medical ethics
When chiropractors try to play medical doctors, their patients are in danger. When they try to play epidemiologists, we might all be in danger. Already in April 2020, the Australian ‘Patrons of Chiropractic Science’ issued a press release on COVID 19 stating:
Good function of the body’s joints, particularly within the spine, may improve neurological function, which is important for an effective natural immune system. Treatment by a qualified and experienced chiropractor offers one of the most effective methods to improve and maintain good spinal joint function. The chiropractic profession attends to many patients, and like all other health workers, the profession truly cares for the welfare of every individual.
Now they have gone further. Their press release of 18/8/2020 states amongst other things:
- Approximately 1.5% of those infected with SARS-CoV-2 may die; all people with a compromised immune system, that being the aged or those suffering a co-morbidity;
- 98.5% of those infected with the COVID-19 virus suffer either no symptoms, mild symptoms or treatable symptoms no worse than seasonal influenza;
- COVID-19 positive test numbers are largely irrelevant, as 98.5% of those testing positive will simply develop natural immunity and recover as the virus moves through the population. Recent studies by the UK based Centre for Evidence Based Medicine confirms increased COVID testing is the primary reason for increased case numbers, which have little relationship to mortality. The focus on case numbers is again designed to engender public fear and compliance;
Patrons of Chiropractic Science demands that the Victorian Government and its senior health officials cease distorting facts, stop blaming Victorian non-compliance for the increased positive testing numbers, and assume full responsibility for the aged care deaths and the current economic damage.
Simple facts: it is critical and more effective to isolate and protect the high-risk groups, effectively quarantine return travellers, but cease the illogical isolation of the vast majority of the population who are not at risk as the virus naturally circulates, and allow them to recommence working to save many businesses and initiate economic recovery.
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Implying that regular chiropractic manipulations improve immunity or protect people from the corona virus is bad enough. But the new press release is worse:
- It is not true that only people with impaired immune systems, of old age, or affected by other diseases die of COVID 19.
- It is not true that all of the 98.5% who do not die have treatable symptoms not worse than a flu; an undefined percentage of the survivors suffer from very severe and sometimes long-lasting conditions.
- It is not true that 98.5% of those testing positive will simply develop natural immunity and recover; many will not recover completely, and the question whether mildly affected individuals develop immunity and for how long is as yet unanswered.
- It is not true that COVID testing results are unrelated to mortality; the figures need, of course, careful interpretation; the percentage of positive tests per number of tests done, for instance, should be independent of the frequency of testing.
- It is not true that the vast majority of the population are not at risk, if the virus were to circulate naturally.
All this looks to me as though the ‘Patrons of Chiropractic Science’ are in urgent need of learning some science. Meanwhile, it would be most helpful, if they could keep quiet.
For many years, ‘HOMEOPATHY‘ (the ‘flag-ship’ journal of homeopathy which started its life in 1911 as THE BRITISH JOURNAL OF HOMOEOPATHY) was edited by Peter Fisher. When Peter fired me from its editorial board, it arguably lost its only expert who was critical of homeopathy. Then the journal was transferred from Elsevier to Thieme. When Peter tragically died, the journal lost its editor who, despite everything, had at least tried to keep the most dangerous loons within the homeopathy cult at bay.
Now, under the new editor, this seems no longer possible. The current issue of HOMEOPATHY holds several papers about the role of homeopathy in the present pandemic:
First paper entitled ‘The COVID-19 Pandemic: A View from New York City’
This article provides a view of homeopathic clinical practice in the New York City area in the first few months of 2020 as the coronavirus disease 2019 (COVID-19) pandemic began to evolve in the United States. Key symptoms used to generate a short list of potentially curative remedies are given, and the pandemic syndrome is viewed as appearing in stages or as having various clinical manifestations each with its own main remedy. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is briefly described, as are the preliminary presenting signs and symptoms of COVID-19 infection. Several clinical examples are given, some with positive laboratory confirmation.
Second paper entitled The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy
Successful homeopathic prescriptions are based on careful individualization of symptoms, either for an individual patient or collectively in the case of epidemic outbreaks. The ongoing COVID-19 pandemic was initially represented as a severe acute respiratory illness, with eventual dramatic complications. However, over time it revealed to be a complex systemic disease with manifestations derived from viral-induced inflammation and hypercoagulability, thus liable to affect any body organ or system. As a result, clinical presentation is variable, in addition to variations associated with several individual and collective risk factors. Given the extreme variability of pathology and clinical manifestations, a single, or a few, universal homeopathic preventive Do not split medicine(s) do not seem feasible. Yet homeopathy may have a relevant role to play, inasmuch as the vast majority of patients only exhibit the mild form of disease and are indicated to self-care at home, without standard monitoring, follow-up, or treatment. For future pandemics, homeopathy agencies should prepare by establishing rapid-response teams and efficacious lines of communication.
During the COVID-19 epidemic in Italy, hospital outpatient clinics progressively decreased their activities; in March 2020 they were closed except for emergencies. During this period, the activities of the public Homeopathy Outpatient Clinic of Lucca aimed at guaranteeing therapeutic continuity to patients by means of telephone or video consultations, and searching for homeopathic medicines that best responded to early COVID-19 symptoms. In March 2020, the Complementary Medicine Working Group participated in the organization of a mission of COVID-19 Chinese experts for the online training of professionals working in the Tuscan Healthcare System. The medical staff of the Lucca Clinic also cooperated in telephone health surveillance of infected patients at home, seroprevalence investigations using the capillary blood rapid test, and the implementation of the CLIFICOL (Clinical Files Collection) project.
Why is this a regrettable development?
In my mind, there is little doubt that homeopathy has no role to play in the current pandemic. To state or imply otherwise is not just false but dangerous. It endangers the lives of millions.
Others might see it differently and argue that it is not a bad thing at all. By coming out on the side of the loons within homeopathy, the ‘flag-ship’ journal of homeopathy has done a favour to rational healthcare: it has demonstrated beyond reasonable doubt that HOMEOPATHY (both the journal and the cult) cannot be taken seriously and can therefore be safely discarded to the waste-basket of medical history.
At present, we see a wave of promotion of Traditional Chinese Medicine (TCM) as a treatment of corona-virus infections. In this context, we should perhaps bear in mind that much of the Chinese data seem to be less than reliable. Moreover, I find it important to alert people to a stern warning recently published by two Australian experts. Here is the crucial passage from their paper:
We wish to highlight significant concerns regarding the association between traditional herbal medicines and severe, non-infective interstitial pneumonitis and other aggressive pulmonary syndromes, such as diffuse alveolar haemorrhage and ARDS which have emerged from Chinese and Japanese studies particularly during the period 2017−2019. Initially the association between traditional herbal therapies and pneumonitis was based on isolated case reports. These included hypersensitivity pneumonitis associated with the use of traditional Chinese or Japanese medicines such as Sai-rei-to, Oren-gedoku-to, Seisin-renshi-in and Otsu-ji-to (9 references in supplemental file). Larger cohorts and greater numbers now support this crucial relationship. In a Japanese cohort of 73 patients, pneumonitis development occurred within 3 months of commencing traditional medicine in the majority of patients [3], while a large report from the Japanese Ministry of Health, Labor and Welfare, described more than 1000 cases of lung injury secondary to traditional medications, the overwhelming majority of which (852 reports) were described as ‘interstitial lung disease [4].
Currently the constituent of traditional herbal medicines which is considered most likely to underlie causation of lung disease is Scutellariae Radix also known as Skullcap or ou-gon, which has been implicated through immunological evidence of hypersensitivity as well as circumstantial evidence, being present in all of those medicines outlined above [3]. Notably, skullcap is a constituent of QPD as used and described in the paper by Ren et al. relating to COVID-19 [1]. Scutellariae Radix-induced ARDS and COVID-19 disease share the same characteristic chest CT changes such as ground-glass opacities and airspace consolidation, therefore distinguishing between lung injury due to SARS-CoV-2 and that secondary to TCM may be very challenging. The potential for iatrogenic lung injury with TCM needs to be acknowledged [5]…
Morbidity and mortality from COVID-19 are almost entirely related to lung pathology [6]. Factors which impose a burden on lung function such as chronic lung disease and smoking are associated with increased risk for a poor outcome. Severe COVID-19 may be associated with a hypersensitivity pneumonitis component responsive to corticosteroid therapy [7]. Against this background the use of agents with little or no evidence of clinical efficacy and which have been significantly implicated in causing interstitial pneumonitis that could complicate SARS-CoV-2 infection, should be considered with extreme caution.
In conclusion, the benefits of TCM in the treatment of COVID-19 remain unproven and may be potentially deleterious. We recognise that there is currently insufficient evidence to prove the role of TCM in the causation of interstitial pneumonitis, however the circumstantial data is powerful and it would seem prudent to avoid these therapies in patients with known or suspected SARS-CoV-2 infection, until the evidence supports their use.
Declaration of Competing Interest: There are no conflicts to declare.
The purpose of this feasibility study was to:
(1) educate participants about the concept of Reiki,
(2) give participants the opportunity to experience six Reiki therapy sessions and subsequently assess outcomes on chronic pain,
(3) assess participants’ impression of and willingness to continue using and recommending Reiki therapy as adjunct for the treatment of chronic pain.
Using a prospective repeated measures pre- and postintervention design, a convenience sample of 30 military health care beneficiaries with chronic pain were educated about Reiki and received six 30-minute Reiki sessions over 2 to 3 weeks. Pain was assessed using a battery of pain assessment tools as well as assessment of impression of and willingness to share the concept of Reiki.
Repeated measures ANOVA analyses showed that there was significant decrease (P < 0.001) in present, average, and worst pain over the course of the six sessions with the most significant effect occurring up to the fourth session. When a variety of descriptor of pain was assessed, Reiki had a significant effect on 12 out of the 22 assessed, with the most significant effect on pain that was described as tingling/pins and needles (P = 0.001), sharp (P = 0.001), and aching (P = 0.001). Pain’s interference with general activity, walking, relationships, sleep, enjoyment of life, and stress significantly decreased (P < 0.001 to P = 0.002). Impression of improvement scores increased 27 % by session 6, and one’s knowledge about Reiki improved 43%. Eighty-one percent of the participants stated that they would consider scheduling Reiki sessions if they were offered with 70% desiring at least four sessions per month.
The authors concluded that 30-minute Reiki session, performed by a trained Reiki practitioner, is feasible in an outpatient setting with possible positive outcomes for participants who are willing to try at least four consecutive sessions. Reiki has the ability to impact a variety of types of pain as well as positively impacting those activities of life that pain often interferes with. However, education and the opportunity to experience this energy healing modality are key for its acceptance in military health care facilities as well as more robust clinical studies within the military health care system to further assess its validity and efficacy.
Where to begin?
- As a feasibility study, this trial should not evaluate outcome data; yet the paper focusses on them.
- To educate people one does certainly not require to conduct a study.
- That Reiki ‘is feasible in an outpatient setting‘ is obvious and does not need a study either.
- The finding that ‘Reiki had a significant effect’ is an unjustified and impermissible extrapolation; without a control group, it is not possible to determine whether the treatment or placebo-effects, or the regression towards the mean, or the natural history of the condition, or a mixture of these phenomena caused the observed outcome.
- The conclusion that ‘Reiki has the ability to impact a variety of types of pain as well as positively impacting those activities of life that pain often interferes with’ is quite simply wrong.
- The authors mention that ‘This study was approved by the U.S. Army Medical Research and Materiel Command Institutional Review Board’; I would argue that the review board must have been fast asleep.
Steiner with his wife (right) and Ita Wegman, his lover (left).
Anthroposophic medicine was founded by Steiner and Ita Wegman in the early 20th century. Currently, it is being promoted as an extension of conventional medicine. Proponents claim that “its unique understanding of the interplay among physiological, soul and spiritual processes in healing and illness serves to bridge allopathy with naturopathy, homeopathy, functional/nutritional medicine and other healing systems.” Its value has repeatedly been questioned, and clinical research in this area is often less than rigorous.
Anthroposophic education was developed in the Waldorf school that was founded by Steiner in 1919 to serve the children of employees of the Waldorf-Astoria cigarette factory in Stuttgart, Germany. Pupils of Waldorf or Steiner schools, as they are also frequently called, are encouraged to develop independent thinking and creativity, social responsibility, respect, and compassion.
Waldorf schools implicitly infuse spiritual and mystic concepts into their curriculum. Like some other alternative healthcare practitioners – for instance, doctors promoting integrative medicine, chiropractors, homeopaths and naturopaths – some doctors of anthroposophic medicine take a stance against childhood immunizations. In a 2011 paper, I summarised the evidence which showed that in the UK, the Netherlands, Austria and Germany, Waldorf schools have been at the centre of measles outbreaks due to their stance regarding immunisations.
More recently, a study evaluated trends in rates of personal belief exemptions (PBEs) to immunization requirements for private kindergartens in California that practice alternative educational methods. The investigators used California Department of Public Health data on kindergarten PBE rates from 2000 to 2014 to compare annual average increases in PBE rates between schools.
Alternative schools had an average PBE rate of 8.7%, compared with 2.1% among public schools. Waldorf schools had the highest average PBE rate of 45.1%, which was 19 times higher than in public schools (incidence rate ratio = 19.1; 95% confidence interval = 16.4, 22.2). Montessori and holistic schools had the highest average annual increases in PBE rates, slightly higher than Waldorf schools (Montessori: 8.8%; holistic: 7.1%; Waldorf: 3.6%).
The authors concluded that Waldorf schools had exceptionally high average PBE rates, and Montessori and holistic schools had higher annual increases in PBE rates. Children in these schools may be at higher risk for spreading vaccine-preventable diseases if trends are not reversed.
As the world is hoping for the arrival of an effective vaccine against the corona virus, these figures should concern us.
I was notified via Twitter (thank you John) that the UK ‘United Lincolnshire Hospitals NHS Trust’ is looking to employ a spiritual healer or reiki therapist. For those who find this perhaps too hard to believe, I have copied a few excerpts from the advertisement:
Employer:
- United Lincolnshire Hospitals NHS Trust
- Department:
- Spiritual Healer / Reiki Therapist
- Location:
- Lincoln County Hospital, Lincoln
- Salary:
- £21,892 – £24,157 per annum pro rata
An exciting opportunity has arisen for an Spiritual Healer / Reiki Therapist to join our friendly and energetic team on Waddington Unit. We are looking for a committed, enthusiastic and a self-motivated therapist to join our well established team.
Waddington Unit is a 26 bedded acute Haematology and Oncology ward that care for male and female patients. The ward has a high acuity, fast paced clinical admissions setting that cares for acutely unwell patients as a result of haematological and oncological conditions such as spinal cord compression and neutropenic sepsis as well as facilitating the delivery of chemotherapy.
We are passionate about improving patient experience and enhancing patients stay in hospital.
We are pleased to be working with The Sam Buxton Sunflower Healing Trust to offer this exciting opportunity on Waddington Unit.
If you are qualified and experienced as a Spiritual Healer /Reiki Therapist with 1 year or more of experience. To have completed the Healing In Hospital course, delivered by Angie Buxton-King and would like this opportunity to join this forward thinking team then please contact the co-ordinator for more information and an informal visit…
… ULHT is one of the largest hospital trusts in the country providing a comprehensive range of hospital based medical, surgical, paediatric, obstetric and gynaecological services to over 800,000 people across the county of Lincolnshire. The Trust’s core values are:
– Patient Centred
– Safety
– Compassion
– Respect and
– Excellence
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END OF QUOTE
The Sam Buxton Sunflower Healing Trust supports cancer patients and their families by providing funds to employ Complementary Therapists (Healers) in the NHS and Hospices. And Angie Buxton-King is a Reiki Master/ Teacher, Spiritual Healer, Author and Public Speaker. She also tells us this about her:
I am a fully qualified tutor of adults in the life learning sector and a Director/Trustee of our charity The Sam Buxton Sunflower Healing Trust ( SBSHT).
Since 2004 following the publication of my first book The NHS Healer; I have been invited to speak at many medical and holistic conferences. I am a past chair of The Doctor Healer Network and a former council member of The College of Medicine representing complementary therapies. Along with my husband Graham we created Energy Healing Training and Reiki Training that complies with National Occupational Standards. We have also created our unique ‘Healing in Hospitals & Hospices Training’ and ‘Delivering Complementary Therapy in a Statutory Setting Training’ to give healers and complementary therapists the necessary skills to work safely and competently in a more formal setting. I was employed by University College London Hospital (UCLH) as a Spiritual Healer to deliver healing to cancer patients as part of an integrated, holistic package of care for 12 years.
David Colquhoun published an excellent comment at the time about the UCLH work. All I want to add here is a list of suggestions to the ‘United Lincolnshire Hospitals NHS Trust’ regarding posts they might consider advertising in the future:
- ACUPUNCTURIST to run the department of anaesthesiology.
- FLYING CARPET MANAGER to relieve the over-worked Lincolnshire ambulance service.
- EXORCIST to deal with whistle blowers of all types.
- ALCHEMIST to turn lead into gold whenever the Trust runs into financial difficulties.
- HOMEOPATH to run the hospital pharmacy.
- QUANTUM PHYSICIST to maintain the ventilators of the IC unit.
- VIRTUAL SURGEON to head the department of surgery.
- VAMPIRE to organise the blood donation activities.
- DISCIPLE OF ANDREW WAKEFIELD to coordinate the Trust’s vaccination service.
- PRO-LIFE ACTIVIST to head the abortion service.
- SCIENTOLOGIST to run the spiritual well-being initiative.
- PSEUDOSCIENTIST to head the clinical trials unit.
- CAOS THEORIST to oversee the accounts.
- ELEPHANT to work in the porcelain shop.
In the interest of improving public health in Lincolnshire, I invite my readers to suggest further posts which might contribute profitably to the success of the ‘United Lincolnshire Hospitals NHS Trust’.
This recently published survey aimed to investigate the use of so-called alternative medicine (SCAM) among long-term cancer survivors and its links with healthy behaviour. Data was used from the VICAN survey, conducted in 2015-2016 on a representative sample of French cancer survivors 5 years after diagnosis.
Among the 4174 participants, 21.4% reported using SCAM at the time of the survey, including 8.4% who reported uses not associated with cancer. The most frequently cited reasons for using SCAM were:
- to improve their physical well-being (83.0%),
- to strengthen their body (71.2%),
- to improve their emotional well-being (65.2%),
- to relieve the side effects of treatment (50.7%).
The SCAM users who reported using SCAM to cure cancer or prevent relapses (8.5% of the participants) also used SCAM for other reasons. They had more often experienced cancer progression, feared a recurrence, and had a poorer quality of life because of sequelae, pain, and fatigue. They also consulted their general practitioners more frequently and had changed their lifestyle by adopting more healthy practices.
The authors concluded that the use of SCAM is not an alternative but a complementary means of coping with impaired health. Further research is now required to determine whether the use of SCAM reflects a lifestyle change or whether it assists survivors rather to make behavioural changes.
The 2012 data from the same survey had previously reported that, among the participants, 16.4% claimed to have used SCAM, and 45.3% of this group had not used SCAM before cancer diagnosis (new SCAM users). Commonly, SCAMs used were:
- homeopathy (64.0%),
- acupuncture (22.1%),
- osteopathy (15.1%),
- herbal medicine (8.1%),
- diets (7.3%),
- energy therapies (5.8%).
SCAM use was found to be significantly associated with younger age, female gender and a higher education level. Previous SCAM use was significantly associated with having a managerial occupation and an expected 5-year survival rate ≥80% at diagnosis; recent SCAM use was associated with cancer progression since diagnosis, impaired quality of life and higher pain reports.
In nearly half of the SCAM users, cancer diagnosis was one of the main factors which incited patients to use SCAM. Opting for SCAM was a pragmatic response to needs which conventional medicine failed to meet during the course of the disease.
These surveys mostly confirm what has been shown over and over again in other countries. What I find remarkable with these results, however, is the increase in SCAM use over time and the extraordinary high use of homeopathy by French cancer patients (more recently, the reimbursement of homeopathy in France has changed, of course). As homeopathy has no effects beyond placebo, this suggests that SCAM use by French cancer patients is far from being driven by evidence.
So, what then does determine it?
My best answer I can give to this question is this: relentless promotion through pharmacies, advertisements and journalists. These have all been very powerful in France in relation to homeopathy (hardly surprising, as the world’s largest homeopathic producer, Boiron, is based in France).
This leads me to the conclusion that SCAM is far more commercially driven than its enthusiasts would ever admit. They think of the pharmaceutical industry as the evil exploiter of the sick. It is now time to realise that the SCAM industry is, to a large extent, part of the pharmaceutical industry and often behaves just as badly or even worse: because what could be more unethical that selling placebos to desperate and vulnerable cancer patients?
Breast cancer and its treatments lead to a decrease in patients’ quality of life (QOL). This systematic review aimed to assess the effectiveness of so-called alternative medicine (SCAM) on the QOL of women with breast cancer.
A total of 28 clinical trials were included in the systematic review, 18 of which were randomized controlled trials (RCTs). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or post-cancer rehabilitation. One study tested a dietary supplement, and the other 27 tested a variety of mind-body techniques (the authors counted the following modalities in this category: acupuncture, hyperthermia, movement therapy (qigong), laser therapy, orthomolecular therapy, osteopathy, phototherapy, healing touch, homeopathy, lymphatic drainage, magnet field therapy, manual therapy, neural therapy, Shiatsu). Twenty-seven studies showed improved QOL.
The authors concluded that the findings may indicate the potential benefits of SCAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.
This is a somewhat odd paper:
- it is poorly written,
- it lumps together SCAMs that do not belong in the same category,
- it only considered studies published in English,
- it included studies regardless of study design, even those without any control groups.
Regardless of these consideration, it stands to reason that patients’ QoL can be improved by SCAM. Only a fool would deny that a bit of extra care, kindness, attention and time is good for patients. The relevant questions, however, are quite different:
- Is this effect due to the extra attention and care or is it due to specific effects of SCAM?
- Which SCAM is best at achieving an improvement of QoL?
- Are the truly effective SCAMs better than conventional interventions aimed at improving QoL?
These are by no means academic questions but issues that need to be addressed to improve cancer care, and tackling them is in the best interest of suffering patients. Sadly, none of them can be answered by conducting poor quality systematic reviews of the evidence. Even more sadly, few of the proponents of integrated medicine want to face the music and answer these questions. They seem to prefer to stand in the way of progress, to ignore medical ethics, to blindly and naively integrate any old nonsense from the realm of SCAM (anything from homeopathy to Reiki) into routine care without probing further and without wanting to know the facts.
It is almost as though they are afraid of the truth.
When I discuss published articles on this blog, I usually focus on recent papers. Not so today! Today I write about a small study we published 17 years ago. It was conducted in Canada by researchers whom I merely assisted in designing the protocol and interpreting the findings.
They trained 8 helpers to pretend being customers of health food stores. They entered individually into assigned stores; the helpers had been informed to browse in the store until approached by an employee. At this time they would declare that their mother has breast cancer. They disclosed information on their mother’s condition, use of chemotherapy (Tamoxifen) and physician visits, only if asked. The helpers would then ask what the employee recommend for this condition. They followed a structured, memorized, pretested questionnaire that asked about product usage, dosage, cost, employee education and product safety or potential for drug interactions.
The helpers recorded which products were recommended by the health food store employees, along with the recommended dose and price per product as well as price per month. Additionally, they inquired about where the employee had obtained information on the recommended products. They also noted whether the employees referred them on to SCAM practitioners or recommended that they consult a physician. Full notes on the encounters were written immediately after leaving the store.
The findings were impressive. Of the 34 stores that met our inclusion criteria, 27 recommended SCAMs; a total of 33 different products were recommended. Here are some further findings:
- Essiac was recommended most frequently.
- The mean cost of the recommended products per month was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600).
- Twenty-three employees (68%) did not ask whether the patient took prescription medications.
- Fifteen (44%) employees recommended visiting a healthcare professional; these included: naturopaths (9), physicians (5) and nutritionists (1).
- Health food store employees relied on a variety of sources of information. Twelve employees (35%) said they had received their information from books, 5 (15%) from a supplier, 3 (9%) had formal education in SCAM, 2 (6%) had in-store training, and 12 (35%) did not disclose their sources of information.
Since our paper has been published, several other investigations have addressed similar issues. Here are a few excerpts:
- Pharmacies and HFS in Greater Wellington provided potentially hazardous advice, recommending products, often branded for pregnancy, which contradicted NZ MOH guidelines. Regulatory reform of CAM products and those who sell them is called for in New Zealand.
- …only about one-quarter [of health food stores (HFSs)] gave appropriate advice regarding possible interactions with warfarin and management of anticoagulation compared with two-thirds of pharmacies.
- HFS promoting herbal products for medical conditions should be regulated in a similar fashion to shops that dispense pharmaceutical products.
- Staff in 25 out of 26 health food stores did not refer the researcher to a medical practitioner; instead they recommended and sold a wide variety of compounds of unproven efficacy
- Store personnel readily provided information and product recommendations, with shark cartilage being the most frequent.
But why do I mention all this today?
The answer is that firstly, I think it is important to warn consumers of the often dangerous advice they might receive in HFSs. Secondly, I feel it would worthwhile to do further research, check whether the situation has changed and repeat a similar study today. Ideally, a new investigation should be conducted in different locations comparing several countries. If you have the possibility to plan and conduct such an experiment, please drop me a line.
Retraction Watch has alerted us to a “Paper urging use of homeopathy for COVID-19 appears in peer-reviewed public health journal”. The paper in question is readily available on the Internet. Here is its abstract:
Today, humanity is living through the third serious coronavirus outbreak in less than 20 years, following SARS in 2002–2003 and MERS in 2012. While the final cost on human lives and world economy remains unpredictable, the timely identification of a suitable treatment and the development of an effective vaccine remain a significant challenge and will still require time.
The aim of this study is to show that the global collective effort to control the coronavirus pandemic (Covid 19) should also consider alternative therapeutic methods, and national health systems should quickly endorse the validity of proven homeopathic treatments in this war against coronavirus disease.
Subject and methods With the help of mathematics, we will show that the fundamental therapeutic law on which homeopathy is founded can be proved.
Results The mathematical proof of the law of similarity justifies perfectly the use of ultra – high diluted succussed solution products as major tools in the daily practices of homeopathy.
Conclusion It is now time to end prejudice and adopt in this fight against Covid-19 alternative therapeutic techniques and practices that historically have proven effective in corresponding situations.
And the full conclusions from the body of the paper read as follows:
Today, it is imperative that ever-safe medicinal products such as homeopathic ultra – high diluted succussed solutions are tested in this pandemic. Epidemiological research has to be carried out to include homeopathic treatment and compare it to established treatments. Patients should be assigned randomly in two different groups of at least 200–400 individuals, and receive respectively established and homeopathic treatment. The evaluation of the results from both groups could reveal which group has a superior outcome in survival, general health conditions, etc., and to what extent.
If there were a competition for the craziest paper published on so-called alternative medicine (SCAM) during 2020, this one would, I am sure, win by some margin! The authors seem to have little idea of the nature of evidence in healthcare or medicine; and they use mathematics like a drunken man uses a lamp-post: not for enlightenment, but for support.
So, who are the authors of this showcase of pseudoscience?
They are D. Kalliantas, M. Kallianta, Ch. S. Karagianni from the Department of Materials Science and Engineering, School of Chemical Engineering, NTUA, GR15780, Athens, Greece; the National Technical University of Athens, 9 Heroon Polytechniou Str. Zografos Campus, 15780 Athens, Greece; and the School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
The first author has previously published weird stuff including a self-published book: Kalliantas D (2008) The Chaos theory of disease. Kallianta A Publications, Eleusis, Greece. On Medline, I also found this paper by two of the three authors:
Trituration is a mechanical process (a form of comminution) for reducing the particle size of a substance. In this manuscript, six different Raw Solid Materials (RSM) which are used in Homeopathy after successive grindings are studied before they are turned into homeopathic solutions. The impact of trituration, with the presence of α‑lactose monohydrate (milk sugar) seems to be quite great and interesting because of the variety of grain size which largely differentiate the properties of the materials. The grain sizes obtained triturations by hand according to C. Herring’s suggestion leads, finally, measurement scale dimensions. The obtained results can be useful information for all the pharmacy industries, as well as for preparing any kind of powder.
Sadly, this renders my suspicion unlikely that the new article is a hoax in which some pranksters were trying to show that any odd nonsense can pass the peer-review of a scientific journal.
And which journal would publish a paper that looks like a hoax but is none? It is the Journal of Public Health: From Theory to Practice (Springer). On the website, the journal tells us that:
The Journal of Public Health: From Theory to Practice is an interdisciplinary publication for the discussion and debate of international public health issues, with a focus on European affairs. It describes the social and individual factors determining the basic conditions of public health, analyzing causal interrelations, and offering a scientifically sound rationale for personal, social and political measures of intervention. Coverage includes contributions from epidemiology, health economics, environmental health, management, social sciences, ethics, and law.
- An interdisciplinary publication for the discussion and debate of international public health issues
- Includes contributions from epidemiology, health economics, environmental health, management, social sciences, ethics, and law
- Offers a scientifically sound rationale for personal, social and political measures of intervention
- 94% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again.
_______________________________
The twice mentioned term SCIENTIFICALLY SOUND does not quite ring true in the present instance, does it?
