NEW!
NEW!
Updated Edition!
A recent paper entitled “Research Ethics and Integrity and the Different Forms of Misconduct: Applications and Challenges in Traditional, Complementary, and Integrative Medicine Research” caught my eye. As the subject is close to my heart and often covered on this blog, I studied it carefully. Here is the abstract:
Research ethics and integrity are foundational to the credibility, safety, and societal trust of scientific inquiry. As the use of traditional, complementary, and integrative medicine (TCIM) grows globally, concerns about research misconduct (including fabrication, falsification, and plagiarism) have become increasingly salient. With up to 80% of populations in certain countries utilizing TCIM, the field’s expansion underscores the need for rigorous, ethically grounded evidence to guide practice and policy. However, around 470 TCIM-related articles have been retracted to date, as indicated on the Retraction Watch database, which may be due to ethical or non-ethical concerns. This educational article critically examines the state of ethics and integrity in TCIM research, drawing on case studies of misconduct and highlighting the broader consequences for patient safety, scientific credibility, and healthcare integration. In addition, the educational article explores emerging ethical dilemmas posed by artificial intelligence (AI), including risks of automated fabrication, falsification, plagiarism, and opacity in research reporting. To strengthen ethical conduct, we propose strategies spanning four domains: 1) improving education and fostering interdisciplinary collaboration to enhance research literacy, 2) embedding open science practices to promote transparency and reproducibility, 3) leveraging meta-research to monitor and advance research quality, and 4) developing policies and safeguards for responsible AI use. Upholding high ethical standards in TCIM research is essential not only to ensure reliable evidence but also to protect patients, sustain public trust, and enable meaningful integration of TCIM within evidence-based healthcare systems.
The full conclusions of the authors are as follows: “With the increasing global use of TCIM therapies, it is crucial for TCIM researchers to uphold high ethical standards to ensure the feasibility, validity, efficacy and safety of TCIM interventions. TCIM research challenges such as heterogeneity, complexity, and lack of standardization practices, alongside issues with research training and funding, create both transformative opportunities and ethical dilemmas that require reflection. Addressing these challenges requires a firm commitment to enhancing research ethics and integrity in TCIM. This commitment must be translated into action through multifaceted strategies: improving research and ethics literacy, fostering open science practices, and ensuring the transparency, integrity, and reproducibility of TCIM research. Strengthening ethical and research practices will not only support its continued development as a discipline but also maximize its potential to contribute to global health.”
I find it most commendable that this subject has finally been addressed by a group of researchers, most of who are known advocates of so-called alternative medicine (SCAM). I hope that this is proves to be a step in the right direction for the fileld of SCAM.
Yet, I fear that it is a small or even tiny step. The reason for my fear is that several important issues related to research ethics and integrity in SCAM are let untouched by the authors. In my view, the one of the most important amongst them is the SCAM researcher him/herself. As often discussed on this blog, SCAM research is unique amongst all areas of medical research for being populated by individuals who have a strong ideological bias in favour of SCAM.
These (pseudo)scientists tend to abuse science by trying to prove that their beliefs are correct. Rather than trying to falsify their hypotheses, they would bend over backwards to show that their favourite SCAM is effective. I tried to demontrate this clearly by establishing my ALTERNATIVE MEDICINE HALL OF FAME on this blog.
As to the many other omissions of important ethical concerns from the above paper, I recommend having a look at our book “More Harm than Good?: The Moral Maze of Complementary and Alternative Medicine“. It offers a much more complete review of the ethical issues involved in SCAM research (amusingly, it was not cited in the paper above).
I have never commented on football before on this blog (I am not even a big fan, yet I have been involved in doctoring for a team many years ago). Today, I make an exception because, in the very early hours of 6 July (UK time), England will be playing Mexico in the World Cup. This would, of course, not be worth writing about, were it not for a crucial detail: the match will be at the ‘Estadio Azteca’ in Mexico City, at about 2,240 meters above sea level, at a hight of roughly 2250 metres above seal level.
It is almost 40 years ago that I was interested in the human physiology at high altitudes. At the time, we concluded that this affects the fluidity of blood unfavourably, an effect that is likely to limit physical performance. But this is just one factor of several that can prove to be a significant handicap for a non-adapted athlete.
Playing at high altitude is medically significant mainly because the thinner air lowers the partial pressure of oxygen, so England’s players will absorb less oxygen with each breath. That means the muscles receive less oxygen when they need it most, e.g. during repeated sprints, accelerations, and recoveries.
The immediate consequence is a higher heart rate, heavier breathing, and faster, profounder and longer-lasting fatigue. In a football match, that can reduce high-intensity running, impair decision-making, and slow recovery between bursts of effort. The extraordinary fitness of professonal football players does not fully protect against low oxygen availability, because the body’s aerobic energy system is being forced to work under a constraint it is not used to. The body can adapt to high altitudes by making more red blood cells, but that process takes days to weeks, so a short turnaround leaves little time for meaningful acclimatisation.
Altitude also creates problems that are less obvious but might still turn out to be important. Sleep would be worse after arrival at high altitude, and poor sleep impairs recovery and performance the next day. In addition, there may also be a tactical issue that few have thought about. The ball travels a little faster and farther in thin air. This obviously can alter passing, shooting, and goalkeeping judgments.
The Mexican team is of course well adapted to the altitude. Their players are used to training and playing at Mexico City’s elevation, so the thinner air is far less of a shock for them. That matters because the home side can maintain intensity for longer, recover more quickly between sprints, and avoid unusual fatigue.
In short, high altitude is not just an inconvenience. It is a significant medical stressor that reduces oxygen delivery, worsens recovery, and makes sustained effort harder for the unadapted England team.
Fingers crossed, I hope they win nontheless.
Will I stay up to watch?
No, that would also be a significant medical stressor, one that I prefer to avoid.
In the US, scientific research is facing a new bureaucratic obstacle marked by a stringent escalation in research security enforcement by major federal funding bodies. Traditionally, the US has positioned itself as the vanguard of open, globalized scientific inquiry, a model predicated on the understanding that breakthrough discoveries thrive on cross-border intellectual synergy. However, recent regulatory shifts initiated by the National Institutes of Health (NIH) and the National Aeronautics and Space Administration (NASA) indicate a retreat from this paradigm. By retroactively and rigidly redefining international authorship as a national security risk, federal grant managers threaten to balkanise academic collaboration and stifle scientific progress.
At the core of the current crisis is the administrative weaponization of the “foreign component” clause. Historically, the NIH mandated prior approval only when federal funds were explicitly exported or when critical project segments were physically conducted abroad. Contemporary enforcement, however, relies heavily on automated digital auditing systems that flag any international institutional affiliation on published papers as evidence of an unauthorised foreign component. This algorithmic surveillance penalizes benign, routine academic practices. US-based principal investigators have been forced to expunge highly cited, peer-reviewed publications from their federal progress reports simply because a co-author was an international scholar, a foreign student working within an US lab, or a colleague who provided isolated research materials.
This bureaucratic overreach is amplified by a lack of institutional transparency. Rather than issuing clear, standardized guidelines through formal rule-making channels, agencies are executing these directives via private, ad-hoc communications between individual grant managers and researchers. This strategy of decentralised intimidation leaves academic institutions without uniform legal recourse, compelling university compliance offices to draft defensive internal policies. For instance, researchers are now advised to attach granular, defensive footnotes to their manuscripts explicitly certifying the physical, geographic location of every contributor during the research process to avoid automated funding freezes.
The ramifications extend beyond administrative inconvenience, posing a existential threat to the integrity of global science. Faced with the existential threat of funding termination or legal prosecution, US scientists are disincentivised from pursuing crucial international partnerships. Others may choose to obfuscate federal sponsorship on collaborative papers to circumvent algorithmic detection, thus undermining the transparency of research funding.
Update:
In June 2026 the White House OMB released proposed revisions to the federal Uniform Guidance that would tighten oversight of federal awards, explicitly addressing foreign collaborations, reporting, and recipient responsibilities; commentators warn these changes could widen the administrative burden on grantees and institutional compliance offices. Coverage in major science outlets and policy analyses framed these actions as part of a broader administration push to overhaul transparency and control in federal research funding. Critics argue some proposals risk politicising grant making and chilling international collaboration.
News pieces and policy briefs describe more aggressive enforcement by grant managers (including retrospective audits and requests to remove or explain foreign co‑authorship), plus institutions drafting defensive procedures to avoid triggering automated audits. Scientists, scientific societies, and international collaborators have expressed concern that tighter rules and algorithmic detection of foreign affiliations will disincentivize open co‑authorship and complicate routine global partnerships.
The proposed Uniform Guidance revisions will follow a formal notice-and-comment process; watch for the final rule text and agency-specific implementing guidance because those will determine the precise legal obligations and whether the most burdensome interpretations survive.
A position paper of the Associazione Pazienti Malattie Oculari (APMO) evaluated IRIDOLOGY. Here is its abstract:
Iridology is an alternative diagnostic practice that claims to identify systemic diseases and organ dysfunction through visual inspection of iris features, including pigmentation patterns, crypts, furrows, and discolorations. Despite its continued presence within complementary and alternative medicine, iridology has not been incorporated into mainstream medical practice. This review critically examines iridology from an ophthalmologic perspective, addressing its historical origins and epistemological foundations, proposed mechanisms, biological plausibility, and clinical evidence. A systematic appraisal of the available literature, including the most recent government-commissioned evidence evaluation, demonstrates a consistent lack of diagnostic accuracy, reproducibility, and pathophysiological rationale. The ethical and clinical implications of iridology use are discussed, with particular attention to the risk of delayed diagnosis and patient misinformation. Based on the totality of evidence, iridology cannot be supported as a diagnostic or screening tool in ophthalmology or general medicine.
In the article itself, the authors drew the following, detailed conclusion: Iridology is a diagnostic practice whose foundational maps were constructed through uncontrolled post hoc observation, without anatomical, physiological, or embryological basis. Decades of controlled investigation – including the most recent government-commissioned systematic review applying GRADE methodology [16] – have failed to demonstrate diagnostic accuracy beyond chance, and no credible mechanism links iris features to systemic organ pathology.
A scientifically rigorous appraisal must acknowledge several nuances: the evidence base itself is limited in volume and methodological quality; a single study using automated photodensitometry produced one marginally significant finding; and one recent unblinded study reported high sensitivity at the cost of unacceptably low specificity. These exceptions do not alter the overall conclusion but illustrate that further high-quality prospective blinded trials would strengthen the evidentiary record.
Based on the available evidence, the Associazione Pazienti Malattie Oculari endorses the following key messages:
- Iridology should not be used or endorsed as a diagnostic or screening tool in ophthalmology or general medicine.
- The epistemological foundations of iridology (chart construction through uncontrolled post hoc correlation) are incompatible with scientific validation regardless of clinical trial results.
- Computer-aided iridology represents a technological advance that has not yet addressed the underlying validity problem and should not be regarded as validated.
- Patient inquiries should be addressed with empathy, scientific clarity, and a clear distinction between genuine ocular signs of systemic disease and unsupported claims.
- Ophthalmologists have a professional responsibility to safeguard the scientific integrity of ocular diagnostics and to protect patients from practices with potential for harm.
All of this confirms what I have been saying and writing for several decades. My recent book BIZARRE MEDICAL IDEAS has a chapter on iridology and his inventor. Here is its abstract:
Ignaz von Peczely (1826-1911) was born into a noble Hungarian family. He became a lay homeopath but later decided to study medicine in Vienna where he graduated aged 36. He then had a thriving medical practice in Vienna. Peczely’s discovery of iridology allegedly goes back to his childhood when he noted discolourings in the eye of an injured owl. Throughout his professional life, Peczely promoted iridology with some success. Other practitioners took over the mantle and made sure iridology is popular to the present day.
What needs stressing, I feel, is the fact that iridology is not just a mere folly, it is dangerous! False negative and false positive diagnoses – iridology is unable to deliver anything else – carry serious, sometimes life-threatening risks.
Ten years after Brexit, it seems reasonable to ask what effects Brexit has caused on health-related matters for the UK and beyond. Here is my attenpt to provide an answer; these are the 8 issues that come to my mind:
- Workforce Disruption and Recruitment Shift: The ending of free movement led to a sharp drop in EU-trained doctors, nurses, and social care staff. To plug these vacancy gaps, the UK was forced into recruiting heavily from non-EU nations. This created a fragile reliance on international recruitment from countries facing their own healthcare worker shortages. In turn, this further supported the xenophobic sentiments of some UK citizens.
- Medicine Supply Problems: Leaving the EU single market introduced significant customs and regulatory friction. This friction directly contributed to the frequency and severity of local pharmaceutical shortages in the UK.
- Loss of Regulatory Leverage: By exiting the European Medicines Agency (EMA), the UK became a standalone market. Pharmaceutical companies now regularly prioritize the much larger EU and US markets for rolling out cutting-edge new treatments, leaving the UK Medicines and Healthcare products Regulatory Agency (MHRA) to act as a “rule-taker” by fast-tracking approvals already granted elsewhere.
- Cross-Border Friction: Reciprocal healthcare arrangements became more complex under the new Global Health Insurance Card (GHIC) system. While basic travel is covered, specialized cross-border medical networks face ongoing administrative and legal hurdles. Many British ex-pats’ found themselves without health cover.
- Regulatory Divergence in Training and Innovation: The UK has increasingly diverged from EU rules, such as lowering the mandatory clinical training hours required for a nursing degree to get staff into hospitals faster. Additionally, medical technology and AI developers now face double-compliance costs (clearing separate UK and EU hurdles). This makes the UK a more expensive market to launch new health technologies.
- The Macro-economic Squeeze: The overall economic downturn resulting from Brexit reduced UK GDP, shrinking the available tax revenues. This has directly limited the government’s financial capacity to fund the NHS, to clear post-pandemic backlogs, and to invest in long-term social care reform.
- Exacerbating Health Inequalities: As inflation, food costs, and supply chain disruptions damaged the UK, vulnerable socioeconomic groups have been hit the hardest. These economic pressures, combined with a chronically strained social care sector, significantly widen UK health inequalities.
- Compounding Pressure on Patient Outcomes: While ultimate health metrics, such as mortality rates and overall life expectancy, are influenced by dozens of complex variables, an underfunded NHS, chronic staffing vulnerabilities, and restricted access to new drugs create a persistent, negative headwind against public health which, in the long run, can only negatively affect patient outcomes.
All of these effects are clearly negative.
Can anyone think of a positive effect?
I can’t!
The WHO’s supportive stance on so-called alternative medicine (SCAM) has been discussed on this blog many times before. Now a BMJ editorial criticized the WHO for uncritically promoting SCAM within mainstream health systems. It argues that WHO’s new strategy gives undue legitimacy to interventions whose evidence base is often weak, inconsistent, or absent. The author’s main concern is not cultural respect or patient choice, but the risk that policy language about “integration,” “tradition,” and “people-centred care” can blur the line between evidence-based medicine and therapies that have not demonstrated reliable benefit. The article points out that, while some traditional practices may be harmless or even useful, broad institutional support should depend on rigorous proof of safety and effectiveness. It also warns that promoting such therapies may waste scarce resources, confuse patients, and create false equivalence with established medical care. More broadly, the editorial presents this as a scientific and ethical issue: global health bodies should strengthen standards, not weaken them. The WHO should prioritize robust clinical evidence, transparent regulation, and careful harm-benefit assessment before endorsing any therapy for widespread use. In short, the article sees WHO’s current approach as a misguided attempt to accommodate alternative medicine rather than critically evaluate it.
The team of international authors of the editorial argue that an ideal strategy should mandate pharmacovigilance, including adverse event reporting, as a prerequisite. Large workforces should be redirected toward evidence-based primary care, such as screening, vaccination, chronic disease identification and maternal health. Research funding should prioritise independent clinical trials with negative results published as systematically as positive ones. The WHO Traditional Medicine Global Library must catalogue documented harms alongside knowledge claims. Commercial conflicts of interest must be transparent. And WHO’s messaging must remain unequivocally aligned with scientific consensus – a proven tool against misinformation that mixed messaging would fatally undermine.
The authors conclude that “billions use traditional medicine – many from uninformed choices. The ethical response is not to validate what remains unvalidated, but to expand access to what withstands scrutiny. Patients everywhere deserve nothing less.”
Readers might remember that I posted my own critique of the WHO’s new strategy on this blog already on 6/11/2025. Here is an excerpt of my post:
The WHO aim to “advance the contribution of evidence-based traditional, complementary and integrative medicine” seems laudable, yet it also raises concerns: once any form of medicine is “evidence-based”, it is not “traditional, complementary and integrative”. Then it is by definition EBM, evidence-based medicine! Thus, the entire premise of the WHO Global traditional medicine strategy 2025–2034 makes no sense.
The fact that “traditional medicine is the primary or preferred care for billions of people worldwide” does not necessarily mean that its “clinical potential is considerable”. More likely it means that billions have to rely on obsolete forms of medicine from the dark ages because they cannot afford effective treatments. This is far from an opportunity; it is a challenge for us to improve this inhuman situation.
The fact that “acupuncture is recommended for migraine”, while the evidence for this (and almost all similar) recommendations are not supported by sound evidence, amounts to a scandal. One would have hoped that, instead of promoting unproven ‘traditional medicine’, an urgent task of the WHO would be to warn people of bogus and often dangerous claims that are ubiquitous in this sector.
The fact that “1% of global health research funding is dedicated to traditional medicine” might look unfair at first glance. But global health research funding is in the range of US$ 200 billion per year. Thus 1% would amount to 2 billion, and I suggest that one could do plenty of good research with this money. Instead, the sector tends to waste its funds on lousy pseudo-research, as anyone interested can confirm by reading this blog. Why does the WHO not point this out and take measures to stop pseudo-science in the realm of ‘traditional medicine’? Do they really think that offensive ideological platitudes such as “restoring balance is a scientific, rights-based and sustainability imperative” cuts the mustard?
My recommendation to the WHO is as simple as it is important: if you want to create meaningful articles, documents or strategies on ‘traditional medicine’ (or indeed any other subject), don’t charge biased proponents with the task but recruit a few well-informed critical thinkers as well.
It is good that the BMJ editorial concurs with my assessment. The question is, will it have an effect? Considering the multiple times we had to criticise the WHO for its irresponsible stance on SCAM, it would be high time for adopting an evidence-based attitude.
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 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.
