MORE than £150,000 was spent by NHS Grampian on homeopathic treatments last year. Referrals to homeopathic practitioners cost £37,000 and referrals to the Glasgow Homoeopathic Hospital cost £7,315 in 2014-15. In view of the fact that highly diluted homeopathic remedies are pure placebos, any amount of tax payers’ money spent on homeopathy is hard to justify. Yet an NHS Grampian spokeswoman defended its use of by the health board with the following words:
“We have a responsibility to consider all treatments available to NHS patients to ensure they offer safe, effective and person-centred care. We also have a responsibility to use NHS resources carefully and balance our priorities across the population as well as individuals. We also recognise that patient reported outcome and experience measures are valued even when objective evidence of effectiveness is limited. Homeopathy can be considered in this arena and we remain connected with the wider debate on its role within the NHS while regularly reviewing our local support for such services within NHS Grampian.”
Mr Spence, a professional homeopath, was also invited to defend the expenditure on homeopathy: “When a friend started talking to me about homeopathy I thought he had lost his marbles. But it seemed homeopathy could fill a gap left by orthodox medicine. Homeopathy is about treating the whole person, not just the symptoms of disease, and it could save the NHS an absolute fortune. If someone is in a dangerous situation or they need surgery then they need to go to hospital. It’s often those with chronic, long-term problems where conventional treatment has not worked that can be helped by homeopathy.”
What do these arguments amount to, I ask myself.
The answer is NOTHING.
The key sentence in the spokeswomen’s comment is : “patient reported outcome and experience measures are valued even when objective evidence of effectiveness is limited.” This seems to admit that the evidence fails to support homeopathy. Therefore, so the argument, we have to abandon evidence and consider experience, opinion etc. This seemingly innocent little trick is nothing else than the introduction of double standards into health care decision making which could be used to justify the use of just about any bogus therapy in the NHS at the tax payers’ expense. It is obvious that such a move would be a decisive step in the wrong direction and to the detriment of progress in health care.
The comments by the homeopath are perhaps even more pitiful. They replace arguments with fallacies and evidence with speculation or falsehoods.
There is, of course, a bright side to this:
IF HOMEOPATHY IS DEFENDED IN SUCH A LAUGHABLE MANNER, ITS DAYS MUST BE COUNTED.
When the British Medical Journal (BMJ) asked me for an interview, I felt very honoured and obliged with great pleasure. The result was published in the BMJ earlier this year. I take the liberty of re-publishing it here on my blog because many of my readers do not see the BMJ, and I think it’s rather fun. Moreover, I hope it might provide my critics with more diverse material for ad hominem attacks – the constant allegations that I am in the pocket of ‘Big Pharma’, that I have never done any original research etc. etc. are getting just too boring.
HERE IT IS
Edzard Ernst is a champion of clear thinking in the often murky waters of alternative medicine. As Britain’s first professor of the subject at Exeter, he investigated claims made by its practitioners and found many to be devoid of supporting evidence. He was productive and highly visible and became a bit of an embarrassment to a craven university administration when he took on the Prince of Wales. He was frozen out, as he explains in his book A Scientist in Wonderland (subtitled A Memoir of Searching for Truth and Finding Trouble). Despite it all he, a German by birth, remains a phlegmatic Anglophile.
What was your earliest ambition?
As a young man I wanted to become a jazz musician. I practised enthusiastically—first on the clarinet, then on the drums—and if it had not been for my mother I might have ended up as a (not all that brilliant) drummer.
Who has been your biggest inspiration?
Hans and Sophie Scholl, two Munich University students and members of the White Rose resistance group who opposed Hitler by distributing leaflets at the university. On 23 February 1943, only five days after their arrest, they were executed.
What was the worst mistake in your career?
Most of my friends thought that leaving my chair in Vienna to become a researcher of alternative medicine was a grave error.
What was your best career move?
Leaving Vienna and becoming a researcher of alternative medicine.
Bevan or Lansley? Who has been the best and the worst health secretary in your lifetime?
Bevan is an undisputed hero who, in my view, cannot possibly be surpassed by the Lansleys of this world. The worst heath secretary will be the one who finally completes the Tory sell off of the NHS.
Who is the person you would most like to thank and why?
My mother for bringing me into this world and for steering me in the right direction with love and determination.
To whom would you most like to apologise?
To all the patients who, day in, day out, become victims of some form of quackery. It should have been my job to warn them and to point them towards treatments that actually work.
If you were given £1m what would you spend it on?
I might start a charity dedicated to counterbalance the overwhelming amount of misinformation about alternative medicine that consumers constantly have to endure.
When are you happiest?
When I manage to give to others in a way that is truly appreciated.
What single unheralded change has made the most difference in your field in your lifetime?
The intervention of the self proclaimed “enemy of the enlightenment” who advocates “integrated medicine” for the NHS that, for the most part, is unmitigated quackery. Prince Charles certainly made a difference in my field, albeit not in a positive way.
Do you support doctor assisted suicide?
Doctors should be able (but not obliged) to assist their patients in this way.
What book should every doctor read?
My memoir, A Scientist In Wonderland, of course. But not really—I find the idea of one book for all doctors a little bizarre.
What poem, song, or passage of prose would you like mourners at your funeral to hear?
When they are about to go home I’d like them to listen to the Bonzo Dog Doo-Dah Band performing “I’m Going to Bring a Watermelon to My Girl Tonight.”
What is your guiltiest pleasure?
Research! During the past 20 years pen pushers of various kinds have managed to make it feel like a guilty pleasure.
If you could be invisible for a day what would you do?
I would try to do some mischief that benefits all of us, such as transferring all bankers’ bonuses to the NHS or vaccinating the children of “anti-vaxxers.”
Clarkson or Clark? Would you rather watch Top Gear or Civilisation? What television programmes do you like?
I have to admit that I do sometimes watch Clarkson, mostly to learn how to avoid coming across like a middle aged chauvinist. If, however, I want to have a good time in front of my TV I watch a Bond film, only to doze off after the opening sequence.
What is your most treasured possession?
My memories of friends and family, of good times and tears of laughter.
What, if anything, are you doing to reduce your carbon footprint?
Wearing one or, if necessary, two extra layers (sometimes even thermal skiing underwear) when an icy wind makes our Suffolk home too cold for comfort.
What personal ambition do you still have?
To be on the BBC Radio 4 programme Desert Island Discs. It would be such a fun way to link life, medicine, and music.
Summarise your personality in three words
Stubborn, compassionate, rational.
Where does alcohol fit into your life?
As a collector of fine Bordeaux wines, I can hardly deny that it often fits very well indeed.
What is your pet hate?
Administrators who seem to think that the prime role of everyone else is to accommodate their whims.
What would be on the menu for your last supper?
As long as the wine for the main course is a Chateau Latour from a good year, I don’t mind.
Do you have any regrets about becoming a doctor and academic?
If you weren’t in your present position, what would you be doing instead?
I would probably be sitting behind a drum kit making even more disturbing noises.
A recent article in the LIVERPOOL ECHO caught my eye. It is about the possibility that the NHS in Liverpool might stop funding their homeopathy service . Maybe I should read the LIVERPOOL ECHO more often, because the short article is most revealing.
It first cites the chairman of the local NHS Clinical Commissioning Group, Dr Nadim Fazlani saying that “There is little evidence that homeopathy has a clinical benefit so, as a governing body, our preferred option would be to stop commissioning this service. However, it is important that the people have an opportunity to provide their views before a decision is made.”
I would like to mention, however, that health care is not a beauty contest or a supermarket shelve. We don’t have popular votes for bone marrow transplants or bypass surgery either. Why? Not because we don’t believe in democracy but because the general public cannot possibly understand medicine well enough. This is why we send some of our kids to medical school and other institutions to help us comprehend and eventually take responsible decisions for us. It is, I think, an ethical imperative to base important health care decisions of this nature on the best evidence and expertise, and it seems foolish to expect the public to have either.
Then the article in the LIVERPOOL ECHO quotes a statement of the Liverpool homeopathy service which is run by GPs Dr Hugh Nielsen and Dr Sue de Lacy: “The patients we see generally have long-standing, complex conditions that are often difficult to treat with conventional medicine. Yet regular audits of our clinic show a very high level of patient satisfaction, with patients consistently reporting an improvement in their health. As experienced doctors trained in homeopathy we see it working every day and that is why we believe Liverpool CCG – and more importantly the patients the CCG serves – is getting excellent value for the relatively small amount of funding the service receives.”
I find this interesting, not least because the arguments used by these two GPs are, in my view, miles better than those we have seen on this blog recently by Christian Boiron, Dana Ullman, Dr Michael Dixon or the Queen’s homeopath Dr Fisher all put together. At least they do not contain blatant lies!
This does not mean, however, that the arguments of the two homeopaths from Liverpool are convincing. They are not – for the following 4 reasons:
- True, long-standing, complex conditions are often difficult to treat with conventional medicine. But if they are difficult to treat with real medicine, they surely are even more difficult to treat with fake medicine.
- I have no problem believing that their audits show high level of patient satisfaction, with patients consistently reporting an improvement in their health. But we need to be quite clear that these effects are not brought about by the homeopathic remedies which contain zero active ingredients. They are due to the compassion shown by these homeopath. If they prescribed real medicine in addition to providing compassion, their results would in all likelihood be even better.
- It is also true that an experienced doctor trained in homeopathy will see it working every day. But the ‘it’ refers not to the remedy, it relates to the compassion – and to convey compassion, we do not need bogus treatments.
- It is a little misleading to claim that homeopathy is ‘excellent value’. The remedies contain nothing but lactose, and £ 5-10 for a gram or two of lactose is jolly expensive! So, the remedies are over-priced placebos, and the consultations might be good value.
Despite these counter-arguments, I must congratulate these two GPs from Liverpool: they seem to be so much more honest and intelligent than the defenders of homeopathy mentioned above.
Regular readers of this blog will have noticed: I recently published a ‘memoir‘.
Of all the books I have written, this one was by far the hardest. It covers ground that I felt quite uncomfortable with. At the same time, I felt compelled to write it. For over 5 years I kept at it, revised it, re-revised it, re-conceived the outline, abandoned the project altogether only to pick it up again.
When it eventually was finished, we had to find a suitable title. This was far from easy; my book is not a book about alternative medicine, it is a book about all sorts of things that have happened to me, including alternative medicine. Eventually we settled for A SCIENTIST IN WONDERLAND. A MEMOIR OF SEARCHING FOR TRUTH AND FINDING TROUBLE. This seemed to describe its contents quite well, I thought (the German edition is entitled NAZIS, NADELN UND INTRIGEN. ERINNERUNGEN EINES SKEPTIKERS which indicates why it was so difficult to put the diverse contents into a short title).
Then a further complication presented itself: at the very last minute, my publisher insisted that the text had to be checked by libel lawyers. This was not only painful and expensive, following their advice and thus changing or omitting passages also took some of the ‘edge’ off it.
Earlier this year, my ‘memoir’ was finally published; to say that I was nervous about how it might be received must be the understatement of the year. As it turned out, it received so many reviews that today I feel deeply humbled (and very proud), particularly as they were all full of praise and appreciation. In case you are interested, I provide some quotes and the links to the full text reviews below.[Ah, yes! Some people will surely claim that I did all this for the money. To those of my critics, I respond by saying that, had I done paper rounds or worked as a gardener or a window-cleaner during all the time I spent on this book, I would today be considerably better off. As it stands, the costs for the libel read are not yet covered by the income generated through the sales of this book.]
AND HERE ARE THE PROMISED QUOTES
Times Higher Education Book of the Week
Times Higher Education – Helen Bynum, Jan 29, 2015
“[F]or all its trenchant arguments about evidence-based science, the second half of A Scientist in Wonderland remains a very human memoir, and Ernst’s account of the increasingly personal nature of the attacks he faced when speaking to CAM practitioners and advocacy groups is disturbing… Ben Goldacre’s 2012 book Bad Pharma created a storm via its exposure of the pharmaceutical industry’s unhealthy links with mainstream medicine. Ernst’s book deserves to do the same for the quackery trading under the name of complementary and alternative medicine.”
The Spectator – Nick Cohen, Jan 31, 2015
“If you want a true measure of the man, buy Edzard Ernst’s memoir A Scientist in Wonderland, which the Imprint Academic press have just released. It would be worth reading [even] if the professor had never been the victim of a royal vendetta.”
The Bookbag review
The Bookbag – Sue Magee, Jan 28, 2015
“Ernst isn’t just an academic – he’s also an accomplished writer and skilled communicator. He puts over some quite complex ideas without resorting to jargon and I felt informed without ever struggling to understand, despite being a non-scientist. I was pulled into the story of his life and read most of the book in one sitting… I was impressed by what Ernst had to say and the way in which he said it.”
Science-Based Medicine review
Science-Based Medicine – Harriet Hall, Feb 3, 2015
“Edzard Ernst is one of those rare people who dare to question their own beliefs, look at the evidence without bias, and change their minds… In addition to being a memoir, Dr. Ernst’s book is a paean to science… He shows how misguided ideas, poor reasoning, and inaccurate publicity have contributed to the spread of alternative medicine… This is a well-written, entertaining book that anyone would enjoy reading and that advocates of alternative medicine should read: they might learn a thing or two about science, critical thinking, honesty, and the importance of truth.”
Nature – Barbara Kiser, Feb 5, 2015
“[T]his ferociously frank autobiography… [is] a clarion call for medical ethics.”
The Times – Robbie Millen, Feb 9, 2015
“A Scientist in Wonderland is a rather droll, quick read… [and] it’s an effective antidote to New Age nonsense, pseudo-science and old-fashioned quackery.”
AntiCancer.org.uk – Pan Pantziarka, Feb 19, 2015
“It should be required reading for everyone interested in medicine – without exception.”
Mail Online review
Mail Online – Katherine Keogh, Feb 28, 2015
“In his new book, A Scientist In Wonderland: A Memoir Of Searching For Truth And Finding Trouble, no one from the world of alternative medicine is safe from Professor Edzard Ernst’s firing line.”
James Randi Educational Foundation review
James Randi Educational Foundation – William M. London, Mar 9, 2015
“The writing in A Scientist in Wonderland is clear and engaging. It combines good storytelling with important insights about medicine, science, and analytic thinking. Despite all the troubles Ernst encountered, I found his story to be inspirational. I enthusiastically recommend the book to scientists, health professionals, and laypersons who like to see nonsense and mendacity exposed to the light of reason.”
The Pharmaceutical Journal review
The Pharmaceutical Journal – Andrews Haynes, Mar 26, 2015
“This engaging book is a memoir by a medical researcher whose passion for discovering the truth about untested therapies eventually forced him out of his job… [This] highly readable book concentrates on fact rather than emotion. It should be required reading for anyone interested in medical research.”
Skepticat – Maria MacLachlan, Apr 18, 2015
“A Scientist in Wonderland is more than an autobiography and I’m not sure I can do justice to the riches to be found in its pages. Sometimes it’s reminiscent of a black comedy, other times it’s almost too painful to read.”
Spiked! – Robin Walsh ,May 15, 2015
“Ernst’s book is a reminder of the need to have the courage to tell the truth as you understand it, and fight your corner against those in authority, while never losing a compassion for patients and a commitment to winning the debate. ”
Australasian Science review
Australasian Science – Loretta Marron, Jun 10, 2015
“Edzard Ernst is a living legend… The book is easy to read and hard to put down. I would particularly recommend it to anyone, with an open mind, who is interested in the truth or otherwise of CAM.”
Journal of the Royal Society of Medicine Review
JRSM – Michael Baum, June 2015
“This is a deeply moving and deeply disturbing book yet written with a light touch, humour and self-deprecation.”
THE BUFFALO NEWS
These enlightening books await summer readers. 21 June 2015
“Medical researcher Edzard Ernst spent most of his career stepping on toes. He first exposed the complicity of the German medical profession in the Nazi genocide. Then he accepted appointment as the world’s first chairman of alternative medicine at England’s University of Exeter. There he studied systematically the claims of the proponents of complementary medicine, a field dominated by evangelic and enthusiastic promoters, including Prince Charles. Needless to say, they did not take kindly to his exposures of many of their widely accepted therapies. His book, “A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble,” is a charming account of a committed life.”
“The book is first and foremost a memoir. Even those of us who have long followed Ernst’s research may well find a few surprises here…[Ernst] did not quite behave as many people expected him to after taking up his post in Exeter. He was committed to carrying out high-quality research into the efficacy and safety of CAM, not simply promoting its use in an uncritical manner. This admirable attitude won him much respect in the eyes of fellow scientists and the wider skeptical community.
Dear Professor Robinson,
please forgive me for writing to you in a matter that, you might think, is really none of my business. I have been following the news and discussions about the BLACKMORE CHAIR at your university. Having been a professor of complementary medicine at Exeter for ~20 years and having published more papers on this subject than anyone else on the planet, I am naturally interested and would like to express some concerns, if you allow me to.
With my background, I would probably be the last person to argue that a research chair in alternative medicine is not a good and much-needed thing. However, accepting an endowment from a commercially interested source is, as you are well aware, a highly problematic matter.
I am confident that you intend to keep the sponsor at arm’s length and plan to appoint a true scientist to this post who will not engage in the promotional activities which the alternative medicine scene might be expecting. And I am equally sure that the money will be put to good use resulting in good and fully independent science.
But, even if all of this is the case, there are important problems to consider. By accepting Blackmore’s money, you have, perhaps inadvertently, given credit to a commercially driven business empire. As you probably know, Blackmores have a reputation of being ‘a bit on the cavalier side’ when it comes to rules and regulations. This is evidenced, for instance, by the number of complaints that have been upheld against them by the Australian authorities.
For these reasons, the creation of the new chair is not just a step towards generating research, it could (and almost inevitably will) be seen as a boost for quackery. It is foremost this aspect which might endanger the reputation of your university, I am afraid.
My own experience over the last two decades has taught me to be cautious and sceptical regarding the motives of many involved in the multi-billion alternative medicine business. I have recently published my memoir entitled ‘A SCIENTIST IN WONDERLAND. SEARCHING FOR TRUTH AND FINDING TROUBLE’; it might be a helpful read for you and the new professor.
I hope you take my remarks as they were meant: constructive advice from someone who had to learn it all the hard way. If I can be of further assistance, please do not hesitate to ask me.
If I tell you that I just read a book by a homeopath writing about homeopathy, would you doubt my sanity? But I did, and I read it in one session with great interest. The book is (in German) by Natalie Grams (perhaps I should mention that I had never heard of her before Springer sent me her book), a German doctor; it is entitled HOMOEOPATHIE NEU GEDACHT (Homeopathy newly considered). I liked it a lot.
The author discusses in some detail why basically everything homeopaths believe in is erroneous. You might think: so what, we all knew that. True, we did, but she then she concludes that homeopathy has still some value as some sort of psychotherapy. The remedy is effective because the consultation with a homeopath gives it a ‘meaning’ which is tailor-made for each patient. Now you will think: that this is hardly original, others have considered this before. And you are, of course, correct again.
So why did this book fascinate me? Mostly because, in a few passages, Natalie Grams tells her very personal story how she matured from an enthusiast to rationalist. This could be reminiscent of my own life, but it isn’t (and by no means do I agree with everything doctor Grams writes). I found myself in a homeopathic hospital directly after medical school, became a homeopath (of sorts), later I learnt to think critically and researched homeopathy. As a scientist, when the evidence was squarely negative, I said so loud and clear (I published the whole story with all the relevant details here).
Natalie Grams studied medicine and seemed to have become disenchanted with the lack of humanity in mainstream medicine (as a clinician, I often felt this too but always concluded that the solution was not to turn away from medicine but to re-introduce more humanity into it). Doctor Grams then experienced serious health problems which were cured/alleviated by homeopathy. This made her look into the subject a little closer. She decided to do the necessary courses, uncritically adopted most of what she was told by die-hard homeopaths and eventually fulfilled her dream: she opened her own private practice as a homeopath. In other words, she dropped out of real medicine and into homeopathy, while I, in a way, did the reverse.
Doctor Grams’ practice seemed to have been successful; many of her patients, even some with serious conditions, got better. All she had been told about homeopathy seemed to get confirmed in her clinical routine. Homeopaths, like most clinicians, remember their success stories and tend to forget their failures. If this happens over and over during an entire life-time, the last doubts a budding homeopath may have once had dissolve into thin air. The result is a clinician who is utterly convinced that like cures like and high dilutions are powerful medicines because water has a memory.
Up to this point, Dr Grams career is a textbook example of a homeopath who would bet on the life of her children that homeopathy is correct and science is wrong. The world is full of them, and I have personally met many. They are usually kind, empathetic and dedicated clinicians. But they are also totally impervious to reason. They have their experience and NOBODY is allowed to question it. If you do, you are no longer their friend.
This is where the typical story of homeopaths ends… and they happily lied ever after (to themselves, their patients and everyone else). Not so in the case of Natalie Grams!
When she was still an enthusiast, she decided to write a book. It was going to be a book that showed how good homeopathy was and how bad its critics were. To do this responsibly, she read a lot of the original literature. What she found shocked her. When reading her account, I could repeatedly feel the agony she must have felt through her discoveries. Eventually, she had no choice but to agree with most of the arguments of homeopathy’s critics and disagreed with practically all of the arguments of her fellow homeopaths.
I predict that Natalie’s painful ‘journey’ has not yet come to an end; she now argues that the 200 year old assumptions of homeopathy are all obsolete and homeopathy is certainly not an effective drug therapy. However, it may turn out to be a valuable ‘talking therapy’, she believes.
I hate to say it, but I am fairly certain that she will have to go through further agony and find that her discovery is not truly workable. It might have some theoretical value but, for a whole number of reasons, it will not function in real life heath care.
My hope is that Natalie will find her way back to what she calls ‘normal medicine’ (there is, of course, the danger that she does the opposite and wanders off into even more esoteric grounds). We need doctors like her who have empathy, compassion and understanding for their patients. These are qualities many homeopaths who I have met have in abundance – but these are qualities that belong not into the realm of quackery, they belong into real medicine.
A few years ago, I fell ill with shingles. When patients had consulted me for this condition, during the times when I still was a clinician, I always had to stop myself smiling; they complained bitterly but, really, this was far from serious. Now, affected myself, I did not smile a bit: this was incredibly painful!
I promptly saw my GP in Exeter who, to my utter amazement, prescribed paracetamol. She too seemed to think that this was really nothing to bother her with. As I had feared, the paracetamol did absolutely nothing to my pain. After a few sleepless nights, I went back and asked for something a little more effective. She refused, and I decided to change GP.
Meanwhile, we went on a scheduled holiday to France. I had hoped my shingles would come to a natural end, but my pain continued unabated. People could see it on my face; so our kind neighbour asked whether she could help. I explained the situation, and she instantly claimed to have just the right treatment for me: she knew a healer who lived just round the corner and had helped many of her friends when they had suffered from pain.
“A healer?” I asked, “you cannot be serious.” I explained that I had conducted studies and done other research into this particular subject. Without exception, the results had shown that healing is a pure placebo. “I prefer to carry on taking even something as useless as paracetamol!” I insisted.
But she would have none of it. The next time I saw her, she declared triumphantly that she had made an appointment for me, and there was no question: I had to go.
As it happened, the day before she announced this, I had met up with a doctor friend of mine who, seeing I was in agony, gave me a prescription for gabapentin. In fact, I was just on the way to the pharmacist to pick it up. Thus I was in hopeful that my ordeal was coming to an end. In this optimistic mood I thanked my neighbour for her effort and concern and said something non-committal like “we shall see”.
A few days later, we met again. By this time, the gabapentin had done it’s trick: a was more or less pain-free, albeit a little dazed from the powerful medication. When my neighbour saw me, she exclaimed: “I see that that you are much improved. Wonderful! Yesterday’s healing session has worked!!!”
In my daze, I had forgotten all about the healing, and I had, of course, not been to see the healer. She was so delighted with her coup, that I did not have the heart to tell her the truth. I only said “yes much better, merci”
These events happened a few years ago, but even today, my kind and slightly alternative neighbour believes that, despite having been highly sceptical, healing has cured me of my shingles. To my embarrassment, she occasionally mentions my ‘miraculous cure’.
One day, I must tell her the truth… on second thoughts, perhaps not, she might claim it was distant healing!
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.
During the next few weeks, I will post several short excerpts from my new book ‘A SCIENTIST IN WONDERLAND‘. Its subtitle already discloses much of what it is all about: ‘A MEMOIRE OF SEARCHING THE TRUTH AND FINDING TROUBLE’.
Some of my critics are likely to claim that I engage in this form of ‘promotion’ because I want to maximise my income by enticing my readers to buy the book. This is partly true, of course: after having worked very hard on this book for about 5 years, I want it to be read (but, at the same time, my critics would be mistaken: I do not expect to get rich on my new book – I am not that naïve; this ‘memoire’ will never be found in any best-seller list, I am sure). So, I suggest (if you do not want me to profit in any way) that you read my memoire after you got it from your library (which obviously would not affect my cash-flow all that much).
So here it is: with much trepidation and even more excitement I present to you the very first, short excerpt (as I said, there will be more).
There are some people, a fortunate few, who seem to know from an early age where they want to go in life, and have no trouble getting there.
I was not one of them. I was born in Germany in the years immediately following the end of World War II and, like many German children of that era, I was acutely aware of the awkwardness and unease that my elders displayed when it came to discussions that touched on the country’s recent history. Even as a young boy, I was conscious that there was a large and restive skeleton in the nation’s closet, and that it belonged to all of us – even to those of us who had not been alive during the Nazi era were somehow nevertheless its legatees, inextricably bound to it simply by the awareness of its existence.
With time, the growing realization that so many of our peers – teachers, uncles, aunts; perhaps even our own parents – had lent their assent, or worse, their enthusiastic assistance to the Nazi regime robbed their generation of its moral authority and left us, their children, unmoored and adrift.
In a profound sense I felt homeless. An accident of fate had landed me on the planet with a German passport, and with German as my mother tongue, but where did I really belong? Where would I go? What would I do with my life?
There had been physicians in my family for generations and there was always an expectation that I, too, would enter that profession. Yet I felt no strong pull towards medicine. As a young man my only real passion was music, particularly jazz, with its anarchic improvisations and disobedient rhythms; and the fact that it had been banned by the Nazis only made it all the more appealing to me. I would have been perfectly happy to linger indefinitely in the world of music, but eventually, like a debt come due, medicine summoned me, and I surrendered myself to the profession of my forebears.
In hindsight I am glad that my mother nudged me gently yet insistently in the direction of medical school. While music has delighted and comforted me throughout my life, it has been medicine that has truly defined me, stretching, challenging and nourishing me intellectually, even as it tested me on a personal level almost to the limits of my endurance.
Certainly, I had never anticipated that asking basic and necessary questions as a scientist might prove so fiercely controversial, and that as a result of my research I might become involved in ideological wrangling and political intrigue emanating from the highest level.
If I had known the difficulties I would face, the stark choices, the conflicts and machinations that awaited me, would I have chosen to spend my life in medicine? Yes, I would. Becoming a physician and pursuing the career of a scientist has afforded me not only the opportunity to speak out against the dangerous and growing influence of pseudoscience in medicine, but also, paradoxically, has given me both the reason and the courage to look back steadily at the unbearable past.
This is the story of how I finally found where I belong.
Guest post by Louise Lubetkin
(A SCIENTIST IN WONDERLAND: A MEMOIRE OF SEARCHING FOR TRUTH AND FINDING TROUBLE has now been published. An apt opportunity perhaps to post a letter and comment from the person who helped me GREATLY in finishing it.)
People write memoirs for a variety of reasons but perhaps one of the strongest impelling forces is the need to make sense of one’s own experiences. It is not surprising that you, who spent your entire professional career searching for explanations, identifying associations and parsing correlations, found yourself looking at your own life with the same analytical curiosity. Memoir is in many respects a natural choice in this regard.
That you chose to undertake a profoundly personal inventory at this juncture is also understandable in human terms. Retirement, whether anticipated and planned for, or (as in your case) thrust rudely upon you, reorders one’s sense of identity in ways that cannot fail to prompt reflection. It would have been surprising had you not felt an urge to look back and take stock, to trace the narrative arc of your life from its beginnings in post-war Germany all the way to the quiet house in rural Suffolk where you now sit, surrounded by the comfort of books and the accumulated paraphernalia of a life spent digging and delving in search of the building blocks of truth.
Given the contentious circumstances surrounding your departure from academic life, it is quite likely that you will be asked whether your decision to write a memoir was driven, at least in part, by a desire to settle scores. I think you can dismiss such a question unhesitatingly. You have no scores to settle: you came to England after a steady and unbroken ascent to the apex of your professional career, voluntarily leaving behind a position that most people would regard with envy and deference. You were never a supplicant at Exeter’s door; far from it. The fact that things went inexorably downhill over the course of your 20 years’ tenure there, and ended so deplorably, is not a reflection on you, your department, or the quality or quantity of work you turned out. Rather, it is a reflection on the very nature of the work you went there to do – and if there is any message in your memoir, it is this:
Alternative medicine is not, at its heart, a logical enterprise, and its adherents are not committed to – nor even interested in – a rational evaluation of their methods. Rather, alternative medicine is primarily an ideological position, a political credo, a reaction against mainstream medicine. To many of its adherents and impassioned advocates, its appeal lies not in any demonstrable therapeutic efficacy but in its perceived outsider status as the countercultural medicine, the medicine for Everyman, the David to the bullying medical-pharmaceutical Goliath. That your research work would elicit howls of protest was perhaps inevitable, given the threat it posed to the profitable and powerful alternative medicine industry. But it didn’t stop there: astonishingly, your work drew the ire of none less than the meddlesome heir apparent to the British throne. Prince Charles’ attempts to stymie your work call to mind the twelfth century martyr Thomas à Becket, of whom Henry II reputedly cried: “Oh, who will rid me of this turbulent priest?” (Henry’s sycophantic henchmen were quick to oblige, dispatching the hapless cleric on the steps of Canterbury cathedral.)
It’s clear that you were acutely aware, as a young man growing up in Germany, that science was not immune to the corrupting influence of political ideology, and that the German medical profession had entered – enthusiastically – into a Faustian compact with the Nazi regime. You have exhibited a courageous insistence on confronting and examining a national past that has at times felt like an intensely personal burden to you. It is ironic that in going to sleepy Exeter in an earnest, conscious attempt to shake off the constricting, intrigue-ridden atmosphere of academic Vienna, you ultimately found yourself once again mired in a struggle against the influence of ideology and the manipulation of science for political ends.
You went to Exeter strictly as a scientist, a skilled inquirer, a methodical investigator, expecting to be able to bring the rigors of logic and the scientific method to bear on an area of medical practice that had until then not been subjected to any kind of systematic evaluation. Instead, you were caught in a maelstrom of intrigue far worse than that which you had gratefully left behind in Vienna, buffeted and bruised by forces against which a lesser man would surely not have had the fortitude to push back so long and so hard.