The ‘Dunning Kruger Effect‘ (DuKE) has been discussed here before. The DuKE means that, the less you know, the less able you are to recognize how little you know, and the less likely you are to recognize your limitations. Consequently, your confidence in yourself is inflated and you believe you are more competent than your opponent. Expressed differently:
- Incompetence prevents the recognition of incompetence.
- Too stupid to doubt.
A recent paper brilliantly shows the DuKE in action; here is its abstract
There is widespread agreement among scientists that genetically modified foods are safe to consume and have the potential to provide substantial benefits to humankind. However, many people still harbour concerns about them or oppose their use. In a nationally representative sample of US adults, we find that as extremity of opposition to and concern about genetically modified foods increases, objective knowledge about science and genetics decreases, but perceived understanding of genetically modified foods increases. Extreme opponents know the least, but think they know the most. Moreover, the relationship between self-assessed and objective knowledge shifts from positive to negative at high levels of opposition. Similar results were obtained in a parallel study with representative samples from the United States, France and Germany, and in a study testing attitudes about a medical application of genetic engineering technology (gene therapy). This pattern did not emerge, however, for attitudes and beliefs about climate change.
As I have stated before, I suspect the DuKE can explain much of what is going on in the realm of SCAM (so-called alternative medicine). So much so that I am tempted to re-write part of the above abstract as follows:
As extremity of belief in SCAM increases, objective knowledge about science and medicine decreases. In parallel, perceived understanding of science and medicine increases. Extreme believers in SCAM know the least, but think they know the most. Moreover, the relationship between self-assessed and objective knowledge shifts from positive to negative at high levels of SCAM-belief.
Yes, yes, I know. You are absolutely correct: this is little more than speculation! And I also realise, of course, that not everyone can have a full understanding of SCAM, medicine and science; however, if someone has a strong interest in (plus a strong opinion of) these matters, it would be advisable to read up about at least the most basic facts.
In case you disapprove, please do have a look at some of the recent comments on this blog or assess what some of the most famous proponents of SCAM tell the public, and I am confident that you will begin to suspect that my speculation might be not that far off the mark.
Today is Charles’ 70th birthday! On previous occasions, I have published a detailed review of Charles’ outstanding achievements in the realm of alternative medicine. For his 70th, I feel that something else is required. How about a personal birthday card?
HAPPY BIRTHDAY YOUR ROYAL HIGHNESS!
I know, it is not easy to become 70, but you must look on the bright side: you are reasonably healthy, you are not exactly a poor man, and you even managed to change the rules and marry the woman you have always loved. What else could you wish for?
Yes, I know, your big idea of ‘Integrated Medicine’ is not doing all that brilliantly. Your book ‘Harmony‘ was viciously ridiculed, and the ‘best of both worlds’ turns out to be a bit of a strange idea. The thing is that, in healthcare, there is only one real world: the world of reality, facts and evidence. The other is the unreal world of fantasy, wishful thinking and mysticism.
We all know you love homeopathy. After listening to Laurence van der Post in your younger days, it would have been lovely for you, had the notion of a remedy based on a mystical vital force been true. It would have avoided all the complexities of reality. But now, at the age of 70, you must have realised that make belief is a poor substitute for fact.
It has become all but impossible to ignore the truth about homeopathy. Only last year, the European Academies Science Advisory Council concluded that “the claims for homeopathy are implausible and inconsistent with established scientific concepts” and that “there are no known diseases for which there is robust, reproducible evidence that homeopathy is effective beyond the placebo effect”. Such brutal realism must be painful. And now the NHS decided to ditch homeopathy completely. All your homeopathic spider memos for nothing!
Yes, it is tough to grow old. But perhaps it is not too late. You could try to forget about van der Post and all your other ill-advised ‘advisers’. Instead, you could gather a few young, energetic, bright scientists and let them inspire you with the beauty and excitement of reality and science. You could still become a force for real progress in healthcare.
Think about it and keep looking on the bright side.
Many happy returns
For years, Margaret McCartney, a GP from Scotland, wrote a weekly column in the BMJ. It was invariably well-worth reading. Recently, she regrettably ended it by publishing her last article entitled A summary of four and a half years of columns in one column. In it, she makes 36 short points. They are all poignant, but the one that made me think most (probably because it is relevant to my work and this blog) reads as follows:
Many people seek to make money from those who don’t understand science. Doctors should call out bollocksology when they see it.
On this blog, I have often discussed people who make money from consumers and patients who are unable to detect the quackery they are being sold. No doubt, the most famous case of me doing this was when, in 2009, I criticised Prince Charles and his ‘Dodgy Originals Detox Tincture’. It made many headlines; the BBC, for instance, reported:
Edzard Ernst, the UK’s first professor of complementary medicine, said the Duchy Originals detox tincture was based on “outright quackery”.
There was no scientific evidence to show that detox products work, he said.
Duchy Originals says the product is a “natural aid to digestion and supports the body’s elimination processes”.
But Professor Ernst of Peninsula Medical School said Prince Charles and his advisers appeared to be deliberately ignoring science, preferring “to rely on ‘make-believe’ and superstition”.
He added: “Prince Charles thus financially exploits a gullible public in a time of financial hardship.”
Marketed as Duchy Herbals’ Detox Tincture, the artichoke and dandelion mix is described as “a food supplement to help eliminate toxins and aid digestion”.
At the time, I got a right blocking from my dean, Prof John Tooke, for my audacity. As far as I could see, there was almost no support from the UK medical profession. Since then, the exploitation of the public by quacks has not diminished; on the contrary, I have the feeling that it is thriving. And are doctors calling out bollocksology left right and centre? No, they are not!
Of course, some do occasionally raise their voices (and some do it even regularly). But mostly, it is the group of non-medical sceptics who open their mouths and try their best to prevent harm. Yet, I wholly agree with my friend Margret: doctors have a responsibility and must do more.
And why don’t they?
I think, there are several reasons for their inactivity:
- doctors are frightfully busy,
- doctors often don’t know how much bollocksology is out there,
- doctors don’t (want to) see how dangerous much of this bollocksology is,
- doctors fail to realise that it would be their ethical responsibility to speak out against bollocksology,
- some doctors do not seem to understand science either,
- some doctors are active bollocksologists themselves,
- some doctors simply don’t care.
This clearly is a depressing state of affairs! But, at the same time, it also is a cheerful occasion for me to thank all those doctors who are the laudable exceptions, who do care, who do think critically, who see their ethical responsibility, and who do something about the never-ending flood of bollocksology endangering their patients’ health and wealth.
When NHS England announced several months ago that they plan to stop the reimbursement of homeopathy, UK homeopaths were understandably upset and decided to launch a legal challenge to this decision. Yesterday, the result of this challenge has been published in a NHS press-release:
START OF QUOTE
NHS chief Simon Stevens has today welcomed the High Court’s decisive rejection of a legal challenge by the British Homeopathic Association to overturn plans to no longer routinely fund homeopathy on the NHS.
As part of action to clamp down on waste, over the last two years NHS England has taken action to curb prescriptions for medicines that can be bought over the counter or are of low value.
At the end of last year NHS England published guidance to curb prescriptions for 18 ineffective, unsafe or low clinical priority treatments, such as coproxamol, some dietary supplements, herbal treatments and homeopathy, saving up to £141 million a year. Earlier this year NHS England published a further list of 35 minor, short-term conditions for which over the counter medicines should not routinely be prescribed, saving around a further £100 million a year.
Savings form a key building block of the NHS’s 10 point efficiency plan contained in the Next Steps on the NHS Five Year Forward View, published in March 2017.
NHS chief, Simon Stevens said: “There is no robust evidence to support homeopathy which is at best a placebo and a misuse of scarce NHS funds.
“So we strongly welcome the High Court’s clear cut decision to kick out this costly and spurious legal challenge.”
Guidance on items which should not be routinely prescribed in primary care is available on the NHS England website.
END OF QUOTE
The reaction of UK homeopaths was as swift and deluded as it was predictable. The British Homeopathy Association, for instance, commented thus:
… The charity’s main claims against NHS England were that the consultation misrepresented homeopathy and therefore was unfair; and a report used in the consultation to inform the public was so complicated it would deter rather than encourage people to respond. Although the judge found there were sufficient grounds for a judicial review, after four days of lengthy legal arguments he dismissed the claims. Margaret Wyllie, BHA Chair, said the case highlighted how health bosses were unfairly manipulating the consultation process and making decisions about healthcare services without genuine patient engagement. “That NHS England attracted fewer than 3,000 responses from patients to a national consultation that ran for three months highlights its failure to genuinely engage with the public on important decisions about healthcare provision. Although 18 medicines were under review the only negative statement in NHS England’s press release promoting its public consultation was about homeopathy. The statement was so prejudicial it was widely reported in the media that the decision to deny patients homeopathic medicines had already been taken. How the judge failed to recognise that this was a deliberate attempt by NHS England to unfairly influence the public is astonishing,” said Mrs Wyllie.
In The Telegraph, Wyllie is quoted saying: “It appears NHS England can fail to engage with patients properly on removing services and get away with it. That is not good enough, for it is important to remember that the real losers in this case are the patients who are now being refused a treatment on which they have come to depend.”
One can only marvel at the lack of insight and self-criticism. I should to add that the BHA is a charity; with this court case, they have wasted significant amounts of public money for their own, hopelessly misguided interests. To me, this indicates that they no longer deserve a charitable status.
Personally, I had very little doubt that the court would decide as it did. The evidence was simply overwhelming and indisputable. In the written judgement, the judge stated that “I am satisfied that NHSE was rigorous in the discharge of the duty to have “due regard” to relevant matters, and that it was entitled, on the evidence before it, to conclude that the Guidance would not have an adverse impact on the statutory equality objectives, but rather, as the Analysis found, “would [enable] patients to have access to the most effective medications to achieve the best outcomes”.
In all this, the open questions, in my view, were whether
- Prince Charles, the prime defender of quackery in the UK, would intervene,
- and whether his intervention might change anything.
So, did he try to intervene?
I do not know. It could be that, after all the hoo-ha about his spider memos, he now is a little more cautions about meddling in health politics. It could also be that, as he is getting ready to become king, he wants to keep a low profile about his more bizarre ideas. Lastly, it could be that his opinion does not weigh as heavily as I had feared.
In any case, The High Court ruling is most welcome and unquestionably just, progressive, and long-overdue. I applaud all who have worked hard to bring it about, and am sure that (most of) my readers agree.
“This utter hokum is symptomatic of the crass stupidity of the vacuous classes before the lumpen mob rebelled and chopped off their useless heads. Where, oh where, is our mob?”
No, I am not calling for a British re-run of the French revolution. This is a comment that made me chuckle. I found it under an article in the SUNDAY TIMES. As it is about acupuncture, I thought I mention it here and show you a few experts:
… Prince Harry and Meghan Markle had regular appointments with an acupuncturist in the lead-up to their wedding. They were treated by Ross Barr, acupuncturist to the stars, who has been described as “divertingly handsome” by many of his enthusiastic fans and whose treatments have been lauded as “better than Botox”. Beauty experts say his appointments “go faster than Glastonbury tickets”.
Barr, whose treatments deal with anything from infertility to hair loss and relationship problems, is understood to have been regularly treating the couple since Meghan moved to London last year. The treatments are said to have been so successful that Barr and his wife, the actress Eva Birthistle, were invited to the wedding alongside celebrities including Oprah Winfrey, who had acupuncture live on her television show…
Harry, 33, has spoken of his struggles with anxiety and depression after the death of his mother, Diana, Princess of Wales in 1997. In an interview with The Sunday Times in 2016 he also admitted “my body . . . has basically been ruined over the last 10 years of army service”. His father, the Prince of Wales, is renowned for championing alternative and complementary therapies such as homeopathy and acupuncture…
It is thought Harry was keen to try acupuncture as part of a recent health drive to prepare for his wedding. He is reported to have reduced his alcohol consumption and is now regularly seen exercising at the exclusive KX gym in Chelsea, west London. Meghan, 36, is likely to be a fan of Barr’s “anti-wrinkle acupressure facial”, which aims to smooth fine lines and may have contributed to the American former actress’s radiant complexion on her wedding day…
Both Kensington Palace and Barr declined to comment yesterday.
Well, let me offer a few comments then:
- The article is recklessly promotional and, in my view, very poor journalism.
- It does not even include the usual attempt at ‘balance’ where an expert warns at the end of the article that acupuncture is unscientific rubbish.
- There is no good evidence that acupuncture works for any of the conditions mentioned in the article.
- Critical thinking, journalistic ethics, or objective analysis do not seem to be the forte of the author of this regrettable drivel.
Yes, I know … this is not very important. It is merely a little innocent story about some VIPs for gullible consumers.
But misleading the public about healthcare can also be seen as short-sighted, counter-productive, unethical, and stupid.
Once upon a time, the University of Exeter prided itself of having the ‘1st chair in complementary medicine’ in the country. That was in 1993, when I was appointed to that position. I then recruited a team of motivated researchers, and we soon managed to become the world’s leading research group in our field. Together, we published more papers on alternative medicine in the peer reviewed medical literature than any other team before or since, and we managed to get an international reputation for high-quality critical assessments of alternative medicine. Unfortunately, not all people were happy; some even seemed to be distinctly unhappy because few of our findings were as they had hoped.
In 2012/13, I retired under circumstances that, I am afraid, were not to the credit or integrity of my peers (the full and rather sad story has been told in my memoir). Since then, I have the status of Emeritus Professor; in that role, I give occasional lectures, publish about one book per year, run this blog, and generally enjoy life. There is not much that can bother me these days…
…at least, this is what I thought until I saw this announcement by Exeter University.
It informed me that the University of Exeter has decided to “offer a range of complementary therapies at a discounted rate to Staff at both Streatham and St Lukes Campus.”
Treatments are not cheap but members will receive the following reductions:
- 60 minutes + treatments £5.00 discount
- 45 minute treatments £4.00 discount
- 30 minute treatments £3.00 discount.
You want to know which therapies precisely are on offer?
Here is a selection of the treatments they are providing:
- Hot Stone Back Massage
- Pregnancy Massage
- Indian Head Massage
- Acupressure points
- Yoga movements
- Somatic movements
- Chi Qong
- Nutrition based Ayurvedic system of health
- Tai Yoga massage
Yes, most impressive – particularly as none of the therapies listed above are supported by anything that looks remotely like good evidence!
So, has my University gone raving mad?
Have they joined the legion of charlatans promoting nonsense?
Do they perhaps want to score even more brownie-points with HRH, the Prince of Wales?
One would assume so … but wait … they added a disclaimer to their announcement:
Whilst the University is pleased to welcome complementary practitioners to the campus and support greater access to a range of wellbeing services, we are not in a position to actively condone the effectiveness of such treatments. However, Reed Mews Wellbeing Centre wants to promote choice and encourage individuals to make informed decisions regarding the management of their health needs.
AHHH – I AM SO PLEASED – THAT’S ALRIGHT THEN!
Gosh, we in the UK needed that boost of jingoism (at least, if you are white, non-Jewish and equipped with a British passport)! But it’s all very well to rejoice at the news that we have a new little Windsor. With all the joy and celebration, we must not forget that the blue-blooded infant might be in considerable danger!
I am sure that chiropractors know what I am talking about.
KISS (Kinematic Imbalance due to Suboccipital Strain) is a term being used to describe a possible causal relation between imbalance in the upper neck joints in infants and symptoms like postural asymmetry, development of asymmetric motion patterns, hip problems, sleeping and eating disorders. Chiropractors are particularly fond of KISS. It is a problem that chiropractors tend to diagnose in new-borns.
This website explains further:
The kinematic imbalances brought on by the suboccipital strain at birth give rise to a concept in which symptoms and signs associated with the cervical spine manifest themselves into two easily recognizable clinical presentations. The leading characteristic is a fixed lateroflexion [called KISS I] or fixed retroflexion [KISS II]. KISS I may be associated with torticollis, asymmetry of the skull, C–scoliosis of the neck and trunk, asymmetry of the gluteal area and of the limbs, and retardation of the motor development of one side. KISS II, on the other hand, displays hyperextension during sleep, occipital flattening that may be asymmetrical, hunching of the shoulders, fixed supination of the arms, orofacial muscular hypotonia, failure to lift the trunk from a ventral position, and difficulty in breast feeding on one side.  The leading trademarks of both KISS I and KISS II are illustrated in Figure 1. 
In essence, these birth experiences lay the groundwork for rationalizing the wisdom of providing chiropractic healthcare to the pediatric population…
END OF QUOTE
KISS must, of course, be treated with chiropractic spinal manipulation: the manual adjustment is the most common, followed by an instrument adjustment. This removes the neurological stress, re-balances the muscles and normal head position. Usually a dramatic change can be seen directly after the appropriate adjustment has been given…
Don’t frown! We all know that we can trust our chiropractors.
Do you have to insist on being a spoil-sport?
Alright, alright, the evidence tells a different story. A systematic review concluded that, given the absence of evidence of beneficial effects of spinal manipulation in infants and in view of its potential risks, manual therapy, chiropractic and osteopathy should not be used in infants with the KISS-syndrome, except within the context of randomised double-blind controlled trials.
And this means I now must worry for a slightly different reason: we all know that the new baby was born into a very special family – a family that seems to embrace every quackery available! I can just see the baby’s grandfather recruiting a whole range of anti-vaccinationists, tree-huggers, spoon-benders, homeopaths, faith healers and chiropractors to look after the new-born.
By Jove, one does worry about one’s Royals!
The UK ‘COLLEGE OF MEDICINE’ has recently (and very quietly) renamed itself; it now is THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH (COMIH). This takes it closer to its original intentions of being the successor of the PRINCE OF WALES FOUNDATION FOR INTEGRATED MEDICINE (PWFIM), the organisation that had to be shut down amidst charges of fraud and money-laundering. Originally, the name of COMIH was to be COLLEGE OF INTEGRATED HEALTH (as opposed to disintegrated health?, I asked myself at the time).
Under the leadership of Dr Michael Dixon, OBE (who also led the PWFIM into its demise), the COMIH pursues all sots of activities. One of them seems to be publishing ‘cutting-edge’ articles.
START OF QUOTE
Professor Sonia Williams … explores how integrated oral health needs to consider the whole body, not just the dentition…
Complementary and alternative approaches can also be considered as complementary to ‘mainstream’ care, with varying levels of evidence cited for their benefit.
Dental hypnosis (British Society of Medical and Dental Hypnosis) can help support patients including those with dental phobia or help to reduce pain experience during treatment.
Acupuncture in dentistry (British Society of Dental Acupuncture) can, for instance, assist with pain relief and allay the tendency to vomit during dental care. There is also a British Homeopathic Dental Association.
For the UK Faculty of General Dental Practitioners, holistic dentistry refers to strengthening the link between general and oral health.
For some others, the term also represents an ‘alternative’ form of dentistry, which may concern itself with the avoidance and elimination of ‘toxic’ filling materials, perceived potential harm from fluoride and root canal treatments and with treating dental malocclusion to put patients back in ‘balance’.
In the USA, there is a Holistic Dental Association, while in the UK, there is the British Society for Mercury-free Dentistry. Unfortunately the evidence base for many of these procedures is weak.
Nevertheless, pressure to avoid mercury in dental restorative materials is becoming mainstream.
In summary, integrated health and care in dentistry can mean different things to different people. The weight of evidence supports the contention that the mouth is an integral part of the body and that attention to the one without taking account of the other can have adverse consequences.
END OF QUOTE
Do I get this right? ‘Holistic dentistry’ in the UK means the recognition that my mouth belongs to my body, and the adoption of a few dubious treatments with w ‘weak’ evidence base?
Well, isn’t this just great? I had no idea that my mouth belongs to my body. And clearly the non-holistic dentists in the UK are oblivious to this fact as well. I am sooooooo glad we got this cleared up.
And what about the alternative treatments used by holistic dentists?
The British Society of Medical and Dental Hypnosis (Scotland) inform us on their website that a trained medical and dental hypnotherapists can help you to deal with a large variety of challenges that you face in your everyday life e.g.
|Anxiety & Stress||Smoking Cessation|
|Weight Problems||Psychosexual Disorders|
|Irritable Bowel||And many other conditions|
I hasten to add that, for most of these conditions, the evidence fails to support the claims.
The British Society of Dental Acupuncture claim on their website that the typical conditions that may be helped by acupuncture are:
- TMJ (jaw joint) problems
- Facial pain
- Muscle spasm in the head and neck
- Stress headaches & Migraine
- Rhinitis & sinusitis
- Dry mouth problems
- Post-operative pain
- Dental anxiety
I hasten to add that, for most of these conditions, the evidence fails to support the claims.
The British Homeopathic Dental Association claim on their website that studies have shown improved bone healing around implants with Symphytum and reduced discomfort and improved healing time with ulcers and beneficial in oral lichen planus.
I hasten to add that none of these claims are not supported by sound evidence.
The COMIH article is entitled “The mouth reflects whole body health – but what does integrated care mean for dentists?’ So, what does it mean? Judging from this article, it means an amalgam (pun intended) of platitudes, bogus claims and outright nonsense.
Pity that they did not change their name to College of Medicine and Integrated Care – I could have abbreviated it as COMIC!
In the current issue of the Faculty of Homeopathy‘s Simile publication, Dr Peter Fisher, the Queen’s homeopath, re-visits the old story of the ‘Smallwood Report’. To my big surprise, I found the following two paragraphs in his editorial:
A prepublication draft [of the Smallwood report] was circulated for comment with prominent warnings that it was confidential and not to be shared more widely (I can personally vouch for this, since I was one of those asked to comment). Regrettably, Prof Ernst did precisely this, leaking it to The Times who used it as the basis of their lead story. The editor of The Lancet, Richard Horton, certainly no friend of homeopathy, promptly denounced Ernst for having “broken every professional code of scientific behaviour”.
Sir Michael Peat, the Prince of Wales’ Principal Private Secretary, wrote to the vice chancellor of Exeter University protesting at the leak, and the university conducted an investigation. Ernst’s position became untenable, funding for his department dried up and he took early retirement. Thirteen years later he remains sore; in his latest book More Harm than Good? he attacks the Prince of Wales as “foolish and immoral”.
END OF QUOTE
Sadly it is true that Horton wrote these defaming words. Subsequently, I asked him to justify them explaining that they were being used by my university against me. He ignored several of my emails, but eventually he sent a reply. In it, he said that, since the university was investigating the issue, the truth would doubtlessly be disclosed. I remember that I was livid at the arrogance and ignorance of this reply. However, being in the middle of my university’s investigation against me, never did anything about it. Looking back at this part of the episode, I feel that Horton behaved abominably.
But back to Dr Fisher.
Why did his defamatory and false accusation in his new editorial come as a ‘big surprise’ to me?
Should I not have gotten used to the often odd way in which some homeopaths handle the truth?
Yes, I did get used to this phenomenon; but I am nevertheless surprised because I have tried to correct Fisher’s ‘error’ before.
This is from a post about Fisher which I published in 2015:
In this article [available here in archive,org – Admin] which he published as Dr. Peter Fisher, Homeopath to Her Majesty, the Queen, he wrote: There is a serious threat to the future of the Royal London Homoeopathic Hospital (RLHH), and we need your help…Lurking behind all this is an orchestrated campaign, including the ’13 doctors letter’, the front page lead in The Times of 23 May 2006, Ernst’s leak of the Smallwood report (also front page lead in The Times, August 2005), and the deeply flawed, but much publicised Lancet meta-analysis of Shang et al…
If you have read my memoir, you will know that even the hostile 13-months investigation my own university did not find me guilty of the ‘leak’. The Times journalist who interviewed me about the Smallwood report already had the document on his desk when we spoke, and I did not disclose any contents of the report to him…
END OF QUOTE
So, assuming that Dr Peter Fisher has seen my 2015 post, he is knowingly perpetuating a slanderous untruth. However, giving him the benefit of the doubt, he might not have read the post nor my memoir and could be unaware of the truth. Error or lie? I am determined to find out and will send him today’s post with an offer to clarify the situation.
I will keep you posted.
Yesterday, a press-release about our new book has been distributed by our publisher. As I hope than many regular readers of my blog might want to read this book – if you don’t want to buy it, please get it via your library – I decided to re-publish the press-release here:
Governments must legislate to regulate and restrict the sale of complementary and alternative therapies, conclude authors of new book More Harm Than Good.
Heidelberg, 20 February 2018
Commercial organisations selling lethal weapons or addictive substances clearly exploit customers, damage third parties and undermine genuine autonomy. Purveyors of complementary and alternative medicine (CAM) do too, argue authors Edzard Ernst and Kevin Smith.
The only downside to regulating such a controversial industry is that regulation could confer upon it an undeserved stamp of respectability and approval. At best, it can ensure the competent delivery of therapies that are inherently incompetent.
This is just one of the ethical dilemmas at the heart of the book. In all areas of healthcare, consumers are entitled to expect essential elements of medical ethics to be upheld. These include access to competent, appropriately-trained practitioners who base treatment decisions on evidence from robust scientific research. Such requirements are frequently neglected, ignored or wilfully violated in CAM.
“We would argue that a competent healthcare professional should be defined as one who practices or recommends plausible therapies that are supported by robust evidence,” says bioethicist Kevin Smith.
“Regrettably, the reality is that many CAM proponents allow themselves to be deluded as to the efficacy or safety of their chosen therapy, thus putting at risk the health of those who heed their advice or receive their treatment,” he says.
Therapies covered include homeopathy, acupuncture, chiropractic, iridology, Reiki, crystal healing, naturopathy, intercessory prayer, wet cupping, Bach flower therapy, Ukrain and craniosacral therapy. Their inappropriate use can not only raises false hope and inflicts financial hardship on consumers, but can also be dangerous; either through direct harm or because patients fail to receive more effective treatment. For example, advice given by homeopaths to diabetic patients has the potential to kill them; and when anthroposophic doctors advise against vaccination, they can be held responsible for measles outbreaks.
There are even ethical concerns to subjecting such therapies to clinical research. In mainstream medical research, a convincing database from pre-clinical research is accumulated before patients are experimented upon. However, this is mostly not possible with CAM. Pre-scientific forms of medicine have been used since time immemorial, but their persistence alone does not make them credible or effective. Some are based on notions so deeply implausible that accepting them is tantamount to believing in magic.
“Dogma and ideology, not rationality and evidence, are the drivers of CAM practice,” says Professor Edzard Ernst.
Edzard Ernst, Kevin Smith
More Harm than Good?
1st ed. 2018, XXV, 223 p.
Softcover $22.99, €19,99, £15.99 ISBN 978-3-319-69940-0
Also available as an eBook ISBN 978-3-319-69941-7
END OF PRESS RELEASE
As I already stated above, I hope you will read our new book. It offers something that has, I think, not been attempted before: it critically evaluates many aspects of alternative medicine by holding them to the ethical standards of medicine. Previously, we have often been asking WHERE IS THE EVIDENCE FOR THIS OR THAT CLAIM? In our book, we ask different questions: IS THIS OR THAT ASPECT OF ALTERNATIVE MEDICINE ETHICAL? Of course, the evidence question does come into this too, but our approach in this book is much broader.
The conclusions we draw are often surprising, sometimes even provocative.
Well, you will see for yourself (I hope).