Ben Goldacre (BadScience columnist from the Guardian) presented a programme about nutrition fads, on BBC Radio 4 today. It’s the first of a two-part series, The Rise of the Lifestyle Nutritionists. You can hear a podcast on the Radio 4 site. (Pick Monday’s choice.) It’s quite entertaining. In this part, Goldacre talks about the history of some classic quackery.

In contrast, today’s Guardian prints a piece by Madeleine Bunting in favour of unscientific medicine. Referring to several anti-alternative medicine books, as well as Dawkins’ 2007 TV series The Enemies of Reason. Bunting says:

It seems the aim of some of these authors is to finish off a burgeoning health industry that they believe is based on charlatans and quacks preying on the gullible and desperate.

This is one of the most common charges made against complementary medicine – that most of it is no better than placebo. But there is a way of turning that accusation around: perhaps complementary medicine is an effective way to harness placebo as one of the most powerful – and cheapest – of healing processes.

Mind and body can’t be conceptually separated. We know relatively little about how they interact. There’s plenty of room for research into how we can use the mind to fight illness. But I still can’t see how this can justifies encouraging the sick to believe in lies.

Why bother with scientific medicine at all, if you can just carry out a ritual or hand out a sugar pill?

Reason number 1 comes down to a similar point to that expressed in the question “Why won’t god heal amputees?” Can you cure cholera by reflexology? That is, alternative medicine “works” where symptoms are ill-defined and at least partly emotional in nature. Or as Bunting says, putting a positive spin on it:

Complementary medicine is most popular where conventional medicine fails, such as with musculoskeletal conditions and mental health – stress, depression, anxiety

Well, if some people’s mental conditions can be cured by ritual, surely these are revealed to be states of mind rather than organic disease. I bet the rituals don’t work so well with brain damage, dementia or full blown psychosis. So isn’t that like saying, lies aren’t powerful enough to cure real diseases.

Reason number 2. There are plenty of things that can make you feel happier/more relaxed/more cared for. These can be your own ritual practices or substances. (In the Asterisk books, the Brits’ magic potion is a cup of tea.)

You don’t necessarily have to pay for them. You do have to pay for alternative medicine.

In its raw form, a placebo may indeed be one of the cheapest healing process (as Bunting says). However, once you pay for the time of the “understanding” practitioner who prescribes you a 30 ml bottle of water, you enter into a commercial transaction that compares very badly with the cost of visiting a doctor, if you live anywhere with a public health service.

Reason 3: Alternative therapies are “alternative” because they haven’t been proved to work. End of story. Yes, medical research is pretty flawed in many ways. But, the very fact that new drugs are immensely profitable for drug companies and expensive for healthcare funders indicates why promising new treatments are unlikely to be ignored. If an alternative medicine or treatment worked, there would be an unseemly scramble to patent it or to use it to replace expensive drugs.

There must be hundreds of traditional medicines and bizarre treatments that would be effective against various illnesses. The only way to find this out is to test them. Why would the discoverer or inventor of an unusual cure not want to test it? Fear it doesn’t work. Fear of loss of profit.

Reason 4: Alternative medicine is generally the exact reverse of “empowering” despite the claims of its supporters. When you give up your power to evaluate solutions to your physical and mental illnesses, you must take the practitioner’s rituals as authoritative, with no basis for doing so except their claims.

Most of us would feel ripped off if we went to buy a toaster, paid for a toaster and were told – in a caring way – that we had got a toaster, when all we took home was an empty box. So, why is it OK to sell people treatments that don’t work? Indeed, not just morally acceptable but apparently desirable, according to Bunting?