Journal of Biblical Ethics in Medicine – Volume 8, Number 1
Quackery Dr. Terrell is Assistant Professor of Family Medicine at McLeod Regional Medical Center in Florence, S.C.
With enactment of medical licensure laws in the latter
without, and among those with higher incomes.
half of the nineteenth century medical practitionersbegan an attempt to define and enforce upon the
Practitioners of orthodox medicine, on the whole,
American public our notion of what ought to be
deserve to have failed in our attempt to abolish
orthodox and permissible in healing. The various states
alternative practices by means of law. Similarly, our
granted exclusive privileges to diagnose and treat
failure to persuade the public more thoroughly of the
diseases to certain groups of practitioners who held
superiority of our methods has earned the leakage to
themselves to be more scientific, more valid, and more
other types of practices. Medical licensure laws render
effective than others. The century-old maneuver has
to Caesar authority God has deposited elsewhere. God
places the physical health of individuals into the hands ofthe individual, the family, and the church (see 1 Cor.
Reporting in the January 28, 1993, New England
6:15-20). Whether such laws "worked" or not is
Journal of Medicine, Dr. David Eisenberg and others
secondary to their biblical propriety. The civil state
describe a representative survey of a significant portion
figures in only for contagious diseases in which coercive
of the United States population regarding its use of
isolation measures are called for. The civil ruler's power
unconventional therapies. Their findings are amazing: (1)
is coercive. Except for contagious diseases where
One-third of the English-speaking, adult population
coerced measures may be beneficial to the whole
used unconventional therapies in 1990, (2) Only one in
community, medical care is a business contract or a
four of those who used unconventional therapies told
ministry of compassion and mercy - hardly fit tasks for
unconventional therapies spent about $10 billion in theprocess, comparable to the amount spent out-of-
Conventional medicine's inability to thoroughly persuade
pocket for hospital care, (4) the number of visits to
the public of its superiority has less to do with its public
providers of unconventional therapy (425 million)
relations perhaps than with its science.' Most orthodox
exceeded those to primary care physicians and the
medical practices stand on rather little proof, majoring
average charge per visit was $27.60.
groupthink acculturation. Even the positive Outcome
It would appear that the attempt by mainstream medical
data we have tends to be narrowly conceived and
practitioners for years to control the healing arts has
tested. The fluoride that might have hardened our tooth
failed both by means of the legal coercion of medical
enamel against decay may also have weakened our
licensure statutes and by persuasion of the public of the
cortical bone. Focus on a decrease in dental caries will
miss the increase in hip fractures later in life.
conventional medicine does dominate the mainstream,the nearly half-billion annual visits to practitioners of
Medical training is as much an acculturation process by
other more or less outcast providers can't be thrust
which initiates are inculcated in "our" way of thinking
aside as insignificant or a quirk of the poor and ignorant.
Use of unconventional therapies is significantly more
argumentation over definitions, theories, logic, and
common among those with some college education than
philosophy that more often marks other higher
Journal of Biblical Ethics in Medicine – Volume 8, Number 1
education is less prominent in medical education, where
therapies has been greatest where patient participation
the engulfing of masses of pre-digested “facts” occupies
has been least. Great things are accomplished in
surgery, where a patient's responsibility is, basically, tosign an op permit and hold still for the anesthetic. Great
What makes unconventional therapies thrive?
things are accomplished in pharmacology where thepatient has but to take a pill, inhale a puff, or stick on a
1. The incurability of many ailments. Dr. Eisenberg and
patch. While many, too many, patients prefer that
his coworkers found that it was the chronic or recurrent
approach, there are others who wish to retain a sense
diseases which collected more devotees of alternative
of control. Unorthodox therapies, accurately or not,
medicine - back pain, allergies, arthritis, insomnia,
may offer this sense, which is one to be encouraged
headache, etc. The natural history of these kinds of
since God did place this responsibility first with the
problems is commonly one of exacerbations and
individual (1 Cor. 3:16,17; 7:12,19,20, 2 Cor. 7:1).
remissions. Human tendency toward post hoc ergopropter hoc "reasoning" will provide many "proofs" of
5. Simple (simplistic?) rationales.2 The rationales of
effectiveness that were only coincidental remissions,
orthodox medicine are exceedingly well-developed,
even for unconventional therapies of no intrinsic value.
beyond the ordinary practitioners ability or interest to
Jesus addressed the illogic of post hoc reasoning when
impart to many patients. Unconventional therapies may
He taught the error of imputing a specific sin as the
more often have rationales that are easier to grasp.
reason for the tragedy of a building collapse (Luke13:1-5). Some would have believed that since the dead
6. A conspiracy view of orthodox medicine. Insofar as
men were sinners, and the tower had fallen on them,
medical care has become a state-granted monopoly,
that the tower fell because of their particular sin. Not
this view is partly justified. The in-group plays footsie
with the political powers-that-be to keep others out. Some people respond to being put out by determining
2. Inordinate desire. Americans, in particular, don't take
to thrive and be happy on the outside. The more
"no" for an answer to their dilemmas. Sarai's desire for
licensed practitioners restrict the allowable practices of
children was inordinate, prompting her to offer Hagar to
others the further the unlicensed practitioners are driven
her husband (Gen. 16:1-5). Any therapy, orthodox or
from the orthodox center toward a periphery that
unorthodox, should be sought within a biblical set of
contains ever more bizarre practices. Massaging the
priorities. We are not free to go to any extent to be rid
of a physical ailment. Paul sought three times that his
organs or analyzing the fibers of the iris for diagnosis is
illness be removed (2 Cor. 12:7-10). He could have let
to a physician with standard training intractably
his life orbit whatever that thorn in the flesh was.
irrational. Even if we grant that some orthodox therapies
Instead, he boasted in his infirmities and determined to
may contain a grain of truth, even if we recall the
pigheaded blindness of past orthodox medicine, thesepractices and rationales just can't be swallowed, and
3. Unsatisfying experience with conventional therapies.
we don't want to be associated with them.
Orthodox practitioners should be intrigued by thequestion of why, if our therapies are superior, and theirs
Perhaps, occasionally, our scientific formulations do us
are inferior, people continue to pursue the latter.
a disservice by impounding our imaginations. The
What do they receive elsewhere that they do not
medical mainstream also does a disservice to the people
receive from us? Could it be, sometimes, that our
by seeking to "guard" them from exercising their God-
mechanistic approach omits healing of the spirit? Omits
given responsibility to attend to their own health. Even if
love? Even at our therapeutic best, where we
all of orthodox medicine's worst opinions about
understand mysteries, do we lack love? (1 Cor. 13:2)
quackery are valid, the health effects alone of removingthat authority from the public will in the long term be
4. Proper locus of control. The success of orthodox
worse. The unorthodox practitioners also have been
Journal of Biblical Ethics in Medicine – Volume 8, Number 1
harmed by the monopoly in that they have been denied
biological change as a treatment. Ergotamine, digoxin,
legitimate access to the marketplace. There is a way for
vincristine, and quinidine are examples. For intrinsic
us to avoid association with them without denying them
danger, what has quackery to compare with cutting
their desire to sell their services. Title licensure could
open the chest, stopping the heart and lungs, sewing in
accomplish that separation, the way that a trademark
artificial heart valves and vessels, followed by years of
does. Mainstream physicians can and do acquire
waffarin therapy? It would seem that this article should
legally-enforceable exclusive use of certain titles, such
have begun by defining its terms. Surely some listing of
as board-certified obstetrician, to give the public a
what is and what is not quackery is forthcoming! Is
means to distinguish one school of therapy from
chiropractic in our out? What about orthomolecular
psychiatry? Colonic irrigation? Chelation therapy?
Is it hypocritical for the mainstream to characterize
That no definition of "quackery" has yet been offered is
unorthodoxy as "quackery?" It is, to the extent that we
part of the point. The line that would circumscribe
by law make our treatments the only ones legally
quackery would vary according to at least a couple of
available to the public without proof of efficacy. There
factors: (1) The rigor of adherence to hard science in
are very many mainstream therapies which stand on
shaky ground. Studies of treatment outcome are not as
common as we believe, nor generally that impressive
(legitimately) use therapies whose mechanisms we don't
when they do exist. Quackery is often scored for
understand very well. (2) The rigor of adherence to
keeping people away from the really effective therapies.
well-conceived therapeutic outcome analyses. Again,
No doubt it does at times. So long as it is a choice of
much conventional medicine would fall outside the line.
the individual to do so, however, the only way to stop it
We prefer to judge insiders by our intentions and
is by using civil police power to prevent it. Such use of
outsiders by their results. When in conventional
the power of the state is not only illegitimate, it is also
medicine the mechanisms are unknown, we plead the
proving to be impossible according to the revelations of
empirical results. When the empirical results are against
Eisenberg, et al. The millions of units of self-governance
us, we plead the cogency of the mechanisms.
embodied in the hearts of individuals are often electingto shop in one of these unorthodox markets. Caesar is
The most honest definition of quackery is that it
not sufficiently omnipotent or omnipresent to prevent it.
approaches that are anathematized by a politically-
"Quackery" practices are also warned against by the
empowered in-group. As the in-group changes in its
mainstream as dangerous in themselves. That is an
views, now incorporating a previously denigrated
interesting charge. In particular cases it may be so.
practice, such as acupuncture, or expelling a previously
Overall, however, quack remedies more likely suffer
acceptable approach, such as frequent feeding and
from a lack of power to achieve anything at all
cream diets for peptic ulcers, the territory of quackery
biomedically, one way or the other. By any rationale it
changes inversely to orthodoxy. What quackery is,
strains credulity to see how sitting under a cardboard
ultimately, is traceable more to what the definer believes
tetrahedron, or wearing a quartz crystal around the
about epistemology. How quackery is to be treated is
neck, eating a garlic clove daily, or taking chemicals
ultimately traceable to what one believes about
diluted to the point that not one molecule of the original
economic and political freedom. In empirical medicine
chemical likely remains in the water, could be harmful in
we would like to hold that we believe what we see.
itself. It is rather the orthodox therapies that more often
Actually, in considerable measure, we see what we
contain biological power, but a power that can cut two
ways. Many of our orthodox medicines are dangerouslypoisonous in larger doses or in patients with certain
Christians, especially, should be circumspect in our
vulnerabilities such as renal insufficiency. Their beneficial
treatment of quackery, for we as a group are vulnerable
effects are secured by dosing low enough to use the
to exclusion on grounds that we hold human beings to
Journal of Biblical Ethics in Medicine – Volume 8, Number 1
be a body/spirit unity, materially affected by spiritual
Endnotes
events, and that the Bible is pertinent to medical care. Those positions are already formally anathematized by
1. Smith, R., Where is the Wisdom.?, British Medical Journal,
the larger culture of medical orthodoxy.
2. Gellert, George A., M.D., M.P.H., [letter] New England
Whenever Christians in recent centuries have advanced
Journal of Medicine, Oct. 14, 1993, pp. 1202-1203.
a belief in the potency and pertinency of biblical inputsto understanding, we have been subject to recital of a
particular piece of history to put us back into our place. In summary, a piece of revisionist history may be
The doctor sits before the august tribunal to which hehas been called. He is nervous. His license has beenchallenged; with it his livelihood is threatened includinghis ability to pay back his education loans. He has beencalled a quack in the news media. He has been chargedwith malpractice. His error is that he maintains that apatient's behavior follows a track around his corebeliefs and that the best way to help some patients is toexamine these issues at the center of gravity of theperson.
The tribunal represents, however, the overwhelminglydominant belief in the profession that reality is the otherway around. The behavior, they say, is the core and thebeliefs, if they exist at all, are an electron cloud orbitingthe behavior. Each one of those beliefs dutifully exhibitsthe Heisenberg uncertainty principle, being ultimatelyindefinable in precise location or precise velocity. Indeed, the doctor's case is injured by the fact thatadherents in his own camp have refused to examinebeliefs and behavior with any sort of precision, holdingmore safely within generalities and platitudes anddescribing specific biblical application to real life issuesas "legalism."
Pressure is applied. Dr. Galileo recants his scientificheresy. He will cease to deal with the patients' corebeliefs as controlling aspects of therapy. Reality is asthey say it must be After all, they are licensed
physicians. To be anything else in health is to be aquack. Heaven forbid!
Emergency Contraception: A National Survey of Adolescent Health Experts By Melanie A. Gold, Aviva Schein and Susan M. Coupey In a survey of 167 physicians with expertise in adolescent health, 84% said they prescribe con- traception to adolescents, but only 80% of these prescribe emergency contraception, general- ly a few times a year at most. Some 12% of respondents said they believe that
Sari Pediatri, Vol. 6, No. 3, Desember 2004Sari Pediatri, Vol. 6, No. 3, Desember 2004: 125-128Penggunaan Sildenafil pada Anak dengan HipertensiPulmonal Sri Endah Rahayuningsih, Nono Sumarna, Armijn Firman, Dani Kurnia Hipertensi pulmonal merupakan penyakit yang jarang akan tetapi mempunyai tingkat mortalitas yang tinggi. Peran vasodilator, menurut beberapa penelitian dapat meningkatkan surv