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Editorials

Integrated medicine

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7279.119 (Published 20 January 2001) Cite this as: BMJ 2001;322:119

Rapid Response:

Integrated medicine

Inasmuch as medicine is defined as "the art of preventing or curing
disease", all successful preventative or curative techniques are that art.
The source of a treatment can't matter. Consider, for instance, the
medicinal value of mould.

It follows that any new or old medical technique can only be measured
by its successfulness, according to the same rigorous standards in all
cases. In fact, throughout history, medicine (and disease) have always
evolved. It has not changed that each treatment, regardless of its
source, eventually stands or falls on its own apparent merit. What has
changed is our ability to apply rigorous standards when determining such
merits. This suggests, therefore, that the NIH is doing a wonderful thing
in embracing opportunities to define and refine medicine.

The tragedy is not that science is soon going to elucidate the merits
and demerits of so many therapies yet untested. The tragedy is the
drawing of a line in the sand of society, a line separating people
educated in universities from people educated elsewhere.

People want to be "masters of their own destiny". We make choices,
act independently, try things out. We have self-help books, the Internet,
distance education, and a growing trend of "choose your own health care
methods". Feeding this basic human drive for independence and self-
control are opportunities to choose amongst multifarious accessible and
ostensibly "proven" (e.g., by testimonials) treatments. In contrast,
feelings of utter dependence are fueled by prescriptions backed up by
realistic but unamazing statistical likelihoods of their effectiveness.

Unless the world at large can be trained in biochemistry, physiology,
statistics, etc., the more formally trained medical community will have to
work fast to erase a line. It is a line undoubtedly darkened by self-
serving financial interests that ironically but so effectively separates
"biomedicine" from "I'm a living human" medicine in the eyes of so many
people. The point has to be made to the alienated public that the
university-trained medical community does not consider itself an elite,
know-it-all race. Perhaps the biggest tragedy of all is that it seems it
all boils down not to verifiable knowledge, integrity, and respect but to
the biggest sell.

Competing interests: No competing interests

24 January 2001
A Karperien
Human Reproductive Unit
Cold Lake, Alberta