Prince Charles
Just when I thought I had received all the insults that one can possibly invent – including that I falsified my qualifications (!) – there comes a new one that nobody has ever thought of.
Like all my books, the new one (this one is in German) is dividing opinions sharply. That has to be expected in the realm of so-called alternative medicine, I suppose. Even though I had hoped to avoid such divisions by discussing the 20 best and the 20 most concerning modalities, there seems to be very little middle ground.
We already discussed the review of our regular Heinrich Huemmer. It was withdrawn by Amazon presumably because it was too offensive and later replaced by his second attempt. Now we have a new review which arguably is even more insulting: 
Edzard Ernst ist ein verbitterter, älterer Ex-Wissenschaftler, der in seiner nachuniversitären Ruhestandszeit die Privatfehde mit seinem Erzfeind Prince Charles, wie im Film “Und täglich grüsst das Murmeltier” wieder und wieder aufarbeiten muss. Das letzte traurige Ergebnis gibt’s jetzt hier.
Here is the translation:
Edzard Ernst is an embittered, elderly ex-scientist who, in his post-university retirement, has to rehash the private feud with his nemesis Prince Charles over and over again, as in the movie “And Every Day the Groundhog Greets.” The latest sad result is now available here.
The review was posted on 21/3/2021 by an anonymous person who had not bought or read the book. As it might also be withdrawn by Amazon for being offensive, I thought I better keep it here for posterity. I find it quite nice because it shows the lack of reason that shines through so often when my critics try to form a coherent argument.
So, please allow me to do a quick analysis:
- I cannot very well judge whether I am embittered. Those around me would deny it, however.
- Yes, I suppose I am elderly; the same age as Charles, actually. If ‘elderly’ is used in a derogatory sense, it gets rather unpleasant, if you ask me.
- I am not an ex-scientist. I still do quite a bit of science which, by any standards, makes me a scientist.
- I don’t think I have a ‘private feud’ with Charles. A feud is an argument that has existed for a long time between two people or groups, causing a lot of anger or violence. If anything I am a critic of Charles’ actions related to SCAM. He has never argued back which means that this does not amount to a feud. If it were a feud, it would also not be private. I have always made my criticism public.
- Is Charles my nemesis? Someone’s nemesis is a person or thing that is very difficult for them to defeat. Charles would indeed be very difficult to defeat because he never discusses with people who are not of his opinion. So, perhaps this point is correct? Yes, except, I never expected to ‘defeat’ Charles; I would be entirely happy to make him realise that some of his notions are ill-conceived.
- Do I really have to rehash whatever it is over and over again? I fear that here the book reviewer is mistaken. Charles is one of the world’s most influential proponents of so-called alternative medicine (SCAM). I am one of the leading experts in this field. Therefore it is only to be expected that I regularly come across his activities.
- “The latest sad result is now available here.” This implies that my new book is full of mentions of Charles. The truth is that Charles or his activities are not mentioned even once (at least I did not find anything when checking just mow).
Boring trivialities?
Not really!
I do find the book review quite revealing. It shows that there must be some (I fear many) people out there who are not willing to even consider an argument deemed to be contrary to their conviction. They close their eyes and ears in motivated ignorance. The funny thing is that this happens even in relation to a book in which I really did try to show some positive sides of SCAM.
In other words, even when I evidently write about the positive aspects of SCAM, the opposition remains stubbornly, closed-minded, and accuses me of closed-mindedness.
Not without irony, that!
I am currently working on a project that involves studying a lot of what our heir to the throne – or is the ‘the heir to our throne? – as done, said and written about so-called alternative medicine (SCAM). Unavoidably, this meant reading his 2010 book HARMONY, A NEW WAY OF LOOKING AT OUR WORLD. In it, Prince Charles states that “… I cannot bear to see people suffer unnecessarily when, so often, a complementary treatment can be beneficial…” This is a statement that Charles has made several times before.
Each time I come across it, I have to think of some of my own patients. It’s a long time since I was a clinician, yet one patient, in particular, often comes to my mind.
He had been a young man healthy, happily married, nice kids, good job, etc. Then one day, he was inattentive or distracted and drove his car full with his wife and kids across a red signal at an unguarded railway crossing. They were all killed instantly.
But almost miraculously, he survived and had just relatively minor injuries which we hoped to put right. So, his body was about to be fine, but his mind was not. Just before being dismissed from the hospital, he tried to commit suicide by jumping out of the 4th-floor window of his room. He survived that too, and we were looking after him and his multiple injuries. As he had lost a lot of blood, he received several blood transfusions. One had been infected and he contracted HIV. He did not survive.
Does Charles know what he is talking about?
How often does he see truly suffering patients?
Does he know that faked empathy might be seen as offensive?
On what evidential basis does he assume that so-called alternative medicine (SCAM) would bring any benefit to severely ill patients?
Does he assume to know better than the clinicians treating the ‘people suffering unnecessarily?
Does he realize that his words are an insult to those who actually do see patients suffer and empathize with them?
Does he know what it means to do everything possible to help patients?
Does he realize that this is achieved by employing the most effective treatments currently available?
Does he know that the most effective treatments would almost never include SCAM?
I am sorry, but sometimes Charles’s musings about SCAM do get under my skin.
When I yesterday reported about Charles’ new paper in a medical journal, I omitted to go into any sort of detail. Merely mumbling ‘this is bait and switch‘ and ‘there is no good evidence that social prescribing is effective‘, is not good enough. Charles deserves better! That’s why today I provide a more detailed analysis of what he wrote on social prescribing.
Social prescribing is a concept that emerged in the UK more than a decade ago [1]. It aims to connect patients to different types of community support, including social events, fitness classes, and social services. Trained professionals, often called link workers or community connections, work with healthcare providers to offer referrals to these types of support. Social prescribing largely exists to fill in healthcare treatment gaps. The basic medical treatment cannot address every concern. Primary care providers don’t always have enough time to get to know their patients and understand the complete picture of their lives.
For example, loneliness can cause stress, which can eventually affect sleep, nutrition, and physical health. Doctors may not be able to offer much help for this problem. That’s where link workers step in. They can provide more specialized support if someone struggles to meet basic wellness or social needs. They get to know a patient’s unique needs and help you take action to meet those needs by referring him or her to helpful resources in the community.[2]
Charles elaborated on social prescribing (or social prescription, as he calls it for some reason) as follows [the numbers in square brackets were added me and refer to my comments below]:
… For a long time, I have been an advocate of what is now called social prescription and this may just be the key to integrating the biomedical, the psychosocial and the environmental, as well as the nature of the communities within which we live and which have such an enormous impact on our health and wellbeing [1]. In particular, I believe that social prescription can bring together the aims of the health service, local authorities, and the voluntary and volunteer sector. Biomedicine has been spectacularly successful in treating and often curing disease that was previously incurable. Yet it cannot hold all the answers, as witnessed, for instance, by the increasing incidence of long-term disease, antibiotic resistance and opiate dependence [2]. Social prescription enables medicine to go beyond pills and procedures and to recognise the enormous health impact of the lives we lead and the physical and social environment within which we live [3]. This is precisely why I have spent so many years trying to demonstrate the vitally important psychosocial, environmental and financial added value of genuinely, sustainable urban planning, design and construction [4].
There is research from University College London, for instance, which shows that you are almost three times more likely to overcome depression if you have a hobby [5]. Social prescription enables doctors to provide their patients with a bespoke prescription that might help them at a time of need …
When we hear that a quarter of 14–16-year-old girls are self-harming and almost a third of our children are overweight or obese, it should make us realise that we will have to be a bit more radical in addressing these problems [5]. And though social prescription cannot do everything, I believe that, used imaginatively, it can begin to tackle these deep-rooted issues [6]. As medicine starts to grapple with these wider determinants of health [7], I also believe that medicine will need to combine bioscience with personal beliefs, hopes, aspirations and choices [8].
Many patients choose to see complementary practitioners for interventions such as manipulation, acupuncture and massage [9]. Surely in an era of personalised medicine, we need to be open-minded about the choices that patients make and embrace them where they clearly improve their ability to care for themselves? [10] Current NHS guidelines on pain that acknowledge the role of acupuncture and mindfulness may lead, I hope, to a more fruitful discussion on the role of complementary medicine in a modern health service [11]. I have always advocated ‘the best of both worlds’ [12], bringing evidence-informed [13] conventional and complementary medicine together and avoiding that gulf between them, which leads, I understand, to a substantial proportion of patients feeling that they cannot discuss complementary medicine with their doctors [14].
I believe it is more important than ever that we should aim for this middle ground [15]. Only then can we escape divisions and intolerance on both sides of the conventional/complementary equation where, on the one hand, the appropriate regulation of the proven therapies of acupuncture and medical herbalism [15] is opposed while, on the other, we find people actually opposing life-saving vaccinations. Who would have thought, for instance, that in the 21st century that there would be a significant lobby opposing vaccination, given its track record in eradicating so many terrible diseases and its current potential to protect and liberate some of the most vulnerable in our society from coronavirus? [16] …
My comments are as follows:
- Is Charles not a little generous to his own vision? Social prescribing is not nearly the same as the concept of integrated medicine which he has been pushing for years.
- There is no good evidence that social prescribing will reduce ‘of long-term disease, antibiotic resistance, and opiate dependence’.
- Here Charles produces a classic ‘strawman fallacy’. Medicine is much more than pills and procedures, and I suspect he knows it (not least because he uses proper medicine as soon as he is really ill).
- Charles has not so much ‘demonstrated’ the importance of ‘psychosocial, environmental and financial added value of genuinely, sustainable urban planning, design, and construction’ as talked about it.
- That does not necessarily mean that social prescribing is effective; correlation is not causation!
- There is no good evidence that social prescribing is effective against self-harm or obesity.
- Medicine has been trying to grapple with ‘wider issues’ for centuries.
- Medicine has done that for many years but we always had to be mindful of the evidence base. It would be unwise to adopt interventions without evidence demonstrating that they do more good than harm.
- Many patients also choose to smoke, drink, or sky-dive. Patient choice is no indicator of efficacy or harmlessness.
- Yes, we should embrace them where they clearly improve their ability to care for themselves. However, the evidence all too often fails to show that they improve anything.
- As we have seen, this discussion has been going on for decades and was not always helped by Charles.
- The best of both worlds can only be treatments that demonstrably generate more good than harm – and that’s called evidence-based medicine. Or, to put it bluntly: in medicine ‘best’ does not signify royal approval.
- ‘Evidence-informed’ is an interesting term. Proper medicine thrives to be evidence-based; royal medicine merely needs to be ‘evidence-informed’? This new term seems to imply that evidence is not all that important. Why? Perhaps because, for alternative medicine, it is largely not based on good evidence?
- If we want to bridge the gulf, we foremost require sound evidence. Today, plenty of such evidence is available. The problem is that it does often not show what Charles seems to think it shows.
- Even the best regulation of nonsense must result in nonsense.
- The anti-vaccination sentiments originate to an alarmingly large extent from the realm of alternative medicine.[4]
REFERENCES
[1] Brandling J, House W. Social prescribing in general practice: adding meaning to medicine. Br J Gen Pract. (2009) 59:454–6. doi: 10.3399/bjgp09X421085
[2] Social Prescribing: Definition, Examples, and More (healthline.com)
[3] Schmidt K, Ernst E. MMR vaccination advice over the Internet. Vaccine. 2003 Mar 7;21(11-12):1044-7. doi: 10.1016/s0264-410x(02)00628-x. PMID: 12559777.
Prince Charles has published his views on integrated health several times before in medical journals. In 2001, authored an editorial in the BMJ promoting his ideas around integrative medicine. Its title: THE BEST OF BOTH WORLDS.[1] This was followed in 2012 by an article in the JRSM where he expressed his views even more clearly.[2] Here is an excerpt:
… By integrated medicine, I mean the kind of care that integrates the best of new technology and current knowledge with ancient wisdom. More specifically, perhaps, it is an approach to care of the patient which includes mind, body and spirit and which maximizes the potential of conventional, lifestyle and complementary approaches in the process of healing. Integrated health, on the other hand, represents an approach to individual and population health which respects and includes all health-related areas, such as the physical and social environment, education, agriculture and architecture…
… I have been attempting to suggest that it might be beneficial to develop truly integrated systems of providing health and care. That is, not simply to treat the symptoms of disease, but actively to create health and to put the patient at the heart of this process by incorporating those core human elements of mind, body and spirit…
This whole area of work – what I can only describe as an ‘integrated approach’ in the UK, or ‘integrative’ in the USA – takes what we know about appropriate conventional, lifestyle and complementary approaches and applies them to patients. I cannot help feeling that we need to be prepared to offer the patient the ‘best of all worlds’ according to a patient’s wishes, beliefs and needs. This requires modern science to understand, value and use patient perspective and belief rather than seeking to exclude them – something which, in the view of many professionals in the field, occurs too often and too readily…
Now, surely, is the time for us all to concentrate some real effort in these areas. We will need to do so by deploying approaches which, at their heart, retain the crucial bedrock elements of traditional and modern civilized health care – of empathy, compassion and the enduring values of the caring professions.
Now Charles has used the current health crisis to do it again. His new article has just been published in the RCP’s ‘Future Healthcare Journal’ [3]. Allow me to show you a crucial section from it:
For a long time, I have been an advocate of what is now called social prescription and this may just be the key to integrating the biomedical, the psychosocial and the environmental, as well as the nature of the communities within which we live and which have such an enormous impact on our health and wellbeing. In particular, I believe that social prescription can bring together the aims of the health service, local authorities, and the voluntary and volunteer sector. Biomedicine has been spectacularly successful in treating and often curing disease that was previously incurable. Yet it cannot hold all the answers, as witnessed, for instance, by the increasing incidence of long-term disease, antibiotic resistance and opiate dependence. Social prescription enables medicine to go beyond pills and procedures and to recognise the enormous health impact of the lives we lead and the physical and social environment within which we live. This is precisely why I have spent so many years trying to demonstrate the vitally important psychosocial, environmental and financial added value of genuinely, sustainable urban planning, design and construction.
There is research from University College London, for instance, which shows that you are almost three times more likely to overcome depression if you have a hobby. Social prescription enables doctors to provide their patients with a bespoke prescription that might help them at a time of need (such as advice on housing and benefits) but which may also provide them with opportunities, hope and meaning by being able to engage in a range of physical, environmental and artistic activities, which resonate with where they are in their lives. Furthermore, social prescription has the potential not only to transform our understanding of what medicine is and does, but also to change the communities in which we all live. I understand, for instance, that alongside social-prescription link workers, there are now people responsible for redesigning and increasing the capacity of the local volunteer and voluntary sector, who can help to create a new social infrastructure and eventually, one might hope, communities that make us healthier rather than making us ill.
When we hear that a quarter of 14–16-year-old girls are self-harming and almost a third of our children are overweight or obese, it should make us realise that we will have to be a bit more radical in addressing these problems. And though social prescription cannot do everything, I believe that, used imaginatively, it can begin to tackle these deep-rooted issues. As medicine starts to grapple with these wider determinants of health, I also believe that medicine will need to combine bioscience with personal beliefs, hopes, aspirations and choices.
Many patients choose to see complementary practitioners for interventions such as manipulation, acupuncture and massage. Surely in an era of personalised medicine, we need to be open-minded about the choices that patients make and embrace them where they clearly improve their ability to care for themselves? Current NHS guidelines on pain that acknowledge the role of acupuncture and mindfulness may lead, I hope, to a more fruitful discussion on the role of complementary medicine in a modern health service. I have always advocated ‘the best of both worlds’, bringing evidence-informed conventional and complementary medicine together and avoiding that gulf between them, which leads, I understand, to a substantial proportion of patients feeling that they cannot discuss complementary medicine with their doctors.
I believe it is more important than ever that we should aim for this middle ground. Only then can we escape divisions and intolerance on both sides of the conventional/complementary equation where, on the one hand, the appropriate regulation of the proven therapies of acupuncture and medical herbalism is opposed while, on the other, we find people actually opposing life-saving vaccinations. Who would have thought, for instance, that in the 21st century that there would be a significant lobby opposing vaccination, given its track record in eradicating so many terrible diseases and its current potential to protect and liberate some of the most vulnerable in our society from coronavirus?
The new article has, I think, all the hallmarks of having been written by Dr Michael Dixon (who has featured many times on this blog). Like the previous papers under Charles’ name, it is a simple ‘BAIT AND SWITCH’ affaire (Bait and switch is a morally suspect sales tactic that lures customers in with specific claims about the quality or low prices on items that turn out to be unavailable in order to upsell them on a similar, pricier item. It is considered a form of retail sales fraud, though it takes place in other contexts).
The bait, in this case, is ‘social prescribing’ (the new hobby horse of Dixon) and the switch is the good old so-called alternative medicine (SCAM). I have discussed social prescribing before, looked at the evidence, and concluded as follows:
The way I see it, it will be (and perhaps already is) used to smuggle bogus alternative therapies into the mainstream. In this way, it could turn out to serve the same purpose as did the boom in integrative/integrated medicine/healthcare: a smokescreen to incorporate treatments into medical routine which otherwise would not pass muster. If advocates of this approach, like Michael Dixon, subscribe to it, the danger of this happening is hard to deny.
The disservice to patients (and medical ethics) would then be obvious: diabetics unquestionably can benefit from a change of life-style (and to encourage them is part of good conventional medicine), but I very much doubt that they should replace their anti-diabetic medications with auto-hypnosis or other alternative therapies.
So, was I right with my prediction that social prescribing will be used to smuggle bogus alternative therapies into the mainstream?
Sadly, the answer seems to be YES.
REFERENCES
[1] The best of both worlds | The BMJ
[2] Hrh. Integrated health and post modern medicine. J R Soc Med. 2012 Dec;105(12):496-8. doi: 10.1258/jrsm.2012.12k095. Epub 2012 Dec 21. PMID: 23263785; PMCID: PMC3536513.
[3] HRH The Prince of Whales: A message from HRH The Prince of Wales, honorary fellow of the Royal College of Physicians. Future Healthcare Journal 2021 Vol 8, No 1: 5–7
PS
Charles new article has a footnote: Address for correspondence: Clarence House, London SW1A 1BA, UK
If you feel strongly about his message, please do write to him and let us know what his response is.
As I don’t live in the UK at present, I miss much of what the British papers report about so-called alternative medicine (SCAM). Therefore, I am a bit late to stumble over an article on the business activities of our Royals. It brought back into memory a little tiff I had with Prince Charles.
The article in the Express includes the following passage:
The UK’s first professor of complementary medicine, Edzard Ernst, dubbed the Duchy Originals detox tincture — which was being sold on the market at the time — “outright quackery”.
The product, called Duchy Herbals’ Detox Tincture, was advertised as a “natural aid to digestion and supports the body’s elimination processes” and a “food supplement to help eliminate toxins and aid digestion”.
The artichoke and dandelion mix cost £10 for a 50ml bottle.
Yet, Professor Ernst said Charles and his advisers seemed to be ignoring the science in favour of relying on “make-believe” and “superstition”, and said the suggestion that such products could remove bodily toxins was “implausible, unproven and dangerous”.
He noted: “Prince Charles thus financially exploits a gullible public in a time of financial hardship.”
This passage describes things accurately but not completely. What actually happened was this:
Unbeknown to me and with the help of some herbalists, Duchy Originals had developed the ‘detox tincture’ during a time when I was researching the evidence about ‘detox’. Eventually, my research was published as a review of the detox concept:
Background: The concept that alternative therapies can eliminate toxins and toxicants from the body, i.e. ‘alternative detox’ (AD) is popular.
Sources of data: Selected textbooks and articles on the subject of AD.
Areas of agreement: The principles of AD make no sense from a scientific perspective and there is no clinical evidence to support them.
Areas of controversy: The promotion of AD treatments provides income for some entrepreneurs but has the potential to cause harm to patients and consumers.
Growing points: In alternative medicine, simplistic but incorrect concepts such as AD abound. AREAS TIMELY FOR RESEARCH: All therapeutic claims should be scientifically tested before being advertised-and AD cannot be an exception.
When I was asked by a journalist what I thought about Charles’ new ‘detox tincture’, I told her that it was not supported by evidence which clearly makes it quackery. I also joked that Duchy Originals could thus be called ‘Dodgy Originals’. The result was this newspaper article and a subsequent media storm in the proverbial teacup.
At Exeter University, I had just fallen out of favor because of the ‘Smallwood Report’ and the complaint my involvement in it prompted by Charles’ first private secretary (full story in my memoir). After the ‘Dodgy Originals story’ had hit the papers, I was summoned ominously to my dean, Prof John Tooke, who probably had intended to give me a dressing down of major proportions. By the time we were able to meet, a few weeks later, the MHRA had already reprimanded Duchy Originals for misleading advertising which took most of the wind out of Tooke’s sail. The dressing down thus turned into something like “do you have to be so undiplomatic all the time?”.
Several months later, I was invited by the Science Media Centre, London, to give a lecture on the occasion of my retirement (Fiona Fox, the head of the SMC, had felt that, since my own University does not have the politeness to run a valedictory lecture for me, she will organize one for journalists). In that short lecture, I tried to summarize 19 years of research which inevitably meant briefly mentioning Charles and his foray into detox.
When I had finished, there were many questions from the journalists. Jenny Hope from the Daily Mail asked, “You mentioned snake-oil salesmen in your talk, and you also mentioned Prince Charles and his tinctures. Do you think that Prince Charles is a snake-oil salesman?” My answer was brief and to the point: “Yes“. The next day, this was all over the press. The Mail’s article was entitled ‘Charles? He’s just a snake-oil salesman: Professor attacks prince on ‘dodgy’ alternative remedies‘.
The advice of Tooke (who by then had left Exeter) to be more diplomatic had evidently not borne fruits (but the tinctures were discreetly taken off the market).
Diplomatic or honest?
This has been a question that I had to ask myself regularly during my 19 years at Exeter. For about 10 years, I had tried my best to walk the ‘diplomatic route’. When I realised that, in alternative medicine, the truth is much more important than diplomacy, I gradually changed … and despite all the hassle and hardship it brought me, I do not regret the decision.
Research into both receptivity to falling for bullshit and the propensity to produce it have recently emerged as active, independent areas of inquiry into the spread of misleading information. However, it remains unclear whether those who frequently produce bullshit are inoculated from its influence. For example, both bullshit receptivity and bullshitting frequency are negatively related to cognitive ability and aspects of analytic thinking style, suggesting that those who frequently engage in bullshitting may be more likely to fall for bullshit. However, separate research suggests that individuals who frequently engage in deception are better at detecting it, thus leading to the possibility that frequent bullshitters may be less likely to fall for bullshit.
Canadian psychologists conducted three studies (N = 826) attempting to distinguish between these competing hypotheses, finding that frequency of persuasive bullshitting (i.e., bullshitting intended to impress or persuade others) positively predicts susceptibility to various types of misleading information and that this association is robust to individual differences in cognitive ability and analytic cognitive style.
This seems to make sense – at least in the contest of so-called alternative medicine (SCAM). Those promoting bullshit are the ones that fall for bullshit.
Think of Prince Charles, for instance. In his book HARMONY and on many other occasions he insists on promoting homeopathy and other SCAM, like for example iridology, osteopathy or detox. He even advocates homeopathy for animals and he proudly tells us that, on his farms, he has instructed the personnel to give his cows homeopathy. Thus he is a good example of someone who is frequently bullshitting with the intend to impress or persuade others while, at the same time, being highly susceptible to various other types of misleading information, such as iridology.
Charles is a good example because we all know about the alternative bee under the royal bonnet. But he is certainly not alone, quite to the contrary. If you look around you, I am sure you will find that there are no end of bullshitters who fall for bullshit. Before bullshit became a term used even in scientific journals, they used to say ‘one can never kid a kidder’, but the new research by the Canadian psychologists seems to suggest that the assumption is not entirely correct.
I was reminded of an event that I had forgotten which, however, is so remarkable that we should remember it. It relates to nothing less than a homeopath’s attempt to save the world!
The homeopath’s name is Grace DaSilva-Hill. She has been a professional homeopath since 1997, with a clinic in Charing (Kent) and international on Zoom, Skype or WhatsApp video. She practises Sensation Homeopathy as refined by Drs Joshis (Mumbai), and Homeopathic Detox Therapy as developed by Dr Ton Jensen. She is also a practitioner of EFT-Tapping. In 2014, Grace very nearly saved the world with homeopathy – well, at least she gave it her very best try. Here is her original plan:
Yes, I agree, that’s hilarious! And it’s hilarious in more than one way:
- It is funnier than any comedian’s attempt to ridicule homeopathy.
- It is a highly effective approach by homeopaths to discrediting themselves.
But, at the same time, it is also worrying. Homeopaths are taken seriously by many influential people. Think of Prince Charles, for instance, or consider the way German homeopaths have convinced the government of Bavaria to invest in research into the question of how homeopathy can be used to reduce antibiotic resistance.
At the time, the formidable Andy Lewis on his QUACKOMETER commented as follows:
We might dismiss this as the fantasies of a small group of homeopaths. However, such thinking is widespread in homeopathic circles and has consequences. Grace is a well known homeopath in the UK, and in the past, has been a trustee and treasurer for the Ghana Homeopathy Project – an organisation that has been exporting this European form of quackery to West Africa. Grace believes that serious illnesses can be treated by a homeopath. For an article in the journal of the Alliance of Registered Homeoapths, Grace discusses treating such conditions as menigitis, malaria and stroke.
Homeopaths in West Africa have hit the news this week as a group tried to enter Liberia in order to use their spells on people with Ebola. The WHO fortunately tried not let them near any actual sick people and they have been kicking and screaming since. The Daily Mail’s rather dreadful article reported that they
“had used homeopathic treatments on patients, despite the instructions from health officials in the capital Monrovia not to do so. She said she had not felt the need to quarantine herself after returning to India but was monitoring her own condition for any signs of the disease.”
The homeopaths appear to have absolutely no understanding how dangerous and irresponsible their actions have been….
Homeopathy is stupid. Magical thinking. A nonsense. Anything goes. And whilst those doctors in the NHS who insist on spending public money on it without taking a responsible stand against the common and dangerous excesses, they can expect to remain under constant fire from those who think they are doing a great deal of harm.
Meanwhile, the public funding of homeopathy in England has stopped; France followed suit. Surely Grace’s invaluable help in these achievements needs to be acknowledged! If we regularly remind decision-makers and the general public of Grace’s attempt to save the world and similarly barmy things homeopaths are up to, perhaps the rest of the world will speed up the process of realizing the truth about homeopathy!?
For some time now, I have been using the umbrella term ‘so-called alternative medicine’ (SCAM). As I explain below, I think it is relatively well-suited. But this is not to say that it is the only name for it. Many other umbrella terms have been used in the past.
Is there perhaps one that you prefer?
- Fringe medicine is rarely used today. It denotes the fact that the treatments under this umbrella are not in the mainstream of healthcare. Some advocates seem to find the word derogatory, and therefore it is now all but abandoned.
- Unorthodox medicine is a fairly neutral term describing the fact that medical orthodoxy tends to shun most of the treatments in question. Strictly speaking, the word is also incorrect; the correct term would be ‘heterodox medicine’.
- Unconventional is also a neutral term but it is open to misunderstandings: any new innovation in medicine might initially be called unconventional. It is therefore less than ideal.
- Traditional medicine describes the fact that most of the modalities in question have been around for centuries and thus have a long tradition of usage. However, as the term is sometimes also used for conventional medicine, it is confusing and far from ideal.
- Alternative medicine is the term everyone seems to know and which is most commonly employed in non-scientific contexts. In the late 1980s, some experts pointed out that the word could give the wrong impression: most of the treatments in question are not used as a replacement but as an adjunct to conventional medicine.
- Complementary medicine became subsequently popular based on the above consideration. It accounts for the fact that the treatments tend to be used by patients in parallel with conventional medicine.
- Complementary and alternative medicine (CAM) describes the phenomenon that many of the treatments can be employed either as a replacement of or as an adjunct to conventional medicine.
- Holistic medicine denotes the fact that practitioners often pride themselves to look after the whole patient – body, mind, and spirit. This could lead to the erroneous impression that conventional clinicians do not aim to practice holistically. As I have tried to explain repeatedly, any good healthcare always has been holistic. Therefore, the term is misleading, in my view.
- Natural medicine describes the notion that many of the methods in question are natural. The term seems attractive and is therefore good for business. However, any critical analysis will show that many of the treatments in question are not truly natural. Therefore this term too is misleading.
- Integrated medicine is currently popular and much used by Prince Charles and other enthusiasts. As we have discussed repeatedly on this blog, the term is nevertheless highly problematic.
- Integrative medicine is the word used in the US for integrated medicine.
- CAIM (complementary/alternative/integrative medicine) is a term that some US authors recently invented. I find this attempt to catch all the various terms in one just silly.
- So-called alternative medicine (SCAM) is the term I tend to use. It accounts for two important facts: 1) if a treatment does not work, it cannot possibly serve as an adequate alternative; 2) if a therapy does work, it should be part of conventional medicine. Thus, there cannot be an ‘alternative medicine’, as much as there cannot be an alternative chemistry or an alternative physics.
Yet,some advocates find ‘SCAM’ derogatory. Intriguingly, my decision to use this term was inspired by Prince Charles, arguably the world’s greatest champion of this sector of healthcare. In his book ‘HARMONY’, he repeatedly speaks of ‘so-called alternative treatments’.
You don’t believe me?
Fair enough!
In this case – and in order to save you the expense of buying Charles’ book for checking – let me provide you with a direct quote: “Some so-called alternative treatments seek to work with these functions to aid recovery…” (page 225).
And who would argue that Charles is dismissive about alternative medicine?
This week, it was reported that a UK bookkeeper has pleaded guilty to abusing his position at In-Light Ltd. by making unauthorized bank transfers to Stroud Accounting Solutions Ltd. The fraud amounted to the sizable sum of £67,000.
In-Light Limited is the holding company for the School of Homeopathy, The School of Health, and Yondercott Press. It offers alternative medicine courses, seminars, books, and webinars focusing on nutrition, homeopathy, herbal medicine, yoga, Indian and Chinese Medicine.
On Twitter, the news of these events prompted several comments, e.g.:
Bookkeeper stole stolen funds, then?
That is typical of a skeptic! Nothing but vicious negativity!!!
Instead of displaying such sarcasm and Schadenfreude, we should empathize, I feel. If not with In-Light Ltd., then with the poor bookkeeper. As another, more compassionate Tweet pointed out, the man is surely innocent:
It started out as 7 pence, but he dropped it in his water bottle and shook it and now look what happened…
This, I think, should have been the line of the bookkeeper’s defense counsel. “My client did nothing wrong at all; he accidentally dropped a penny of In-Light Ltd. that was lying around the office into a water bottle. The bottle then got inadvertently shaken and the water/money mixture thus got potentised. Before my client could do anything to avert the disaster, the money had become the sizable sum of £ 67 000 which my client dutifully put on his bank account for safe-keeping. We, therefore, plead not guilty, your honour”
What, you think the owners of In-Light Ltd. would not have believed this story?
But if they believe in homeopathy, they have no choice. If you believe in homeopathy, you believe anything.
And the judge? Well, the judge has to accept that homeopathy is a fact. And a fact for more than 200 years! Thus, potentisation is real. If all else failed, the defense counsel could call expert witnesses …
Prince Charles, for instance.
I was alerted to an article in which some US doctors, including the famous Andrew Weil, promote the idea that so-called alternative medicine (SCAM) has a lot to offer for people recovering from Covid-19 infections. There would be a lot to argue about their recommendations, but today I will not go into this (I find it just too predictable how SCAM proponents try to promote SCAM on the basis of flimsy evidence; perhaps I am suffering from ‘BS for Covid fatigue’?). What did, however, strike me in their paper was a definition of INTEGRATIVE MEDICINE (IM) that I had not yet come across:
Integrative medicine is defined as healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.
Ever since the term IM became fashionable, there have been dozens of definitions of the term (almost as though IM proponents were not quite sure themselves what they were promoting). And ever since I first heard about IM, I felt it was a thinly disguised attempt to smuggle unproven treatments into the routine of evidence-based medicine (EBM). In 2002, I published my 1st comment on the subject. In it, I warned that IM must not become an excuse for using every conceivable untested treatment under the banner of holism. Nineteen years on, this is exactly what has happened, and one definition of IM after the next is soaked in platitudes, falsehoods and misunderstandings.
So, let’s see how reasonable this new definition is. I will try to do this by briefly discussing each element of the two sentences.
- IM is healing-oriented medicine: this is a transparently daft platitude. Does anyone know a medicine that is not oriented towards healing? Healing is the process of becoming well again, especially after a cut or other injury, or of making someone well again. Healing is what medicine has always been and always be aimed at. In other words, it is not something that differentiates IM from other forms of healthcare.
- IM takes account of the whole person: This is the little holistic trick that IM proponents like to adopt. It implies that normal medicine or EBM is not holistic. This implication is wrong. Any good medicine is holistic, and if a sector of healthcare fails to account for the whole person, we need to reform it. (Here are the conclusions of an editorial I published in 2007 entitled ‘Holistic heath care?‘: good health care is likely to be holistic but holistic health care, as it is marketed at present, is not necessarily good. The term ‘holistic’ may even be a ‘red herring’ which misleads patients. What matters most is whether or not any given approach optimally benefits the patient. This goal is best achieved with effective and safe interventions administered humanely — regardless of what label we put on them.) Creating a branch of medicine that, like IM, pretends to have a monopoly on holism can only hinder this process.
- IM includes all aspects of lifestyle: really, all of them? This is nonsense! Good physicians take into account the RELEVANT lifestyles of their patients. If, for instance, my patient with intermittent claudication is a postman, his condition would affect him differently from a patient who is a secretary. But all lifestyles? No! I fear this ‘over the top’ statement merely indicates that those who have conceived it have difficulties differentiating the important from the trivial.
- IM emphasizes the therapeutic relationship: that’s nice! But so do all other physicians (except perhaps pathologists). As medical students, we were taught how to do it, some physicians wrote books about it (remember Balint?), and many of us ran courses on the subject. Some conventional clinicians might even feel insulted by the implication that they do not emphasize the therapeutic relationship. Again, the IM brigade take an essential element of good healthcare as their monopoly. It almost seems to be a nasty habit of theirs to highjack a core element of healthcare and declare it as their invention.
- IM is informed by evidence: that is brilliant, finally there emerges a real difference between IM and EBM! While proper medicine is BASED on evidence, IM is merely INFORMED by it. The difference is fundamental, because it allows IM clinicians to use any un- or disproven SCAM. The evidence for homeopathy fails to show that it is effective? Never mind, IM is not evidence-based, it is evidence-informed. IM physiciance know homeopathy is a placebo therapy (if not they would be ill-informed which would make them unethical), but they nevertheless use homeopathy (try to find an IM clinic that does not offer homeopathy!), because IM is not EBM. IM is evidence-informed!
- IM makes use of all appropriate therapies: and the last point takes the biscuit. Are the IM fanatics honestly suggesting that conventional doctors use inappropriate therapies? Does anyone know a branch of health care where clinicians systematically employ therapies that are not appropriate? Appropriate means suitable or right for a particular situation or occasion. Are IM practitioners the only ones who use therapies that are suitable for a particular situation? This last point really does count on anyone falling for IM not to have the slightest ability to think analytically.
This short analysis confirms yet again that IM is little more than a smokescreen behind which IM advocates try to smuggle nonsense into routine healthcare. The fact that, during the last two decades, the definition constantly changed, while no half decent definition emerged suggests that they themselves don’t quite know what it is. They like moving the goal post but seem unsure in which direction. And their latest attempt to define IM indicates to me that IM advocates might not be the brightest buttons in the drawer.
