fraud
The Journal of Evidence Based Homeopathy (JEBH)?
Yes, it does exist!
It was launched in 2023 by Willmar Schwabe India, as a twice yearly publication that presents itself as a peer-reviewed outlet for research, clinical trials, case studies, reviews, and theoretical pieces about homeopathy. Its own site describes it as a “groundbreaking” journal meant to promote the “evidence-based practice and understanding of homeopathy,” and lists the editor-in-chief as Dr. Ramachandran Valavan who seems to be on the payroll of Schwabe India. As far as I can see, the editorial board consist exclusively of Indian homeopathy supporters.
The publisher is Dr. Willmar Schwabe India Pvt. Ltd., with a Noida/Ghaziabad address in Uttar Pradesh, India. The firm is a branch of the well-known German manufacturer of homeopathic products. JEBH is a specialty homeopathy journal rather than a mainstream medical journal. Its language is strongly promotional, emphasizing “rigorous investigation,” “scientific exploration,” and “solid evidence,” but those claims are made by the journal itself rather than independently demonstrated in the material available here.
JEBH claims it is peer-reviewed. However, its articles often read like advocacy: they present homeopathy as being refined by “modern scientific exploration” and “real-world data,” and frequently treat positive case reports or reviews as confirmation of homeopathy’s validity. That style is, of course, not unusual in homeopathy publications, but from an evidence-based medicine perspective it is a ridiculous substitute for reproducible controlled data.
To give you a taster, here is the first section of a recent editorial published in the JEMH:
The Journal of Evidence-Based Homeopathy (JEBH) continues to strengthen its mission of uniting classical homeopathy with modern scientific exploration. This issue exemplifies how research, provings, and clinical observations converge to validate and refine homeopathic practice. The original articles section presents a diverse set of contributions from clinical case management to digital tools aiding repertorization. The featured case on Natrum muriaticum exemplifies the precision of individualized prescribing in addressing emotional and mental health concerns , while an insightful review on repertory software underscores the evolving integration of technology in clinical decision-making …
I wonder: does anyone know of another so-called “evidence-based” medical journal that is fully controlled, financed and run by a BIG PHARMA firm?
I don’t!
The JEBH confirms what we all suspected:
HOMEOPATHY IS UNIQUE.
The Nazi relic of the German Heilpraktiker – alternative health practitioner, who practise so-called alternative medicine (SCAM)) – is a topic that I wrote about repeatedly, e.g.:
- Prison sentence for a German HEILPRAKTIKER who issued false vaccination certificates
- Another death caused by a ‘Heilpraktiker’, non-medically trained alternative practitioner?
- A German Heilpraktiker was sent to jail for fraud
The path to becoming a Heilpraktiker is as unique as it is scandelously unregulated. By law, the profession requires no mandatory curriculum, no accredited school attendance, and no state-regulated university degree. Technically, anyone over the age of 25 holding a basic middle-school education (Hauptschulabschluss) can sit for the exam (the Heilpraktikerüberprüfung), even without any education or training at all. While some candidates choose to prepare by voluntarily attending a private and expensive school (a Heilpraktikerschule) for one to three years, the lack of standardized educational oversight leaves massive gaps in crucial medical and professional subjects.
Chief among these neglected subjects is, in my view, medical ethics. For those who do attend a school, average ethics instruction ranges from minimal to non-existent. Because private institutes design their own proprietary curricula, ethics is rarely taught as a standalone subject. Instead, it is briefly touched within broader modules concerning Berufs- und Gesetzeskunde (Professional and Legal Studies).
This systemic omission is directly tied to the narrow scope of the state licensing exam. Conducted by local health departments (Gesundheitsamt), the examination is explicitly designed around Gefahrenabwehr, i.e. the prevention of immediate danger to public health. The state’s priority is ensuring that applicants know what they are legally forbidden to do, such as managing highly infectious diseases, prescribing prescription-only medications, or practicing dentistry.
Consequently, broader ethical education is completely sidelined. Vital topics like the biomedical principles of patient autonomy, managing clinical conflicts of interest, and the complexities of informed consent are virtually absent. While some voluntary professional associations have established a code of conduct (Berufsordnung für Heilpraktiker), learning and understanding these ethical guidelines is entirely voluntary and self-guided.
Beyond ethics, maany other critical subjects are severely neglected in the Heilpraktiker schools, e.g.:
- Evidence-Based Medicine (EBM) and Scientific Literacy: students are rarely taught how to critically appraise clinical research, differentiate between correlation and causation, or recognize the cognitive biases inherent in anecdotal “success stories.”
- Pharmacology and Interaction Risks: While forbidden from prescribing prescription drugs, practitioners heavily utilize herbs and other dietary supplements. The study of how these substances interact with each other and a patient’s conventional pharmaceutical regimens is usually overlooked.
- Emergency Medicine and Differential Diagnosis: Because training lacks mandatory, standardized clinical rotations, practical competency in identifying red flags, such as atypical cardiac symptoms or early-stage oncological presentations, is dangerously variable.
The Heilpraktiker system offers unparalleled freedom of practice. At the same time, there is a near total lack of rigorous educational standards. This huge and dangerous imbalance leaves practitioners ill-equipped and put the public at unacceptable risks. Here are some examples of what can thus happen:
- The Klaus Ross / 3-Bromopyruvat (3-BP) Tragedy (2016): In one of Germany’s most notorious SCAM scandals, a Heilpraktiker operating a “Biological Cancer Center” in Brüggen treated terminally ill cancer patients with 3-Bromopyruvat, an unapproved, highly experimental chemical compound. Using an inaccurate kitchen scale to mix the powder himself, he administered massive overdoses via intravenous infusions. At least three patients died within days of the treatment, leading to his conviction for negligent homicide.
- The “BG-Mun” Fake Cancer Cure Scandal (Schrobenhausen): A Heilpraktiker, working alongside a businessman, defrauded desperately ill cancer patients by selling a fake “miracle serum” called BG-Mun for up to €5,900 per package. The practitioner explicitly pressured patients to abandon their conventional oncological treatments (like chemotherapy), promising that the serum would reverse tumor growth. Chemical testing later revealed the expensive liquid was nothing but worthless dilutions of glucose and basic amino acids. Multiple patients, including a 52-year-old esophagus cancer patient who went public with the story, died after their cancers metastasized following their cessation of proper medical care.
- Severe Complications from Autologous Blood Therapy (Eigenbluttherapie): A widespread SCAM among Heilpraktiker involves drawing a patient’s blood, mixing it with ozone, oxygen, or homeopathic remedies, and reinjecting it back into the muscle or vein to “stimulate the immune system.” Due to insufficient training in strict clinical hygiene, numerous documented cases have occurred where patients suffered from sepsis, internal abscesses, and systemic bacterial infections requiring emergency ICU hospitalizations.
- Misdiagnosis of Life-Threatening Emergencies: Because the Heilpraktiker exam does not mandate clinical training, practitioners have no clinical experience and frequently miss time-critical medical diagnoses. Documented cases include patients presenting with atypical chest pain being treated with acupuncture for “energy blockages” rather than being immediately referred to a hospital for an evolving myocardial infarction. Similarly, early-stage, highly curable melanomas or other malignancies have been misidentified as benign skin lesions or metabolic imbalances, delaying life-saving surgeries until the diseases reached terminal stages.
- Ineffective SCAMs for Acute Psychiatric Crises: Some Heilpraktiker choose to specialize in psychotherapy (Heilpraktiker für Psychotherapie). Scandals have arisen where patients suffering from severe clinical depression or acute psychotic episodes were treated solely with Bach flower remedies, St. John’s wort, or talking therapy rooted in esoteric ideas. The rejection of conventional psychiatric intervention and pharmaceutical stabilization in these acute phases has directly led to preventable self-harm and suicides.
So, why does Germany put up with the Heilpraktiker?
Despite repeated and fierce criticism, the German Heilpraktiker is sustained by a combination of law, politics, and tradition. The primary legal shield is Article 12 of the German Basic Law, which guarantees freedom of occupation (Berufsfreiheit). Because the state’s entry exam pretends to screen for immediate public danger (Gefahrenabwehr), courts pretend the system is legally sufficient; completely banning the profession would trigger severe constitutional challenges.
Furthermore, as often discussed on this blog, SCAM enjoys immense public popularity in Germany. Millions of Germans value the Heilpraktiker for the long and empathetic consultations that the overburdened conventional insurance system rarely permits. This widespread voter support, coupled with a highly organised political lobby, makes outright abolition a political non-starter.
Thus Germany continues to have a two-tier health system. This paradox exposes a profound cultural contradiction in the German psyche, which is famously stereotyped as risk-averse, highly bureaucratized, and obsessed with systemic order. While Germany tends to regulate everything from highway speeds to the exact composition of its beer, its tolerance of the Heilpraktiker system represents a massive, hazardous blind spot.
By clinging to an outdated Nazi-law out of political convenience and romanticized cultural traditions, the state has allowed this two-tier medical landscape to persist – one built on rigorous science, and another shielded by a legal loophole. In trying to uphold the constitutional freedom of occupation, the German legislative framework inadvertently compromises a far more fundamental duty: the protection of the public from dangerous quacks. This leaves a nation known for “playing it safe” in the ironic position of legally sanctioning pseudo-scientific nonsense within its healthcare system.
A fuller analysis of the Heilpraktiker can be found in my book “Vorsicht Heilpraktiker” [in German].
Because homeopathic remedies are usually diluted to the point where none of the original substance remains (often beyond Avogadro’s number), the ethical concerns with this treatment must focus on veracity (truth-telling), patient autonomy, beneficence, and justice. Here are some of the problems that ensue**:
Violations of Veracity and Informed Consent
Informed consent is an essential element of medical ethics and dictates that a patient must be given full, accurate, and evidence-based information regarding a treatment’s nature, mechanisms, risks, and efficacy to make an autonomous decision.
Homeopathy operates on two main principles: “like cures like” (Law of Similars) and the “law of minimum dose” (the more diluted a substance, the more potent it becomes). Scientifically, these principles contradict established kowledge of chemistry, physics, and pharmacology. Presenting these concepts nevertheless as scientifically valid violates veracity.
When a practitioner administers or sells a homeopathic remedy without explicitly stating that it contains no active ingredients and performs no better than a placebo in clinical trials, the patient’s autonomy is compromised. In other words, patients are making a healthcare choice based on deception or omission.
Maleficence
While homeopathics are physically inert and thus unlikely to cause direct harm, homeopathy poses a severe threat via indirect harm.
The most critical ethical issue occurs when patients use homeopathy for severe, progressive, or life-threatening conditions (such as cancer, severe infections, or chronic diseases like diabetes). Delaying or entirely replacing evidence-based medicine with placebo treatments (i.e. homeopathy) violates the duty of non-maleficence (do no harm). It can lead to preventable suffering, worsening of the condition, or even death in extreme cases.
Homeopathic “Vaccines” (Homeoprophylaxis) is an apt example. Some homeopaths offer all sorts of homeopathic vaccinations as alternatives to standard immunizations. Marketing these as effective protection against potentially deadly diseases like measles, polio, or pertussis erodes public herd immunity, leaves individuals entirely unprotected, and can endanger us all. This is a massive failure of both individual and public health ethics.
Beneficence
Beneficence requires healthcare providers to act in the best interest of the patient by offering treatments that provide a tangible, therapeutic benefit.
While the empathetic, unhurried nature of a homeopathic consultation can provide psychological comfort, homeopaths cannot ethically justify charging high fees for what is essentially a placebo wrapped in pseudo-medicine. Relying on a mechanism that depends on the patient remaining ignorant of the treatment’s true nature is fundamentally paternalistic and violates modern standards of beneficence.
Justice and the Exploitation of Vulnerability
The ethical principle of justice involves fairness, equity, and the responsible distribution of healthcare resources. It is regularly violated in the realm of homeopathy.
Homeopathic remedies are cheap to manufacture, yet they are marketed at unjustifiably inflated prices. Targeting vulnerable populations, such as the chronically ill, parents anxious about medication side effects in their children, or low-income individuals seeking cheap alternatives, is an ethical violation of justice.
When public the health insurance programs of certain countries, or mainstream pharmacies fund or promote homeopathic products alongside effective medicines, they misallocate resources and mislead the public. In other words, they give a false stamp of authority to quackery, draining resources that could support evidence-based public health initiatives.
So, how unethical is homeopathy? My short answer is: VERY!
** for a more detailed discussion, please have a look at our book.
I recently coined a new term: Chutzpah-Based Medicine (CBM). It requires a bit of an explanation which I herewith try to deliver. Medical decisions should rely on a rational hierarchy: systematic reviews at the top, followed by randomised clinical trials, observational studies, and way down at the bottom we anecdotal experience and opinion. The new paradigm of “Chutzpah-Based Medicine” (CBM) turns this pyramid upside down.
In CBM, double-blind trials are replaced by double-down charisma. Why wait 10 years for evidence when you can assert a medical breakthrough in 15 seconds on video with dynamic lighting, an unbuttoned linen shirt, and absolute, unshakable certainty? Here is an overview of the core tenets and leading luminaries of this revolutionary field.
The Dogmas of CBM
- The Confidence-to-Evidence Ratio: The validity of any health claim is directly proportional to the volume, velocity, and eye contact with which it is delivered.
- The “Big Pharma Secret” Axiom: If a treatment worked and had evidence, it would evidently be mainstream. Therefore, the total absence of evidence is the ultimate proof that “They” are trying to suppress it.
- Quantum Syllogism: If you insert the word “quantum” before anything, biology no longer applies, and anything becomes possible.
Four Ambassadors of CBM
- Gwyneth Paltrow
The undisputed pioneer of High-End CBM. Paltrow proved that with enough aesthetic minimalism and raw audacity, one can sell jade eggs, vaginal steaming, and “psychic vampire repellent” as essential wellness routines. Scientific consensus is but a sign of unrefined taste. See also previous posts, e.g.:
- Time for Gwyneth Paltrow’s ‘Emotional Detox Bath Soak’
- We all have misungerstood good old Gwyneth Paltrow. At heart, she is a true sceptic!
- What is it with Gwyneth Paltrow and the vagina?
- Rectal ozone therapy? Gwyneth seems to like it!
- Dr. Mehmet Oz
Before entering politics, Dr. Oz laid the groundwork for CBM. He demonstrated that a cardiothoracic surgeon could look directly into a camera and declare green coffee bean extract a “miracle burn in a bottle” without blinking. “Magic” is, according to Oz, a valid clinical outcome. See also previous posts, e.g.:
- It seems to me that Dr. Mehmet Oz is breaking the law!
- Donald Trump nominated SCAM promoter, Mehmet Oz, to lead the Centers for Medicare and Medicaid Services (CMS)
- Columbia University cut ties with Dr. Mehmet Oz … or did they?
- Dr. Joseph Mercola
He is a true titan of digital CBM mastering the art of building a multi-million-dollar supplement empire by warning millions that modern medicine is a toxic conspiracy, while conveniently offering his own unapproved tanners, liposomal vitamins, and other SCAMs as the sole salvation. See also previous posts, e.g.:
- The ‘moral and intellectual decay’ of COVID disinformants
- The anti-vaccination movement is financed by the dietary supplement industry
- Deepak Chopra
Chopra brought profound philosophical chutzpah to CBM by blending endocrinology with poetic quantum bollox. By asserting that human bodies are “localized energy fields” capable of “quantum healing,” he elevated clinical vagueness into a high-margin spiritual enterprise. See also previous posts, e.g.:
- Deepak Chopra – Karma can be a real bitch!
- The ‘LOVETUNER’: Have a look at this, and you will never again think that Deepak Chopra is a charlatan
- Deepak Chopra’s finest hour
- Deepak Chopra enters my ‘ALT MED HALL OF FAME’
While Evidence-Based Medicine requires years of arduous testing, CBM offers immediate answers, simple villains, and premium-priced remedies. Why let a clinical trial get in the way of an excellent means of getting rich quickly?
I spent the last 2 months in France where it happened to be hot. Too hot for my taste! I could not do much during the day and, at night, I was unable to sleep well. As the heatwave carried on, it began to impact on my mood and health. I may be particularly sensitive to heat, but I am by no means the only one who suffered. Record-breaking temperatures and unprecedented ocean warming have triggered a global health emergency. Driven by climate change, modern heatwaves are predicted to strike with greater frequency, intensity, and duration, pushing human physiology to (and sometimes past) its limits.
Extreme heat operates as a silent killer by severely exacerbating pre-existing cardiovascular and respiratory conditions. It can also cause acute medical issues like severe dehydration, kidney damage, heatstroke, and even death. Extreme heat disproportionately impacts highly vulnerable groups, including older adults, children, outdoor laborers, and individuals who are unhealthy to start with. Urban populations face magnified dangers due to the urban heat island effect, which traps dense pockets of heat in city environments.
The consequences are already devastating. The recent heatwaves in Europe caused over 1,300 excess deaths within just a few weeks. Extreme heat contributes to a global toll of hundreds of thousands of heat-related fatalities each year. It also ripples through societal infrastructure. Extreme heat heavily strains our healthcare systems, disrupts local economies, worsens food and water insecurity worldwide, endangers local transport and other infrastructure. Here in France, for instance, we had prolonged cuts first of electricity and then on the Internet/telephone; many people and shops had to throw away the content of their fridges and freezers. Even more alarming: one of France’s largest rivers, the Loire, went completely dry.
An analysis of nearly 2,500 UK media articles covering the June heatwave found that most reports failed to connect the event to climate change, despite strong scientific evidence that global heating intensifies extreme weather. Approximately three-quarters of the articles made no reference to climate change or global warming, highlighting a significant gap between scientific consensus and public communication. Such omissions are problematic because they leave audiences without crucial context. Attribution science now allows researchers to quantify how much more likely or intense specific heatwaves have become due to greenhouse gas emissions, primarily from fossil fuel use. Without this information, heatwaves may be perceived as isolated or purely natural events rather than manifestations of a broader, human-driven trend. Failing to link extreme weather to climate change undermines public understanding and may weaken support for mitigation and adaptation policies.
The most worrying thing is that we are rapidly approaching irreversible thresholds. To mitigate this mounting catastrophe, immediate international cooperation is required. We must deploy both short-term adaptation strategies, such as robust local heat action plans and early warning weather networks, as well as aggressive, long-term global emissions reductions. And we also should vote out politicians who still:
- pretend that climate change is a hoax,
- blame their neighouring country, despite being huge polluters themselves,
- shout “drill baby, drill”,
- pretend that summers have always been hot,
- claim (against all medical knowledge) that humans will somehow manage to adapt to extreme heat.
Without urgent measures, the human and economic toll will escalate uncontrollably.
Hypothyroidism is a prevalent hormonal disorder symptoms often persist despite levothyroxine therapy. Adjunctive individualized homeopathic medicines (IHMs) may improve clinical outcomes, biochemical markers, and quality of life, robust evidence of efficacy remains limited.
The objective of this study was to evaluate the efficacy of add-on IHMs alongside standard levothyroxine therapy in the treatment of hypothyroidism in children and adults.
A 3-month, double-blind, randomized, placebo-controlled trial was conducted in a homeopathic hospital involving 64 trial subjects with hypothyroidism undergoing levothyroxine therapy. The participants received either IHMs plus levothyroxine (verum; n = 32) or placebo plus levothyroxine (control; n = 32) for 3 consecutive months. Patients, study investigators, outcome evaluators, and data entry staff were all kept blinded about the allocation concealment according to a double-blinded approach. The codes were not disclosed to the principal investigator, and unblinding occurred only in cases of clear medication-related risk, substantial benefit, or futility. The primary outcome was the Zulewski’s Clinical Scoring (ZCS); secondary outcomes included thyroid-stimulating hormone (TSH), T3, T4, and ThyroPRO-39 scores.
Both groups showed significant improvement in symptoms and thyroid indices. Between-group difference in ZCS was nonsignificant (mean diff: 0.1, 95% confidence interval [CI] −0.3–0.6, P = 0.567), but significant in T3 (mean diff: −0.2, 95% CI −0.4 to −0.1, P = 0.002), T4 (mean diff: 1.6, 95% CI 1.2–2.0, P < 0.001), and TSH (mean diff: −3.0, 95% CI −5.8 to −0.3, P = 0.033), favoring homeopathy against placebo. Quality-of-life changes were minimal, though some ThyroPRO-39 domains improved significantly with IHMs (e.g., symptoms, P < 0.001; tiredness, P = 0.012; nervousness and tension, P = 0.001; and daily activity, P = 0.001).
The authors concluded that adjunctive IHMs did not improve symptoms or quality-of-life outcomes over placebo conclusively, but revealed favorable biochemical changes, meriting further long-term studies.
I must admit: I am puzzled by this paper:
- According to the primary endpoint, the result is squarely negative.
- Yet, the article itself is presented as though the findings were positive.
- This is because the some secondary endpoints yielded positive results.
- But how can this be?
- I find the power justification unconvincing; perhaps the study was under-powered?
- The authors report that “Neither group experienced any adverse effects.”
- How can this be?
- Even placebo therapy generates adverse effects!
- And common problems of levothyroxine therapy are palpitations, tremor, nervousness, insomnia, sweating, heat intolerance, headache, diarrhoea, weight loss, and increased appetite.
As I said, I am puzzled. Perhaps the authors’ affiliations might explain?
- Department of Materia Medica, D. N. De Homoeopathic Medical College and Hospital, Affiliated to the West Bengal University of Health Sciences, Kolkata – 700 046, West Bengal, India
- Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Affiliated to the West Bengal University of Health Sciences, Kolkata – 700 046, West Bengal, India
- Department of Homeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, Under Department of Health and Family Welfare, Govt. of West Bengal, India
My previous post provided tips for examining health claims. An area where health claims need to be examined cautiously is supplements, and one UK firm seems to deserve scrutiny more than most. British Supplements, was founded around 2015 by Chris Boyle. Rather than positioning himself as a traditional executive or scientist, Boyle markets himself as a rebellious outsider fighting against a corrupt health industry. He heavily promotes a narrative of “us versus them,” framing himself as a truth-teller. He regularly uses his platform to criticize mainstream competitors like Holland & Barrett, alleging they sell “private-label junk” filled with binders and excipients.
There is no publicly available record of any formal professional background, medical training, scientific schooling, or nutritional education for Chris Boyle. As far as I can see, he does not hold degrees or certifications in biochemistry, pharmacology, dietetics, medicine, or any related fields. In his public branding and communication, Boyle’s lack of formal scientific or medical training is not something he attempts to hide; rather, he weaponizes it as part of his “rebel outsider” persona to build trust with customers who are skeptical of the traditional medical and regulatory establishment.
Boyle’s firm is an online seller of mushroom and herbal products marketed under a “Clean Genuine” label. Operating with an antagonistic, anti-establishment brand voice, the company has constructed a conspiratorial marketing ecosystem designed to bypass UK advertising laws. It has fast grown into a highly profitable, multi-million-pound operation. Despite its “underdog” and “persecuted outsider” marketing narrative, it is now a major player in the direct-to-consumer wellness market, fueled by heavy advertising on social media and public transport. Recently, the company has even taken out a nationwide bus-advertising deal. To sell products like Turkey Tail and Lion’s Mane for serious illnesses without violating UK regulations, Boyle employs a “half-censorship” tactic. By partially starring out crucial terms, he tells customers that he is forced to censor the text due to a corrupt alliance between “Big Pharma” and the UK government.
His website employs customer reviews to make forbidden clinical claims. British Supplements encourages customers to leave detailed, condition-specific feedback, structuring its website collections such that searching for terms like “cancer” highlights these reviews. While the UK Advertising Standards Authority (ASA) demands that customer testimonials used in marketing are legally considered advertisements and must be clinically backed, the company falsely claims that “Article 10 of the Human Rights Act 1998” protects this type of “free speech”, dismissing regulators as tools of a “United Kingdom of North Korea.”
The brand positions itself within a broader web of alternative-medicine conspiracies. On social media and review platforms like Trustpilot, Boyle aggressively attacks critics. Negative reviewers are routinely insulted, with Boyle publicly labeling them as “woke,” “Karens,” “femboys,” or suffering from “mental breakdowns.”
This aggressive stance is more than just an offensive marketing strategy; it represents a growing public health challenge. By promoting unproven remedies to severely ill patients and actively cultivating distrust in evidence-based medicine and regulatory bodies, British Supplements not only financially exploit vulnerable consumers, it also endager the health of those who might believe in their unsubstantiated claims.
The Medical Journalists’ Association (MJA) has outlined six practical tips to help scrutinise health claims responsibly and accurately. They are primarily meant for journalists but, I think, they are also usefull for the general public, particularly when dealing with health claims in the realm of so-called alternative medicine (SCAM):
Check the source
Assess whether the claim originates from credible, peer-reviewed research and a reputable institution. Be wary of press releases, anecdotal reports, or media outlets known for sensationalism. Specifically for claims about SCAM, we might also add caution regarding the many third class SCAM journals.
Look for conflicts of interest
Investigate who funded the research and whether any authors or organisations stand to profit from the findings. Industry sponsorship can introduce bias, even in otherwise well-conducted studies. For claims about SCAM, we should remember that financial interest might be secondary to ideological ones.
Examine the study design
Consider whether the research used appropriate methods – such as randomisation, control groups, and adequate sample sizes – to support its conclusions. Observational studies, or case reports, or trials with the often-discussed ‘A+B versus B’ design, for example, cannot prove causation.
Consider the magnitude and relevance of effects
Distinguish between statistical significance and clinical importance. A tiny effect may be statistically significant in a large trial but meaningless in practice. Also ask whether the study population is representative and the outcome can be generalised.
Look for independent replication
Single studies should be treated cautiously until confirmed by other researchers. Consistent findings across multiple studies increase confidence in a claim.
Beware of over-interpretations
Scrutinise whether the authors or media coverage extrapolate beyond what the data support. For instance, generalising from animal studies to humans, or implying benefits without evidence of improved health outcomes.
___________________
If I may, I will add an 7th to the six by the MJA. It is one that I have issued many times previously and that is, I think, essential in SCAM:
If it sounds too good to be true, it probably is!
Exaggerated or false health claims are endemic in SCAM. These 7 tips might be useful in disclosing them and in minimising the harm they can do.
Medical ethics rests on 4 core principles: autonomy, beneficence, non-maleficence, and justice, along with the crucial rule of veracity (truth-telling). In the realm of chiropractic, the most significant ethical issues/problems generally fall into the following ethical categories:
- Compromised Informed Consent & Veracity
Informed consent requires that a patient fully understands the nature, risks, benefits, and scientific backing of a treatment before proceeding.
1.1.The “Subluxation” Theory: A sizable segment of the chiropractic community still adheres to the erroneous belief that spinal “vertebral subluxations” cause a disruption in the body’s “innate intelligence,” leading to systemic disease. From an ethical standpoint, promoting an unproven, pseudo-scientific premise as medical fact violates veracity and compromises patient autonomy, as patients cannot give truly informed consent based on erroneous concepts.
1.2. Over-claiming Scope of Efficacy: While evidence might support spinal manipulation for acute lower back pain (if one were to interpret the dtat optimistically), most chiropractors claim they can treat many other illnesses, including non-musculoskeletal conditions such as asthma, allergies, infantile colic, ADHD, and high blood pressure. Marketing these services without robust clinical trial backing misleads vulnerable populations.
- Violations of Non-Maleficence
The principle of non-maleficence requires practitioners to avoid inflicting unnecessary harm or exposing patients to disproportionate risks.
2.1. Cervical Manipulation and Stroke Risk: One of the most severe ethical concerns involves high-velocity, low-amplitude (HVLA) thrusts to the upper neck, the hallmark modality of chiropractors. This procedure has been linked to vertebral artery dissection (VAD), which can cause strokes and deaths. The ethical failure is most obvious when chiropractors perform these adjustments without warning the patient of this and other adverse outcomes.
2.2. Paediatric Chiropractic: Performing spinal adjustments on infants and toddlers (whose spines are primarily cartilage and still developing) poses distinct physical risks. Because infants cannot consent and the evidence of benefit for childhood ailments is practically non-existent, this behaviour violates non-maleficence.
- Secondary Harm: Delay of Standard Medical Care
Harm does not only come from physical injury; it also comes from omitting or delaying necessary medical treatment.
3.1. Anti-Vaccine and Anti-Medicine Sentiments: A large proportion of the chiropractic profession advise patients against conventional medicine, pharmaceuticals, and vaccination. When a chiropractor discourages a patient from seeking standard medical care, they are actively contributing to potentially life-threatening delays in care.
- Violations of Beneficence and Justice
Beneficence means acting in the patient’s best interest, while justice involves the fair and equitable distribution of healthcare resources.
4.1. The “Maintenance Care” Business Model: A common predatory practice of chiropractors involves convincing patients that they require lifelong, regular spinal adjustments to “stay aligned” and prevent disease, often locked into expensive upfront contracts. Recommending continuous, costly treatments that lack clinical evidence of long-term benefit shifts the focus from patient welfare (beneficence) to practitioner financial gain.
4.2.Over-Utilization of X-rays: Some chiropractic clinics mandate full-spine X-rays for every new patient, regardless of symptoms, and repeat them frequently to “prove” alignment changes. Exposing patients to unnecessary ionizing radiation for marketing or diagnostic justification is a direct violation of both non-maleficence and the ethical use of healthcare resources.
For a more detailed account of the ethical problems in so-called alternative medicine, please see our book on this very subject.
People use unproven so-called alternative medicine (SCAM) even when evidence quite clearly indicates that the SCAM in question does not work.
Why?
Here are some of the factors that can play a role:
- The Placebo Effect Makes People Feel Better
SCAM “helps” even though it doesn’t work. The placebo effect is a real neurobiological phenomenon that can reduce pain, improve mood, decrease stress, and affect lots of other, mostly subjective endpoints. In some situations, placebos can be as effective as real treatments. This creates genuine subjective improvement that convinces many people the SCAM in question is effective.
- False Hope and the Need for Control
When conventional medicine offers little, people “grab at straws” because hope drives them. For seriously ill patients, suggesting unproven interventions can provide hope and a sense of control over their illness. The ritual involved in administering SCAM creates profound impact because people feel they’re getting the attention they crave.
- Confirmation Bias
People selectively gather evidence conforming to their beliefs, while neglecting contradictory evidence. If someone feels better after acupuncture, for instance, they attribute it to the treatment rather than natural recovery, placebo, the attention from the therapist, or simply the restful time spent on the treatment bench. Experience or stories from others bring helped by a treatment are not evidence, of course, but they can be very compelling.
- The “Expensive = Good” Heuristic
It feels reassuring to spend some money on one’s health. “If it’s expensive, it must be good!” Traveling abroad for exotic SCAMs creates hope through fundraising. And expectation boosts the placebo response.
- Anti-Science Beliefs Predict SCAM Use
Anti-science beliefs and conspiracy theories increase the willingness to take risks and try SCAM. People who are suspicious, untrusting, eccentric, and see the world as dangerous tend to see meaningful patterns where none exist. If you believe that Big Pharma is trying to kill you, you are likely to employ SCAM.
- Dissatisfaction with Conventional Medicine
It’s “frustrating and demoralising when medical therapies do not offer the benefits people need or expect”. When doctors can’t provide answers or effective treatments, people are likely to seek SCAM. Sadly, I have to admit that some conventional healthcare professionals can behave such that one simply cannot be surprised, if patients look elsewhere.
- Humans Are Wired to See Patterns
Humans evolved to quickly detect patterns and understand how events might be causally related. We seek explanations rather than seeing randomness, but this makes us prone to seeing connections where none exist. This cognitive vulnerability is why we mistake correlation for causation. We are easily fooled, and most easily by ourselves.
8. Misinformation
Over the years, I have come to realise that all of these factors – and many more – can play a role, but that none of them is as important as misinformation. SCAM has been in the limelight sice decades, and the public is bombarded with misleading information about SCAM. It comes from journaalists, book authors, influencers, marketeers, bloggers, social media, and many other sources. And it continuously brainwashes the public into believing that even the most deplorably useless SCAM is effective, safe, and supressed by the establishment. I sympathise with everyone who is being sent up the garden path in this way and thus may get deprived of his/her savings or – much worse – health.
