Criticism

Legitimacy

"CAM", meaning "complementary and alternative medicine", is not as well researched as conventional medicine which undergoes intense research before being released to the public. Funding for research is also sparse making it difficult to do further research for effectiveness of CAM. Most funding for CAM is funded by government agencies. Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable. The research for CAM has to meet certain standards from research ethics committees which most CAM researchers find almost impossible to meet. Because the results of CAM are not quantifiable, it is hard to prove its effectiveness and it appears to work in a more holistic sense. CAM is thought to help the patient in a mental or psychological sense since the research for CAM is hit and miss. Even with the little research done on it, CAM has not been proven to be effective. This creates an issue of whether the patient is receiving all the information about the treatment that is necessary for the patient to be well informed.

Steven Novella, a neurologist at Yale School of Medicine, wrote that government funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate." Marcia Angell argued that it was "a new name for snake oil." Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with. It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. A prominent supporter of this position is George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA).

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)

In March 2009 a staff writer for the Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.

Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The demon–haunted world: science as a candle in the dark have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

The NCCIH budget has been criticized because, despite the duration and intensity of studies to measure the efficacy of alternative medicine, there had been no effective CAM treatments supported by scientific evidence as of 2002, according to the QuackWatch website; the NCCIH budget has been on a sharp and sustained rise. Critics of the Center argue that the plausibility of interventions such as botanical remedies, diet, relaxation therapies and yoga should not be used to support research on implausible interventions based on superstition and belief in the supernatural, and that the plausible methods can be studied just as well in other parts of NIH, where they should be made to compete on an equal footing with other research projects.

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment. Barrett has pointed out that there is a policy at the NIH of never saying something doesn't work only that a different version or dose might give different results. Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.

A 2002 report on public attitudes and understanding issued by the US National Science Foundation defined the term "alternative medicine" as treatments that had not been proven effective using scientific methods, and described them as giving more weight to ancient traditions and anecdotes over biological science and clinical trials.

English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests." Another essay in the same book quoted an article by John Diamond in The Independent: "There is really no such thing as alternative medicine, just medicine that works and medicine that doesn't. Dawkins argued that if a technique is demonstrated effective in properly performed trials it ceases to be alternative and simply becomes medicine.

Terminology

Use of the terms "Complementary and alternative medicine (CAM)" and "alternative medicine" have been criticized.

Criticisms have come from individuals such as Wallace Sampson in an article in Annals of the New York Academy of Sciences, June 1995. Sampson argued that proponents of alternative medicine often used terminology which was loose or ambiguous to create the appearance that a choice between "alternative" effective treatments existed when it did not, or that there was effectiveness or scientific validity when it did not exist, or to suggest that a dichotomy existed when it did not, or to suggest that consistency with science existed when it might not; that the term "alternative" was to suggest that a patient had a choice between effective treatments when there was not; that use of the word "conventional" or "mainstream" was to suggest that the difference between alternative medicine and science-based medicine was the prevalence of use, rather than lack of a scientific basis of alternative medicine as compared to "conventional" or "mainstream" science-based medicine; that use of the term "complementary" or "integrative" was to suggest that purported supernatural energies of alternative medicine could complement or be integrated into science-based medicine. "Integrative medicine" or "integrated medicine" is used to refer to the belief that medicine based on science would be improved by "integration" with alternative medical treatments practices that are not, and is substantially similar in use to the term "complementary and alternative medicine". Sampson has also written that CAM is the "propagation of the absurd", and argues that alternative and complementary have been substituted for quackery, dubious, and implausible.

Stephen Barrett, founder and operator of Quackwatch, has argued that practices labeled "alternative" should be reclassified as either genuine, experimental, or questionable. Here he defines genuine as being methods that have sound evidence for safety and effectiveness, experimental as being unproven but with a plausible rationale for effectiveness, and questionable as groundless without a scientifically plausible rationale.

In October 2008, the NIH National Center for Complementary and Alternative Medicine (NCCAM) published their perspectives on the terms "Complementary", "Alternative" and "Integrative" medicine. On December 14, 2014 it was announced that the NCCAM, via support of the United States Congress and signed by President Barack Obama, would be changing its name to the National Center for Complementary and Integrative Health (NCCIH) in order to acknowledge the shift in terminology away from "alternative medicine" and to recognize the cultural and scientific support for complementary and integrative approaches to healthcare.

Ethics

CAM is not as well regulated as conventional medicine. There are ethical concerns about whether people who perform CAM have the proper knowledge to perform the treatments they give to patients. CAM is often done by non-physicians and does not operate with the same medical licensing laws as conventional medicine. It is an issue of non-maleficence.

According to two writers, Wallace Sampson and K. Butler, marketing is part of the medical training required in chiropractic education, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.

In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this." Ernst requested that Prince Charles recall two guides to alternative medicine published by the Foundation for Integrated Health, on the grounds that "They both contain numerous misleading and inaccurate claims concerning the supposed benefits of alternative medicine" and that "[t]he nation cannot be served by promoting ineffective and sometimes dangerous alternative treatments." In general, he believes that CAM can and should be subjected to scientific testing.

In 2016, a paper published in Bioethics concluded that "there are significant ethical problems, from the perspective of the ethics of commerce, with the production, advertising and selling of complementary and alternative medicines.... Market interactions, in order to be considered ethical, need to involve products that actually work, that are advertised honestly, and that do not have undue effects on innocent third parties. Many examples of CAM fail on one or even all of those counts."