Mindblog reader Ian has pointed me to this essay on alternative medicine and new age spirituality by Bruce Charlton, at the University of Newcastle upon Tyne. His website contains other interesting bits of writing. He paints what I think should be a useful and clear distinction:
I would define alternative therapies in terms of them having non-scientific explanations. In so far as a therapy does have a biological explanation, I would regard that therapy as simply part of orthodox medicine. The crucial difference between orthodox and alternative therapies is therefore that alternative medical systems have non-scientific explanations based on spiritual, mystical, legendary or otherwise intuitively-appealing insights...I am broadly supportive of alternative and complementary therapies because I think that overall they do a great deal of good for a large number of people. But the kind of good they do is psychological and spiritual; not medical. They are about making people feel better (‘healing’) not mending their dysfunctional brains and bodies (‘curing’). Alternative therapies certainly are not a part of medical science. So, on the one hand, I would like to see alternative therapies thrive and spread, and on the other hand they should drop all their pretensions to ‘scientific’ validity. In future, alternative medicine should explicitly become part of New Age spirituality, and thereby clearly be differentiated from orthodox medicine and biological science.He argues against the relevance of randomized trials to test alternative therapies:
...when randomised trials are used in alternative medicine, the usual process of therapeutic development is turned on-its-head. Instead of coming at the end of a long process of scientific evaluation, randomized trials are placed at the beginning of evaluation, and are indeed expected to be the only form of scientific evaluation – with randomization used in isolation with no possibility for cross-checking using other scientific methods...The problem is not so much that alternative therapy systems are scientifically primitive; it is that alternative systems are not scientific at all. By definition they do not have scientifically-grounded explanations. When the constraints of randomized trials are properly understood, it becomes clear that 'positive' trials in alternative medicine are irrelevant.His summary:
Orthodox medicine is based on scientific theories and is properly characterized by objective evaluation criteria and formal professional structures of education and certification. Alternative healing deploys a wide range of intuitively-appealing but non-scientific explanations, and constitutes a consumer-dominated marketplace of ideas and therapies which are personally-evaluated by the client...Orthodox medicine focuses on curing disease and promoting health. But alternative therapies should be based on promoting well-being and personal fulfillment. To do this they need to be able freely to deploy poetic explanations and charismatic healers as part of the wide and growing practice of New Age spirituality.