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

legal action

Time for celebrations and congratulations!

Why?

You might remember the story; over a year ago, I reported that a SCAM practitioner was suing a critic:

‘Doctor’ Colleen Huber (DCH) is the US naturopath who is currently suing Britt Hermes. For me, this is enough reason to do a bit of reading and find out who DCH is and what motivates her. Here is what I found out (I added some * to the quotes [all in italics] and comments below).

DCH has an impressive presence on the Internet. One website, for instance, tells us that DCH is a Naturopathic Medical Doctor* in Tempe, Arizona. Her clinic, Nature Works Best Cancer Clinic, has had the most successful results of any clinic in the world reporting its results over the last 9 years **.

Dr. Huber authored the largest and longest study*** in medical history on sugar intake in cancer patients, which was reported in media around the world in 2014. Her other writing includes her book, Choose Your Foods Like Your Life Depends On Them ****, and she has been featured in the books America’s Best Cancer Doctors and Defeat Cancer. Dr. Huber’s academic writing has appeared in The Lancet *****, the International Journal of Cancer Research ***** and Molecular Mechanisms *****,  and other medical journals ******. Her research interests are in the use of therapeutic approaches targeting metabolic aspects of cancer…

*I am puzzled by this title. Is it an official one? I only found this, and it omits the ‘medical’: Currently, 20 states, five Canadian provinces, the District of Columbia, and the U.S. territories of Puerto Rico and the U.S. Virgin Islands have passed laws regulating naturopathic doctors. Learn more about licensure from the Association of Accredited Naturopathic Medical Colleges. It seems that Arizona is the only state where the ‘medical’ is allowed. However, don’t take this to mean that DCH went to medical school.

** ‘most successful results of any clinic in the world’? Really? Where are the comparative statistics?

*** the study had all of 317 patients and was published in an obscure, non-Medline listed journal.

**** currently ranked  #1,297,877 in Books on Amazon.

***** no such entries found on Medline.

****** sorry, but my Medline search for ‘huber colleen’ located only 2 citations, both on arthritis research conducted in an US Pfizer lab and therefore probably not from ‘our’ DCH.

Another website on or by DCH informs us that her outfit Nature Works Best is a natural cancer clinic located in Tempe, Arizona, that focuses on natural, holistic, and alternative cancer treatments. Our treatments have proved to be an effective alternative to traditional chemotherapy and radiation, which we do not use in our treatments. Rather, we have developed a natural method of treating cancers based on intravenous vitamin therapy which may include Vitamin-C, Baking Soda, and other tumor fighting agents as well as a simple food plan. *

Our team of naturopathic medical doctors have administered an estimated 31,000 IV nutrient treatments, used for all stages and types of tumors. As of July 2014, 80% of patients who completed our treatments alone went into remission, 85% of patients who completed our treatments and followed our food plan went into remission. **

* Give me a break! Vitamin-C and Baking Soda are claimed to have proved to be an effective alternative to traditional chemotherapy and radiation ? I would like to see the data before I believe this!

** Again, I would like to see the data before I believe this!

Finally, a further website proudly repeats that her academic writing has appeared in The Lancet and Cancer Strategies Journal, and other medical journals. It even presents an abstract of her published work; here it is:

Recent recommendations for the more widespread prescription of statin drugs in the U.S. have generated controversy.  Cholesterol is commonly thought to be the enemy of good health.  On the other hand, previous research has established the necessity of cholesterol in production of Vitamin D and steroid hormones, among other purposes, some of which have been shown to have anti-cancer effect.  We compare total serum cholesterol (TC) in cancer survivors vs cancer fatalities, and we assess the value of deliberately lowering TC among cancer patients.  We also examined diet in the survivors as well as those who then died of cancer.

In this original previously unpublished research, we conducted a double-blind retrospective case series, in which we looked back at data from all 255 cancer patients who came to and were treated by our clinic with either current dietary information, and/or a recent serum TC level, measured by an unaffiliated laboratory or an unaffiliated clinic over the previous seven years, comparing TC in the surviving cancer patients versus those cancer patients who died during that time.

Surviving cancer patients had 24.0 points higher mean total cholesterol than the mean for deceased cancer patients.  A number of dietary differences between cancer survivors and those who then died of cancer were also found to be notable.

Caution is advised before attempting to lower cholesterol in cancer patients with close to normal TC levels.  Those cancer patients with higher TC were more likely to survive their cancer.

I don’t know about you, but I am not impressed. Surviving cancer patients had 24.0 points higher mean total cholesterol than the mean for deceased cancer patients. Has DCH thought of the possibility that moribund patients quite simply eat less? In which case, the observed difference would be a meaningless epiphenomenon.

At this point, I stopped my reading; I now knew more than I needed to know about DCH (if you want to read more, I recommend this or this post).

As I mentioned at the beginning of this post, DCH is currently suing Britt Hermes for libel…

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Yesterday Britt Hermes reported that she has won the court case:

On May 24, 2019, the District Court (Landgericht) of Kiel, Germany ruled against naturopathic cancer quack Colleen Huber in a defamation lawsuit she brought against me. Huber filed suit in September 2017 over my opinions about the dubious treatments and human subjects research at her cancer clinic in Tempe, Arizona (USA), and also over my suspicions that Huber was cybersquatting domains in my name…

In a blog post from December 2016, I theorized that Huber or someone in her close orbit had registered domains using my first and last names to misrepresent my position on naturopathic “doctors.” You can view the archive of brittmariehermes.com from 31 March 2016 here. In my post, I also wrote about Huber’s dubious cancer treatments of intravenous baking soda, mega-doses of intravenous vitamin C, and a strict sugar-free diet. Huber advocates against state-of-the-art oncology, especially chemotherapy and radiation, because she thinks these therapies strengthen cancer…

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I am sure that many readers of the blog want to join me in congratulating Britt.

VERY WELL DONE INDEED!

The purpose of this recently published survey was to obtain the demographic profile and educational background of chiropractors with paediatric patients on a multinational scale.

A multinational online cross-sectional demographic survey was conducted over a 15-day period in July 2010. The survey was electronically administered via chiropractic associations in 17 countries, using SurveyMonkey for data acquisition, transfer, and descriptive analysis.

The response rate was 10.1%, and 1498 responses were received from 17 countries on 6 continents. Of these, 90.4% accepted paediatric cases. The average practitioner was male (61.1%) and 41.4 years old, had 13.6 years in practice, and saw 107 patient visits per week. Regarding educational background, 63.4% had a bachelor’s degree or higher in addition to their chiropractic qualification, and 18.4% had a postgraduate certificate or higher in paediatric chiropractic.

The authors from the Anglo-European College of Chiropractic (AECC), Bournemouth University, United Kingdom, drew the following conclusion: this is the first study about chiropractors who treat children from the United Arab Emirates, Peru, Japan, South Africa, and Spain. Although the response rate was low, the results of this multinational survey suggest that pediatric chiropractic care may be a common component of usual chiropractic practice on a multinational level for these respondents.

A survey with a response rate of 10%?

An investigation published 9 years after it has been conducted?

Who at the AECC is responsible for controlling the quality of the research output?

Or is this paper perhaps an attempt to get the AECC into the ‘Guinness Book of Records’ for outstanding research incompetence?

But let’s just for a minute pretend that this paper is of acceptable quality. If the finding that ~90% of chiropractors tread kids is approximately correct, one has to be very concerned indeed.

I am not aware of any good evidence that chiropractic care is effective for paediatric conditions. On the contrary, it can do quite a bit of direct harm! To this, we sadly also have to add the indirect harm many chiropractors cause, for instance, by advising parents against vaccinating their kids.

This clearly begs the question: is it not time to stop these charlatans?

What do you think?

I have just been in Sao Paulo to give a lecture at the opening of a new university institute, ‘Question of Science‘. Under the leadership of Natalia Pasternak, the institute will promote scepticism in Brazil, particularly in the area of alternative medicine. Brazil currently has no less than 29 types of alternative medicine paid for with public money, and even homeopathy is officially being recognised and taught at all Brazilian medical schools.

But the most peculiar case of Brazilian quackery must surely be phosphoethanolamine. Gilberto Chierice, a Chemistry Professor at the University of São Paulo, used resources from a campus laboratory to unofficially manufacture, distribute, and promote the chemical to cancer patients claiming that it was a cheap cure for all cancers without side-effects. Remarkably, this was in the total absence of through clinical testing. In September 2015, university administrators therefore began preventing him from continuing with this practice. However, in October 2015, several courts in Brazil ruled in favour of plaintiffs who wanted the compound to remain available. In an unusual move of defence of common sense, a state court overturned the lower courts’ decision a month later, and the secretary for Brazil’s science and technology ministry promised to fund further research on the compound. In 2016, a law was passed in Brazil allowing the sale of synthetic phosphorylethanolamine for cancer treatment. Due to opposition from the Brazilian Medical Association, the Brazilian Society of Clinical Oncology, and the regulatory agency ANVISA, the country’s Supreme Court then suspended the law. I was told that a stepwise plan of clinical testing had been implemented. As the drug even failed to pass the most preliminary tests, the program had to be aborted.

This story seems like a re-play of many similar tales of bogus cancer cures of the past. They all seem to follow a similar pattern:

  1. Someone dreams up a ‘cure’ for all cancers that is cheap and free of side-effects.
  2. This appeals to many desperate cancer patients who are fighting for their lives.
  3. It also attracts several entrepreneurs who are hoping to make a fast buck.
  4. The story is picked up by the press and consequently a sizable grass-roots movement of support emerges.
  5. Populist politicians jump on the vote-winning band-waggon.
  6. The experts caution that the bogus cancer ‘cure’ is devoid of evidence and might put patients’ lives at risk.
  7. The legislators get involved.
  8. Law suits start left, right and centre.
  9. Eventually, the cancer ‘cure’ is scientifically tested and confirmed to be bogus.
  10. Eventually, the law rules against the bogus ‘cure’.
  11. A conspiracy theory emerges stating that the cancer ‘cure’ was unjustly suppressed to protect the interests of Big Pharma.
  12. A few years later, the subject re-surfaces and the whole cycle starts from the beginning.

Such stories remind us that fighting bogus claims is hugely important, even if it does not always succeed or turns out to be merely an exercise of damage limitation. Every life saved by the struggle against quackery makes it worthwhile.

I wish the new Institute ‘Question of Science‘ all the luck it richly deserves and desperately needs.

On 29 August, I published a post discussing a case report of a patient who had suffered multiple unilateral pre-retinal haemorrhages immediately following chiropractic neck manipulation suggesting that chiropractic spinal adjustments can not only affect the carotid artery, but also could lead to pre-retinal haemorrhages. Two days ago (over one month after my blog-post), the story was reported in the Daily Mail. They (originally) quoted me both in their on-line and print version as follows: “Edzard Ernst, an expert in alternative medicine, said chiropractic treatments were too dangerous and not sufficiently effective to be recommended for any condition.”

I think this is a statement that does not really relate well to the story. Crucially, it is a sentence that I do not identify with.

So, why did I say it?

The answer is simple: I didn’t!

What happened is this:

The ‘science correspondent’ of the Mail emailed me asking whether she could speak to me. I replied that I am currently in Brittany and that it would be better to send me questions which I promised to answer swiftly. She then send a press-release about the above-mentioned case report and asked for a quote. The paragraph I swiftly sent her read as follows:

“Chiropractors frequently manipulate patients’ neck in such a way that the joints are taken beyond their physiological range of motion. This can lead to all sorts of problems, sometimes even death. This new report suggests that chiropractic neck manipulations can also damage the eyes. As the ensuing problems tend to be temporary, it is likely that such eye-damage occurs often after chiropractic treatments. Chiropractic neck manipulations are not convincingly effective for any condition; as they can cause a lot of harm, their risk/benefit balance is clearly negative. In other words, we should not use or recommend them.”

The science correspondent thanked me and replied that my quote was too long and had to be shortened; would I be happy, she asked, with the following text:

“Edzard Ernst, an expert in the study of alternative medicine and former professor at the University of Exeter, said: ‘Chiropractors frequently manipulate patients’ neck in such a way that the joints are taken beyond their physiological range of motion.
‘The ensuing problems tend to be temporary but it is likely that this kind of eye damage occurs often after chiropractic treatments.
‘Chiropractic neck manipulations are not convincingly effective for any condition as they can cause a lot of harm. Therefore we should not use or recommend them.’ ”

I made a slight alteration (exchanging ‘the ensuing problems’ for ‘the ensuing eye-problems’) and replied that this was fine by me.

When I saw what was eventually published (the nonsense printed in bold above), I was baffled and irritated. Therefore I instantly complained to the science correspondent. She apologised saying that my quote had been “paraphrased from [my] full quote, probably for reasons of space during the production process”. She also changed the quote in the on-line version to what it says currently.

I replied: “of course, I accept your apology personal, as I knew it was not your doing. nevertheless, I find it totally unacceptable that someone at the DM can just go ahead and change direct quotes. you say he/she paraphrased me; I disagree! the published sentence has an entirely different meaning. this is not journalism! I want an apology from the person who is responsible.”

The science correspondent then promised to take care of it; but, so far, nothing has happened.

One could easily view this episode as trivial. However, I believe that decent journalism should stick to the rules. And one of the most fundamental one is that journalists cannot put words into people’s mouths just because it fits their story-line (Boris Johnson did this when he was a journalist, and look what a formidable mess he is now creating!). If we let journalists get away with such behaviour, we cannot have trust in journalism. And if we cannot trust journalism, it has lost its purpose.

So, should I continue insisting on an adequate apology from the person responsible or not?

What do you think?

Did you know that I falsified my qualifications?

Neither did I!

But this is exactly what has been posted on Amazon as a review of my book HOMEOPATHY, THE UNDILUTED FACTS. The Amazon review in question is dated 7 August 2018 and authored by ‘Paul’. As it might not be there for long (because it is clearly abusive) I copied it for you:

Edzard Ernst falsified his qualifications to get a job as a professor. When the university found out they fired him. This book is as false as the Mr Ernst

Over the years, I have received so many insults that I stared to collect them and began to quite like them. I even posted selections on this blog (see for instance here and here). Some are really funny and others are enlightening because they reflect on the mind-set of the authors. All of them show that the author has run out of arguments; thus they really are little tiny victories over unreason, I think.

But, somehow, this new one is different. It is actionable, no doubt, and contains an unusual amount of untruths in so few words.

  • I never falsified anything and certainly not my qualification (which is that of a doctor of medicine). If I had, I would be writing these lines from behind bars.
  • And if I had done such a thing, I would not have done it ‘to get a job as a professor’ – I had twice been appointed to professorships before I came to the UK (Hannover and Vienna).
  • My university did not find out, mainly because there was nothing to find out.
  • They did not fire me, but I went into early retirement. Subsequently, they even re-appointed me for several months.
  • My book is not false; I don’t even know what a ‘false book’ is (is it a book that is not really a book but something else?).
  • And finally, for Paul, I am not Mr Ernst, but Prof Ernst.

I don’t know who Paul is. And I don’t know whether he has even read the book he pretends to be commenting on (from what I see, I think this is very unlikely). I am sure, however, that he did not read my memoir where all these things are explained in full detail. And I certainly do not hope he ever reads it – if he did, he might claim:

This book is as false as the Mr Ernst

Currently, there are measles outbreaks almost everywhere. I have often pointed out that SCAM does not seem to be entirely innocent in this development. Now another study examined the relationship between SCAM-use and vaccination scepticism. Specifically, the researchers wanted to know whether a person’s more general health-related worldview might explain this relationship.

A cross-sectional online survey of adult Australians (N = 2697) included demographic, SCAM, and vaccination measures, as well as the holistic and magical health belief scales (HHB, MHB). HHB emphasises links between mind and body health, and the impact of general ‘wellness’ on specific ailments or resistance to disease, whilst MHB specifically taps ontological confusions and cognitive errors about health. SCAM and anti-vaccination were found to be linked primarily at the attitudinal level (r = -0.437). The researchers did not find evidence that this was due to SCAM practitioners influencing their clients. Applying a path-analytic approach, they found that individuals’ health worldview (HHB and MHB) accounted for a significant proportion (43.1%) of the covariance between SCAM and vaccination attitudes. MHB was by far the strongest predictor of both SCAM and vaccination attitudes in regressions including demographic predictors.

The researchers concluded that vaccination scepticism reflects part of a broader health worldview that discounts scientific knowledge in favour of magical or superstitious thinking. Therefore, persuasive messages reflecting this worldview may be more effective than fact-based campaigns in influencing vaccine sceptics.

Parents opposing vaccination of their kids are often fiercely determined. Numerous cases continue to make their way through the courts where parents oppose the vaccination of their children, often inspired by the views of both registered and unregistered health practitioners, including homeopaths and chiropractors. A recent article catalogued decisions by the courts in Australia, New Zealand, the UK and Canada. Most of them ruled in favour of vaccination and dismissed the arguments of those opposed to vaccination as unscientific. The author, an Australian barrister and Professor of Forensic Medicine, concluded that Australia should give serious consideration to emulating the model existing in multiple countries, including the United States, and should create a no-fault vaccination injury compensation scheme.

Such programs are based on the assumption that it is fair and reasonable that a community protected by a vaccination program accepts responsibility for and provides compensation in those rare instances where individuals are injured by it. To Me, this seems a prudent and ethical concept that should be considered everywhere.

This study examined websites of naturopathic clinics and practitioners in the provinces of British Columbia and Alberta, looking for the presence of discourse that may contribute to vaccine hesitancy, and for recommendations for ‘alternatives’ to vaccines or flu shots.

Of the 330 naturopath websites analysed, 40 included vaccine hesitancy discourse and 26 offered vaccine or flu shot alternatives. Using these data, the authors explored the potential impact such statements could have on the phenomenon of vaccine hesitancy.

Next the researchers considered these misrepresentations in the context of Canadian law and policy, and outlined various legal methods of addressing them. They concluded that tightening advertising law, reducing CAM practitioners’ ability to self-regulate, and improving enforcement of existing common and criminal law standards would help limit naturopaths’ ability to spread inaccurate and science-free anti-vaccination and vaccine-hesitant perspectives.

The paper listed some poignant examples of vaccine hesitancy discourse:

1) ‘…children are now being given increasing numbers of vaccinations containing potentially harmful derivatives and substances such as mercury, thimerisol [sic], aluminum and formaldehydes. These harmful derivatives can become trapped in our tissues, clogging our filters and diminishing one’s ability of further toxins out.’ — www.evolvenaturopathic.com

2) ‘Vaccines given to children and adults contain mercury and aluminum. Babies are especially susceptible to small amounts of mercury injected directly into their tiny bodies. It is now suspected that the increase in autism and Asperger Syndrome is related to the mercury in childhood vaccinations.’ — www.vancouvernaturopathicclinic.com

3) ‘The conventional Flu Shot is a mixture of 3 strains of flu viruses mixed with a number of chemical preservatives and these strains are based on a prediction of what flu viruses some medical experts think will be the most problematic this season. This is really an impossible prediction to make when we have thousands of different strains of viruses that are continuously mutating.’ — www.advancednaturopathic.com

4) ‘A [sic] epidemiologist researcher from British Columbia, Dr. Danuta Skowronski, published a study earlier this year showing that people who were vaccinated consecutively in 2012, 2013 and 2014 appeared to have a higher risk of being infected with new strains of the flu.’ — www.drtas.ca

5) ‘Increasing evidence suggests that injecting a child with nearly three dozen doses of 10 different viral and bacterial vaccines before the age of five, while the immune system is still developing, can cause chronic immune dysfunction. The most that vaccines can do is lead to an increase in antibodies to a specific disease.’ — www.evolvevitality.com

6) ‘The bugs in question (on the Canadian Vaccine List) can enter our systems and depending on our bodies, our histories, and mostly the bugs’ propensity, they can cause serious harm. There are certainly questionable ingredients in vaccines that have the potential to do the same.’ — www.tharavayali.ca

The authors also considered that, in Canada, a naturopath who recommends homeopathic vaccines or who counsels against conventional vaccination could potentially be criminally negligent. Section 219 of the Criminal Code of Canada [Code] states that ‘[e]very one is criminally negligent who, in doing anything, or in omitting to do anything that it is his duty to do, shows wanton or reckless disregard for the lives or safety of other persons’. Subsection (2) goes on to state that, for the purposes of criminal negligence, ‘duty’ means a duty imposed by law; a legal duty in this context is one arising from statute or from the common law. The Code creates a legal duty for anyone ‘who undertakes to administer surgical or medical treatment to another person or to do any other lawful act that may endanger the life of another person’ to ‘have and to use reasonable knowledge, skill and care in so doing’. This duty is a uniform standard, meaning the requirement of reasonable knowledge, care, and skill is based on the treatment or lawful act in question, not on the level of experience of the person administering it. As such, naturopaths offering services similar to medical doctors will be held to the same standards under the Code.

Criminal negligence occurs due to the ‘failure to direct the mind to a risk of harm which [a] reasonable person would have appreciated’. Fault is premised on the wrongful act involved, rather than the guilty mind of the perpetrator. Naturopaths counseling patients against vaccination are arguably undertaking a lawful act that endangers the life of another person (especially in the case of a young child, elderly individual, or immunocompromised person), breaching s.216 of the Code. In addition, since relevant legal duties include those arising through the common law, naturopaths could alternatively be criminally negligent for failing to satisfy the aforementioned duty of reasonable disclosure inherent to standard of care in tort. In the context of a community with diminished vaccination rates, either failure could be considered wanton or reckless, as it may greatly and needlessly endanger the patient. However, under the standard for criminal negligence, the trier of fact must ‘assess whether the accused’s conduct, in view of his or her perception of the facts, constituted a marked and substantial departure from what would be reasonable in the circumstances’. This is similar to the standard of gross negligence, so ultimately a finding of criminal negligence would require meeting a rather onerous threshold.

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This, of course, is according to Canadian law; but I imagine that the law in other countries must be similar.

Therefore, this is a legal opinion which might be worth considering also outside Canada.

If there is a legal expert amongst my readers, please do post a comment.

On this blog, we have seen more than enough evidence of how some proponents of alternative medicine can react when they feel cornered by critics. They often direct vitriol in their direction. Ad hominem attacks are far from being rarities. A more forceful option is to sue them for libel. In my own case, Prince Charles went one decisive step further and made sure that my entire department was closed down. In China, they have recently and dramatically gone even further.

This article in Nature tells the full story:

A Chinese doctor who was arrested after he criticized a best-selling traditional Chinese remedy has been released, after more than three months in detention. Tan Qindong had been held at the Liangcheng county detention centre since January, when police said a post Tan had made on social media damaged the reputation of the traditional medicine and the company that makes it.

On 17 April, a provincial court found the police evidence for the case insufficient. Tan, a former anaesthesiologist who has founded several biomedical companies, was released on bail on that day. Tan, who lives in Guangzhou in southern China, is now awaiting trial. Lawyers familiar with Chinese criminal law told Nature that police have a year to collect more evidence or the case will be dismissed. They say the trial is unlikely to go ahead…

The episode highlights the sensitivities over traditional Chinese medicines (TCMs) in China. Although most of these therapies have not been tested for efficacy in randomized clinical trials — and serious side effects have been reported in some1TCM has support from the highest levels of government. Criticism of remedies is often blocked on the Internet in China. Some lawyers and physicians worry that Tan’s arrest will make people even more hesitant to criticize traditional therapies…

Tan’s post about a medicine called Hongmao liquor was published on the Chinese social-media app Meipian on 19 December…Three days later, the liquor’s maker, Hongmao Pharmaceuticals in Liangcheng county of Inner Mongolia autonomous region, told local police that Tan had defamed the company. Liangcheng police hired an accountant who estimated that the damage to the company’s reputation was 1.4 million Chinese yuan (US$220,000), according to official state media, the Beijing Youth Daily. In January, Liangcheng police travelled to Guangzhou to arrest Tan and escort him back to Liangcheng, according to a police statement.

Sales of Hongmao liquor reached 1.63 billion yuan in 2016, making it the second best-selling TCM in China that year. It was approved to be sold by licensed TCM shops and physicians in 1992 and approved for sale over the counter in 2003. Hongmao Pharmaceuticals says that the liquor can treat dozens of different disorders, including problems with the spleen, stomach and kidney, as well as backaches…

Hongmao Pharmaceuticals did not respond to Nature’s request for an interview. However, Wang Shengwang, general manager of the production center of Hongmao Liquor, and Han Jun, assistant to the general manager, gave an interview to The Paper on 16 April. The pair said the company did not need not publicize clinical trial data because Hongmao liquor is a “protected TCM composition”. Wang denied allegations in Chinese media that the company pressured the police to pursue Tan or that it dispatched staff to accompany the police…

Xia is worried that the case could further silence public criticism of TCMs, environmental degredation, and other fields where comment from experts is crucial. The Tan arrest “could cause fear among scientists” and dissuade them from posting scientific comments, he says.

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On this blog, we have repeatedly discussed concerns over the validity of TCM data/material that comes out of China (see for instance here, here and here). This chilling case, I am afraid, is not prone to increase our confidence.

“In at least one article on chiropractic, Ernst has been shown to be fabricating data. I would not be surprised if he did the same thing with homeopathy. Ernst is a serial scientific liar.”

I saw this remarkable and charming Tweet yesterday. Its author is ‘Dr’ Avery Jenkins. Initially I was unaware of having had contact with him before; but when I checked my emails, I found this correspondence from August 2010:

Dr. Ernst:

Would you be so kind as to provide the full text of your article? Also, when would you be available for an interview for an upcoming feature article?

Thank you.

Avery L. Jenkins, D.C.

I put his title in inverted commas, because it turns out he is a chiropractor and not a medical doctor (but let’s not be petty!).

‘Dr’ Avery Jenkins runs a ‘Center for Alternative Medicine’ in the US: The Center has several features which set it apart from most other alternative medicine facilities, including the Center’s unique Dispensary.  Stocked with over 300 herbs and supplements, the Dispensary’s wide range of natural remedies enables Dr. Jenkins to be the only doctor in Connecticut who provides custom herbal formulations for his patients. In our drug testing facility, we can provide on-site testing for drugs of abuse with immediate result reporting. Same-day appointments are available. Dr. Jenkins is also one of the few doctors in the state who has already undergone the federally-mandated training which will be necessary for all Department of Transportation Medical Examiners by 2014. Medical examinations for your Commercial Drivers License will take only 25 minutes, and Dr. Jenkins will provide you with all necessary paperwork.

The good ‘doctor’ also publishes a blog, and there I found a post from 2016 entirely dedicated to me. Here is an excerpt:

.. bias and hidden agendas come up in the research on alternative medicine and chiropractic in particular. Mostly this occurs in the form of journal articles using research that has been hand-crafted to make chiropractic spinal manipulation appear dangerous — when, in fact, you have a higher risk of serious injury while driving to your chiropractor’s office than you do of any treatment you receive while you’re there.

A case in point is the article, “Adverse effects of spinal manipulation: a systematic review,” authored by Edzard Ernst, and published in the Journal of the Royal Society of Medicine in 2007. Ernst concludes that, based on his review, “in the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.”

This conclusion throws up several red flags, beginning with the fact that it flies in the face of most of the already-published, extensive research which shows that chiropractic care is one of the safest interventions, and in fact, is  safer than medical alternatives.

For example, an examination of injuries resulting from neck adjustments over a 10-year period found that they rarely, if ever, cause strokes, and lumbar adjustments by chiropractors have been deemed by one of the largest studies ever performed to be safer and more effective than medical treatment.

So the sudden appearance of this study claiming that chiropractic care should be stopped altogether seems a bit odd.

As it turns out, the data is odd as well.

In 2012, a researcher at Macquarie University in Australia, set out to replicate Ernst’s study. What he found was shocking.

This subsequent study stated that “a review of the original case reports and case series papers described by Ernst found numerous errors or inconsistencies,” including changing the sex and age of patients, misrepresenting patients’ response to adverse events, and claiming that interventions were performed by chiropractors, when no chiropractor was even involved in the case.

“In 11 cases of the 21…that Ernst reported as [spinal manipulative therapy] administered by chiropractors, it is unlikely that the person was a qualified chiropractor,” the review found.

What is interesting here is that Edzard Ernst is no rookie in academic publishing. In fact, he is a retired professor and founder of two medical journals. What are the odds that a man with this level of experience could overlook so many errors in his own data?

The likelihood of Ernst accidentally allowing so many errors into his article is extremely small. It is far more likely that Ernst selected, prepared, and presented the data to make it fit a predetermined conclusion.

So, Ernst’s article is either extremely poor science, or witheringly inept fraud. I’ll let the reader draw their own conclusion.

Interestingly enough, being called out on his antics has not stopped Ernst from disseminating equally ridiculous research in an unprofessional manner. Just a few days ago, Ernst frantically called attention to another alleged chiropractic mishap, this one resulting in a massive brain injury.

Not only has he not learned his lesson yet, Ernst tried the same old sleight of hand again. The brain injury, as it turns out, didn’t happen until a week after the “chiropractic” adjustment, making it highly unlikely, if not impossible, for the adjustment to have caused the injury in the first place. Secondly, the adjustment wasn’t even performed by a chiropractor. As the original paper points out, “cervical manipulation is still widely practiced in massage parlors and barbers in the Middle East.”  The original article makes no claim that the neck adjustment (which couldn’t have caused the problem in the first place) was actually performed by a chiropractor.

It is truly a shame that fiction published by people like Ernst has had the effect of preventing many people from getting the care they need. I can only hope that someday the biomedical research community can shed its childish biases so that we all might be better served by their findings.

END OF QUOTE

Here I will not deal with the criticism a Australian chiropractor published in a chiro-journal 5 years after my 2007 article (which incidentally was not primarily about chiropractic but about spinal manipulation). Suffice to say that my article did NOT contain ‘fabricated’ data. A full re-analysis would be far too tedious, for my taste (especially as criticism of it has been discussed in all of 7 ‘letters to the editor’ soon after its publication)

I will, however, address ‘Dr’ Avery Jenkins’ second allegation related to my recent (‘frantic’) blog-post. I will do this by simply copying the abstract of the paper in question:

Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic* manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic* cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations.

*my emphasis


With this, I rest my case.

The only question to be answered now is this: TO SUE OR NOT TO SUE?

What do you think?

I have to admit that I had little hope it would come. But after sending my ‘open letter’ twice to their email address, I have just received this:

Click to enlarge

 

 

As you might remember, the AACMA had accused me of an pecuniary undeclared link with the pharmaceutical industry. Their claim was based on me having been the editor of a journal, FACT, which was co-published by the British Pharmaceutical Society (BPS). When I complained and the AACMA learnt that the journal had been discontinued, they retracted their claim but carried on distributing the allegation that I had formerly had an undeclared conflict of interest. When they finally understood that the BPS was not the pharmaceutical industry (all it takes is a simple Google search), and after me complaining again and again, they sent me the above email.

The full details of this sorry story are here and here.

So, the AACMA have done the right thing?

Yes and no!

The have retracted their repeated lies.

But they have not done this publicly as requested (this is partly the reason for me writing this post to make their retraction public).

More importantly, they have not apologised !!!

Why should they, you might ask.

  1. Because they have (tried to) damage my reputation as an independent scientist.
  2. Because they have not done their research before making and insisting on a far-reaching claim.
  3. Because they have shown themselves too stupid to grasp even the most elementary issues.

By not apologising, they have, I find, shown how unprofessional they really are, and how much they lack simple human decency. On their website, the AACMA state that “since 1973, AACMA has represented the profession and values high standards in ethical and professional practice.” Personally, I think that their standards in ethical and professional practice are appalling.

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