Previously we have discussed in detail the role of various health disciplines of disease management and their permissibility in Islam in a general sense. We said:
The various different disciplines of disease management in a Islamic legislative perspective are from the worldly means (al-wasaailul-kawniyyah) to achieve, with Allah’s permission, treatment of ill-health despite these disciplines having differences of opinion with one another. This difference of opinion is permitted and one could argue inevitable as their methods of approach are different. From the conditions of the worldly means (al-wasaailul-kawniyyah) is that they are required to be beneficial through observation or experience.
By the term ‘disciplines of disease management’ we gave examples
These disciplines of disease management include the likes of herbalism, traditional/folk medicine, homoeopathy, aromatherapy, Chinese medicine, physiotherapy, modern medicine etc. All of these disciplines of disease management are complementary to one another and likewise complementary to the Prophetic medicine providing they are able to demonstrate benefit
Complementary or Alternative Medicines – CAMs
With the emergence of evidence based modern medicine over the past 45 years (or so) with such a great predominance whereby it has been taken up by nearly every single hospital around the world and being advocated by every Islamic government health ministry. Hence the rest of these minority disciplines have been clumped together into the term ‘complementary or alternative medicine’ (CAM) and this is despite them being established and evolving many years and decades before modern medicine. These complementary or alternative medicines (CAMs) have some form of acceptable medical evidence source upon which they are based even though they, in general, are a relatively weaker form of medical evidence. The treatments from within CAMs which possessed a relatively stronger evidence had their active ingredients isolated and then adopted into modern medicine such as the example of aspirin coming from willow.
There are a few complementary or alternative medicines (CAMs) that modern medicine still strongly rely upon due to they beneficial effects with in their own field. The best example for this is physiotherapy which has a relatively strong evidence base and you will find many modern medicine practitioners referring to such specialists frequently for illness that involve muscles, tendons, ligaments and bones. Physiotherapists are likewise present in nearly all hospitals around the world alongside modern medicine doctors.
There appears to be some confusion about the roles of two professions which we will pause to clarify here. The first are ‘clinical biochemists’ who deal specifically with undertaking tests within the biochemistry laboratory and do not usually have direct contact with patients and therefore do not directly treat patients; although this is the normal UK practice there may be some rare exceptions with a handful of professors. Clinical biochemists generally do not interpret the test results, they just carry out the test upon the fluid sample and then forward that result to the requesting clinician. The second profession are osteopaths who are regarded as a CAM with competency within muscular manipulation in low back pain and have then evolved further from this practice. We will discuss this second group later.
We have previously discussed quackery at length however based upon comments we have received it is clear that many have not been able to distinguish the difference between quackery and CAM. The distinction is that complementary or alternative medicine (CAM) has a form of validated evidence to attain their goal or are likely to do so (i.e. statistically significant effect) that is recognised by well-known health specialists who have the skills to evaluate medical evidences. Evidence that is either observed via some form of test or clinical trial or experienced by trustworthy health practitioners in their usage. If the trustworthiness of the health practitioner can not be ascertained then the observed or experienced effects particularly the latter needs to be reproducible by others.
Quackery will often try to pass itself off as a complementary or alternative medicine (CAM) because the so-called medical evidence they provide is designed to bamboozle the common person but in reality this so-called evidence they provide is either completely misinterpreted, not establishing that which they intend to claim, or it is outright fabricated thus unable to be reproduced by anyone else. An example of outright quackery or pseudo-science is hypnotherapy which claims to be a complementary or alternative medicine (CAM) to treat illness like irritable bowel syndrome and addictions like cigarette smoking however the evidence they provide do not substantiate their claim and this is from the reasons as to why Shaikh Nasir al-Albani rahimullah stated
Hypnotherapy and Seances are modern-day Quackery. The Muslim only relies upon simple means which are in the scope of knowledge and experience.
Thus the origin of such claimed pseudo-sciences is questionable and not accepted as a complementary or alternative medicine (CAM) despite them claiming to be a CAM. Only up until they bring the aforementioned level of proof then they can be accepted as a CAM.
Likewise there are several pseudo-sciences who in their origin have been unable to provide the acceptable evidence with common examples being (to add words before “medicine” itself, like) ‘integrated’ medicine, ‘functional’ medicine, ‘orthomolecular’ medicine, etc. These all fall into quackery in their origin due to their inability to produce the required medical evidence for their basis. Their so-called evidences are complicated academic issues that are designed to trick the common everyday people which only those with skills within medical evidence evaluation (and to a lesser extent their students of health and those that tread that path of evidence based medicine) are able to identify the flaws present.
Another outright fraudulent behaviour is for people to name themselves with the titles like ‘nutritional expert’ or ‘nutritionist’ which unfortunately are generally not protected in law by governments. Titles like that of ‘doctor’ or ‘dietician’ are protected under UK governmental laws to help prevent fraud. So one needs to be on-guard of these tactics by such charlatans.
Hence to protect everyday common people it is from the Islamic methodology to return health issues to those most knowledgable in that particular field in accordance with the revelation, as discussed in detail elsewhere. Attempting to decipher their fraudulent evidence is only done by those that are skilled in medical evidence evaluation and not for the everyday person, as discussed in detail elsewhere.
Competency within various fields needs to be established
We have also discussed that each of the practitioners of these various health disciplines (including complementary or alternative medicine) needs to be competent with the appropriate knowledge & skills within that field having directly learned the skills of that health discipline from a teacher & practitioner from within that health discipline having their approval to practice independently and thereby becoming known as a medical practitioner citing as evidence the statement of the Messenger of Allah sallallaahu‘alaihiwasallam :
من تطبّب ولم يعلم منه طب قبل ذلك فهو ضامن
“If anyone carries out medical treatment, yet previously he was not known as a medical man, then he takes the responsibility.”
Likewise we gave the explanation of this narration from the religious scholar and doctor Ibnul Qayyim rahimullah (return to the section for the details). This issue of competency is important as nowadays we witness many claimants to a field of knowledge yet their skills are in a completely different field.
Quackery can be present in the origin or fundamentals of a pseudo-science, yet other times quackery can be a deviation or side-hobby of an established health practitioner and thus we can find that some modern medical doctors offer the likes of hypnotherapy as a treatment. The label of quackery is based upon the evidence or the lack there of. Not all health practitioners, nor all doctors are able to assess medical evidence, and many doctors may initiate or propagate quackery however this does not give an automatic license for it to be advocated just because their a doctor. Rather one returns to the experts in the field of medical evidence evaluation and those that traverse they path. A recent example of this is that of a gastroentrologist advocating ‘alkaline water’ and selling machines to alkalinise the pH of tap water at a considerable premium. This side-hobby or deviation of a health practitioner from their original established health field is very common place amongst many quacks particularly osteopaths who practice osteopathic manipulation therapy which is a complementary or alternative medicine (CAM) with some evidence for treatment of low back pain. However they claim they can manipulate a ‘persons muscle energy with their hands’ and make unsubstantiated claims that they can thereby treat Parkinsons disease, asthma and other illnesses without providing adequate evidence. These are genuine health practitioners that practice a discipline of disease management in some illnesses and then using that influential role to sell quackery in other illnesses. The quackery will give more financial gain so they will increase in it.
Likewise health practitioners can falsely claim knowledge of an entire field of treatment, such as a person who is a biochemist or an osteopath (DO) yet claim knowledge in fields of nutrition while they have never sat with, nor learnt the knowledge & skills of nutrition from a Nutritional Doctor or even a Dietician; thus never having their approval within this new field to propagate or practice. Whenever one looks into a complementary or alternative medicine (CAM) then we needs to see if those who are advocating such treatments are really from those who have learnt from experts having sat with them and achieved their approval to practice within that particular field prior to propagating it or treating patients with it.
Thus in summary, complementary or alternative medicine (CAM) itself is permissible in Islam as already stated but one needs to ensure that it is indeed a CAM. Likewise, the one advocating the CAM is from its true practitioners and recognised by his peers within that CAM. Further, that such practitioners treat within their own fields of expertise alone.
Imported quackery amongst the muslims
The more recent level of quackery amongst the muslims has not been seen previously in that known muslim ‘community religious teachers’ used Islamic sources and scholarly texts to support specific health issues of quackery. More importantly, those specific health issues were not taken from any of the religious scholars, rather they took those specific issues from well-known non-muslim quacks, in particular those in the field of osteopathic manipulative medicine, a complementary medicine in muscular back pain. This known osteopath digressed out from his own speciality into nutritional medicine, oncology and many other fields without any formal learning or recognition from the experts from within those other fields. Furthermore, his bringing unacceptable sham evidences for his newly invented treatments fell into quackery. So even though he was competent as an osteopath, he was not competent nor recognised for nutritional medicine, oncology, metabolic illnesses etc.
Unfortunately these ‘community religious teachers’ took from the writings of such quacks yet they did not sit and learn from these quacks directly, neither in the field of osteopathic manipulation medicine or other than it, hence they were ‘self-taught health students’. Without a true teaching of skills they can not be regarded as ‘students of health’. Covering confusion with more confusion as they were advising treatments to individualised cases and as well as on a broad general level. We have previously mentioned the companions (sahaabah) warning of such behaviour.
As a direct result, issues emerged among the muslim community such as the maligning of pasteurised milk with medical illnesses based upon extremely weak unacceptable medical evidences and then they went further to remove pasteurised milk from the general religious texts (ahadeeth) about the curative properties of milk. More importantly as it now became an issue of prophetic narration it was done without any precedence from any of the religious scholars as discussed in detail elsewhere. Likewise they used the words of religious scholars that died centuries ago trying to give the impression to everyday people that those scholars were in full support of these individual health issues, despite them issues not being even in existence (i.e. completely unknown) during the lifespan of those scholars, thereby falsely trying to give it an element of religious authority. This religious authority was done on the basis of their own extrapolation of principles without returning back to any of the religious scholars of recent times.
This is the heart of the issue that they started to use religious texts to advocate their claims of specific health issues of quackery to everyday people based upon extremely weak unacceptable medical evidence that no true expert accepted. Furthermore these were being taught and practiced without competency.
By doing so they gave themselves a level of religious authority that did not really exist, as the issues of contention were not issues of Prophetic medicine. No doubt Prophetic medicine is more excellent than any health discipline as it is based upon revelation. However most of what was propagated had no connection to Prophetic medicine. Furthermore, none of the specific health issues originated from any of the muslim scholars that they quoted rather these issues originated from non-muslim quacks.
War on Modern Medicine and upon Muslim Doctors
A common sign that helps to distinguish Quackery from complementary or alternative medicines (CAMs) is that quackery often try to establish itself by attacking modern medicine and it practitioners accusing them of bribery or greed for money where in reality that is the very motivation that drives quackery itself. Extending from this initial incursion and onslaught on modern medicine is to attack medical treatments themselves accusing them of being harmful than beneficial or even poisonous. This style of war was not taken from the Prophetic medicine or methodology, nor from the religious scholars who in general speak highly of modern medicine and its treatments being well-researched. Rather the scholars often use the example of the modern doctor and his training to give a similitude of training required for a religious scholar and not for anyone to just issue a religious verdict. This itself is a sufficient virtue for the muslim doctor and their medical practice. Unfortunately the aforementioned community teachers gave the reverse picture of this where they implied on social media that one of the major scholars of recent times accused doctors of impermissible bribery as discussed in detail elsewhere (without giving the details when asked).
This style of attack is not a new one rather it is the same style used against the religious scholars too, with them being accused of bribery with slogans of “Scholars for dollars” and the like. This being followed up by further attacks against their lessons and verdicts claiming they only discuss menstrual and post-natal issues. The exact same style of war being applied to modern medicine atacking the doctors honour and then their treatments. This war and its style did not emanate from the religious scholars but rather from their enemies.
Time and time again, the religious scholars have warned against attacking the modern medical profession yet over the years the attacks on modern medicine have increased.
So we advise such individuals to fear Allah, aza wa jal, and cease this war on muslim doctors. Likewise we advise not to abandon muslim doctors by giving them the cold shoulder purely because such doctors have advised about this health tribulation that struck the muslim community and advised everyday muslims to not return health issues back to those ‘community religious teachers’ that were speaking in issues of health, nutrition and medicine yet they were speaking outside of their knowledge but did not recognise it, as discussed in detail elsewhere.
Failing to give up this animosity against modern muslim doctors can become an issue of sectarianism (hizbiyyah) from a religious perspective. So we advise those that initiated this war from the muslims upon modern medicine and muslim doctors to cease and remove their attacking statements and replace those very statements with appropriate statements of virtues of muslim doctors, thereby rebuilding the appropriate muslim brotherhood particularly more so if they advocate themselves as community ‘elders’ and teachers.
With Allah is all success.