85. The Placebo Effect Strikes Back – Jesper Madsen
What is complementary and alternative medicine and treatments (CAM)? The definitions vary in different parts of the world. ”But at least here in Denmark, the definition is not based on evidence, on whether it works or not, but on the formal status of what is being done”, says Jesper Odde Madsen, who is a guest on the podcast for the second time. Jesper is a Danish science journalist and communication consultant with a focus on complementary and alternative medicine. He has an affiliation with the Galileo Commission, whose aim it is to expand science and free it from its underlying materialist assumptions. To what extent different kinds of CAM are accepted, or tolerated, also varies widely. Yoga and massage are popular. Homeopathy is a no-go zone in most of the West, whereas it is considered more or less normal in India. Conducting research on CAM is an uphill battle. Jesper Madsen talks of four main obstacles. ”There is no money in it. You can't get a patent by treating people with reflexology or acupuncture. You won’t make a career of studying these methods. There are no international organizations to back this up. And communication between the stakeholders is random or at least limited.” There is also a methodological dilemma when it comes to conducting CAM studies: The holy grail of western medical research is to employ RCT, randomized control trials, to show whether a treatment works or not. ”But here is a secret: When you want to study something, you should choose the trial method that's suitable for the thing you want to investigate. This truth has been kept away.” ”All governments listen to mainstream doctors. And mainstream doctors say: we must have RCT. Amen.” Alternative practitioners have a holistic approach. Before they apply their treatment, they learn things about every individual patient. And afterwards they talk to the patient and give advice. ”The point is that most alternative treatments consist of several parts, and only one of them is the technical fix, like needles in your arm”, says Jesper. ”There is nothing wrong with RCT but you have to start with the research question and analyze the issue before you make the choice of which investigation design to use.” If you make the method in itself a criterion of quality, then it is a question of belief, according to Jesper Madsen. ”And that is exactly what I have heard medical doctors say about alternative treatments: that they are beliefs, almost religious.” Is the placebo effect in essence an alternative treatment that the mainstream is using without knowing it? ”Yes. I am happy about the growing interest in studying the placebo. Even many doctors say today that this is more than just noise. There is a link between the psyche and the physical body. It would be great if we could take this seriously. But it will be difficult to make money on it.” Why are journalists reluctant to cover CAM in a neutral way? Are they also afraid of being ridiculed? ”I have been asking myself this question for years. Journalists tend to go to the usual mainstream sources. They tend to have a belief in authorities. I think this has been shown during the pandemic.” How to break the materialist paradigm, take down the ”wall”? ”It is not a question of evidence. We have the evidence. It is a question of reaching a critical mass of people and events. Maybe even that some researchers die and the younger ones think differently.” Personal website (English) Non-profit website & newsletter about CAM The Galileo Commission Presentation & speech, World Health Congress, Prague, 2021