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

test of time

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The Nazi relic of the German Heilpraktiker – alternative health practitioner, who practise so-called alternative medicine (SCAM)) – is a topic that I wrote about repeatedly, e.g.:

The path to becoming a Heilpraktiker is as unique as it is scandelously unregulated. By law, the profession requires no mandatory curriculum, no accredited school attendance, and no state-regulated university degree. Technically, anyone over the age of 25 holding a basic middle-school education (Hauptschulabschluss) can sit for the exam (the Heilpraktikerüberprüfung), even without any education or training at all. While some candidates choose to prepare by voluntarily attending a private and expensive school (a Heilpraktikerschule) for one to three years, the lack of standardized educational oversight leaves massive gaps in crucial medical and professional subjects.

Chief among these neglected subjects is, in my view, medical ethics. For those who do attend a school, average ethics instruction ranges from minimal to non-existent. Because private institutes design their own proprietary curricula, ethics is rarely taught as a standalone subject. Instead, it is briefly touched within broader modules concerning Berufs- und Gesetzeskunde (Professional and Legal Studies).

This systemic omission is directly tied to the narrow scope of the state licensing exam. Conducted by local health departments (Gesundheitsamt), the examination is explicitly designed around Gefahrenabwehr, i.e. the prevention of immediate danger to public health. The state’s priority is ensuring that applicants know what they are legally forbidden to do, such as managing highly infectious diseases, prescribing prescription-only medications, or practicing dentistry.

Consequently, broader ethical education is completely sidelined. Vital topics like the biomedical principles of patient autonomy, managing clinical conflicts of interest, and the complexities of informed consent are virtually absent. While some voluntary professional associations have established a code of conduct (Berufsordnung für Heilpraktiker), learning and understanding these ethical guidelines is entirely voluntary and self-guided.

Beyond ethics, maany other critical subjects are severely neglected in the Heilpraktiker schools, e.g.:

  • Evidence-Based Medicine (EBM) and Scientific Literacy: students are rarely taught how to critically appraise clinical research, differentiate between correlation and causation, or recognize the cognitive biases inherent in anecdotal “success stories.”
  • Pharmacology and Interaction Risks: While forbidden from prescribing prescription drugs, practitioners heavily utilize herbs and other dietary supplements. The study of how these substances interact with each other and a patient’s conventional pharmaceutical regimens is usually overlooked.
  • Emergency Medicine and Differential Diagnosis: Because training lacks mandatory, standardized clinical rotations, practical competency in identifying red flags, such as atypical cardiac symptoms or early-stage oncological presentations, is dangerously variable.

The Heilpraktiker system offers unparalleled freedom of practice. At the same time, there is a near total lack of rigorous educational standards. This huge and dangerous imbalance leaves practitioners ill-equipped and put the public at unacceptable risks. Here are some examples of what can thus happen:

  • The Klaus Ross / 3-Bromopyruvat (3-BP) Tragedy (2016): In one of Germany’s most notorious SCAM scandals, a Heilpraktiker operating a “Biological Cancer Center” in Brüggen treated terminally ill cancer patients with 3-Bromopyruvat, an unapproved, highly experimental chemical compound. Using an inaccurate kitchen scale to mix the powder himself, he administered massive overdoses via intravenous infusions. At least three patients died within days of the treatment, leading to his conviction for negligent homicide.
  • The “BG-Mun” Fake Cancer Cure Scandal (Schrobenhausen): A Heilpraktiker, working alongside a businessman, defrauded desperately ill cancer patients by selling a fake “miracle serum” called BG-Mun for up to €5,900 per package. The practitioner explicitly pressured patients to abandon their conventional oncological treatments (like chemotherapy), promising that the serum would reverse tumor growth. Chemical testing later revealed the expensive liquid was nothing but worthless dilutions of glucose and basic amino acids. Multiple patients, including a 52-year-old esophagus cancer patient who went public with the story, died after their cancers metastasized following their cessation of proper medical care.
  • Severe Complications from Autologous Blood Therapy (Eigenbluttherapie): A widespread SCAM among Heilpraktiker involves drawing a patient’s blood, mixing it with ozone, oxygen, or homeopathic remedies, and reinjecting it back into the muscle or vein to “stimulate the immune system.” Due to insufficient training in strict clinical hygiene, numerous documented cases have occurred where patients suffered from sepsis, internal abscesses, and systemic bacterial infections requiring emergency ICU hospitalizations.
  • Misdiagnosis of Life-Threatening Emergencies: Because the Heilpraktiker exam does not mandate clinical training, practitioners have no clinical experience and frequently miss time-critical medical diagnoses. Documented cases include patients presenting with atypical chest pain being treated with acupuncture for “energy blockages” rather than being immediately referred to a hospital for an evolving myocardial infarction. Similarly, early-stage, highly curable melanomas or other malignancies have been misidentified as benign skin lesions or metabolic imbalances, delaying life-saving surgeries until the diseases reached terminal stages.
  • Ineffective SCAMs for Acute Psychiatric Crises: Some Heilpraktiker choose to specialize in psychotherapy (Heilpraktiker für Psychotherapie). Scandals have arisen where patients suffering from severe clinical depression or acute psychotic episodes were treated solely with Bach flower remedies, St. John’s wort, or talking therapy rooted in esoteric ideas. The rejection of conventional psychiatric intervention and pharmaceutical stabilization in these acute phases has directly led to preventable self-harm and suicides.

So, why does Germany put up with the Heilpraktiker?

Despite repeated and fierce criticism, the German Heilpraktiker is sustained by a combination of law, politics, and tradition. The primary legal shield is Article 12 of the German Basic Law, which guarantees freedom of occupation (Berufsfreiheit). Because the state’s entry exam pretends to screen for immediate public danger (Gefahrenabwehr), courts pretend the system is legally sufficient; completely banning the profession would trigger severe constitutional challenges.

Furthermore, as often discussed on this blog, SCAM enjoys immense public popularity in Germany. Millions of Germans value the Heilpraktiker for the long and empathetic consultations that the overburdened conventional insurance system rarely permits. This widespread voter support, coupled with a highly organised political lobby, makes outright abolition a political non-starter.

Thus Germany continues to have a two-tier health system. This paradox exposes a profound cultural contradiction in the German psyche, which is famously stereotyped as risk-averse, highly bureaucratized, and obsessed with systemic order. While Germany tends to regulate everything from highway speeds to the exact composition of its beer, its tolerance of the Heilpraktiker system represents a massive, hazardous blind spot.

By clinging to an outdated Nazi-law out of political convenience and romanticized cultural traditions, the state has allowed this two-tier medical landscape to persist – one built on rigorous science, and another shielded by a legal loophole. In trying to uphold the constitutional freedom of occupation, the German legislative framework inadvertently compromises a far more fundamental duty: the protection of the public from dangerous quacks. This leaves a nation known for “playing it safe” in the ironic position of legally sanctioning pseudo-scientific nonsense within its healthcare system.

A fuller analysis of the Heilpraktiker can be found in my book “Vorsicht Heilpraktiker” [in German].

I was reminded of a paper that I published a long time ago – 23 years to be precise. It is entitled THE LECTURE FROM HELL.  As it is not available online, let me give you a slightly revised version of it here:

When it comes to giving lectures, I have certainly made every mistake there is, and therefore I consider myself qualified to write this personal account on how to deliver THE LECTURE FROM HELL. I do this in the hope that others might learn from my imperfections.

In preparing for a lecture, it is best to be cool and leave things to the last minute. You are so gifted and competent that a few scribbles made on the way to the venue will easily suffice for fascinating your audience. Don’t bother enquiring who they are; what you have to say will capture the attention of a lay audience as much as that of a highly specialised one.

The kind people who have invited you will certainly have suggested a topic. Don’t get irritated by that; you know best what you can and want to talk about and, after all, it is always best to stick to what you know. If your subject is palliative cancer care, for instance, it should not be too difficult, after a few introductory sentences, to shift the attention to the most revealing survey you conducted on 10 back pain patients 25 years ago – cancer patients suffer from back pain too!

From the outset, you need to show the audience that you are better than they are. A good way of achieving this aim is to display your knowledge of as many acronyms as possible. Making abundant use of abbreviations has the added advantage that it could hide a few glitches in your arguments (or spelling). People might even think you are talking about palliative care after all.

Another golden rule is never produce evidence for your statements. Some people use visual aids to produce the evidence, but this is both tiring and confusing (and it would, of course, require much more preparation than you allowed for). If you want to use visual aids, use photographs of your kids (pets if you are childless) or your last holiday in Corfu. This will add the personal touch that people crave. Surely, if they had wanted evidence they would have gone to a library, not to your lecture.

It is advisable to spend as much time as possible with lengthy preliminaries, particularly if you are not really covering the subject as printed in the programme. Mention that you first met Cathy (who just introduced you) when you were both in nursery and give a full and colourful account of your relationship since then. If you haven’t actually been to nursery with Cathy, perhaps you could talk about the car accident you saw en route and what it made you think of. Or you could take the holistic approach, ask everyone to stand up, do a few relaxation exercises and feel the flow of energy in the body, room or universe. The obvious aim is to leave as little time as possible for the proper lecture. Thus, you can pretend to know much more about your subject than you had time to disclose and you can end your unfinished lecture with the upbeat exclamation ‘‘yeah! perhaps another time’’.

Most lecturers find the ensuing discussion period the most challenging part of their task. Not you! First, you have wisely ensured that there is no time left. Thus, the discussion slot will either be completely cancelled or it will be refreshingly brief. When the first difficult question comes your way, remember the important principle: you are so much cleverer than anyone else in this room! Make sure you show it. Arrogance has always been a perfect shield for hiding incompetence.

Another good strategy is to ridicule the person who dared ask the awkward question. Thus, they end up with egg on their face instead of you. If all else fails and you really don’t know how to answer, the best approach is to say: ‘‘this is a bit too complex right now; perhaps I could explain this to you later over coffee’’. Just ensure that you are safely on the way home when the coffee break starts.

Generally speaking, the overriding principles of a truly diabolically bad talk are quite simple. Lectures are neither the time nor place for transmitting knowledge to those who came to listen. Their predominant purpose is to massage the lecturer’s ego and increase their income. If you keep this in mind, you will stop worrying about things like evidence, structure and delivery and simply enjoy the outing.

I was reminded of this article because I saw the title of a recently published paper: HOW TO GIVE A BAD TALK. It starts as follows: “It is crucial to know how to communicate your work by delivering an effective talk, but our training for doing so is limited, so it is a skill often learned by watching others — who sometimes do it badly”.

Sadly, I could not read on; the journal asked almost 30 Euros for the privilege! So, I will never know what else I can do to give a truly poor lecture. Yet, I did learn something important: the knowledge of how to give a bad talk does not always come cheap!

I recently coined a new term: Chutzpah-Based Medicine (CBM). It requires a bit of an explanation which I herewith try to deliver. Medical decisions should rely on a rational hierarchy: systematic reviews at the top, followed by randomised clinical trials, observational studies, and way down at the bottom we anecdotal experience and opinion. The new paradigm of “Chutzpah-Based Medicine” (CBM) turns this pyramid upside down.

In CBM, double-blind trials are replaced by double-down charisma. Why wait 10 years for evidence when you can assert a medical breakthrough in 15 seconds on video with dynamic lighting, an unbuttoned linen shirt, and absolute, unshakable certainty? Here is an overview of the core tenets and leading luminaries of this revolutionary field.

The Dogmas of CBM

  • The Confidence-to-Evidence Ratio: The validity of any health claim is directly proportional to the volume, velocity, and eye contact with which it is delivered.
  • The “Big Pharma Secret” Axiom: If a treatment worked and had evidence, it would evidently be mainstream. Therefore, the total absence of evidence is the ultimate proof that “They” are trying to suppress it.
  • Quantum Syllogism: If you insert the word “quantum” before anything, biology no longer applies, and anything becomes possible.

Four Ambassadors of CBM

  1. Gwyneth Paltrow

The undisputed pioneer of High-End CBM. Paltrow proved that with enough aesthetic minimalism and raw audacity, one can sell jade eggs, vaginal steaming, and “psychic vampire repellent” as essential wellness routines. Scientific consensus is but a sign of unrefined taste. See also previous posts, e.g.:

  1. Dr. Mehmet Oz

Before entering politics, Dr. Oz laid the groundwork for CBM. He demonstrated that a cardiothoracic surgeon could look directly into a camera and declare green coffee bean extract a “miracle burn in a bottle” without blinking. “Magic” is, according to Oz, a valid clinical outcome. See also previous posts, e.g.:

  1. Dr. Joseph Mercola

He is a true titan of digital CBM mastering the art of building a multi-million-dollar supplement empire by warning millions that modern medicine is a toxic conspiracy, while conveniently offering his own unapproved tanners, liposomal vitamins, and other SCAMs as the sole salvation. See also previous posts, e.g.:

  1. Deepak Chopra

Chopra brought profound philosophical chutzpah to CBM by blending endocrinology with poetic quantum bollox. By asserting that human bodies are “localized energy fields” capable of “quantum healing,” he elevated clinical vagueness into a high-margin spiritual enterprise. See also previous posts, e.g.:

While Evidence-Based Medicine requires years of arduous testing, CBM offers immediate answers, simple villains, and premium-priced remedies. Why let a clinical trial get in the way of an excellent means of getting rich quickly?

Religiosity has been linked to a wide range of health outcomes, with evidence for both benefits and harms.

Alleged positive effects

Many studies have found positive associations between religious involvement and physical and mental health, including lower mortality, better self-rated health and greater psychological well‑being. However, most of this literature is methodologically weak, with selection bias, poor control for confounders and selective reporting, so firm causal conclusions are difficult.

Religiosity and spirituality have frequently been associated with positive effects on mental health, such as higher levels of life satisfaction, meaning in life, hope, optimism and lower rates of depression, substance misuse and some forms of suicidal behaviour. Proposed mechanisms include social support from religious communities, promotion of coping resources, encouragement of health‑promoting behaviours and cognitive frameworks that help some people make sense of adversity.

In addition, observational studies have linked religious participation with positive effects on physical endpoints, such as reduced smoking, more moderate alcohol use and in some cases better cardiovascular outcomes and lower all‑cause mortality, though effect sizes are usually modest. Cross‑national analyses show that religious people sometimes report better self‑rated health, but these associations vary widely by country and are sensitive to socioeconomic and cultural context.onlinelibrary.

Alleged negative effects

Some aspects of religiosity might be harmful: religious struggles—such as feeling punished by God, spiritual discontent or conflict with religious communities—are consistently associated with higher levels of depression, anxiety and distress. Some studies also suggest that rigid or punitive religious beliefs can exacerbate guilt, internalized stigma (for example around sexuality) and delay help‑seeking for mental illness.

In highly secular societies, belonging to a religious minority may correlate with poorer health, possibly via discrimination, lower social integration or economic disadvantage. A critical economic analysis even reports a negative relationship between religious background and some health indicators once socioeconomic factors are carefully controlled, challenging simple “religion is good for you” narratives.

Methodological problems

Much of the evidence relies on observational studies, making it difficult to be sure about causality: healthier or more socially integrated people may be more likely to be religiously active. Measures of religiosity and spirituality are heterogeneous, ranging from attendance to private practices to diffuse “spiritual well‑being”, which complicates comparisons and may inflate positive findings. In other words, the effects of religiosity on health are less that certain or clear.

Homeopaths tend to voice a standard set of arguments when confronted with irrefutable evidence against homeopathy. In the discussion sections of this blog, we heard them all:

  • “The negative trials are flawed designed.” They claim these trials were done by ungifted therapists or used the wrong remedies, wrong potencies, wrong dosing schedules, etc. Therefore, they do not reflect true homeopathic practice.
  • “Homeopathy is individualised, RCTs can’t capture it.” They argue that randomised clinical trials are inherently unsuitable because homeopathic treatment must be tailored to each patient, rendering RCTs “unfair” or even “unscientific.”
  • “Only a fraction of the evidence has been considered.” They assert that critics cherry-pick negative evidence and ignore positive small trials, case series, or observational data that they regard as equally valid.
  • “There is much positive evidence.” They point to older or methodologically weak positive studies and claim these outweigh or at least balance the otherwise negative body of evidence.
  • “Meta-analyses and systematic reviews are biased and/or politically motivated.” They allege that negative evaluations are driven by ideological hostility to homeopathy, Big Pharma influence, or institutional bias.
  • “Statistical significance is not the same as clinical reality.” They argue that  statistics miss “real-world” benefits observed in practice and that evidence-based medicine is too narrow.
  • “Evidence-based medicine overvalues RCTs and undervalues experience.” They insist that long clinical experience, case reports, patient testimonies, etc. should count as strong evidence and that their accumulated practice is itself proof of efficacy.
  • “Patient demand and satisfaction are evidence.” They use high patient satisfaction, repeat consultations, and word-of-mouth popularity as a proxy for effectiveness.
  • “Millions use it worldwide.” They argue that longstanding, global usage implies that it must work; otherwise it would have disappeared.
  • “Conventional medicine is not perfect either.” They respond to criticism by highlighting harms, errors, and historical reversals in conventional medicine, implying that science-based critics lack moral authority.
  • “If it were only placebo, it wouldn’t work on XY.” They claim efficacy in infants, animals, or unconscious patients as evidence that placebo cannot fully explain the effects.
  • “Mechanisms aren’t fully known, but that doesn’t matter.” They liken homeopathy to earlier medical advances whose mechanisms were unknown at the time (e.g. aspirin), arguing that lack of a plausible mechanism is not a valid reason to reject positive clinical observations.
  • “Physics and chemistry are incomplete; future science will explain it.” They invoke concepts like quantum physics, nanostructures, or complex systems to argue that current science is still too limited to explain homeopathy.
  • “Regulatory / institutional conspiracies.” They suggest that powerful pharmaceutical or medical lobbies seek to suppress homeopathy to protect their financial interests.
  • “Homeopathy is cheap and safe; risk–benefit favours it.” They argue that even if evidence is thin, the very low risk and low cost justify its use.
  • “The therapeutic encounter itself is part of the effect.” They turn criticisms about placebo and context effects into a strength: the long consultation, empathy, and attention are claimed to be legitimate and central components of homeopathy.
  • “Freedom of choice / patient autonomy.” They shift from scientific to ethical/political ground, insisting that patients should be free to choose homeopathy regardless of scientific consensus.
  • “Skeptics misunderstand what homeopathy really is.” They claim that people conflate homeopathy with herbalism, confuse potencies, or misunderstand Hahnemann’s principles, so their critiques do not address true homeopathy.
  • “Critics don’t see the individual ‘miracle’ cases.” They counter population-level data with vivid anecdotes of dramatic improvements which they regard as decisive.
  • “Negative evidence is ‘absence of evidence’, not ‘evidence of absence’.” They argue that failed trials or negative reviews merely show that efficacy hasn’t been proved yet, not that homeopathy does not work.
  • “Science evolves; today’s ‘overwhelming evidence’ may be overturned.” They claim that scientific consensus has been wrong before and that homeopathy will eventually be vindicated when paradigms shift.

In discussions with homeopaths, these points are repeated endlessly. One could easily get the impression of a broken record. All of the above arguments have in common that – even as some of then contain a kernel of truth – they are erroneous. In theory it could be easy to point this out to the stereotypical homeopathy promoter; in practice, however, it often is impossible, since the broken record continues turning senselessly.

 

On May 27, 2026, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) announced they are investigating a 3rd multistate outbreak of Salmonella infections linked to moringa powder supplements in 2026. Moringa oleifera supplements (including green powders and capsules) are heavily marketed as a “superfood” and a natural multivitamin powerhouse. They are primarily promoted for:

  • Nutritional Support: Providing high concentrations of protein, iron, calcium, and vitamins A, C, and E.
  • Energy & Metabolism: Boosting daily vitality and supporting healthy weight management.
  • Blood Sugar & Heart Health: Helping to regulate glucose levels, lower cholesterol, and manage blood pressure.
  • Immune & Inflammation Support: Using rich antioxidant content (like quercetin) to combat cellular stress and ease joint pain or chronic inflammation.

The agencies re-opened an outbreak investigation originally closed on March 17 after discovering 22 new illnesses from 4 US states. The total now stands at 119 patients across 36 states infected with Salmonella Typhimurium or Salmonella Newport strains, including 32 hospitalizations and no deaths. Illness onset dates range from August 22, 2025, to April 26, 2026.

Among 79 interviewed patients, 70 reported consuming moringa leaf powder products. The recalled product list expanded to include TNvitamins-brand Ultra Potent Complete Green Superfood Moringa capsules and Doctor’s Pride Complete Green Superfood Ultra Potent Moringa capsules distributed by Total Nutrition Inc., plus Why Not Natural Pure Organic Moringa capsules and All Live it Up-brand Super Greens dietary supplement powders.

The new investigation involves Salmonella Typhimurium infections linked to MOGO-brand moringa powder capsules distributed by MOGO Moringa LLC of St. Louis. 18 people infected with the outbreak strain have been reported from 14 states, with illness onset from February 3 to April 7, 2026. Of 8 interviewed individuals, 6 reported consuming moringa powder capsules, including 4 who specifically consumed MOGO-brand products. Seven hospitalizations occurred with no deaths reported. MOGO Moringa LLC has recalled specific lots (#15525AA EXP 6/2027 and #00926AA EXP 1/2028) of MOGO-brand Pure Moringa Oleifera capsules. The FDA is conducting traceback investigations to identify the contamination source and working with state partners to collect samples.

In April 2026, the FDA closed a separate outbreak investigation involving moringa supplements contaminated with “extensively drug-resistant” Salmonella. This outbreak linked to Rosabella-brand moringa powder capsules distributed by Ambrosia Brands LLC resulted in seven illnesses across seven states, with three hospitalizations.

Three moringa-related outbreaks in a single year underscore systemic issues affecting botanical ingredients in the global natural health industry, particularly regarding imported moringa leaf powder contamination. Health officials urge consumers who used moringa products and developed symptoms – diarrhea, abdominal cramps, fever within 12-72 hours – to seek medical attention and inform doctors about potential Salmonella exposure. Healthy adults typically remain ill for 4-7 days. Severe diarrhea may require hospitalization.

Update, 7/6/26:

Following the May 27, 2026, announcements, Total Nutrition Inc. expanded its voluntary recall on June 2 to include Lot 2748 (Exp. 07/2027) for both TNVitamins and Doctor’s Pride brands after a traceability review linked it to previously contaminated raw materials. Meanwhile, the active investigation into MOGO-brand capsules remains unchanged with 18 reported illnesses, and the FDA continues to urge consumers to check their pantries for any remaining Rosabella-brand products from the closed April outbreak. Federal and state health officials are actively working with major online platforms—including Amazon, Walmart, and TikTok Shop—to ensure all recalled moringa supplements are fully removed from the market, while reminding consumers to seek medical care if they experience Salmonella symptoms.

I came across an interesting paper entitled “The Ethics of Tawas and Other Rituals in Medical Practices“. Here is its abstract:

Rituals in medical practice have either been seen as an anthropological aspect of current biomedical processes or as a pre-scientific aspect of complementary and alternative medicine (CAM). In either tendency, the literature has since failed to account for these rituals as rituals—conveyors of meaning, expressions of identity, and even as a rite of passage from illness to wellness. As an alternative to current discussions, this paper presents the case study of tawas, a diagnostic ritual from Philippine traditional medicine that determines personalistic and mystical causes of illnesses. As a non-intrusive procedure, tawas involves incantations and some ritual objects, e.g., rice, candle, axe, etc., that do not pose any direct harm nor benefit to the patient. While complete reliance on tawas at the expense of proper medical procedures could harm patients, the very ritual of tawas itself occupies a limbo within non-beneficence and non-maleficence. Following a Wittgensteinian perspective of treating rituals as meaning-laden human activities, this paper argues that rituals like tawas, much like other rituals embedded in biomedical practices, should be understood as rituals and not as empirical cures, thereby allowing their tolerance in medical practice in general.

The author seems to advocate for the cultural integration of traditional practices like tawas into a broader medical framework. They categorize tawas not as a physiological intervention, but define it as a conveyor of meaning.  By addressing the “meaning-laden” aspect of illness, the ritual may address the psychological and social dimensions of a patient’s health, even if it has no effect on their physical pathology.

It is claimed that, since tawas involves non-intrusive objects (candles, rice), it is physically benign. At the same time it is acknowledged that “complete reliance” on tawas could harm patients. From a clinical safety standpoint, the “limbo” is only maintained if the ritual is strictly adjunctive rather than alternative.

The text uses a Wittgensteinian perspective, focusing on rituals as expressions rather than theories. Modern neuroscience suggests that the “ritual” of care—the white coat, the focused attention, the diagnostic process—triggers real neurobiological changes (e.g., dopamine and endorphin release). Aacknowledging the symbolic healing power that rituals have on patient anxiety and the “meaning response,” which can objectively improve health outcomes by reducing cortisol and stress.

The author identifies tawas as a diagnostic ritual which might well be the most contentious point. In science, a “diagnosis” must be reliable and valid. Tawas clearly fails the scientific criteria for validity. The author’s defence is that tawas shouldn’t be judged by those criteria at all. While this might be philosophically sound, in a clinical setting, a “mystical diagnosis” must conflict with a biological one, potentially leading to patient non-compliance with life-saving treatments.

I remember it well: when I was a kid, I went every day in the evening to a nearby farm to fetch a litre of luke warm raw milk. I was lucky; I never caught tuberculosis or any other infection that is transmitted in this way.

Today, raw milk has become the centrepiece of a heated debate. Once only on rural homesteads, unpasteurized milk is now being championed by a powerful coalition of political figures like Robert F. Kennedy Jr., promoters of so-called alternative medicine (SCAM), and “trad wife” influencers. This movement frames raw milk as a “magical health secret” suppressed by a corrupt establishment. However, beneath the veneer of “food freedom” and nostalgic aesthetics lies a complex interplay of populism, nutritional misinformation, outright BS, and significant public health risks.

The issue is largely fuelled by RFK Jr. and his “Make America Healthy Again” (MAHA) idiocy. For him, raw milk is less of a dietary preference and more of a symbol of resistance against federal overreach. He frequently characterizes the FDA’s restrictions on raw milk as a “war on farmers” and an example of “regulatory capture.” In his worm-eaten mind, federal agencies are not protecting the public from pathogens but are instead protecting the profits of “Big Dairy” by criminalising traditional foodways. By pushing for the legalisation of raw milk, Kennedy taps into a deep-seated distrust of institutions that has intensified in the post-pandemic US. He frames the choice to drink unpasteurized milk as a fundamental civil liberty, positioning himself as a defender of the individual against a nasty “nanny state.”

Simultaneously, the “trad wife” and SCAM movements are providing the lifestyle framework for raw milk promotion. On social media, influencers portray a return to traditional domesticity, featuring sourdough starters, hand-churned butter, and glass jars of creamy, raw milk. In this context, raw milk provides a “moral signal” for those who have little else to worry about. What counts is the willingness to go to great lengths to bypass industrial food systems and provide “pure” and “natural” nourishment for the whole family – because pasteurisation “kills” the milk, destroying vital enzymes and probiotics that could cure everything from asthma to lactose intolerance.

As soon as these claims are held up to scientific scrutiny, the “magic” begins to dissipate. The core argument – namely that raw milk is nutritionally superior – is largely unsupported by sound evidence. Modern pasteurisation is as non-invasive as possible. While heat slightly reduces levels of Vitamin C, milk is not a primary source of that vitamin anyway. Moreover, the levels of protein, calcium, and essential minerals remain virtually identical to the raw product. Furthermore, the valuable “enzymes” touted by advocates are enzymes that the human stomach acid neutralizes before they can be absorbed.

On top of all this, there is potential for serious harm. The most dangerous aspect of the raw milk nonsense is the dismissal of microbial risk. Before pasteurisation became standard in the early 20th century, milk was a leading cause of tuberculosis, typhoid, and scarlet fever. Today, even on the most meticulously managed farms, cows can naturally shed E. coli, Salmonella, and Listeria and contamination can occur in a split second during the milking process. The rise of the H5N1 (Bird Flu) virus in dairy cattle in recent years has added a lethal new variable; while pasteurisation effectively inactivates the virus, raw milk remains a potential vector for human infection. A recent study showed, for instance, that unpasteurized milk, consumed by only 3.2% of the population, and cheese, consumed by only 1.6% of the population, caused 96% of illnesses caused by contaminated dairy products.

So, the current raw milk frenzy puts a spotlight on the ignorance of those who support it. While raw milk is marketed as a health-conscious return to nature, it is primarily a brainless and unnecessary revival of long-forgotten risks. Pasteurization is – after immunisation (that is also rejected by these clowns) – one the most successful public health interventions in history. Advocates are not just embracing “food freedom”; they are embracing a level of risk that modern medicine spent a century eliminating.

 

The US “Health Freedom Movement” (HFM) is a coalition of activists, alternative practitioners, supplement and device manufacturers, and libertarian or populist politicians who oppose strong government regulation of healthcare. They claim to defend the individual’s right to choose any treatment or product they consider beneficial, especially so-called alternative medicine (SCAM).

Its roots lie in resistance to medical licensing and in movements around homeopathy, naturopathy, and chiropractic, which often portrayed organized medicine as a cartel limiting patient choice. The John Birch Society and other conservative groups use the term to oppose fluoridation, vaccination mandates, and federal health programs. During 1990s–2000s, the Dietary Supplement Health and Education Act (DSHEA) of 1994, backed by a coalition of supplement companies and “health freedom” advocates, limited the FDA’s pre‑market control over supplements; libertarian politicians like Ron Paul and figures such as Prince/King Charles support aspects of this agenda. More recently, anti‑vaccination activism, opposition to the Affordable Care Act, and then COVID‑19 mandates and vaccines gave the HFM a major boost and re-grouped as “medical freedom” or “health freedom” across partisan lines, but with a strong right‑wing infrastructure.

The HFM’s main players include politicians (e.g. Ron Paul, Tom Harkin, Orrin Hatch, Robert F. Kennedy Jr.) and media personalities (e.g. Gary Null, Kevin Trudeau, and many supplement‑selling influencers as well as SCAM doctors). Many of them have strong financial ties to supplement, wellness, or SCAM industry.

The HFM’s stated aims sound liberal: individual autonomy, informed and access to SCAM. In practice, however, its core goals are sharper and consistently deregulatory:

  • Limit or abolish pre‑market safety and efficacy requirements for supplements and many SCAMs.
  • Oppose or roll back mandatory childhood vaccination, COVID‑19 vaccination and mask rules, school-entry requirements, and sometimes even basic disease‑reporting obligations.
  • Resist overarching government health programs, including water fluoridation, electronic health records, and population‑level data sharing, which they portray as surveillance or tyranny.
  • Create broad legal shields for all types of SCAM practitioners and restrict the enforcement powers of medical boards and public‑health authorities.

While the rhetoric centres on “freedom” and “choice”, the policy is liberating commercial interests from evidence‑based standards and oversight. For this, the HFM uses a mixture of advocacy and classic populist agitation:

  • Legislative lobbying: Drafting model bills that redefine or exempt SCAM practitioners, weaken vaccination requirements, and restrict state health departments’ emergency powers.
  • Litigation: Groups such as the “Health Freedom Defense Fund” use lawsuits against mask mandates, vaccine requirements, and school or airline rules both as legal tools and as high‑visibility fundraising and mobilization devices.
  • Electoral politics: Endorsing and funding candidates who promise to “reign in” public‑health agencies, defund WHO, or defy CDC guidance; in some places, anti‑vaccine activists have captured local hospital or school boards.
  • Media ecosystems: Conferences, podcasts, Substack newsletters, and “documentaries” circulate narratives of regulatory capture, big‑pharma malfeasance, and heroic mavericks, often entwined with sales of supplements or courses.

These activities reinforce distrust of science and conventional medicine and thus create a host of issues and problems:

  • Selective use of autonomy: Autonomy is invoked vigorously when opposing vaccines, fluoridation, or regulation of supplements, but tend to disregard it when patients are misled by misinformation, coercive marketing, or opaque conflicts of interest in the alternative sector itself. Yet protection against deception and unsafe products is essential for meaningful autonomy; “choice” among misrepresented options is not genuine choice.
  • Systematic downplaying of risk and evidence: The HFM treats lack of evidence of benefit as if it were evidence of safety and legitimacy and often dismisses adverse‑event data. Regulators and critics must meet impossibly high standards, while proponents of SCAM face essentially none.
  • Commercial conflicts of interest: Many leading voices within the HFM derive substantial income from selling SCAM. The HFM criticizes “Big Pharma” conflicts of interest while largely ignoring or concealing its own.
  • Wilful ignorance of collective harms: Opposition to vaccination, masking, and quarantine treats infections as purely individual matters, neglecting that infectious disease risk is shared and that one person’s “choice” can impose morbidity and mortality on others. Yet any rights framework that leaves no space for legitimate public‑health constraints on individual choice is incompatible with controlling epidemics.
  • Alliance with broader conspiracist and extremist currents: Sections of the HFM have fused with anti‑globalist, anti‑UN/WHO, and sometimes far‑right political currents, amplifying conspiracy narratives and distrust that spill over into many domains beyond health. Thus they corrode trust in institutions that are necessary for coordinating large‑scale health responses.

In a nutshell, the HFM is a deregulatory, commercially entangled project that uses the language of liberty to erode evidence‑based medicine and to normalise quackery as well as anti‑vaccination politics. To put it bluntly: the HFM does not seem to operate in the best interest of either the individual patient or the collective public health.

The defence of anthroposophical medicine – or of any other unproven modality – as articulated, for example, by figures like Weleda CEO Tina Müller, presents a vision of patient-centred care and economic pragmatism. However, when held against the light of current clinical standards and the principles of evidence-based medicine (EBM), it reveals significant cracks.

The most profound problem lies in the definition of scientific evidence. Proponents often point to decades of “positive experience” and high patient satisfaction as proof of effectiveness. Yet, in the hierarchy of science, anecdotal success sits at the very bottom. Anthroposophical treatments lack biological plausibility. Their perceived benefits are largely indistinguishable from context effects (such as placebo). Anthroposophical medicine might provide more time, empathy, and personal attention – factors that undoubtedly improve a patient’s well-being but do not validate the effectiveness of the specific remedies used. When independent bodies subject these treatments to rigorous, high-quality trials, the purported effects usually vanishe.

Anthroposophical medicine represents merely a tiny percentage of our healthcare expenditures. Therefore, proponents argue, little money would be saved by getting rid of it. This argument is a calculated distraction from the ethical core of the issue. While the fiscal burden may be marginal, the scientific cost is immense. A statutory health insurance system is built on a social contract of solidarity; it functions under the premise that public funds are reserved for treatments of proven value and effectiveness. To fund therapies that lack plausibility as well as reproducible results is to erode the credibility of medicine and rational thought. It is not a question of the amount of money, but the principle of integrity: every Euro, £ and $ spent on unproven treatments is a euro, £, and $ diverted from underfunded and often life-saving healthcare.

The regularly made appeal to the Swiss Model as a beacon of success also requires a more critical reading. The integration of so-called alternative medicine (SCAM) in Switzerland was, at its heart, a result of direct democracy rather than evidence. While the Swiss public voted for inclusion, the majority of the medical community remains deeply sceptical. To cite Switzerland as “proof” that anthroposophical medicine has fulfilled the criteria of EBM is to conflate political popularity with scientific validation. Democracy can decide how a nation spends its money, but it cannot vote a reliable evidence-base into existence.

Finally, we must consider the human risk of legitimizing non-evidenced-based practices. When a state-sanctioned insurance system places such therapies on the same pedestal as EBM, it risks misleading vulnerable individuals. For patients facing chronic or life-threatening illnesses, the “integrative” path can lead to a dangerous delay in seeking conventional, life-saving interventions. By treating subjective belief and peer-reviewed science as equal peers, we risk entering a “post-truth” medical era where the desire for a “natural” or “holistic” experience outweighs the necessity for proof.

In conclusion, while the call for a more “human” and “holistic” medical system might be noble, it must not come at the expense of scientific rigor. It is deeply misleading to imply that this is an ‘either or’; good medicine will always be based on both. A healthcare system that prioritizes popularity over proof risks becoming a system of expensive comfort rather than one of effective healing. True patient appreciation lies not in offering unproven choices, but in ensuring that every treatment covered by the public purse is supported by sound evidence. Not following this strategy is a disservice to patients and to progress.

So, the next time you hear people defending anthroposophical medicine or any other unproven modality, please look behind the smoke screen and find out why they do it. More often than not, you will then identify a massive conflict of interest. My advice is to listen to independent experts and to dismiss the people with an axe to grind.

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