MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

It has been announced that Susan and Henry Samueli have given US$ 200 million to medical research at the University of California, Irvine (UCI). Surely this is a generous and most laudable gift! How could anyone doubt it?

As with any gift, one ought to ask what precisely it is for. If someone made a donation to research aimed at showing that climate change is a hoax, that white supremacy is justified, or that Brexit is going to give Brits their country back, I doubt that it would be a commendable thing. My point is that research must always be aimed at finding the truth and discovering facts. Research that is guided by creed, belief or misinformation is bound to be counter-productive, and a donation to such activities is likely to be detrimental.

Back to the Samuelis! The story goes that Susan once had a cold, took a homeopathic remedy, and subsequently the cold went away. Ever since, the two Samuelis have been supporters not just of homeopathy but all sorts of other alternative therapies. I have previously called this strikingly common phenomenon an ‘epiphany‘. And the Samuelis’ latest gift is clearly aimed at promoting alternative medicine in the US. We only need to look at what their other major donation in this area has achieved, and we can guess what is now going to happen at UCI. David Gorski has eloquently written about the UCI donation, and I will therefore not repeat the whole, sad story.

Instead I want to briefly comment on what, in my view, should happen, if a wealthy benefactor donates a large sum of money to medical research. How can one maximise the effects of such a donation? Which areas of research should one consider? I think the concept of prior probability can be put to good use in such a situation. If I were the donor, I would convene a panel of recognised experts and let them advise me where there are the greatest chances of generating important breakthroughs. If one followed this path, alternative medicine would not appear anywhere near the top preferences, I dare to predict.

But often, like in the case of the Samuelis, the donors have concrete ideas about the area of research they want to invest in. So, what could be done with a large sum in the field of alternative medicine? I believe that plenty of good could come it. All one needs to do is to make absolutely sure that a few safeguards are in place:

  • believers in alternative medicine must be kept out of any decisions processes;
  • people with a solid background in science and a track-record in critical thinking must be put in charge;
  • the influence of the donor on the direction of the research must be minimised as much as possible;
  • a research agenda must be defined that is meaningful and productive (this could include research into the risks of alternative therapies, the ethical standards in alternative medicine, the fallacious thinking of promoters of alternative medicine, the educational deficits of alternative practitioners, the wide-spread misinformation of the public about alternative medicine, etc., etc.)

Under all circumstances, one needs to avoid that the many pseudo-scientists who populate the field of alternative or integrative medicine get appointed. This, I fear, will not be an easy task. They will say that one needs experts who know all about the subtleties of acupuncture, homeopathy, energy-healing etc. But such notions are merely smoke-screens aimed at getting the believers into key positions. My advice is to vet all candidates using my concept of the ‘trustworthiness index’.

How can I be so sure? Because I have been there, and I have seen it all. I have researched this area for 25 years and published more about it than any of the untrustworthy believers. During this time I trained about 90 co-workers, and I have witnessed one thing over and over again: someone who starts out as a believer, will hardly ever become a decent scientist and therefore never produce any worthwhile research; but a good scientist will always be able to acquire the necessary knowledge in this or that alternative therapy to conduct rigorous and meaningful research.

So, how should the UCI spend the $ 200 million? Apparently the bulk of the money will be to appoint 15 faculty chairs across medicine, nursing, pharmacy and population health disciplines. They envisage that these posts will go to people with expertise in integrative medicine. This sounds extremely ominous to me. If this project is to be successful, these posts should go to scientists who are sceptical about alternative medicine and their main remit should be to rigorously test hypotheses. Remember: testing a hypothesis means trying everything to show that it is wrong. Only when all attempts to do so have failed can one assume that perhaps the hypothesis was correct.

My experience tells me that experts in integrative medicine are quite simply intellectually and emotionally incapable of making serious attempts showing that their beliefs are wrong. If the UCI does, in fact, appoint people with expertise in integrative medicine, it is, I fear, unavoidable that we will see:

  • research that fails to address relevant questions;
  • research that is of low quality;
  • promotion masquerading as research;
  • more and more misleading findings of the type we regularly discuss on this blog;
  • a further boost of the fallacious concept of integrative medicine;
  • a watering down of evidence-based medicine;
  • irreversible damage to the reputation of the UCI.

In a nutshell, instead of making progress, we will take decisive steps back towards the dark ages.

16 Responses to A $ 200 million donation to medical research is a good thing… or isn’t it?

  • Sadly, this is like asking for all political campaigns-imcludimg Brexit- to be based on facts and evidence. Some people, like Colin and Iqbal, insist on their right to believe rubbish. Which is indeed a right,albeit one which might usefully be kept private.Whetjher any imstitution which sinks to this level can maintain its reputation for integrity remains to be seen.

  • It would be lovely if the money was spent on well-designed clinical trials which further showed homeopathy up as the nonesense if is. I’m sure the Samuelis would be delighted to see their bequest used in such a manner.

  • $200 million splashed on worthless placebos. In the land of Donald Duck it’s quack, quack, quack, all the way to the bank.

  • This is more “evidence” that we are returning to the dark ages of health care. They will tout biased findings to promote even more fake medical treatments and the science/health care industry will just accept it as long as consumers buy products through their institutions. Honorable and science based critics are too few it seems.

  • Edzard

    ” They will say that one needs experts who know all about the subtleties of acupuncture, homeopathy, energy-healing etc. But such notions are merely smoke-screens aimed at getting the believers into key positions. My advice is to vet all candidates using my concept of the ‘trustworthiness index’.”

    I believed with your experience of 20 years, you are the best candidate, and would have, by now applied for the Chair’s position. $ 200 million is a fair amount of money to get advertising space in most medical journals and newspapers to help under mine complementary medicine. And who can be better at it than you. You also have claim to hands on experience of most complementary medicines.
    Perfect opportunity: Don’t waste time. Use it.

    • thank you for your kind encouragement!
      as it happens, I have just been offered another professorship at a European University [despite my age]. moreover, I would never move to a country that is fast descending into fascism.

    • Professor Ernst was (and is, Emeritus at Exeter), Professor of Complementary Medicine – not ‘Integrative Medicine.’
      ‘IM’ represents fraud on the intellect and lacks integrity.
      EE does not!

  • I am mystified by the concept of ‘integrated medicine’ which seeks the integration of conventional orthodox regular ‘medicine’, developed over thousands of years, with particular and improved modalities since the practical application of Francis Bacon’s Novum Organon and subsequent Enlightenment, and which is now subject to the intensive rigour of critical thinking and the panoply of modern methods which are not perfect, but are the best we have – with arcane, bizarre, esoteric, anachronistic and intellectually unsound concepts.

    I just don’t see what camists and camees (who practice and use CAMs), want out of all this.
    Some are in the pay of, or gain favour and advantage from being associated with manufacturers of pins, pillules, potions and pummeling devices; some find employment in promoting these concepts in training institutions (BJ Palmer was financially very successful); some lack confidence and want approbation for beliefs and faiths which have surfaced from their gods know where; some are just foolish or ignorant by contemporary standards – but I believe (with no actual evidence) that the majority are caring and well meaning.
    But why do they want ‘integration’? Why not be content to be involved in ‘alternatives to medicine’ and leave it at that – while the rest of us try to develop ‘medicine’?

    Both Samuel Hahnemann and DD Palmer declared they had ‘left medicine’.
    Why can’t modern camists and camees be as honest and display similar integrity?

    • why do they want ‘integration’?

      Evangelical fervour among the “true believer” and billing rights for everyone.

      In either case, more use of quack medicine.

  • What credulous nonsense.

    Dr. Prasanta Banerji, a famed doctor for his homeopathy treatments, has cured so many cancer patients in India (using the integrative medicine techniques that Western doctors seem to hate) that there has been a cancer treatment protocol named after him. In fact, on a personal level, I have seen family members with autism improve their social skills due to homeopathic remedies.

    He gave it that name himself! It’s his clinic! Sheesh!

    • The article concludes: “The worst case scenario is that UCI learns, through research, that integrative medicine is ineffective. But I would rather dismiss something after I receive evidence for its dismissal rather than dismiss it simply because it clashes with my perceptions of medicine.”

      The article’s author, Sharmin Shanur “is a second-year cognitive sciences major. She can be reached at sshanur@uci.edu“.

      Let us hope that by the end of her course Miss Shanur will have studied the scientific method, understand the necessity of applying the null hypothesis and appreciate that there is no need for ‘evidence for dismissal’ (of any proposition) – in other words, those who make claims must provide evidence for them. IM is ineffective until proved otherwise – but due to clever marketing and cherry picking of ideas, much which is promoted by camists is of course already part of ‘medicine’, which gives the false impression of IM’s validity.

      Miss Shanur presently has an erroneous ‘perception of medicine’ – there are not two dimensions (Eastern and Western), but simply that which works and that which does not. ‘Eastern’ doctors know this full well and many have made major contributions to ‘medicine’ without the false dichotomy of East/West.

      I look forward to her musings when she qualifies (as I hope she does), and moves onwards.

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