Leader: A suitable subject for teaching?

October 30, 2008

If alternative medicine can't produce scientific evidence of its efficacy, should universities be offering courses in it?

An estimated 20 per cent of the UK population uses complementary and alternative medicine (CAM) regularly, spending some £1.6 billion a year, and unsurprisingly the Prince of Wales has registered his support for it. But although these "alternative" medicines and therapies seem to be accepted by the wider public, in universities a debate is raging over their efficacy and whether they should even be considered a legitimate academic subject.

If, as one anonymous CAM lecturer told Times Higher Education, it is "romantic medicine for people who don't want to do the hard work of learning how to think critically", does it really deserve a place in the academy?

Opponents have derided CAM as "mumbo-jumbo" that "no respectable university should provide", "bogus" and "the denial of rationality" - and these are all criticisms that must be taken seriously. Reservations about the teaching of the subject have been around as long as the discipline has been on the curriculum. Earlier this year, the University of Central Lancashire faced a revolt from its own staff, who claimed it was promoting "quackery" by offering courses in homoeopathy, acupuncture and herbalism. The university conducted a review of the courses, the findings of which it is yet to report.

There are those who argue that there is a significant scientific element in the courses and that a double standard is being applied to CAM when other non-science subjects award Bachelor of Science degrees. But the other subjects do not arouse the same passions and hostilities from the scientific community. As one posting on the Times Higher Education website put it: "I studied astrophysics at university. If my lecturers spent 50 per cent of their time teaching me astrology and Noel Edmonds' Cosmic Ordering then I would quite rightly consider my degree to be utterly invalid and a disgrace."

What is also clear is that the other subjects do not have the same importance. The stakes in healthcare are high, and critics believe that CAM should be held to the same scientific standards as conventional Western medicine - that is, subjected to an evidence-based approach. Some argue that any practice that cannot or does not produce evidence for its efficacy should be described as "non-evidence-based" medicine or "not medicine at all". For one blogger, the fact that it is unscientific is cut and dried - "if it wasn't, it wouldn't be alternative, it would just be medicine".

A close look at some of the course content in CAM reveals practices such as "energy testing" that undermine the claim that it is scientifically sound. But there is no doubt that anecdotal evidence exists for the effectiveness of some CAM, and its practitioners argue that academic assessment is difficult because their treatments are specific to individuals. But whether CAM can be truly comfortable in the glare of scientific scrutiny is debatable.

Cynics see financial motives for universities to continue to offer CAM courses despite opposition from scientists. The number of students studying CAM has more than doubled in the past four years, and there are now 7,000 enrolled on these courses. Academics delivering the subject feel they are under siege, and scientists feel CAM is diluting science.

At present, the quality of the courses is subjected to scrutiny by the Quality Assurance Agency, but content is approved by universities' committees of experts, a practice that has drawn its own criticisms. It is, of course, in everyone's interest that these courses are properly evaluated and validated. But even before that happens, while CAM fails to be subjected to the same rigorous scrutiny applied to other, more conventional, therapies, question marks will always remain over its suitability as a subject for inclusion in higher education.

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