politics
“Crusade Against Naturopathy” (Kreuzzug gegen Naturheilkunde) is the title of a recent article (in German – so, I translated for you) published in ‘MULTIPOLAR‘. It is a defence of – no, not naturopathy – quackery. The authors first defend the indefencible Heilpraktiker. Subsequently, they address what they call ‘The Homeopathy Controversy‘. This is particularly ridiculous because homeopathy is not a form of naturopathy. Yes, it uses some natural materials, but it also employs any synthetic substance that you can think of.
The section on homeopathy contains many more amusing surprises; therefore, I have translated it for you [and added a few numers in square brackets that refer to my brief comments below]:
According to a representative survey conducted by the Allensbach Institute for Public Opinion Research in 2023, 35 per cent of homeopathy users are fully convinced of its effectiveness, while 55 per cent rate it as partially effective. Only nine per cent of respondents described homeopathic medicines as completely ineffective. [1]
Nevertheless, Health Minister Karl Lauterbach announced at the beginning of 2024 that he wanted to abolish homeopathy as a health insurance benefit. Stefan Schmidt-Troschke, paediatrician and managing director of the ‘Gesundheit Aktiv Association’, then launched a petition for the preservation of homeopathic medicines as statutory benefits in statutory health insurance. The petition was signed by more than 200,000 people. In March 2024, the cancellation of homeopathy and anthroposophic medicines as additional statutory benefits was revoked. [2]
Shortly afterwards, in May 2024, the ‘German Medical Assembly’ passed a motion against homeopathy to bring about a total ban for doctors. Dr Marc Hanefeld, official supporter of the ‘Informationsnetzwerk Homöopathie’, was behind the motion. Doctors should be banned from practising homeopathy in future, as well as billing via statutory and private health insurance. [3]
The case of the Charité University Hospital in Berlin shows just how much influence opponents of homeopathy have: for years, the hospital’s website stated ‘that homeopathic medicine can cure or improve even the most serious conditions’. After fierce protests – including from the health journalism portal MedWatch – the statement was removed. [4]
My comments:
- Effectiveness is not something to be quantified by popular votes. Responsible healthcare professionals employ rigorous clinical trials for that purpose.
- Lauterbach caved in because of the pressure from the Green Party and insists that his plans are merely postponed.
- The ‘German Medical Assembly’ decided that the use of homoeopathy in diagnostics and therapy does not constitute rational medicine. German doctors continue to be free to practice homeopathy, if they so wish.
- The notion that ‘homeopathic medicine can cure or improve even the most serious conditions’ is so obviously and dangerously wrong that it had to be corrected. This has little to do with the influence of opponents but is due to the influence of the evidence.
I feel that, if proponents of homeopathy want to save their beloved quackery from the face of the earth, they could at least get their facts right and think of some agruments that are a little less ridiculous.
It is already 7 years ago that I listed several ‘official verdicts on homeopathy‘, i.e. conclusions drawn by independent, reputable bodies evaluationg the evidence for or against homeopathy:
“The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available”
Russian Academy of Sciences, Russia
“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”
National Health and Medical Research Council, Australia
“These products are not supported by scientific evidence.”
Health Canada, Canada
“Homeopathic remedies don’t meet the criteria of evidence based medicine.”
Hungarian Academy of Sciences, Hungary
“The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.”
Swedish Academy of Sciences, Sweden
“We recommend parents and caregivers not give homeopathic teething tablets and gels to children and seek advice from their health care professional for safe alternatives.”
Food and Drug Administration, USA
“There is little evidence to support homeopathy as an effective treatment for any specific condition”
National Centre for Complementary and Integrative Health, USA
“There is no good-quality evidence that homeopathy is effective as a treatment for any health condition”
National Health Service, UK
“Homeopathic remedies perform no better than placebos, and that the principles on which homeopathy is based are “scientifically implausible””
House of Commons Science and Technology Committee, UK
Since then, there have been many more statements from similar organisations (does someone know of a complete list? if so, please let me know). One such statement is from French veterinarians: Avis 2021- 3 sur l’Homéopathie vétérinaire. Aloow me to translate the crucial passages for you:
Opinion 2021- 3 on Veterinary Homeopathy. The Report of a Working Group on Veterinary Homeopathy, an Opinion on Veterinary Homeopathy adopted in the academic session on May 6, 2021. The report ecommends that :
no medical discipline or practice claiming to be a medical discipline should be exempt from the ethical duty of testing its claims;
in this respect, clinical studies on the individual, reconciling scientific rigor and practical constraints, be explored, and in particular the N of 1 trials described in human medicine;
veterinary medicine be defined as evidence-based medicine, and not as allopathic medicine;
it is reaffirmed that veterinary medicine must above all be holistic, and that consequently the label of holistic veterinary medicine cannot be monopolized by particular practices;
homeopathy in veterinary medicine, as in human medicine, is not currently recognized nor can it be claimed as an exclusive veterinary medical activity;
institutional communication provides ongoing information on the scientific approach, evidence-based medicine and complementary medicine, tailored respectively to veterinarians, the general public and, in particular, animal keepers;
veterinary surgeons who, in the absence of recognized scientific proof of the efficacy of homeopathy in particular, wish to pursue this activity, particularly as a complementary medicine, should be fully aware of their increased responsibilities due to the current lack of scientific confirmation of efficacy;
it is possible to use homeopathic preparations, insofar as the medical decision to use a complementary and non-alternative therapy systematically requires informed consent, and does not result in a loss of opportunity by delaying the diagnostic procedure and/or the establishment of a recognized effective treatment;
that, in order to provide the information needed to obtain informed consent, a prescription for a homeopathic preparation should be accompanied, on any suitable medium, by a statement to the effect that, in the current state of knowledge, veterinary homeopathy has a contextual effect;
that the term “homeopathic medicine” be eventually replaced by “homeopathic preparation” in national and European legislation, that labelling state that “the efficacy of the preparation has not been demonstrated in accordance with current standards”, and that homeopathic preparations cannot claim the properties of vaccines or replace them, without incurring criminal sanctions;
in veterinary medicine, no university diploma in homeopathy be awarded by schools and other public establishments, and that training in homeopathy only take place within the framework of training that takes into account the realities of the scientific approach;
as part of their initial training, veterinary schools are places for debate and training in critical thinking, by offering interdisciplinary seminars on non-conventional approaches;
_____________________________
So, the next time someone claims “homeopathy has been proven to work in animals”, let’s show them what the experts think of this notion.
I recently published an article in the German newspaper ‘DIE WELT‘ about the Bavarian Homeopathy trial. My comments did not go down well with the German Association of Homeopathic Doctors (DZVhÄ). Here is their ‘OPEN LETTER’ (my translation) in response to my article (the numbers [in bold brackets refer to my comments below):
Berlin, 11 December 2024: Open letter to Ulf Poschardt, editor-in-chief of the daily newspaper Die Welt, asking whether Prof. Edzard Ernst is really still acceptable as a WELT author. This letter refers to E. Ernst’s article ‘Why a globule study was discontinued’ (DIE WELT, Tuesday, 3 December 2024).
Edzard Ernst is a member of the GWUP (Gesellschaft zur Wissenschaftlichen Untersuchung von Parawissenschaften). (1) This organisation within the so-called sceptic movement has set itself the task of pointing out in the health sector that belief in alternative medicine (‘pseudoscience’) prevents more effective therapies from being used. (2) From this point of view alone, Ernst’s polemic against the iHOM study by the Technical University of Munich[1] misses the mark by a mile, as the study design explicitly does not envisage treating patients with recurrent cystitis ‘either with individually selected homeopathic remedies or a placebo’. On the contrary, it provides for all patients to be treated strictly in accordance with the rules of evidence-based medicine if necessary and if the findings are clear, but also to investigate whether concomitant homeopathic treatment could lead to a reduction in the frequency of antibiotic use. It must be assumed that Ernst has read the study design, but either he is deliberately omitting the true aim of the study or he is simply unable to recognise the difference between a study and his personal fight against homeopathy (3). In both cases, he cannot be taken seriously (!) as an expert on scientific issues in the field of medicine, and certainly not in a serious print medium such as WELT.
Health services research shows: Homeopathy can save antibiotics
The members of the Bavarian state parliament, some of whom were cross-party supporters of this study, were clearly aware of the results of healthcare research, according to which homeopathy can help to reduce the use of antibiotics in defined clinical pictures. In France, for example, a large survey (EPI3-MSD cohort study[2]) came to the conclusion that GPs who use homeopathy for respiratory diseases only use around half as many antibiotics as their conventionally working colleagues. (4) To date, however, there have been no studies that have investigated this at the highest scientific level (randomised, double-blind, placebo-controlled). Against the background of increasing antibiotic resistance worldwide, it was therefore neither ‘ignorance on the part of the Bavarian state government’ nor a foreseeable ‘waste of money’ to investigate this option.(5) If you add to this the fact that panel doctors with an additional qualification in ‘homeopathy’ can even get confirmation in black and white from their panel doctors’ association that their antibiotic consumption is below the average for their respective specialist group, then it would be “unethical” – in complete contrast to Ernst’s assessment – not to have attempted this study. (6)
The article shows the ideological ‘blinding’ of Edzard Ernst
It is clear that Mr (7) Ernst’s ideological ‘blinding’ as an exponent of the sceptic movement (8) leads him, consciously or unconsciously, to draw conclusions that are contrary to open-ended science (9). Reducing the use of antibiotics in the fight against the increasing development of resistance is simply a medical necessity, and those who do not or do not want to face up to this task are manoeuvring themselves into scientific obscurity with flimsy interpretations. (10) The fact that there are individual cases (Italy, child, middle ear infection, globules, dead) in which a method was not applied with sufficient care or expertise does not change this. It should be added at this point that there are always examples in the field of conventional medicine where misdiagnoses can lead to complications or even death. In addition, the RKI (Robert Koch Institute) estimates 9,700 deaths[3] due to antimicrobial resistance, and the trend is rising! Against this dramatic backdrop, Mr Ernst’s polemic should actually be out of the question. (11)
One must come to the same conclusion if one scrutinises the meaning of the reference to a ‘series of experiments in the Third Reich’ and a ‘Homeopathy World Congress’ under Nazi rule. The attempt to discredit homeopathy by pointing out the involvement of homeopathically orientated doctors in the Third Reich is well known. (12) Of course, this usually ignores the fact that the doctors convicted of crimes against humanity at the Nuremberg medical trial were exclusively representatives of the scientific medicine of the time. (13)
However, Ernst’s references to the ‘Third Reich’ conceal something else: the ‘Society of Truth-Loving Men’, which studied the effectiveness of homeopathy in 1835, was a Masonic lodge, and although it was a ‘double-blind trial’, it was of course not ‘the first randomised, placebo-controlled double-blind trial in the history of medicine’, as it is accepted and applied today as a scientific experiment with strict ethical and legal regulations. The first such study worthy of its name was not conducted until 1947 (treatment of tuberculosis with streptomycin). (14)
And of course there was the so-called ‘Donner Report’ (after Dr Fritz Donner), which Ernst indirectly refers to and which summarises the results of drug trials in the ‘Third Reich’. The result was indeed not convincing in favour of homeopathy (15), but this report had a not inconsiderable ‘flaw’: it is extremely problematic in terms of source criticism because it was not written until around two decades after the end of the Second World War, and the original documents Donner referred to have not reappeared and must therefore be considered lost. (16)
If, like Mr Ernst, one sets out in search of arguments against homeopathy and goes back more than half a century (17), then it would also be fair and obvious to mention that the homeopathic medical profession commissioned the Institute for the History of Medicine of the Robert Bosch Foundation years ago to scientifically investigate the role of homeopathic doctors during National Socialism (Mildenberger 2016[4]). The result: to quote Mr Ernst from a different context, there is no more ‘dirt on their sleeves’ than with other professional and socially relevant groups. (18)
Edzard Ernst ignores the current state of homeopathic research
‘Sugar pellets are the basis of many homeopathic treatments. However, all previous research (19) has shown that their effect does not exist.’ This statement by Edzard Ernst is simply wrong! The current state of research is described by the University of Bern as follows: ‘Summarising the current state of preclinical and clinical research, it can be concluded that homeopathic preparations show specific effects that differ from placebo when they are used appropriately…’[5]. (20)
But Ernst could have come up with the idea of comparing the quality of old studies with the current meta-analyses up to a systematic review of six such meta-analyses (Hamre and Kiene, 2023[6]). But he didn’t! If he had, he would have had to admit that the quality and rigour of the latest scientific homeopathy research need not shy away from comparison with studies in conventional medicine. (21)
Based on positive study results, additional homeopathic treatment was included as a treatment option in the medical S3 guideline ‘Complementary medicine in the treatment of oncological patients’[7] in 2021. Ernst also deliberately ignores this treatment recommendation from scientific medical societies. (22)
Edzard Ernst is part of a sceptic association and not the international research community
As an activist of the GWUP (23), Ernst is known for the fact that he has not been scientifically active for a long time (24), but regularly tries to discredit those scientists who conduct research into complementary medical procedures. (25) This uncollegial behaviour has meant that Ernst has not been invited to speak at international scientific research congresses on integrative and complementary medicine for a long time. (26) Agitation, however, is no substitute for a fact-based exchange, but prevents dialogue, in this specific case about the meaning of the Bavarian state government’s commitment. Furthermore, polemics do not contribute in the slightest to coming even a small step closer to a solution to the obvious problem of increasing antibiotic resistance (27). As a reputable print medium, WELT is therefore advised to distance itself from Mr Ernst and his comments or to dismiss him.
[1] https://www.ihom.nephrologie.med/de#iHOM-Studie
[2] https://www.dzvhae.de/homoeopathische-arzneimittel-antibiotika-notstand/epi3laser_study_de-18/
[3] https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2022/06_2022.html
[4] https://www.wallstein-verlag.de/9783835318793-der-deutsche-zentralverein-homoeopathischer-aerzte-im-nationalsozialismus.html
[5] https://www.ikim.unibe.ch/forschung/uebersichten_zum_stand_der_forschung/homoeopathie/index_ger.html
[6] https://pubmed.ncbi.nlm.nih.gov/37805577/
[7] https://register.awmf.org/de/leitlinien/detail/032-055OL
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- If you want to demonstrate how well informed you are, it is always a good idea to start with a falsehood: I left the GWUP about a year ago, a move that created considerable huhah in Germany.
- Wrong again: “The GWUP has set itself the task of promoting science and scientific thinking.”
- My description of the study did not mention that homeopathy was to be used as an add-on. I thought this was obvious (not least because otherwise the study would have not been ethical) but I gladly admit it was my mistake to not spell this out for those who are slow on the uptake.
- These studies merely show that homeopaths tend to prescribe less antiiotics, and the quoted French study was so convincing that the French government promptly ceased the reimbursement of homeopathy.
- I would still argue that my comment is entirely correct here.
- The notion that it might be unethical not to study homeopathy in expensive clinical trials flies in the face of medical ethics.
- Have I been demoted?
- I probably should be flattered to be called an ‘exponend for the skeptic movement’; however, this is far from what I am. I am simply a scientist trying his best to inform the public responsibly.
- In my WELT article, I point out that virtually every respectable panel worldwide looking at the evidence has concluded that homeopathy is a dangerous nonsense. Does that not suggest that my conclusions might be more accurate than those of homeopaths?
- I am all for rigorous research into the over-prescribing of antibiotics, antibiotic resistance, etc. – so much so that I would have used the Euro 800 000 not for the nonsensical homeopathy study but for that purpose.
- Do I detect a bit of the ‘Tu quoque’ fallacy here?
- I mentioned the project not primarily because I wanted to discredit homeopathy, but mostly because it was the largest research project ever conducted in homeopathy. Omitting it in a review of the history would have been wrong.
- The Nuremberg Doctors Tribunal tried barely more than a handfull of physicians, while, in total, hundreds had committed crimes agaimst humanity.
- The 1835 study was a placebo-controlled, randomised study; the streptomycin trial was the first to be generally aknowledged.
- From all we know, the results were devastatingly negative, not just “not convincingly in favour”.
- The original files of the project disappeared in the hands of homeopaths after WWII.
- No, I did a review of the history, for which puropose it is inevitable to go back in time.
- Do I detect more ‘Tu quoque’ fallacy here?
- Mea culpa: I should have written: “all previous credible research”.
- Yes, we recently discussed the current state of research on my blog.
- And we also discussed this review; in neither instance were we impressed!
- The guidelines had to rely on the Frass study which has since been disclosed as fraudulent.
- When you issue a falsehood, it is best to repeat it; only then you can make sure to discredit yourself completely.
- And when you tell one lie, you might as well tell a few more (a simple Medline search would have told them that I am ‘research-active’ to the present day!)
- I have often noticed that homeopaths find it tough to accept or even deal with criticism; they thus often prefer to interpret it as a personal attack and discreditation.
- Yes, why not? It’s fun to add yet another falsehood to the hilarious mix of lies and ad hominem attacks!
- A comment in a newspaper cannot possibly find “a solution to the obvious problem of increasing antibiotic resistance”. This has to be found with rigorous research – something homeopaths would not recognise if it bit them in their behinds.
I am, of course, not surprised that the German homeopath did not like my article. Yet, I am truly amazed by their emarrassingly poor (but highly amusing) arguments against me and my comments. I had hoestly thought they had more sense.
Homeopathy is ‘First-Line-Medicine’ – at least this is what a German pro-homeopathy website recently proclaimed. The notion, it informs us, is based on EU law.
But is that true?
Does the ‘Regulation (EU) 2018/848 of the European Parliament and of the Council on organic production (…)’ really recommend homeopathy for treating animals?
This is what the EU law states (my translation from a German original):
‘Diseases shall be treated immediately to avoid animal suffering; chemically-synthesised allopathic veterinary medicinal products, including antibiotics, may be administered, if necessary, under strict conditions and under the responsibility of a veterinarian, when treatment with phytotherapeutic, homeopathic and other remedies is inappropriate … phytotherapeutic and homeopathic preparations are preferable to chemically synthesised allopathic veterinary medicinal products, including antibiotics, provided that their therapeutic effect is guaranteed for the species concerned and the disease to be treated’.
Let’s analyse the text and find out what it really means. It states that:
- Vets should treat suffering animal without delay.
- They should use conventional therapies when homeopathy is inappropriate.
- Homeopathics are preferable, if their therapeutic effect is guaranteed for the species concerned and the disease to be treated.
So, homeopathy is recommended under two important and well-defined conditions:
- They have to be appropriate.
- They have to be proven to be effective.
It is amply clear that homeopathy has not been proven to be effective in any condition that afflicts animals. As this is so, homeopathics are evidently inappropriate.
But why, does the EU make it so complicated?
I don’t know the answer to this question but suspect that there was plenty of lobbying going on, and they had to find a phraseology that apeases the homeopaths and their industry.
It has been reported that Kash Patel, Donald Trump’s pick to lead the FBI. Patel seems to be a scary man. During 2023 appearance on Steve Bannon‘s “War Room” podcast, Patel agreed that Trump is “dead serious” about his intent to seek revenge against his political enemies should he be elected in 2024. Patel stated:
“We will go out and find the conspirators — not just in government, but in the media … we’re going to come after the people in the media who lied about American citizens, who helped Joe Biden rig presidential elections … We’re going to come after you. Whether it’s criminally or civilly, we’ll figure that out. But yeah, we’re putting you all on notice, and Steve, this is why they hate us. This is why we’re tyrannical. This is why we’re dictators … Because we’re actually going to use the Constitution to prosecute them for crimes they said we have always been guilty of but never have.”
Meanwhile, Patel has been flogging a range of very odd products aimed at the MAGA crowd, making hundreds of thousands of dollars from Trump-aligned businesses. In particular, Patel promoted pills that claim to reverse the effects of the Covid-19 vaccine. Marketed under the trademark “Nocovidium,” the pills from a company called ‘Warrior Essentials’ contain a range of ‘natural ingredients none of which has been shown to do anything significant in relation to Covid-19 or vaccines:
“Spike the Vax, order this homerun kit to rid your body of the harms of the vax,” Patel said in a Truth Social post promoting the SCAM remedy. Another advert stated: “You were immune to the propaganda, but are you immune to the shedders.”
The website explains:
“The ingredients are listed above, but they break down into a few distinct categories. Polyamines are the driving force that helps to push the body into autophagy. These are found in many foods and are also in all living organisms. Our formula is designed to give a boost of externally supplied polyamines, while also working to turn your body into a polyamine producing gigafactory. This is done by providing the body the precursors, activators, and synthesizers to ramp up production. The third goal is to inhibit pathogens, including the spike protein, from interfering with the process. It’s a 1-2-3 patent-pending punch. Every ingredient was specifically chosen and balanced for its ability to promote autophagy, polyamine production, the inhibition of factors that can stop the process, or a combination of all three.”
The website even explains how the supplement works: “With regards to the spike protein, the body identifies this as a foreign object, and the autophagy process is designed to help protect your body by completely eliminating items like the spike. Many indicators show that the spike’s ability to block this process may be why the spikes are lasting far longer in the body than anybody ever expected. Our formula was developed to counter these measures allowing the process to complete and the objects, including the spike, identified by the body for removal, to be eliminated.”
Is there any evidence?
One should not ask such probing questions!
Why not?
The answer is as simple as it is scary: “We’re going to come after you!”
Being a dedicated crook and a liar himself, Donald Trump has long had an inclination to surround himself with crooks and liars. As discussed repeatedly, this preferance naturally extends into the realm of healthcare, Some time ago, he sought the advice of Andrew Wakefield, the man who published the fraudulent research that started the myth about a causal link between MMR-vaccinations and autism.
Early November this year, Trump stated that, if he wins the election, he’ll “make a decision” about whether to outlaw some vaccines based on the recommendation of Robert F. Kennedy Jr., a notorious vaccine critic without any medical training. The president doesn’t have authority to ban vaccines but he can influence public health with appointments to federal agencies that can change recommendations or potentially revoke approvals.
Now that he did win the election, Trump suggested that Robert F. Kennedy Jr., his pick to run Health and Human Services, will investigate supposed links between autism and childhood vaccines, a discredited connection that has eroded trust in the lifesaving inoculations.
“I think somebody has to find out,” Trump said in an exclusive interview with “Meet the Press” moderator Kristen Welker. Welker noted in a back-and-forth that studies have shown childhood vaccines prevent about 4 million deaths worldwide every year, have found no connection between vaccines and autism, and that rises in autism diagnoses are attributable to increased screening and awareness.
Trump, too stupid to know the difference between correlation and causation, replied: “If you go back 25 years ago, you had very little autism. Now you have it.” “Something is going on,” Trump added. “I don’t know if it’s vaccines. Maybe it’s chlorine in the water, right? You know, people are looking at a lot of different things.” It was unclear whether Trump was referring to opposition by Kennedy and others to fluoride being added to drinking water.
Kennedy, the onetime independent presidential candidate who backed Trump after leaving the race, generated a large following through his widespread skepticism of the American health care and food system. A major component of that has been his false claims linking autism to childhood vaccinations. Kennedy is the founder of a prominent anti-vaccine activist group, Children’s Health Defense. The agency Trump has tasked him with running supports and funds research into autism, as well as possible new vaccines.
The debunked link between autism and childhood vaccines, particularly the inoculation against mumps, measles and rubella, was first claimed in 1998 by Andrew Wakefield who was later banned from practicing medicine in the UK. His research was found to be fraudulent and was subsequently retracted. Hundreds of studies have found childhood vaccines to be safe.
Autism diagnoses have risen from about 1 in 150 children in 2000 to 1 in 36 today. This rise has been shown to be due to increased screening and changing definitions of the condition. Strong genetic links exist to autism, and many risk factors occurring before birth or during delivery have been identified.
If Trump does, in fact, ‘outlaw’ certain vaccinations, he would endanger the health of the US as well as the rest of the world. Will he really be that stupid?
If you live in the UK, you could not possibly escape the discussion about the ‘Assisted Dying Bill’ which passed yesterday’s vote in the House of Commons (MPs have voted by 330 to 275 in favour of legalising voluntary assisted suicide). Once the bill passed all the further parliamentary hurdles – which might take several years – it will allow terminally ill adults who are
- expected to die within six months,
- of sound mind and capable of managing their own affairs
to seek help from specialised doctors to end their own life.
After listening to many debates about the bill, I still I have serious concerns about it. Here are just a few:
- Palliative care in the UK is often very poor. It was argued that the bill will be an incentive to improve it. But what, if this is wishful thinking? What if palliative care deteriorates to a point where it becomes an incentive to suicide? What if the bill should even turn out to be a reason for not directing maximum efforts towards improving palliative care?
- How sure can we be that an individual patient is going to die within the next six months? Lawmakers might believe that predicting the time someone has left to live is a more or less exact science. Doctors (should) know that it is not.
- How certain can we be that a patient is of sound mind and capable of managing their own affairs? By definition, we are dealing with very ill patients whose mind might be clouded, for example, by the effects of drugs or pain or both. Lawmakers might think that it is clear-cut to establish whether an individual patient is compos mentis, but doctors know that this is often not the case.
- In many religions, suicide is a sin. I am not a religious person, but many of the MPs who voted for the bill are or pretend to be. Passing a law that enables members of the public to commit what in the eyes of many lawmakers must be a deadly sin seems problematic.
In summary, I feel the ‘Assisted Dying Bill’ is a mistake for today; it might even be a very grave mistake for a future time, if we have a government that is irresponsible, neglects palliative care even more than we do today and views the bill as an opportunity to reduce our expenditure on pensions.
The alleged harm of Covid-vaccinations is a topic that still leads to misunderstandings, perhaps nowhere more than in the realm of so-called alternative medicine. Therefore, this paper seems relevant.
The first dose of COVID-19 vaccines led to an overall reduction in cardiovascular events, and in rare cases, cardiovascular complications. There is less information about the effect of second and booster doses on cardiovascular diseases. Using longitudinal health records from 45.7 million adults in England between December 2020 and January 2022, this study compared the incidence of thrombotic and cardiovascular complications up to 26 weeks after first, second and booster doses of brands and combinations of COVID-19 vaccines used during the UK vaccination program with the incidence before or without the corresponding vaccination.
The incidence of common arterial thrombotic events (mainly acute myocardial infarction and ischaemic stroke) was generally lower after each vaccine dose, brand and combination. Similarly, the incidence of common venous thrombotic events, (mainly pulmonary embolism and lower limb deep venous thrombosis) was lower after vaccination. There was a higher incidence of previously reported rare harms after vaccination: vaccine-induced thrombotic thrombocytopenia after first ChAdOx1 vaccination, and myocarditis and pericarditis after first, second and transiently after booster mRNA vaccination (BNT-162b2 and mRNA-1273).
The authors concluded that these findings support the wide uptake of future COVID-19 vaccination programs.
The authors stress that their study has several limitations.
- First, residual confounding, including that linked to delayed vaccination in high-risk individuals, may persist despite extensive adjustments for available covariates. We were able to identify some, but not all people who were clinically vulnerable (and hence might have been eligible for earlier vaccination): for example, younger adults in long-stay settings could not be reliably identified.
- Second, we did not adjust for potential confounding by time-varying post-baseline factors that may have influenced receipt of vaccination and the outcomes of interest: for example, development of respiratory symptoms or being admitted into hospital leading to postponement of vaccination. Such confounding may explain estimated lower hazard ratios soon after vaccination.
- Third, ascertainment of some outcomes may have been influenced by public announcements from regulatory agencies, such as the European Medicines Agency Pharmacovigilance Risk Assessment Committee announcement or the CDC announcement on myocarditis. This was addressed in sensitivity analyses for myocarditis and pericarditis, censoring follow-up at the time of public announcements of these adverse effects of vaccination, although the shorter follow-up times and corresponding smaller numbers of events in the restricted analyses meant that aHRs were estimated with reduced precision.
- Fourth, outcomes may be underreported, particularly from people in nursing homes or among those with severe health conditions, due to diagnostic challenges; also, routine electronic health records, not intended for research, may under-ascertain less severe, non-hospitalised events. Both forms of potential underreporting, however, are expected to be uncommon for hospitalised thrombotic events.
- Fifth, we restricted follow-up to 26 weeks after vaccination to prevent an influence of subsequent vaccinations on estimated associations and limit the impact of delayed vaccination on our findings. Horne et al. demonstrated selection bias in estimated HRs for non-COVID-19 death arising from deferred next-dose vaccination in people with a recent confirmed COVID-19 diagnosis or in poor health.
- Sixth, we did not address long-term safety of vaccination, or the impact of subsequent booster doses.
Nonetheless, this study offers reassurance regarding the cardiovascular safety of COVID-19 vaccines, with lower incidence of common cardiovascular events outweighing the higher incidence of their known rare cardiovascular complications. No novel cardiovascular complications or new associations with subsequent doses were found. These findings support the wide uptake of future COVID-19 vaccination programs. The authors express their hope that this evidence addresses public concerns, supporting continued trust and participation in vaccination programs and adherence to public health guidelines.
Will the evidence convince the notorious anti-vaxers that regularly comment on my blog?
I very much doubt it – not because of the limitations of the study but because of the fact that anti-vaxers seem to be immune to any evidence that is out of line with their beliefs and conspiracy theories.
“As a medical doctor having taken care of thousands of patients in my life, I strive to ensure the health safety and superior wellbeing of my patients. I continue to encourage, educate and inform not only my patients, but the public to stay strong and healthy any time, not just during a pandemic. Our body is our temple and what we put in it and what we don’t affects the way we feel, think and function. Essential vitamins and minerals are key component to daily functioning but thats not always possible in this day and age with our busy hectic lifestyles, so after years of educating my patients, now I made it a little easier to get all the nutrition you need to live strong and stay healthy.”
These are the words from an advertisement for “Immune System Support for your Active Life” sold by Dr. Janette Nesheiwat who was just nominated as Donald Trump’s next SURGEON GENERAL. Amongst other items, she sells 60 capsules of ‘B+C BOOST Plus D3 & Zinc‘ for US$26.99.
Her website describes the new US Surgeon General as follows:
Dr. Janette Nesheiwat is a top Family and Emergency Medicine doctor. She brings a refreshingly no-nonsense attitude to the latest medical news, breaking down everything you need to know to keep you- and your family- healthy at all times.
Whether caring for her patients in the ER, serving on the front lines of disaster relief with the Red Cross, or sharing need-to-know info with TV audiences, Dr. Nesheiwat’s mission is not only to save lives—but to change them, by giving real people the treatment and the expertise they need.
Her sincere and straightforward approach is a product of her background. She was one of five kids raised by a widowed mother, and also completed US Army ROTC Advanced Officer Training in Ft. Lewis, Washington prior to becoming a Family and Emergency Physician. She has led medical relief missions around the globe and today she is a medical news correspondent and the Medical Director at CityMD.
I was always telling my patients who were unwell drink some tea, take some vitamin b12 and vitamin C. I found myself repeating my all natural regimen to my patients over and over “take some B12 and C to Boost” your immune system. Thats how I came up with BC Boost. Although I am a doctor, I am not quick to prescribe drugs unless I feel necessary as we want to put into our body the most natural wholesome ingredients.
Vitamin B12 is a cofactor in DNA synthesis. It helps maintain healthy blood cells and nerve function as well as prevent anemia which causes fatigue, a common complaint in those who are sick, tired, run down. Vitamin C is needed for development of collagen and a strong immune system as well as body repair and growth.
Yes, you are quite right, Dr. Nesheiwat might have forgotten one or two not-so-unimportant details:
- If you eat a healthy diet, you don’t need vitamins.
- If you do need vitamins, you can buy them cheaper elsewhere.
- These vitamins do not boost your immune system.
- Boosting the immune system could actually do a lot of harm to the many people suffering from auto-immune diseases.
But never mind, we can nevertheless be confident that Dr. Nesheiwat will bring great joy to the US supplement industry. I am less confident, however, that she did public health a great service when, in her role as a regular ‘Fox News’ commentator, she warned that wearing face masks during the pandemic exposed consumers to toxic substances linked to seizures and cancer.
The Bavarian homeopathy study has been aborted!
As I posted in 2019, the Bavarian government has given the go-ahead to a major study of homeopathy.
The study was aimed at clarifying whether the use of homeopathic remedies can reduce the use of antibiotics in humans and animals. The vote was carried because of the CDU delegates being in favour. The debate of the project was, however, controversial. Critics stressed that, at best, the study is superfluous and pointed out that the project is negligent because it implies that homeopathics might be effective, whereas the evidence shows the opposite. A SPD delegate stated that he is ‘open moth’, homeopathy works because of the doctor-patient contact and not because of its remedies which are pure placebos. The project was tabled because some people had worried about antibiotic resistance and felt that homeopathy might be an answer. Some CSU delegates stated that in ENT medicine, there is evidence that homeopathics can reduce the use of antibiotics. Even in cases of severe sepsis, there was good evidence, they claimed.
The FRANKFURTER ALLGEMEINE just reported more details about this remarkable project and its failure to produce meaningful results:
The double-blind, placebo-controlled RCT carried out at the Technical University of Munich examined women with regular urinary tract infections – all were to be given antibiotics or ibuprofen if necessary. Around 120 of the women were to receive either placebo or individually selected globules as a preventative measure. Differences were to be measured by whether infections occurred less frequently in the globule group and whether antibiotics were necessary.
The results should have been available a long time ago. However, as the lead-investigator of the study, nephrologist Lutz Renders, has now revealed that the study has apparently come to nothing. ‘The study has cancelled recruitment because the required number of test subjects could not have been reached within a reasonable period of time,’ he explains. Only the women who have already been included will now be followed up until the beginning of 2025.
‘Of the 200 or so women who registered, around 40 were found to have urinary tract infections’, says Renders, ‘so that they could be included in the study. It is a pity that the actual aim of the study was not achieved, as it is possible that something could be learnt about urinary tract infections in general from the extensive examinations of the women. I don’t have much to do with homeopathy,’ says Renders.
Georg Schmidt, head of the ethics committee at the Technical University of Munich, says that the committee found it ‘extremely difficult’ to authorise the study at all. ‘We had a heated discussion along the lines that you can’t compare nothing with nothing. We all agreed that homeopathy is ineffective.’ The commission decided to ensure that the risk of a false-positive result is as low as possible – the statistics have been tightened up for this purpose’.
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The notion that a definitive test of homeopathy is needed seems to beset German govenments from time to time – the last such initiative occurred during the Third Reich. Perhaps, one day, even politicians will understand that, on the scientific level, the discussion about homeopathy is now well and truly over, and that no more money needs to be wasted on it?
