The politics and political status of Complementary / Alternative / Integrated Medicine have been central features throughout the past 16 years since Positive Health PH Online has been published. Although many of the overt signs of the struggles and vicissitudes facing many complementary disciplines haven't always been visible, pressure from the media, the medical and pharmaceutical professions have never been very far away.
The issues and machinations concerning the regulation of Complementary / Alternative / Integrated Medicine have been bubbling away, for many years since 1993, to a large extent under the auspices of The Prince's Foundation for Integrated Health (FIH), which helped to set in motion regulatory framework processes for many individual professions and which has announced that the Charity will be closing down imminently.
There is already statutory regulation in place for Osteopathy and Chiropractic. Acupuncture and Herbal medicine are currently undergoing proposals for statutory regulation. Since 2005 FIH has been working with government and a dozen other complementary healthcare practitioners to help them establish self-regulatory frameworks for their professions. These are Alexander Technique, Aromatherapy, Bowen Technique, Cranial Therapy, Homeopathy, Massage, Naturopathy, Nutritional Therapy, Yoga Therapy, Reflexology, Reiki and Shiatsu.
Political and clinical issues surrounding regulation of Complementary / Alternative / Integrated Medicine play a prominent role in several features published this June Issue 171:
Dr Brian Isbell PhD BSc DO MRN highlights a number of factors influencing the entire education agenda in his article Challenges Facing CAM Education Providers in the New Decade:
... the economic crisis will be a major factor with many potential students wishing to train, but being unable to afford the fees as well as the other expenses of full or part time education...
...Over the past decade groups such as Sense About Science have campaigned against not only educational provision, but in the case of Homeopathy, also the access of patients to this treatment within the NHS. These attacks have been resisted by groups such as Homeopathy Worked for Me, formed to oppose the erosion of patient choice especially for many of those with chronic conditions for which orthodox healthcare has provided little relief. The House of Commons, Science and Technology Committee report's recommendation that Homeopathy should no longer be funded on the NHS was a further set back. However, the report's identification that the only acceptable research methods are Randomized Controlled Trials (RCTs), showed how little consideration and understanding there had been by the committee of the complexities of the clinical setting. Members and associates of the anti-CAM pressure groups that write newspaper columns have also taken to unprofessionally attacking individuals without affording the courtesy of an informed, right of reply. In addition, the attacks on education providers provision is most often based on quoting lecture notes out of context without seeking a balanced or informed understanding, which does little to encourage such institutions to do anything other than keep what they do away from such individuals or groups.
And Bernadette Ward MSc describes how the lack of a Register has affected both patients and practitioners in The Absence of Regulation for Acupuncturists and Chinese Medicine Practitioners - Impact upon the Clinical Relationship:
...In 2005 The National Working Group report on the regulation of CAM therapists was published. The report recommended the statutory regulation of Acupuncture, Herbalism and TCM, as "Category 1" therapies in terms of risk exposure to the patient, also in the interests of public safety.
To date none of the recommendations have been implemented either in Ireland or the UK. The sector is again undergoing another period of consultation. Acupuncturists and CAM therapists remain unregulated and unregistered by statute with no immediate prospect of further progress. No further initiatives have been announced by the DOHC. (Department for Health and Children Ireland).
... this study has found that the continued absence of government regulation and registration of Acupuncturists and Chinese Medicine practitioners does affect the clinical relationship from both the patient's and the practitioner's point of view in both the UK and Ireland. Data from both countries showed similar results, and patients from both countries are obliged to source practitioners in an unregulated environment...
Nutritionist Penny Crowther DN Med MBANT NTCC delves into the evidence for some of the discredited nutritional strategies for cardiovascular disease, including some cholesterol myths and research demonstrating the clinical ineffectiveness of statins.
...A US study in 2008 involved a group of 74 patients with raised cholesterol who were randomly divided into two groups. One group received treatment with a statin drug, together with printed materials about diet and exercise recommendations. The other group received fish oil and red yeast rice supplements and received face to face lifestyle advice from a variety of professionals, both orthodox and alternative. The results after three months were that the alternative treatment group showed a 42.4% reduction in cholesterol levels compared to a 39.6% reduction in the statin group.
Another study, a meta-analysis, the gold standard in evidence based medicine, showed that statins were ineffective.
Statins have side effects, amongst which are liver damage, nerve damage, cognitive decline (memory loss and depression has been reported), violent behaviour, mood alteration and muscle damage. Statins are known to block the production of CO Q10, which is needed for cellular energy production. It is particularly important for the heart muscle function; anyone taking statins should supplement 60-100mg CO Q10...
In the Research Updates of this Issue under Heart, Fung and Frank from Department of Nutrition, Simmons College, Boston, MA 02115, USA prospectively examined the association between consumption of sugar-sweetened beverages (SSBs) and the risk of coronary heart disease (CHD) in women. The authors concluded that regular consumption of SSBs is associated with a higher risk of CHD in women, even after other unhealthful lifestyle or dietary factors are accounted for. www.positivehealth.com/research-list.php?subjectid=127
Despite The Prince's Foundation for Integrated Health (FIH)'s contention that Complementary / Alternative / Integrated Medicine has now been brought to a level alongside mainstream medicine, it is my opinion that given the eternal propensity of experts to argue about approaches to health treatment, the political and methodological battles between the various camps won't be subsiding anytime soon.
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