The issue of alternative medicine has been around for a while, but seems to have intensified in recent years, particularly with the rise of Google and social media, where any number of opinions can be supported by anecdotes from others, even if these anecdotes are not exactly scientific in nature or evidence-based.

Those who support alternative medicine often believe that this is a more “natural” way of treating illness, as compared to medical treatments offered by the healthcare establishment. They also tend to be wary of institutions more generally, suspecting that the profit motive impacts the moves companies (like pharmaceutical companies) make, rather than the desire to heal or cure. As well, alternative treatments can often be prepared at home, using household items that most people can easily access. Thus, for those living at, near, or below the poverty line, and those who lack prescription coverage, these alternatives offer low-cost options to those with low socio-economic status.

On the other hand, those who oppose alternative treatments mainly do so because of the lack of scientific evidence confirming the validity of such treatments. Either there is no evidence and there have been no studies on an alternative treatment, or the evidence that has been collected suggests that such treatment is ineffective or that any relief experienced is just the result of the placebo effect. As well, alternative treatments lack the rigorous oversight and quality control measures of medical treatments, so treatments sold by others may be inconsistent or have small amounts of any “active” ingredient, and treatments created at home could be vulnerable to all sorts of contamination, imprecision, or other errors that are accounted for when producing medical treatments in a laboratory.

Finally, it is critical that we understand that recourse to alternative treatments is frequently the result of a fracture in trust between a patient and their physician or the medical establishment as a whole. Along with the potentially inaccessible cost of treatments, this is one of the key factors in comprehending why some people make this move. Internet boards are full of people discussing their (actual or perceived) struggles with the medical establishment, and such boards often act as both sounding boards and echo chambers, reinforcing suspicions and suggesting other ways of moving forward outside the formal institutions of medicine.

With all this in mind, I would first want to speak privately with this family member, to understand the reasons behind their use of alternative treatments, to the complete exclusion of traditional medicine. I would be very careful with my tone of voice and body posture, and ensure that I’m actively listening, to ensure I don’t come off as judgmental or condescending, and I’ll want to keep the above concerns in mind. Ultimately, I’d want to show my support for evidence-based medicine, but I also need to keep my family member’s autonomy in mind.

If they are pursuing alternative medicine because of the cost of traditional care, I would validate their concerns, but also try to see if there are any cost-cutting measures that could be taken. For example, some drug companies offer medications at reduced cost for people who are financially struggling, but you must contact the company directly to learn about such opportunities. If they are open to this, I would remain with them as they made the call, just in case they need moral support or additional information.

If they are pursuing alternative medicine because of a fracture in trust, I would want to hear them out and understand what happened – was this a one-time occurrence that was particularly negative? Was it a series of events over time? Understanding what led to such a fracture is key in thinking through how to resolve it. If possible, I would recommend other physicians or healthcare facilities, while still supporting my relative’s autonomy in making such decisions.

Finally, if they are pursuing alternative medicine because they feel they have experienced results from these treatments, I would validate their experience, but I would also want to know exactly what was in their treatment – what the active ingredients are, what measure of active ingredients are in the treatment, etc. It’s true that many alternative treatments haven’t been studied scientifically, and while it’s very unlikely that the treatment is causing a significant change, I wouldn’t want to rule it out entirely if it hasn’t been studied. Much more likely, however, is that this relative is experiencing the placebo effect. As long as no harm is being done, then there is nothing inherently problematic about the placebo effect. If this were not a life-endangering condition, and my relative is experiencing the placebo effect, then I probably wouldn’t pursue the issue further. If, however, we are dealing with something that is or could be life-threatening, I’d want to have a detailed, private conversation with them about the risks of this kind of treatment. I’d offer evidence-based information (including articles, if accessible) and try to understand why they find this treatment preferable. While I respect my relative’s autonomy, I would at least want to plead my case for evidence-based medicine – in doing so, however, I would be very careful about my approach, ensuring it’s clear that I’m coming from a place of love, not of condescension or frustration.

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