pseudo-science
I was fascinated to find a chiropractor who proudly listed ‘the most common conditions chiropractors help kids with‘:
- Vision problems
- Skin conditions
- Bedwetting
- Sinus problems
- ADD/ADHD
- Stomachaches
- Asthma
- Allergies
- Loss of hearing
- Ear Infections
- Hip, leg, or foot pain
- Constipation
- Poor coordination
- Breastfeeding difficulties
- Arm, hand, or shoulder pain
- Anxiety and nervousness
- Colic
- Scoliosis
The birth process, even under normal conditions, is frequently the first cause of spinal stress. After the head of the child appears, the physician grabs the baby’s head and twists it around in a figure eight motion, lifting it up to receive the lower shoulder and then down to receive the upper shoulder. This creates significant stress on the spine of the baby.
“Spinal cord and brain stem traumas often occur during the process of birth but frequently escape diagnosis. Infants often experience lasting neurological defects. Spinal trauma at birth is essentially attributed to longitudinal traction, especially when this force is combined with flexion and torsion of the spinal axis during delivery.” ~Abraham Towbin, MD
Growth patterns suggest the potential for neurological disorders is most critical from birth to two years of age, as this time is the most dynamic and important phase of postnatal brain development. Over sixty percent of all neurological development occurs after birth in the child’s first year of life. This is why it is so important to bring your child to a local pediatric chiropractor to have them checked and for your child to get a chiropractic adjustment during the first year of their life. Lee Hadley MD states “Subluxation alone is a rational reason for Pediatric Chiropractic care throughout a lifetime from birth.”
As our children continue to grow, the daily stresses can have a negative impact on an ever growing body. During the first few years of life, an infant often falls while learning to walk or can fall while tumbling off a bed or other piece of furniture. Even the seemingly innocent act of playfully tossing babies up in the air and catching them often results in a whiplash-like trauma to the spine, making it essential to get your baby checked by a pediatric chiropractor every stage of his/her development as minor injuries can present as major health concerns down the road if gone uncorrected.
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On the Internet, similar texts can be found by the hundreds. I am sure that many new parents are sufficiently impressed by them to take their kids to a chiropractor. I have yet to hear of a single case where the chiropractor then checked out the child and concluded: “there is nothing wrong; your baby does not need any therapy.” Chiropractors always find something – not something truly pathological, but something to mislead the parent and to earn some money.
Often the treatment that follows turns out to be a prolonged and thus expensive series of sessions that almost invariably involve manipulating the infant’s fragile and developing spine. There is no compelling evidence that this approach is effective for anything. In addition, there is evidence that it can do harm, sometimes even serious harm.
And that’s the reason why I have mentioned this topic before and intend to continue doing so in the future:
- There is hardly a good reason for adults to consult a chiropractor.
- There is no reason to take a child to a chiropractor.
- There are good reasons for chiropractors to stop treating children.
But let’s be a bit more specific. Let’s deal with the above list of indications on the basis of the reliable evidence:
- Vision problems – no sound evidence that chiropractic manipulations are effective.
- Skin conditions – no sound evidence that chiropractic manipulations are effective.
- Bedwetting – some evidence that chiropractic manipulations are ineffective.
- Sinus problems – no sound evidence that chiropractic manipulations are effective.
- ADD/ADHD – some evidence that chiropractic manipulations are ineffective.
- Stomachaches – no sound evidence that chiropractic manipulations are effective.
- Asthma – some evidence that chiropractic manipulations are ineffective.
- Allergies – no sound evidence that chiropractic manipulations are effective.
- Loss of hearing – no sound evidence that chiropractic manipulations are effective.
- Ear Infections – some evidence that chiropractic manipulations are ineffective.
- Hip, leg, or foot pain – no sound evidence that chiropractic manipulations are effective.
- Constipation – no sound evidence that chiropractic manipulations are effective.
- Poor coordination – no sound evidence that chiropractic manipulations are effective.
- Breastfeeding difficulties – no good evidence that chiropractic manipulations are effective.
- Arm, hand, or shoulder pain – no sound evidence that chiropractic manipulations are effective.
- Anxiety and nervousness – no sound evidence that chiropractic manipulations are effective.
- Colic – some evidence that chiropractic manipulations are ineffective.
- Scoliosis – no sound evidence that chiropractic manipulations are effective.
I rest my case.
This study aimed to evaluate the number of craniosacral therapy sessions that can be helpful to obtain a resolution of the symptoms of infantile colic and to observe if there are any differences in the evolution obtained by the groups that received a different number of Craniosacral Therapy sessions at 24 days of treatment, compared with the control group which did not received any treatment.
Fifty-eight infants with colic were randomized into two groups:
- 29 babies in the control group received no treatment;
- babies in the experimental group received 1-3 sessions of craniosacral therapy (CST) until symptoms were resolved.
Evaluations were performed until day 24 of the study. Crying hours served as the primary outcome measure. The secondary outcome measures were the hours of sleep and the severity, measured by an Infantile Colic Severity Questionnaire (ICSQ).
Statistically significant differences were observed in favor of the experimental group compared to the control group on day 24 in all outcome measures:
- crying hours (mean difference = 2.94, at 95 %CI = 2.30-3.58; p < 0.001);
- hours of sleep (mean difference = 2.80; at 95 %CI = – 3.85 to – 1.73; p < 0.001);
- colic severity (mean difference = 17.24; at 95 %CI = 14.42-20.05; p < 0.001).
Also, the differences between the groups ≤ 2 CST sessions (n = 19), 3 CST sessions (n = 10), and control (n = 25) were statistically significant on day 24 of the treatment for crying, sleep and colic severity outcomes (p < 0.001).
The authors concluded that babies with infantile colic may obtain a complete resolution of symptoms on day 24 by receiving 2 or 3 CST sessions compared to the control group, which did not receive any treatment.
Why do SCAM researchers so often have no problem leaving the control group of patients in clinical trials without any treatment at all, while shying away from administering a placebo? Is it because they enjoy being the laughingstock of the science community? Probably not.
I suspect the reason might be that often they know that their treatments are placebos and that their trials would otherwise generate negative findings. Whatever the reasons, this new study demonstrates three things many of us already knew:
- Colic in babies always resolves on its own but can be helped by a placebo response (e.g. via the non-blinded parents), by holding the infant, and by paying attention to the child.
- Flawed trials lend themselves to drawing the wrong conclusions.
- Craniosacral therapy is not biologically plausible and most likely not effective beyond placebo.
The global interest in dieting has increased, and many people have become obsessed with certain fad diets, assuming they are magic bullets for their problems. A fad diet is a popular dietary pattern known to be a quick fix. This review article explores the current evidence related to the health impacts of (amongst others) detox diets (DDs). DDs are interventional diets specifically designed for toxins elimination, health promotion, and weight management. They involve multiple approaches, including total calorie restriction, dietary modification, or juice fasts, and often the use of additional minerals, vitamins, diuretics, laxatives, or ‘cleansing foods’. Some of the many DDs used today are listed below:
| Diet type | Duration | Foods allowed | Proposed claims |
| Liver cleansing diet | 8 weeks | Plant-based, dairy-free, low-fat, high-fiber, unprocessed foods are allowed. Epsom salt and liver tonics are also consumed. | Improved energy levels and liver function Toxins removal Improved immune response Efficient metabolism of fats and better weight control |
| Lemon detox diet/Master cleanser | 10 days | A liquid-only diet based on purified water, lemon juice, tree syrup, and cayenne pepper. A mild laxative herbal tea and sea salt water is also incorporated. | Toxins removal Shiny hair, glowing skin, and strong nails Weight loss |
| The clean cleanse | 21 days | Breakfast and dinner comprise probiotic capsules, cleanse supplements and cleanse shakes. A solid meal in lunch while avoiding gluten, dairy, corn, soy, pork, beef, refined sugars, some fruits, and vegetables. | Toxins removal Improved energy, digestion, sleep, and mental health Reduction in joint pains, headaches, constipation, and bloating |
| Martha’s vineyard detox diet | 21 days | Herbal teas, vegetable soups and juices, specially formulated tablets, powders and digestive enzymes are on the menu. | Weight loss Toxins removal Improved energy levels |
| Weekend wonder detox | 48 h | Protein-rich meals salads, detox-promoting superfoods, and beverages. Healthy lifestyle, spa treatments, and herbal remedies. | Toxins removal Improved organ function Strengthen body Enhance beauty |
| Fat flush | 2 weeks | Large meals are replaced with dilute cranberries, hot water with lemon, pre-prepared cocktails, supplements, and small meals | Toxins removal Reduced stress Weight loss Improved liver function |
| Blueprint cleanse | 3 days | Consumption of six pre-prepared vegetable and fruit juices is allowed per day. | Toxins removal |
| The Hubbard purification rundown | Several weeks | Niacin doses along with sustained consumption of vitamin-A, B, C, D, and E. Daily exercise with balanced meals. Restriction of alcohol and drugs. Sitting in a sauna for ≤ 5 h each day. | Toxins removal from fat stores Improved memory and intelligence quotient Better blood pressure and cholesterol levels |
Currently, there is no good clinical evidence for the effectiveness of DDs and some evidence to suggest they might do harm. Many of the DD are liquid-based, low-calorie, and nutrient-poor. For example, a part of BluePrint Cleanse, Excavation Cleanse, provides only 19 g protein and 860 kcal/day which is far below the actual requirement. Food and Agriculture Organization (FAO) recommends a minimum of 0.83 g/kg body weight of high-quality protein and 1,680 kcal/day for an adult. DDs may also induce stress, raise cortisol levels, and increase appetite, resulting in binge eating and weight gain.
As no convincing positive evidence exists for DDs and detox products, their use needs to be discouraged by health professionals. Moreover, regulatory review and adequate safety monitoring should be considered.
Guest post by Norbert Aust and Viktor Weisshäupl
Readers of this blog may remember the recent study of Frass et al. about the adjunct homeopathic treatment of patients suffering from non-small cell lung cancer (here). It was published in 2020 by the ‘Oncologist’, a respectable journal, and came to stunning results about to the effectiveness of homeopathy.
In our analysis, however, we found strong indications for duplicity: important study parameters like exclusion criteria or observation time were modified post hoc, and data showed characteristics that occur when unwanted data sets get removed.
We, that is the German Informationsnetzwerk Homöopathie and the Austrian ‘Initiative für wissenschaftliche Medizin’, had informed the Medical University Vienna about our findings – and the research director then asked the Austrian Agency for Scientific Integrity (OeAWI) to review the paper. The analysis took some time and included not only the paper and publicly available information but also the original data. In the end, OeAWI corroborated our findings: The results are not based on sound research but on modified or falsified data.
Here is their conclusion in full:
The committee concludes that there are numerous breaches of scientific integrity in the Study, as reported in the Publication. Several of the results can only be explained by data manipulation or falsification. The Publication is not a fair representation of the Study. The committee cannot for all the findings attribute the wrongdoings and incorrect representation to a single individual. However following our experience it is highly unlikely that the principal investigator and lead author, but also the co-authors were unaware of the discrepancies between the protocols and the Publication, for which they bear responsibility. (original English wording)
Profil, the leading news magazine of Austria reported in its issue of October 24, 2022, pp 58-61 (in German). There the lead author, Prof. M. Frass, a member of Edzard’s alternative medicine hall of fame, was asked for his comments. Here is his concluding statement:
All the allegations are known to us and completely incomprehensible, we can refute all of them. Our work was performed observing all scientific standards. The allegation of breaching scientific integrity is completely unwarranted. To us, it is evident that not all documents were included in the analysis of our study. Therefore we requested insight into the records to learn about the basis for the final statement.
(Die Vorwürfe sind uns alle bekannt und absolut unverständlich, alle können wir entkräften. Unsere Arbeit wurde unter Einhaltung aller wissenschaftlichen Standards durchgeführt. Der Vorhalt von Verstößen gegen die wissenschaftliche Intergrität enbehrt jeder Grundlage. Für uns zeigt sich offenkundig, dass bei der Begutachtung unserer Studie nicht alle Unterlagen miteinbezogen wurden. Aus diesem Grunde haben wir um Akteneinsicht gebeten, um die Grundlagen für das Final Statment kennenzulernen.)
The OeAWI together with the Medical University Vienna asked the ‘Oncologist’ for a retraction of this paper – which has not occurred as yet.
Aging often contributes to a decrease in physical activity. As age advances, a decrease in muscle mass, muscle strength, and flexibility can impair physical function. One obvious way to prevent these developments might be regular physical exercise.
This open-label, randomized trial was intended to evaluate the effects of an integrated yoga module in improving the flexibility, muscle strength, and quality of life (QOL) of older adults. Participants were 96 older adults, aged 60-75 years (64.1 ± 3.95 years). The program was a three-month, yoga-based lifestyle intervention. The participants were randomly allocated to the intervention group (n = 48) or to a waitlisted control group (n = 48). The intervention group underwent three one-hour sessions of yoga weekly, with each session including loosening exercises, asanas, pranayama, and meditation spanning.
At baseline and post-intervention, the following assessments were made:
- spinal flexibility using a sit-and-reach test,
- back and leg strength using a back leg dynamometer,
- handgrip strength (HGS) and endurance (HGE) using a hand-grip dynamometer,
- Older People’s Quality of Life (OPQOL) questionnaire.
Analysis was performed employing Wilcoxon’s Sign Rank tests and Mann-Whitney Tests, using an intention-to-treat approach.
The results show that, compared to the control group, the intervention group experienced a significantly greater increase in spinal flexibility (P < .001), back leg strength (P < .001), HGE (P < .01), and QOL (P < .001) after three months of yoga.
The authors concluded that yoga can be used safely for older adults to improve flexibility, strength, and functional QOL. Larger randomized controlled trials with an active control intervention are warranted.
I agree with the authors that this trial was too small and not properly controlled. I disagree that their study shows yoga to be effective or safe. In fact, the two sentences of the conclusion do not seem to fit together at all.
Is it surprising that doing yoga exercises is better than doing nothing at all?
No!
Is it relevant to demonstrate this fact in an RCT?
No!
If anyone wants to test the value of yoga exercises, they must compare them to conventional exercises. And why don’t they do this? Could it be because they know they would be unlikely to show that yoga is superior?
Yesterday, L’EXPRESS published an interview with me. It was introduced with these words (my translation):
Professor emeritus at the University of Exeter in the United Kingdom, Edzard Ernst is certainly the best connoisseur of unconventional healing practices. For 25 years, he has been sifting through the scientific evaluation of these so-called “alternative” medicines. With a single goal: to provide an objective view, based on solid evidence, of the reality of the benefits and risks of these therapies. While this former homeopathic doctor initially thought he was bringing them a certain legitimacy, he has become one of their most enlightened critics. It is notable as a result of his work that the British health system, the NHS, gave up covering homeopathy. Since then, he has never ceased to alert us to the abuses and lies associated with these practices. For L’Express, he looks back at the challenges of regulating this vast sector and deciphers the main concepts put forward by “wellness” professionals – holism, detox, prevention, strengthening the immune system, etc.
The interview itself is quite extraordinary, in my view. While UK, US, and German journalists usually are at pains to tone down my often outspoken answers, the French journalists (there were two doing the interview with me) did nothing of the sort. This starts with the title of the piece: “Homeopathy is implausible but energy healing takes the biscuit”.
The overall result is one of the most outspoken interviews of my entire career. Let me offer you a few examples (again my translation):
Why are you so critical of celebrities like Gwyneth Paltrow who promote these wellness methods?
Sadly, we have gone from evidence-based medicine to celebrity-based medicine. A celebrity without any medical background becomes infatuated with a certain method. They popularize this form of treatment, very often making money from it. The best example of this is Prince Charles, sorry Charles III, who spent forty years of his life promoting very strange things under the guise of defending alternative medicine. He even tried to market a “detox” tincture, based on artichoke and dandelion, which was quickly withdrawn from the market.
How to regulate this sector of wellness and alternative medicines? Today, anyone can present himself as a naturopath or yoga teacher…
Each country has its own regulation, or rather its own lack of regulation. In Germany, for instance, we have the “Heilpraktikter”. Anyone can get this paramedical status, you just have to pass an exam showing that you are not a danger to the public. You can retake this exam as often as you want. Even the dumbest will eventually pass. But these practitioners have an incredible amount of freedom, they even may give infusions and injections. So there is a two-tier health care system, with university-trained doctors and these practitioners.
In France, you have non-medical practitioners who are fighting for recognition. Osteopaths are a good example. They are not officially recognized as a health profession. Many schools have popped up to train them, promising a good income to their students, but today there are too many osteopaths compared to the demand of the patients (knowing that nobody really needs an osteopath to begin with…). Naturopaths are in the same situation.
In Great Britain, osteopaths and chiropractors are regulated by statute. There is even a Royal College dedicated to chiropractic. It’s a bit like having a Royal College for hairdressers! It’s stupid, but we have that. We also have professionals like naturopaths, acupuncturists, or herbalists who have an intermediate status. So it’s a very complex area, depending on the state. It is high time to have more uniform regulations in Europe.
But what would adequate regulation look like?
From my point of view, if you really regulate a profession like homeopaths, it means that these professionals may only practice according to the best scientific evidence available. Which, in practice, means that a homeopath cannot practice homeopathy. This is why these practitioners have a schizophrenic attitude toward regulation. On the one hand, they would like to be recognized to gain credibility. But on the other hand, they know very well that a real regulation would mean that they would have to close shop…
What about the side effects of these practices?
If you ask an alternative practitioner about the risks involved, he or she will take exception. The problem is that there is no system in alternative medicine to monitor side effects and risks. However, there have been cases where chiropractors or acupuncturists have killed people. These cases end up in court, but not in the medical literature. The acupuncturists have no problem saying that a hundred deaths due to acupuncture – a figure that can be found in the scientific literature – is negligible compared to the millions of treatments performed every day in this discipline. But this is only the tip of the iceberg. There are many cases that are not published and therefore not included in the data, because there is no real surveillance system for these disciplines.
Do you see a connection between the wellness sector and conspiracy theories? In the US, we saw that Qanon was thriving in the yoga sector, for example…
Several studies have confirmed these links: people who adhere to conspiracy theories also tend to turn to alternative medicine. If you think about it, alternative medicine is itself a conspiracy theory. It is the idea that conventional medicine, in the name of pharmaceutical interests, in particular, wants to suppress certain treatments, which can therefore only exist in an alternative world. But in reality, the pharmaceutical industry is only too eager to take advantage of this craze for alternative products and well-being. Similarly, universities, hospitals, and other health organizations are all too willing to open their doors to these disciplines, despite the lack of evidence of their effectiveness.
We have repeatedly discussed the issue of detox as used in so-called alternative medicine (SCAM) and seen that, for a whole range of reasons, it is utter nonsense, e.g.:
- Remember Prince Charles’ ‘Duchy Originals Detox Tincture’?
- Now that you have paid through your nose for the ‘tox’, how about a ‘detox’ through your nose?
- Homotoxicology: ‘the best kept detox secret’? No, it’s even worse than homeopathy!
- Detox is bunk; save your money for something useful, fun or pleasant!
- Scientology detox? No thanks!!!
- ‘DETOX’ = a dangerous and counter-productive illusion
- Have yourself a merry little detox
- It’s beginning to look a lot like DETOX…everywhere I go
But would it not be better to keep toxins from entering the body in the first place?
Yes, you suspected correctly: there are products that claim to do exactly this. Here is a particularly ‘impressive’ one:
ION* Gut Support seals cells in the gut lining, helping to keep toxins out of your body and strengthening the terrain upon which your microbiome can diversify. it uses Humic Extract (from Ancient Soil) and Purified Water.
Humic extract is sourced from ancient soil (roughly 60 million years old), and contains a blend of bacterial metabolites (aka, fulvate) as well as less than 1% of a variety of trace minerals and amino acids including chloride, sodium, lithium, calcium, phosphorus, sulfur, bromide, potassium, iron, antimony, zinc, copper, gold, magnesium, alanine, glycine, histidine, isoleucine, methionine, threonine, and valine.
… the trace minerals in our humic extract are naturally occurring, well below the RDI, and not meant to be used as supplementary to any deficiencies. The truly active compound in humic extract is the fulvate, a unique family of carbon molecules with oxygen-binding sites that are produced by bacteria when they digest nutrients. These molecules are the backbone of the ION* blend, helping with critical functions like cellular and microbial communication and chelation of nutrients.
The science behind ION* lies in strengthening the cellular integrity of your body’s barriers, including not just your gut, but your sinuses and skin as well. Keeping your cells connected keeps these barriers intact, which sets the stage (or “terrain” as we like to call it) for seamless interaction between you and your microbiome.
At ION*, we’re all about connection – starting with the very foundation of our science: tight junction integrity. Tight junctions are the seals between your cells which help to create defensive barriers at the gut, skin, and sinuses. They act intelligently to keep toxins and foreign particles out of the blood stream while also allowing nutrients to enter. These seals are protected by the carbon and mineral metabolites of bacterial digestion.
Unfortunately, tight junction barriers can be degraded with exposure to gluten, glyphosate (the main chemical in commercial herbicides like Roundup), and other environmental insults. ION* has been scientifically shown to promote the strengthening of this barrier through redox signaling, even in the face of those environmental insults.
Your body’s barriers know what to let in (nutrients) and what to ward off (toxins). But the barriers must be strong. ION* works to strengthen your gut, sinus, and skin barriers at a cellular level by fostering tight junction integrity, helping to promote this intelligent defense system at a foundational level.
So much scientific-sounding language can make your head spin.
Which toxins are we talking about?
Are there any clinical studies of the product?
Why is the product so expensive?
What exactly are Humic substances?
I found an answer to only the last question. Humic substances are organic compounds that are important components of humus, the major organic fraction of soil, peat, and coal, and also a constituent of many upland streams, dystrophic lakes, and ocean water.
I imagine that tightening the named junctions – if this is truly a realistic mechanism of action – might interfere with the absorption of all sorts of substances that the body needs for survival. I am, of course, speculating, but one should ask about the risks of using this product (other than the one to the consumer’s bank account).
What we need are clinical studies. And there seem to be none (if anyone knows one, please let me know).
So, what do we call again a health product that makes unsubstantiated claims?
Was it perhaps ‘snake oil’?
The objective of this study was to evaluate the effect of acupuncture on cognitive task performance in college students.
Sixty students aged 18-25 years were randomly allocated into acupuncture group (AG) (n=30) and control group (CG) (n=30). The AG underwent 20 min of acupuncture/day, while the CG underwent their normal routine for 10 days. Assessments were performed before and after the intervention.
Between-group analysis showed a significant increase in AG’s six-letter cancellation test (SLCT) score compared with CG. Within-group analysis showed a significant increase in the scores of all tests (i.e. SLCT, forward and backward Digit span test [DST]) in AG, while a significant increase in backward DST was observed in CG.
The authors concluded that acupuncture has a beneficial effect on improving the cognitive function of college students.
I am unable to access the full paper [it is behind a paywall]. Thus, I am unable to assess the study in further detail. As I am skeptical about the validity of the effect, I can only assume that it is due to the expectation of the volunteers receiving acupuncture. There was not even an attempt to control for placebo effects!
The over-stated conclusion made me wonder what else the 1st author has published. It turns out he has three more Medline-listed papers to his name all of which are about so-called alternative medicine (SCAM).
The 1st one is an RCT similar to the one above, i.e. without an attempt to control for placebo effects. Its conclusion is equally over-stated: Acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.
The other two papers refer to one case report each. Despite the fact that case reports (as any researcher must know) do not lend themselves to conclusions about the effectiveness of the treatments employed, the authors’ conclusions seem to again over-state the case:
- This suggests that integrative Naturopathy and Yoga therapies could be considered as an adjuvant to conventional medicine in rheumatoid arthritis associated with type-2 diabetes and essential hypertension.
- Though the results are encouraging, further studies are required with larger sample size and advanced inflammatory markers.
What does that tell us?
I don’t know about you, but I would not rely on acupuncture to improve my mental performance.
Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Placebo
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
The ‘Münster Circle‘ is an informal association of multi-disciplinary experts who critically examine issues in and around so-called alternative medicine (SCAM). We exist since June 2016 and are the result of an initiative by Dr Bettina Schöne-Seifert, Professor and Chair of Professor and Chair of Medical Ethics at the University of Münster.
In the past, we have published several documents which have stimulated discussions on SCAM-related subjects. Yesterday, we have published our ‘MEMORANDUM INTEGRATIVE MEDICINE‘. It is a critical analysis of this subject and will hopefully make some waves in Germany and beyond.
Here is its English summary:
The merging of alternative medicine and conventional medicine has been increasingly referred to as Integrative (or Integrated) Medicine (IM) since the 1990s and has largely replaced other terms in this field. Today, IM is represented at all levels.
IM is often characterised with the thesis of the ‘best of both worlds’. However, there is no generally accepted definition of IM. Common descriptions of IM emphasise:
– the combination of conventional and complementary methods,
– the holistic understanding of medicine,
– the great importance of the doctor-patient relationship,
– the hope for optimal therapeutic success,
– the focus on the patient,
– the high value of experiential knowledge.
On closer inspection, the descriptions of IM show numerous inconsistencies. For example, medicine in the hands of doctors is stressed, but it is also emphasised that all relevant professions would be involved. Scientific evidence is emphasised, but at the same time, it is stressed that IM itself includes homeopathy as well as other unsubstantiated treatments and is only ‘guided’ by evidence, i.e. not really evidence-based. It is claimed that IM is to be understood as ‘complementary to science-based medicine’; however, this implies that IM itself is not science-based.
The ‘best of both worlds’ thesis impresses many. However, if one investigates what is meant by ‘best’, one finds that this term is not interpreted in nearly the same way as in conventional medicine. Many claims of IM are elementary components of all good medicine and thus cannot be counted among the characterising features of IM. Finally, it is hard to ignore the fact that the supporters of IM use it as a pretext to introduce unproven or disproven modalities into conventional medicine. Contrary to promises, IM has no discernible potential to improve medicine; rather, it creates confusion and entails considerable dangers. This cannot be in the interest of patients.
Against this background, it must be demanded that IM is critically scrutinised at all levels.
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