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

Scientifically implausible treatments are offered by some hospital cancer departments. Examples are reiki, aromatherapy, and reflexology. Salaried practitioners are employed to deliver these therapies, which are provided as palliative care, although they lack evidence of effectiveness. Such practices, Les Rose feels, seem to conflict with efforts to make health care evidence based.

The aims of his survey therefore were:

  • to estimate the extent of certain pseudoscientific practices in cancer care departments in NHS hospitals in England,
  • and to evaluate the rationale for such provision.

Relevant documents were requested from NHS Trusts under the Freedom of Information Act 2000 (FOIA). The main outcome measures were:

  • number of trusts offering pseudoscientific practices in cancer departments,
  • time to full FOIA response,
  • presence and content of practice governance documents,
  • presence and quality of evidence for practices.

The results showed that:

  • A total of 13.6% of eligible NHS trusts were offering pseudoscientific clinical practices.
  • No trust provided a valid business case.
  • No trust offered any robust evidence for the practices.
  • The governance documents included claims about chakras, meridians, and invisible energy.
  • Ten trusts required that informed consent be obtained from patients.

Yet, informed consent, Les argues, could not have been obtained because information given was misleading.

Les concluded that pseudoscientific practices are embedded in the NHS in England, and governance documents show poor understanding of clinical evidence.

This paper is an important contribution to the state of cancer care in England and deserves to get widely known and discussed. It discloses not one but two scandals, in my view.

  • The first scandal is the fact that NHS Trusts spend scarce money on nonsense and thus do a significant disservice to vulnerable patients and to us all.
  • The second scandal is one that Les is too polite to disclose. Several major journals refused to publish this important wake-up call. Eventually, he had to resort to this somewhat unusual way of self-publishing. I think that all the journal editors who rejected this paper should bow their heads in shame!

7 Responses to Pseudoscience in the Cancer Services of the English National Health Service

  • Has the paper been peer reviewed?

  • I share Les Rose’s concerns, as expressed in his excellent paper, and have questioned two NHS Trusts about their intentions to employ ‘Reiki therapists’.
    One said it had withdrawn the advertisement, one that it would do so. But it claimed no NHS funds were used and that such ‘therapies’ were offered by a charity (Sam Buxton Trust). When I asked who pays for the utilities, room, heating, lighting, and staff for reception and chaperonage (the non-variable costs) – they were silent!

    Other issues arise: ’ Informed consent’ was only obtained in some trusts, and I question whether the information provided to the patient included the fact that the scientific community knows of no plausible reason how such ‘energy’ can be identified, or utilised.

    Reiki is indeed a placebo. Which is fine (for a while) – providing patients are so informed. And yes, informing patients placebos are being used may diminish the ‘effect’, but there is still a (temporary) effect which some find pleasurable. That’s why it’s called a placebo!

    But consider this: If a Reiki Master II can generate energies capable of being transmitted international distances, (as they claim) is it not possible that such energy might, and does, make illnesses, conditions, cancer even, worse if applied just a bit from the ‘correct’ place?
    How do we know it does not?

    What evidence is there that any NHS trust had its Ethical Committee inquire into the proposal to introduce this novel treatment to a NHS institution, Was the Trust’s EC even asked – as is required for any novel treatment? If there was no ethical approval, the CEO is culpable and liable for any hastening of a cancer’s progress, or even death, after being treated by Reiki, should a patient or relatives make such a claim.

    Use of Reiki in the NHS is a vital issue because it gives rise to a minds-set amongst NHS staff that it is ‘OK’ to be un-scientific, to play foot-loose with patients’ emotions and to ignore embarrassing questions. Promotors of Reiki are on their own ego trip.

    Importantly, the failure of editors to publish Rose’s article in regular journals suggests a conspiracy of silence about this unethical practice which is most unedifying. I will press further with the BMA’s Board of Science. The public, politicians, professionals and all patients must be properly informed.

  • the story has been taken up by the press:
    One in ten NHS trusts offering ‘quack’ treatments to cancer patients https://mol.im/a/13588369 via @MailOnline

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