title: Complementary and alternative drug therapy versus science-oriented medicine.
abstract: This opinion deals critically with the so-called complementary and alternative medical (CAM) therapy on the basis of current data. From the authors' perspective, CAM prescriptions and most notably the extensive current endeavours to the "integration" of CAM into conventional patient care is problematic in several respects. Thus, several CAM measures are used, although no specific effects of medicines can be proved in clinical studies. It is extensively explained that the methods used in this regard are those of evidence-based medicine, which is one of the indispensable pillars of science-oriented medicine. This standard of proof of efficacy is fundamentally independent of the requirement of being able to explain efficacy of a therapy in a manner compatible with the insights of the natural sciences, which is also essential for medical progress. Numerous CAM treatments can however never conceivably satisfy this requirement; rather they are justified with pre-scientific or unscientific paradigms. The high attractiveness of CAM measures evidenced in patients and many doctors is based on a combination of positive expectations and experiences, among other things, which are at times unjustified, at times thoroughly justified, from a science-oriented view, but which are non-specific (context effects). With a view to the latter phenomenon, the authors consider the conscious use of CAM as unrevealed therapeutic placebos to be problematic. In addition, they advocate that academic medicine should again systematically endeavour to pay more attention to medical empathy and use context effects in the service of patients to the utmost. The subsequent opinion discusses the following after an introduction to medical history: the definition of CAM; the efficacy of most common CAM procedures; CAM utilisation and costs in Germany; characteristics of science-oriented medicine; awareness of placebo research; pro and contra arguments about the use of CAM, not least of all in terms of aspects related to medical ethics.
authors.affiliation: Medical Care Centre Cuxhaven GmbH, Medical Office for Internal Medicine, Cuxhaven, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Anlauf
authors.affiliation: Albert-Ludwigs-Universität (University), Institute for Experimental and Clinical Pharmacology and Toxicology, Department 2, Freiburg i. Br., Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Hein
authors.affiliation: University of Münster, Institute for Epidemiology and Social Medicine, Münster, Germany.
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.affiliation: Wuppertal, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Köbberling
authors.affiliation: Bergisch Gladbach, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Lasek
authors.affiliation: Ludwig-Maximilians-Universität (University), Institute for Health Economics and Health Care Management, Munich, Germany ; Helmholtz Research Centre, Institute for Health Economics and Health Care Management, Munich, Germany.
authors.forename: Reiner
authors.initials: R
authors.lastname: Leidl
authors.affiliation: University of Münster, Institute for Ethics, History and Theory of Medicine, Münster, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Schöne-Seifert
mesh_terms: D000887:Anthroposophy; D035843:Biomedical Research; D000529:Complementary Therapies / Q000191:economics / Q000941:ethics; D019317:Evidence-Based Medicine; D005858:Germany; D006705:Homeopathy; D006801:Humans; D008517:Phytotherapy; D015990:Placebo Effect
keywords: CAM; anthroposophic medicine; complementary alternative therapy; homeopathy; medical ethics; phytotherapy; placebo research; science-oriented medicine