gullible consumer
Tolerance is widely regarded as a moral virtue, a cornerstone of pluralistic societies and a safeguard against dogmatism. Yet, tolerance can sometimes be misplaced. Thomas Mann suggested that “tolerance becomes a crime when applied to evil”. In a similar vein, I propose that tolerance can become unethical when applied to homeopathy.
Homeopathy presents itself as a benign and natural alternative to or complement of conventional medicine. Its appeal lies partly in its historical pedigree and partly in its promise of gentle healing without side effects. However, beneath this veneer lies a system of belief that is fundamentally incompatible with science and ethics. Its core principles – the notions that like cures like and that substances become more potent through extreme dilution – contradict basic laws of physics, chemistry and pharmacology. After more than two centuries of use and more that 500 clinical studies, there is no credible evidence that homeopathic remedies perform better than placebos.
In many areas of life, tolerance for differing beliefs is both appropriate and necessary. However, medicine is different. It is not merely a matter of opinion; it is a field grounded in empirical evidence, where opinions can have direct and drastic consequences for health and survival. To tolerate ineffective and therefore potentially harmful treatments within this domain risks legitimizing misinformation and undermining public trust in evidence-based care.
The ethical problem intensifies when homeopathy is integrated into healthcare systems or endorsed by public institutions. Such endorsement conveys an implicit message of efficacy and legitimacy, misleading patients who may lack the expertise to critically evaluate medical claims. This is particularly concerning in cases where patients choose homeopathic remedies as an alternative therapy, i.e.in place of effective treatments, potentially resulting in preventable harm. Here, tolerance can easily degenerate into complicity.
Defenders of homeopathy often invoke patient choice and patient autonomy. While these are important principles, they do not justify the abdication of professional responsibility. True respect for patients involves providing accurate information and protecting them from ineffective or deceptive practices. Allowing patients to choose homeopathy without clear, despite all the evidence that speaks against it is not an expression of respect but a failure of duty.
Moreover, the commercial dimension of homeopathy raises additional ethical concerns. The marketing of homeopathic products often exploits the language of science and medicine while evading the standards that govern them. Consumers are led to believe they are purchasing effective treatments. In reality, they are buying fake medicines that contain no active ingredients. This practice tolerance has degenerated into exploitation.
A society that prides itself on scientific progress and rational inquiry cannot afford to suspend its critical faculties in the name of tolerance. While civility and openness are essential virtues, they must not be confused with randomness or indiscriminate acceptance. Tolerance has limits, particularly when it intersects with matters of public health and scientific integrity.
Thus, the tolerance extended to homeopathy is not merely misplaced; it is ethically problematic. By granting homeopathy a status it does not merit, we risk eroding the very standards that protect patients and uphold the credibility of medicine. In this context, I feel that intolerance is not a vice but a necessary stance, one that affirms the primacy of evidence, reason, and the ethical obligation to do no harm.
A recent paper entitled “Research Ethics and Integrity and the Different Forms of Misconduct: Applications and Challenges in Traditional, Complementary, and Integrative Medicine Research” caught my eye. As the subject is close to my heart and often covered on this blog, I studied it carefully. Here is the abstract:
Research ethics and integrity are foundational to the credibility, safety, and societal trust of scientific inquiry. As the use of traditional, complementary, and integrative medicine (TCIM) grows globally, concerns about research misconduct (including fabrication, falsification, and plagiarism) have become increasingly salient. With up to 80% of populations in certain countries utilizing TCIM, the field’s expansion underscores the need for rigorous, ethically grounded evidence to guide practice and policy. However, around 470 TCIM-related articles have been retracted to date, as indicated on the Retraction Watch database, which may be due to ethical or non-ethical concerns. This educational article critically examines the state of ethics and integrity in TCIM research, drawing on case studies of misconduct and highlighting the broader consequences for patient safety, scientific credibility, and healthcare integration. In addition, the educational article explores emerging ethical dilemmas posed by artificial intelligence (AI), including risks of automated fabrication, falsification, plagiarism, and opacity in research reporting. To strengthen ethical conduct, we propose strategies spanning four domains: 1) improving education and fostering interdisciplinary collaboration to enhance research literacy, 2) embedding open science practices to promote transparency and reproducibility, 3) leveraging meta-research to monitor and advance research quality, and 4) developing policies and safeguards for responsible AI use. Upholding high ethical standards in TCIM research is essential not only to ensure reliable evidence but also to protect patients, sustain public trust, and enable meaningful integration of TCIM within evidence-based healthcare systems.
The full conclusions of the authors are as follows: “With the increasing global use of TCIM therapies, it is crucial for TCIM researchers to uphold high ethical standards to ensure the feasibility, validity, efficacy and safety of TCIM interventions. TCIM research challenges such as heterogeneity, complexity, and lack of standardization practices, alongside issues with research training and funding, create both transformative opportunities and ethical dilemmas that require reflection. Addressing these challenges requires a firm commitment to enhancing research ethics and integrity in TCIM. This commitment must be translated into action through multifaceted strategies: improving research and ethics literacy, fostering open science practices, and ensuring the transparency, integrity, and reproducibility of TCIM research. Strengthening ethical and research practices will not only support its continued development as a discipline but also maximize its potential to contribute to global health.”
I find it most commendable that this subject has finally been addressed by a group of researchers, most of who are known advocates of so-called alternative medicine (SCAM). I hope that this is proves to be a step in the right direction for the fileld of SCAM.
Yet, I fear that it is a small or even tiny step. The reason for my fear is that several important issues related to research ethics and integrity in SCAM are let untouched by the authors. In my view, the one of the most important amongst them is the SCAM researcher him/herself. As often discussed on this blog, SCAM research is unique amongst all areas of medical research for being populated by individuals who have a strong ideological bias in favour of SCAM.
These (pseudo)scientists tend to abuse science by trying to prove that their beliefs are correct. Rather than trying to falsify their hypotheses, they would bend over backwards to show that their favourite SCAM is effective. I tried to demontrate this clearly by establishing my ALTERNATIVE MEDICINE HALL OF FAME on this blog.
As to the many other omissions of important ethical concerns from the above paper, I recommend having a look at our book “More Harm than Good?: The Moral Maze of Complementary and Alternative Medicine“. It offers a much more complete review of the ethical issues involved in SCAM research (amusingly, it was not cited in the paper above).
A position paper of the Associazione Pazienti Malattie Oculari (APMO) evaluated IRIDOLOGY. Here is its abstract:
Iridology is an alternative diagnostic practice that claims to identify systemic diseases and organ dysfunction through visual inspection of iris features, including pigmentation patterns, crypts, furrows, and discolorations. Despite its continued presence within complementary and alternative medicine, iridology has not been incorporated into mainstream medical practice. This review critically examines iridology from an ophthalmologic perspective, addressing its historical origins and epistemological foundations, proposed mechanisms, biological plausibility, and clinical evidence. A systematic appraisal of the available literature, including the most recent government-commissioned evidence evaluation, demonstrates a consistent lack of diagnostic accuracy, reproducibility, and pathophysiological rationale. The ethical and clinical implications of iridology use are discussed, with particular attention to the risk of delayed diagnosis and patient misinformation. Based on the totality of evidence, iridology cannot be supported as a diagnostic or screening tool in ophthalmology or general medicine.
In the article itself, the authors drew the following, detailed conclusion: Iridology is a diagnostic practice whose foundational maps were constructed through uncontrolled post hoc observation, without anatomical, physiological, or embryological basis. Decades of controlled investigation – including the most recent government-commissioned systematic review applying GRADE methodology [16] – have failed to demonstrate diagnostic accuracy beyond chance, and no credible mechanism links iris features to systemic organ pathology.
A scientifically rigorous appraisal must acknowledge several nuances: the evidence base itself is limited in volume and methodological quality; a single study using automated photodensitometry produced one marginally significant finding; and one recent unblinded study reported high sensitivity at the cost of unacceptably low specificity. These exceptions do not alter the overall conclusion but illustrate that further high-quality prospective blinded trials would strengthen the evidentiary record.
Based on the available evidence, the Associazione Pazienti Malattie Oculari endorses the following key messages:
- Iridology should not be used or endorsed as a diagnostic or screening tool in ophthalmology or general medicine.
- The epistemological foundations of iridology (chart construction through uncontrolled post hoc correlation) are incompatible with scientific validation regardless of clinical trial results.
- Computer-aided iridology represents a technological advance that has not yet addressed the underlying validity problem and should not be regarded as validated.
- Patient inquiries should be addressed with empathy, scientific clarity, and a clear distinction between genuine ocular signs of systemic disease and unsupported claims.
- Ophthalmologists have a professional responsibility to safeguard the scientific integrity of ocular diagnostics and to protect patients from practices with potential for harm.
All of this confirms what I have been saying and writing for several decades. My recent book BIZARRE MEDICAL IDEAS has a chapter on iridology and his inventor. Here is its abstract:
Ignaz von Peczely (1826-1911) was born into a noble Hungarian family. He became a lay homeopath but later decided to study medicine in Vienna where he graduated aged 36. He then had a thriving medical practice in Vienna. Peczely’s discovery of iridology allegedly goes back to his childhood when he noted discolourings in the eye of an injured owl. Throughout his professional life, Peczely promoted iridology with some success. Other practitioners took over the mantle and made sure iridology is popular to the present day.
What needs stressing, I feel, is the fact that iridology is not just a mere folly, it is dangerous! False negative and false positive diagnoses – iridology is unable to deliver anything else – carry serious, sometimes life-threatening risks.
Ten years after Brexit, it seems reasonable to ask what effects Brexit has caused on health-related matters for the UK and beyond. Here is my attenpt to provide an answer; these are the 8 issues that come to my mind:
- Workforce Disruption and Recruitment Shift: The ending of free movement led to a sharp drop in EU-trained doctors, nurses, and social care staff. To plug these vacancy gaps, the UK was forced into recruiting heavily from non-EU nations. This created a fragile reliance on international recruitment from countries facing their own healthcare worker shortages. In turn, this further supported the xenophobic sentiments of some UK citizens.
- Medicine Supply Problems: Leaving the EU single market introduced significant customs and regulatory friction. This friction directly contributed to the frequency and severity of local pharmaceutical shortages in the UK.
- Loss of Regulatory Leverage: By exiting the European Medicines Agency (EMA), the UK became a standalone market. Pharmaceutical companies now regularly prioritize the much larger EU and US markets for rolling out cutting-edge new treatments, leaving the UK Medicines and Healthcare products Regulatory Agency (MHRA) to act as a “rule-taker” by fast-tracking approvals already granted elsewhere.
- Cross-Border Friction: Reciprocal healthcare arrangements became more complex under the new Global Health Insurance Card (GHIC) system. While basic travel is covered, specialized cross-border medical networks face ongoing administrative and legal hurdles. Many British ex-pats’ found themselves without health cover.
- Regulatory Divergence in Training and Innovation: The UK has increasingly diverged from EU rules, such as lowering the mandatory clinical training hours required for a nursing degree to get staff into hospitals faster. Additionally, medical technology and AI developers now face double-compliance costs (clearing separate UK and EU hurdles). This makes the UK a more expensive market to launch new health technologies.
- The Macro-economic Squeeze: The overall economic downturn resulting from Brexit reduced UK GDP, shrinking the available tax revenues. This has directly limited the government’s financial capacity to fund the NHS, to clear post-pandemic backlogs, and to invest in long-term social care reform.
- Exacerbating Health Inequalities: As inflation, food costs, and supply chain disruptions damaged the UK, vulnerable socioeconomic groups have been hit the hardest. These economic pressures, combined with a chronically strained social care sector, significantly widen UK health inequalities.
- Compounding Pressure on Patient Outcomes: While ultimate health metrics, such as mortality rates and overall life expectancy, are influenced by dozens of complex variables, an underfunded NHS, chronic staffing vulnerabilities, and restricted access to new drugs create a persistent, negative headwind against public health which, in the long run, can only negatively affect patient outcomes.
All of these effects are clearly negative.
Can anyone think of a positive effect?
I can’t!
The WHO’s supportive stance on so-called alternative medicine (SCAM) has been discussed on this blog many times before. Now a BMJ editorial criticized the WHO for uncritically promoting SCAM within mainstream health systems. It argues that WHO’s new strategy gives undue legitimacy to interventions whose evidence base is often weak, inconsistent, or absent. The author’s main concern is not cultural respect or patient choice, but the risk that policy language about “integration,” “tradition,” and “people-centred care” can blur the line between evidence-based medicine and therapies that have not demonstrated reliable benefit. The article points out that, while some traditional practices may be harmless or even useful, broad institutional support should depend on rigorous proof of safety and effectiveness. It also warns that promoting such therapies may waste scarce resources, confuse patients, and create false equivalence with established medical care. More broadly, the editorial presents this as a scientific and ethical issue: global health bodies should strengthen standards, not weaken them. The WHO should prioritize robust clinical evidence, transparent regulation, and careful harm-benefit assessment before endorsing any therapy for widespread use. In short, the article sees WHO’s current approach as a misguided attempt to accommodate alternative medicine rather than critically evaluate it.
The team of international authors of the editorial argue that an ideal strategy should mandate pharmacovigilance, including adverse event reporting, as a prerequisite. Large workforces should be redirected toward evidence-based primary care, such as screening, vaccination, chronic disease identification and maternal health. Research funding should prioritise independent clinical trials with negative results published as systematically as positive ones. The WHO Traditional Medicine Global Library must catalogue documented harms alongside knowledge claims. Commercial conflicts of interest must be transparent. And WHO’s messaging must remain unequivocally aligned with scientific consensus – a proven tool against misinformation that mixed messaging would fatally undermine.
The authors conclude that “billions use traditional medicine – many from uninformed choices. The ethical response is not to validate what remains unvalidated, but to expand access to what withstands scrutiny. Patients everywhere deserve nothing less.”
Readers might remember that I posted my own critique of the WHO’s new strategy on this blog already on 6/11/2025. Here is an excerpt of my post:
The WHO aim to “advance the contribution of evidence-based traditional, complementary and integrative medicine” seems laudable, yet it also raises concerns: once any form of medicine is “evidence-based”, it is not “traditional, complementary and integrative”. Then it is by definition EBM, evidence-based medicine! Thus, the entire premise of the WHO Global traditional medicine strategy 2025–2034 makes no sense.
The fact that “traditional medicine is the primary or preferred care for billions of people worldwide” does not necessarily mean that its “clinical potential is considerable”. More likely it means that billions have to rely on obsolete forms of medicine from the dark ages because they cannot afford effective treatments. This is far from an opportunity; it is a challenge for us to improve this inhuman situation.
The fact that “acupuncture is recommended for migraine”, while the evidence for this (and almost all similar) recommendations are not supported by sound evidence, amounts to a scandal. One would have hoped that, instead of promoting unproven ‘traditional medicine’, an urgent task of the WHO would be to warn people of bogus and often dangerous claims that are ubiquitous in this sector.
The fact that “1% of global health research funding is dedicated to traditional medicine” might look unfair at first glance. But global health research funding is in the range of US$ 200 billion per year. Thus 1% would amount to 2 billion, and I suggest that one could do plenty of good research with this money. Instead, the sector tends to waste its funds on lousy pseudo-research, as anyone interested can confirm by reading this blog. Why does the WHO not point this out and take measures to stop pseudo-science in the realm of ‘traditional medicine’? Do they really think that offensive ideological platitudes such as “restoring balance is a scientific, rights-based and sustainability imperative” cuts the mustard?
My recommendation to the WHO is as simple as it is important: if you want to create meaningful articles, documents or strategies on ‘traditional medicine’ (or indeed any other subject), don’t charge biased proponents with the task but recruit a few well-informed critical thinkers as well.
It is good that the BMJ editorial concurs with my assessment. The question is, will it have an effect? Considering the multiple times we had to criticise the WHO for its irresponsible stance on SCAM, it would be high time for adopting an evidence-based attitude.
“Science and pseudoscience diverge particularly sharply in their ethical and moral foundations. While science is built upon principles of honesty, openness, and responsibility, pseudoscience undermines these values often by placing ideology and belief over evidence and truth. Science is not least an ethical enterprise, and the divide between science and pseudoscience is a matter of profound moral importance. The ethical stakes become especially acute when pseudoscience causes harm…”
These lines come from my recent book, THE LEOPARD LILY PROJECT, which is only marginally about so-called alternative medicine (SCAM). Yet they do apply well to SCAM which does not merely fail the test of scientific rigor but also fails the test of medical ethics. When a practice trades empirical validation for dogmatic ideology, it ceases to be an innocent alternative and becomes a profound moral transgression. SCAM regularly promises holistic salvation while actively undermining the principles of honesty, openness, and responsibility, effectively replacing rigorous scrutiny with profitable mystique.
The ethical stakes transition from academic to tragic whenever a vulnerable patient is guided away from effective treatments. SCAM cloaks itself in the gentle language of empathy and natural, holistic, individualised healing, yet its business model relies on exploiting the desperation of the sick. Informed consent is rendered impossible when patients are fed misleading or even fabricated data and disproven promises. By substituting anecdotes for evidence, SCAM weaponizes false hope, monetizing the fear of illness under the guise of medical autonomy. SCAM fosters a broader culture of conspiratorial thinking that systematically erodes public trust in collective public health infrastructure.
When conventional physicians prescribe a treatment, they are bound by evidence, medical ethics, regulatory oversight, and a legal duty of care. When SCAM practitioners prescribe an unproven therapy, they operate in an ethical void, often shielded from accountability by vague disclaimers.
Science remains an ethical enterprise acknowledging its own limitations and subjecting its claims to rigorous correction. Pseudoscience demands faith instead of evidence and leaves its patients to bear the physical consequences of its intellectual dishonesty. To pick up and rephrase the theme from my recent book: evidence-based medicine and SCAM diverge particularly sharply in their ethical and moral foundations.
A legal report has been published on 25 June 2026 examining whether the German political party Alternative für Deutschland (AfD) is unconstitutional under German Basic Law. The study represents the most extensive and methodologically rigorous analysis of the party to date. Conducted over a period of 13 months, the project involved a team of eight experts in constitutional law, right-wing extremism, and data analysis. They systematically evaluated more than 3 million statements by the AfD and identified approximately 2,500 pieces of evidence deemed legally relevant.
A key finding of the report is that, when assessed against the criteria used by the German Federal Constitutional Court (Bundesverfassungsgericht) in party ban proceedings, the AfD meets the threshold for being classified as unconstitutional. The authors state that a formal prohibition request submitted to the Court would “likely succeed.” Importantly, they emphasize that their approach was “open-ended” and aligned with established constitutional jurisprudence, and that their methodology received external validation from two established constitutional law professors.
The report highlights several patterns in AfD positions and rhetoric that it interprets as incompatible with the democratic constitutional order. These include:
- proposals to criminally prosecute political opponents,
- the idea of revoking citizenship from certain criminal offenders who are German nationals,
- calls for the systematic legal discrimination of Muslims.
It also points to demands for unrestricted deportations and statements by supporters denying the legitimacy or existence of transgender individuals. These examples are presented as indicative rather than exhaustive.
The report seeks to shift what it characterizes as a stalled political and legal debate about the AfD’s constitutional status. By providing a large-scale empirical and legal foundation, it implicitly strengthens arguments in favour of initiating formal proceedings to ban the party. In Germany, such a process can only be initiated by constitutional bodies such as the Bundestag, Bundesrat, or federal government, and requires demonstrating both anti-constitutional aims and active efforts to undermine the democratic order.
The report calls on citizens to contact members of parliament to raise awareness of the findings and encourage political action. This reflects an attempt to translate the report’s conclusions into legislative momentum.
Overall, the document combines elements of academic research, legal argument, and political campaigning. Its central significance lies not only in its conclusions but in its potential to influence public discourse and decision-making. Let’s just hope its effect is just that.
Having narcissistic tendencies, e.g. bragging or making yourself the center of attention, are normal, if they occur only occasionally. However, Narcissistic Personality Disorder (NPD) is different. With NPD, symptoms are more severe, occur regularly and in different situations and environments, and make relationships with others challenging.
The 9 most common symptoms of NPD are the following:
- Grandiose sense of self-importance.
- Preoccupation with fantasies of success, power, brilliance, beauty, or ideal love.
- Belief that they are “special” and should associate only with high-status people or institutions.
- Need for excessive admiration.
- Strong sense of entitlement.
- Interpersonally exploitative behaviour, using others to achieve their own ends.
- Lack of empathy, with little recognition of others’ feelings or needs.
- Envy of others, or belief that others are envious of them.
- Arrogant or haughty attitudes and behaviours.
Now, let’s consider a person who is almost constantly in our minds, mainly because he makes the headline news practically every day:
DONALD J TRUMP.
Does he perhaps display any of the above-listed symptoms? Let’s find out by going through them one by one and citing concrete examples**:
- Trump displays grandiose sense of self-importance regularly and to an extreme degree. Example: in August 2019, he told reporters, “I am the chosen one”.
- Trump displays preoccupation with fantasies of success, power, brilliance, beauty, or ideal love regularly and to an extreme degree. Example: he said he was “always the best athlete” before his first presidential physical in January 2018.
- Trump displays his belief that he is “special” and should associate only with high-status people or institutions regularly and to an extreme degree. Example: in his 2018 rally line about the “elite,” he said, “We’re the elite… We’re the super-elite”.
- Trump displays a need for excessive admiration regularly and to an extreme degree. Example: according to a 2026 analysis, he has a “relentless demand for exaltation,” wants “praise, admiration, and accolades,” and even accepts honors that critics said were meant for others.
- Trump displays a strong sense of entitlement regularly and to an extreme degree. Example: he defended accepting a luxury Boeing 747 from Qatar by saying it would be “stupid” to turn down a “free plane,” and the aircraft was reported to be intended for his use as Air Force One.
- Trump displays interpersonally exploitative behaviour, using others to achieve their own ends regularly and to an extreme degree. Example: in the border detention context, he “exploits his power” and “leverages cruelty strategically,” especially in policies that harmed vulnerable migrants and children.
- Trump displays lack of empathy, with little recognition of others’ feelings or needs regularly and to an extreme degree. Example: the family-separation policy at the US border, which causes severe suffering, while Trump continues to treat it as a political instrument rather than a human tragedy.
- Trump displays envy of others, or belief that others are envious of them regularly and to an extreme degree. Example: he has repeatedly made unverified claims about his inauguration crowd size, television ratings, and rally attendance, frequently comparing them directly to Obama’s numbers in an attempt to prove he is more widely loved
- Trump displays arrogant or haughty attitudes and behaviours regularly and to an extreme degree. Example: While accepting the party’s nomination in Cleveland, Ohio, Trump delivered a dark assessment of the US, describing a nation plagued by rising crime, economic decay, and international humiliation. After spending a large portion of the speech detailing these systemic crises, he uttered (in grammatically wrong English): “Nobody knows the system better than me, which is why I alone can fix it.”
So is Trump suffering from NPD?
Judge for yourself.
I guess he is not suffering from but enjoying it!
___________________
And what is the solution? Treatment of NPD can be difficult because people with NPD may not feel therapy is necessary, so progress often depends on motivation and a good therapeutic fit. There is no effective drug treatment and talking therapies are usually recommended. In Trump’s case, removal from office would obviously be an acutely necessary measure.
__________________
**I am sure you know of much better examples (the coice is truly vast); feel free to cite them in the comments.
A contentious debate has just erupted in Germany over the government’s plan to remove homeopathy and anthroposophic medicine from coverage under statutory health insurance (GKV). Former prominent politicians, including Green Party leader Winfried Kretschmann (former Minister President of Baden-Württemberg) and SPD leader Malu Dreyer (former Minister President of Rhineland-Palatinate), signed an “open letter” opposing the removal, arguing it would harm patients and violate ethical principles.
The open letter, launched by the German Central Association of Homeopathic Doctors (DZVhÄ) on June 17, 2026, claims that removing these therapies would be “an expensive wrong decision at the expense of patients.” It cites studies suggesting homeopathy is effective beyond the placebo effect and argues that the majority of German citizens value and benefit from these treatments. Signatories include former Federal Interior Minister Otto Schily (SPD), Greens co-founder Lukas Beckman, actress Sarah Wiener, Alo natura founder Götz Rehn, and “Tatort” actors Hans-Jochen Wagner and Felix Klare, along with former BMG state secretaries Marion Caspers-Merk and Edgar Franke.
The German Ministry of Health (BMG) defends the planned removal as part of the “GKV Contribution Rate Stabilization Act,” which aims to save €20–50 million annually. The ministry correctly states there is “insufficient scientific evidence for effectiveness” and that no evidence exists to justify cost coverage for these therapies. Under the new law, statutorily insured patients would need to pay for homeopathy and anthroposophic medicine themselves or obtain private insurance.
The Bundestag’s final reading of the law was delayed from June 26 to July 10, 2026, giving lawmakers more time to review the open letter before the parliamentary summer recess. This delay reflects the political sensitivity of the issue.
Opposition to the open letter comes from major healthcare organizations. The GKV-Spitzenverband (health insurance federation) supports removing services without scientific evidence, the Kassenärztliche Bundesvereinigung (doctors’ association) welcomes returning to “proven treatment methods.” and IQWIG, the health economics institute, confirms that homeopathy and anthroposophy lack evidence for GKV coverage.
This controversy is unusual because Kretschmann (Greens) and Dreyer (SPD) have in the past been aligned with evidence-based medicine and scientific attitude towards so-called alternative medicine (SCAM).
Allow me to congratulate the signatories for producing what possibly is the finest piece of health-related BS of 2026!
Many commentators have wondered what the bothches on Trump’s hands might be and whether they signify some sinister cause. The White House medical updates and Trump himself have attributed the bruising to a combination of factors:
- Frequent Handshaking: Both Trump and his physician have claimed that shaking hands with thousands of people causes minor soft-tissue trauma.
- Aspirin Use: His medical team disclosed that he takes daily low-dose aspirin as part of a routine cardiovascular prevention regimen, which thins the blood and allegedly increases the likelihood of noticeable bruising from minor bumps.
- Venous Insufficiency: Medical disclosures have also noted a diagnosis of chronic venous insufficiency which allegedly can contribute to bruising.
In my view, these official explanations are a good example of the BS that comes out of the White House these days. The marks Trump regularly displays on his hands are most likely actinic purpura, also known as senile purpura, or solar purpura, or Bateman’s purpura. This is a common and completely benign condition that causes easy bruising on the hands and forearms of older adults. First described by Bateman in 1818, this dermatosis presents as dark purple, irregularly shaped blotches on photo-exposed areas, particularly the dorsal surfaces of the hands and extensor aspects of the forearms. Despite its somewhat alarming appearance, actinic purpura has no health consequences and does not indicate systemic disease.
The condition affects approximately 10 per cent of people over age 50, with prevalence rising to around 30 per cent after age 75. It is painless and occurs more frequently in men than women and is strongly associated with fair skin tones and cumulative lifetime ultraviolet exposure. The prevalence increases exponentially with advancing age, reflecting the progressive nature of the underlying pathophysiological changes.
Actinic purpura results from increased fragility of superficial capillaries due to atrophy or damage of dermal connective tissue. Chronic ultraviolet radiation degrades collagen and elastin fibres, weakening the structural support for blood vessels. Ageing contributes through skin thinning and changes in fat distribution that bring vessels closer to the surface. Various medications exacerbate the condition, including corticosteroids, aspirin, warfarin, clopidogrel, and non-steroidal anti-inflammatory drugs. Minor trauma, such as negligible bumps, scratching, or poking, readily ruptures these fragile vessels. The brown pigmentation that occasionally persists after resolution results from haemosiderin deposition from lysed red blood cells.
Patients present with flat red lesions that progress to purple and then darken over time. The lesions are typically painless and non-tender, persisting for one to three weeks before resolution. They may leave permanent brown pigmentation and recur chronically with lifelong reappearance of new lesions. The differential diagnosis includes bleeding disorders, vasculitis, vitamin C deficiency, and drug-induced purpura. Actinic purpura is associated with by normal coagulation and platelet function, absence of inflammation, and confinement to photo-exposed skin areas.
The condition has no health consequences and is not associated with systemic disease or blood dyscrasias. It does not herald severe bleeding elsewhere and has no systemic implications. Crucially, actinic purpura is not associated with coronary or cerebral artery fragility, bleeding disorders, or internal vascular disease.
No specific treatment is required because the condition is self-resolving. Preventive measures include daily sunscreen application, protective clothing to prevent further photodamage, moisturisers to maintain skin suppleness, protective arm clothing to minimise trauma, and reducing topical steroid use on thin skin areas. Citrus bioflavonoids taken twice daily reduced lesions by 50 per cent in 70 seniors in a 2011 study that has not been independently confirmed. Vitamin C supplementation is only helpful if deficiency exists, with no benefit in non-deficient individuals.
