MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

legal action

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We have repeatedly discussed financial and other fraud by (mostly US chiropractors, e.g.:

Many of these cases are impressive in their illegality or even viciousness. Yet, this one takes the biscuit, I think:

It has been reported that a former chiropractor will be spending a long time behind bars following his conviction for running a colossal workers’ compensation fraud that bagged him $150 million over several years. Peyman Heidary has been sentenced to 54 years and 8 months in state prison on April 12, and will also have to shell out more than $23 million in fines, according to the Riverside County District Attorney’s Office.

Convicted in January of 68 counts including insurance fraud, conspiracy, and money laundering, Heidary’s scheme involved the control of fake health clinics and law firms from 2009 to 2014. He manipulated the workers’ comp system to exploit legitimately injured people and run up unnecessary treatments to inflate insurance billings, according to a Riverside County jury.

District Attorney Mike Hestrin made clear the gravity of Heidary’s exploitation: “The California workers’ compensation system is designed to help injured workers get back on their feet without ruining them financially,” Hestrin stated, adding “Sophisticated criminals like Mr. Heidary don’t just steal money, they take advantage of innocent patients”.  The trial also heard from one such patient, Denise Rivera, a worker injured on the job who despite being promised care, was left untreated.

Originally pegged at $98 million, the fraud was ultimately revealed to have caused about $150 million in damages. Judge Charles Koosed, overseeing the sentencing, called out Heidary’s greed, exploiting his detailed knowledge of the workers’ compensation landscape, Judge Koosed noted, “’[Heidary] took advantage of that knowledge based on greed.”

Heidary used the sham law firm to recruit thousands of legitimately injured patients, referring them to his network of clinics to create unnecessary billing. One of the injured workers, Denise Rivera, slipped and fell while working as a certified nurse assistant for special needs children. Ms. Rivera testified that she was recruited into Heidary’s scheme, but never received any effective treatment. “[Heidary’s employees] released me,” Rivera told jurors. “They told me … basically I was okay. My knee was okay.” When asked during the trial if her knee actually was OK, she simply responded, “No.”

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It will probably not take long for some chiro to post a comment pointing out that dishonest chiropractors are extremely rare exceptions. Most are law-abiding and behave ethically, he/she will insist. It will then be useless, of course, to counter that, in fact, there is plenty of evidence that dishonesty is rife amongst chiropractors and more frequent than with other healthcare professionals. They will not accept that and would like me to withdraw the allegation.

Such arguments often remind me of the Labour politician, Dennis Skinner, who once stated in the UK Parliament: “Half the Tories opposite are crooks.” When the Speaker insisted he should retract this remark, he responded, “OK, half the Tories opposite aren’t crooks.

Prof Michael Frass is the undisputed star amongst researchers of homeopathy. Here are the awards and achievements that he mentions on his website:

  • 1994 until 2019Head, Special Outpatient Clinic “Homeopathy in Malignant Diseases”, Department of Internal Medicine I, General Hospital of the City of Vienna
  • 1992 until Feb. 2004Director, Intensivstation 13.i2, Klinik für Innere Medizin I
  • 1994 until 1998 Medical Director Maimonides Center
  • since May 1994Vice President of the “Medical Society for Classical Homeopathy” (ÄKH)
  • since Oct. 1995Head of the Working Group for Homeopathy of the ÄKH in Vienna
  • since Jan. 1998 Speaker of the ÄKH at training courses
  • 1999 – 2012Training Officer of the Austrian Society for Internal and General Intensive Care Medicine (ÖGIAIM)
  • 2001 until 2019 Coordinator of the lecture series “Selected chapters and scientific discussion of complementary medicine methods”, Med. Univ. Vienna, VO 560480
  • May 2002 – Dec. 2005Director of the Ludwig Boltzmann Institute for Homeopathy
  • since June 2003Member of the Scientific Advisory Board of the Vienna International Academy of Holistic Medicine
  • 2004 until 2019Expert in Airway Management and Homeopathy in Intensive Care Medicine at the Center of Excellence in Internal Critical Care Medicine (CEMIC).
  • 2005 until 2019Coordinator of the free elective “Homeopathy”, Med. Univ. Vienna, VO 562 923
  • since June 2005Director, Institute for Homeopathy Research
  • 2006 until 2019Member of the planning area + lecturer for the line element “Interdisciplinary Patient Management” (compulsory lecture for medical students)
  • since June 2006President of the Austrian Umbrella Association for Medical Holistic Medicine.
  • since Nov. 2010Chairman of the Scientific Society for Homeopathy (WissHom)

Many of my readers will remember the case of the Prof. Frass et al study of homeopathy for cancer. On this blog, we have seen several articles about it:

The study and the suspicion of scientific misconduct it raised eventually resulted in an official complaint by the Viennese Medical School to the authority that deals with suspicions of publication fraud, the ‘Austrian Agency for Scientific Integrity’. It took a very long time, but recently they have published their final on-line summary of their assessment of the case; here is my translation:

Enquiry A 2021/10:
After an Austrian university was informed externally and by name of possible scientific misconduct in a study and the resulting publication, the institution concerned submitted the already publicised suspected case in the field of applied natural sciences to the OeAWI with a request for examination by the Commission.

After establishing sufficient suspicion of various violations of good scientific practice, the Commission declared itself responsible and initiated proceedings. In the course of this, the principal investigator was given the opportunity to submit a written statement and to provide the Commission for Research Integrity Annual Report 2022 material that would help to clarify the facts of the case, which the accused submitted in large quantities.

In a very complex, comprehensive investigation, which required, among other things, the on-site inspection of original documents, the Commission was able to substantiate the suspicion of data falsification, fabrication and manipulation. In a final statement, the study director, who no longer works for the university in question, and the numerous co-authors were informed in detail about the course and results of the commission’s investigation and informed of the recommendations to the university and journal.  The Commission recommended that the university concerned should consider investigating its own responsibilities and act accordingly, and that the publication should be withdrawn as a matter of urgency. The journal responsible for the publication was asked to withdraw the publication on the basis of the findings of the investigation.

Nobody who has studied the Frass paper in some detail can be surprised by the verdict. I do applaud the ‘Austrian Agency for Scientific Integrity’ for their work. Yet, I do also have some criticism: health fraud on the scale of Frass can easily costs lives. I find it therefore unacceptable that the verdict took so long to get published.

Even worse is, in my view, the fact that the journal, ‘Oncologist’, is still offering this paper today, albeit with this ‘expression of concern’:

This is an Expression of Concern regarding: Michael Frass, Peter Lechleitner, Christa Gründling, Claudia Pirker, Erwin Grasmuk-Siegl, Julian Domayer, Maximilian Hochmair, Katharina Gaertner, Cornelia Duscheck, Ilse Muchitsch, Christine Marosi, Michael Schumacher, Sabine Zöchbauer-Müller, Raj K. Manchanda, Andrea Schrott, Otto Burghuber, Homeopathic Treatment as an Add-On Therapy May Improve Quality of Life and Prolong Survival in Patients with Non-Small Cell Lung Cancer: A Prospective, Randomized, Placebo-Controlled, Double-Blind, Three-Arm, Multicenter Study, The Oncologist, Volume 25, Issue 12, December 2020, Pages e1930–e1955, https://doi.org/10.1002/onco.13548

In August 2022, the journal editors received credible information from the Austrian Agency for Research Integrity about potential data falsification and data manipulation in this article.*** While The Oncologist editorial team investigates and communicates with the corresponding author, the editors are publishing this Expression of Concern to alert readers that, pending the outcome and review of a full investigation, the research results presented may not be reliable.

Cancer patients will thus still read the dangerously misleading conclusions of the Frass fabrication: “Quality of life (QoL) improved significantly in the homeopathy group compared with placebo. In addition, survival was significantly longer in the homeopathy group versus placebo and control. A higher QoL might have contributed to the prolonged survival. The study suggests that homeopathy positively influences not only QoL but also survival. Further studies including other tumor entities are warranted.” And lives of cancer patients remain needlessly at risk. In my view, this is seriously unethical.

***As far as I know, they received credible information from others long before that!

It has been reported that 5 people who took a Japanese health supplement have died and more than 100 have been hospitalized as of Friday, a week after a pharmaceutical company issued a recall of the products, officials said. Osaka-based Kobayashi Pharmaceutical Co. came under fire for not going public quickly with problems known internally as early as January. Yet the first public announcement came only on 22 March. Company officials said 114 people were being treated in hospitals after taking products — including Benikoji Choleste Help meant to lower cholesterol — that contain an ingredient called benikoji, a red species of mold. Some people developed kidney problems after taking the supplements, but the exact cause was still under investigation in cooperation with government laboratories, according to the manufacturer.

“We apologize deeply,” President Akihiro Kobayashi told reporters last Friday, bowing for a long time to emphasize the apology alongside three other top company officials. He expressed remorse to those who have died and have been taken ill and to their families. He also apologized for the troubles caused to the entire health food industry and the medical profession, adding that the company was working to prevent further damage and improve crisis management.

The company’s products have been recalled — as have dozens of other products that contain benikoji, including miso paste, crackers, and a vinegar dressing. Japan’s health ministry put up a list on its official site of all the recalled products, including some that use benikoji for food coloring. The ministry warned the deaths could keep growing. The supplements could be bought at drug stores without a prescription from a doctor, and some may have been purchased or exported before the recall, including by tourists who may not be aware of the health risks.

Kobayashi Pharmaceutical had been selling benikoji products for years, with a million packages sold over the past 3 fiscal years, but a problem crept up with the supplements produced in 2023. Kobayashi Pharmaceutical said it produced 18.5 tons of benikoji last year. Some analysts blame the recent deregulation initiatives, which simplified and sped up approval for health products to spur economic growth.

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Anouther source reported that Japanese authorities on Saturday raided a drug factory after a pharmaceutical company reported at least five deaths and 114 hospitalizations possibly linked to a health supplement. About a dozen Japanese health officials walked into the Osaka plant of the Kobayashi Pharmaceutical Co., as seen in footage of the raid widely telecasted on Japanese news. The health supplement in question is a pink pill called Benikoji Choleste Help. It is said to help lower cholesterol levels. A key ingredient is benikoji, a type of red mold. The company has said it knows little about the cause of the sickness, which can include kidney failure. It is currently investigating the effects in cooperation with Japan’s government.

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More recent reports update the figure of affected individuals: Japanese dietary supplements at the center of an expanding health scare have now been linked to at least 157 hospitalizations, a health ministry official said Tuesday.The figure reflects an increase from the 114 hospitalization cases that Kobayashi Pharmaceutical said on Friday were linked to its products containing red yeast rice, or beni kōji.

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A Kobayashi Pharmaceutical spokeswoman confirmed the latest hospitalization cases without elaborating further.

Benikoji is widely sold and used; not just in Japan. It comes under a range of different names:

  • red yeast rice,
  • red fermented rice,
  • red kojic rice,
  • red koji rice,
  • anka,
  • angkak,
  • Ben Cao Gang Mu.

It is a bright reddish purple fermented rice which acquires its color from being cultivated with the mold Monascus purpureus. Red yeast rice is used as food and as a medicine in Asian cultures, such as Kampo and TCM.

It contains lovastatin which, of course, became patented  and is marketed as the prescription drug, Mevacor. Red yeast rice went on to become a non-prescription dietary supplement in the United States and other countries. In 1998, the U.S. FDA banned a dietary supplement containing red yeast rice extract, stating that red yeast rice products containing monacolin K are identical to a prescription drug, and thus subject to regulation as a drug.

The Amercian Medical Association (AMA) recently published a lengthy article on naturopathy in the US. Here are some excerpts:

There are three types of health professionals who offer naturopathic treatment:

  • Naturopathic doctors. These nonphysicians graduate from a four-year, professional-level program at an accredited naturopathic medical school, earning either the doctor of naturopathy (ND) degree or the doctor of naturopathic medicine (NMD) degree.
  • Traditional naturopaths, who have obtained education through some combination of a mentorship program with another professional or at an alternative clinic, distance-learning program or classroom schooling on natural health, or other holistic studies.
  • Other health professionals such as chiropractors, massage therapists, dentists, nurses, nutritionists, or physicians who practice under a professional license but include some naturopathic methods in their practice and who may have studied on their own or taken courses on naturopathic methods.

At least 24 states and the District of Columbia regulate the practice of naturopathy. In order to be licensed, naturopaths in these states must earn an ND or NMD from an accredited naturopathic program and pass the Naturopathic Physicians Licensing Exam. Three states—Florida, South Carolina and Tennessee—prohibit the practice of naturopathy. In states that neither license nor prohibit the practice of naturopathy, traditional naturopaths and NDs alike may practice without being subject to state regulation.

Postgraduate training is neither common nor required of graduates of naturopathic schools, except in Utah … less than 10% of naturopaths participate in an approved residency, and such residencies last only a year and lack a high degree of standardization.

… naturopaths are required to get at least 1,200 hours of direct patient contact, physicians get 12,000–16,000 hours of clinical training…

ND programs emphasize naturopathic principes—for example, the healing power of nature—and naturopathic therapeutics such as botanical medicine, homeopoathy and hydrotherapy. Coursework in naturopathic therapeutics is combined with, and taught alongside, coursework in sciences. But there are no specifications around the number of hours required in each area … naturopathic students may lack exposure to key clinical scenarios in the course of their training … naturopathic students’ clinical experience is typically gained through outpatient health care clinics, as naturopathic medical schools typically do not have significant hospital affiliation. This means there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the “worried well.”

… Naturopaths claim they are trained as primary care providers and, as such, are educated and trained to diagnose, manage and treat many conditions, including bloodstream infections, heart disease and autoimmune disorders. Yet their education and training falls several years and thousands of hours short of what physicians get.

…The AMA believes it is the responsibility of policymakers to ensure that naturopaths’ claims that they can treat a broad range of conditions are backed by facts—facts that include the specific education and training necessary to ensure patient safety.

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The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere, e.g.:

Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous. Regulators must be reminded that they have the duty to protect the public from charlatans and should therefore ensure that no false therapeutic or diagnostic claims can be made by naturopaths.

The 29th of February is an unusual date, and I will do something fittingly unusual today – something that I have never done before: I will with a heavy heart resign from an organisation of skeptics.

After I had observed the self-destructive debates within the GWUP for almost one year without saying a single word about it (hoping they would soon dissolve into thin air), I published a comment a few days ago. Soon after, I was aggressed, defamed, wrongly denounced as an anti-Semite, and blackmailed by leading members of that organisation.

Confronted with these events, it was inevitable that I would have doubts about my previous plan to remain a member until the upcoming general assembly in May. While I was contemplating, I received a Tweet on 27/2/2024 from someone under the pseudonym Endgegner der Kommentarspalten; it included this sentence:

Einer der verschwörungsideologischen Clowns, die seit gut einem Jahr Kulturkrieg in der GWUP mit rechtsextremen Talking Points spielen und Märchen von einem “woken Putsch” herbeiphantasieren?

My translation:

One of the conspiracy ideological clowns who have been playing culture war in the GWUP for a good year with right-wing extremist talking points and fantasising about a “woke coup”?

Next, I watched a long discussion on youtube between the new chair of the GWUP, my accuser (Bartoschek) and Sebastian Hirsch. There I learnt that the latter is, in fact, nobody else than Endgegner der Kommentarspalten. He was recently put in charge of Twitter account for GWUP by the chair.

At this point, I lost the hope that the GWUP might be saved. It seems to be in the hand of thugs who call not me personally but their opponents ‘ideological clowns who have been playing culture war’. They claim that they want to keep politics out of the GWUP, yet almost all they do is engaging in politics.

Since the former formidable chair, Amardeo Sarma, left and the rift started, the GWUP has done nothing wothwhile, as far as I can see. On the GWUP website, we are told that (my translation):

  • The GWUP aims at promoting science and scientific thinking.
  • The GWUP investigates parascientific theories according to the current state of scientific knowledge and reports publicly and comprehensibly on its findings.
  • The GWUP aims to disseminate scientific and critical thinking and scientific methods, explain them in a generally understandable way and clearly distinguish real science from parascience. The GWUP thus wants to contribute to reducing society’s susceptibility to parascientific ideas and promises.
  • The GWUP is an internationally orientated society. It is happy to work with like-minded individuals, organisations and institutions.

GWUP stands for ‘Gesellschaft zur wissenschaftlichen Untersuchung von Parawissenschaften’ (Society for the Scientific Investigation of Parasciences). The people currently in charge claim to be scientists but most of them are not (talking about science or publishing books for the lay reader about it does not, in my view, make you a scientist!). The leadership of the GWUP, it seems to me, is currently dominated by small-minded inward-looking guys with no international perspective who are in the middle of a mega-ego trip.

Instead of fighting parascience, they feel entitled to fight their colleagues. Instead of doing their job, they open the door to parascience. Instead of being scientists, they are using skepticism as an excuse for their machinations. Instead of running a scientific organisation, they turned it into a veritable kindergarden. In a nutshell: to the utmost delight of German parascientists, they have completely lost the plot.

I do not believe that the general assembly can turn things around. More likely, matters will get worse and it will come to a complete split. Personally, I cannot – not even until May – remain a member of an organisation where the man officially put in charge of the Twitter account feels entitled to collectively call his opponents ‘ideological clowns who have been playing culture war’. This remark in itself might not be all that significant but, for me, it is the ‘last straw’ and a symptom of a deep and irreversible rot.

So, I have come to the conclusion that I can do my work better without any further GWUP-hindrance. Therefore, I will now email my resignation as a member of the GWUP.

Guest post by Ken McLeod

This week a Coroner’s Inquest into the death of Jarrad Antonovich resumes [1] in Byron Bay, New South Wales, Australia. Meanwhile, pending the outcome of Inquests and other investigations, the NSW Health Care Complaints Commission has imposed interim prohibition order on Mr Soulore Solaris, ‘….a Counsellor who facilitates Ayahuasca ceremonies.’

Under section 41AA of the Health Care Complaints Act 1993 (Act), Mr Solaris: “….must not under any circumstances provide, or cause to be provided, any health services, either in paid employment or voluntary, to any member of the public.” [2] This applies until 11 March 2024, when the matter will be reconsidered.

So what is all this about? To go back a while, Mr Antonovich died from a perforated oesophagus after consuming ayahuasca and kambo frog toxin in October 2021, at the age of 46, while attending the ‘Dreaming Arts festival’, a six-day retreat at Arcoora near Kyogle in northern New South Wales. At the festival he had consumed ayahuasca and participated in a “Kambo” ceremony, involving secretions harvested from an Amazonian tree frog.

Ayahuasca is a psychedelic substance made from boiling plants that is used in ritualistic ceremonies in the Amazon basin. [3] Ayahuasca contains chemicals of concern, such as N,N-Dimethyltryptamine (DMT), a highly psychedelic substance and a Schedule I drug under the Convention on Psychotropic Substances. Ayahuasca is illegal in many countries, and it is illegal to sell, import, produce and possess it in Australia. [4]

Kambo is made from secretions harvested from an Amazonian tree frog. Kambo is usually used in a group setting, called a Kambo circle or Kambo ceremony. Wikipedia lists a whole smorgasbord of dangerous consequences, including tachycardia, nausea, vomiting, diarrhea, psychosis, SIADH, kidney damage (including acute renal failure), pancreas damage, liver damage including toxic hepatitis, dermatomyositis, esophageal rupture, seizures, and death. [5]

The Australian Therapeutic Goods Administration has listed it as a schedule 10 poison, in the category for “substances of such danger to health as to warrant prohibition of sale, supply and use”. [6]

Earlier in the Inquest we heard that:

  • – While Jarrad Antonovich‘s condition worsened there was resistance to calling for an ambulance. An ambulance was finally called at 11.30pm and took an hour to arrive because of the remote location.
  • -One ambulance officer reported that a female told them to “move away from Jarrad because it was affecting his aura” and no one told them he had consumed Kambo. [7]
  • -The event organiser Soulore “Lore” Solaris described Jarrad Antonovich’s death as ‘beautiful.’ [8]
  • -Fred Woller, the site manager at Arcoora, was unaware those running the event did not have any medical training. [9]
  • -Soulore “Lore” Solaris said Mr Antonovich ”…. had good support, a couple of kinesiologists with him and they couldn’t find anything wrong,” [10]
  • -Mr Antonovich “was surrounded by people who loved him and an Aboriginal elder called Uncle Andrew who was chanting sacred songs and calling the spirit out of his body” and “the koalas were making a special sound that is known to the elders when the land accepts a spirit”.
  • -“Mr Solaris has stated that he has plans to leave Australia for Brazil to visit his teachers.” [11]

We will keep you informed.

REFERENCES

  • 1 Court Lists http://tinyurl.com/3fzjd6uy
  • 2 Health Care Complaints Commission http://tinyurl.com/yh76rzc6
  • 3 The Guardian http://tinyurl.com/328manjt
  • 4 Wikipedia https://en.wikipedia.org/wiki/Legal_status_of_ayahuasca_by_country
  • 5 Wikipedia https://en.wikipedia.org/wiki/Kambo_(drug)
  • 6 The Guardian http://tinyurl.com/2s398psy
  • 7 The Guardian http://tinyurl.com/328manjt
  • 8 ABC http://tinyurl.com/5n7ejydy
  • 9 The Guardian http://tinyurl.com/59wa3rmn
  • 10 ABC http://tinyurl.com/5n7ejydy
  • 11 Byron Bay Echo http://tinyurl.com/44n78s2w

The French ‘National Assembly’ has yesterday adopted a major law aimed at reinforcing the prevention and combat against sectarian aberrations in France. This marks a significant step forward in strengthening the protection of citizens against abuse and manipulation by charlatans, gurus and other sectarian movements.

This bill, the result of particularly fruitful work and debate in both chambers, reflects the Government’s commitment to meeting the expectations of the victims of these sectarian movements.

Some of the key measures voted through by parliamentarians include:

  • The enshrinement in law of the powers of MIVILUDES (Interministerial Mission of Vigilance and Combat against Sectarian Aberrations);
  • The reinforcement of the penal response with the creation of the offence of placing or maintaining in a state of psychological or physical subjection;
  • The creation of an offence of incitement to abandon or refrain from treatment, or to adopt practices which clearly expose the person concerned to a serious health risk;
  • Support for victims, with the extension of the categories of associations that can bring civil action;
  • Information for the judiciary, with the introduction of an “amicus curiae” role for certain government departments in legal cases relating to cults.

Despite sometimes heated debates, particularly around article 4, fuelled by the opinion of the Conseil d’Etat, the adoption of this law by the National Assembly bears witness to a shared desire to protect the rights and freedoms of individuals while providing better protection for our fellow citizens against sectarian aberrations.

This bill is part of a multi-annual national strategy for 2023-2027 resulting from the conference on sectarian aberrations held in spring 2023. It is a major step towards strengthening the penal arsenal and protecting victims.

_______________

Sabrina Agresti-Roubache, Secretary of State for Citizenship and Urban Affairs, commented:

“Long-awaited by victim support associations, this text aims to strengthen our legal arsenal in the fight against sectarian aberrations. I’m delighted that all the articles have been adopted, particularly Article 4, which creates an offence of incitement to abandon or abstain from treatment. There have been some passionate debates in the Chamber, but I’d like to reiterate the basis of this bill: the State is not fighting against beliefs, opinions or religions, but against all forms of sectarian aberrations, these dangerous behaviors which represent a threat to our social cohesion and put lives at risk.”

_______________

Obviously, we shall have to see how the new law will be applied. But, in any case, it is an important step into the right direction and could put an end to much of so-called alternative medicine that endangers the health of French consumers.

Other nations should consicer following the Franch example.

We have often asked whether the General Chiropractic Council (GCC) is fit for purpose. A recent case bought before the Professional Conduct Committee (PCC) of the GCC provides further food for thought.

The male chiropractor in question admitted to the PCC that:

  • he had requested the younger female patient remove her clothing to her underwear for the purposes of examination;
  • he then treated the area near her vagina and groin with a vibrating tool;
  • that he also treated the area around her breasts.

After the appointment, which the patient had originally booked for a problem with her neck, the patient reflected on the treatment and eventually complained about the chiropractor to the GCC. The PCC considered the case and did not find unprofessional conduct in the actions and conduct of the chiropractor. His the diagnosis and treatment were both found to be clinically justified.

According to the GCC, the lesson from this case is that the complaint to the GCC may have been avoided if the chiropractor had been more alert to the need to ensure he communicated effectively so that the patient was clear as to why the intimate areas were being treated and, on that basis, given informed consent. Patients often feel vulnerable before, during and after treatment; and this effect is magnified when the patient is unclothed, new to chiropractic treatment or the work of a particular chiropractor, or they are being treated in an intimate area. Chiropractors can reduce this feeling of vulnerability by offering a chaperone and gown (and recording a note of the patient’s response) as well as taking the time to ensure you have fully explained the procedure to them and obtained informed consentStandard D4 of the GCC Code states registrants must “Consider the need, during assessments and care, for another person to be present to act as a chaperone; particularly if the assessment or care might be considered intimate or where the patient is a child or a vulnerable adult.”

Excuse me?

I find this unbelievably gross and grossly unbelievable!

It begs, I think, the following questions:

  • What condition requires treatment with a ‘vibrating tool’ near the vagina (I assume they mean vulva)?
  • What condition requires treatment with a ‘vibrating tool’ around the breasts?
  • Is there any reliable evidence?
  • Was informed consent obtained?
  • What precisely did it entail?

About 15 years ago, I was an expert witness in a very similar UK case. The defendant was sent to prison for two years. The GCC is really not fit for purpose. It seems to consistently defend chiropractors rather than do its duty and defend their patients.

My advice to the above-mentioned patient is not to bother with the evidently useless GCC but to initiale criminal proceedings.

The so-called ‘Miracle Mineral Solution’ (MMS) – bleach for you and me – is a SCAM that keeps on giving. On this blog, we have featured MMS several times before, e.g.:

Now,it has been reported that a New Zealand anti-vaxxer has been jailed for selling more than $100,000 worth of an industrial bleach as a “miracle” cure for Covid-19. Roger Blake, who describes himself as a “human man”, was sentenced to just over 10 months’ imprisonment after being found guilty at trial of 29 charges in the Hamilton District Court.

Blake advertised and sold MMS products, claiming it could treat, prevent and cure coronavirus. However, New Zealand’s Ministry of Health had not approved the product, and detailed that when ingested became chlorine dioxide – a bleach commonly used for water treatment, bleaching textiles and paper.

The court heard Blake had marketed the product as a cure in New Zealand from the start of the pandemic between December 2019 and December 2020. Medsafe, the health ministry’s safety authority, said Blake’s company had sales of NZ$160,000 in that period – with sales spiking in March when the country was placed in lockdown.

Judge Brett Crowley said Blake’s behaviour had been “utterly disgraceful”. He added that Blake had “seized upon the tragedy” of the pandemic for financial gain. Before selling MMS as a “cure” for the coronavirus, Blake had marketed the product as a preventive of other diseases and illnesses such as cancer, Alzheimer’s, diabetes and HIV.

Medsafe prosecuted him under the Medicines Act, with compliance manager Derek Fitzgerald saying the “fake cure” Blake spruiked presented a “significant public health risk”. “He targeted the vulnerable, preyed on public fears and exposed people to harm”, he said. “This decision sends a strong message that people who engage in selling so called ‘miracle cures’ will be held to account and face fines or imprisonment.”

The website which sold MMS in New Zealand was registered to US-based Mark Grenon, who set up the “Genesis II Church of Health and Healing”. As reported previously, Grenon and his three sons were jailed in October for several years in the US for selling more than US$1m of the product. Michael Homer, an assistant US lawyer who prosecuted the case, said at the time the family targeted people suffering from life-threatening illnesses. The Grenons poisoned thousands of people with their bogus miracle cure, which was nothing more than industrial bleach,” he said.

Medsafe warns: “Drinking MMS is the same as drinking bleach and can cause dangerous side effects, including severe vomiting, diarrhoea, and life-threatening low blood pressure. We strongly encourage people to only go to trusted sources, such as your doctor, to get reliable information”.

Medsafe received three reports of people requiring hospitalizations after drinking MMS. “His conduct presented a significant risk to public health, and that is why Medsafe acted. His actions were in stark contrast to the requirements of the Medicines Act 1981, which is public welfare legislation designed to protect the public” said Mr Fitzgerald.

This review aimed to investigate and categorize the causes and consequences of ‘quack medicine’ in the healthcare.

A scoping review, using the 5 stages of Arksey and O’Malley’s framework, was conducted to retrieve and analyze the literature. International databases including the PubMed, Scopus, Embase and Web of Science and also national Iranian databases were searched to find peer reviewed published literature in English and Persian languages. Grey literature was also included. Meta-Synthesis was applied to analyze the findings through an inductive approach.

Out of 3794 initially identified studies, 30 were selected for this review. Based on the findings of this research, the causes of quackery in the health were divided into six categories:

  • political,
  • economic,
  • socio-cultural,
  • technical-organizational,
  • legal,
  • and psychological.

Additionally, the consequences of this issue were classified into three categories:

  • health,
  • economic,
  • and social.

Economic and social factors were found to have the most significant impact on the prevalence of quackery in the health sector. Legal and technical-organizational factors played a crucial role in facilitating fraudulent practices, resulting in severe health consequences.

The authors concluded that it is evident that governing bodies and health systems must prioritize addressing economic and social factors in combating quackery in the health sector. Special attention should be paid to the issue of cultural development and community education to strengthen the mechanisms that lead to the society access to standard affordable services. Efforts should be made also to improve the efficiency of legislation, implementation and evaluation systems to effectively tackle this issue.

The authors point out that, in the health systems, particularly those of developing countries, a phenomenon known as “Quack Medicine” has been a persistent problem, causing harm in various branches of health care services. They define quackery as unproven or fraudulent medical practices that have no scientifically plausible rationale behind them. Someone who does not have professional qualification, formal registration from a legitimated institution, or required knowledge of a particular branch of medicine but practices in the field of medicine, is a quack, according to the authors’ definition. Finally, they define quack medicine as a fraudulent practice of quacks claiming to possess the ability and experience to diagnose and treat diseases, and pretending that the medicine or treatment they provide are effective, generally for personal and financial gain.

The authors rightly point out that, in some countries, there may be a lack of willpower, determination and effort among political leaders to deal with and prevent fraud and charlatanism in various fields, especially in the health system. This can be due to conflict of interests, corruption network, or insufficient infrastructure and resources, such as financial capacity and human resources. In some cases, they stress, policy makers may choose to tolerate small levels of unproven medical practices if the cost of prosecuting and correcting the situation outweigh the financial benefits. This can lead to a cycle of continued fraud and a lack of effective interventions to address the issue. In many countries laws against quack medicine do exist. However, their effectiveness depends on proper and strict implementation. More efforts and measures must be taken to implement the existing laws. Inadequate enforcement of laws and approval of pseudo-medicine can result in people receiving improper care.

The authors recommend that the healthcare systems, prioritize addressing economic and sociocultural factors in order to effectively combat this issue. In developing solutions, attention must be given to cultural development and community education, and efforts should be made to strengthen mechanisms that provide access to affordable, standard healthcare services for all. Lastly, it is crucial to enhance the performance of systems responsible for legislation, implementation and evaluation of laws and regulations related to quack medicine.

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