evidence
Turmeric is a commonly used herbal product implicated in causing liver injury. The aim of this case series
was to describe the clinical, histologic, and human leukocyte antigen (HLA) associations of turmeric-associated liver injury enrolled in the U.S. Drug Induced Liver Injury Network (DILIN).
All adjudicated cases enrolled in DILIN between 2004-2022 in which turmeric was an implicated product were reviewed. Causality was assessed using a 5-point expert opinion score. Available products were analyzed for the presence of turmeric using ultra-high-performance liquid chromatography. Genetic analyses included HLA sequencing.
Ten cases of turmeric-associated liver injury were found, all enrolled since 2011 and six since 2017. Of the 10 cases, 8 were women, 9 were White and the median age was 56 years (range, 35-71). Liver injury was hepatocellular in 9 patients and mixed in one. Liver biopsies in 4 patients showed acute hepatitis or mixed cholestatic-hepatitic injury with eosinophils. Five patients were hospitalized, and one patient died of acute liver failure. Chemical analysis confirmed the presence of turmeric in all 7 products tested; 3 also contained piperine (black pepper). HLA typing demonstrated that 7 patients carried HLA-B*35:01, 2 of whom were homozygous, yielding an allele frequency of 0.450 compared to population controls of 0.056-0.069.
The authors concluded that liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. Turmeric causes potentially severe liver injury that is typically hepatocellular, with a latency of 1 to 4 months and strong linkage to HLA-B*35:01.
Turmeric or curcumin is said to cause multiple effects, such as inhibiting inflammation, oxidative stress, tumor cell proliferation, cell death, and infection. Yet, sound clinical trials to test whether these effects might translate into health benefits are rare. In addition, the bioavailability of oral turmeric supplements is known to be low.
Turmeric has been used in food for millennia and is thus generally considered to be safe. Known adverse effects include gastrointestinal problems such as nausea and diarrhea and allergic reactions. Clearly, the new case series casts considerable doubt on the safety of turmeric. Yet, one ought to point out that the number of cases is low (but, on the other hand under-reporting can be assumed to be high). Furthermore, we should take into account that the quality of commercially available products is often low. One must therefore ask whether the liver injuries were truly caused by turmeric itself or by contaminants.
My conclusion is that turmeric is unquestionably an interesting plant with considerable potential as a medicine. At present, there is much hype surrounding it. Yet, hype is almost always contra-productive. If we want to know the true value of turmeric, we need to solve the bioavailability problem and do much more research into its safety and efficacy for defined conditions.
Aging often contributes to a decrease in physical activity. As age advances, a decrease in muscle mass, muscle strength, and flexibility can impair physical function. One obvious way to prevent these developments might be regular physical exercise.
This open-label, randomized trial was intended to evaluate the effects of an integrated yoga module in improving the flexibility, muscle strength, and quality of life (QOL) of older adults. Participants were 96 older adults, aged 60-75 years (64.1 ± 3.95 years). The program was a three-month, yoga-based lifestyle intervention. The participants were randomly allocated to the intervention group (n = 48) or to a waitlisted control group (n = 48). The intervention group underwent three one-hour sessions of yoga weekly, with each session including loosening exercises, asanas, pranayama, and meditation spanning.
At baseline and post-intervention, the following assessments were made:
- spinal flexibility using a sit-and-reach test,
- back and leg strength using a back leg dynamometer,
- handgrip strength (HGS) and endurance (HGE) using a hand-grip dynamometer,
- Older People’s Quality of Life (OPQOL) questionnaire.
Analysis was performed employing Wilcoxon’s Sign Rank tests and Mann-Whitney Tests, using an intention-to-treat approach.
The results show that, compared to the control group, the intervention group experienced a significantly greater increase in spinal flexibility (P < .001), back leg strength (P < .001), HGE (P < .01), and QOL (P < .001) after three months of yoga.
The authors concluded that yoga can be used safely for older adults to improve flexibility, strength, and functional QOL. Larger randomized controlled trials with an active control intervention are warranted.
I agree with the authors that this trial was too small and not properly controlled. I disagree that their study shows yoga to be effective or safe. In fact, the two sentences of the conclusion do not seem to fit together at all.
Is it surprising that doing yoga exercises is better than doing nothing at all?
No!
Is it relevant to demonstrate this fact in an RCT?
No!
If anyone wants to test the value of yoga exercises, they must compare them to conventional exercises. And why don’t they do this? Could it be because they know they would be unlikely to show that yoga is superior?
Here in the UK, we are looking yet again for a new Prime Minister (PM). Did I say ‘we’? That’s not quite true; the Tory party is hunting for one, and it seems a difficult task for the talent-depleted conservatives. Eventually, the geriatric group of Tory members might again have the say. Amazingly, some senior Tories are already suggesting Boris Johnson (BJ).
To me, this demonstrates how common cognitive decline and memory loss seem to be among the elderly. They evidently have already forgotten that, only a few months ago, BJ has already been our PM.
Yes, it is often the short-term memory that suffers first!
It might, therefore, help to remind the Tory membership thus affected that BJ:
- was elected as PM in 2019,
- he then created scandal after scandal,
- he was even found guilty of breaking the law,
- he is still under investigation for misleading the Parliament,
- eventually, in 2022, he was removed from office after mishandling a sexual abuse scandal.
I hope this helps to refresh your memory, Tory members suffering from cognitive decline. Considering this blog is about so-called alternative medicine (SCAM), I should perhaps also offer you some treatments for the often progressive deterioration of mental capacity. Here is a recent paper that might point you in the right direction:
Senile ages of human life is mostly associated with developmental of several neurological complicated conditions including decreased cognition and reasoning, increased memory loss and impaired language performance. Alzheimer’s disease (AD) is the most prevalent neural disorder associated with dementia, consisting of about 70% of dementia reported cases. Failure of currently approved chemical anti-AD therapeutic agents has once again brought up the idea of administering naturally occurring compounds as effective alternative and/or complementary regimens in AD treatment. Polyphenol structured neuroprotecting agents are group of biologically active compounds abundantly found in plants with significant protecting effects against neural injuries and degeneration. As a subclass of this family, Flavonoids are potent anti-oxidant, anti-inflammatory and signalling pathways modulatory agents. Phosphatidylinositol 3-kinase (PI3K)/AKT and mitogen activated protein kinase (MAPK) pathways are both affected by Flavonoids. Regulation of pro-survival transcription factors and induction of specific genes expression in hippocampus are other important anti AD therapeutic activities of Flavonoids. These agents are also capable of inhibiting specific enzymes involved in phosphorylation of tau proteins including β-secretases, cyclin dependent kinase 5 and glycogen synthase. Other significant anti AD effects of Flavonoids include neural rehabilitation and lost cognitive performance recovery. In this review, first we briefly describe the pathophysiology and important pathways involved in pathology of AD and then describe the most important mechanisms through which Flavonoids demonstrate their significant neuroprotective effects in AD therapy.
Sorry, I forgot that this might be a bit too complex for semi-senile Tories. Put simply, this means consuming plenty of:
- berries,
- apples,
- garlic,
- onion,
- green tea,
- beans (beware flatulence in Parliament!)
In addition, I might advise you to stay off the Port, get enough rest, avoid stress of any type, and do plenty of aerobic exercise. And please:
- not too much excitement,
- stimulate your brain (this means avoid reading right-wing papers),
- no major scandals,
- no further deterioration of moral standards,
- no more lies,
- no more broken promises!
In other words, no vote for BJ!!!
On 14 October 2012, I published the very first article on this blog:
Why another blog offering critical analyses of the weird and wonderful stuff that is going on in the world of alternative medicine? The answer is simple: compared to the plethora of uncritical misinformation on this topic, the few blogs that do try to convey more reflected, sceptical views are much needed; and the more we have of them, the better.
But my blog is not going to provide just another critique of alternative medicine; it is going to be different, I hope. The reasons for this are fairly obvious: I have researched alternative medicine for two decades. My team and I have conducted about 40 clinical trials and published more than 100 systematic reviews of alternative medicine. We were by far the most productive research unit in this area. For 14 years, we hosted an annual international conference for researchers in this field. I know many of the leading investigators personally, and I understand their way of thinking. I have rehearsed every possible argument for or against alternative medicine dozens of times.
In a nutshell, I am not someone who judges alternative medicine from the outside; I come from within the field. Arguably, I am the only researcher in this area who is willing [or capable?] to state publicly what is wrong with alternative medicine. This is perhaps one of the advantages of being retired and writing a blog in an entirely private capacity…
Ten years later, much has happened but I am still at it – and what is more, I am enjoying it.
The blog has been a success, I think. We had
- almost 3 000 posts,
- ~30 guest bloggers,
- and ~70 000 comments.
I know that many journalists and others use the blog as a source of information on so-called alternative medicine (SCAM) – if you search it for acupuncture, homeopathy, chiropractic, or any other SCAM, you find plenty of evidence. So, the blog has now become a much-frequented database.
Yet, the blog is more than that. It is foremost a place to discuss controversial issues. Its 10th anniversary is a good occasion to thank:
- all regular commentators,
- the many guest bloggers,
- and foremost the man who persuaded me in the first place to give it a go, and who now looks after all the technical bits.
THANKS, ALAN
Yesterday, L’EXPRESS published an interview with me. It was introduced with these words (my translation):
Professor emeritus at the University of Exeter in the United Kingdom, Edzard Ernst is certainly the best connoisseur of unconventional healing practices. For 25 years, he has been sifting through the scientific evaluation of these so-called “alternative” medicines. With a single goal: to provide an objective view, based on solid evidence, of the reality of the benefits and risks of these therapies. While this former homeopathic doctor initially thought he was bringing them a certain legitimacy, he has become one of their most enlightened critics. It is notable as a result of his work that the British health system, the NHS, gave up covering homeopathy. Since then, he has never ceased to alert us to the abuses and lies associated with these practices. For L’Express, he looks back at the challenges of regulating this vast sector and deciphers the main concepts put forward by “wellness” professionals – holism, detox, prevention, strengthening the immune system, etc.
The interview itself is quite extraordinary, in my view. While UK, US, and German journalists usually are at pains to tone down my often outspoken answers, the French journalists (there were two doing the interview with me) did nothing of the sort. This starts with the title of the piece: “Homeopathy is implausible but energy healing takes the biscuit”.
The overall result is one of the most outspoken interviews of my entire career. Let me offer you a few examples (again my translation):
Why are you so critical of celebrities like Gwyneth Paltrow who promote these wellness methods?
Sadly, we have gone from evidence-based medicine to celebrity-based medicine. A celebrity without any medical background becomes infatuated with a certain method. They popularize this form of treatment, very often making money from it. The best example of this is Prince Charles, sorry Charles III, who spent forty years of his life promoting very strange things under the guise of defending alternative medicine. He even tried to market a “detox” tincture, based on artichoke and dandelion, which was quickly withdrawn from the market.
How to regulate this sector of wellness and alternative medicines? Today, anyone can present himself as a naturopath or yoga teacher…
Each country has its own regulation, or rather its own lack of regulation. In Germany, for instance, we have the “Heilpraktikter”. Anyone can get this paramedical status, you just have to pass an exam showing that you are not a danger to the public. You can retake this exam as often as you want. Even the dumbest will eventually pass. But these practitioners have an incredible amount of freedom, they even may give infusions and injections. So there is a two-tier health care system, with university-trained doctors and these practitioners.
In France, you have non-medical practitioners who are fighting for recognition. Osteopaths are a good example. They are not officially recognized as a health profession. Many schools have popped up to train them, promising a good income to their students, but today there are too many osteopaths compared to the demand of the patients (knowing that nobody really needs an osteopath to begin with…). Naturopaths are in the same situation.
In Great Britain, osteopaths and chiropractors are regulated by statute. There is even a Royal College dedicated to chiropractic. It’s a bit like having a Royal College for hairdressers! It’s stupid, but we have that. We also have professionals like naturopaths, acupuncturists, or herbalists who have an intermediate status. So it’s a very complex area, depending on the state. It is high time to have more uniform regulations in Europe.
But what would adequate regulation look like?
From my point of view, if you really regulate a profession like homeopaths, it means that these professionals may only practice according to the best scientific evidence available. Which, in practice, means that a homeopath cannot practice homeopathy. This is why these practitioners have a schizophrenic attitude toward regulation. On the one hand, they would like to be recognized to gain credibility. But on the other hand, they know very well that a real regulation would mean that they would have to close shop…
What about the side effects of these practices?
If you ask an alternative practitioner about the risks involved, he or she will take exception. The problem is that there is no system in alternative medicine to monitor side effects and risks. However, there have been cases where chiropractors or acupuncturists have killed people. These cases end up in court, but not in the medical literature. The acupuncturists have no problem saying that a hundred deaths due to acupuncture – a figure that can be found in the scientific literature – is negligible compared to the millions of treatments performed every day in this discipline. But this is only the tip of the iceberg. There are many cases that are not published and therefore not included in the data, because there is no real surveillance system for these disciplines.
Do you see a connection between the wellness sector and conspiracy theories? In the US, we saw that Qanon was thriving in the yoga sector, for example…
Several studies have confirmed these links: people who adhere to conspiracy theories also tend to turn to alternative medicine. If you think about it, alternative medicine is itself a conspiracy theory. It is the idea that conventional medicine, in the name of pharmaceutical interests, in particular, wants to suppress certain treatments, which can therefore only exist in an alternative world. But in reality, the pharmaceutical industry is only too eager to take advantage of this craze for alternative products and well-being. Similarly, universities, hospitals, and other health organizations are all too willing to open their doors to these disciplines, despite the lack of evidence of their effectiveness.
We have repeatedly discussed the issue of detox as used in so-called alternative medicine (SCAM) and seen that, for a whole range of reasons, it is utter nonsense, e.g.:
- Remember Prince Charles’ ‘Duchy Originals Detox Tincture’?
- Now that you have paid through your nose for the ‘tox’, how about a ‘detox’ through your nose?
- Homotoxicology: ‘the best kept detox secret’? No, it’s even worse than homeopathy!
- Detox is bunk; save your money for something useful, fun or pleasant!
- Scientology detox? No thanks!!!
- ‘DETOX’ = a dangerous and counter-productive illusion
- Have yourself a merry little detox
- It’s beginning to look a lot like DETOX…everywhere I go
But would it not be better to keep toxins from entering the body in the first place?
Yes, you suspected correctly: there are products that claim to do exactly this. Here is a particularly ‘impressive’ one:
ION* Gut Support seals cells in the gut lining, helping to keep toxins out of your body and strengthening the terrain upon which your microbiome can diversify. it uses Humic Extract (from Ancient Soil) and Purified Water.
Humic extract is sourced from ancient soil (roughly 60 million years old), and contains a blend of bacterial metabolites (aka, fulvate) as well as less than 1% of a variety of trace minerals and amino acids including chloride, sodium, lithium, calcium, phosphorus, sulfur, bromide, potassium, iron, antimony, zinc, copper, gold, magnesium, alanine, glycine, histidine, isoleucine, methionine, threonine, and valine.
… the trace minerals in our humic extract are naturally occurring, well below the RDI, and not meant to be used as supplementary to any deficiencies. The truly active compound in humic extract is the fulvate, a unique family of carbon molecules with oxygen-binding sites that are produced by bacteria when they digest nutrients. These molecules are the backbone of the ION* blend, helping with critical functions like cellular and microbial communication and chelation of nutrients.
The science behind ION* lies in strengthening the cellular integrity of your body’s barriers, including not just your gut, but your sinuses and skin as well. Keeping your cells connected keeps these barriers intact, which sets the stage (or “terrain” as we like to call it) for seamless interaction between you and your microbiome.
At ION*, we’re all about connection – starting with the very foundation of our science: tight junction integrity. Tight junctions are the seals between your cells which help to create defensive barriers at the gut, skin, and sinuses. They act intelligently to keep toxins and foreign particles out of the blood stream while also allowing nutrients to enter. These seals are protected by the carbon and mineral metabolites of bacterial digestion.
Unfortunately, tight junction barriers can be degraded with exposure to gluten, glyphosate (the main chemical in commercial herbicides like Roundup), and other environmental insults. ION* has been scientifically shown to promote the strengthening of this barrier through redox signaling, even in the face of those environmental insults.
Your body’s barriers know what to let in (nutrients) and what to ward off (toxins). But the barriers must be strong. ION* works to strengthen your gut, sinus, and skin barriers at a cellular level by fostering tight junction integrity, helping to promote this intelligent defense system at a foundational level.
So much scientific-sounding language can make your head spin.
Which toxins are we talking about?
Are there any clinical studies of the product?
Why is the product so expensive?
What exactly are Humic substances?
I found an answer to only the last question. Humic substances are organic compounds that are important components of humus, the major organic fraction of soil, peat, and coal, and also a constituent of many upland streams, dystrophic lakes, and ocean water.
I imagine that tightening the named junctions – if this is truly a realistic mechanism of action – might interfere with the absorption of all sorts of substances that the body needs for survival. I am, of course, speculating, but one should ask about the risks of using this product (other than the one to the consumer’s bank account).
What we need are clinical studies. And there seem to be none (if anyone knows one, please let me know).
So, what do we call again a health product that makes unsubstantiated claims?
Was it perhaps ‘snake oil’?
Osteopathy is becoming under increasing criticism – not just in the UK but also in other countries. Here are the summary points from a very good overview from Canada:
– Osteopathy is based on the belief that illness comes from the impaired movement of muscles, bones, and their connecting structures, and that an osteopath can restore proper movement using their hands
– Offshoots of osteopathy include visceral osteopathy and craniosacral osteopathy, which make extraordinary claims that are not backed up by good evidence
– There is an absence of good quality evidence to support the use of osteopathy to address musculoskeletal issues
– Osteopathy has been reformed in the United States, with osteopathic physicians receiving training comparable to medical doctors and few of them regularly using osteopathic manual manipulations
An article from Germany is equally skeptical. Here is my translation of an excerpt from a recent article:
When asked which studies prove the effectiveness, the VOD kindly and convincingly handed the author of this article a list of about 20 studies. And emphasized that these were listed in Medline, i.e. a recognized medical database. But a close examination of the studies reveals: Almost without exception, all of them qualify their results and point to uncertainties.
The treatment is “possibly helpful,” for example, they say, the study quality is “very low,” “low” to “moderate,” there are too few studies, they are small, the “evidence is preliminary” and “insufficient to draw definitive conclusions. Again and again it is emphasized that further, methodically better, more sustainable studies are needed, which also record more precisely what happened in osteopathic treatment in the first place.
Another article was published by myself in ‘L’Express’. As it is in French, I translated the conclusion for you:
… would I recommend consulting an osteopath? My answer is a carefully considered NO! For patients with back pain, the evidence is as good (or bad, depending on your point of view) as for many other proposed therapies. So if a patient insists on osteopathy, I might support it, but I would still prefer physical therapy. For all other musculoskeletal conditions, there is not enough evidence to make positive recommendations. For patients with conditions other than musculoskeletal, I would advise against osteopathy.
All this comes after it has been shown that worldwide research into osteopathy is scarce and has hardly any impact at all. The question we should therefore ask is this:
why do we need osteopaths?
PS
Osteopaths in the US have studied medicine, rarely practice manual treatments, and are almost indistinguishable from MDs. Everywhere else, osteopaths are practitioners of so-called alternative medicine.
The objective of this study was to evaluate the effect of acupuncture on cognitive task performance in college students.
Sixty students aged 18-25 years were randomly allocated into acupuncture group (AG) (n=30) and control group (CG) (n=30). The AG underwent 20 min of acupuncture/day, while the CG underwent their normal routine for 10 days. Assessments were performed before and after the intervention.
Between-group analysis showed a significant increase in AG’s six-letter cancellation test (SLCT) score compared with CG. Within-group analysis showed a significant increase in the scores of all tests (i.e. SLCT, forward and backward Digit span test [DST]) in AG, while a significant increase in backward DST was observed in CG.
The authors concluded that acupuncture has a beneficial effect on improving the cognitive function of college students.
I am unable to access the full paper [it is behind a paywall]. Thus, I am unable to assess the study in further detail. As I am skeptical about the validity of the effect, I can only assume that it is due to the expectation of the volunteers receiving acupuncture. There was not even an attempt to control for placebo effects!
The over-stated conclusion made me wonder what else the 1st author has published. It turns out he has three more Medline-listed papers to his name all of which are about so-called alternative medicine (SCAM).
The 1st one is an RCT similar to the one above, i.e. without an attempt to control for placebo effects. Its conclusion is equally over-stated: Acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.
The other two papers refer to one case report each. Despite the fact that case reports (as any researcher must know) do not lend themselves to conclusions about the effectiveness of the treatments employed, the authors’ conclusions seem to again over-state the case:
- This suggests that integrative Naturopathy and Yoga therapies could be considered as an adjuvant to conventional medicine in rheumatoid arthritis associated with type-2 diabetes and essential hypertension.
- Though the results are encouraging, further studies are required with larger sample size and advanced inflammatory markers.
What does that tell us?
I don’t know about you, but I would not rely on acupuncture to improve my mental performance.
Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Placebo
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
The ‘Münster Circle‘ is an informal association of multi-disciplinary experts who critically examine issues in and around so-called alternative medicine (SCAM). We exist since June 2016 and are the result of an initiative by Dr Bettina Schöne-Seifert, Professor and Chair of Professor and Chair of Medical Ethics at the University of Münster.
In the past, we have published several documents which have stimulated discussions on SCAM-related subjects. Yesterday, we have published our ‘MEMORANDUM INTEGRATIVE MEDICINE‘. It is a critical analysis of this subject and will hopefully make some waves in Germany and beyond.
Here is its English summary:
The merging of alternative medicine and conventional medicine has been increasingly referred to as Integrative (or Integrated) Medicine (IM) since the 1990s and has largely replaced other terms in this field. Today, IM is represented at all levels.
IM is often characterised with the thesis of the ‘best of both worlds’. However, there is no generally accepted definition of IM. Common descriptions of IM emphasise:
– the combination of conventional and complementary methods,
– the holistic understanding of medicine,
– the great importance of the doctor-patient relationship,
– the hope for optimal therapeutic success,
– the focus on the patient,
– the high value of experiential knowledge.
On closer inspection, the descriptions of IM show numerous inconsistencies. For example, medicine in the hands of doctors is stressed, but it is also emphasised that all relevant professions would be involved. Scientific evidence is emphasised, but at the same time, it is stressed that IM itself includes homeopathy as well as other unsubstantiated treatments and is only ‘guided’ by evidence, i.e. not really evidence-based. It is claimed that IM is to be understood as ‘complementary to science-based medicine’; however, this implies that IM itself is not science-based.
The ‘best of both worlds’ thesis impresses many. However, if one investigates what is meant by ‘best’, one finds that this term is not interpreted in nearly the same way as in conventional medicine. Many claims of IM are elementary components of all good medicine and thus cannot be counted among the characterising features of IM. Finally, it is hard to ignore the fact that the supporters of IM use it as a pretext to introduce unproven or disproven modalities into conventional medicine. Contrary to promises, IM has no discernible potential to improve medicine; rather, it creates confusion and entails considerable dangers. This cannot be in the interest of patients.
Against this background, it must be demanded that IM is critically scrutinised at all levels.
________________________
