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

medical ethics

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By guest blogger Ken Harvey

Loretta Marron was the catalyst. The ‘critical thinking’ bug hit her as a child, reinforced by a BSc in Physics. If something didn’t sound logical, she couldn’t let it go. She had to check. She killed many a party by disputing misinformation – with evidence.

TV advertisements for magnetic underlays got her going, then homeopathic remedies, followed by ‘natural’ cures for cancer. To investigate outlandish claims and submit complaints, she needed to consult with experts. These included Professors John Dwyer (Medicine and Immunology) and Alastair MacLennan (Obstetrics and Gynaecology). They were always willing to help.

They also had concerns about universities teaching pseudoscience, such as ‘subluxation theory’ in chiropractic and ‘meridians’ in Traditional Chinese Medicine.

In late 2011, Professor Dwyer proposed that Loretta join forces with Professors Alastair MacLennan, Marcello Costa (neuroscientist), and Rob Morrison (science communicator) to form a new organisation promoting scientific evidence in health care. Friends of Science in Medicine (FSM) was born. John Dwyer was the inaugural President and Loretta Marron Chief Executive Officer (CEO).

The aim was to emphasise the importance of basing Australian health care on scientifically sound research and established scientific knowledge published in peer-reviewed journals of accepted standing. Valuing scientific rigour is especially important in an age where unsubstantiated health claims are rampant and scientific consensus is ‘imbalanced’ by the views of extremists.

FSM’s focus is helping consumers and health professionals to make more informed choices about medical interventions, medicines, and medical devices. We do this by submitting complaints about unethical practice, analysing policy, making submissions, encouraging regulators to act, and being a credible source of expertise for the media and others. We also encourage tertiary institutions and medicine and health sciences students to critically appraise therapeutic products and services as part of the courses offered.

Currently, FSM has more than 1,200 leading scientists, clinicians, lawyers, and consumer advocates as supporters. We also work closely with organisations such as Australian Skeptics and Choice (Australian Consumers Association).

I took over as President from John Dwyer in 2019. Loretta remains FSM CEO. The founding members continue their involvement as consultants. Ten years on, it’s worth reflecting on what has been achieved and the ongoing challenges.

An appendix lists some of the areas in which FSM has been involved and the outcomes achieved (often with the help of others).

Unethical promotion of therapeutic goods and services remain an ongoing concern. The advertising of therapeutic goods is subject to provisions in the Therapeutic Goods Advertising Code, first promulgated in 1999. Until July 2018, complaints about alleged Code violations were heard by the Therapeutic Goods Advertising Complaints Resolution Panel (CRP), thereafter by the Therapeutic Goods Administration (TGA).

FSM members submitted numerous complaints to the CRP and analysed the outcome. If a complaint was upheld, the CRP could only ‘recommend’ that it be removed. If it was not, the complaint was referred to the TGA for action. We found that certain companies consistently ignored the determinations of the CRP and, when referred to the TGA, took resulting action.

In July 2018, FSM engagement with numerous consultations and reviews eventually resulted in the TGA taking over the advertising complaint system. The TGA was given stronger investigative and compliance powers and a revised, legally enforceable advertising code. However, given the TGA’s previous track record, we continued to submit complaints, including many previously upheld by the CRP, but for which promotion continued.

An analysis of the first 12 months of the new system found that the TGA had classified most complaints as ‘low priority’. These were either ignored or closed by sending the advertiser a ‘Regulatory Obligation letter’ which stated that no further action would be taken. While the letter sometimes worked, often it did not. Stronger compliance powers were rarely used. The new complaint system was also less transparent than the one it replaced. For those low priority complaints with published outcomes, no details of the product, advertiser, or alleged Code violation were published, and no follow-up was recorded. Of 121 higher priority complaints, 79% failed to meet their key performance indicator, time to closure in 60–90 days. These included complaints about dangerous sports supplements and ineffective weight loss and hangover products.

In August 2020, an independent review of the first two years of the TGA’s compliant system was published. The study noted an unexpectedly high volume of complaints since the TGA took over the advertising complaints system, producing a large and growing backlog. A government-appointed consultant (ThinkPlace Pty Ltd) stated that providing more resources would not be in the public interest. Instead, they recommended a more cost-effective and efficient approach: amalgamating all complaints into an information database from which the TGA could consider compliance priorities.

As a result, complaints were closed by sending complainants a letter stating that their complaints will be used for ‘intelligence’ to set priorities. The TGA said risk assessment informed whether a complaint was converted into a case for investigation or stored in their information database to determine future compliance priorities. Therapeutic goods associated with COVID-19 were declared ‘priority 1’, while weight loss, hangover, and four other products groups were said to be ‘priority 2’.

A focus on COVID-19 stimulated the TGA to deal with some of these complaints more effectively. However, apart from token action on individual products, no systemic action was taken on weight loss, hangover products and many other objects of our complaints.

More recently, the TGA’s complaint database for 2018 -2020 has been removed and replaced by a new database containing only a few complaints pre-2021. In addition, the fields of many ‘products’ and ‘responsible person’, are missing. The TGA say that migration of data to the new system is continuing. Meanwhile, complainants now only receive an automated acknowledgment.

Transparency remains a problem as there is no clear indication of how many complaints the TGA receives, what they are about, how many are filed for ‘intelligence’’, how many are actioned, and what outcome eventuates.

Given this lamentable state of affairs, in association with Australian Skeptics, it is proposed to publish reports on all complaints submitted to the TGA in 2022 and their outcomes. Past experience shows that documenting problems, pointing out underlying issues and putting forward solutions can produce progress. But patience and persistence are required.

FSM has grappled with unethical advertising of pseudo-medical interventions. Controls differ for practitioners regulated by the Australian Health Practitioner Regulation Agency (AHPRA) and those regulated by State and Territory Health Complaints Commissioners. The former includes medical practitioners, pharmacists, nurses, chiropractors, osteopaths, and Traditional Chinese Medicine practitioners. The latter includes naturopaths, homeopaths, and practitioners of western herbal medicine.

FSM has held regular meetings with AHPRA senior managers. We have also met several of their national boards and attended stakeholder forums. Chiropractic was an initial focus. Many practitioners advertised that chiropractic care in pregnancy could shorten labour duration and prevent caesarean delivery – despite the absence of evidence. Pregnant women were warned that labour often resulted in the newborn babe’s spinal misalignment, which could lead to numerous problems unless put right by regular chiropractic adjustments. It was also claimed that chiropractic ‘adjustments’ could improve attention deficit hyperactivity disorder, infantile colic, and ear infection.

In 2015, FSM submitted hundreds of complaints to AHPRA, alleging that chiropractic websites were in breach of both s.133 of the Health Practitioner Regulation National Law Act 2009 and the Chiropractic Board of Australia’s Guidelines for advertising regulated health services. These provisions prohibit advertising which is false, misleading, or deceptive, creates an unreasonable expectation of beneficial treatment, or can encourage the indiscriminate or unnecessary use of health services.

Five years have passed since the Chiropractic Board first asked practitioners to ensure that their websites met legal advertising requirements. Over this time, the Board’s sole approach to this problem was educational. Although chiropractors consistently had the highest advertising complaints of all practitioners (38 per 1,000 chiropractors in 2013–14), no penalties nor disciplinary action had been applied for advertising offences.

FSM argued that repeated advertising offences required appropriate penalties. We also pointed out that some practitioners now invited patients to consult them about services they were no longer permitted to advertise. We said that limitations should be placed on chiropractic practice which lacked evidence.

AHPRA responded that, although it could act on misleading advertising, it had no power to restrict the scope of practice of chiropractors (or other registered practitioners). We said that, if lack of good evidence makes it illegal to publicly advertise a treatment, then it should be equally illegal to offer it to patients privately; after all, the real harm is caused by the treatment, not the advertising.

In 2019, following damning publicity and further representations, the Victorian Health Minister eventually instructed Safer Care Victoria (SCV) to undertake an independent review of the practice of chiropractic spinal manipulation on children under 12 years. The result was a recommendation that spinal manipulation should not be provided to children under 12 years of age, for general wellness or for the management of conditions such as hyperactivity disorders, infantile colic, or ear infections.

The Chiropractic Board has also stated that chiropractors are not trained to apply any direct treatment to an unborn child and should not deliver any treatment to the unborn child. Neither should they provide materials, information or advice that is anti-vaccination in nature. After numerous complaints from FSM members, the Chiropractic Board finally referred a prominent anti-vax chiropractor, Simon Floreani, to the Victorian Civil and Administrative Tribunal (VCAT). His registration was suspended for 6 months, and conditions placed on his re-registration.

FSM has not just been concerned about chiropractors. We have complained (with varied success) about medical practitioners promoting stem cell therapy for multiple sclerosis, Traditional Chinese Medical practitioners claiming that acupuncture can treat infertility and dubious laboratory tests used in complementary and alternative medicine.

In conclusion, the peddling of unproven and sometimes dangerous remedies has existed throughout human history.

There will always be companies (and individuals) who put the pursuit of profit before ethical behaviour. There will always be advocates for de-regulation and regulators captured by industry. To protect consumers there must be opposing forces. That is the role that FSM is proud to play, along with colleagues from the sceptical community and consumer movements.

Appendix

FSM activities and outcomes (often in association with others), 2011-2021.

  1. Removal of extravagant claims for acupuncture from the World Health Organization website and instigation of a WHO evidence review.
  2. Involvement in the 2015 Review of the Australian Government Rebate on Private Health Insurance for Natural Therapies. This led to removal of cover for therapies that lacked evidence such as homeopathy, iridology, reflexology and naturopathy (currently being reviewed again to see if additional evidence exits).
  3. Removal of unproven/disproven courses or modules from Australian universities.
  4. Removal of continuing professional development (CPD) points required annually by relevant registered practitioners for a number of AltMed courses.
  5. Following complaints to the TGA, removal of some illegal medicines not on the Australian Register of Therapeutic Goods (ARTG).
  6. De-listing some complementary medicines and medical devices (such as ‘bio-resonance’ machines) lacking evidence.
  7. Getting the TGA to declare two products of self-declared ‘Foods for special medical purposes’ illegal therapeutic goods and have them removed from the market-place.
  8. Publishing academic articles, in peer-reviewed journals, documenting regulatory problems investigated and solutions suggested.
  9. Publishing articles in lay media on current problems including in The Conversation, MJA Insight and Pearls and Irritations (around 200 over the last 5 years).
  10. Responding to consultation requests from the TGA, Medical Boards, National Medicines Policy Review, and others.
  11. Achieving the suspension of anti-vax chiropractor Simon Floreani’s registration.
  12. Stimulating the Chiropractic Board to publish standards on pregnancy and paediatric care.
  13. Responsible for the setting up of AHPRA’s ‘Advertising Compliance’ section, including their pilot auditing system (yet to report).
  14. Responding to requests for information from journalists.
  15. Correction of misinformation from the Victorian government’s ‘Better Health’ Channel.
  16. Providing a complaints avenue for people who want to remain anonymous.

The ‘Control Group Cooperative Ltd‘ is a UK Company (Registration Number: 13477806) is registered at 117 Dartford Road, Dartford, Kent DA1 3EN, UK. On its website, it provides the following statement:

The Vaccine Control Group is a Worldwide independent long-term study that is seeking to provide a baseline of data from unvaccinated individuals for comparative analysis with the vaccinated population, to evaluate the success of the Covid-19 mass vaccination programme and assist future research projects. This study is not, and will never be, associated with any pharmaceutical enterprise as its impartiality is of paramount importance.

The VaxControlGroup is a community cooperative, for the people. All monies raised will be re-invested into the project and its community.

Volunteers for this study are welcome from around the world, providing they have not yet received any of the SARS-CoV-2 vaccinations and are not planning to do so.

So, the Vaccine Control Group (VCC) aims at recruiting people who refuse COVID vaccinations. The VCC issues downloadable and printable COVID-19 Vaccine self exemption forms that you can complete (either online or by hand) supplied by: Professionals for Medical Informed Consent and Non-Discrimination (PROMIC). The form contains the following text:

COVID-19 vaccines, that have been administered to the public under emergency use authorisation, have been
associated with moderate to severe adverse events and deaths in a small proportion of recipients. There are currently insufficient available long-term safety data from Phase 3 trials and post-marketing surveillance to be able to predict which population sub-groups are likely to be most vulnerable to these reactions. However, clinical assessments have identified a range of conditions or medical histories that are associated with increased risk of serious adverse events (see Panel B). Individuals with such medical concerns, along with those who have already had COVID-19 and acquired natural immunity, have justifiable grounds to not consent to COVID-19 vaccination. Such individuals may choose to use alternate approaches to reduce their risk of developing serious COVID-19 disease and associated viral transmission. UK and international law enshrines an individual’s right to refuse any medical treatment or intervention without being subjected to penalty, restriction or limitation of protected rights or freedoms, as this would otherwise constitute coercion.

I do wonder, after reading this, what scientific value this ‘study’ might have (nowhere could I find relevant methodological details about the ‘study’). In search of an answer, I found ‘Doctors & Health Professionals supportive of this project’. The only one supportive of the VCC seems to be Prof Harald Walach who offers his support with these words:

A vaccine control group, especially for Covid-19 vaccines, is extremely useful, even necessary, for the following reasons:

    1. We are dealing with a vaccination technology that has never been used in humans before.
    2. All studies that have planned a control group long term, i.e. longer than only 6 weeks, have meanwhile been compromised, i.e. there are no real control groups around, because those originally allocated to the control group have mostly been vaccinated now. So there are no real control groups available.
    3. Covid-19 vaccinations are one of the biggest experiments on mankind ever conducted – without a control group. Hence those, who are either not willing to be vaccinated or have not yet been vaccinated are our only chance to understand whether the vaccines are safe or whether symptoms reported after vaccination are actually due to the vaccination or are only an incidental occurrence or random fluctuation.

Comparing unvaccinated people and those with a vaccination history regarding Covid-19 vaccines long term is important to determine long-term safety, because in many instances in the past some problems only were seen after quite some time. This can happen, if auto-immune processes are triggered, which often occur only in very few people. Hence, it is also important to have a long-term observation period and a large number of people participating.

Prof. Dr. Dr. phil. Harald Walach

This does not alleviate my doubts about the scientific value at all. Prof Walach, promoter of so-called alternative medicine (SCAM) and pseudoscientist of the year 2012, has in the past drawn our attention to his odd activities around COVID and vaccinations. Here are three recent posts on the subject:

In view of all this, I do wonder what the VCC is truly about.

It couldn’t be a front for issuing dodgy exemption certificates, could it?

Anthony Fauci is the American physician, scientist, and immunologist who serves as the director of the National Institute of Allergy and Infectious Diseases (NIAID) and the Chief Medical Advisor to the President. I have never met him in person but, from all that I know about him, I have great respect for him and his work (he also happens to share with me a John Maddox Prize for standing up for science; he received it in 2020 and I in 2015). Not everyone, however, shares my admiration for Fauci.Image

This week Lara Logan, a host on Fox News’ streaming platform Fox Nation, confirmed Godwin’s law by comparing Dr. Anthony Fauci to Josef Mengele, the Nazi doctor who performed some of the most horrific experiments on Jewish twins at Auschwitz Concentration Camp during the Third Reich: “This is what people say to me: He doesn’t represent science,” the former “Logan of Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases. He represents Josef Mengele … the Nazi doctor who did experiments on Jews during the Second World War in the concentration camps. And I am talking about people all across the world are saying this! Because the response from COVID. What it has done to countries everywhere. What it has done to civil liberties. The suicide rates. The poverty.”

She made the comment during an appearance on “Fox News Primetime,” following a rant about how there was “no justification for putting people out of their jobs or forcing mandates” for a disease that has death rates “that compare very much to seasonal flu.” (The death rate from COVID-19 is up to 10 times higher than that of most strains of the flu.)

Only hours after the comments by Logan, the Fox News host, Tucker Carlson has compared Dr Anthony Fauci to Italian fascist World War II dictator Benito Mussolini. Holocaust comparisons have become a common feature of protests against COVID-19 strategies. Conservative politicians and media personalities have repeatedly compared vaccine mandates and pandemic restrictions to the treatment of Jews during the Holocaust.

The US is sadly not alone. In Germany and Austria, such comparisons between the atrocities of the Third Reich and COVID vaccinations have become common too. In Germany, this has gone so far that the judiciary is now taking action against people who compare Corona politics with the crimes of Nazis.

Personally, I find these comparisons not just stupid but despicable, and I agree that they should be outlawed. Journalists, in particular, must know that by employing this type of rhetoric, they act against all decency and undermine our efforts to protect the public from the pandemic. I, therefore, feel that Logan, Carlson, and anyone else who descends that low should be prosecuted.

Dr. Mehmet Oz is one of the most influential promoters of outright quackery. I once (many years ago) met him at a meeting where we both were lecturing. My impression was that he does not believe a single word he speaks. Oz later became a TV star and had ample occasion to confirm my suspicion.

Oz’s wife, Lisa, is a Reiki master and has spoken widely of her insights into energy and health. Mehmet Oz appeared as a health expert on The Oprah Winfrey Show. In 2009, Winfrey offered to produce a syndicated series. The Dr. Oz Show debuted in September 2009 and became the most successful promotion of charlatanery in the US. During a Senate hearing on consumer protection in 2014, Senator Claire McCaskill stated that “the scientific community is almost monolithic against you” for airing segments on weight loss products that are later cited in advertisements, concluding that Oz plays a role, intentional or not, in perpetuating these scams, and that she is “concerned that you are melding medical advice, news, and entertainment in a way that harms consumers.” This judgement was supported by a 2014 analysis published in the BMJ; here is the abstract:

Objective To determine the quality of health recommendations and claims made on popular medical talk shows.

Design Prospective observational study.

Setting Mainstream television media.

Sources Internationally syndicated medical television talk shows that air daily (The Dr Oz Show and The Doctors).

Interventions Investigators randomly selected 40 episodes of each of The Dr Oz Show and The Doctors from early 2013 and identified and evaluated all recommendations made on each program. A group of experienced evidence reviewers independently searched for, and evaluated as a team, evidence to support 80 randomly selected recommendations from each show.

Main outcomes measures Percentage of recommendations that are supported by evidence as determined by a team of experienced evidence reviewers. Secondary outcomes included topics discussed, the number of recommendations made on the shows, and the types and details of recommendations that were made.

Results We could find at least a case study or better evidence to support 54% (95% confidence interval 47% to 62%) of the 160 recommendations (80 from each show). For recommendations in The Dr Oz Show, evidence supported 46%, contradicted 15%, and was not found for 39%. For recommendations in The Doctors, evidence supported 63%, contradicted 14%, and was not found for 24%. Believable or somewhat believable evidence supported 33% of the recommendations on The Dr Oz Show and 53% on The Doctors. On average, The Dr Oz Show had 12 recommendations per episode and The Doctors 11. The most common recommendation category on The Dr Oz Show was dietary advice (39%) and on The Doctors was to consult a healthcare provider (18%). A specific benefit was described for 43% and 41% of the recommendations made on the shows respectively. The magnitude of benefit was described for 17% of the recommendations on The Dr Oz Show and 11% on The Doctors. Disclosure of potential conflicts of interest accompanied 0.4% of recommendations.

Conclusions Recommendations made on medical talk shows often lack adequate information on specific benefits or the magnitude of the effects of these benefits. Approximately half of the recommendations have either no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical about recommendations made on medical talk shows.

During the presidential campaign in 2016, Oz supported Trump and hosted him on his TV show. In 2018, Donald Trump appointed him to the President’s Council on Sports, Fitness, and Nutrition, Oz was criticized as an example of choosing “pundits over experts”. Recently, Oz announced he intends to run for the U.S. Senate as a Republican.

A fellow physician commented that he has the same amount of enthusiasm for Oz’s candidacy as he would with a case of dysentery, the intestinal infection that causes bloody diarrhea. Dr. Daniel Summers, MD, begged Pennsylvania not to elect Oz. “It’s been obvious for years that Oz is more than happy to leverage his reputation as a cardiothoracic surgeon and medical scientist in service to his own celebrity and advancement, and isn’t one to let quaint little things like facts stand in his way,” he wrote. “Stroll down a checkout aisle in your local grocery store, and chances are strong you’ll see his smiling face on the cover of a magazine touting some wildly unhealthy weight-loss claim. He’s been promoting pseudoscience on his show for years, from obesity ‘remedies’ like green coffee and garcinia cambogia to hawking ‘homeopathy starter kits,’ so this is nothing new.” Oz faced criticism for hosting a show in which he debated the utility of “reparative therapy” and “forms of therapy that are designed to turn a gay person straight,” even though they’ve been banned by many states at the urging of the American Psychological Association.

In April 2020, Oz also spurred controversy because he said that children should be sent back into schools despite the fact that the novel coronavirus pandemic had only just begun and there were no vaccines or therapeutics yet available. “I tell you, schools are a very appetizing opportunity,” he said, claiming that resuming classes “may only cost us 2 to 3 percent in terms of total mortality,” according to his “reading” of medical journals. The mistake was so substantial that Oz later provided a kind of half-apology, saying that he “misspoke.”

But what Dr. Summers finds worse is that Oz eagerly pushed treatments like hydroxychloroquine for COVID patients. He even went so far as to push the drug on Fox & Friends. It prompted Dr. Anthony Fauci, a virologist, to explain that the data simply wasn’t clear at the time. “Although there is some suggestion [of effectiveness] with the study that was just mentioned by Dr. Oz . . . I think we’ve got to be careful that we don’t make that majestic leap to assume that this is a knockout drug,” Fauci said at the time. “We still need to do the kinds of studies that definitively prove whether any intervention, not just this one . . . is truly safe and effective.”

“Medical misinformation is literally killing people, and it is unconscionable that anyone who should know better would contribute to it. And Oz most certainly should and does know better,” said Dr. Summers. “It is telling that Oz would see a space for himself in the Republican primary field. The GOP is riddled with prominent figures who undermine the seriousness of the pandemic, refute the importance of getting vaccinated, and denigrate the public health officials tasked with keeping the American people as safe and healthy as possible. Voters for those people are the ones Oz sees himself capable of wooing. That is the base he will need to capture to make his candidacy a success.”

Open-label placebos (OLPs) are placebos without deception in the sense that patients know that they are receiving an inert sugar pill with no activity of its own. Intuitively, we think that such treatments must be ineffective. Yet, there have been several studies that seemed to show otherwise.

The objective of this paper was to systematically review and analyze the effect of OLPs in comparison to no treatment in clinical trials. A systematic literature search was carried out in February 2020. Randomized controlled trials of any medical condition or mental disorder comparing OLPs to no treatment were included. Data extraction and risk of bias rating were independently assessed. 1246 records were screened and 13 studies were included in the systematic review. Eleven trials were eligible for meta-analysis.

These trials assessed the effects of OLPs on

  • back pain,
  • cancer-related fatigue,
  • attention deficit hyperactivity disorder,
  • allergic rhinitis,
  • major depression,
  • irritable bowel syndrome,
  • menopausal hot flushes.

The risk of bias was moderate among all studies.

Click to enlarge.

A significant overall effect (standardized mean difference = 0.72, 95% Cl 0.39–1.05, p < 0.0001, I2 = 76%) of OLP. Thus, OLPs appear to be a promising treatment in different conditions. Yet, the researchers spotted several caveats and discuss them in some detail.

First, we detected hints of a publication bias in the study sample, but the respective test was not significant. The quantitative basis of the meta-analysis is based on a small number of studies, reflecting the early state of research in this field. Moreover, the set of studies showed some heterogeneity. Finally, four studies were rated to have a high risk of bias, and nine to have some concerns.

In order to assess the impact of these high-risk studies we performed an exploratory best-evidence synthesis. We excluded the four studies with a high risk of bias. In this analysis, the heterogeneity could be reduced to a non-critical value and almost all variance in the set of studies could be explained by a sampling error (I2 = 4%). With the exclusion of these four studies the mean effect size was reduced to a more conservative SMD = 0.49.

Regardless of this reduction of the overall effect, the same conclusions about the treatment-effect of OLPs can be drawn, although the lack of robustness means that interpretations require some caution. The decrease of heterogeneity shows that methodological impairments might be responsible for the considerable unexplained variance in our results. We abstained from carrying out a further sensitivity analysis for explaining heterogeneity because of the small number of studies.

This is certainly an interesting subject. And the above findings are certainly counter-intuitive.

My impression is that the effect of OLPs is small and of doubtful value in clinical practice. My prediction is that, as more and better research emerges, it will diminish further, if not vanish totally. I think that there are several reasons for this:

  • The number of trials is still quite small.
  • The studies obviously lack patient blinding.
  • Positive messages can be included alongside open-label placebos.
  • The “time lag bias” is high.

This type of bias means that, due to initial enthusiasm in a new subject, negative results are published with some delay. I have observed this bias repeatedly in the past. A new treatment initially tends to generate nothing but positive results, and only after a while, when the researchers’ euphoria has subsided, more realistic findings emerge.

Yesterday, it was reported that one of Austria’s best-known opponents of vaccination has died as a result of coronavirus infection. He vehemently refused treatment in hospital. Instead, he insisted on treating himself – and tragically, he is not an isolated case.

Miracle Mineral Solution” (MMS) is being promoted as a treatment for all kinds of diseases – including, of course, the coronavirus. But MMS is nothing more than the bleach and disinfectant chlorine dioxide, or CDL for short. It made headlines when Donald Trump suggested it as a remedy against Covid-19. Subsequently, CDL became highly popular amongst the anti-vax brigade.

Johann Biacsics was one of the leading figures of the anti-vaccination scene in Austria. On 11 November, he was seen in a Vienna hospital with an acute corona infection. At this stage, he had already taken chlorine dioxide because of fever complaints. Biacsics was, of course, not vaccinated and refused treatment. He was firmly convinced that he had already overcome the infection thanks to his treatment with chlorine dioxide.

The senior physician at the Vienna hospital saw things differently. His condition was “life-threatening”, she said. But instead of accepting treatment in hospital, Biacsics discharged himself and said he would rather treat himself. Once home, Biacsics put in an IV line with chlorine dioxide and sodium chloride. Two days later he was dead.

Only two weeks before his death, Biacsics had demonstrated in Vienna against the Austrian Corona measures. In a television interview from September, he can be seen in front of the parliament. “There are mainly vaccinated people in the intensive care units. 67 percent of them are vaccinated,” he said on camera at the time. When the reporter corrected him, he only replied that he had “inside information”.

His followers are now suggesting that he was poisoned. And for once they are, of course, correct. He basically poisoned himself with MMS. His family, meanwhile, blames the hospital and claim that he did not die of COVID, nor that Biacsics’ death is the result of treatment with chlorine dioxide.

Biacsics is not the first Austrian Covid patient who has refused treatment or used “alternative remedies”. And he is not the first who has died as a result. Self-treatment is booming among vaccination opponents and Corona deniers. It was even propagated in the Austrian parliament. For weeks, FPÖ leader Herbert Kickl (who also is COVID-positive) and his party colleagues have been promoting the deworming drug ivermectin – despite warnings from doctors, scientists, and the manufacturer.

All too often, the consequences are fatal: In Styria, two patients died from poisoning with ivermectin, in the district of Rohrbach in Upper Austria, a Corona patient left the intensive care unit in critical condition and died. He had also relied on ivermectin and refused other treatments.

 

Conspiracy beliefs are associated with detrimental health attitudes during the coronavirus pandemic. Prior research on these issues was mostly cross-sectional, however, and restricted to attitudes or behavioral intentions. This investigation was designed to examine to what extent conspiracy beliefs predict health behavior and well-being over a longer period of time.

In this multi-wave study on a large (N = 5745) Dutch research panel (weighted to provide nationally representative population estimates), the researchers examined if conspiracy beliefs early in the pandemic (April 2020) would predict a range of concrete health and well-being outcomes eight months later (December 2020).

The results revealed that Covid-19 conspiracy beliefs prospectively predicted a decreased likelihood of getting tested for corona; if tested, an increased likelihood of the test coming out positive; and, an increased likelihood of having violated corona regulations, deteriorated economic outcomes (job loss; reduced income), experiences of social rejection, and decreased overall well-being. Most of these effects generalized to a broader susceptibility to conspiracy theories (i.e. conspiracy mentality).

The authors concluded that conspiracy beliefs are associated with a myriad of negative life outcomes in the long run. Conspiracy beliefs predict how well people have coped with the pandemic over a period of eight months, as reflected in their health behavior, and their economic and social well-being.

These findings tie in with another recent study that investigated whether individual beliefs and personal characteristics differences affect people’s likelihood of contracting COVID-19. In the early months of the pandemic, U.S. participants responded to a variety of individual difference measures as well as questions specific to the pandemic itself. Four months later, 2120 of these participants were asked whether they had contracted COVID-19. Nearly all of the included individual difference measures significantly predicted whether a person reported testing positive for the virus in this four-month period. Additional analyses revealed that all of these relationships were primarily mediated by whether participants held accurate knowledge about COVID-19.

I find it hard not to despair vis a vis such results. Not that they were not to be expected – if you ignore the existence of risk factors exist for heart attacks, it seems plausible that your likelihood of dying of myocardial infarction is increased. What is particularly desolating are two facts:

  • This pandemic seems to have rendered the voices of stupidity and ignorance loud and popular, even fashionable.
  • Those lunatics who adhere to conspiracy beliefs harm not merely themselves but endanger all of us.

I ask myself how we will ever get past this new age of unreason.

Psychosocial distress, depression, or anxiety are frequent problems of women after a breast cancer diagnosis and treatment. Many try so-called alternative medicine (SCAM) in an attempt to deal with them. But is this effective?

The purpose of this study was to assess the potential benefit of lavender oil as a perioperative adjunct to improve anxiety, depression, pain, and sleep in women undergoing microvascular breast reconstruction.

This was a prospective, single-blinded, randomized, controlled trial of 49 patients undergoing microvascular breast reconstruction. Patients were randomized to receive lavender oil or a placebo (coconut oil) throughout their period of hospitalization. The effect of lavender oil on perioperative stress, anxiety, depression, sleep, and pain was measured using the hospital anxiety and depression scale, Richards-Campbell Sleep Questionnaire, and the visual analogue scale.

Twenty-seven patients were assigned to the lavender group and 22 patients were assigned to the control group. No significant differences were seen in the perioperative setting between the groups with regard to anxiety (p = 0.82), depression, sleep, or pain scores. No adverse events were noted, and no significant differences in surgery-related complications were observed. When evaluating the entire cohort, postoperative anxiety scores were significantly lower than preoperative scores, while depression scores were significantly higher postoperatively as compared with preoperatively.

The authors concluded that, in the setting of microvascular breast reconstruction, lavender oil and aromatherapy had no significant adverse events or complications; however, there were no measurable advantages pertaining to metrics of depression, anxiety, sleep, or pain as compared with the control group.

One could argue that the sample size of the trial was too low to pick up small differences in the outcome measures. Yet, even then, the findings do not suggest that the treatment did make a large enough difference to justify the effort and expense of the treatment.

One could also argue that – who cares? – if a patient wants aromatherapy (or another SCAM that is harmless), why not? The answer to this is the fact that researchers have the ethical duty to identify the most effective treatment, and clinicians have the ethical duty to employ not just any odd therapy but the one that works demonstrably best. Seen from this perspective, the place of SCAM in cancer care seems far less certain than many enthusiasts try to make us believe.

“There is a battle raging for humanity”, claims Dr Carrie Madej, a US osteopathic doctor (in the US, osteopaths are [almost] conventional physicians). She thinks she has discovered how Big Tech collaborates with Big Pharma introduced new technologies in the coming vaccines, that will alter our DNA and turn us into hybrids. This, she submits, will end humanity as we know it, and start the process of transhumanism: HUMAN 2.0 They use vaccines to inject nanotechnology into our bodies and connect us to the Cloud and artificial intelligence. This will enable corrupt governments and tech giants to control us, without us being aware of it.Image

Dr. Carrie Madej is from Dearborn, Michigan, and received her medical degree from Kansas City University of Medical Biosciences in 2001. She then completed her traditional internship at The Medical Center in Columbus, Georgia, and internal medicine residency at Mercer University in Macon Georgia. Dr. Madej served as a private clinician and medical director of clinics in Georgia until 2015. Dr. Madej also served as an attending physician for the Pennsylvania College of Osteopathic Medicine. She has served as a public speaker and was featured in the documentary, “The Marketing of Madness” about the overuse of prescription psychotropic medicines. Dr. Madej now dedicates her time educating others on vaccines, nanotechnology, and human rights via multiple platforms and speaking engagements.

IN HER NEWEST SCORCHED EARTH DISCUSSION, Dr. Carrie Madej simply Can NOT stay silent about the ABSOLUTE DANGERS of the Covid-19 “vaccines” any longer! In fact, in this SCATHING PRESENTATION, she literally describes the ‘Killer Concoctions’ as ‘THE FRANKENSTEIN CODE” and HAMMERS the ‘Purveyors of the Poison Jab’ as ‘Murdering Psychopath Witch Doctors’ who are HELL BENT on the TOTAL DESTRUCTION & ANNIHILATION of the ENTIRE HUMAN RACE, as we know it today.

The ‘Kung Flu’ (as it’s been referred to by none other than POTUS Trump), is only ‘KILLING PEOPLE who are already suffering from cancer, diabetes, heart disease and a plethora of other autoimmune problems’ – so now WHY IN THE WORLD IS EVERYBODY being told to get the ‘Killer Jab’ when the risk of DIRE & GROTESQUE INJURY FAR OUTWEIGHS the risk of dying from Covid-19 or the fake Delta Variant, or Beta, or Gamma or WHATEVER ELSE THE DEMONIC FAUCI & GATES CONCOCT NEXT?! Get ready for a BEATING unlike you’ve seen in recent days, as Dr. Madej RIPS THE THROATS straight out of these Deep State Demons in this ‘DO NOT MISS’ Epic Video! Grab the popcorn, and get ready for a trip down the Rabbit Hole and a takedown of Satan’s Army!

This was published by the ‘REPUBLIC BROADCASTING NETWORK’ (RBN) who also published articles such as ‘Who are the Jews behind the coronavirus vaccines?

Dr. Carrie Madej is certainly no fan of COVID vaccines: Doctor Carrie Madej says she personally examined multiple vials of the vaccines that are being forced into people’s arms, and she was horrified by what she saw. She says she cried harder than she ever has before. Elsewhere she explained in detail:

“First it looked just translucent. And then as time went on, over two hours, colors appeared. I had never seen anything like this. There wasn’t a chemical reaction happening. It was a brilliant blue, and royal purple, yellow, and sometimes green,” she said.

She later shared that when she asked nanotech engineers what the emerging brilliant colors might come from, the engineers said the “only thing they knew that could do that” was a white light, over time, causing a reaction on “a super-conducting material.” In this case, Madej noted, white light came from the microscope itself.

She pointed out that an example of a super-conducting substance would be “an injectable computing system.”

Madej went on, “These fibers were appearing more and more. Some of the fibers had a little cube structure on them, I’m not sure what that was. And also metallic fragments were in there. They were not metallic fragments I’m used to seeing. They were exotic. They were very opaque.”

In time, Madej said, “all the particulates, all these colors started moving to the edge” of the cover slide. “There was self-assembling going on, things were growing. They looked synthetic.”

Madej noticed something else quite strange: “There was one particular object or organism, I’m not sure what to call it, that had tentacles coming from it. It was able to lift itself up off of the glass slide. It appeared to be self-aware, or to be able to grow or move in space.”

She found it disturbing but said she thought, “Maybe that was a fluke in a way, maybe that was just that one vial.”

Some time later, the same lab obtained more vials from a different batch of Moderna shots, as well as a J&J vial. Madej was concerned to see the same things she had observed in the first vial.

“Another one of those tentacle-like structures appeared,” she said. “This was now completely under the cover slip, so there was no movement because it wasn’t on the edge, but I just couldn’t believe I saw another one. Same thing.” Madej also saw the “same colors” appear over time, as well as the fibers.

In the J&J vial, Madej said, there was “definitely a substance that looked like graphene. They all had graphene-like structures in there. Whether or not they were, I don’t have the capability of testing them in order to know at this lab, but that’s what they appeared to be.”

The vial’s contents also had “fatty substances, a sticky glue-like substance that would be considered a hydrogel in those, both of them.”

The J&J vial “also had colors appear.” “Their colors were different, like a fluorescent pastel kind of color. Again, a lot of synthetic structures in there as well.” Madej also noticed many “spherical ring structures” in the J&J contents.

“I’ve never seen anything like this before. They’re not supposed to be in these injections. What are they going to do to somebody? What are they going to do to a child? I started crying when I saw these the second time under a microscope, because it was confirmation of everything I saw the first time,” Madej said.

Madej again appeared on the Stew Peters show on October 20 to discuss her findings from a Pfizer jab vial as well as another J&J vial. “What I’m seeing in all of these manufacturers are synthetic substances, graphene-like, also these nano-carbon tubes,” Madej said.

“In this particular J&J” vial, Madej saw “round spheres, which were not air bubbles.” She continued, “There’s many of these rings, and as time went on they would get thinner and thinner and expand out and then finally extrude out some gelatinous material — I’m not sure what it was, but different kinds of things were inside these spheres. So they’re almost like a delivery structure, that’s what they were doing.”

On one of these rings, Madej saw what “looked like a translucent organism that went around, and back and forth.” Madej first “thought it was another water parasite,” but after continuing to observe its movements, “thought perhaps it was moving in a more robotic way.”

Madej saw the “same kind of synthetic things” in the Pfizer jab, as well as “something that looks similar to teslaphoresis. That’s when these little graphite-like black, metallic particles start to coalesce into strings, like a spider web. They do that through any external force — it could be light, it could be a magnetic force, it could be an impulse, like a frequency. Anyhow, all these little particles would then coalesce and form their own neural network, or their own fibers, or wires.”

After listening to Madej’s findings and seeing the photo and video documentation she provided, Peters commented, “It’s like I’m watching a seriously bad B-movie, a horror thriller.”

Madej believes the tentacled entity she found in the Moderna jabs has a connection with the organism hydra vulgaris. “It is one of the model organisms that the transhumanists like to study and look at. They feel that this is an amazing organism for humanity,” said Madej, in part because “it’s immortal in the lab setting” and “continuously produces its own stem cells.”

“It never stops. You can chop it up into little bits, put it in a petri dish and it forms itself again and again,” she continued. “They’re thinking, wouldn’t this be great if we could put this inside of a human body’s genome, and then if your hand was chopped off by a trauma, you could grow a new hand.”

My friend Joe Schwarcz recently wrote a brilliant article about Dr. Madej. He concluded by asking:  Is Dr. Madej a maddeningly malicious malfeasant, or does she just have a few loose marbles? I fear that it might be both.

Neck pain affects a vast number of people and leads to reduced quality of life and high costs. Clinically, it is a difficult condition to manage, and the effect sizes of the currently available treatments are moderate at best. Activity and manual therapy are first-line treatment options in several guidelines. But how effective are they really?

This study investigated the combination of home stretching exercises and spinal manipulative therapy in a multicentre randomized controlled clinical trial, carried out in a multidiscipline range of primary care clinics.

The treatment modalities utilized were spinal manipulative therapy combined with home stretching exercises compared to home stretching exercises alone. Both groups received 4 treatments for 2 weeks. The primary outcome was pain, where the subjective pain experience was investigated by assessing pain intensity (NRS – 11) and the quality of pain (McGill Pain Questionnaire). Neck disability and health status were secondary outcomes, measured using the Neck Disability Indexthe EQ-5D, respectively.

One hundred thirty-one adult subjects were randomized to one of the two treatment groups. All subjects had experienced persistent or recurrent neck pain the previous 6 months and were blinded to the other group intervention. The clinicians provided treatment for subjects in both groups and could not be blinded. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. An intention-to-treat analysis was used.

Sixty-six subjects were randomized to the intervention group, and 65 to the control group. For NRS – 11, a B-coefficient of – 0,01 was seen, indication a 0,01 improvement for the intervention group in relation to the control group at each time point with a p-value of 0,305. There were no statistically significant differences between groups for any of the outcome measures.

Four intense adverse events were reported in the study, three in the intervention group, and one in the control group. More adverse incidents were reported in the intervention group, with a mean pain intensity (NRS-11) of 2,75 compared to 1,22 in the control group. There were no statistically significant differences between the two groups.

The authors concluded that there is no additional treatment effect from adding spinal manipulative therapy to neck stretching exercises over 2 weeks for patients with persistent or recurrent neck pain.

This is a rigorous and well-reported study. It suggests that adjuvant manipulations are not just ineffective for neck pain, but also cause some adverse effects. This seems to confirm many previously discussed investigations concluding that chiropractors do not generate more good than harm for patients suffering from neck pain.

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