medical ethics
As we have discussed ad nauseam on this blog, spinal manipulation therapy (SMT) can cause serious adverse events, including spinal epidural hematoma (SEH), an emergency that can cause severe neurological dysfunction. Chinese surgeons have reported three cases of SEH after SMT.
- The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT. Her symptoms persisted after 3 d of conservative treatment, and she was admitted to our hospital. Magnetic resonance imaging (MRI) demonstrated an SEH, extending from C6 to C7.
- The second case was a 55-year-old man with sudden back pain 1 d after SMT, numbness in both lower limbs, an inability to stand or walk, and difficulty urinating. MRI revealed an SEH, extending from T1 to T3.
- The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT. He was unable to stand or walk and experienced mild back pain. MRI revealed an SEH, extending from T1 to T2.
All three patients underwent surgery after failed conservative treatment. Blood clots were found during the operation in case 1 and case 2, and the postoperative pathology confirmed a hematoma. In case three, a vein ruptured during the operation, causing massive bleeding. The three patients recovered to ASIA grade E on day 5, 1 wk, and day 10 after surgery, respectively. All patients returned to normal after 3 mo of follow-up.
Imaging examinations of case 1. A: T1-weighted preoperative magnetic resonance imaging (MRI) image shows high signal intensity (orange arrow); B and C: Preoperative T2-weighted image shows low signal intensity, and an axial T2-weighted image demonstrates that the hematoma occurred in the posterior region (white arrow); D: Preoperative enhanced MRI suggests an enhanced hematoma signal (orange arrow); E: Intraoperative photograph shows that spinal cord compression has recovered; F: Postoperative pathology suggested a hematoma; G and H: X-ray at the 3-mo follow-up indicated intact internal fixation.
The authors concluded that before proceeding with SMT, each patient should be evaluated in detail and checked for risk factors. In cases where the physical condition changes rapidly, physicians should be alert to the danger and send the patient to the emergency department for a complete MRI examination. We recommend surgery if neurological symptoms appear.
In their paper, the authors also review 15 further cases of SEH that have been previously published. They stress several times in their article that this complication is rare. In my view, this begs the question: how do they know? As there is no post-marketing surveillance of chiropractors or other clinicians doing SMT, I would insist that nobody can be sure about the true incidence of SEH or any other complication after SMT.
Recently, I wrote about the court case of a French naturopath. Last week, the judge has issued his verdict. Miguel Barthéléry was sentenced
to a two-year suspended prison term and to a fine of 5 000 Euros. Two cancer patients had died following his treatments and recommendations. Barthéléry was also found guilty of impersonating a doctor and illegally practising medicine. In addition, he was also banned for life from practising as a healthcare professional.
The Paris criminal court found that Miguel Barthéléry had deliberately created confusion about his qualifications by presenting himself as a doctor on the internet and in text messages to the two victims. The defendant had claimed to have a doctorate and a post-doctorate from the United States. The judgment “has the consequence of dissuading all those who engage in the same abuses, they are now warned that we can not do anything with the health of people,” said the judge.
The case had begun in February 2019 with the complaint of the companion of a man who had died two months earlier of testicular cancer. Diagnosed in 2016, the patient had not consulted a doctor but had preferred to follow a “health plan” drawn up by the naturopath. It was based on fasting and cures, raw food, and essential oils. Later, the family of a Belgian physiotherapist, who died of uterine cancer at the age of 39, joined the legal case. However, according to Code Source, the Parisien podcast, the case is more extensive, with seven further suspicious deaths of Barthéléry’s patients.
Barthéléry’s lawyer said that the decision “raises questions more generally about the appreciation that we now have of alternative therapeutic practices, which now seem, although not prohibited by law, to be subject to condemnation by the courts.”
The bad news for German homeopathy just keeps on coming. As I reported, recent events must be depressing for homeopaths, e.g.:
- A recent investigation disclosed that the German homeopathy cult is at the heart of Germany’s anti-vax movement.
- In July 2021, a German court ruled against a homeopathic HCG remedy.
- In 2020, a German study failed to show that homeopathy is cost-effective.
- In 2019, the attempt by a German homeopathy manufacturer to silence critics backfired spectacularly.
- About 10 years ago, 5 German firms clubbed together supporting a journalist at the tune of Euro 30 000/year to defame me (at the time I was one of the few who regularly informed the public about the evidence on homeopathy). The plot was discovered and published whereupon the journalist committed suicide.
After heated debates in the run-up, the Bavarian Medical Association decided yesterday to ditch the postgraduate education program in homeopathy for its doctors. This means that, of the 17 regional medical associations in Germany, 12 have now discontinued their further education efforts in homeopathy. The ones that have not yet done so are:
- Baden-Württemberg,
- Rhineland-Palatinate,
- Saxony,
- Thuringia,
- Westphalia-Lippe.
In the past months, homeopaths had collected 11,597 signatures in favor of maintaining the additional qualification of homeopathy. The ~ 400 doctors in Bavaria, who have acquired ‘homeopathy’ as an additional title, will be permitted to continue to use it.
The spokesperson of the Information Network Homeopathy, Dr. Christian Lübbers, welcomed the decision of the Medical Association. It was a “landslide victory for patient safety”, he said. The Bavarian regional chairman of the German Central Association of Homeopathic Doctors, Dr. Ulf Riker, regretted the outcome of the vote and added: “We will consider legal steps very seriously.” I would advise against such a step which would only render homeopaths more ridiculous than they already are.
Yes, it’s bad news for German homeopaths – very bad news indeed. Of course, homeopathy fans will claim that it is all a sinister conspiracy against them. Sadly, they are unable to realize that the only driving force behind the long-overdue decline of German homeopathy is the evidence: HOMEOPATHY DOES NOT WORK BEYOND PLACEBO and therefore it has no place in the evidence-based medicine of the 21st century.
One argument that we hear regularly in the comment sections of this blog and elsewhere goes something like this:
“Why worry about a bit of so-called alternative medicine (SCAM like homeopathy or chiropractic, or Reiki, or Bach flower remedies, or detox, etc.)? Why should it bother us? Why not let everyone use what they want? Why not be a bit more tolerant?”
Tolerance is defined as sympathy or indulgence for beliefs or practices differing from or conflicting with one’s own. It is, of course, a quality that normally should be welcomed, taught, and celebrated. So, why not be more tolerant with enthusiasts of pseudoscientific SCAM?
In my view, there are several reasons.
- Ineffective therapies harm patients. The public tends to believe that SCAM is inherently safe. This is, of course, not true – think of chiropractic, for instance. But some treatments seem entirely harmless. Homeopathy might be a good example; its remedies contain nothing and therefore homeopathy can do no harm. Sadly, this is not true either. If a patient uses homeopathy to treat a serious condition, she is likely to harm herself by not treating that condition effectively. In extreme cases, this course of action can be fatal.
- Ineffective therapies are a waste of resources. It seems obvious that the money spent on something that does not work is money wasted. This is true whether we buy a car that is beyond repair or a SCAM that does not work beyond placebo.
- Pseudoscience makes a mockery of evidence-based medicine. If we are tolerant towards useless SCAM and accept that some people make money on, and mislead the public about SCAM, we basically send out a message that evidence is of secondary importance. This would weaken the trust in evidence-based medicine which, in turn, is bound to render healthcare less effective and stand in the way of progress.
- Pseudoscience undermines rationality and one form of irrationality begets another. Perhaps the biggest danger of tolerating promoters of quackery is that this undermines rational thinking far beyond the realm of healthcare. “Those who can make you believe absurdities can make you commit atrocities,” wrote Voltaire. I fear that he might have been correct.
In my view, tolerance about pseudoscientific, implausible, ineffective, or harmful SCAMs is misplaced. On the contrary, I feel that it is our duty to limit the harm they do to the public, patients, and progress by exposing them for what they are.
The ‘International Chiropractors Association’ (ICA) has just issued a statement entitled “International Chiropractors Association Affirms Policy on Health Freedom“. On the background of the fact that US President Biden, issued a series of Executive Orders related to mandating federal employees and federal contractors to receive the COVID-19 vaccine, the ICA try to explain their position regarding vaccinations. Here are a few passages from this statement:
…In a world of public health that promotes evidence-based decision making, we see the importance of natural immunity being ignored and replaced with a totalitarian approach of compulsory vaccination. At a time when the Surgeon General says misinformation has become an urgent threat to public health, misinformation is now being used in an attempt to discredit the chiropractic profession, the International Chiropractors Association, and all chiropractic patients who desire to focus on improving health naturally. After enduring 18 months of shutdowns, lockdowns, flattening the curve, masking, limitations of speech on social media; and a cancel culture environment that threatens the basic freedoms our country was founded upon in 1776, ICA will not compromise on the importance of protecting health freedom…
The ICA Policy on Immunization and Vaccination has remained unchanged for almost 50 years and clearly states:
“The International Chiropractors Association recognizes that the use of vaccines is not without risk and questions the wisdom of mass vaccination programs. Chiropractic principles favor the enhancement of natural immunity over artificial immunization.
The ICA supports each individual’s right to select his or her own health care and to be made aware of the possible adverse effects of vaccines upon a human body. In accordance with such principles and based upon the individual’s right to freedom of choice, the ICA is opposed to compulsory programs which infringe upon such rights.
The International Chiropractors Association is supportive of a conscience clause or waiver in compulsory vaccination laws, providing an elective course of action for all regarding immunization, thereby allowing patients freedom of choice in matters affecting their bodies and health.”
The International Chiropractors Association maintains that all healthcare interventions, including the chiropractic adjustment, are associated with some level of risk and that every individual is entitled to be informed of those risks, no matter how insignificant. All individuals must retain the freedom to accept or reject any healthcare product, procedure, or medication including vaccinations. The International Chiropractors Association therefore strongly opposes the use of medical mandates that violate personal sovereignty, violate the principles of informed consent, and constrain the rights of patients to make their own health care choices…
The ICA encourages the recognition that natural efforts to enhance the innate immune system ability to adapt to novel viruses are grounded in science and rejects the notion that the patients’ freedom to rely on naturally acquired immunity is not based upon unscientific beliefs.
The ICA rejects the premise that the chiropractic profession’s long history of promoting health freedom and supporting conscientious exemptions is based upon unscientific or non-mainstream beliefs…
I find this statement clear as mud and have the following questions:
- Do the ICA recommend vaccinations?
- In particular, do they encourage their members to get vaccinated with the COVID-19 vaccines?
- Do they advise to recommend COVID-19 vaccinations to their patients?
- Or do they think that natural immunity is preferable and advise their members and patients accordingly?
- Do they believe that spinal manipulation enhances natural immunity?
- Do they think that spinal manipulations are an effective alternative to COVID-19 vaccinations?
- Do they believe that scientific evidence trumps dogma or vice versa?
- Which of the two should, according to their conviction, must influence the decision-making processes in healthcare?
- If the ICA object to misinformation about COVID, why do they not stop their members from promoting it?
- What makes them think that information about the possible adverse effects of vaccines upon a human body is unavailable?
- If the ICA recognizes the risks of spinal manipulation, why do they not inform the public about them regularly and objectively?
- If the ICA knows about the importance of informed consent, why do not all of their members adhere to it?
- And finally, why do the ICA insist on the term ‘international’ in the name of their organization, if they purely deal with the US situation?
I do not expect the ICA to give me the answers to these questions. But perhaps their Wiki page goes some way towards answering some of them: “… The ICA supports the efforts of the National Vaccine Information Center (NVIC).[13] The NVIC is known for promoting false and misleading information about vaccines, in particular the discredited claim that vaccines cause autism.
The ICA’s annual conferences have featured anti-vaccination propaganda. In 2018 Guest Speaker Beau Pierce (Pierce co-produced a series entitled Vaccines Revealed) hosted a session entitled Vaccines Revealed.,[14] and Jeff Hays, known for producing the anti-Vaccine propaganda Vaccines Revealed, was invited to host a session the 2017 ICA Council on Chiropractic Pediatrics Annual Conference. In 2016 the widely discredited anti-vaccination propaganda film VAXXED was shown at a conference sponsored by the ICA’s Council on Chiropractic Pediatrics …”
SAY NO MORE!
Therapeutic touch (TT) is a form of paranormal or energy healing developed by Dora Kunz (1904-1999), a psychic and alternative practitioner, in collaboration with Dolores Krieger, a professor of nursing. TT is popular and practised predominantly by US nurses; it is currently being taught in more than 80 colleges and universities in the U.S., and in more than seventy countries. According to one TT-organisation, TT is a holistic, evidence-based therapy that incorporates the intentional and compassionate use of universal energy to promote balance and well-being. It is a consciously directed process of energy exchange during which the practitioner uses the hands as a focus to facilitate the process.
The question is: does TT work beyond a placebo effect?
This review synthesized recent (January 2009–June 2020) investigations on the effectiveness and safety of therapeutic touch (TT) as a therapy in clinical health applications. A rapid evidence assessment (REA) approach was used to review recent TT research adopting PRISMA 2009 guidelines. CINAHL, PubMed, MEDLINE, Cochrane databases, Web of Science, PsychINFO, and Google Scholar were screened between January 2009-March 2020 for studies exploring TT therapies as an intervention. The main outcome measures were for pain, anxiety, sleep, nausea, and functional improvement.
Twenty-one studies covering a range of clinical issues were identified, including 15 randomized controlled trials, four quasi-experimental studies, one chart review study, and one mixed-methods study including 1,302 patients. Eighteen of the studies reported positive outcomes. Only four exhibited a low risk of bias. All others had serious methodological flaws, bias issues, were statistically underpowered, and scored as low-quality studies. Over 70% of the included studies scored the lowest score possible on the GSRS weight of evidence scale. No high-quality evidence was found for any of the benefits claimed.
The authors drew the following conclusions:
After 45 years of study, scientific evidence of the value of TT as a complementary intervention in the management of any condition still remains immature and inconclusive:
- Given the mixed result, lack of replication, overall research quality and significant issues of bias identified, there currently exists no good quality evidence that supports the implementation of TT as an evidence‐based clinical intervention in any context.
- Research over the past decade exhibits the same issues as earlier work, with highly diverse poor quality unreplicated studies mainly published in alternative health media.
- As the nature of human biofield energy remains undemonstrated, and that no quality scientific work has established any clinically significant effect, more plausible explanations of the reported benefits are from wishful thinking and use of an elaborate theatrical placebo.
TT turns out to be a prime example of a so-called alternative medicine (SCAM) that enthusiastic amateurs, who wanted to prove TT’s effectiveness, have submitted to multiple trials. Thus the literature is littered with positive but unreliable studies. This phenomenon can create the impression – particularly to TT fans – that the treatment works.
This course of events shows in an exemplary fashion that research is not always something that creates progress. In fact, poor research often has the opposite effect. Eventually, a proper scientific analysis is required to put the record straight (the findings of which enthusiasts are unlikely to accept).
In view of all this, and considering the utter implausibility of TT, it seems an unethical waste of resources to continue researching the subject. Similarly, continuing to use TT in clinical settings is unethical and potentially dangerous.
Germany seems to have a significant problem with anti-vaxxers. Today, only 68% of the population has had a COVID vaccination. In the UK and France, these figures are 72% and 75% respectively.
How come?
This study investigated the willingness to vaccinate of parents of minors and people without children who are minors. The investigation was based on a random sample of Germans (telephone survey, n = 2,014, collected between 12 November and 10 December 2020). The evaluation is primarily based on the sub-sample of people with minors in the household (n = 461).
Parents of minors consistently show a lower willingness to be vaccinated with a COVID-19 vaccine than respondents without minors (54.1% vs 71.1%). Fathers show a stronger willingness to be vaccinated than mothers. Furthermore, men are more willing to get their own child vaccinated with a COVID-19 vaccine than are women.
The authors concluded that among parents and especially mothers, a considerable misrepresentation of vaccination risks and frequent beliefs in vaccination conspiracy theories can be observed. Clear and easily understandable information on the effects and side effects of vaccination with a COVID-19 vaccine by relevant institutions and physicians is recommended.
And what has this to do with so-called alternative medicine (SCAM) and homeopathy?
In the results section of the paper, the authors report interesting additional findings (my translation):
In the total sample, a significantly higher willingness to vaccinate is associated with the rejection of “alternative healing methods”. There is also a significant correlation between the attitude towards homeopathy and one’s own willingness to vaccinate: if homeopathy is supported, the willingness to vaccinate is lower. This correlation between the attitude towards homeopathy and willingness to vaccinate is also evident in the sub-sample of parents. Among parents, it is again women who significantly more often have a positive attitude towards homeopathy than men, who more often do not think anything of it.
The authors also report that the parents were asked: “If a vaccine against the coronavirus is approved in Germany, would you get vaccinated?” CERTAINLY NOT was the answer of:
- 41% of homeopathy fans
- 10% of people who thought nothing at all about homeopathy
- 15% of participants who were not fully convinced by homeopathy
Yes, Germany seems to have a problem with the anti-vaccination brigade but it seems that at the heart of it is a problem with a homeopathy cult.
This article from AP News caught my attention. Here it is (I haven’t changed a word):
The flashy postcard, covered with images of syringes, beckoned people to attend Vax-Con ’21 to learn “the uncensored truth” about COVID-19 vaccines.
Participants traveled from around the country to a Wisconsin Dells resort for a sold-out convention that was, in fact, a sea of misinformation and conspiracy theories about vaccines and the pandemic. The featured speaker was the anti-vaccine activist who appeared in the 2020 movie “Plandemic,” which pushed false COVID-19 stories into the mainstream. One session after another discussed bogus claims about the health dangers of mask wearing and vaccines.
The convention was organized by members of a profession that has become a major purveyor of vaccine misinformation during the pandemic: chiropractors.
At a time when the surgeon general says misinformation has become an urgent threat to public health, an investigation by The Associated Press found a vocal and influential group of chiropractors has been capitalizing on the pandemic by sowing fear and mistrust of vaccines.
They have touted their supplements as alternatives to vaccines, written doctor’s notes to allow patients to get out of mask and immunization mandates, donated large sums of money to anti-vaccine organizations and sold anti-vaccine ads on Facebook and Instagram, the AP discovered. One chiropractor gave thousands of dollars to a Super PAC that hosted an anti-vaccine, pro-Donald Trump rally near the U.S. Capitol on Jan. 6.
They have also been the leading force behind anti-vaccine events like the one in Wisconsin, where hundreds of chiropractors from across the U.S. shelled out $299 or more to attend. The AP found chiropractors were allowed to earn continuing education credits to maintain their licenses in at least 10 states.
On this blog, I have often discussed that chiropractors tend to be anti-vax. It all goes back to their founding father, DD Palmer, who famously wrote:
- Vaccination and inoculation are pathological; chiropractic is physiological,
- and who in 1894, published his views on smallpox vaccination: ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …’
- and who stated in 1896 that keeping tissue healthy is therefore the best prevention against infections; and this is best achieved by magnetic healing.
But that’s long ago! We are not like that anymore! … say the chiros of today.
Do you believe them?
If so, you might want to read this article by Jann Bellamy. Or alternatively, just look at some of my finds from the Internet:
The purpose of this survey was to quantify and describe the clinical practice beliefs and behaviors associated with US chiropractors. A 10% random sample of US chiropractors (n = 8975) was selected from all 50 state regulatory board lists and invited to participate in a survey. The survey consisted of a 7-item questionnaire; 6 items were associated with chiropractic ideological and practice characteristics and 1 item was related to the self-identified role of chiropractic in the healthcare system which was utilized as the dependent variable to identify chiropractic subgroups. Multinomial logistic regression with predictive margins was used to analyze which responses to the 6 ideology and practice characteristic items were predictive of chiropractic subgroups.
The survey instrument used in this study was developed by the authors and modeled after similar chiropractic identity analyses. The survey instrument included a total of 7 items intended to elicit divergent ideologies and practice behaviors. The figure below is a copy of the survey instrument.
A total of 3538 responses were collected (39.4% response rate). Respondents self-identified into three distinct subgroups based on the perceived role of the chiropractic profession in the greater healthcare system:
- 57% were spine/neuromusculoskeletal focused;
- 22% were primary care focused;
- 21% were vertebral subluxation focused.
Patterns of responses to the 6 ideologies and practice characteristic items were substantially different across the three professional subgroups.
The authors concluded that respondents self-identified into one of three distinct intra-professional subgroups. These subgroups can be differentiated along themes related to clinical practice beliefs and behaviors.
Here are the results in more detail as sated by the authors:
Regarding scope of examination (survey question 1), respondents reporting the scope of their clinical examination to only include spinal analysis for the assessment of vertebral subluxation had a 70% probability of belonging to the subluxation focused subgroup, a 20% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. Conversely, respondents who reported the scope of their clinical examination only includes a differential diagnosis had a 0% probability of belonging to the vertebral subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup.
Concerning conditions treated (survey question 2), respondents who reported predominantly treating vertebral subluxation as an encumbrance to health had an 80% probability of belonging to the vertebral subluxation focused subgroup, a 10% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. In contrast, respondents reporting predominantly treating neuromusculoskeletal conditions had a 0% probability of belonging to the vertebral subluxation focused subgroup, a 90% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.
Regarding the role of spinal manipulation for those with cancer (survey question 4), respondents reporting the role of spinal manipulation for those with cancer is to remove interference to innate intelligence had a 70% probability of belonging to the vertebral subluxation focused subgroup, a 20% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. Respondents reporting there is no role of spinal manipulation in those with cancer also had a 10% probability of belonging to the subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.
Regarding vaccination (survey question 5), respondents who strongly disagreed that vaccinations have had a positive effect on global public health had a 50% probability of belonging to the vertebral subluxation focused subgroup, an approximately 25% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and an approximately 25% probability of belonging to the primary care focused subgroup. In contrast, respondents who strongly agreed that vaccinations have had a positive effect on global public health had a 0% probability of belonging to the vertebral subluxation focused subgroup, a 90% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.
Concerning the detection of vertebral subluxation on x-ray (survey question 6), respondents who strongly agreed that x-ray is helpful in detecting vertebral subluxations had a 40% probability of belonging to the vertebral subluxation focused subgroup, a 40% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup. Respondents who strongly disagreed that x-ray is helpful in detecting vertebral subluxations had a near 0% probability of belonging to the vertebral subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and slightly below a 20% probability of belonging to the primary care focused subgroup.
Regarding use of x-rays for new patients (survey question 7), respondents who reported prescribing x-rays for 0–20% of new patients had a 20% probability of belonging to the vertebral subluxation focused subgroup, a 60% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup. Respondents reporting prescribing x-rays for 81–100% of new patients had a 40% probability of belonging to the vertebral subluxation focused subgroup, a 40% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup.
END OF QUOTE
While I am not sure that the division into the 3 subgroups is valid and suspect that there must be a substantial overlap between them, I must admit that the paper is rich in fascinating information. Generally speaking, I find all subgroups somewhat mysterious and would ask them the following questions:
Subgroup 1: why did you not study medicine or physiotherapy?
Subgroup 2: does it not bother you that your education and training are woefully insufficient for primary care?
Subgroup 3: is it not time to abandon the obsolete nonsense of your guru, the old charlatan DD Palmer?
Practitioners of so-called alternative medicine (SCAM) regularly claim with great pride that they treat the ROOT CAUSES of disease. The claim has at least 4 effects:
- It distracts from the true causes of disease which are often multifactorial.
- It attracts customers to SCAM.
- It implies that conventional medicine is at best symptomatic and thus far inferior to SCAM.
- It encourages the patients of SCAM practitioners to turn their backs on mainstream healthcare.
The notion that SCAM practitioners treat the root causes is based on the practitioners’ understanding of etiology:
- If a traditional acupuncturist, for instance, becomes convinced that all disease is the expression of an imbalance of life-forces, and that needling acupuncture points will re-balance these forces thus restoring health, he must automatically assume that he is treating the root causes of any condition.
- If a chiropractor believes that all diseases are due to ‘subluxations’ of the spine, it must seem logical to him that spinal ‘adjustment’ is synonymous with treating the root cause of whatever complaint his patient is suffering from.
- If a Bowen therapist is convinced that “the Bowen Technique aims to balance the whole person, not just the symptoms“, he is bound to be equally sure that the root cause of “practically any problem can potentially be addressed” by this intervention.
- If a homeopath is convinced that all illness stems from a weakness of the ‘vital force’ and that only homeopathic remedies can revitalize it, they are likely to believe that their remedies tackle the root cause of all diseases.
- Etc., etc.
So, are SCAM practitioners correct when they claim to treat the root causes of disease?
When a root cause has been eliminated, the disease has been eliminated by its root. Treating a root cause, therefore, means that the disease is permanently cured. The above question can therefore be re-phrased as follows:
Is there any SCAM that cures any disease permanently?
I think the answer is NO. (At least, I know none. I would, however, be most grateful if someone could name one together with the evidence)
Even demonstrably effective forms of SCAM are effective only in terms of alleviating the symptoms. The one with the best evidence is probably St John’s wort. It works fine for mild to moderate depression. Yet, it does not cure depression: if we discontinue the treatment, the depression is likely to return.
And what about conventional medicine? Does it offer any permanent cures?
I have been searching and have to admit that I cannot find many either. Here is my list so far of diseases that are potentially curable (meaning they are unlikely to come back once the treatment has stopped and excluding disease prevention) with conventional medicine – and again, I would be really grateful if readers could add to my preliminary list:
- Acute emergencies, like anaphylaxis, cardiac arrest, etc.
- Bacterial infections (well most of them)
- Cancer (some), like Hodgkin lymphoma
- Malnutrition like beriberi of iron-deficiency anemia
- Phobias (some)
- Fungal infections (some)
- Poisonings (some)
- Many surgical indications such as appendicitis, gall stones, carpal tunnel syndrome, etc.
Not a long list, I admit (but better than nothing!) – so, please help me to prolong it by adding diseases that I did not mention.
THANKS
