Polarized thinking about complementary, alternative and integrative care is negative, well, downright dangerous. It undermines the health care encounter and harms individuals and nations. This can be read in an opinion piece in the journal European Journal of Integrative Medicine, written by researchers at I C.
This article is based on over ten years of research and development, including the researchers’ own experiences of low-, medium-, and high-income countries. The aim is to explore trends and challenges of importance to the development of evidence-based integrative care. Here is a brief summary of the extensive article, containing examples of integrative care and research from three continents.
As early as 1978, the World Health Organization urged the international community to include efficient and safe methods of traditional, complementary and alternative medicine into public health care. The main reason was that these methods are available to low-income countries.
Three theoretical positions
Theoretically, there are three possible positions or relationships between conventional health care and CAM: opposition, integration and pluralism. Opposition or polarization is not an option, because it is a threat to patient safety and does not cater to the needs of citizens, the authors say.
In a pluralistic relationship, systems coexist side by side and cooperate with each other. Integrative systems, however, are characterized by therapists from different treatment traditions collaborating based on the conviction that it is possible to integrate the methods and approaches from different traditions.
In many countries, such as Sweden, the public health sector hardly collaborates with non- licensed health care providers at all. This forces patients who make use of both types of treatments to themselves build bridges between different medical traditions.
In addition to medical research, there is also interest in CAM and integrative care within nursing research, where there are many points of contact.
The authors argue that the best way to improve health is to integrate evidence-based knowledge from different traditions. This should include a holistic view of humans as biological, psychological, social and spiritual beings, according to World Health Organization guidelines.
Undermines ethical values
Against this movement stands “scientism”, an approach represented by including the so-called sceptics movement. It dismisses as “pseudoscience” everything that can´t be based in an observable material reality. Such a view, however, undermines the values that an ethically sound science should be based on, write the authors.
The question is no longer whether CAM and integrative medicine should play a role in future health system. The question is – as countries at the WHO World Health Assembly for several years running have expressed – how the positive potential of the alternative traditions may be exploited in Western health care through regulation, research and integration.
Media can play a major role
A section of the article also deals with the potentially large role – positive and negative – of the mass media for public health. Research shows that the media rarely provide balanced, comprehensive health information. Much is to be gained by trying to improve the health quality of journalism.
A systematic attempt in this direction is the Internet service Media Doctor, which reviews and rates the quality of health items in the media by using ten criteria. The aim is to guide health professionals and lay people in the information jungle. On the IC’s website the same criteria are used to assess the Swedish media reports about CAM with a tool called CritiCAM, critical analysis of media reports about CAM.
David Finer
References
Sundberg T, Hök J, Finer D, Arman M, Swartz J och Falkenberg T. Evidence-informed integrative care systems – The way forward. European Journal of Integrative Medicine. In press.
