risk
Homeopathy is harmless – except when it kills you!
Death by homeopathy has been a theme that occurred with depressing regularity on my blog, e.g.:
- Death by homeopathy
- Another death by homeopathy
- Death by homeopathy?
- The case of a boy tortured to death with homeopathy
- Homeopathy is the death of the patient suffering from gangrene
Now, there is yet another sad fatality that must be added to the list. This case report presents a 61-year-old woman with metastatic breast cancer who opted for homeopathic treatments instead of standard oncological care. She presented to the Emergency Department with bilateral necrotic breasts, lymphedema, and widespread metastatic disease. Imaging revealed extensive lytic and sclerotic lesions, as well as pulmonary emboli. Laboratory results showed leukocytosis, lactic acidosis, and hypercalcemia of malignancy.
During hospitalization, patient was managed with anticoagulation and broad-spectrum antibiotics. Despite disease progression, patient declined systemic oncological treatments, leading to a complicated disease trajectory marked by frailty, sarcopenia, and functional quadriplegia, ultimately, a palliative care approach was initiated, and she was discharged to hospice and died.
This case highlights the complex challenges in managing advanced cancer when patients choose alternative therapies over evidence-based treatments. The role of homeopathy in cancer care is controversial, as it lacks robust clinical evidence for managing malignancies, especially metastatic disease.
Although respecting patient autonomy is essential, this case underscores the need for healthcare providers to ensure patients are fully informed about the limitations of alternative therapies. While homeopathy may offer emotional comfort, it is not a substitute for effective cancer treatments. Earlier intervention with conventional oncology might have altered the disease course and improved outcomes. The eventual transition to hospice care focused on maintaining the quality of life and dignity at the end-of-life, emphasizing the importance of integrating palliative care early in the management of advanced cancer to enhance patient and family satisfaction.
Even though such awful stories are far from rare, reports of this nature rarely get published. Clinicians are simply too busy to write up case histories that show merely what sadly must be expected, if a patient refuses effective therapy for a serious condition and prefers to use homeopathy as an “alternative”. Yet, the rather obvious truth is that homeopathy is no alternative. I have pointed it out many times before: if a treatment does not work, it is dangerously misleading to call it alternative medicine – one of the reasons why I nowadays prefer the term so-called alternative medicine (SCAM).
But what about homeopathy as an adjunctive cancer therapy?
In 2011, Walach et al published a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). The authors observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment.
Walach and other equally deluded defenders of homeopathy (such as Wurster or Frass) tend to interpret these findings as being caused by homeopathy. Yet, this does not seem to be the case, as they regularly forget about the possibility of other, more plausible explanations for their results (e.g. placebo or selection bias). I am not aware of a rigorous trial showing that adjunctive homeopathy has specific effects when used by cancer patients (if a reader knows more, please let me know; I am always keen to learn).
So, is there a role for homeopathy in the fight against cancer?
My short answer:
No!
I has been reported that a man is pleading to steer clear of chiropractors. Last year, Tyler Stanton endured “the worst pain I had ever experienced in my life,” a hospital stay, and the beginning of an ongoing struggle that has left him unable to work. All started immediately after a chiropractor cracked his neck — and something popped.
After adjusting Stanton’s back, the chiropractor moved on to his neck. “It didn’t crack on the first time. On the second time where he tried to crack my neck, he put a lot of force behind it, and I heard one huge and painful pop. I knew immediately that something was wrong.” Stanton recalled that when he tried to sit up, the room began to spin. “My equilibrium was just completely f—ked. I was instantly, profusely sweating.”
After laying on the table for half an hour, Stanton made the short trip back to his home, where he became “violently ill.” Throwing up uncontrollably and unable to see straight, he got into bed, hoping rest would alleviate his symptoms. The following morning, Stanton woke up to “the worst pain I had ever experienced in my life. The entire right side of my body was numb. It was really scary.”
He was taken to the hospital, where he was diagnosed with a herniated disc between the C5 and C6 vertebrae in his neck. Due to the acute pain he was experiencing, he stayed in the hospital for several weeks. “They ended up giving me epidural injections into my spine, and they didn’t even make a dent into the pain,” he said. Ultimately, doctors gave him two choices: spinal fusion therapy or physical therapy to manage his discomfort.
Fearful of the consequences of surgery, Stanton opted for PT. “I had a pharmacy of pain medication to help the nerves be less inflamed so I can get mobility and feeling back into the right side of my body. Essentially, I just had to go home and lay down for about two more months.”
Unable to work, Stanton burned through his savings, and six months into his recovery, he is just beginning to regain sensation in his right arm. “I still deal with pain. I’m still limited in what I can do physically. It just destroyed me. Mentally, financially, physically, all of it.” With limited mobility and mounting medical bills, Stanton is consulting with lawyers and considering legal action. “I kinda feel like I just don’t have another choice because this really just derailed my entire life overnight,” he said.
While proponents say chiropractors help alleviate pain, many doctors describe the field as pseudoscience — and warn that it can actually lead to serious problems. ““There are reports of severe side effects with chiropractic treatment, including blood clot formation, herniated discs, fractures, artery dissection, stroke, paralysis, and death,” explained Gbolahan Okubadejo, MD, a spinal surgeon and the head of The Institute for Comprehensive Spine Care. Dr. Charles R. Wira III, an emergency medicine doctor at Yale Medicine, told the Huffington Post that there’s a known link between chiropractic neck manipulations and major artery tears that can cause strokes. “Thankfully, overall the incidence of neck dissections are small,” he said. “But intentional and aggressive manipulations of the neck merits strong consideration for concern.” Cardiologist Dr. Danielle Belardo said she was “heartbroken” to see a young patient with “dissection of the vertebral artery” following a neck adjustment. “How can we live in a world where it’s legal to perform something with zero evidence for benefit (neck adjustment from a chiro) when there are such incredibly dangerous and life changing risks?” she wrote on Twitter. “[My patient] trusted a licensed healthcare practitioner to provide care that has more benefit than harm. This is a disgrace.”
Stanton hopes his story can serve as a warning for others. “I think it’s important that I share this story because I just don’t want what happened to me to happen to someone else,” he said. “Please don’t go to the chiropractor, OK? If I can do anything with my platform to share the story and save somebody from experiencing what I had to experience, then hopefully, something positive can come out of what I went through. Please hear me when I say this: Please be careful. This is the last thing that you want to experience.”
In a disturbing parallel, a young woman who felt a “crack to her neck” during a gym workout in 2021 died weeks later after going to a chiropractor to treat her neck pain. In 2022, a Georgia woman became paralyzed after a routine neck adjustment ended up rupturing her spinal arteries in several spots. In 2023, an Australian man suffered a stroke after cracking his neck in an ill-advised attempt to cure his chronic back pain.
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None of these are proper case reports in a medical sense, of course. Such publications are relatively rare.
I wonder why.
Could it be related to the fact that many chiropractors are in denial and, as a profession, they still have no adequate monitoring system for adverse event?
Robert F. Kennedy Jr. is coming out with so much stupidity, ignorance and quackery that it is getting difficult to keep up. A recent article reported that he touted two particular medications that have not been shown to work as first-line treatments for measles:
- the steroid budesonide,
- the antibiotic clarithromycin.
Kennedy claimed on X that the medications had been instrumental in treating around 300 children in Texas, and told Fox News that doctors prescribing them had seen “very, very good results.”
Consequently, families in Texas have turned to questionable remedies — in some cases, also prompted by the recommendation of two Texas doctors, Dr. Ben Edwards and Dr. Richard Bartlett. Kennedy called Edwards and Bartlett “extraordinary healers” who have “treated and healed” hundreds of children with budesonide and clarithromycin, sharing a photo of himself and the doctors with three Mennonite families whose children had become ill. Two of the families had each recently lost a daughter to measles: 6-year-old Kayley Fehr died in February and 8-year-old Daisy Hildebrand died last week. Neither child was vaccinated.
Edwards, a conventionally trained doctor who has shifted to promoting natural remedies and prayer, has been operating a makeshift clinic in Seminole, offering children these unproven treatments — including, according to a video posted by an anti-vaccine group, while he said he was sick with measles. Edwards has allied himself with the anti-vaccine movement in recent months, hosting influencers and activists on his podcast, including Andrew Wakefield.
“There is no evidence to support the use of either aerosolized budesonide or clarithromycin for treatment of children with measles,” said Dr. Adam Ratner, a spokesman for the American Academy of Pediatrics. Prescribing treatments that have not been vetted in clinical trials amounts to experimenting on patients, added Dr. Susan McLellan, a professor in the infectious diseases division at the University of Texas Medical Branch.
During the measles outbreak, both Edwards and Bartlett have each warned of risks associated with the MMR vaccine: Edwards claimed, falsely, that it causes “potentially” hundreds of deaths a year and Bartlett has said that the complications caused by measles, including brain swelling and pneumonia, can also be caused by the vaccine. In reality, the MMR vaccine, which is only given to children with healthy immune systems, has been overwhelmingly safe since its approval more than five decades ago, and has saved an estimated 94 million lives worldwide.
Public health experts said touting these medications as first-line treatments sends the wrong message. “By mentioning such treatments without that context, RFK Jr. continues to distract away from the prevention measure that incontrovertibly works — the vaccine,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security
A national public health organization is calling for RFK Jr. to resign citing “implicit and explicit bias and complete disregard for science.” Georges Benjamin, executive director of the American Public Health Association, said in a statement that concerns raised during Kennedy’s confirmation hearing last month have been realized, followed by massive reductions in staff at key health agencies.
What’s next? I aslk myself.
Perhaps homeopathy as a savior of the US healthcare system?
Watch this space.
In a recent post, I mentioned a new report which allegedly claimed that “employing chiropractors in the [English] health service could save £1.5 billion“. Thanks to ‘Blue Wode’, we can now read the original report, and I had a critical look at it. Here are some quotes of crucial passages from the report:
The objective of this analysis was to establish how chiropractors could help to address the unmet need of people with MSK [musculoskeletal] conditions, who are currently absent from work due to these conditions, on NHS MSK physiotherapy waiting lists …
To assess the available evidence on the relative effectiveness of chiropractors, physiotherapists and osteopaths a pragmatic literature review was undertaken. This consisted of a rapid, pragmatic search of existing literature evidence to explore the effectiveness of chiropractic interventions (in terms of productivity/return to work) compared with physiotherapists and/or osteopaths … The strategies were not designed to be ‘comprehensive’ but focused to target records for relevant studies whilst retrieving record numbers that were manageable within the project timescales and available resources…
The results of the analysis are based on the assumption that there are equivalent work-related outcomes associated with MSK physiotherapy and chiropractic care…
1,270 records were retrieved from the database searches and 41 records were sent by the BCA. 101 duplicates were removed, and the remaining 1,210 references were screened for inclusion. 18 studies met the eligibility criteria and were included in data extraction (see Appendix B for the study flow diagram). Included studies had the following study designs: five systematic reviews [29-32] (of which one was only a summary [33]), three non-systematic reviews [34, 35] with one running a meta analysis [36], five randomised controlled trials [37-41], three cohort studies [42-44], and two case series studies [26, 45]…
A pragmatic review of literature found that evidence of the effectiveness of chiropractors in helping people with MSK conditions to get back to work is sparse and poor quality. There is weak evidence to suggest that chiropractors treating MSK conditions would be able to achieve equivalent return-to-work outcomes as physiotherapists. If more robust evidence could be developed, it is feasible that chiropractors could be used to address supply shortages in treatment for MSK conditions. This would require the NHS to consider closely the clinical governance arrangements it would need to put in place to ensure patient safety. It would also need to review the type of treatment and advice that chiropractors were able to provide for people with MSK conditions.
The initial analysis carried out for this study estimated that there are almost 1.6 million people unable to work due to an MSK condition in the UK. Spare capacity in the chiropractic profession indicates that around 114,000 more people per year could be treated by chiropractors. This represents around 7% of the current waiting list. Chiropractors have an average waiting time of 1.5 weeks compared with a minimum of 11 weeks for physiotherapists.
If the spare chiropractor capacity was used to address MSK conditions preventing people from working, then this could improve workforce productivity by reducing the time people are waiting for treatment. Adopting a simple analysis, assuming that all of the spare capacity could be used in the most efficient way, the estimated value of the improvement in productivity is £612 million per year. Using the Markov model to factor in a wider range of potential outcomes provides a more conservative, more robust estimated value of £399 million per year. If minimum rather that median wages are used to value the productivity gain based on an 11 week wait then it would reduce to £258 million.
A range of factors may increase or decrease the potential productivity gains. If the 11-week waiting time for physiotherapists is an under-estimate and the waiting times are 18 or 24 weeks, then the productivity gain would increase to £713 million and £1 billion respectively.
This analysis focused on productivity costs only, but people may also potentially have better health outcomes and lower treatment costs if they are treated more quickly.
Recommendations
Key recommendations emerging from this research are:
- The NHS should consider commissioning pilot research studies to generate evidence to make the case for the use of chiropractors in providing treatment for people with MSK conditions to allow them to return to work more quickly.
- The NHS should consider how the potential use of chiropractors to provide treatment and advice for people with MSK conditions can help to address the demand, capacity and financial challenges facing the health and social care system. This would need to be within the constraints of clinical guidelines and governance, to ensure safety and effective outcomes.
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And here are a few critical points:
- What on earth is a “pragmatic literature review”; was the term invented to disguise tha fact that the review is not systematic and thus is a bonanza in cherry-picking? I had a look at the cited literature and can confirm that any critical assessment of chiropractic has been excluded.
- “The results of the analysis are based on the assumption that there are equivalent work-related outcomes associated with MSK physiotherapy and chiropractic care.” Are you kidding me? I thought the aim was to “assess the available evidence on the relative effectiveness of chiropractors, physiotherapists and osteopaths”. How can you then assume equivalent outcomes as a basis for conducting the research?
- “Included studies had the following study designs: five systematic reviews [29-32] (of which one was only a summary [33]), three non-systematic reviews [34, 35] with one running a meta analysis [36], five randomised controlled trials [37-41], three cohort studies [42-44], and two case series studies [26, 45].” So, just 5 RCTs are the basis of the evaluations? What did you do with the dozens of other RCTs in this area? Did they perhaps not fit your conclusions?
- “If more robust evidence could be developed, it is feasible that chiropractors could be used to address supply shortages in treatment for MSK conditions.” However, I predict that more robust evidence will show the opposite of what you seem to wish!
- “Ensure patient safety”. Yes, thanks for mentioning safety. The report neglects safety completely. In view of the known risks of chiropractic this seems a serious mistake!
- “The estimated value of the improvement in productivity is £612 million per year.” From my comments above, it follows that this wild and largely unsubstantiated estimate was guided by little more than wishful thinking.
- “This analysis focused on productivity costs only, but people may also potentially have better health outcomes and lower treatment costs if they are treated more quickly.” More likely people experience health outcomes that are very similar to those of doing nothing at all. In this case, it would follow that a lot of money might be saved if we scrap MSK treatments altogether.
This report is a transparent and dilettante attempt to push more chiropractic on the NHS, a move that would not improve much and could even put a few patients in wheelchairs.
It has been reported that a five-year-old boy died after being “incinerated” inside a pressurised oxygen chamber while undergoing alternative treatment for ADHD and sleep apnoea. Thomas Cooper was pronounced dead at the scene on Jan 31 at the Oxford Center in Detroit. The following people have been charged in connection with the boy’s death:
- The center’s founder and chief executive, Tamela Peterson, 58, was charged with second-degree murder.
- The facility’s manager Gary Marken, 65, and safety manager Gary Mosteller, 64, were charged with second-degree murder and involuntary manslaughter.
- The operator of the chamber when it exploded, Aleta Moffitt, 60, was charged with involuntary manslaughter and intentionally placing false medical information on a medical records chart.
The boy was undergoing hyperbaric oxygen therapy, which involves breathing pure oxygen in a pressurised chamber.
A hyperbaric chamber at the Oxford Center Credit: David Guralnic
“A single spark it appears ignited into a fully involved fire that claimed Thomas’s life within seconds,” Dana Nessel, Michigan’s Attorney General, explained. “Fires inside a hyperbaric chamber are considered a terminal event. Every such fire is almost certainly fatal and this is why many procedures and essential safety practices have been developed to keep a fire from ever occurring,” she added.
Thomas had been undergoing unapproved treatment for ADHD and sleep apnoea
Ms Nessel accused those charged of putting children’s bodies at risk through unaccredited and debunked treatments for profit. Raymond Cassar, the attorney for centre manager Mr Marken, said the second-degree murder charge comes as “a total shock”. “This was a tragic accident and our thoughts and our prayers go out to the family of this little boy. “I want to remind everyone that this was an accident, not an intentional act. We’re going to have to leave this up to the experts to find out what was the cause of this.”
Ms Nessel said. “The Oxford Center routinely operated sensitive and lethally dangerous hyperbaric chambers beyond their expected service lifetime and in complete disregard of vital safety measures and practices considered essential by medical and technical professionals.”
The fact that animal parts are used for so-called alternative medicine (SCAM) is well-known. The problem has so far been related mostly to China and TCM. A recent article reminds us of the fact that the abuse of animals for SCAM is also an African issue:
The use of animals for zootherapeutic purposes has been reported worldwide, and with the patronage of complementary and alternative medicines being on the ascendency, the trade and use of animal parts will only escalate. Many more of these animals used in traditional medicine will be pushed to extinction if policies for their sustainable use and conservation are not formulated. There have been studies across the world which assessed the trade and use of animals in traditional medicine including Ghana. However, all previous Ghanaian studies were conducted in a few specific cities. It therefore makes it imperative for a nationwide study which would provide more comprehensive information on the trade and use of animals in traditional medicine and its conservation implications. Using direct observation and semi-structured questionnaires, data were collected from 133 vendors of animal parts used in traditional medicines in 48 markets located across all 16 administrative regions of Ghana. Analysis of the data showed that the trade in wild animal parts for traditional medicine was more prevalent in the urban centres of Ghana. Overall, 75 identifiable animal species were traded on Ghanaian traditional medicine markets. Using their relative frequency of citation values, chameleons (Chamaeleo spp.; 0.81), lions (Panthera leo; 0.81) and the West African crocodile (Crocodylus suchus; 0.67) were the most commonly traded animals in Ghana. Majority of the vendors (59.1%) indicated that their clients use the animal parts for medicinal purposes mainly for skin diseases, epilepsy and fractures, while clients of 28.2% of the vendors use the animal parts for spiritual or mystical purposes, such as protection against spiritual attacks, spiritual healing and money rituals. Up to 54.2% of the animals were classified as Least Concern by IUCN, 14.7% were threatened, with 51.2% of CITES-listed ones experiencing a decreasing population trend. This study also found that 68.5% of the traded animal species are not listed on CITES, but among those listed, 69.6% are classified under Appendix II. Considering the level of representation of animals of conservation concerns, the harvesting and trade of animal parts for traditional medicine must be regulated. This call is even more urgent since 40.0% of the top ten traded animals are mammals; a class of animals with long gestation periods and are not prolific breeders.
The authors concluded that the trade of animal parts and products for traditional medicine in Ghana is widespread, especially in market centres in the urban area. These animals are used mainly for medicinal purposes, especially skin diseases, but their use for mystical purposes is also prevalent. Again, with the topmost traded animals being those in CITES Appendices I and II, means there is some laxity in the enforcement of laws that are to ensure sustainable use of animal resources. Although a majority of animals traded for traditional medicine may not be currently of conservation concern and not listed under CITES, policymakers and other stakeholders in Ghana and beyond would have to start working on ensuring the survival of the threatened ones and prevent the sliding of the non-threatened species into extinction so the biodiversity will be conserved for the use of the future generation.
All I want to add here is the fact that there is not a shred of evidence that animal parts in SCAM have any positive health effects. It is high time that this barbaric and useless trade stops!
The hallmark of the Trump administration is the discrepancy between its appointees’ responsibilities and their qualifications/competence for their jobs. A well-known anti-vaccine activist assigned the job of reviewing the supposed link between vaccination and autism is a recent case in point. The Washington Post reported that David Geier has been nominated for a study on possible links between immunizations and autism. Retraction Watch recently dedicated an article to Geier pointing out that he has a long history of promoting the debunked claim of a link between vaccines and autism. In 2011, the Maryland State Board of Physicians even had to disciplin Geier for practicing medicine without a license!
The Trump administration has also announced that it will prioritize replicating medical research. At least 20 percent of the NIH budget will now be directed towards replication efforts. But studies of a link between vaccines and autism have failed to find a connection time and time again. “We have already done that many times over. It wastes valuable resources to revisit the same question instead of using them to address critical health challenges,” commented David Higgins, a practicing pediatrician and health services researcher at the University of Colorado Anschutz Medical Campus. “Re-examining settled questions that have already been repeated, replicated, and tested many times is not healthy skepticism; it’s cynicism and science denial.”
The news of the HHS study comes as measles cases in Texas increase, and further outbreaks have been reported in numerous other states, while Kennedy has downplayed the role of vaccination. As of 27 March, the US Centers for Disease Control and Prevention (CDC) has confirmed 483 measles cases in the US this year. This is the highest number of infections since 2019, when there were more than 1200 confirmed cases. The CDC is aware of more potential measles cases but is waiting for confirmation before including them in the case count.
David Geier and his father Mark Geier, MD, are known for several discredited studies claiming that thimerosal, a preservative containing low levels of ethylmercury used in some vaccines, increased the risk of autism. But Thimerosal has been reduced or eliminated from vaccines for decades, and all vaccines recommended for children 6 and younger are available in formulations that do not contain thimerosalopens in a new tab or window.
“The [Geier] studies were poorly done; they were full of confounding variables,” commented Paul Offit, MD, of Children’s Hospital of Philadelphia. The American Academy of Pediatrics warned that it contained “numerous conceptual and scientific flaws, omissions of fact, inaccuracies, and misstatements,” and failed to show a connection between thimerosal and autism.
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They say that, if you elect a clown, you’ll get a circus. So, to make the farce complete, why does RFKJr not recruit our friend Andrew Wakefield to the team of clowns, jesters and illusionists?
A long article on chiropractic casts doubt that chiropractic is useful. Here is an abbreviated version of it:
The chemistry and biology graduate from the University of Georgia, 28-year-old Caitlin Jensen, visited a chiropractor to sort out her lower back pain. During the session, the therapist performed an adjustment. It severed four arteries in her neck. She collapsed shortly after, unable to speak or move. The injury had caused her to suffer a series of strokes. Today, she has regained some movement in her head, legs and arms but she is still unable to speak, is partially blind and relies on a wheelchair.
- One 66-year-old grandmother said a visit to a chiropractor to treat her sore shoulder left her covered in bruises, hearing ringing in her ears and with a splitting pain in her jaw. She was later diagnosed by doctors with trigeminal neuralgia – a chronic pain disorder caused by a trapped or irritated nerve in the neck that causes sudden, electric shock-like pain in the face. She believes the condition – which, three years later, still sometimes leaves her unable to open her mouth wide enough to speak to her grandchildren – was triggered by a chiropractic adjustment of her neck.
- A 55-year-old woman was left with chronic neck and shoulder pain after visiting a chiropractor for a sore back. The pain was so bad she once spent 72 hours immobile and unable to sleep despite taking a concoction of painkillers.
- And a 66-year-old man says his back went into spasm as he was leaving his first chiropractor appointment – which left him hospitalised and bedbound for weeks. The intense treatment, he later learned, had pushed one of the discs of his spine out of place, causing him to lose feeling in his right leg for ever.
Faith healing is the attempt to bring about healing through divine intervention. It is a form of paranormal or ‘energy’ healing. 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 often takes the form of laying on hands where the preacher channels the divine energy via his hands into the patient’s body. Faith healing has no basis in science, is biologically not plausible. Some methodologically flawed studies have suggested positive effects e.g. , however, this is not confirmed by sound clinical trials.
Faith healing is often alleged to be safe, and many of us might thus say: WHY NOT? The truth, however, is that it can turn into a dangerous, even fatal SCAM. It has been reported that two parents from Lansing, USA who shunned medical care for their critically ill newborn daughter because of their religious beliefs, despite warnings the baby could die, were convicted on murder and child-abuse charges stemming from the infant’s death.
Less than 24 hours after Abigail Piland was born in 2017, a midwife and her apprentice noticed the infant was very ill and advised the mother to seek immediate medical attention. The mother declined, saying the baby was “born complete” and “God makes no mistakes.” “When you see abnormal, it can stand out pretty stark,” Laurie Vance, the apprentice, testified. “We could tell pretty immediately there were concerns because of the coloring of her skin. Her skin had become yellow.” Abigail died less than two days later, the result of a treatable condition known as hemolytic disease of the newborn.
Abigail died on the morning of Feb. 9, 2017. The parents and a group of friends prayed over Abigail’s lifeless body, and no one at the home called 911 to report the death, according to testimony. Rachel Piland’s brother, Joel Kerr, who lives in San Jose, California, testified Monday that he called Child Protective Services and Lansing police after learning from other family members that Abigail had died. The baby had been dead for about nine hours by the time investigators arrived on the night of Feb. 9.
Joshua and Rachel Piland, who had been free on bond since the case began about eight years ago, were led from the courtroom in handcuffs after a jury in Ingham County Circuit Court convicted them of second-degree murder and first-degree child abuse following a two-week trial.
The jury was allowed to consider lesser charges of involuntary manslaughter and third-degree child abuse, as well as not-guilty verdicts. They nonetheless convicted the Pilands on the most serious charges. Both charges carry a maximum sentence of up to life in prison. Sentencing is set for June 11.
The jury deliberated about four hours over two days before returning its verdicts after listening to days of often complex testimony by police, lay witnesses and medical doctors.
“It’s about Abigail,” Deputy Chief Assistant Ingham County Prosecutor Bill Crino had said during closing arguments in the trial. “She didn’t choose to be born into this situation. She was vulnerable. She was not communicative. She didn’t have a voice. Today, she gets a voice.”
The attorneys for the Pilands had argued they cared for their daughter as best they could. They said Crino failed to prove the parents acted with the intent necessary for them to be guilty of murder or involuntary manslaughter.
The aim of this recent review was to investigate the efficacy of non-surgical and non-interventional treatments for adults with low back pain compared with placebo. It included all randomised controlled trials evaluating non-surgical and non-interventional treatments compared with placebo or sham in adults (≥18 years) suffering from non-specific low back pain.
Random effects meta-analysis was used to estimate pooled effects and corresponding 95% confidence intervals on outcome pain intensity (0 to 100 scale) at first assessment post-treatment for each treatment type and by duration of low back pain—(sub)acute (<12 weeks) and chronic (≥12 weeks). Certainty of the evidence was assessed using the Grading of Recommendations Assessment (GRADE) approach.
A total of 301 trials (377 comparisons) provided data on 56 different treatments or treatment combinations. One treatment for acute low back pain: (non-steroidal anti-inflammatory drugs (NSAIDs)), and five treatments for chronic low back pain:
- exercise,
- spinal manipulative therapy,
- taping,
- antidepressants,
- transient receptor potential vanilloid 1 (TRPV1) agonists)
were found to be efficacious. However, effect sizes were small and of moderate certainty. Three treatments for acute low back pain (exercise, glucocorticoid injections, paracetamol), and two treatments for chronic low back pain (antibiotics, anaesthetics) were not efficacious and are unlikely to be suitable treatment options; moderate certainty evidence. Evidence is inconclusive for remaining treatments due to small samples, imprecision, or low and very low certainty evidence.
The authors concluded that the current evidence shows that one in 10 non-surgical and non-interventional treatments for low back pain are efficacious, providing only small analgesic effects beyond placebo. The efficacy for the majority of treatments is uncertain due to the limited number of randomised participants and poor study quality. Further high-quality, placebo-controlled trials are warranted to address the remaining uncertainty in treatment efficacy along with greater consideration for placebo-control design of non-surgical and non-interventional treatments.
This is an important analysis, not least because of the fact that the research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The methodology is sound and the results thus seem reliable.
The findings are in keeping with what we have been discussing at nauseam here: no treatment works really well for back pain. For acute symptoms no so-called alternative medicine (SCAM) at all is efficacious. For chronic pain, spinal manipulation therapy (SMT) have small effects. As SMT is neither cheap nor free of risks, excercise is much preferable.
Considering that most SCAMs are heavily promoted for low back pain (e.g. acupuncture, Alexander technique, cupping, Gua Sha, herbal medicine, homeopathy, massage, mind-body therapies, reflexology, Reiki, yoga), this verdict is sobering indeed!
