Ethics

A nurse on the medical wing
Had taken a course in I Ching
While checking the charts she would practise her arts
On the ills that the patients would bring

Spurred on by the welcome this bought
She soon other therapies sought
Iridology, Zen, Yoga, Tarot and then...
Transcendental... (well TM for short)

The doctors were caught on the hop
And ordered 'this practice must stop'
But all that their scrutiny prompted was mutiny
Awkwardness, temper and strop

So pond'ring their options awhile
Consulting the ward rank and file
They humbly suggested, then boldly requested
A double-blind crossover trial

The management couldn't agree
Such trials are so costly you see
They ordered both pills and the New Agers' skills
And to charge for each service a fee

The Rise of Alternative Medicine

One in four people in the UK use at least one form of alternative medicine; in the US and Germany the figures are even higher at 35% and 60% respectively. Three out of four people in the UK favour alternative therapies being available on the NHS.

One study cited by a recent BMA report suggested that there may be up to 15 million consultations to non-conventional therapists each year in the UK, with about 1.5 million people (2.5% of the population) each year receiving treatment.

The British Register of Complementary Practitioners has 1,000 members and the number is rising by 10% per year. A survey in the UK in 1980 suggested that there were 12.1 non-medically qualified practitioners per 100,000 population - 27% of the number of general practitioners. In addition, 35% of UK GPs have received some training in alternative medicine. In Denmark there are 2,000 registered complementary practitioners and only 3,200 general practitioners.

In most member states of the European Union (eg Belgium, France, Spain, Italy and Greece) the practice of medicine by non-recognised health professionals is illegal. In Germany and Scandinavia there is some regulation but in the United Kingdom and Ireland there is virtually no regulation at all.

Two exceptions to this state of affairs are osteopathy and homeopathy. The Osteopaths Bill in 1993 established a statutory register and a governing body, the Osteopaths Council; and the UK faculty was set up in 1950 to train and examine homeopaths.

The United Kingdom is the only EU country with complementary medicine hospitals in the public sector. There are five such hospitals in London, Glasgow, Liverpool, Bristol and Tunbridge Wells.

In the main however, practitioners of alternative medicine are unregulated in the UK and when considering the tight controls on the training and practice of orthodox medical practitioners there is clearly a double standard operating.

What is alternative medicine?

Problems of definition

The report of the BMA's Board of Science and Education's working party, Complementary Medicine, New Approaches to Good Practice[1] defines non-conventional therapies as 'those which are not widely used by orthodox medical professionals nor widely taught at undergraduate level in medical and paramedical courses' - but this varies throughout Europe. Some therapies which would be regarded as alternative in the UK are taught formerly elsewhere as part of the normal undergraduate syllabus.

The three terms complementary, alternative and holistic are used almost interchangeably - but convey different messages. The word 'alternative' implies an either/or relationship with orthodox medicine; 'complementary' a both/and relationship and 'holistic' implies that non-orthodox therapies treat the 'whole person'. All these presuppositions are controversial in themselves.

The Diversity of Therapies

The BMA report says that as many as 160 different forms of non-conventional therapy have been identified. The most common and best known in an A to Z listing are:

Acupuncture - A branch of Chinese medicine involving insertion of needles beneath the skin at various pre-defined points.

Acupressure - Similar to acupuncture but involving finger massage rather than needles.

Alexander Technique - Teaching about the use of posture to relieve back or neck pain or headaches.

Aromatherapy - The use of plant oils for massage, bathing, inhaling or taking internally.

Auricular Therapy - Insertion of needles into the ear to treat illnesses all over the body.

Bach Flower Remedies - Infusions from wild plants and trees are taken internally.

Chiropractic - Manipulation and massage of joints, particularly in the spine to treat predominantly musculoskeletal disorders.

Crystal Therapy - Based on the idea that crystals and gems have healing properties; and involves placing them on various parts of the body or meditating upon them.

Herbs - Plants or herb-based remedies are taken internally or rubbed in as creams.

Homeopathy - The treatment of diseases by compounds which produce the same symptoms, but which have been diluted many thousands of times.

Hypnosis - The use of suggestion, imagination or mind control to bring about a change in behaviour or conscious state.

Iridology - Diagnosis based on the analysis of colour patterns in the iris.

Macrobiotics - Diets consisting of combinations of vegetables which have been prepared in certain prescribed ways.

Massage - A variety of different forms.

Naturopathy - Based on the idea that the body can be stimulated to heal itself through a variety of means including herbal remedies and manipulation.

Osteopathy - Manipulation of spinal joints or soft tissues allegedly to stimulate nerve supply and/or lymphatic drainage.

Reflexology - Massaging of prescribed points on the sole of the foot which are believed to apply to certain internal organs, in order to treat disease.

Shiatsu - Essentially a Japanese form of acupressure involving manipulation of body surface points.

Therapeutic Touch- Use of the hands hovering several inches away from the body to discern the presence of disease and heal it.

Yoga and Transcendental Meditation - Healing through adopting different body positions or mental states.

Zone Therapy - Similar to reflexology; pressure on predefined body points to effect healing of internal organs.

‘Life force’ and ‘vital energy’

On first glance there seems to be very little similarity between one form of alternative medicine and another; but what unifies most of them is the idea of 'life force' or 'vital energy' which ensures health, becomes disrupted in disease and can be manipulated by various means. For example let us consider acupuncture:

Underlying this form of Chinese alternative medicine is the belief that there is a vital force or energy called 'Chi' which flows freely through the body in twelve meridians or channels. The flow of this energy depends on the balance between two opposite forces: an active, 'male' force called 'yin' and a passive, 'female' force called 'yang'. There are supposedly 6 yin meridians passing through the 'storage' organs (eg heart, liver and spleen) and 6 yang meridians passing through the 'hollow' organs (eg intestine). For example the yang meridian serving the colon passes through the index finger, arm, neck and nose.

When the flow of the Chi energy is free and uninterrupted health is ensured but if the balance between yin and yang is disturbed or if there is any blockage to energy flow then disease results.

Acupuncture is based on the ancient Chinese religion of Taoism which has Chi, yin and yang as fundamental concepts.

Ideologies which underlie other forms of medicine use different words for the same general concept of 'life force'. Shiatsu is based on Shintoism and calls the energy 'Ki'. Yoga and TM are based on Hinduism and call the force 'prana'. Homeopathy uses the term 'vital energy', chiropractic 'innate intelligence' and Maori medicine terms the life force 'mana'.

The common theme of ‘correcting imbalance’

In most alternative therapies health is believed to be restored by relieving blockage and restoring flow in the 'life force', but the means whereby this is achieved vary widely. So for example the following modalities use the methods listed:

Modality	Method
Acupuncture	Needling
Homeopathy	Minute doses of diluted medicine
Reflexology	Foot massage
Aromatherapy	Aromatic Oils
Yoga	Adopting Body Postures
Transcendental Meditation	Meditation
Therapeutic Touch	Hovering hands
Macrobiotics	Diet

Why is Alternative Medicine so popular?

There are seven main factors accounting for the rise in popularity of alternative medicine in the Western World.

1. Changes in the Western world-view

Two hundred years ago in Britain most people had a theistic world-view; that is they believed in the existence of a personal creator God who sustained and ran the universe and had revealed himself in the course of history. They believed that man was made in God's image, that morality was absolute and that death led to judgement and either heaven or hell. With the publication of Darwin's Origin of the Species and the rise of liberal biblical criticism, the theistic world view gave way to an atheistic one.

People began to doubt the existence of God and life after death. Man came to be seen simply as a clever monkey, the product of matter, chance and time in a directionless and purposeless universe. Morality was seen as relative and absolute.

What we are seeing now is another world-view shift from atheism into pantheism. Pantheism is the ideology which lies behind Eastern religions like Hinduism and also the New Age Movement. God, rather than being seen as a personal being, is seen as an impersonal force of which we are all simply a part. Death leads not to judgement or 'nothing' but to reincarnation, and morality simply means being in harmony with nature. All is one and all is God. With this world-view shift comes an increasing openness to all sorts of belief that are not Christian along with a scepticism and suspicion about science.

The change of world view from theism, to atheism and then pantheism has had profound effects on the way that medicine is practised. Christian doctors see human beings as a tri-unity of spirit, soul (or mind) and body (1 Thes 5:23). Atheistic doctors see them as consisting of just body and mind and the tendency has been to look at the body in parts or in systems rather than as an integrated whole; and so we have psychiatrists for the mind, ophthalmologists for the eyes, nephrologists for the kidneys etc.

New Age or alternative medicine practitioners see human beings as an integrated whole; but from a pantheistic rather than a theistic perspective.

Much of alternative medicine has its roots in the New Age Movement. The idea of the New Age has its roots in Astrology. Exponents believe that for the last 2,000 years we have been in the age of Pisces (the fishes), but that now we are moving into the age of Aquarius (the water-carrier). The Age of Pisces was characterised by rationality, logic, objectivity and black and white, analytical 'left brain' thinking. By contrast the Age of Aquarius is characterised by intuitional, subjective, grey, 'right brain' thinking.

Sociologically, the New Age Movement spawned the counterculture of the 1960s with 'flower-power', peace protests, drug experimentation and the Hippie movement. Spiritually, it paved the way for a wide acceptance of Eastern religious ideology, Astrology and the Occult. Medically, the New Age Movement meant an increasing disillusionment with scepticism of scientific medicine.

As Christians we reject both the atheistic and pantheistic world views. They are quite simply not the way the world is. God does exist. We are made in his image, yet fallen; and death leads to judgement. We embrace the scientific method as a gift of God, but we also see human beings as being more than simply the sum of their parts. It is no surprise to us that the body affects the mind and vice versa; as in psychosomatic diseases like peptic ulcer, rheumatoid arthritis and asthma. It is just what we would expect believing what we do about the nature of human beings.

2. The failings of orthodox medicine

There have been great advances in orthodox medicine over the last two centuries which have led to the eradication and alleviation of many diseases which were previously neither preventable nor curable: immunisations for smallpox, antibiotics for infection, anti-psychotics for schizophrenia, chemotherapy for cancer, drugs for heart failure and surgery for a whole host of structural and anatomical problems.

But medicine also has its limits. We do not yet know what new treatments the genetic revolution will bring; but there are presently illnesses where we have a long way to go. Solid tumours (eg lung, breast and bowel) are in general difficult to treat if surgery fails. There is still much progress to be made in chronic diseases like multiple sclerosis and rheumatoid arthritis, and there is still no orthodox cure for musculoskeletal back pain and the common cold. If we also consider that 75% of people seeing their doctor do not have any defined organic illness, it is easy to see why people may decide to consult alternative practitioners. Patients may also become impatient or disillusioned with the NHS system of referrals and waiting lists.

With some diseases alternative medicine fares no worse than orthodox medicine and it is in these areas that alternative medicine thrives.

3. Medical arrogance

Orthodox doctors have not always been ready to admit failure; and on occasions may go on using treatments of doubtful value, or with potential side-effects rather than simply stating that nothing else can be done. The inappropriate use of some chemotherapeutic agents or radical surgery for advanced cancer, for instance, may cultivate distrust in patients who then seek other solutions.

4. The side-effects of orthodox medicine

Some orthodox medicines and surgery can produce side-effects; sometimes these are fatal. Such cases are widely publicised often by an unforgiving press.

The thalidomide disaster is one of the best-known events of medical history, when the children of mothers given a drug for pregnancy-related nausea and vomiting were born with limb defects.

The effects of non-steroidal anti-inflammatories in producing gastrointestinal bleeding, or chloramphenicol in producing pancytopenia are less well known, but horror stories in tabloid newspapers, instead of just inducing sensible caution, can lead patients to be suspicious of all orthodox medicine or surgery.

Most alternative medicine has little in the way of side-effects (although there are notable exceptions which we will come to later). Sceptics may say that alternative medicine is generally ineffective in treatment as well, and that is why its side-effects are in general less marked.

5. Loss of a whole person perspective

Advances in the science of medicine may have been at the expense of the art of medicine. Doctors have less time for the patient, touch patients less often, and perhaps are tempted much more, now that they can do so such more, to treat their patients simply as anatomical structures or biochemical machines.

By contrast alternative medical practitioners generally are able to give much more in terms of time and touch, thereby engendering more trust.

Whereas a famous text by Balint on medical consultation has been titled 'Six minutes for the patient', homeopaths may spend up to 90 minutes in a first consultation and 45 minutes on follow up.

There is much less in medicine now of the ritual handshake, pulse-taking, hand on the shoulder etc. Too often the doctor is now esconced behind his PC and perhaps a formidable desk; while many alternative therapies involve plenty of 'hands-on' diagnosis and treatment.

This volume of time and touch ultimately builds up trust. 'He must know what he is doing because he spends so much time with me'.

6. Costs of high-tech medicine

At the time the case of Tony Bland was going through the courts, the public were shocked to hear that the care of patients in persistent vegetative state (PVS) costs the country about £30 million every year. High-tech medicine is expensive, while often the only cost of alternative medicine is the therapist's time.

This is one feature making alternative therapies increasingly attractive to NHS managers looking to cut costs; as the poem with which we started cynically demonstrates.

7. Consumer demand

The final reason alternative medicine is more popular is consumer demand. Patients are prepared to pay for therapies which promise what orthodox medicine has failed to deliver; especially for incurable cancer or chronic pain.

This demand has meant that there is plenty of room in the market place for more practitioners.

Why does Alternative Medicine seem to work?

Why is it that so many people are seeking alternative medicine therapies when so many of them have been shown not to work in clinical trials? Why do they seem to work? There are at least ten reasons why.

1. Genuine therapeutic effects

Some alternative medicines do genuinely work. Over half of prescription and over the counter drugs originate as natural compounds or are based on them (eg aspirin, digitalis, morphine, adrenaline, curare, all antibiotics except the quinolones etc); and reports from a recent New York Conference suggest that the natural world may hold many more therapeutic treasures.[2]

Dramatic examples in the public health field this century have included iodide in preventing goitre, fluoride in preventing dental caries and folate in lowering the incidence of neural tube defects.

Examples given of new natural compounds now under trial or in clinical use include the new anticancer agents paclitaxel (from tree bark) and eleutherobin (from a Caribbean sea squirt); the anticoagulant echistatin (from the Indian tree viper); the antibiotic apicidin (from a Costa Rican fungus) and the analgesic ziconotide (from a poisonous cone snail).

It is quite conceivable that some alternative medicine practitioners are using compounds which are not yet known to orthodox medicine. But if this is the case then we need to discover what they are so that they can be isolated and given in the correct dose!

2. Belief in the therapist

Belief in the ability of the therapist can become a self-fulfilling prophecy. If we strongly believe that someone has the power to help us, then we are much more likely to experience a placebo effect.

3. Belief in the therapy (placebo)

It is a fact that one third of people given an inert compound to relieve a particular symptom will report relief of that symptom. This is called the placebo effect. Belief alone in the treatment will account for all the improvement seen in some people.

4. The use of other therapies concurrently

Belief in an alternative therapy's effectiveness may develop when it is used concurrently with another more effective orthodox therapy. The effect is then wrongly ascribed to the alternative therapy.

For example, acupuncture may be used in conjunction with anaesthesia for pain, a macrobiotic diet in conjunction with radiotherapy for cancer or homeopathic remedies in conjunction with prescription drugs.

5. Psychosomatic illness

Many illnesses are psychosomatic; in other words a patient's stress level or mental state can aggravate the symptoms. Asthma, eczema, peptic ulcer and rheumatoid arthritis fall into this category.

Any alternative therapy which induces relaxation may then improve the symptoms.

6. Spontaneous remissions

Many diseases spontaneously remit, in other words they get better by themselves. This is particularly true of viral infections. The common cold is an obvious example; a less obvious one is warts. People may well then attribute the therapeutic effect to the remedy they were trying at the time of recovery, when in fact their improvement at that time may just have been coincidence. This is called the post hoc, propter hoc fallacy; in other words 'because B followed A, the A must have caused B'.

Other diseases, like malignant melanoma - an aggressive skin cancer, may sometimes spontaneously regress. Again wrong inferences can be made.

7. Dietary influences

There is a strong link between diet and health, and many alternative therapists, in addition to recommending, say, homeopathic remedies may suggest a change of diet. The resulting improvement may then be due to the change in diet, rather than the alternative therapy.

Many alternative therapists will, like doctors, recommend that a patient drinks less coffee or alcohol, eats less fat or more fibre or vitamins etc.

8. Same world-view shared by patient

Patients who share the therapist's belief in New Age pantheism, or the existence of 'life force', 'energy fields' or auras will be more likely to benefit from the placebo effect.

9. Imagined improvement

Some patients, especially if open to suggestion from others that they 'look better', may simply imagine that they 'feel better'; especially if the symptoms were of a vague nature in the first place. Alternatively they may simply grow used to tolerating the symptoms and deduce that it is the symptoms rather than their tolerance of them which has changed.

10. Demonic involvement

There may be real spiritual forces operating to bring healing through demonic power. Such healings may be the bait that Satan then uses to draw a person more deeply into the occult, or into accepting a pantheistic world-view.

How do we assess individual modalities?

It is not possible to comment in detail here on each and every branch of alternative medicine; my intention is to give seven principles that can be applied when assessing any given therapy.

1. Does it work? (ie Do the claims fit the facts?)

Any new orthodox medicine has to undergo extensive pharmacological testing to assess its therapeutic potential, side-effects and interactions with other drugs. Tests are first carried out in animals, then in human volunteers and only then are short and long term studies carried out on real patients.

The drug, if it passes these tests, must then be passed by the appropriate drug regulatory authorities. In the UK this responsibility lies with the Health Ministers for England, Scotland, Wales and Northern Ireland who together form the Licensing Authority. The Medicines Control Agency is an agent of the licensing authority and has the power to ensure that legal requirements are met. These safeguards ensure that drugs reaching the public are both safe and effective.

In the same way medical practitioners must undergo a five year undergraduate training and then work for a further year before they are registered and able to practice independently of an NHS institution.

Similar safeguards for alternative medicines and practitioners are largely absent in the UK. There is simply no comparison between the double-blind, randomised, placebo-controlled cross-over trials which many orthodox drugs undergo and the subjective anecdotal 'evidence' supporting much alternative medicine.

Some alternative therapies may not lend themselves to this level of rigorous investigation but it is mandatory that good evidence is sought of their safety and efficacy. When such trials are employed the results are often inconclusive:

For example, recently published research has demonstrated that practitioners of 'therapeutic touch' are unable to detect the 'human energy fields' they claim to rely on for diagnosis and treatment. In the study 21 practitioners detected the presence of a human hand behind a screen less than 50% of the time.

Therapeutic touch involves passing hands a few inches above a patient's body to 'repattern energy flow'. Despite the lack of objective evidence for its efficacy, proponents say that more than 100,000 people world-wide have been trained in the technique, including 43,000 healthcare professionals.[3]

Likewise a 1990 French review of 40 controlled trials on homeopathy concluded that the majority were flawed by small sample size and subjective measures of improvement.[4] A 1991 review of 107 trials was similarly inconclusive.[5]

By contrast there is some evidence that patients with low back pain treated with chiropractic derive more benefit and long term satisfaction than those treated by hospitals;[6] and acupuncture is an effective treatment for nausea and vomiting induced by anaesthesia, pregnancy or chemotherapy, according to a consensus panel of the US National Institutes of Health.[7]

A Department of Complementary Medicine has recently been set up at the University of Exeter to review trials on alternative and complementary therapies. The contents pages of their quarterly journal FACT (Focus on Alternative and Complementary Therapies) are available on the internet[8] and make interesting reading. But it would be fair to say that many of the published studies give inconclusive results.

The biblical injunction to 'enquire, probe and investigate thoroughly' (Dt 13:14ff) must surely be relevant here. We should always ask, 'What is the evidence that it really works?'

2. Does it have a rational scientific basis?

We know how most orthodox drugs work. They may stimulate receptors (eg b agonists in asthma), modify cell transport (eg probenecid), block enzymes (eg allopurinol), replace missing compounds (eg vitamin B12) or chelate toxins (eg penicillamine).

The action of any given drug is determined by its concentration at the site of action; and the actions are understandable in view of their known biochemical and physiological effects.

By contrast the majority of alternative medicines have no rational scientific basis.

Homeopathy involves diluting an active compound to such a degree that the resulting 'potency' contains not even a molecule of the original active ingredient.

Iridology claims to link each area of the iris with a separate part of the body when it is known that no such connections exist. This is not to deny that the iris can give clues to such conditions as ochronosis, Wilson's disease or hypercholesterolemia; but in these cases there is a good scientific explanation for the iris' changes.

Reflexology is based on the belief that there are connections between the sole of the foot and internal organs; again in the absence of any scientific evidence.

There is similarly no evidence for the existence of the 'meridians' (energy channels) of acupuncture, the 'chakras' (psychic spinal centres) of yoga or the 'innate intelligence' of chiropractic.

In some cases an alternative therapy may be working because of some scientific reason unknown to the therapist. It has been suggested, for instance that the therapeutic effects of acupuncture could be explained by the release of endogenous (naturally produced) pain-killers called endorphins. If this is indeed confirmed, then acupuncture will be shown to have a scientific basis, but this will not, by any means prove that Taoist ideology is true or that Chi energy exists.

3. Is it the methodology or the principle?

Transcendental Meditation lowers blood pressure, but why? Is it because it causes the Goddess Kundalini to migrate up the spine and unite with Brahman in the head (as Hindus believe), or is it simply that meditation induces relaxation and reduces the sympathetic output that raises blood pressure?

Chiropractic has been shown to help low back pain, but is this because manipulation of the spine alters the flow of 'innate intelligence' or because it helps to alleviate musculoskeletal trigger points?

Recent research has demonstrated that close to 100% of pain sufferers benefit from sham acupuncture where needles are stuck into non-acupuncture points.

In each of these cases it seems to be the methodology rather than the principle of prana, innate intelligence or Chi that brings the therapeutic effect.

There is thus a world of difference between the GP who makes a diagnosis by taking a history and doing an examination and the alternative medicine practitioner who does it by examing an iris or swinging a pendulum. There is also a huge gulf between the GP who uses acupuncture on the basis of its proven effectiveness in clinical trials and the practitioner who uses it because he believes it alters the balance of yin and yang.

4. What is the world-view behind it?

What is the world-view behind the therapy? As mentioned, acupuncture has its roots in Taoism, yoga in Hinduism and therapeutic touch in New Age ideology.

This alone should make us naturally suspicious of these therapies.

What was the motivation of the therapist who developed the treatment? Hahnemann, the German physician who developed homeopathy, was a freemason. Kreger, the New York Nursing Professor who invented therapeutic touch, is a Buddhist; and her collaborator Kunz was Vice President of the Theosophical Society and an occultist and psychic. Edward Bach (of 'flower remedy' fame) was a doctor who trusted his 'spirit self' for knowledge and guidance.

Any talk of 'life force', 'vital energy' or 'energy balance' should make us wary of pantheism.

It might be objected here that much orthodox medicine has been developed by atheists with an atheistic world-view and yet that does not stop us benefiting from their insights. This is true. We are not saying that pantheists are not able to discover beneficial treatments which God has given; simply that we should be sure that the therapy itself does not involve disobedience to God through embracing the ideology behind it.

5. Does it involve the occult?

Many alternative practitioners use occult techniques (eg pendulums, dowsing) in order either to make a diagnosis or to decide on which therapy to use. The Bible describes the King of Babylon using an occult practice known as splanchnomancy (Ezk 21:21) to help him decide whether or not to attack Jerusalem. This involved sectioning the liver of a goat and examining the cut surface.

This practice probably had its origin in a chance coincidence and then later developed into a complex mapping exercise. The resemblance with the use of the foot (reflexology), the iris (iridology), star charts (astrology) and electrical conductance (radionics) to give diagnostic information is similar.

Iridology began when the founder Peczely, discovered that an owl with a broken wing had a coloured fleck in its iris and (incorrectly) deduced that one abnormality had caused the other. Evil spirits can use such 'illogical channels' to give information that eventually grafts people into an occult belief system.

The Bible is very clear in its condemnation of occult practice as the following passages demonstrate:

Mediums and Spiritists (Lv 19:31, 20:6; Acts 16:16-21)
Astrology (Is 47:13-15)
Magic Charms (Ezk 13:20ff)
Diviner's Wand (Ho 4:12)
Sorcery (Acts 19:19)
Witchcraft (Gal 5:20)
Magic Arts (Rev 9:21, 21:8, 22:15)
Occult (Dt 18:10-12)

6. Is it medically safe?

Part of the attractiveness of alternative medicine is that the side-effects are generally minimal, however there are some exceptions.

Chiropractic manipulation of the neck can be associated with vertebral artery thrombosis and lateral medullary syndrome.

Acupuncture can cause pneumothorax and infection.

Herbal therapies are probably the most dangerous. An Indian eye remedy called surma was found to contain 85% lead and resulted in lead poisoning in children. In the UK in 1992 a traditional healer was sentenced to three years in prison after giving patients near fatal doses of mercury and arsenic; and some chinese herbal remedies have caused liver toxicity.

Other 'herbal' remedies have been shown to contain mixtures of prescription drugs; usually in below therapeutic or toxic quantities (eg antihistamines, steroids, antibiotics).

One of the main dangers of such remedies, even if they don't have toxic effects of their own, is that they delay diagnosis, produce a false sense of security and may interact with other prescription drugs that the patient may have obtained from orthodox sources.

7. Has it stood the test of time?

This is not a guarantee, as clearly many occult devices stand the test of time, but we can be equally sure that something which does not genuinely work and is not of God will not stand the test of time.

Applying the tests

As an example of applying the tests above let us consider homeopathy. First, there is no clear evidence that it actually works. Second, it has no rational scientific basis; there is no reason known to science why a solution containing not a single molecule of a given active substance should have any therapeutic effect. Third, it is based on a pantheistic world-view with the concept of 'vital energy' playing a prominent role. Fourth, practitioners will often use occult means (such as pendulums) in diagnosis. While it does appear to be safe and to have stood the test of time, these other considerations should make us very wary indeed.

Difficult Questions

Finally, let us finish by considering some of the objections which Christians might raise to the kind of critique I have just given.

1. Weren’t many medical treatments initially ‘natural’ anyway?

This is correct (eg. aspirin (willow bark), digitalis (foxglove), Morphine (poppies)) but the natural ingredient needs to be clearly identified and given in the right dose. Many useful natural drugs are toxic if given in too high a dose (eg digitalis, opium).

Decisions about which compound to give must also not be based on occult practices (eg rituals, spells, charms, astrology, clairvoyance, pendulums, spirit guides etc) as previously mentioned.

2. How can something be wrong if it actually works?

First we need to be sure that the given therapy does actually work. Have there been properly controlled clinical trials carried out showing that it is better than placebo, or is it supported simply by anecdotal testimony?

Second we need to ask why it works. Is it working as a result of occult power? (Dt 13:1-6; Ex 7:11,22, 8:7, 18,19; Mt 24:24). If so it may be leading to the bondage, rather than to the liberation, of the patient. We must be ready to test everything (1 Thes 5:21).

3. How do we know there’s not some good in it?

It's often objected that we should not throw out the baby with the bath water; and there is some truth in this... but is the baby and bath water really a good analogy? It is very easy to see the difference between baby and bath water but often extremely difficult to separate out the good and bad in alternative medicine.

A better analogy is the poison mushroom. While poison mushrooms contain plenty of good fat, carbohydrate and protein we recommend that people don't eat them because it is impossible to separate out the good and the bad.

Everything that does not proceed from faith is sin; so if we have doubts it may well be better to abstain (Rom 14:23).

4. How can it be wrong if good Christians I know use it?

Good Christians may be ignorant or deceived or simply have their consciences blunted from habitual sin. There is no-one with perfect discernment who is right in all their words, let alone all their beliefs (Jas 3:1).

Good Christians may also have a lot personally invested in a therapy and their objectivity may be accordingly clouded.

We should therefore test everything, holding fast to that which is good and abstaining from every form of evil.

Summary

We have reviewed the rapid rise in popularity in alternative medicine, and seen that while therapies are diverse, there is a pantheistic ideology behind many of them.

Alternative medicine is popular because of changes in the Western world-view, the perceived failings, arrogance, costs and side-effects of orthodox medicine, and because it appears to bring a 'whole person' perspective.

While some therapies may genuinely work, apparent improvements are often due to other reasons such as spontaneous remissions, the use of concurrent orthodox medicine or the placebo effect.

Each branch of alternative medicine needs to be assessed individually to determine its effectiveness, scientific basis, mode of action, safety, underlying world-view and links with the occult.

We should use only those therapies which pass these tests.