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

neglect

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Considering the incessant promotion of the integration of so-called alternative medicine (SCAM) into conventional medicine, it seems high time to evaluate and carefully consider the opportunities and challenges that such a strategy would pose. This article addresses both; it was written on the basis of information published in the books and articles available in real and virtual libraries in a descriptive-explanatory way.

Integrating SCAM with conventional medicine brings many opportunities as well as numerous challenges. The most important challenges are legal and ethical challenges, regulation, formulation and implementation of the training program and attention to research-orientedness and validity of research. Every medical field needs legislation, control and legal supervision from inside and outside the organization. In addition to guaranteeing the quality, efficiency and reducing the risk of using tools and methods, this work prevents any abuse and fraud. This issue is more important in the field of complementary medicine, where there is a great need for a relationship based on trust between the therapist and the patient.

The authors concluded that integrating of traditional and complimentary medicine into conventional medicine, despite its many advantages, faces serious challenges that require appropriate stategies in the fields of law making, regulatory and quality control, education and research. In the legal field, it is necessary to have appropriate laws for the purpose of issuing employment licenses and clarifying the quality standards of specialists, including avoiding negligence and mistakes, and compensating for damages through increasing medical liability insurance coverage and ways to avoid legal liability, including acquiring Informed consent and privacy should be included in the rules. Regulation in both product and specialist sectors should be implemented carefully in terms of quality, safety and efficiency of products and methods.

The paper was written by two authors from the “Smart University of Medical Sciences, Tehran, Iran”. We therefore have to forgive them their often unclear English. Their paper does, however, alert us to important and much-neglected issues.

The ethical problems that arise through the use of SCAM are as significant as the legal ones. On this blog, I have repeatedly tried to alert the public to them, e.g.:

In my view, the ethical issues in and around SCAM are central to most of the problems we discuss on this blog. They are nonetheless strangely neglected by SCAM professionals, SCAM users, SCAM researchers and almost everyone else.

Why?

I have come to the conclusion that this is because addressing them adequately would more or less prevent the practice of SCAM – just think of the thorny issue of informed consent. Arguably, fully informed consent for a SCAM therapy is impossible or would chase away even the most enthusiastic parient.

In case you are looking for a book where the entire spectrum of ethical issues are concisely addressed, let me recomment our own work (it even received an award from the British Medical Association).

Yes, this was the (rather sensationalist) headline of a recent article in the Daily Mail that I allegedly wrote. Its unusual genesis might interest some of you.

I was contacted by a journalist who asked for a telephone interview on the subject of chiropractic as well as my recent book. I agreed under the condition that we do this not over the phone but in writing via email. So, he sent me his questions and I supplied the responses; here they are:

 

· What’s the absolute worst case scenario of seeing a chiropractor?

The worst that can happen is that you die. Certain manipulations that chiropractors regularly do can injure an artery that supplies part of the brain. This would then result in a stroke; and a stroke can of course be fatal. This is what happened, for example, to the American model Katie May. She had pinched a nerve in her neck on a photoshoot and consulted a chiropractor who manipulated her neck. This caused a tear to an artery in her upper spine. The result was a massive stroke of which she died a few days later.

· How did you first become interested in the topic?

I learned hands on spinal manipulation as a junior doctor. Later, as the head of the department of Physical Medicine and Rehabilitation at the University of Vienna, we used such techniques routinely. In 1993, I became chair of Complementary Medicine in Exeter, and my task was to scientifically investigate alternative therapies such as chiropractic. Recently, I decided to summarize all our research in a book.

· What did you learn from your research?

In essence, our investigations found that almost all the claims that chiropractors make are unsubstantiated. Their manipulations are not nearly as effective as they claim. More worryingly, they are also not free of risks. About 50% of patients who see a chiropractor suffer from side effects after spinal manipulation. These are usually not severe and disappear after 2 or 3 days. But, in addition, very serious complications like stroke, death, bone fractures, paralysis can also occur. Chiropractors say that these are rare, and I hope they are right, but the truth is that nobody knows because there is no system of monitoring such events. We once asked British neurologists to report cases of neurological complications occurring within 24 hours of cervical spine manipulation over a 12-month period. This unearthed a total of 35 cases. Particularly striking was the fact that none of these cases had previously been reported anywhere. So, the underreporting was exactly 100%. This tells me that, when chiropractors claim there are just a few such incidents, in truth there might be a few hundred or even thousand.

· Is there an especially shocking finding?

What I find particularly unnerving is the way chiropractors regularly disregard medical ethics. Take the issue of informed consent, for example. It means that we all have to fully inform patients about the treatment we plan to give. In the case of chiropractic spinal manipulation, it would need to include that the therapy is of doubtful effectiveness, that other options are more likely to help, and that the treatment carries very frequent minor as well as probably rare major risks. I do understand why chiropractors do often not provide this information – it would chase away most patients and thus impact of their income. At the same time, I feel that chiropractors should not be allowed to violate fundamental principles of medical ethics. This is not in the interest of patients!!!

· Why do you think patients are so keen on chiropractors?

I am not sure that they really are so keen; some are but the vast majority are not. Our own research suggests that, depending on the country, between 7 and 33% of the population see chiropractors. This means that between 93 and 67% have enough sense to avoid chiropractors.

· But what does the evidence actually show about the efficacy of chiropractic?

As it happens our most recent summary has just been published. It concluded that “it is uncertain if chiropractic spinal manipulation is more effective than sham, control, or deep friction massage interventions for patients with headaches” [Is chiropractic spinal manipulation effective for the treatment of cervicogenic, tension-type, or migraine headaches? A systematic review – ScienceDirect]. For other conditions the evidence tends to be even less convincing. The only exception might be chronic low back pain, according to another recent summary [Analgesic effects of non-surgical and non-interventional treatments for low back pain: a systematic review and meta-analysis of placebo-controlled randomised trials | BMJ Evidence-Based Medicine]. But here too, I would argue that other treatments are safer and cheaper.

· Are some chiropractors worse than others?

The profession is divided into 2 groups, the ‘straights’ and the ‘mixers’. The former believe in all the nonsense their founding father, DD Palmer, proclaimed 120 years ago, including that spinal manipulation is the only treatment for virtually all our ailments, and that vaccinations must be avoided at all cost. The mixers have realized that Palmer was a charlatan of the worst kind, focus on musculoskeletal conditions and use treatments borrowed from physiotherapy. Needless to say that the mixers might be bad, but the straights are even worse.

· What can patients do to keep safe?

Avoid chiropractors, go to a library and read my book.

· If you have backpain or joint pain what can you do instead?

There is lots people can do but advice has to be individualized. By far the best is to prevent back pain from happening. Here advice might include more exercise, loosing weight, changing your mattress, avoiding certain things like heavy lifting, etc. If you are acutely suffering, see a physio or a doctor, keep moving and be aware that over 90% of back pain disappears within a few days regardless of what you do.

________________________

I had insisted that I see his edits before this gets published, and a little while later I received the edited version. To my big surprise, the journalist had transformed the interview into an article allegedly authored by me. I told him that I was uncomfortable with this solution, and we agreed that he would make it clear that the article was merely based on an interview with me. I then revised the article in question and the result was the mentioned article published still naming me as its author but with a footnote: “As told in an interview with Ethan Ennals”

Never a dull day when you research so-called alternative medicine!

Homeopathy is harmless – except when it kills you!

Death by homeopathy has been a theme that occurred with depressing regularity on my blog, e.g.:

Now, there is yet another sad fatality that must be added to the list. This case report presents a 61-year-old woman with metastatic breast cancer who opted for homeopathic treatments instead of standard oncological care. She presented to the Emergency Department with bilateral necrotic breasts, lymphedema, and widespread metastatic disease. Imaging revealed extensive lytic and sclerotic lesions, as well as pulmonary emboli. Laboratory results showed leukocytosis, lactic acidosis, and hypercalcemia of malignancy.

During hospitalization, patient was managed with anticoagulation and broad-spectrum antibiotics. Despite disease progression, patient declined systemic oncological treatments, leading to a complicated disease trajectory marked by frailty, sarcopenia, and functional quadriplegia, ultimately, a palliative care approach was initiated, and she was discharged to hospice and died.

This case highlights the complex challenges in managing advanced cancer when patients choose alternative therapies over evidence-based treatments. The role of homeopathy in cancer care is controversial, as it lacks robust clinical evidence for managing malignancies, especially metastatic disease.

Although respecting patient autonomy is essential, this case underscores the need for healthcare providers to ensure patients are fully informed about the limitations of alternative therapies. While homeopathy may offer emotional comfort, it is not a substitute for effective cancer treatments. Earlier intervention with conventional oncology might have altered the disease course and improved outcomes. The eventual transition to hospice care focused on maintaining the quality of life and dignity at the end-of-life, emphasizing the importance of integrating palliative care early in the management of advanced cancer to enhance patient and family satisfaction.

Even though such awful stories are far from rare, reports of this nature rarely get published. Clinicians are simply too busy to write up case histories that show merely what sadly must be expected, if a patient refuses effective therapy for a serious condition and prefers to use homeopathy as an “alternative”. Yet, the rather obvious truth is that homeopathy is no alternative. I have pointed it out many times before: if a treatment does not work, it is dangerously misleading to call it alternative medicine – one of the reasons why I nowadays prefer the term so-called alternative medicine (SCAM).

But what about homeopathy as an adjunctive cancer therapy?

In 2011, Walach et al published a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). The authors observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment.

Walach and other equally deluded defenders of homeopathy (such as Wurster or Frass) tend to interpret these findings as being caused by homeopathy. Yet, this does not seem to be the case, as they regularly forget about the possibility of other, more plausible explanations for their results (e.g. placebo or selection bias). I am not aware of a rigorous trial showing that adjunctive homeopathy has specific effects when used by cancer patients (if a reader knows more, please let me know; I am always keen to learn).

So, is there a role for homeopathy in the fight against cancer?

My short answer:

No!

The primary aim of this ‘mixed-methods, feasibility pilot study’ was to evaluate the feasibility of providing Reiki at a behavioral health clinic serving a low-income population. The secondary aim was to evaluate outcomes in terms of patients’ symptoms, emotions, and feelings before and after Reiki.
The study followed a pre-post experimental design. Reiki was offered to adult outpatients at a community behavioral health center in Rochester, Minnesota. Patients with a stable mental health diagnosis completed surveys before and after the Reiki intervention and provided qualitative feedback. Patients were asked to report their ratings of:
  • pain,
  • anxiety,
  • fatigue,
  • feelings (eg, happy, calm)

on 0- to 10-point numeric rating scales. Data were analyzed with Wilcoxon signed rank tests.

Among 91 patients who completed a Reiki session during the study period, 74 (81%) were women. Major depressive disorder (71%), posttraumatic stress disorder (47%), and generalized anxiety disorder (43%) were the most common diagnoses. The study was feasible in terms of recruitment, retention, data quality, acceptability, and fidelity of the intervention. Patient ratings of pain, fatigue, anxiety, stress, sadness, and agitation were significantly lower, and ratings of happiness, energy levels, relaxation, and calmness were significantly higher after a single Reiki session.
The authors concluded that the results of this study suggest that Reiki is feasible and could be fit into the flow of clinical care in an outpatient behavioral health clinic. It improved positive emotions and feelings and decreased negative measures. Implementing Reiki in clinical practice should be further explored to improve mental health and well-being.
One might have expected better science from the Mayo Clinic, Rochester; in fact, this is not science at all; it’s pure pseudo-science! Here are some critical remarks:
  • What on earth is a ‘mixed-method, feasibility, pilot study’? A hallmark of pseudo-researchers seems to be that they think they can invent their own terminology.
  • There is no objective, validated outcome measure.
  • The conclusion that ‘Reiki is feasible‘ has been known and does not need to be tested any longer.
  • The conclusion that ‘Reiki improved positive emotions and feelings and decreased negative measures’ is false. As there was no control group, these improvements might have been caused by a whole lot of other things than Reiki – for instance, the extra attention, placebo effects, regression towards the mean or social desirability.
  • The conclusion that ‘implementing Reiki in clinical practice should be further explored to improve mental health and well-being’ is therefore not based on the data provided. In fact, as Reiki is an implausible esoteric nonsense, it is a promotion of wasting resources on utter BS.

Does it matter?

Why not let pseudo-scientists do what they do best: PSEUDO-SCIENCE?

I think it matters because:

  • Respectable institutions like the Mayo Clinic should not allow its reputation being destroyed by quackery.
  • The public should not be misled by charlatans.
  • Patients suffering from mental health problems deserve better.
  • Resources should not be wasted on pseudo-research.
  • ‘Academic journals like ‘Glob Adv Integr Med Health’ have a responsibility for what they publish.
  • ‘The ‘Academic Consortium for Integrative Medicine & Health‘ that seems to be behind this particular journal claim to be “the world’s most comprehensive community for advancing the practice of whole health, with leading expertise in research, clinical care, and education. By consolidating the top institutions in the integrative medicine space, all working in unison with a common goal, the Academic Consortium is the premier organizational home for champions of whole health. Together with over 86 highly esteemed member institutions from the U.S., Australia, Brazil, Canada and Mexico, our collective vision is to transform the healthcare system by promoting integrative medicine and health for all.” In view of the above, such statements are a mockery of the truth.

 

This study investigated the impact of spirituality and SCAM (so-called alternative medicine) use on perceptions of vaccine harmfulness, with a focus on COVID-19 and mandatory childhood vaccinations. Additionally, it examined whether spirituality indirectly influences vaccine hesitancy through SCAM use and beliefs in conspiracies.

A cross-sectional probability-based survey was conducted with over 1300 participants from South Tyrol, Italy, in 2023, using the GrAw-7 (Gratitude/Awe) scale as a measure of the experiential aspect of non-religious spirituality. Statistical analysis encompassed Spearman’s correlation and linear regression to assess the associations between spirituality and vaccine perceptions. A mediation model was applied to evaluate the role of spirituality in shaping attitudes towards vaccination.

The results show that higher experiential spirituality was associated with increased perceived harmfulness of COVID-19 and mandatory childhood vaccinations. Spirituality as well as perceived harmfulness of COVID-19 vaccination and mandatory childhood vaccination were correlated with age, increased SCAM utilisation and conspiracy ideation, while institutional distrust was solely associated with vaccine scepticism but not with spirituality; well-being and altruism were only associated with spirituality. Mediation analysis revealed that experiential spirituality accounted for a modest but significant portion of the influence of SCAM use and conspiracy thinking on vaccine perceptions.

The authors concluded that their study underscores the association between experiential spirituality and vaccine perceptions, particularly among individuals with a predisposition towards SCAM and those who exhibit conspiracy-related beliefs, highlighting the intricate relationships without implying causation. While spirituality does not appear to directly hinder vaccine uptake, it correlates with heightened perceptions of vaccine risks, particularly within contexts where alternative health practices and distrust in mainstream medical authorities are prevalent. This relationship emphasises that people who score high on spiritual awareness may be indirectly influenced to differ from others with respect to vaccination attitudes by promoting scepticism towards vaccine safety and efficacy. Even if we cannot change the spirituality of people, we know now that we can address information campaigns not only by attempting to build trust but also by addressing information to people preferring SCAM use and being spiritual at once. We think that this result is an important insight when focusing vaccine campaigns on vaccine-hesitant persons. These findings emphasise the importance of incorporating spiritual awareness, convictions, and beliefs into public health communication strategies. To address vaccine hesitancy within spiritually inclined populations, public health campaigns could explore framing vaccination in ways that resonate with values such as community care, personal responsibility, or altruism while ensuring that these messages are tailored to the diverse beliefs and perspectives of these groups. Moreover, collaboration with spiritual and community leaders could serve as a strategy to strengthen vaccine acceptance in populations that perceive health through a spiritual perspective. Future research should further explore the interactions between spirituality, SCAM use, and beliefs in conspiracies, with an emphasis on understanding how spirituality mediates health behaviours in culturally and religiously diverse contexts. Longitudinal studies and analyses across broader demographic groups are necessary to generalise these findings and refine public health interventions aimed at addressing spirituality-linked vaccine hesitancy.

My interpretation of these findings is that they confirm what we have repeatedly discussed here: There is a link between SCAM use and vaccination hesitance. It most likely is due to a cross-correlation: a certain mindset (that includes spirituality and several other phenomena) influences the distrust in vaccinations as well as the use of SCAM (and other things like, for instance, the belief in conspiracy theories).

Measles had been declared eliminated from the US in 2000. Now the disease is back with a vengeance. In February, an unvaccinated Texan child became the first person in a decade to die from measles in the US. Another death occurred in New Mexico.

The reason for the outbreak is simple: the uptake of the measles vaccine dropped below the 95% rate that is necessary for herd immunity. In the region where the current outbreak began, only 82% of the kids were vaccinated. This triggered the outbreak and, in turn, might mean that the US will lose its ‘measles elimination status’.

Only days after his appointment, Trump pledged to withdraw the United States from the World Health Organization and to drastically cut the US Agency for International Development. Both moves are likely to cause more cases of measles and similarly vaccine-preventable diseases in the US and around the world. To make matters worse, Trump administration has fired hundreds of workers from the US Centers for Disease Control and Prevention (CDC).

And to make matters even worse, Trump appointed Robert F. Kennedy Jr., one of the US most deluded antivaxer. Since being appointed, Kennedy has downplayed the importance of the current measles outbreak, postponed a meeting of the CDC vaccine advisers, made statements like “vaccinations are over-rated” and claimed that good nutrition and treatment with vitamin A as ways to reduce measles severity. He even praised the benefits of cod liver oil as a measure against measles. “There are adverse events from the vaccine,” Kennedy said in a March 11 interview. “It does cause deaths every year. It causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera. And so people ought to be able to make that choice for themselves.” Further confirming his cluelessness Kennedy also stated: “When you and I were kids, everybody got measles, and measles gave you … lifetime protection against measles infection. The vaccine doesn’t do that… The vaccine wanes 4.5% per year.”

But Kennedy does not just propagate BS in interviews, he also plans to investigate whether vaccines cause autism — an assumption that has been discredited ad nauseam. A spokesperson for the US Department of Health and Human Services (DHHS) said: “The rate of autism in American children has skyrocketed. CDC will leave no stone unturned in its mission to figure out what exactly is happening.”

Meanwhile in Texas, some parents, who evidently believe Kennedy’s deluded nonsense, are giving unvaccinated children vitamin A, which, of course, is toxic at high doses.

This review is entitled “A narrative review of the impact of reiki and therapeutic touch on sleep quality and health in women” and aimed to evaluate the application methods of energy therapies, specifically Reiki and Therapeutic Touch, their health effects, and their positive impact on sleep quality, particularly in women.

The author who is from the Osmaniye Korkut Ata University, Faculty of Health Sciences, Midwifery Department, Osmaniye, Turkey, states in her abstract that:

“energy therapies are holistic approaches designed to restore energy balance and enhance overall health. Reiki utilizes universal energy flow to promote physical, mental, and spiritual harmony. By balancing energy centers, Reiki helps alleviate stress, anxiety, and depression while being a generally safe practice with no reported side effects.”

The author continues by claiming that studies involving menopausal women suggest that Reiki improves sleep quality, reduces the time to fall asleep, and stabilizes sleep patterns.

Therapeutic Touch, the author explains:

“focuses on sensing and balancing the body’s energy fields, operating on the principle that energy imbalances contribute to illness. Research indicates that Therapeutic Touch alleviates stress, fatigue, anxiety, and pain, while enhancing sleep quality, relaxation, and overall quality of life. Studies in menopausal women confirm its effectiveness in addressing sleep disturbances and promoting well-being.”

The author concludes that energy therapies, particularly methods like Reiki and Therapeutic Touch, have garnered attention for their positive impact on women’s health and overall well being. These noninvasive, safe, and low-cost practices have shown promise, especially in areas such as sleep quality, stress management, and the alleviation of menopausal symptoms. However, the limited scientific literature in this field necessitates further research to solidify their efficacy.

The author also issues the following ecommendations:

• Theoretical and practical training on energy therapies should be integrated into nursing education
programs to enhance awareness and application.
• Randomized controlled trials should be conducted to investigate the effectiveness of energy
therapies across different age groups and health conditions.
• Research on women’s health should focus specifically on the effects of energy therapies on sleep
quality and menopausal symptoms.
• Public awareness of energy therapies should be increased, and their integration into healthcare systems
should be facilitated.
• Energy therapies should be recognized as complementary treatment options in health institutions,
contributing to patient satisfaction and stress management.

This paper is a good example to show why I have often warned that research of so-called alternative medicine (SCAM) is in serious danger to be no longer taken seriously. Scientists and rational healthcare professionals will simply dismiss it outright because it simply is pseudo-research masquarading as the real thing.

The review fails to contain a methods section which means we do not know on what evidence the conclusions are based. Once we have a closer look, we realize that the paper:

  • relies on highly selected studies;
  • does not even consider the implausibility of energy healing;
  • fails to assess the methodological quality of the primaary studies.

All this is done so that the author – presumably a nurse who practices energy healing – can arrive at the conclusion she set out to draw.

Such papers are deeply disturbing because they mislead the reader and undermine trust in science.

 

PS

In case you are interested in a reasonable and evidence-based conclusion about energy healing, here is one I suggest:

A review of the evidence shows that energy healing flies in the face of science and is not supported by sound clinical evidence. Energy healing has therefore no place in rational healthcare. 

I have to admit I don’t normally read the DALLAS MORNING NEWS -but perhaps I should! Here are a few excerpts from an article they just published:

Texas health experts are warning that vitamin A — found in food and in supplements such as cod liver oil — is not an alternative to measles vaccination. They’re urging Texans to vaccinate themselves and their children, as the West Texas measles outbreak continues to grow and after an unvaccinated child died from the illness.

Their concerns come after U.S. Health and Human Services Secretary Robert F. Kennedy Jr. wrote about vitamin A in a Fox News column responding to the Texas measles outbreak. (Kennedy has also falsely stated in the past that vaccines cause autism.)

Kennedy’s comments in the column — that the U.S. Centers for Disease Control and Prevention recommend vitamin A for people hospitalized with measles, and that studies have found vitamin A can help prevent measles deaths — are not inaccurate.

But they lack important context, said Dr. Peter Hotez, a vaccine expert at the Baylor College of Medicine. Hotez worries the missing context might mean people put their faith in vitamin A over vaccination — a decision that could cost lives. “The thing that I worry about is by [Kennedy] playing this up and others playing this up, it sends a false equivalency message, that somehow treating with vitamin A is equivalent to getting vaccinated, which is clearly not the case,” Hotez said…

“There’s zero evidence that it’s preventative,” said Dr. Christopher Dreiling, a pediatrician at Pediatric Associates of Dallas. Dreiling said he hasn’t had parents ask him about vitamin A for measles, but he wouldn’t be surprised if it started popping up after Kennedy’s comments. Dreiling’s main concern, he said, is that parents have correct information to make informed decisions…

____________________

Kennedy is, of course, not alone in pushing Vitamin A for measles. On this blog, we recently saw Dana Ullman (MPH, CCH) doing the same. On Feb 28, he wrote the following comment:

Thank YOU for verifying that the Texas hospital here seems to have killed these children. According to your article above, the head of this Texas hospital asserted, “Unfortunately, like so many viruses, there aren’t any specific treatments for measles.”

And yet, according to the New England Journal of Medicine, Vitamin A has clearly been shown: “Treatment with vitamin A reduces morbidity and mortality in measles, and all children with severe measles should be given vitamin A supplements, whether or not they are thought to have a nutritional deficiency.”

https://www.nejm.org/doi/full/10.1056/NEJM199007193230304

And what might Kennedy and Ullman have in common (apart from being dangerous nut-cases and quackery-promoters)?

Simple: they both don’t understand science!

This fascinating article [ full title: THE CRIMINAL OFFENSE OF QUACK MEDICINE AND QUACK PHARMACY (ART. 254 OF THE CRIMINAL CODE)] was written by Igor Vuković, PhD, Professor at the University of Belgrade, Faculty of Law. Here is its English language abstract:

The development of conventional medicine throughout history was accompanied by the appearance of quackery. On the one hand, in the absence of trained doctors, people all the same needed treatment, which was generally available only from unqualified persons. On the other hand, this need has generated greed and often deception regarding the expected success in treatment. This caused this phenomenon to be considered a criminal offense in most legislations. However, with the increasing legalization of the so-called complementary (alternative) medicine, whose methods are less scientifically proven, the attitude towards quackery is somewhat changing. The author notes that the scope of the act of „providing other medical services“ is particularly debated, since in that way acts of not only treatment but also medical assistance and care are brought under the framework of incrimination. Serbian law also considers as punishable acts of quack pharmacy, which is defined as preparing or issuing of medicaments without the appropriate professional qualification. This incrimination also raises important questions, which the author tries to answer. In the conclusion, it is stated that, according to the factual situation, situations of quackery can
often be brought under the criminal offense of fraud.

Even though it is not always clear to me what the authors meant to express, I feel that surely he is right in raising some of the issues related to so-called alternative medicine (SCAM). On this blog, I have repeatedly highlighted legal aspects of SCAM as they arose, e.g.:

Even a short glance at this list makes it obvious, I think, that there are plenty of legal issues in and around SCAM. I feel it would be important that we all – consumers, clinicians, researchers, lawyers and politicians – become aware of them and, when necessary, act accordingly.

 

 

As we have discussed previously, there is an outbreak of measles affecting unvaccinated children in the US. In an attempt to reassure the US public, Robert F. Kennedy Jr., said that the U.S. Department of the Health and Human Services is watching the Texas measles outbreak. “It’s not unusual,” he claimed when pressed by reporters. “We have measles outbreaks every year.” This, of course, is quite misleading.

Yes, there are regular outbreaks, but they are hardly comparable to the current one. The last person to succumb to measles in the US died in 2015 during an outbreak in Clallam County, Washington state, in which only a couple dozen people were infected. Measles was then identified as the cause of death of a woman. The autopsy found that she had “several other health conditions and was on medications that contributed to a suppressed immune system,” the US Health Department said at the time.

Kennedy misstated a number of further facts:

  • Kennedy claimed that most of the patients who had been hospitalized were there only for “quarantine.” Dr. Lara Johnson at Covenant, the hospital in question, contested that characterization. “We don’t hospitalize patients for quarantine purposes,” said Johnson, the chief medical officer.
  • Kennedy claimed that two people had died of measles. Yet Andrew Nixon, the spokesperson for the Department of Health and Human Services clarified that, at the time, the U.S. Centers for Disease Control and Prevention has identified only one death.

Gaines County has reported 80 measles cases so far. It has one of the highest rates of school-aged children in Texas who have opted out of at least one required vaccine, with nearly 14% skipping a required dose last school year.

Some of the hospitalised patients’ respiratory issues progressed to pneumonia, and they needed an oxygen tube to breathe, Johnson explained. Others had to be intubated, though Johnson declined to say how many. “Unfortunately, like so many viruses, there aren’t any specific treatments for measles,” she said. “What we’re doing is providing supportive care, helping support the patients as they hopefully recover.”

Last week, Trump seemed to buy into the already thoroughly debunked vaccines-cause-autism conspiracy that Kennedy famously has been promoting for years. Trump claimed that the Pennsylvania Dutch’s simplistic and unvaccinated lifestyle could be used as a potential model to avoid the disorder.

Meanwhile, multiple vaccine projects have been stopped by Kennedy. He paused a multimillion-dollar project to create a new Covid-19 vaccine in pill form on Tuesday. This project was a $460 million contract with Vaxart to develop a new Covid vaccine in pill form, with 10,000 people scheduled to begin clinical trials on Monday. Of that, $240 million was reportedly already authorized for preliminary research.

Furthermore, the FDA’s Vaccines and Related Biological Products Advisory Committee, or VRBPAC, was scheduled to meet in March to discuss the strains that would be included in next season’s flu shot, but federal officials told the committee that the meeting was canceled, said committee member Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Offit told NBC News that no explanation was given for the cancellation of the yearly spring meeting, which comes in the middle of a flu season in which 86 children and 19,000 adults have died, according to the Centers for Disease Control and Prevention. In an email to NBC, Norman Baylor, a former director of the FDA’s Office of Vaccine Research and Review, said, “I’m quite shocked. As you know, the VRBPAC is critical for making the decision on strain selection for the next influenza vaccine season.”

Finally, an upcoming CDC vaccine advisory committee meeting was also postponed last week. The Advisory Committee on Immunization Practices, or ACIP, was scheduled to meet Feb. 26 through Feb. 28. The group of independent experts convenes three times a year on behalf of the CDC to weigh the pros and cons of newly approved or updated vaccines. The postponement will put Kennedy at odds with Sen. Bill Cassidy, R-La., who is a doctor and the chair of the Senate Committee on Health, Education, Labor and Pensions, which oversees HHS.  Kennedy had promised Cassidy to give the Senate prior notice before making changes to certain vaccine programs. “If confirmed, he [Kennedy] will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without change,” Cassidy said in a speech on the Senate floor supporting Kennedy’s HHS nomination earlier this month.

The dangerous mess the new US governement got itself into within days of alledgedly governing seems monsterous. It is hard to conclude that Kennedy is competent or has abandonned his longstanding anti-vax stance. He clearly does not persue a reasonable strategy to protect the US from outbreaks of infections, endemics or pandemics. On the contrary, he is playing fast and loose with the health of US citizens and. as a consequence, with the health of all of us.

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