The “gold standard” randomized clinical trial (RCT) to evaluate the efficacy of both alternative and holistic medicine is ongoing. However, holistic medicine treats the individual patient in a very individualized way, generally using multiple interventions simultaneously. Such an approach does not lend itself to validation by the RCT approach.
Nevertheless, to date clinical trials far exceed pre-clinical basic science studies and we feel this is a mistake. True, clinical trials have demonstrated some varying degrees of efficacy of holistic therapies in the amelioration of anxiety, depression, hypertension, diabetes, autoimmune disease, and a host of other conditions. Medicinal mushrooms are being studied in cancer patients with promising results; in vitro studies are showing exciting data on the induction of apoptosis in cancer cells by botanical compounds, modulation of immune function by herbal formulas and the mitigation of cellular oxidative stress by whole plant botanical extracts. However there is a gaping chasm in our knowledge of how any of these treatment work. Nor can we explain why they are effective for some individuals and ineffective for others. This gap in our knowledge makes the design of holistic medical research studies as challenging as throwing darts in the dark.
Federal funding for “alternative” research has remained dismally inadequate over the past two decades, but the real problem is with regard to the prioritization of using these precious funds.
In our view at FHMR, it is a question of ethics–the ethics of biomedical human research. We feel that prior to conducting any clinical study using human subjects or animals, we owe it to people and animals we experiment on to maximize the probability that the experimental treatment will be safe and effective. For this reason we feel there is the urgent need for a great deal more pre-clinical and preliminary basic science research before going to large human trials. Researchers should be obliged to justify their treatment with sound science that explains why it is plausible, and how it is therefore likely to be of benefit to the study subjects.
For example, thanks to a $374,000 taxpayer-funded grant, we now know that inhaling lemon and lavender scents doesn’t do a lot for our ability to heal a wound. With $666,000 in federal research money, scientists “discovered” that distant prayer could not heal AIDS. The NIH also funded scientists to conclude that coffee enemas cannot treat advanced pancreatic cancer (a $406,000 grant). These are all real examples of research funding.
The funding of medical research into highly implausible modalities without prior solid scientific basis are a waste of resources which offer little probability of resulting in effective treatments for humankind.
We propose that as scientists and researchers we strike a bargain with society. Society should fund research into holistic approaches to health and disease where conventional medicine is failing and when it is reasonably ethical and scientifically plausible to do so. And in exchange, scientists and researchers should agree to abandon research for which foundational scientific evidence of efficacy and plausible mechanism of action is not found. Fantasy can be fun, but the real world is infinitely more rewarding.