,000 deaths per year and 2,000,000 severe side effects in U.S. hospitals alone. However, this study did not include deaths from pharmaceutical drugs that occur outside the hospital, or deaths from prescription errors by doctors or pharmacists. Additionally, because 90-99 percent of all adverse drug reactions are never reported (see following reference), this figure should be adjusted substantially upwards.
- David Kessler, " Introducing MedWatch: A new approach to reporting medication and device adverse effect and product problems" Journal of American Medical Association, July 2, 1993, 269(21): 2765-68.
- Dennis Cauchon, " Analysis of financial conflicts at 159 FDA advisory committee meetings from Jan. 1, 1998, through June 30, 2000" USA Today, September 15, 2000, 11-17. The analysis found that more than half of the experts hired to advise the government on the safety and effectiveness of medicine had financial relationships with the pharmaceutical companies that will be helped or hurt by their decisions. The article is no longer available online in the archives of USA Today, but has been retrieved in full, thanks to the diligence of Dr Joseph Mercola, ND
External Links
