How Not to Use Complementary Medicine
There is a report in the British Medical Journal that the Amsterdam Medical Disciplinary Tribunal has struck one doctor from the medical register and suspended two others for their exclusive use of unorthodox approaches in the treatment of a famous Dutch actor and comedian named Sylvia Millecam, who sadly died of breast cancer in 2001 at the age of 45.
After being diagnosed, the patient was recommended to have surgery and chemotherapy, but instead sought unorthodox treatment. Although the patient wanted this type of treatment, the legal case was that the doctors failed to give a reasonable assessment of the chance that their treatments would help, or made it clear that the only treatment that had been proven to help the course of the illness is the conventional route. One of the doctors was also judged to have caused her unnecessary suffering by withholding conventional palliative care as she deteriorated.
Not surprisingly, this case has attracted a lot of interest in Europe, where alternative, complementary and integrated approaches to health care are far more commonly used than in the United States. Many alternative practitioners feel that conventional medicine simply “suppresses” the underlying cause of the illness, and that there is no need to use orthodox and unorthodox together.
The approach that I have been advocating for many years is that if the individual warrants it, to use conventional and unconventional approaches together. But to see them as working on different dimensions of the person: what I call integrated medicine, though the term “integrative” is more popular in the United States. There is nothing very integrated about using St. John’s Wort instead of Prozac. That is just an alternative, which may be appropriate for certain individuals. And everything gets tailored to the individual: a man came to see more for acupuncture, but left with a prescription for a medicine. Once the medicine had done its part, some acupuncture was a very helpful adjunct. And there have been many folk where we have worked the other way round: acupuncture or homeopathy, and sometimes also a medicine. Whatever it takes to help people get to where they need to be.
In an ideal world, Ms. Millecam would probably have had surgery, but also psychological and energetic work, and perhaps some other remedies and spiritual counseling to support her through the process. Would it have enabled her to live longer? Perhaps, but the point is that the integrated approach would have aimed to help her quality of life and to help her to find the meaning and purpose of what she was going through.
She may have declined all this, but the problem was that enthusiastic doctors were using their approaches in place of regular evidence based medicine, without making it clear to Ms. Millecam what she was letting herself in for. Yes, a mentally competent individual has the right to decide whether or not to have a course of treatment, but he or she must be given all the options, so that he or she can make an informed decision. It was all rather sad and probably avoidable.
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