MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

My memoir ‘A SCIENTIST IN WONDERLAND’  has already brought many surprises (and about 20 most flattering reviews). A few days ago, the German version was published entitled ‘NAZIS, NADELN UND INTRIGEN’ (people who have not read it might find this title puzzling). The German publisher reported that the first print-run was sold out in the first 4 days.

In order to tempt you to read my memoir, I publish here the final section of the book which affirms that the link between my rather diverse experiences boils down to ethics.

…the most important link between my research into alternative medicine and that related to the Third Reich was that of medical ethics.

It should be axiomatic that ethics is indispensable to the practice of medicine, and is not something that can just be switched off at will. No branch of health care, including alter-native medicine, can be considered exempt from it. But the subject of ethics is seldom even considered in alternative medicine; many alternative practitioners have never been taught medical ethics, and where training in this area does exist, it tends to be at best superficial. There are thousands of books on alternative medicine but hardly more than a handful cover the subject of medical ethics in any depth. It is perhaps not surprising, therefore, that the principles of medical ethics are routinely ignored and frequently violated by promoters of alternative medicine.

Medical ethics seem to me to be violated, for example: when homeopaths prescribe or recommend homeopathic vaccinations for which there is not a shred of evidence; when chiropractors or other alternative practitioners happily promote bogus treatments for children with asthma or other serious conditions; when practitioners fail to obtain informed consent before commencing their treatments; when Prince Charles sells his “detox tincture” which is unable to eliminate poisons from your body, merely cash from your purse; when quacks inveigle desperate cancer patients by pretending they have found a cure; when pharmacists sell Bach Flower Remedies or other glorified placebos; when applied kinesiologists, iridologists, etc. claim that their baseless diagnostic tests are able to identify serious diseases; when pseudoscientists claim that certain alternative therapies are evidence-based because they managed to generate a false positive result purely by cherry-picking or massaging their data; when politicians who lack even the most basic understanding of science publicly support quackery, proclaiming that it is evidence-based.

And so on, and so on.

Some might criticize me here for claiming the moral high ground. But if I do so, it is for a good reason. Medical consultations are intrinsically unequal, with the clinician occupying a position of considerable power over often highly vulnerable patients. This places an important ethical onus on the caregiver to assist patients in making informed choices—an imperative and a trust that is breached each and every time that unproven nostrums born of ideology and wishful thinking are offered to people with assertions that they are an effective, valid approach to the treatment of disease.

When science is abused, hijacked or distorted in order to serve political or ideological belief systems, ethical standards will inevitably slip. The resulting pseudoscience is a deceit perpetrated on the weak and the vulnerable. We owe it to ourselves, and to those who come after us, to stand up for the truth, no matter how much trouble this might bring.

Today, I look back at the often stormy past from the peaceful vantage point of my retirement with a mixture of satisfaction and incredulity. The doctor and scientist may still be full of questions, but the musician in me breathes a sigh of relief that the performance, with all its impossible demands and fiendishly difficult passages, is finally over.

6 Responses to Wonderland (7): pseudoscience is a deceit perpetrated on the weak and the vulnerable

  • All of us, practitioners, commentators, patients must now heed these wise words.
    CAMs are quite simply unethical because they take advantage of the vulnerable and gullible, and the ignorant. And with significant opportunity costs for patients and for those expected to fund CAM therapies, whether from the public purse or through insurance.
    They are unethical by the practices described:
    ‘When homeopaths prescribe or recommend homeopathic vaccinations for which there is not a shred of evidence; when chiropractors or other alternative practitioners happily promote bogus treatments for children with asthma or other serious conditions; when practitioners fail to obtain informed consent before commencing their treatments; when Prince Charles sells his “detox tincture” which is unable to eliminate poisons from your body, merely cash from your purse; when quacks inveigle desperate cancer patients by pretending they have found a cure; when pharmacists sell Bach Flower Remedies or other glorified placebos; when applied kinesiologists, iridologists, etc. claim that their baseless diagnostic tests are able to identify serious diseases; when pseudoscientists claim that certain alternative therapies are evidence-based because they managed to generate a false positive result purely by cherry-picking or massaging their data; when politicians who lack even the most basic understanding of science publicly support quackery, proclaiming that it is evidence-based. etc.’
    This mantra must be repeated on each and every possible occasion by each and every one of us.
    We all know mantras are good for you!

  • Politicians pontificate about crooks who scam the weak and vulnerable; all kinds of regulators are set up to stop it happening. Occasionally one particularly nasty case will make headlines and something will be done, but the problem with CAM is that it is not one single nasty case but many smaller ones – every time someone is conned into using ‘natural remedies’ by a sales assistant in a ‘health food’ shop, every person who doesn’t realise their taxes are supporting homeopathic hospitals, every woman (it usually is women) who thinks a visit to a chiropractor will be more useful than a visit to a GP because she has to shell out money for it …

    Keep up the good work, Prof! We need you!

  • The German publisher reported that the first print-run was sold out in the first 4 days.

    Congratulations! I think that is fantastic. To the best of my knowledge, not a single one of my books ever made it to a second printing.
     
    I finished reading the book a few days ago, and I was riveted. It does present me with a major challenge though. I have to figure out how to review it, because it reminds me of my inability to reply when I was asked about “the most important part” of a computer. All I could do was propose that there is no such thing, because a computer stops being a computer when any part is removed.
     
    Same with “A Scientist in Wonderland”. I think Edzard Ernst stops being Edzard Ernst if a part of the book is removed. I have never been much of a novel reader, as I prefer to spend whatever little time I have on reading about reality rather than fiction, and if anything, “A Scientist in Wonderland” elegantly demonstrates that reality is far more interesting and captivating than fiction will ever be. As a life’s story, there simply aren’t any “most important” parts, they all are.
     
    That said, I am particularly fond of the part about the trial of “spiritual healing”.
     
    Even though I run a paperless office and library, I have some serious apprehensions regarding buying e-books (as opposed to buying the paper versions and scanning them), but I set them aside for this book, and I am happy I did.

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