Edzard Ernst

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

The claim that Elon Musk might be “killing millions” sounds like hyperbolic rhetoric, but it is an entirely predictable mathematical projection of his policy choices. Peer-reviewed global health modeling showed that the systematic dismantling of USAID—spearheaded by Musk’s Department of Government Efficiency (DOGE)—will result in over 14 million preventable deaths by 2030, millions of whom are children. By freeze-framing and terminating programs that provide life-saving vaccines, malaria bed nets, and HIV therapeutics, these actions have directly triggered the resurgence of entirely controllable diseases.

Hard to believe?

See for yourself; here is the abstract of the paper published in the Lancet:

Background: Official development assistance (ODA) accounts for the majority of humanitarian and development assistance in the world’s most vulnerable countries and has played a pivotal role in advancing global health. We aimed to comprehensively evaluate the impact of ODA funding on mortality across the past two decades, and to project the potential consequences of current defunding trends.

Methods: We conducted an integrated retrospective evaluation and forecasting analysis using longitudinal panel data from 93 low-income and middle-income countries (LMICs). First, we estimated the association between ODA per-capita funding and mortality outcomes from 2002 to 2021 using a two-ways fixed-effects multivariable Poisson regression model with robust standard errors, adjusted for all relevant demographic, socioeconomic, and health-system covariates. We then assessed age-specific and cause-specific effects, performing extensive sensitivity and triangulation analyses to test the robustness and causal interpretation of results. Finally, we integrated the retrospective impact estimates into validated country-level microsimulation models to forecast mortality under three defunding scenarios up to 2030: a business-as-usual trajectory, a severe defunding scenario, and a mild defunding scenario.

Findings: Higher ODA funding levels were associated with a 23% reduction in age-standardised all-cause mortality (rate ratio [RR] 0·77; 95% CI 0·70-0·85) and a 39% reduction in under-5 mortality (0·61; 0·49-0·75). ODA funding was associated with large mortality declines in major communicable diseases: 70% for HIV/AIDS (RR 0·30; 95% CI 0·24-0·39), 56% for malaria (0·44; 0·35-0·56), 56% for nutritional deficiencies (0·44; 0·30-0·65), and 54% for neglected tropical diseases (0·46; 0·36-0·59). Significant reductions were also observed in mortality from tuberculosis, diarrhoeal diseases, lower respiratory infections, and maternal and perinatal causes. Forecasting analyses projected that ongoing reductions in ODA funding could, under a severe defunding scenario, result in 22·6 million (95% uncertainty interval [UI] 16·3-29·3) additional deaths across all ages by 2030, including 5·4 million (4·1-6·8) among children younger than 5 years. Under a mild defunding scenario-defined as a continuation of current downward trends-the projected excess deaths would be 9·4 million (95% UI 6·2-12·6) overall and 2·5 million (1·8-3·2) among children younger than 5 years.

Interpretation: ODA funding has played a decisive role in reducing preventable mortality across LMICs over the past two decades, and the abrupt withdrawal of this support threatens to cause millions of avoidable deaths, reversing decades of progress in global health.

Funding: RF Catalytic Capital and the Spanish Ministry of Science and Innovation.

Attempting to shield Musk from the moral indictment of these deaths by hiding behind bureaucratic complexity is a cop-out. Musk is not a passive advisor suggesting minor budgetary trims; he has aggressively engineered and celebrated the destruction of these aid mechanisms on his public platform, explicitly branding the defunding of life-saving infrastructure as “clipping waste.” When an individual wields unchecked power to eliminate interventions with legally and medically proven survival rates, the line between “efficiency” and institutional negligence disappears. He is fully aware of the survival benefits of these programs, making the choice to dismantle them a calculated acceptance of mass mortality.

While defenders argue that epidemiological models deal in macro-statistics rather than localized causality, this defense elides the nature of modern accountability. Musk cannot hand-select which specific child dies of malaria, but he did hand-select the budget line that funded their treatment. Pretending this is just a structural or collective government failure sanitizes the reality: a single billionaire used his leverage to treat global survival infrastructure like an unprofitable corporate acquisition, making him materially and morally responsible for the human body count that follows.

In March 2025, a federal judge ruled that DOGE’s effort to dismantle USAID likely violated the Constitution and ordered restoration of access to key systems, saying USAID had been effectively eliminated. That matters because it weakens any claim that the dismantling was merely speculative or rhetorical: courts have already treated the shutdown effort as legally serious.

For a deeper look into the systemic impact of these specific health program suspensions and the firsthand accounts of how these funding disruptions unfolded on the ground, you can watch this France 24 Interview with a USAID Whistleblower.

Critics of so-called alternative medicine (SCAM) often point out that much of it lacks plausibility. Proponents of SCAM tend to think that this is an irrelevance. So, what is plausibility, and why does it matter?

Think of scientific plausibility as a reality check. Before scientists spend time and money testing a new idea, they ask a basic question: Does it actually line up with what we already know about how the universe works? While an idea being plausible doesn’t automatically make it true, it acts as a crucial filter. It helps us separate ideas that are worth investigating from those that break the fundamental laws of logic, physics, chemistry, biology, etc.

This is exactly where many SCAMs fall apart. Their claims often contradict basic science before a study even begins. Take homeopathy, for example. It relies on the idea that a substance can cure an illness, even if it is diluted over and over again, often to the point where not a single molecule of the original ingredient is left. This directly defies molecular theory and the well-established “dose-response relationship,” which simply states that the amount of a substance matters. Similarly, practices like “energy healing” postulate mysterious vital energies that cannot be seen, felt, or measured by any instrument known to modern science.

This matters because it changes how we look at “proof.” In science, if an idea is highly unlikely from the start, a single positive study usually isn’t a breakthrough. Instead, it’s much more likely to be a fluke, a statistical error, the result of a flawed experiment or even fraud.

Instead of trying to fix these scientific contradictions, proponents of SCAM often change the subject or move the goalpost. They might, for instance, that claim the scientific method is closed-minded or simply ignore negative results. But you cannot bypass the rules of reality. If a treatment claims to do something that contradicts everything we know about nature, it requires extraordinary proof to be taken seriously.

I do understand why SCAM enthusiasts try to ignore the issue of plausibility. But ignoring it runs several risks. For instance, it risks doing research that is entirely wasteful. More importantly perhaps, it risks paying undue attention to false positive results which, in turn, can seriously harm vulnerable patients – just think of a cancer patient who has fallen victim to the claims of homeopaths – backed by multiple, implausible and fase-positive results – suggesting that homeopathy can cure cancer.

The Trump administration is trying to introduce new rules that would put political appointees, rather than career scientists and civil servants, in the decisive role on federal research grants. The proposal would make senior appointees review grants for compliance with law and the Trump’s priorities, and it would make it easier to terminate grants already awarded.

The proposal was published by the White House budget office in late May 2026 and is part of a broader effort to tighten political control over federal spending rules. The administration plans to implement the proposal on 1 October. The comment period is open through 13 July*.

Under the draft rules, political appointees would have oversight over grants and could decide whether funding aligns with Trump’s wishes. The new rules would let appointees terminate grants after they have already been awarded. Scientists therefore warn that ongoing projects could be put at risk. Peer review would be weakened and expert views treated as advisory rather than decisive.

This would decisively move funding decisions away from scientific merit and toward political criteria which would chill work on politically sensitive topics and give non-experts the power to shape what gets investigated.

Crucially, this is not a one-off move: Trump has already signed an executive order in August 2025 directing agencies to give appointees oversight of grants so they would advance his priorities. The new proposal this is the regulatory mechanism that would turn that earlier order into a permanent system.

In practical terms, this legislation is a major shift from expert-led grant to politically supervised grant making. It constitutes a direct threat to scientific independence.

*You can submit your public comment on the OMB proposed rule at:

https://www.regulations.gov/docket/OMB-2026-0034

Steps:

      • Go to that link and click the “Open for Comments” button (or directly click “Comment” on the docket page).
      • Scroll to the bottom and click “Comment.”
      • Start your comment by including the relevant section number in brackets, for example [200.461], so OMB can route it properly.
      • Write in your own words, focusing on specific impacts on your work or institution.
      • Avoid including private details like your home address or phone number, since comments are posted publicly.

“Science and pseudoscience diverge particularly sharply in their ethical and moral foundations. While science is built upon principles of honesty, openness, and responsibility, pseudoscience undermines these values often by placing ideology and belief over evidence and truth. Science is not least an ethical enterprise, and the divide between science and pseudoscience is a matter of profound moral importance. The ethical stakes become especially acute when pseudoscience causes harm…”

These lines come from my recent book, THE LEOPARD LILY PROJECT, which is only marginally about so-called alternative medicine (SCAM). Yet they do apply well to SCAM which does not merely fail the test of scientific rigor but also fails the test of medical ethics. When a practice trades empirical validation for dogmatic ideology, it ceases to be an innocent alternative and becomes a profound moral transgression. SCAM regularly promises holistic salvation while actively undermining the principles of honesty, openness, and responsibility, effectively replacing rigorous scrutiny with profitable mystique.

The ethical stakes transition from academic to tragic whenever a vulnerable patient is guided away from effective treatments. SCAM cloaks itself in the gentle language of empathy and natural, holistic, individualised healing, yet its business model relies on exploiting the desperation of the sick. Informed consent is rendered impossible when patients are fed misleading or even fabricated data and disproven promises. By substituting anecdotes for evidence, SCAM weaponizes false hope, monetizing the fear of illness under the guise of medical autonomy. SCAM fosters a broader culture of conspiratorial thinking that systematically erodes public trust in collective public health infrastructure.

When conventional physicians prescribe a treatment, they are bound by evidence, medical ethics, regulatory oversight, and a legal duty of care. When SCAM practitioners prescribe an unproven therapy, they operate in an ethical void, often shielded from accountability by vague disclaimers.

Science remains an ethical enterprise acknowledging its own limitations and subjecting its claims to rigorous correction. Pseudoscience demands faith instead of evidence and leaves its patients to bear the physical consequences of its intellectual dishonesty. To pick up and rephrase the theme from my recent book: evidence-based medicine and SCAM diverge particularly sharply in their ethical and moral foundations.

Internal HHS and CDC communications leaked by the US Senate HELP Committee expose a truly scary crisis of institutional integrity. Secretary Robert F. Kennedy Jr. systematically dismantled evidence-based public health infrastructure to implement his personal, ideological and dangerous agenda. This was not merely a shift in administrative policy; it was an aggressive, top-down politicisation of science that directly compromised public safety.

It is now clear that less than 24 hours after his confirmation on 29/30 January 2025 – in the midst of a severe flu season that had already claimed 16,000 lives, including 68 children – Kennedy issued a direct mandate to halt active flu vaccine public service advertisements. Internal communications from HHS Director of Communications Andrew Nixon explicitly confirm this “was a direct ask from Secretary Kennedy.”

The institutional damage caused by Kennedy’s actions extends far beyond suppressed messaging into structural purges. In fact, it seems likely that Kennedy committed perjury. During his confirmation hearings, Kennedy misled lawmakers regarding his intentions to restrict vaccine access and his past anti-vaccine interventions. Once in power, his chief of staff enforced an “absolute need for political review” over career scientists. Kennedy subsequently fired the entire 17-member Advisory Committee on Immunization Practices (ACIP), replacing them with people with strong anti-vaccine views. When career CDC Director Susan Monarez resisted rubber-stamping these politically motivated recommendations, Kennedy fired her, triggering a wave of high-level resignations among the agency’s top medical officers.

The leaked emails also confirm that Kennedy bypassed standard scientific clearance protocols to dispatch handpicked researchers into confidential CDC databases. This was a deliberate attempt to weaponize raw public health data to manufacture evidence for a spurious vaccine-autism link that has been thoroughly debunked by global longitudinal studies involving millions of children.

By substituting ideological loyalty for empirical evidence, the US administration has compromised the foundational mechanics of medicine. When a federal health agency is forced to prioritize dogma over data, the ultimate cost is inevitably paid in preventable human disease and death.

The conclusion: Kennedy has likely committed the serious crime of perjury, has shown to be a danger to our (the damage can quickly spread beyond the US) health, and in my view has to be removed from office asap.

An interesting case-report caught my eye. Here is its abstract:

Background: 

Advanced Alzheimer’s disease (AD) is generally regarded as a stage of irreversible functional decline. Psilocybin is known to transiently alter large-scale brain network dynamics and to induce plasticity-related mechanisms in preclinical models, yet clinical data in advanced dementia remain lacking.

Case presentation: 

We report the case of an octogenarian Japanese-American woman with a 10-year history of Alzheimer’s disease, including 5 years of marked hypofunction and predominantly monosyllabic speech. Baseline features included chronic urinary incontinence, executive dysfunction, dysphagia, dependent mobility, flat affect, and severe reduction in spontaneous communication. The patient received 5 g of orally administered psilocybin-containing mushrooms (Enigma strain). The acute phase was marked by autonomic activation, clinically suspected hyperthermia, profuse sweating, and a prolonged deep sleep-like state. Approximately 19 h post-administration, spontaneous autobiographical speech emerged. Over subsequent days and weeks, functional improvements included restoration of urinary continence, improved ambulation, autonomous dressing, increased emotional responsiveness, sustained social interaction, contextual memory retrieval, preserved working memory for social context, and spontaneous conversational engagement.

Conclusion: 

This case documents transient multidomain functional improvement in advanced Alzheimer’s disease following psilocybin administration. The findings do not imply disease reversal but suggest that residual functional capacity may persist in late-stage neurodegeneration and may become transiently accessible under specific neuromodulatory conditions.

Of course, causality cannot be established with a case-report; the findings are therefore hypothesis-generating only. Plausible alternative explanations for the observed outcome include:

  • Natural fluctuation in dementia severity or a transient “plateau” of improvement unrelated to psilocybin.
  • Caregiver expectancy and observer bias, given that the same people who administered the intervention also documented the improvements.
  • Confounding medical events (e.g., resolution of infection, metabolic correction, medication change) that were not systematically ruled out.
  • Regression to the mean or random variation in functional status.

The lack of an objective endpoint (biomarker or imaging confirmation) of Alzheimer’s disease further weakens internal validity. Mixed pathology (vascular, Lewy body, frontotemporal) could produce different patterns of fluctuation and response. The absence of objective endpoints introduces subjective interpretation. “Autobiographical speech,” “improved continence,” and “better mobility” were not defined operationally or measured quantitatively.

The authors propose a plausible but speculative hypothesis: psilocybin’s disruption of the default mode network (DMN) and promotion of global functional integration may temporarily restore cross-network connectivity, allowing residual but inaccessible function to become expressed. This is consistent with psychedelic effects on network flexibility and DMN disruption, as well as with the idea that late-stage neurodegeneration may leave residual functional capacity that is normally inaccessible. However, the paper provides no neuroimaging, no electrophysiological data, and no direct evidence of network changes. The mechanism thus remains a hypothesis.

Still, the report does raise a question worthy of proper investigation: can psychedelic neuromodulation unmask residual function in late-stage neurodegeneration?

The Nazi’s sterilisation programme aimed at preventing Germans from reproducing who were deemed to be of inferior genetic make-up. It is well-known, and dozens of books have been published about it. In contrast, the ‘LEOPARD LILY PROJECT’ has been almost forgotten. Even though it also was about sterilising large groups of people, it had a very different overall aim.

The porject can be traced back to an Austrian dermatologist named Dr. Adolf Pokorny. Pokorny had encountered a scientific paper detailing animal experiment involving Dieffenbachia seguine (commonly known as the Leopard Lily or “dumb cane”). The juice of this tropical plant could be administered secretly to nonconsenting victims and was assumed to cause permanent sterility without affecting the capacity to work.

Pokorny recognized the dark potential of this botanical property. In his letter to Himmler, he explicitly proposed using Leopard Lily to secretly sterilize “three million Bolsheviks” and other populations in Eastern Europe. Pokorny’s vision was calculated and ruthless: by rendering the inhabitants of occupied territories infertile, the Third Reich could exploit them as slave labour for a single generation. Once that generation aged and died, the population would naturally become extinct, leaving the land cleared for German colonization.

The primary reason this unproven botanical theory was taken seriously at the highest levels of the Nazi command rests on the unique obsessions of Heinrich Himmler. The SS leader was deeply fascinated by alternative medicine, occultism, and pseudoscience. He harboured an intense distrust of mainstream academic medicine and actively promoted natural, herbal remedies.

Captivated by Pokorny’s letter, Himmler bypassed conventional, rigorous scientific channels, assigning high-ranking SS bureaucrats and doctors to fast-track the cultivation of the plant and initiate medical experimentation. However, to operationalize the project, the SS faced an immediate bottleneck: Leopard Lily is native to tropical climates, and Himmler did not possess enough of the plant to extract toxins at a mass scale. Huge, specialized greenhouses were commissioned, and efforts were made to cultivate the plant under controlled conditions within Germany. Yet, the project collapsed under the weight of its own scientific flaws and the changing tides of World War II. The plant could not be grown in quantities large enough to fulfil Himmler’s genocidal dream.

Following the collapse of the Third Reich, the details of the project were brought to light during the Nuremberg Doctors’ Trial (1946–1947). Dr. Adolf Pokorny was placed in the dock alongside prominent Nazi medical war criminals. Pokorny was one of the few to be acquitted by the tribunal. What then became of him remains a mystery.

The very last paragraph of my new book reads as follows: “The story of the Leopard Lily project can serve as a reminder of the dangers caused by unholy alliances of pseudoscience, ideology, immorality, and political power. These dangers have not ended with the Third Reich. If the book can contribute to reducing the risks of future recurrences, it was worth the effort of writing it.”

A legal report has been published on 25 June 2026 examining whether the German political party Alternative für Deutschland (AfD) is unconstitutional under German Basic Law. The study represents the most extensive and methodologically rigorous analysis of the party to date. Conducted over a period of 13 months, the project involved a team of eight experts in constitutional law, right-wing extremism, and data analysis. They systematically evaluated more than 3 million statements by the AfD and identified approximately 2,500 pieces of evidence deemed legally relevant.

A key finding of the report is that, when assessed against the criteria used by the German Federal Constitutional Court (Bundesverfassungsgericht) in party ban proceedings, the AfD meets the threshold for being classified as unconstitutional. The authors state that a formal prohibition request submitted to the Court would “likely succeed.” Importantly, they emphasize that their approach was “open-ended” and aligned with established constitutional jurisprudence, and that their methodology received external validation from two established constitutional law professors.

The report highlights several patterns in AfD positions and rhetoric that it interprets as incompatible with the democratic constitutional order. These include:

  • proposals to criminally prosecute political opponents,
  • the idea of revoking citizenship from certain criminal offenders who are German nationals,
  • calls for the systematic legal discrimination of Muslims.

It also points to demands for unrestricted deportations and statements by supporters denying the legitimacy or existence of transgender individuals. These examples are presented as indicative rather than exhaustive.

The report seeks to shift what it characterizes as a stalled political and legal debate about the AfD’s constitutional status. By providing a large-scale empirical and legal foundation, it implicitly strengthens arguments in favour of initiating formal proceedings to ban the party. In Germany, such a process can only be initiated by constitutional bodies such as the Bundestag, Bundesrat, or federal government, and requires demonstrating both anti-constitutional aims and active efforts to undermine the democratic order.

The report calls on citizens to contact members of parliament to raise awareness of the findings and encourage political action. This reflects an attempt to translate the report’s conclusions into legislative momentum.

Overall, the document combines elements of academic research, legal argument, and political campaigning. Its central significance lies not only in its conclusions but in its potential to influence public discourse and decision-making. Let’s just hope its effect is just that.

Having narcissistic tendencies, e.g. bragging or making yourself the center of attention, are normal, if they occur only occasionally. However, Narcissistic Personality Disorder (NPD) is different. With NPD, symptoms are more severe, occur regularly and in different situations and environments, and make relationships with others challenging.

The 9 most common symptoms of NPD are the following:

  1. Grandiose sense of self-importance.
  2. Preoccupation with fantasies of success, power, brilliance, beauty, or ideal love.
  3. Belief that they are “special” and should associate only with high-status people or institutions.
  4. Need for excessive admiration.
  5. Strong sense of entitlement.
  6. Interpersonally exploitative behaviour, using others to achieve their own ends.
  7. Lack of empathy, with little recognition of others’ feelings or needs.
  8. Envy of others, or belief that others are envious of them.
  9. Arrogant or haughty attitudes and behaviours.

Now, let’s consider a person who is almost constantly in our minds, mainly because he makes the headline news practically every day:

DONALD J TRUMP.

Does he perhaps display any of the above-listed symptoms? Let’s find out by going through them one by one and citing concrete examples**:

  1. Trump displays grandiose sense of self-importance regularly and to an extreme degree. Example: in August 2019, he told reporters, “I am the chosen one”.
  2. Trump displays preoccupation with fantasies of success, power, brilliance, beauty, or ideal love regularly and to an extreme degree. Example: he said he was “always the best athlete” before his first presidential physical in January 2018.
  3. Trump displays his belief that he is “special” and should associate only with high-status people or institutions regularly and to an extreme degree. Example: in his 2018 rally line about the “elite,” he said, “We’re the elite… We’re the super-elite”.
  4. Trump displays a need for excessive admiration regularly and to an extreme degree. Example: according to a 2026 analysis, he has a “relentless demand for exaltation,” wants “praise, admiration, and accolades,” and even accepts honors that critics said were meant for others.
  5. Trump displays a strong sense of entitlement regularly and to an extreme degree. Example: he defended accepting a luxury Boeing 747 from Qatar by saying it would be “stupid” to turn down a “free plane,” and the aircraft was reported to be intended for his use as Air Force One.
  6. Trump displays interpersonally exploitative behaviour, using others to achieve their own ends regularly and to an extreme degree. Example: in the border detention context, he “exploits his power” and “leverages cruelty strategically,” especially in policies that harmed vulnerable migrants and children.
  7. Trump displays lack of empathy, with little recognition of others’ feelings or needs regularly and to an extreme degree. Example: the family-separation policy at the US border, which causes severe suffering, while Trump continues to treat it as a political instrument rather than a human tragedy.
  8. Trump displays envy of others, or belief that others are envious of them regularly and to an extreme degree. Example: he has repeatedly made unverified claims about his inauguration crowd size, television ratings, and rally attendance, frequently comparing them directly to Obama’s numbers in an attempt to prove he is more widely loved
  9. Trump displays arrogant or haughty attitudes and behaviours regularly and to an extreme degree. Example: While accepting the party’s nomination in Cleveland, Ohio, Trump delivered a dark assessment of the US, describing a nation plagued by rising crime, economic decay, and international humiliation. After spending a large portion of the speech detailing these systemic crises, he uttered (in grammatically wrong English): “Nobody knows the system better than me, which is why I alone can fix it.”

So is Trump suffering from NPD?

Judge for yourself.

I guess he is not suffering from but enjoying it!

___________________

 

And what is the solution? Treatment of NPD can be difficult because people with NPD may not feel therapy is necessary, so progress often depends on motivation and a good therapeutic fit. There is no effective drug treatment and talking therapies are usually recommended. In Trump’s case, removal from office would obviously be an acutely necessary measure.

__________________

 

**I am sure you know of much better examples (the coice is truly vast); feel free to cite them in the comments.

Breast cancer and its treatments affect patients’ physical, psychological, and emotional well-being. Practices such as Reiki are used to support symptom management, particularly during chemotherapy. This systematic review aims to evaluate the effects of Reiki practice on improving symptoms in breast cancer patients within the framework of Martha E. Rogers’ “Science of Unitary Human Beings.”

The research was conducted as a systematic review in accordance with the PRISMA 2020 guidelines. A comprehensive literature search was performed in the PubMed, Web of Science, CINAHL (EBSCOhost), Google Scholar, and DergiPark databases, with the search updated through May 2026 prior to the final analysis. Randomized controlled trials, experimental studies, and quasi-experimental studies investigating Reiki interventions in breast cancer patients were included. Methodological quality and risk of bias were independently assessed by two researchers using Joanna Briggs Institute (JBI) critical appraisal tools and the Cochrane Risk of Bias Tool.

Four studies meeting the inclusion criteria included a total of 339 participants. The included studies suggested that Reiki practice may reduce fatigue and improve overall comfort and well-being. Some studies also reported improvements in quality of life, comfort, mental well-being, and mood.

The authors concluded that Reiki appeared to be a safe and well-tolerated complementary intervention in the included studies. Reiki practice may contribute to symptom management, improve quality of life, and support psychological well-being in breast cancer patients. However, due to the limited number of studies, small sample sizes, and methodological differences, larger, well-designed randomized controlled trials are needed.

This is a weird review, if there ever was one!

  • It certainly did not follow the PRISMA guidelines.
  • It evaluated the effects of Reiki practice on improving symptoms in breast cancer patients; much clearer can one not display a pro-Reiki bias!
  • It included non-randomised trials.
  • None of the included studies were of sufficiently good quality.

But the weirdest aspect must be the conclusion of the abstract: it aknowledges the fact that the primary studies were rubbish and nevertheless praises the multiple alleged benefits of Reiki. If the evidence is unconvincing due to many flaws of the primary data, the only adequate conclusion should read something like this:

Because of serious flaws of the included studies, the evidence that Reiki affects the symptoms of breast cancer patients fails to be positive.

 

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