Sunday, March 22, 2015

Modern American Quackery

Quackery in Contemporary American Culture

"Quackery is the promotion of false and unproven health schemes for a profit. It is rooted in the traditions of the marketplace", with "commercialism overwhelming professionalism in the marketing of alternative medicine". Considered by many an archaic term, quackery is most often used to denote the peddling of the "cure-alls" described above. Quackery continues even today; it can be found in any culture and in every medical tradition. Unlike other advertising mediums, rapid advancements in communication through the Internet have opened doors for an unregulated market of quack cures and marketing campaigns rivaling the early 20th century. Most people with an e-mail account have experienced the marketing tactics of spamming—in which modern forms of quackery are touted as miraculous remedies for "weight-loss" and "sexual enhancement", as well as outlets for unprescribed medicines of unknown quality.

While quackery is often aimed at the aged or chronically ill, it can be aimed at all age groups, including teens, and the FDA has mentioned some areas where potential quackery may be a problem: breast developers, weight loss, steroids and growth hormones, tanning and tanning pills, hair removal and growth, and look-alike drugs.

In a 1992 article in the journal Clinical Chemistry, then president of The National Council Against Health Fraud, William T. Jarvis, wrote:

The U.S. Congress determined quackery to be the most harmful consumer fraud against elderly people. Americans waste $27 billion annually on questionable health care, exceeding the amount spent on biomedical research. Quackery is characterized by the promotion of false and unproven health schemes for profit and does not necessarily involve imposture, fraud, or greed. The real issues in the war against quackery are the principles, including scientific rationale, encoded into consumer protection laws, primarily the U.S. Food, Drug, and Cosmetic Act. More such laws are badly needed. Regulators are failing the public by enforcing laws inadequately, applying double standards, and accrediting pseudomedicine. Non-scientific health care (e.g., acupuncture, ayurvedic medicine, chiropractic, homeopathy, naturopathy) is licensed by individual states. Practitioners use unscientific practices and deception on a public who, lacking complex health-care knowledge, must rely upon the trustworthiness of providers. Quackery not only harms people, it undermines the scientific enterprise and should be actively opposed by every scientist.

For those in the practice of any medicine, to allege quackery is to level a serious objection to a particular form of practice. Most developed countries have a governmental agency, such as the Food and Drug Administration (FDA) in the US, whose purpose is to monitor and regulate the safety of medications as well as the claims made by the manufacturers of new and existing products, including drugs and nutritional supplements or vitamins. The Federal Trade Commission (FTC) participates in some of these efforts.  To better address less regulated products, in 2000, US President Clinton signed Executive Order 13147 that created the White House Commission on Complementary and Alternative Medicine. In 2002, the commission's final report made several suggestions regarding education, research, implementation, and reimbursement as ways to evaluate the risks and benefits of each.  As a direct result, more public dollars have been allocated for research into some of these methods.

Individuals and non-governmental agencies are active in attempts to expose quackery. According to Norcross et al. (2006) several authors have attempted to identify quack psychotherapies, e.g., Carroll, 2003; Della Sala, 1999; Eisner, 2000; Lilienfeld, Lynn, & Rohr 2003; Singer and Lalich 1996. The evidence-based practice (EBP) movement in mental health emphasizes the consensus in psychology that psychological practice should rely on empirical research. There are also "anti-quackery" websites, such as Quackwatch, that help consumers evaluate claims.  Quackwatch's information is relevant to both consumers and medical professionals.

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