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

Many charities in the UK (and most other countries) openly promote bogus treatments. After having been reminded of this fact regularly, the UK Charity Commission have decided to look into this issue. Arguably, such charities – I have previously discussed ‘YES TO LIFE’  as an example (in total there are several hundred ‘SCAM charities’ operating in the UK today)-  do not provide a valuable public service and should therefore not benefit from such status and tax privileges. While the commission is contemplating, an article in the NEW SCIENTIST provided more information on this important issue. Here are a few excerpts:

A commission briefing document says the most important issue is the level of evidence it will require to judge whether a provider of complementary therapy dispenses services of benefit to public health, thereby qualifying legally for charitable status. The document says that at present, suitable evidence includes peer-reviewed research in recognised medical journals such as The Lancet or the BMJ, or recognition by the Department of Health or other government regulatory bodies. Personal testimonies and anecdotal evidence are not sufficient to demonstrate efficacy, says the commission, and nor are non-scientific articles and features promoting methods, treatments or therapies.

However, organisations such as the Good Thinking Society have presented evidence that these standards are not being applied rigorously, meaning some organisations may have been granted charitable status without the necessary evidence that their therapies are of benefit to public health. The commission is reassessing how its existing guidelines are enforced. It is also seeking guidance on how to deal with conflicting or inconsistent evidence, or evidence that certain therapies might cause harm – by displacing conventional therapies, for example.

Complementary providers argue that it’s unfair to be judged purely on evidence in mainstream medical journals, as demanded by the Good Thinking Society. “We know there’s a well-being factor with some complementary medicines which could be palliative, or a placebo effect,” says Jayney Goddard, director of The Complementary Medical Association. “These include massage or meditation, for example, which have tremendously supportive effects, but if the evidence isn’t forthcoming, it means those charities currently offering them might not be able to in future.” If the consultation does ultimately result in revocation of charitable status for some providers, Goddard argues that this would make it harder for them to raise donations and benefit from tax breaks that make their services more affordable.

END OF QUOTE

The argument of Jayney Goddard borders on the ridiculous, of course. If treatment X improves well-being beyond placebo and generates more good than harm, it is clearly effective and the above debate does not even apply. But it obviously does not suffice to claim that treatment X improves well-being, it is mandatory to demonstrate it with sound evidence. If, on the other hand, treatment X has not been shown to be effective beyond placebo, it must be categorised as unproven or bogus. And promoting bogus treatments/ideas/concepts (including diverting patients from evidence-based treatments and undermining rational thought in our society at large) is unquestionably harmful both to individual patients and to society as a whole.

SCAM charities are thus dangerous, unethical and an obstacle to progress. They not only should lose their charitable privileges as a matter of urgency, but they should also be fined for endangering public health.

 

 

6 Responses to ‘SCAM charities’ = charities promoting so-called alternative medicine

  • Couldn’t agree more. We need somehow to change to whole cultural acceptance of SCAM therapies. There is a belief among much of the public that these things DO work, and they are taken in by the hype, the anecdotes and the flim-flam. There is also a general belief that these people wouldn’t be allowed to publicize these modalities if they weren’t legit – a hopeless position.
    Then there’s the whole conspiracy theory set – Big Pharma, chemtrails, ‘ancient’ acupuncture, etc – critical thinking education ought to be mandatory in schools and universities.
    But I never cease to be amazed at the things people will believe. A local magazine regularly advertises distant energy healing – energy is transmitted from the Archangel X from another galaxy into the healer’s hands….I mean really? The credulous accompanying article never thought to question how they know any of this stuff, or what is the evidence this Archangel exists. It’s just given a free pass. Meanwhile the same uncritical attitude allows anti-vaccine tropes to be taken seriously.
    So big pharma pays doctors to endorse vaccines – but which SCAMs are providing their wonderful therapies for free?

    • I’ve wondered for years already about the acceptability and legality of alternative treatments as opposed to other services and products.
      I myself run a business in biomedical engineering, and I have to comply with a horrendous amount of rules, guidelines, conditions, and quality checks before any product of mine is even allowed near a patient, let alone be used in invasive procedures.
      And although I have a suspicion that quite a few of the more nitpickery rules have been drawn up at the behest of the Big Boys in this marketplace (e.g. GE, Philips, Siemens and the likes) to hinder competition, I still acknowledge the rationale behind all this: patients should be able to blindly trust the products and services with respect to (relative) safety and effectiveness.
      If I even so much as offer anything untested or unproven for use in regular medicine, I am committing a serious economic offence, and run the risk of legal prosecution, huge fines, and even jail time. Ditto when I make false claims about the products and services that I offer — I can and most probably will be prosecuted for fraud.

      I therefore find it very puzzling that even completely uneducated people offering treatments without any proven effectiveness (and very often even proven ineffectiveness) are totally exempt from similar legislation, just because they operate outside the confines of regular medicine. It would almost appear that simply slapping on a sticker saying “Alternative” is a perfect shield against any and all legal repercussions, allowing the alternative practitioner to perpetrate fraud(*) and deception without indemnity, something which is unthinkable in any other area of business or governmental services such as healthcare.

      This notion is even more important above the level of individual quacks, because the larger the organization endorsing or even merely tolerating rank quackery, the more credibility this quackery gains in the eyes of the public. This article once again shows how ‘innocent’ yet misguided arguments about people’s well-being and ‘what’s the harm’ etcetera in fact lead to an ever-growing acceptance of what I can only call health fraud.

      *: And yes, for instance homeopaths claiming that the effectiveness of their services is ‘scientifically proven’ are committing fraud, plain and simple. They are lying through their teeth about what they sell.
      Because if one thing about homeopathy can be considered ‘scientifically proven’ by an overwhelming consensus among scientists, it is the exact opposite, i.e. that homeopathy is not effective for any condition whatsoever.

      • It depends on your jurisdictions. The Nordic countries have laws that do have laws that place liability on medically unqualified quacks treating patients. Criminal offence.

        I think the law in the UK needs to be changed. See https://ukhomeopathyregulation.blogspot.co.uk/2018/05/pragmatism.html for starters.

        • That is an interesting exposé, and I’m particularly looking forward to the next instalment about lay practitioners.
          The title concept of ‘Pragmatism’ deserves some more elaborate comments, in my opinion, even if my observations aren’t readily addressed in the piece itself.
          Here in the Netherlands, lawmakers have also decided on a ‘pragmatic’ approach some two decades ago. Up until 1996, we had a law from the late 1800’s explicitly forbidding uneducated persons to provide healthcare. Unfortunately, this law was never enforced rigorously, and from the 1970’s onwards, quackery was allowed to grow unhindered. E.g. around 1970, we had some four or five types of ‘alternative medicine’, with less than 1,000 practitioners. Around 1990, the number of practitioners had exploded to some 25,000 already, providing well over a hundred types of ‘alternative medicine’, and now there are an estimated 40.000 alternative practitioners — about the same number as registered doctors.
          This appalling situation has in part come about through our ‘Individual Healthcare’ law, which explicitly stipulates that “Anyone can provide any healthcare, with the exception of certain interventions which may only be carried out by professionals with proper credentials.”
          The huge problem here is that the lawmaker never defined ‘healthcare’, opening the door to fraud and quackery on a massive scale, without any legal means to do anything about it — one can simply claim that waving one’s hands over a customer’s body is ‘providing healthcare’, justifying a steep bill, regardless that the procedure does literally nothing at all for the customer’s health.

          As a result, virtually all of those 40,000 alternative practitioners commit fraud on a daily basis: they charge people substantial amounts of money for something they offer yet never deliver, i.e. effective healthcare.

          The fact that these people rarely cause physical harm to their clients is in my opinion not a mitigating factor, and certainly not a reason to accept this status quo, no matter how ‘pragmatic’ this may be (as enforcing anti-quackery laws is sometimes difficult).
          Financial harm is harm too, and in any other field it is a punishable offence to charge people for something that is never delivered, so why are alternative practitioners exempt?

          Also note that these views of mine are highly pragmatic: they do not involve credentials in any way. If someone actually helps people get healthier through lifestyle and diet advice, coaching and whatnot, I couldn’t care less if this person has any formal training. It’s just about the transaction taking place: does the customer pay for something that has proven or at least highly plausible beneficial effects? If not, the practitioner should be forced to stop offering that service or product (after being allowed to deliver proof of efficacy and/or other defensive evidence of course). In case of doubt, scientific consensus should be the guiding principle, not ‘pragmatism’.

  • My view is that charities should not be permitted to promote a specific form of treatment. A charity that focuses on a disease can support whatever treatment is shown to work, a charity focused on a type of treatment has an irresolvable conflict if a better treatment is found, or if the treatment they support is found not to work.

    Imagine having a knee washout surgery trust. What would they do in response to the evidence that knee washout surgery doesn’t work? Would they shut down, or would they, like homeopathy charities, invest in undermin8ng science?

  • I endorse Guy’s post 100%.
    There is no question that doctors and health ‘practitioners’ of all sorts are tempted to do that which pays.
    I know.
    I was one (an arthroscopist).
    I resisted the temptation and stopped when the evidence was properly adduced.

    Camists and scamists are not so ethical.

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