Selection Pressure on Altie Medicine

Evidence-based medicine, alternative medicine and weaponry change through time because of selection pressure. This means that they evolve and produce a fossil record of discontinued methods and therapies.

Any method or therapy introduced into alternative medicine will face selection pressure from two directions. If a method hurts patients to a visible extent, it will be recognised as weaponry and thrown out of altie medicine. Government regulations will forbid it and the more savvy altie practicioners will soon learn that it leads to nasty law suits.

If on the other hand a method introduced into alternative medicine turns out to be significantly beneficial to patients, it will soon be co-opted by evidence-based medicine and thus leave the altie realm.

So, there is evolutionary pressure on alternative therapies to achieve near-zero effect. This is why homeopathy is still around: its main method being the administration to patients of small amounts of clean water, it’s uniquely suited to surviving indefinitely in the alternative-therapy biotope. Homeopathic remedies can neither harm nor benefit patients.

Update 13 November: There’s a third kind of pressure on altie medicine to do nothing. Many evidence-based functional therapies incorporate drugs and procedures that can be dangerous if used in the wrong way. In order to be effective, a method must be pretty potent, and all power can be misused. Thus, an altie practitioner can never recommend a potent beneficial method due to the risk of patients ODing and dying.

Respectful Insolence and Neurologica liked the idea, picked it up and ran with it.

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Comments

  1. #1 ArchAsa
    November 12, 2007

    Excellent proof of Darwinian processes. Except homeopathetic (yes!) medicines can be harmful if idiots try to cure serious diseases with watered out molecules. I once travelled in northern India with a girl (an aquantance made during the journey), when we got quite seriously stricken with diarrhea (after checking into an expensive nice hotel at her request…). I managed to drag myself off to a doctor who prescribed antibiotics, but did not want to give me medicines for my companion without examining her first, since he was a proper professional and such drugs can be dangerous if you have additional problems.

    She however, opted for her homeopathic medicines. In a couple of days I was back on wobbly legs . She had worsened and finally admitted to be dragged to the doctor. Her condition had deteriorated enough for dysentry by that time, and mere antibiotics could not cure it. She was sent off on a plane to Thailand to finish up her vacation at a hospital.

    Good riddance.

    I am very firmly against pumping farm animals full of antibiotics and drugs – it is insane from a scientific stand point not the least. However, nature romantics that try to cure their poor suffering animals ailments with that humbug should be slapped across the face. I shudder to think they might use it on their children also.

    So in sum, homeopathic “medicines” have not done enough damage to warrant a ban – but in the wrong hands even the harmless becomes harmful…

  2. #2 Martin R
    November 12, 2007

    Yeah, a huge problem with altie meds is that they keep people from getting real care. And sometimes it puts others at risk, like when antivaxers put at risk a) their children, b) everyone around because they may cause an epidemic.

  3. #3 Jonathan Jarrett
    November 12, 2007

    Although I see the larger point, I don’t think this works very well in Darwinian terms. You have to assume that the alternative therapy is a mature organism trying to replicate itself. But if the alternative therapy is only a larval stage, and its goal is actually to grow up into accepted medicine, then the ones that remain alternative are the failures of the litter, and evolutionary success is growth into a more successful form. And surely evolution is all about self-propagation. An evolutionary pressure to reproduce minimally doesn’t make a lot of sense to me…

  4. #4 Martin R
    November 12, 2007

    Yeah, you could use the metaphor in that way too. But my idea is that alternative medicine is an economic niche where practicioners can survive if they have the right survival traits. Homeopathy is a highly adaptive trait for that niche.

  5. #5 angry doc
    November 12, 2007

    Just think of them as “living fossils”. :)

  6. #6 Tristram Brelstaff
    November 13, 2007

    If on the other hand a method introduced into alternative medicine turns out to be significantly beneficial to patients, it will soon be co-opted by evidence-based medicine and thus leave the altie realm.

    Not only that, in the UK at least, it becomes subject to pharmaceutically-active product regulations. This is a strong incentive for the manufactures of alternative medicines NOT to test their products. See here and here.

  7. #7 Calli Arcale
    October 19, 2010

    An evolutionary pressure to reproduce minimally doesn’t make a lot of sense to me…

    It happens, though, even in nature. Minimal reproduction crops up frequently enough that it must be a viable strategy under certain circumstances, even if it does make the species more vulnerable to extinction.

    Animals with low reproductive rates include:
    * Emperor penguins (one chick per year)
    * African Elephants (one calf every four to nine years, starting at around age 13 or so)
    * Kiwis (one ginormous egg per year)
    * Kakopos (flightless parrots, up to three eggs per breeding cycle, but only breeds once every four or five years, when certain trees go into a mast cycle, and the eggs are highly vulnerable to ground predators — lowest reproductive rate of any bird — critically endangered)
    * Blue Whale (one calf every one to two years, starting around age 10 or so)
    * Rhinoceros (one calf every two to three years, starting around at 5 or so)
    * Giant Panda (one or two cubs every two years; in the wild, only one survives as the mother has a low milk supply)

    Or heck, consider humans. Human females usually reach reproductive maturity around age 15, and cease reproducing around 45. That’s thirty years. Twins are rare; most of the time, it would be a typical rate of one baby every year (and a more realistic rate of one baby every two years), which would only get fifteen offspring over the entire life of the female. Even in cultures which avoid birth control, that doesn’t happen very often, in large part because humans have a higher stillbirth rate than most people are prepared to accept. Also, outside of hospitals, human mothers have a high mortality rate themselves, further reducing the effective reproduction rate. Why, then, are we so numerous? Simple: we’ve done away with our main predators, and found ways to exploit a wide variety of environments.

    Minimal reproduction is not always a handicap. Indeed, it can be necessary to avoid over exploitation of an environment. Kakapos have evolved to only breed when there is sufficient food, for instance. Kakapos which bred too frequently would have experienced more territorial conflicts, and this would threaten both reproductive success and basic survival.