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

2013 has been an extremely busy year on this blog. We have had so many posts and comments that it is hard to decide which were the best, most important or most thought-provoking. The following selection is an entirely subjective and personal choice. I have copied the titles of the chosen posts and linked them to the original; in addition, I have selected a short conclusion from each post to provide an impression of its content so that, if interested, you can easily read the whole thing.

Prince Charles’ vision of a “post-modern medicine”

I don’t think anyone doubts that medicine needs improving. However, I do doubt that Charles’ vision of a “post-modern medicine” is the way to achieve improvement – in fact, I fear that it would lead us straight back to the dark ages.

Research in chiropractic seems in a dismal state

So, what does this tiny investigation suggest? … I think it supports the hypothesis that research into chiropractic is not very active, nor high quality, nor does it address the most urgent questions.

Three fallacies for the price of one!

The often-used and seemingly reasonable sentence “I don’t care how it works, as long as it is helpful” turns out to be a package of fallacies used to support the use of unproven treatments.

I’ve been fired!

I think it is regrettable that the journal ‘Homeopathy’ has now lost the only editorial board member who had the ability to openly and repeatedly display a critical attitude about homeopathy – remember: without a critical attitude progress is unlikely!

Saving lives with alternative medicine research?

For 20 years, I have tried my best to dispel these dangerous myths and fallacies. In doing so, I had to fight many tough battles (sometimes even with the people who should have protected me, e.g. my peers at Exeter university), and I have the scars to prove it. If, however, I did save just one life by conducting my research into the risks of alternative medicine and by writing about it, the effort was well worth it.

“Strictly confidential”- for chiropractors only

The most remarkable aspect is that the BCA seems to attempt to silence its own members regarding the controversy about the value of their treatments. Instead they proscribe answers (should I say doctrines?) of highly debatable accuracy for them, almost as though chiropractors were unable to speak for themselves. To me, this smells of cult-like behaviour, and is by no means indicative of a mature profession – despite their affirmations to the contrary.

EBM and how it is abused in alternative medicine

To pretend that external evidence can be substituted by something else is erroneous and introduces double standards which are not acceptable – not because this would be against some bloodless principles of nit-picking academics, but because it would not be in the best interest of the patient. And, after all, the primary concern of EBM has to be the patient.

Time to re-write the guidelines on spinal manipulation for low back pain

The conclusion of such considerations is, I fear, obvious: the value of and need for these two professions [chiropractors and osteopaths] should be re-assessed.

Where is the line between poor and unethical research?

Unethical research of this nature should be prevented, and the existing mechanisms to achieve this aim must be strengthened.

Alternative medicine promotion dressed up as research

It is time that AM investigators focus on real research answering important questions which advance our knowledge, that AM-journal editors stop publishing meaningless nonsense, and that decision-makers understand the difference between promotion dressed up as science and real research.

Alternative medicine, is it a cult?

There are many other parallels between a cult and alternative medicine, I am sure. In my view, the most striking one must be the fact that any spark of cognitive dissonance in the cult-victim is being extinguished by highly effective and incessant flow of misinformation which often amounts to a form of brain-washing.

The “competent homeopath”, a contradiction in terms?

If a clinician practices evidence-based medicine, he/she cannot possibly practice homeopathy – the evidence shows that homeopathy is a placebo-therapy. So, here we have it: a competent homeopath has to be a contradiction in terms because either someone practices homeopathy or he/she practices evidence-based medicine. Doing both at the same time is simply not possible.

Why ‘patient choice’ does not apply to alternative medicine

To be meaningful, ethical and responsible, choice needs to be guided by sound evidence if not, it degenerates into irresponsible arbitrariness, and health care deteriorates into some kind of Russian roulette. To claim, as some fans of alternative medicine do, that the principle of PATIENT CHOICE gives everyone the right to use unproven treatments at the expense of the taxpayer is pure nonsense. But some extreme proponents of quackery go even further; they claim that the discontinuation of payment for treatments that have been identified as ineffective amounts to a dangerous curtailment of patients’ rights. This, I think, is simply a cynical attempt to mislead the public for the selfish purpose of profit.

MORE GOOD THAN HARM? I herewith challenge my critics

I challenge my critics to answer this simple question: For how many alternative therapies is there a well-documented positive risk/benefit balance?

My double-life as a homeopath

Some homeopaths, rather than admitting they are in the wrong, are prepared to dilute the truth until it might be hard for third parties to tell who is right and who is wrong. But however they may deny it, the truth is still the truth: I have been trained as a homeopath.

Nine lessons for the budding pseudo-scientist

This is how pseudo-scientists make sure that the body of pseudo-evidence for their pseudo-treatments is growing at a steady pace.

AFTER THE STORM… the lies? Or: Does alternative medicine have an alternative truth?

Not only has the truth about the libel case been turned upside down, but also the evidence on chiropractic as a treatment for infant colic seems mysteriously improved.

A tribute to Prince Charles, champion of anti-science, on his 65th birthday

I am sure that, in the future, we will hear much more about Charles’ indulgence in quackery; and, of course, we will hear more criticism of it.

ERNST’S LAW

This is the bizarre phenomenon that ‘Ernst’s law’ seems to capture quite well – and this is why I believe the ‘law’ is worth more than a laugh and a chuckle. In fact, ‘Ernst’s law’ might even describe the depressing reality of retrograde thinking in alternative medicine more accurately than most of us care to admit.

The ‘homeopathic epiphany’ and its role in creating true believers

In my experience, true believers will not change their mind; I have never seen this happening. However, progress might nevertheless be made, if we managed to instil a more (self-) questioning rationality and scientific attitudes into the minds of the next generations. In other words, we need better education in science and more training of critical thinking during their formative years.

Homeopaths’ often criminal fight against public health

Yes, I am afraid the fight of many homeopaths against public health is active, incessant and often criminal. Of course, they do not for one second believe that they are doing anything wrong; on the contrary, they are convinced of their good intentions. As Bert Brecht once wrote, THE OPPOSITE OF GOOD IS NOT EVIL, BUT GOOD INTENTIONS

3 Responses to Highlights of 2013

  • Dear Ernst,

    I am sure I speak for all your readers when I say ‘thank you’ for all you do for the cause of honesty and integrity in medical and healthcare practice.

    Every best wish for a happy, productive and rational New Year.

    Every kind regard,

    Richard

  • Mmm, hate to call attention to what I thik is a typo – but you say the BCA proscribes answers for its members. If only! I suspect they prescribe them – yes, just what a regular GP does, but without the beneficial results.

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