Shadow Medicine: The Placebo in Conventional and Alternative Therapies

Can Evidence Based Medicine (EBM) and Complementary and Alternative Medicine (CAM) find common ground? A distinguished historian of medicine, John S. Haller Jr., explores the epistemological foundations of EBM and the challenges these conceptual tools present for both conventional and alternative therapies. As he explores a possible reconciliation between their conflicting approaches, Haller maintains a healthy, scientific skepticism yet finds promise in select complementary and alternative (CAM) therapies. Haller elucidates recent research on the placebo effect and shows how a new engagement between EBM and CAM might lead to a more productive medical practice that includes both the objectivity of evidence-based medicine and the subjective truth of the physician-patient relationship. Haller's book tours key topics in the standoff between EBM and CAM: how and why the double blinded, randomized clinical trial (RCT) came to be considered the gold standard in modern medicine; the challenge of postmodern medicine as it counters the positivism of evidence-based medicine; and the politics of modern CAM and the rise of the National Center for Complementary and Alternative Medicine. He conducts an in-depth case study of homeopathy, explaining why it has emerged as a poster-child for CAM, and assesses CAM's popularity despite its poor performance in clinical trials. Haller concludes with hope, showing how new experimental protocols might tease out the evidentiary basis for the placebo effect and establish a foundation for some reconciliation between EBM and CAM. Read more