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

cult

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Governments and key institutions have had to implement decisive responses to the danger posed by the coronavirus pandemic. Imposed change will increase the likelihood that alternative explanations take hold. In a proportion of the general population there may be strong scepticism, fear of being misled, and false conspiracy theories.

The objectives of this survey were to estimate the prevalence of conspiracy thinking about the pandemic and test associations with reduced adherence to government guidelines. The survey was conducted in May 2020 as a non-probability online survey with 2501 adults in England, quota sampled to match the population for age, gender, income, and region.

Approximately 50% of this population showed little evidence of conspiracy thinking, 25% showed a degree of endorsement, 15% showed a consistent pattern of endorsement, and 10% had very high levels of endorsement. Higher levels of coronavirus conspiracy thinking were associated with less adherence to all government guidelines and less willingness to take diagnostic or antibody tests or to be vaccinated. Such ideas were also associated with

  • paranoia,
  • general vaccination conspiracy beliefs,
  • climate change conspiracy belief,
  • a conspiracy mentality, and distrust in institutions and professions.

Holding coronavirus conspiracy beliefs was also associated with being more likely to share opinions.

The authors concluded that, in England, there is appreciable endorsement of conspiracy beliefs about coronavirus. Such ideas do not appear confined to the fringes. The conspiracy beliefs connect to other forms of mistrust and are associated with less compliance with government guidelines and greater unwillingness to take up future tests and treatment.

The authors also state that the coronavirus conspiracy ideas ascribe malevolent intent to individuals, groups, and organisations based on what are likely to be long-standing prejudices. For instance, almost half of participants endorsed to some degree the idea that ‘Coronavirus is a bioweapon developed by China to destroy the West’ and around one-fifth endorsed to some degree that ‘Jews have created the virus to collapse the economy for financial gain’.

The survey did not include questions about so-called alternative medicine (SCAM). This is a great shame, in my view. We know from previous research that people who adhere to conspiracy theories feel strongly that SCAM is being suppressed via some sinister complot by the establishment. Moreover, we know that SCAM enthusiasts tend to believe in vaccination conspiracy theories. One might therefore expect that proponents of SCAM are also prone to conspiracy beliefs about coronavirus.

When reading some of the comments on this blog, I have little doubt that this is, in fact, the case.

Many people have pointed out that the US election was disappointing because, after Trump’s four years in office, people must have realised that he is a vile and dangerous president. Yet, a very large proportion of Americans voted for him. Some commentators even speak of a cult-like movement supporting Trump.

Many people have also pointed out that some forms of so-called alternative medicine (SCAM) are irrational and even harmful. Yet, a sizable proportion of the population continue to use them. Some experts even speak of a cult-like movement supporting SCAM.

WHY?

Why do so many people make irrational choices?

Are they all stupid?

I don’t think so!

The way I see it, a key here must be critical thinking. Critical thinking means making decisions and judgements based on (often confusing) evidence. According to the ‘National Council for Excellence in Critical Thinking’ it is the intellectually disciplined process of actively and skilfully conceptualizing, applying, analysing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action.

Critical thinking is not something one is born with; but most people can learn this skill. In one study, researchers measured the relationship between student’s religion, gender, and propensity for fantasy thinking with the change in belief for paranormal and pseudoscientific subjects following a science and critical thinking course. Following the course, overall beliefs in paranormal and pseudo-scientific subcategories were lower by 6.8–28.9%.

Though easily confused with intelligence, critical thinking has little to do with it. Critical thinking is a collection of cognitive skills that allow us to rationalise. Critical thinkers are flexible thinkers who require evidence to support their beliefs and recognize fallacious attempts to mislead them. Critical thinking is the skill of minimising cognitive biases.

If I am correct, those people who voted for Trump in the US (or similar politicians, such as Boris Johnson in the UK) and those consumers who spend their money on bogus SCAMs both are deficient in their ability to think critically. This does not mean that they are the same individuals. I merely suggest they have one characteristic in common.

It is crucial, I think, to realise that critical thinking can be improved with education. In the final analysis, disappointing results of any election in which (far too many) people voted for a dishonest, corrupt politician, and the disappointingly high usage of bogus SCAMs have, I believe, their roots in poor education. This means that, if we want to reduce the risk of the Trump disaster repeating itself, we need to invest effectively and generously in better educating our children (and adults). And if we want to minimise the risk of consumers wasting their money or damaging their health with bogus SCAMs, we need to make sure the public has a sufficient understanding of logic, reason, evidence and science.

A study from the US found that belief in conspiracy theories is rife in health care. The investigators presented people with 6 different conspiracy theories, and the one that was most widely believed was the following:

THE FOOD AND DRUG ADMINISTRATION IS DELIBERATELY PREVENTING THE PUBLIC FROM GETTING NATURAL CURES FOR CANCER AND OTHER DISEASES BECAUSE OF PRESSURE FROM DRUG COMPANIES.

A total of 37% agreed with this statement, 31% had no opinion on the matter, and just 32% disagreed. What is more, the belief in this particular conspiracy correlated positively with the usage of alternative medicine.

The current popularity of so-called alternative medicine (SCAM) is at least partly driven by the conviction that there is a sinister plot by the FDA or more generally speaking ‘the establishment’ that prevents people from benefitting from the wonders of SCAM.

But where do those conspiracy theories come from?

How do they evolve?

A new article investigates these questions. Here is its abstract:

Although conspiracy theories are endorsed by about half the population and occasionally turn out to be true, they are more typically false beliefs that, by definition, have a paranoid theme. Consequently, psychological research to date has focused on determining whether there are traits that account for belief in conspiracy theories (BCT) within a deficit model. Alternatively, a two-component, socio-epistemic model of BCT is proposed that seeks to account for the ubiquity of conspiracy theories, their variance along a continuum, and the inconsistency of research findings likening them to psychopathology. Within this model, epistemic mistrust is the core component underlying conspiracist ideation that manifests as the rejection of authoritative information, focuses the specificity of conspiracy theory beliefs, and can sometimes be understood as a sociocultural response to breaches of trust, inequities of power, and existing racial prejudices. Once voices of authority are negated due to mistrust, the resulting epistemic vacuum can send individuals “down the rabbit hole” looking for answers where they are vulnerable to the biased processing of information and misinformation within an increasingly “post-truth” world. The two-component, socio-epistemic model of BCT argues for mitigation strategies that address both mistrust and misinformation processing, with interventions for individuals, institutions of authority, and society as a whole.

This makes a lot of sense to me, and it seems to apply well to the BCT in SCAM.

To mitigate BCT, the authors advocate asking:

  • Who do you trust or mistrust and why?
  • How do you decide what to believe?

Effective mitigation strategies, they state, may necessitate wholescale approaches that:

  1. confer resistance against BCT by utilizing inoculation strategies that counter misinformation where it occurs (e.g. online),
  2. teach analytic thinking within educational systems at an early age,
  3. restructure or otherwise impose restrictions on the digital architectures that distribute information in order to label or curb misinformation and promote “technocognition”.

These are no small challenges, and I am proud to say that, in the realm of SCAM, I am doing what I can to tackle them.

I came across the following fascinating advertisement:
Post: Chief Operating Officer
Location: London office
(at least one day per week) and home/office based the rest of the time
Salary: £48,000 – £53,600
Contract Type: Permanent
Hours: 30 hours (flexible, but ideally over 4 days)
This is a fantastic opportunity to join the Faculty of Homeopathy; one of the world’s leading homeopathic membership organisations. The Faculty of Homeopathy is honoured to have HRH The Prince of Wales as its Patron.
We are looking for a strategic operational leader to work with the Executive Council and our Members to increase the Faculty’s presence on the world stage. The Faculty of Homeopathy is 176 years old; and has a rich and impressive history. Do you have the skills and enthusiasm to help us write the next chapter? If so, we would be delighted to hear from you.
Key Responsibilities:
* Providing leadership, management, and vision to help grow the membership
* Overseeing all day-to-day operations
* Responsible for external communications, including PR
* Writing bid or grant applications, and/or fundraising
* Brand ambassador for the Faculty of Homeopathy
Experience:
* Strong leadership and motivational skills
* Proven track record in income generation
* Excellent verbal, written, and interpersonal skills with a diverse audience
* Structured decision making skills
* Experience/knowledge of good governance, and working with non- executive or trustee boards
Desirable:
* Experience/knowledge of membership organisations
* Experience/knowledge of working with a charity or non-profit organisation
* Experience of managing external communications, PR, and reputational
   management
Note: Applicants must have a legal right to work in the UK
For further information or the full application pack please contact Liz Tucker
Closing date for applications is Friday 30 October 2020
__________________________________
No, I am not interested. But I find several aspects of the advertisement interesting:
  • The main concern of the FoH seems to be boosting their membership. This suggests that their numbers are dwindling sharply. I wonder why. Is it because of the nasty sceptics? Or is it because the public is slowly understanding that homeopathics are placebos?
  • No expertise or even previous exposure to science or healthcare seem to be needed. Considering that the successful candidate is expected to write grant applications, this seems surprising to say the least.
  • No knowledge of homeopathy seems required. I find this odd. How is the ‘Chief Operating Officer’ going to understand the weird and wonderful world he/she is supposed to immerse into?
  • Reputational management! What a great term! I had not heard it before. It makes sense in relation to Boris Johnson or Donald Trump. In connection with homeopathy, it is truly hilarious, I feel.

So, here it is:

  • they offer a decent salary;
  • they allow you to work from home most of the time;
  • they require skills and expertise only in homeopathic doses.

Come on, Sandra, Lollypop, Dana, Heinrich, RG, Roger, Old Bob:

GO FOR IT!

Yes, I know what you will say: homeopathic remedies are all nothing but diluted water. But the ‘diluted water’ remedies that this post is about are different. Even their starting material – homeopaths call it mother tincture – is nothing but water. And what is more, homeopaths are so fond of these ‘diluted water’ remedies that they have more than one of it! One might think that water is water, especially, if you dilute it endlessly with pure distilled water. This may be true for most of us, but not for homeopaths – FAR FROM IT!

Here I present you those commercially available ‘diluted water’ remedies that I have found (I am fairly sure there are more, if you search more thoroughly than I did):

I don’t know about you, but I was impressed to find this big a variety of water – better than in a three-star restaurant! My favourite is not the water from my place of birth, Wiesbaden, but LORDES WATER. I am sure you will ask me what all these waters are used for. Lourdes water is the only water remedy for which we can tell with any degree of certainty:

  • The original Lourdes water is supposed to heal patients of all ills.
  • Now, please apply the ‘like cures like’ hypothesis of homeopathy to this fact.
  • The result is clear: homeopathic Lourdes water is supposed to give you all diseases known to mankind.

And then some nutters try to tell you that homeopathy is not dangerous!!! 

In this second part of my series ‘Heedless Homeopathy‘, I want to introduce you to some remedies that are based on mother tinctures which might be viewed as less than appetising by some of the more faint-hearted of my readers. Some time ago, we had already discussed that the urethral discharge of a male patient suffering from gonorrhoea is used to make a popular remedy sold under the name of Medorrhinum. But in the ‘revolting range’, homeopathy has more – much more – to offer. Here is a selection of my personal favourites:

Did I put you off homeopathy, because you find these substances disgusting?

Sorry (perhaps some Nux vomica C30?)! But you really need not worry: as with practically all homeopathic remedies, there will be not a single molecule of what it says on the bottle left in the remedy you buy.

Or did I put you off homeopathy, because you find such remedies ridiculous?

No, I am not sorry for that!

In fact, I think it is time that the public learn how silly homeopathy truly is.

 

 

PS

I do hope they pay a good salary to the man who has to collect the tiger urine!

 

Many people think that homeopathy is akin to herbal medicine and that its remedies are based on plants. This could not be further from the truth. Herbal remedies are not diluted, while homeopathics are – usually to the point where not a single molecule is left of the mother tincture. Some homeopathic remedies are clearly plant-based, but many are not. In fact, homeopathics can be made from just about anything.

In this series of posts, I intend to list a few surprising materials that are used to produce homeopathic remedies. Confusingly, I will start with a list of remedies where even the mother tinctures are based on an absence of any material. For want of a better term, I shall call them radiant remedies. As this might be unbelievable to some consumers, I include the link to the manufacturer.

About 200 years ago, Hahnemann postulated that his remedies work via a ‘spirit like’ activity. This fantasy has been all but abandoned by today’s homeopaths. They currently like to claim that homeopathics work because, during the process of potentisation (shaking at every step of multiple dilutions), nano-particles of the active material are being generated. And these nano-particles, they believe, somehow bring about the desired pharmacological actions.

Now, here is my question to those ‘nano-homeopaths’:

HOW DO YOU EXPLAIN THE MODE OF ACTION OF ANY OF THE ABOVE-LISTED REMEDIES?

For many years, ‘HOMEOPATHY‘ (the ‘flag-ship’ journal of homeopathy which started its life in 1911 as THE BRITISH JOURNAL OF HOMOEOPATHY) was edited by Peter Fisher. When Peter fired me from its editorial board, it arguably lost its only expert who was critical of homeopathy. Then the journal was transferred from Elsevier to Thieme. When Peter tragically died, the journal lost its editor who, despite everything, had at least tried to keep the most dangerous loons within the homeopathy cult at bay.

Now, under the new editor, this seems no longer possible. The current issue of HOMEOPATHY holds several papers about the role of homeopathy in the present pandemic:

First paper entitled ‘The COVID-19 Pandemic: A View from New York City’

This article provides a view of homeopathic clinical practice in the New York City area in the first few months of 2020 as the coronavirus disease 2019 (COVID-19) pandemic began to evolve in the United States. Key symptoms used to generate a short list of potentially curative remedies are given, and the pandemic syndrome is viewed as appearing in stages or as having various clinical manifestations each with its own main remedy. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is briefly described, as are the preliminary presenting signs and symptoms of COVID-19 infection. Several clinical examples are given, some with positive laboratory confirmation.

Second paper entitled The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy

Successful homeopathic prescriptions are based on careful individualization of symptoms, either for an individual patient or collectively in the case of epidemic outbreaks. The ongoing COVID-19 pandemic was initially represented as a severe acute respiratory illness, with eventual dramatic complications. However, over time it revealed to be a complex systemic disease with manifestations derived from viral-induced inflammation and hypercoagulability, thus liable to affect any body organ or system. As a result, clinical presentation is variable, in addition to variations associated with several individual and collective risk factors. Given the extreme variability of pathology and clinical manifestations, a single, or a few, universal homeopathic preventive Do not split medicine(s) do not seem feasible. Yet homeopathy may have a relevant role to play, inasmuch as the vast majority of patients only exhibit the mild form of disease and are indicated to self-care at home, without standard monitoring, follow-up, or treatment. For future pandemics, homeopathy agencies should prepare by establishing rapid-response teams and efficacious lines of communication.

Third paper entitled The Experience of an Italian Public Homeopathy Clinic during the COVID-19 Epidemic, March-May 2020

During the COVID-19 epidemic in Italy, hospital outpatient clinics progressively decreased their activities; in March 2020 they were closed except for emergencies. During this period, the activities of the public Homeopathy Outpatient Clinic of Lucca aimed at guaranteeing therapeutic continuity to patients by means of telephone or video consultations, and searching for homeopathic medicines that best responded to early COVID-19 symptoms. In March 2020, the Complementary Medicine Working Group participated in the organization of a mission of COVID-19 Chinese experts for the online training of professionals working in the Tuscan Healthcare System. The medical staff of the Lucca Clinic also cooperated in telephone health surveillance of infected patients at home, seroprevalence investigations using the capillary blood rapid test, and the implementation of the CLIFICOL (Clinical Files Collection) project.

Why is this a regrettable development?

In my mind, there is little doubt that homeopathy has no role to play in the current pandemic. To state or imply otherwise is not just false but dangerous. It endangers the lives of millions.

Others might see it differently and argue that it is not a bad thing at all. By coming out on the side of the loons within homeopathy, the ‘flag-ship’ journal of homeopathy has done a favour to rational healthcare: it has demonstrated beyond reasonable doubt that HOMEOPATHY (both the journal and the cult) cannot be taken seriously and can therefore be safely discarded to the waste-basket of medical history.

The Society of Homeopaths (SoH) is the UK’s professional organisation of ‘lay-homeopaths’, therapists who treat patients without having studied medicine. They prefer the term ‘professional homeopathy’, but there is little professional about them, it seems. The SoH has a long track record of endangering public health by promoting anti-vaxx nonsense.

A few months ago, it was reported that Linda Wicks, chair of the Society of Homeopaths (S0H), has shared a series of petitions claiming that childhood immunisations are unsafe. Mrs Wicks also posted a petition supporting Andrew Wakefield, the disgraced former doctor who falsely linked the MMR vaccine to autism claiming that the scientific establishment’s rejection of his flawed research was ‘the greatest lie ever told’.

In 2018, I pointed out that the SoH was violating its own code of ethics. At the time, two new members were appointed to the Society’s Public Affairs (PAC) and Professional Standards (PSC)  committees, and both were promoting the deeply anti-vaxx CEASE therapy.

Today, THE TELEGRAPH reports that Sue Pilkington, the SoH’s ‘Head of Standards’, has been promoting anti-vaxx propaganda online. On April 14, she posted anti-vaxx content made by the ‘Children’s Health Defense’ – an organisation accused by NBC News last year as being one of the largest global creators of spreading misinformation’. The page advised that any new vaccine could trigger “lethal” immune reactions.

In a separate post on Facebook, Pilkington shared a post that describes vaccines as “poison” – alongside medical advice declaring that no child should be vaccinated, if any member of their family has a skin disorder. Pilkington also tried to contact Health Secretary Matt Hancock, attempting to share with him a video of content from an American comedian claiming that it’s ‘realistic’ for vaccines to cause autism.

As though this were not enough nonsense, Pilkington also promotes homeopathy as a solution to the current epidemic. On her homeopathy business website, she has section on coronavirus which states the following: “The current primary homeopathic remedy advised for Coronavirus (2019-nCoV) symptoms is Gelsemium with a possible following remedy of Eupatorium Perforatum, Bryonia or Belladonna depending on how the symptoms progress”. Other homeopathic remedies are in common use for people with influenza and pneumonia, according to Pilkington, these do not “prevent viruses” but may “reduce the severity and length of illness”. She also claims that homeopathy has a “great track record of success in epidemics” – referencing both the Spanish influenza pandemic and the bird flu pandemic.

“In our opinion, the Professional Standards Authority (PSA) has a simple choice to make: remove the SoH and their uninformed vaccination paranoia from the register, or continue to allow homeopaths to make these dangerous claims with the tacit approval of the PSA.” said Michael Marshall, projector director of the Good Thinking Society.

A government health spokesperson was quoted in today’s TELEGRAPH article stating this: “Vaccine misinformation in any form – book, film, website or otherwise – is completely unacceptable.” The spokesperson added that NICE does not recommend homeopathy for the treatment of any health condition and noted that vaccines “save lives and are a foundation of public health.”

 

The objective of this survey was to assess the prevalence and types of so-called alternative medicine (SCAM) usage as well as the participants’ spirituality/religiousness in an outpatient department for endocrinology and metabolic diseases. All individuals visiting the outpatient department at a German university hospital from April to June 2009 were offered a standardized questionnaire on the use of dietary supplements and other SCAMs as well as their religiousness/spirituality. Demographic and clinical data of 428 respondents were taken from the electronic health record.

Of the respondents, 16.4% (n = 66) classified themselves to be religious/spiritual and 67.9% (n = 273) as not religious/spiritual. The results show that:

  • 41.4% of the respondents used supplements and 27.4% additional therapies;
  • the use of supplements and other SCAMs was more frequent in people with higher religiousness/spirituality (p = 0.005 and p = 0.01,resp.);
  • there were no associations between religiousness/spirituality and the number of consultations, costs for drugs, appraisal of the physicians treatment methods, the perceived effectiveness of prescribed drugs, fear of late complications or of side effects.

The authors concluded that a higher religiousness/spirituality is associated with a more frequent use of supplements or additional therapies in individuals with endocrinopathies or metabolic diseases. As SCAM has been shown to be associated with worse outcome, addressing religiousness/spirituality which stresses the responsibility of the person for his life might offer an additional resource and should be further studied.

This survey has a dismal sample size and even worse response rate and must therefore be taken with more than a pinch of salt. Yet vaguely similar associations have been shown before. For instance, analysing data from the 1995-1996 National Survey of Midlife Development in the United States (n=3032), researchers examined the correlations between four aspects of spirituality/religiousness-i.e., spiritual only, religious only, both spiritual and religious, and neither spiritual nor religious-and six measures of SCAM. Compared with spiritual only persons, the odds of using energy therapies were 86% lower for spiritual and religious persons, 65% lower for religious only persons, and 52% lower for neither spiritual nor religious persons. Compared to spiritual only persons, spiritual and religious individuals were 43% more likely to use body-mind therapies in general; however, when this category did not contain prayer, meditation, or spiritual healing, they were 44% less likely. Religious only individuals were disinclined toward SCAM use.

There might be considerable cultural and national differences, of course, but if it is true that religiousness/spirituality is associated with a more frequent use of SCAM, we ought to ask what the nature of the link between the two might be. There are, as far as I can see, three possibilities:

  1. religiousness/spirituality causes SCAM use;
  2. SCAM use causes religiousness/spirituality;
  3. the two are related via one or several other factors.

I see no reason why 1 or 2 should be true. More likely there is a common denominator. The obvious one might be that both religiousness/spirituality and SCAM use are somewhat irrational, more a matter of belief than evidence, and revealing a lack of scepticism or critical thinking. In this case, religiousness/spirituality and SCAM use would simply be two different expressions of the same frame of mind.

What do you think?

 

 

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