Double Lens 207
Voodoo and Herbs: Judging Complementary and Alternative Medicines
Complementary and alternative medicine (CAM) threw into bold relief
many of these complexities and conflicts concerning assessments of medical
information, and had particular implications. Every year, Americans spend
as much as $47 billion on CAM (14), and most use CAM in some way (14,
15, 16). In recent years, CAM has received increased attention in the
medical literature, with researchers arguing both pro and con. Ill physicians
now had to face the possibilities of using these non-Western treatments for
themselves. Many remained wary, evaluating claims scientifically, while
others became more appreciative of the possible benefits—often despite
their own prior biomedical education and long-instilled caution.
Biases Against CAM
Despite claims of benefits from CAM, and the threats from their own
illness, a few physicians nevertheless maintained long-standing biases
toward Western medicine. Brian, who had hepatitis C, said:
I’m not averse to alternative treatments. A friend says, ‘‘You can’t
believe in Western medicine alone.’’ But my epistemological ap-
proach to data is very scientific. With the one medication, I had a
30 percent chance to clear this disease. I didn’t make it, but I took
the chance. What are the numbers with milk thistle? I have no
idea. Will it help? It could. Can it do any harm? Probably not. So
I’ll take it. But I’m not going to give up one for the other, unless
there’s compelling evidence. Indian medicine and meditation
might be effective, but you have to really believe in it. I don’t know
if I’m going to spend that much time learning it to believe in it.
As Brian indicated, he conducted a complex risk-benefit analysis of using
CAM, thinking through arguments for and against. He also felt a pa-
tient had to believe in it—suggesting that it operated in part through a
placebo effect.
Doctors can harbor strong biases against CAM, but not recognize them.
In contrast, lay patients may perceive and resent this prejudice, and hold
it against physicians, seeing conflicts of interest. Jeff, the adolescent