Probing Edges Of Medicine -- And Reality
Tuesday, July 12, 2005
Ask Wayne B. Jonas why the scientific foundation he directs is funding research into the effects of prayer, the use of homeopathy to fight bioterrorism and whether magnetic devices can heal orthopedic injuries, and he offers a straightforward answer: Science is the way to determine whether they work.
"We're trying to stimulate good-quality research," said Jonas, a former chief of the Office of Alternative Medicine at the National Institutes of Health (NIH) who directs the nonprofit Samueli Institute for Information Biology (SIIB) in Alexandria. "There is a good case for looking at these things scientifically, because we don't know a lot about them."
But, the 51-year-old board-certified family physician and retired Army doctor adds, "it's difficult to walk the scientific fence" -- dodging criticism from "the hard-core skeptics" who dismiss alternative medicine as quackery and the "hard-core advocates" who accept it uncritically.
Jonas has headed the institute -- named for its principal benefactor, California philanthropist Susan Samueli -- since its inception in 2001. What began as a two-person foundation has grown into a research organization with four offices and a staff of 15. It has an annual budget of about $4 million provided by the Samueli family, and an additional $5 million in contracts from the Department of Defense (DOD) to study alternative treatments. Currently the institute is funding about 50 projects, awarding grants ranging from $20,000 to $250,000 to researchers in the United States, Europe and Asia. Some grants have been awarded to institute staff members.
Among the DOD-related projects, which are a collaboration with the Uniformed Services University of the Health Sciences, the military medical school in Bethesda where Jonas is a clinical professor, are several to determine whether the use of extremely diluted poisons, including cyanide and botulinum toxin, might protect soliders from higher doses to which they could be exposed in biological warfare.
"The work in this area is in its earliest stages but has some promising characteristics," said Iris R. Bell, director of research for the integrative medicine program at the University of Arizona College of Medicine. "The Samueli staff are open-minded scientists, they are not taking anything as dogma. They are asking the bigger questions, such as what are the assumptions of science? I would expect the work they do and the work they fund is going to be controversial."
Critics of the institute say that while they support rigorous research into alternative medical treatments, Samueli is not doing it.
"There is nothing of scientific value they're doing that I'm aware of," said Wallace Sampson, editor of the Scientific Review of Alternative Medicine and clinical professor emeritus of medicine at Stanford. "They're all ideologues trying to prove something that doesn't exist."
Homeopathy, prayer and other forms of "energy medicine" belong to a category the NIH's National Center for Complementary and Alternative Medicine, the name for the office Jonas once directed, calls "among the most controversial of CAM practices."
Homeopathy, a treatment invented in the late 1700s, is predicated on the belief that "like cures like" and that illnesses can be treated by stimulating a healing response through the ingestion of highly diluted substances such as herbs, heavy metals or poison ivy, which would cause harm at larger doses. In most cases no single molecule of the substance remains.
Homeopathy has not been conclusively proven to be effective for any clinical condition, according to NCCAM, and its "key concepts do not follow the laws of science."
Sampson and other critics of Samueli's work also question its use of terminology not found in science, such as "information biology," which Jonas defines as "the interaction of information with biological systems"; and "salutogenesis," which he says is the process of healing and the opposite of pathogenesis, the process of disease.