herbal straw men

Let's take a closer look at the quackwatch article about herbs. It is titled "the herbal minefield", so we should expect it to be quite explosive. The author Stephen Barrett begins,

"Herbs are also marketed by naturopaths, acupuncturists, iridologists, chiropractors, and unlicensed herbalists, many of whom prescribe them for the entire gamut of health problems. Many such practitioners are not qualified to make appropriate medical diagnoses or to determine how the products they prescribe compare to proven drugs."

What he fails to say is that many, perhaps most, of those who make a career out of herbalism, are indeed qualified. Some may have undergone formal training at a federally accredited institution (such as ND, DC, LAc). If they are practicing herbalism legally in their state, then they have met certain standards including licensing examinations. In additon, common law gives all citizens the right to practice herbalism as long as certain precedents are adhered. These precedents have now been enshrined as Health Freedom acts in various states including California. Health freedom acts recognize the long history of safe practice of herbalism by assorted non medically trained practitioners. This would include native americans, chinatown herbalists and hispanic curanderos. Which is not to say that herbs are inherently safe, but rather there are ancient traditions that allow herbs to be used safely despite their risks. Such herbalists may not always have gone to a formal medical school, but are still able to be both safe and effective. The human mind has developed many strategies with which to cope with the natural world. We should be careful not to hastily dismiss the ideas of great civilizations despite their peculiar nature. China has perhaps not survived thousands of years by chance.

Health freedom acts require certain disclosures on the part of the herbalist and take a buyer beware philosophy as well. In other words, if the law if followed, the patient is acting with informed consent. Finally, lay herbalists are acutely aware of their precarious legal footing and often go to great lengths to insure that their patients seek conventional medical attnetion for all lingering or emergent complaints. If this were not true, there would have been a rash of adverse incidents in the past 2 decades. Instead, there are no incidents of incompetence or negligence related to the professional practice of herbalism (ND, DC, LAc) as far as we know. All the major media incidents involved self-medication, typically with stimulants like ephedra used for weight loss (a nontraditional use).

If its not obvious to everyone, the mandatory regulation of substances by the government is paternalism of the highest order. Citizens should have free access to information and substances and practitioners. At the same time, the government should encourage and oversee a voluntary framework that addresses licensing, certification, standardization, etc. The public should be made aware through televison advertising that while there are no restrictions on procuring any herbal products for any use nor upon contracting the services of any person for health advice, there is no inherent government protection for such actions either. The use of standardized products and licensed healthcare professionals ultimately makes it the government's responsibility if something goes wrong. I believe a large percentage of the population prefers this type of protection against loss as compared to the risk that comes from unguaranteed personal contracts. Thus there would always be a certain demand for a market that catered to this need. And doesn't a true libertarian government need to give those who want to have government oversight in certain areas that option (most of us would choose some degree of environmental, worker and food safety laws if history is to be any lesson to us).

But I see no reason why a parallel unregulated herb and herbalism market cannot exist side by side this regulated one. As long as consumers had a regulated option, how does the presence of a legal unregulated market affect those who choose risk. I think that is the crux. Certain elements of American society would prefer that one not even be able to choose certain risks (sure, you can eat donuts and bungie jump all you want, but god forbid you should use an herb to treat a headache much less treat your head). Arguably, though, there are times when an educated risk is necessary for a quantum leap forward. Republicans say they want small government. Well, let's start here. So while Mr. Barrett's intention is no doubt to protect us, I think we can each protect ourselves from the big bad herbalist on the corner. On the other hand, we all need protection from the big bad corporation on the internet that preys on us with endless misinformation designed solely to sell. I started this blog in part to help cut through all that. Stay tuned.