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

religion

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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:

  1. 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?
  2. 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.
  3. 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.
  4. 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.

I remember vividly when, on the morning the Brexit vote was announced in 2016, I switchted on the radio, heard the news and broke out in tears. Today, a similar thing happened.

I was wrong in thinking that the US would not elect a dangerous felon.

I was wrong in assuming the Americans had more sense.

I was wrong in believing in reason.

I was too optimistic.

I am distraught.

Forgive me, but I cannot produce a normal blog post on a day like this!

Recent studies have demonstrated that sociopolitical attitudes partially explain variance in (SARS-CoV-2) vaccine hesitancy and uptake. Other attitudes, such as those towards esoteric beliefs, so-called alternative medicine (SCAM), and religion, have also been proposed. However, pertinent studies provide limited direction for public health efforts, as the impact of such attitudes has been tested in isolation or on different outcomes. Moreover, related associations between SARS-CoV-2 immunization drivers as well as views towards other modes of immunization (e.g., routine pediatric immunization), remain unclear.

Based on a sample of ~7400 survey participants (Germany), where esoteric belief systems and SCAM (Waldorf, homeopathy) are rather prevalent, and controlling for other sociological factors, this study found that:

  • individuals with positive attitudes towards Waldorf education and homeopathy are significantly less likely to have received a (further) dose of SARS-CoV-2 vaccine compared to those with positive views of mainstream medicine;
  • for the former, immunization decisions are primarily driven by external pressures, and for the latter overwhelmingly by voluntary considerations;
  • attitudes influencing adult SARS-CoV-2 vaccine uptake similarly influence views towards routine pediatric immunization.

The authors concluded that their findings provide significant evidence informing a more nuanced design of public health and communication campaigns, and pertinent policies.

As the authors of this study point out, the attitudes towards mainstream medicine remained the single most influential factor for vaccine uptake. Individuals who viewed mainstream medicine highly favorably, received on average an estimated 1.48 (p < 0.001) more doses of SARS-CoV-2 vaccine than those who held very negative views. In contrast, those who viewed homeopathy highly positively received on average 0.51 (p < 0.001) fewer doses than those who viewed homeopathy highly negatively.

Regarding religious denominations, individuals self-classifying as Roman-Catholic or Protestant received on average 0.17 (p < 0.001) and 0.15 (p < 0.001) more vaccine doses than those self-classifying as non-denominational. The associations between other denominations and vaccine doses were statistically insignificant.

While these associations have been observed before or at least seem logical to me (and we discusses them frequently on this blog), one finding is, I think new (albeit not surprising, in my view): Supporters of the right-wing populist AfD received 1.37 (p < 0.001) fewer vaccine doses than the reference category Christian democrats.

So, does that in essence mean that the typical (German) vaccination hesitant person votes extereme right and loves SCAM?

I am sure that I am not the only one who has occasionally wondered what political orientation is associated with a high level of SCAM-use. Surprisingly, there is very little research on this question. This study is one of the rare ones (if not the only one) that has looked into the issue. It investigated whether individual political orientation (PO) predicts the use of conventional (CM) and SCAM across Europe.

Cross-sectional samples representative of persons aged 15 and over from 19 European countries were used (ESS 2015; round 7; N = 35,572). PO assessments were based on participants’ vote choice in the most recent national election, using expert ratings of party positioning along five political-ideological dimensions: left-right general; left-right economic; Green/alternative/libertarian vs. Traditional/authoritarian/nationalist; anti-elite; and anti-corruption. Use of CM was defined as having consulted a general practitioner or specialist, and use of SCAM as having used acupuncture, acupressure, Chinese medicine, homeopathy, herbal treatment, hypnotherapy, or spiritual healing.

The results suggested that individual political orientation predicted not only the use of SCAM treatments but also the use of CM. While the traditional left-right axis did not predict either category of service use, the political orientation that was relevant was one focused on corruption. People who voted for political parties with salient anti-corruption agendas were less likely to seek CM and more likely to use SAM. In addition, voters of parties that prefer expanded personal freedoms—such as access to abortion, same-sex marriage, greater democratic participation—were more likely to use SCAM than other Europeans. People in poor health tended to use CM regardless of their political leanings: a relationship between anti-corruption and CM usage was observed onlu among people who were in good health. By contrast, health status did not affect the links between political orientation and SCAM.

The authors concluded that their study shows that the political dimensions relevant for health behaviors do not align primarily along the traditional left-right axis in Europe. The results suggest that the lay public may not necessarily see conventional healthcare as a politically neutral enterprise, and that SCAM providers may be serving needs that are unmet by conventional medicine. The results further suggest that perceptions of corruption among the lay public are more relevant for healthcare usage than has been acknowledged. An important question for future research is how the association between concerns about corruption and reluctance to seek conventional biomedical care is best explained.

I must admit I am surprised by some of these findings. Before we seek an explanation, I feel, we ought to have an independent replication of the results.

Perhaps, the associations are much more complex. I have the impression, for instance, that they depend not only on the country but also on the specific SCAM in question. If I had to guess, I’d say, for example, that:

  • German naturopathy is associated with conservative politics;
  • British homeopathy is associated with liberal politics;
  • French homeopathy is associated with conservative politics;
  • US chiropractic is associated with right wing politics;
  • Austrian acupuncture is associated with left wing politics;

But these are truly wild guesses!

If anyone has some factual information, I’d like to see it, please.

 

Conspiracy theories have become a frequent theme on this blog, e.g.:

 

In fact, I have previously postulated that so-called alternative medicine (SCAM) can be understood as a conspiracy theory.

A new paper asked a relevant question: who believes in conspiracy theories? Conspiracy theories are ubiquitous and can have negative consequences. Thus, there is an increasing need for evidence-based recommendations with respect to interventions and prevention measures. Present Bayesian three-level meta-analysis includes a synthesis of the extant literature with respect to 12 personality correlates and their relationship with conspiracy beliefs. On average, people who believe in pseudoscience, suffer from paranoia or schizotypy, are narcissistic or religious/spiritual and have relatively low cognitive ability, are more likely to believe in conspiracy theories. Heterogeneity was partially explained by the examined moderators and no strong evidence for publication bias was found. Implications for developing tailored interventions are discussed in the article.

Conspiracy is a “secret plot by two or more powerful actors … Conspiracies typically attempt to usurp political or economic power, violate rights, infringe upon established agreements, withhold vital secrets, or alter bedrock institutions”. Conspiracy theories are used to describe and explain purported conspiracies.

People who believe in conspiracy theories are, according to this meta-analysis, more likely than other people to hold pseudoscientific beliefs, exhibit paranoid ideation, suffer from schizotypy, be narcissistic, be religious/spiritual and have lower cognitive ability.

Reading the comments sections of my blog, I agree with this conclusion.

I am glad to hear that the Vatican is issueing  new guidelines on supernatural phenomena. The document, compiled by the Vatican’s Dicastery for the Doctrine of the Faith, will lay out rules to assess the truthfulness of supernatural claims. Reports of such phenomena are said to have soared in recent years in an era of social media – sometimes spread through disinformation and rumour. The guidelines are likely to tighten criteria for the screening, analysis, and possible rejection of cases.

Apparitions have been reported across the centuries. Those recognised by the Church have prompted pilgrims, and popes, to visit spots where they are said to have taken place. Millions flock to Lourdes in France, for example, or Fatima in Portugal, where the Virgin Mary is alleged to have appeared to children, promising a miracle – after which crowds are said to have witnessed the sun zig-zagging through the sky. The visitation was officially recognised by the Church in 1930.

But other reports are found by church officials to be baloney. In 2016, an Italian woman began claiming regular apparitions of Jesus and Mary in a small town north of Rome after she brought back a statue from Medjugorje in Bosnia, where the Virgin Mary is also said to have appeared. Crowds prayed before the statue and received messages including warnings against same-sex marriage and abortion. It took eight years for the local bishop to debunk the story.

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Perhaps the Vatican should also have a look at faith healing*, the attempt to bring about healing through divine intervention. The Bible and other religious texts provide numerous examples of divine healing, and believers see this as a proof that faith healing is possible. There are also numerous reports of people suffering from severe diseases, including cancer and AIDS, who were allegedly healed by divine intervention.

Faith healing has no basis in science, is biologically not plausible. Some methodologically flawed studies have suggested positive effects, however, this is not confirmed by sound clinical trials. Several plausible explanations exist for the cases that have allegedly been healed by divine intervention, for instance, spontaneous remission or placebo response. Another explanation is fraud. For instance, the famous German faith healer, Peter Popoff, was exposed in 1986 for using an earpiece to receive radio messages from his wife giving him the home addresses and ailments of audience members which he purported had come from God during his faith healing rallies.

Faith healing may per se be safe, but it can nevertheless do untold indirect harm, and even fatalities are on record: “Faith healing, when added as an adjuvant or alternative aid to medical science, will not necessarily be confined to mere arguments and debates but may also give rise to series of complications, medical emergencies and even result in death.”

Alternatively, the Vatican might look at the healing potential of pilgrimages*, journeys to places considered to be sacred. The pilgrims often do this in the hope to be cured of a disease. The purpose of Christian pilgrimage was summarized by Pope Benedict XVI as follows:

To go on pilgrimage is not simply to visit a place to admire its treasures of nature, art or history. To go on pilgrimage really means to step out of ourselves in order to encounter God where he has revealed himself, where his grace has shone with particular splendour and produced rich fruits of conversion and holiness among those who believe.

There are only few scientific studies of pilgrimages. The purpose of this qualitative research was to explore whether pilgrims visiting Lourdes, France had transcendent experiences. The authors concluded that visiting Lourdes can have a powerful effect on a pilgrim and may include an “out of the ordinary” transcendent experience, involving a sense of relationship with the divine, or experiences of something otherworldly and intangible. There is a growing focus on Lourdes as a place with therapeutic benefits rather that cures: our analysis suggests that transcendent experiences can be central to this therapeutic effect. Such experiences can result in powerful emotional responses, which themselves may contribute to long term well-being. Our participants described a range of transcendent experiences, from the prosaic and mildly pleasant, to intense experiences that affected pilgrims’ lives. The place itself is crucially important, above all the Grotto, as a space where pilgrims perceive that the divine can break through into normal life, enabling closer connections with the divine, with nature and with the self.

Other researchers tested the effects of tap water labelled as Lourdes water versus tap water labelled as tap water found that placebos in the context of religious beliefs and practices can change the experience of emotional salience and cognitive control which is accompanied by connectivity changes in the associated brain networks. They concluded that this type of placebo can enhance emotional-somatic well-being, and can lead to changes in cognitive control/emotional salience networks of the brain.

The risks involved in pilgrimages is their often considerable costs. It is true, as the text above points out that “millions flock to Lourdes in France”. In other words, pilgrimiges are an important source of income, not least for the catholoc church.

A more important risk can be that they are used as an alternative to effective treatments. This, as we all know, can be fatal. As there is no good evidence that pilgrimiges cure diseases, their risk/benefit balance as a treatment of disease cannot be positive.

So, will the new rules of the Vatican curtail the risks on supernatural healing practises? I would not hold my breath!

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* for references see my book from where this text has been borrowed and modified.

An interesting and fully referenced (205 references) article caught my attention; it seems highly relevant to the discussions we are having on this blog. Let me show you the abstract:

Medical misinformation has always existed, but it has recently become more frequent due to the development of the internet and social media. Medical misinformation can cover a wide variety of topics, and studies show that some groups are more likely to be affected by medical misinformation than others, like those with less trust in health care, less health literacy, and a more positive attitude toward alternative medicines. Aspects of the internet, like echo chambers and algorithms, have contributed to the rise of medical misinformation, along with belief in anecdotal evidence and alternative remedies that are not backed by science. Some personal beliefs and a lack of media literacy skills are also contributing to medical misinformation. Medical misinformation causes higher rates of death and negative health outcomes, a lack of trust in medical professionals, and more racism and hate crimes. One possible way to combat the spread of misinformation is education surrounding media literacy. Still, there are gaps in this practice that must be addressed like a lack of high-quality research about different educational programs.

The author also offers the following key points:

  • Medical misinformation is becoming an urgent issue for United States citizens—leading to increased deaths,
    a lack of trust in health professionals, and hate crimes and racism.
  • Although this is a worldwide issue, the United States has the second highest rate of misinformation of any
    country, behind India.
  • One piece of misinformation during the COVID-19 pandemic stated that highly concentrated alcohol could
    disinfect the body and kill the virus. Studies show that 800 people died, 5,876 were hospitalized, and 60
    became completely blind from drinking methanol, thinking it would cure coronavirus.
  • Studies estimate that only 14% of the United States population has proficient health literacy, which makes it difficult to recognize medical misinformation.
  • Media literacy education is being pursued in order to combat the spread of misinformation, but more research is needed in order to understand the long-term effects of this education and what programs are best.

__________________

I would like to stress, as indeeed the author does as well, that medical misinformation is a phenomenon that is by no means confined to the US. Like most information, misinformation has become a global issue. Its dangers cannot be under-estimated. My blog offers an abundance of reports where misinformation in the realm of so-called alternative medicine (SCAM) has caused harm and even death. The author advocates media literacy as a remedy for the problem. I would argue that even more important would be to teach CRITICAL THINKING, a task that has to start at school and must continue well into adult life.

This conclusion is so very obvious that it begs an important question: WHY HAS IT NOT BEEN DONE YEARS AGO? The answer, I fear, is simple: for reasons that are self-evident, governments have little interst in the public being able to think critically. On the contrary, governments across the world foremost want to be re-elected, and critical thinking would be a major obstacle to this aim.

 

Please allow me to write a post today that has nothing at all to do with so-called alternative medicine, not even with medicine.

Yesterday, 13 March, was my mother’s birthday. She was born in 1911 and died in 1989. I often think of her and the remarkable life she had, particularly, of course, on 13 March.

Going through my X-feed yesterday, I saw this post from the Auschwitz Memorial:

13 March 1911 | A Pole, Józef Kowalski, was born in Siedliska. A Catholic priest, Salesian. In Auschwitz from 26 June 1941. No. 17350 On 4 July 1942 he was drowned in a barrel of fecal matter in the Penal Company, where he was placed for refusing to trample a rosary.

Image

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I am not a religious person but I was struck: this man was born on the same day as my mother and lived not far from where she did. He was brutally killed, while she, not far away, was peacefully trying to buid a future with my father,
I simply had to find out more about him. This turned out to be easy because there is plenty of information, even a Wiki page on him. Here is a short summary of his life:

Józef Kowalski was born in Siedliska on 13 March 1911 to Wojciech and Zofia Borowiec, the seventh of their nine children. He was ordained a priest on 29 May 1938 as member of the Salesian Religious Society. During the German occupation of Poland, the Salesians continued their educational work. The Gestapo arrested Kowalski on 23 May 1941, along with eleven other Salesians. They were taken to Montelupich Prison and tortured.

Kowalski was sent to Auschwitz on 26 June 1941. There, he ministered to his fellow prisoners usually in secret, but at least once in front of everyone at the moment of mass execution. He was ordered by Blockführer Gerhard Palitzsch to trample upon his rosary but refused. Palitzsch was one of the most brutal of all the SS officers of the camps (he later vanished from the records, possibly killed in action). As punishment, he was assigned to a penal company. In his last letter to his parents, Józef wrote:

Do not worry about me; I am in God’s hands. I want to assure you that I feel His help at every step. Despite the present situation, I am happy and completely at peace.

On 3 July 1942 he was mocked and severely beaten by the guards for being a priest. The same night, they pulled him out of his barracks, gravely beat him again and killed him. Kowalski’s body was found the next day and burned with others. He was 31 years of age.

Pope John Paul II who had known Kowalski personally beatified Kowalski on 13 June 1999.

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Please forgive me if you find this post irrelevant or inappropriate.

 

The French ‘National Assembly’ has yesterday adopted a major law aimed at reinforcing the prevention and combat against sectarian aberrations in France. This marks a significant step forward in strengthening the protection of citizens against abuse and manipulation by charlatans, gurus and other sectarian movements.

This bill, the result of particularly fruitful work and debate in both chambers, reflects the Government’s commitment to meeting the expectations of the victims of these sectarian movements.

Some of the key measures voted through by parliamentarians include:

  • The enshrinement in law of the powers of MIVILUDES (Interministerial Mission of Vigilance and Combat against Sectarian Aberrations);
  • The reinforcement of the penal response with the creation of the offence of placing or maintaining in a state of psychological or physical subjection;
  • The creation of an offence of incitement to abandon or refrain from treatment, or to adopt practices which clearly expose the person concerned to a serious health risk;
  • Support for victims, with the extension of the categories of associations that can bring civil action;
  • Information for the judiciary, with the introduction of an “amicus curiae” role for certain government departments in legal cases relating to cults.

Despite sometimes heated debates, particularly around article 4, fuelled by the opinion of the Conseil d’Etat, the adoption of this law by the National Assembly bears witness to a shared desire to protect the rights and freedoms of individuals while providing better protection for our fellow citizens against sectarian aberrations.

This bill is part of a multi-annual national strategy for 2023-2027 resulting from the conference on sectarian aberrations held in spring 2023. It is a major step towards strengthening the penal arsenal and protecting victims.

_______________

Sabrina Agresti-Roubache, Secretary of State for Citizenship and Urban Affairs, commented:

“Long-awaited by victim support associations, this text aims to strengthen our legal arsenal in the fight against sectarian aberrations. I’m delighted that all the articles have been adopted, particularly Article 4, which creates an offence of incitement to abandon or abstain from treatment. There have been some passionate debates in the Chamber, but I’d like to reiterate the basis of this bill: the State is not fighting against beliefs, opinions or religions, but against all forms of sectarian aberrations, these dangerous behaviors which represent a threat to our social cohesion and put lives at risk.”

_______________

Obviously, we shall have to see how the new law will be applied. But, in any case, it is an important step into the right direction and could put an end to much of so-called alternative medicine that endangers the health of French consumers.

Other nations should consicer following the Franch example.

Jean-Maurice Latsague (85 years old) has a track record of sexual assaults. Recently, he stood trial before the Sarthe Assize Court from 13 to 15 December for rapes committed during healing sessions. He has worked as an energy healer for many years, and it was in this capacity that he came into conflict with the law nearly 30 years ago.

  • In 1994, he was sentenced to 10 years’ imprisonment for the rape and indecent assault of minors that he had committed in the Dordogne.
  • In February 2023, he settled in Sarthe after his release from prison and was again convicted for sexual assaults.
  • Now we’re talking about crimes again, with an accusation of rape against two women.

During the first few hours of the current trial, Jean-Maurice Latsague listened to the proceedings, bent over on his cane. He explained that he had asked his patients to strip naked because “healing energy doesn’t pass through tissue”.

The healing sessions seemed to always follow the same routine:

  • They begin with discussions.
  • This is followed by prayers.
  • Subsequently, Jean-Maurice Latsague asks his victims to strip naked.
  • Then he administeres massages with oil.
  • Finally, he rapes his victim.

On the second day of the proceedings, one of the victims chose to bring a civil action. She is one of three other women attacked by Jean-Maurice Latsague (apart from a mother and daughter who gave evidence before), but who had not lodged a complaint at the time of the investigation.

New testimony sheds light on the healer’s practices, in a much more sordid and perverse way. “He would masturbate in front of me to stimulate ovulation,” said a victim who took the witness stand and was undergoing treatment for infertility.

At the end of a three-day trial, the Sarthe Assize Court found Jean-Maurice Latsague guilty of repeated rape and sexual assault committed by a person abusing the authority conferred by his position.

He was sentenced to twenty years’ imprisonment.

Sources:

Un magnétiseur accusé de plusieurs viols devant les Assises de la Sarthe (francetvinfo.fr)

Deuxième jour du procès devant les assises de la Sarthe du magnétiseur accusé de viols (francetvinfo.fr)

À 85 ans, le magnétiseur condamné à vingt ans de réclusion criminelle pour viols (ouest-france.fr)

 

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