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

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I have recently been alerted to this remarkable article. It starts by telling the story of a patient who got rid of his alcohol addiction by using a homeopathic remedy. The story ends with these words: “It’s been two years now since I have been sober and I have no plans to consume alcohol ever gain.” Then the article continues:

This was Rahul’s story. Do you find your story quite similar to Rahul’s? Do you feel yourself falling down the abyss of addiction? Like you’ve lost control over your actions? Then Be like Rahul and take the first step. Join the 45 day No Alcohol challenge and see the difference for yourself.

There are Homeopathic Ingredients which work wonders in Getting You Rid of Addiction to Alcohol. Alcoban is a Homeopathic Anti-Addiction Treatment that helps you Overcome Addiction Using Homeopathy. It is one of the Most Trusted Homeopathic Anti-Addiction Treatment in the world. It can help an addict Beat Any Type of Addiction whether its tobacco, alcohol, drugs or anything else. Regular intake of this homeopathic formula gradually decreases the cravings of drinking. Continuous and prolonged use of Alcoban drop decreases cravings of bad things. You can Get Rid of Alcoholism with Alcoban Homeopathic Drop.

All the Effective Homeopathic Ingredients For Anti-Addiction present in Alcoban are individually quite effective in dealing with various symptoms of addiction but when combined together they form a potent formula that can Curb Tobacco Craving, Treat Alcohol Withdrawal Symptoms, make you Stop Using Drugs. Alcoban is also tasteless and colorless which means that it can be given without addict’s knowledge.

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Naturally, I was interested, not because I am an alcoholic but because I was intrigued by the homeopathic remedy and what it might contain. The Alcoban website itself informs us that:

Alcoban Drop is homeopathic anti-addiction formulation made utilizing the benefits of selective homeopathic ingredients, which are further processed as defined in Homeopathy to induce reluctance towards habit-forming mood-altering substances. The substances used in Alcoban detoxify the body for toxic materials deposited in the system from prolonged use of any such substance.

Alcoban is a potent remedy to stop and recover from substance abuse without facing the extreme withdrawal symptoms.

  • Alcoban treatment suppresses cravings naturally.
  • Alcoban helps in anxiety as well as yearnings.
  • Alcoban is well suited to outpatient treatment.
  • Alcoban acts as an anti-addiction treatment for tobacco, alcohol, drug, and smoking addiction.
  • Alcoban treatment is holistic.

Precautions while using:

  • People with severe heart ailments or any other major disease should use Alcoban only after consulting their physician.
  • Pregnant or lactating females should avoid using it.
  • If there is excessive vomiting on using Alcoban, the doses should be reduced. If there is still no change, then it should be stopped completely.

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Sadly, I could not find any information about Alcoban’s ingredients. Nor did I find any evidence that the product is effective. But I don’t give up that easily. A Medline search produced one paper on homeopathy for alcoholism:

This paper discusses the use of homoeopathy in the work of a community alcohol team, focusing on the application of homoeopathy for treating sleep disorder in alcohol-dependent clients. This work is placed in the context of the historical use of homoeopathy for treating ‘alcoholism’ and of the increasing use of complementary therapies in mainstream health care and in drug and alcohol agencies. Issues of research methodology and measurement of outcomes are examined. Examples of some specific homoeopathic treatments, together with a case report, are given to illustrate the potential uses of this form of therapy. It is concluded that homoeopathy can provide a valid and effective therapy to help clients break the cycle of dependence on alcohol. A number of further research questions arise and much clinical and research work needs to be done by those attempting to bring complementary therapies into drug and alcohol treatment.

The article is 22 years old and tells us very little. In particular it does not amount to anything like evidence of efficacy, nor does this indicate that there is much research going on in this area.

What can we conclude from all this?

Not a lot!

Perhaps that Alcoban is not just tasteless and colourless, as the Indian manufacturer proudly points out, but also useless?

In 2010, we published an investigation which revealed that the majority of chiropractors and their associations in the English speaking world seem to make therapeutic claims that are not supported by sound evidence, whilst only 28% of chiropractor websites promote lower back pain, which is supported by some evidence. If you go on the Internet (or just study this blog), you can easily see that the advertising of chiropractors is still far from adequate. Recently, a researcher investigated this issue systematically.

The aims of this survey were to determine the frequency, type and nature of at-risk advertising by Australian chiropractors and physiotherapists and whether there is a correlation between professional association membership and advertising guideline compliance. A cross sectional audit examining practitioner advertising was performed on representative samples of Australian chiropractors and physiotherapists. Two auditors examined advertising by 380 physiotherapists and 359 chiropractors for material potentially in breach of the regulatory authorities’ advertising guidelines. The advertising appeared on practitioner websites and linked Facebook pages.

Two-hundred and fifty-eight (72%) audited chiropractors and 231 (61%) audited physiotherapists had breaches of the Advertising Guidelines on their websites and linked Facebook pages. The frequency of breaches by chiropractors was higher. The type and nature of the breaches by chiropractors was potentially more harmful. Membership in a professional association influenced neither the frequency nor the severity of breaches with chiropractors.

The nature (top graph) and the severity (bottom graph) of the false claims.

The author (who is affiliated with the Murdoch University, School of Chiropractic, Murdoch, Australia) concluded that advertising breaches were common in both samples even though regulators and professional associations provide practitioners with explicit information on how to comply with advertising guidelines. Breaches by chiropractors were more numerous and more serious due to their greater potential to lead consumers to make inappropriate and potentially harmful healthcare decisions.

In the discussion section of the paper, the author makes this important comment:

The chiropractic findings are of major concern for two reasons, the first being public safety. Society expects and accepts that professionals advertise their services to assist consumers in making informed choices. To meet societal expectations and legal obligations, advertising must be socially responsible, truthful, appropriate and not misleading or deceptive. Advertising that fails to meet these expectations has the potential to harm. To assist practitioners in fulfilling their obligations, regulators formulated specific rules about advertising of health services to protect the rights of consumers however the data indicate that both professions and chiropractors in particular are not fulfilling their obligations.

The second reason is the high percentage of chiropractors advertising in an unacceptable manner. This raises questions about the profession’s culture and understanding of its obligations under the social contract. It is beyond the scope of this paper to examine this; however, this topic has been the subject of papers by observers both within the profession and external to it over several decades. The consensus is, although the profession has many of the trappings of a mainstream healthcare provider, (legislative recognition, high utilization rates, growing global footprint etc.), it is lacking in other key areas such as civic professionalism and upholding the social contract, both of which are critical components within health care. This research reinforces that position.

You might say that the findings of this investigation apply only to Australia. This is true, of course, but I see so much nonsense in advertisements by chiropractors from any country, that I very much doubt that elsewhere the situation is any better.

New evidence on adverse effects of manual therapy comes from an unexpected source. Here is the abstract of the paper:

The aim of this study was to investigate if mild or moderate adverse events after manual therapy has an impact on the chance to recover from back/neck pain in men and women. A prospective cohort study of 771 patients with at least three treatment sessions in a randomized controlled trial performed in January 2010 – December 2013. Adverse events within 24 h after each treatment were measured with questionnaires and categorized as: no, mild or moderate, based on bothersomeness. Outcome measure was the perceived recovery at seven weeks and at three months follow-up. Odds Ratios (OR) and 95% confidence intervals (CI) were calculated by Logistic regression to investigate the associations between the exposure and outcome, and to test and adjust for potential confounding. There were no statistically significant associations observed between the experience of mild or moderate adverse events and being recovered at the seven weeks follow-up. The only statistically significant association observed at the three months follow-up was for mild adverse events in men with an OR of 2.44, 95% CI: 1.24–4.80 in comparison to men with no adverse events. This study indicates that mild adverse events after manual therapy may be related to a better chance to recover in men.

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In my view this is a rather boring analysis of a bizarre hypothesis … were it not for a result that cropped up almost unintendedly: AE were reported in 81% of women and 66% of men. No severe irreversible AE were reported, but 178 AEs were rated as moderate to severe. As only symptoms within 24 h after the first three treatment session were reported, the true figures might even be larger.

These figures are considerably higher than previously reported. Our own systematic review of prospective studies suggested that AEs occur in approximately half of all patients receiving spinal manipulation. It follows, I think, that we have to discuss the question about risk versus benefit of manual treatments (such as spinal manipulations) even more critically than before.

I have recently given interviews to German, Austrian, French and Canadian journalists. They all had different perspectives, but they all had one question in common:

YOU ARE RETIRED AND COULD BE ENJOYING LIFE, WHY DO YOU CARRY ON WORKING?

And every time I was asked this question, I was surprised. To me, it seems perfectly natural to carry on. But having been asked several times, I did ponder: why do I do it? Here are some answers found through this exercise of introspection.

First let me list three reasons that my detractors regularly imply which, however, are all false:

  1. I do not do it for the money. In fact, I earn nothing from writing this blog and even have to pay for the pleasure.
  2. I do not do it because of a bad personal experience; such an event does simply not exist.
  3. I do not do it because I want to be famous.

So, why then?

The best reason I can give is that I feel a responsibility to do what I do. I am perhaps the only person on the planet who has studied so-called alternative medicine (SCAM) extensively and who, at the same time, has been critical about it. Practically all other full-time SCAM researchers are demonstrably less than critical about their subject (in case you know someone who isn’t, please tell me). And other SCAM critics are often (rightly or wrongly) dismissed by SCAM enthusiasts because they have never done original research on the subject. This does not easily work in my case.

The responsibility I feel relates to the abominable amount of false or unreliable information that is being published every day about SCAM. In my view, it harms and even endangers the life of many consumers and patients (see, for instance, this recent case). Confronted with this endless flow of seriously misleading information, I feel unable not to do anything about it. I thus see my work since retirement as an attempt to counter-balance this danger and to make a small contribution to progress.

If I am honest, I also have to admit that I am enjoying what I do. Thus the question ‘why don’t you enjoy life…?’ entirely misses the point. I have enough time to pursue my hobbies and, when I work on SCAM, I usually have plenty of fun.

In conclusion, I am retired and I enjoy life!

In 1995, the Church of Scientology attempted to suppress the Fishman Affidavit which contained Church-copyrighted versions of Operating Thetan levels I-VII. This promptly resulted in hundreds of copies being circulated around the world.

In 2003, Barbra Streisand’s lawyers sent a cease and desist letter to the California Coastal Records Project about the inclusion of a photo of her Malibu beach house on their website. When the website operators rejected the demand, Streisand sued. Subsequently, the Los Angeles Superior Court dismissed the case and the worlds attention focussed on her villa (see below).

 

Today, there are numerous further cases where someone has tried to censor another party and the attempt spectacularly backfired thus resulting in the opposite effect. Ever since the events surrounding the Streisand affair, the phenomenon has been called the ‘Streisand Effect‘. But recently, German sceptics have proposed to re-name it in

THE ‘HEVERT EFFECT’.

The reason is that a firm producing homeopathic remedies in Germany, Hevert, sent a desist letter to German critics of homeopathy demanding they stop stating that homeopathy is not effective beyond placebo (I did mention the story in a previous post).

I do get the impression that Hevert are not very lucky with their PR. On their website, they claim that homeopathy activates the body’s own self-healing powers. I fear this is much more wishful thinking than fact; at least I know of no sound evidence that would prove this statement to be correct. They also claim that homeopathy is a naturopathic treatment method that was developed at the beginning of the 19th century by German physician and pharmacist Samuel Hahnemann (1755-1843). This does not seem correct either; homeopathy does not fall under the umbrella of naturopathic medicine, not least because it includes plenty of remedies as unnatural as the Berlin Wall. The Hevert website furthermore states that Hahnemann discovered that, with many substances, the healing powers are only released by potentization. He also discovered that toxic substances became valuable medicines when potentized. I fear that this is wrong too; in fact, Hahnemann discovered nothing of the sort – he merely postulated stuff that evidently turned out to be untrue.

Anyway, one of the recipients of the above mentioned desist letters, Natalie Grams, decided not to comply and rather risk the penalty of Euro 5 100. This news then resulted in a storm of angry protests. Germans do not like to be told what to say, and freedom of speech is valued highly these days. Numerous newspapers, magazines, radio broadcasts, blogs and tweets thus sided firmly with Dr Grams.

This week, even a prominent and rather excellent German TV satirical programme aired a long film mercilessly mocking Hevert and homeopathy (no, nothing to do with me!). It is is, in my view, the best critique of homeopathy ever broadcast on German TV. Even if you do not understand the language , it is worth watching, if only for the musical finale:

One theme that occurs repeatedly in the film is the concept of ‘the three pillars of homeopathy’:

  1. dilute;
  2. shake;
  3. waffle BS (the German original is even less polite [‘Scheisse labern’]).

The ‘three pillars’ have become an instant hit on twitter, with bloggers and elsewhere. They look destined to become the future hallmark of homeopathy. Hevert will now be asking themselves whether the thing with the desist letters was such a brilliant idea.

I suspect it wasn’t – perhaps only trumped by the idea to sell homeopathic remedies?

 

 

 

A few days ago, I received this email:

Dear Dr. Edzard Ernst,

I am xxyy*, Editorial assistant from xxxzzz* Publishing Group Ltd. contacting you with the reference from our editorial department. Basing on your outstanding contribution to the scientific community, we would like to write a book for you.

Researchers like you are adding so much value to the scientific community, yet you are not getting enough exposure. No matter how many papers you publish in famous journals, you will be still unknown to common people. To solve this problem, we came up with this unique solution.

With our book writing service, we will write your research contributions in common man’s language. We will also include all your published papers into this book in a way that a common man can understand it. And then, we will publish your book with our publishing group. Before, publication, we will send the draft to you for scientific accuracy, once you approve our draft, we then proceed for publication. You will get all the rights of your book, and all the sales generated from your book will be credited to you.

Your book will then be listed on famous websites like Amazon, eBay, Goodreads, and many other popular book websites. As a result, you will get good credit and people will recognize your hard work and your scientific contributions.

Last but not least, after the publication of your book, it will be published in Google News, Yahoo, and other major news channels. What more can you ask for?

All we need is your book writing contract, and you will get all the rights for your book.

Will be waiting to hear from you.

Best Regards,

xxyy

__________________________________________________

Amazed and curious, I replied:

Thanks xxyy,

that sounds interesting; please let me know what costs are involved.

Regards

E Ernst

____________________________________________________

The answer came a few days later. Here is the passage that addressed my question:

Usually, Researchers want their articles converted into common man’s language and make them into a book. But if you have a special requirement, then please let us know, so that our writers can write according to your needs. And once the drafting has finished, we will send it for your review for scientific accuracy. This includes book cover & page design, ISBN (International Standard Book Number) for your book, proofreading service and publication fee. And Our service fee for this is $1895. And it will take around 1 month to complete your project. Last but not least, once your book is published, we will write a news article about you and your book and will publish it in major newspapers to get proper publicity.

Image result for ghost writer, comic

_______________________________________________________

I have to admit, I am still amazed! The price seems not high (though, judging from the quality of their English, the price/value balance might still be doubtful). Whenever I write a book, it takes me the best part of a year. Once I calculate a realistic $-figure for this effort, it would surely be more than one dimension higher.

So, am I going to have my next book ghost-written by this or any other service?

No, thanks!

(*Yes, I deleted the names)

The question whether chiropractic spinal manipulations are an effective treatment of infantile colic has been raging ever since the BCA sued Simon Singh over it (and lost). On this blog, I have discussed the evidence several times (see here, here, here and here). Now a new paper has emerged with the title ‘MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. As it was published on a journal not listed in Medline (J Contemporary Chiropr 2019;2:60-75), I will quote more extensively from it than I do normally. Here is the abstract in its original form:

Objective: Strong evidence is found for European medical management of ‘infantile colic’ by spinal manipulation. This paper identifies and describes this body of evidence. We apply the social research method of document analysis to the European medical literature and report the medical practices regarding the management of infantile colic by manual means including manipulation.
Data Sources: Primary data sources were Medline, accessed via PubMed, and the Index to Chiropractic Literature (ICL). Secondary material was sourced from the private collections of the authors. Acceptability criterion included a report of the medical management of infantile colic.
Data Synthesis: A range of languages were accepted and either translated or interpreted by clinicians known to the authors. Each retrieved paper was then hand-searched to identify additional citations which were also collected. A total of 69 papers met the acceptance criteria. The statements accepted for appraisal were those of methods descriptive of the clinical assessment and management of patients classified by the practitioner as a child with infantile colic.
Results: The medical management of infantile colic by spinal manipulation is well reported in the European medical literature. Triangulation also identified reports of medical management of a range of pediatric nonneuromusculoskeletal conditions. European medical papers report a number of positive outcomes for infantile colic with care broadly considered to be manipulative care. These outcomes parallel those known to be widely reported in the chiropractic literature.
Conclusion: We report strong evidence from the European medical literature related to the management by manipulation of infants with infantile colic and other conditions.

In the article proper, the authors conclusions are more detailed and very much longer:

It is difficult to reconcile the positive evidence for manipulative management of infantile colic recorded in
the European medical literature and the known safety of chiropractic management with the need for the 2019 Safer Care Victoria inquiry into Chiropractic manipulation of infants. We consider there is no reasonable evidential basis for this inquiry.
The evidence is that “Infantile colic is an easily identified childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.” (163)
Infantile colic remains a medical enigma with no evidence of safety for medical management, in fact the determination of terminology for reporting such adverse events is relatively new. (164) On the other hand the remarkable safety of chiropractic management is known and the finding that European medical literature strongly indicates manipulative management of infantile colic as a safe and effective practice, places conventional chiropractic as a safe evidence-based choice to meet parental demand.
Alcantara et al (165) show support for this position by stating “chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.”
In the absence of consistently effective management options, accepting the evidence of the European medical literature shows the benefit of manipulative care for infantile colicky patients and the wider collateral beneficial effect on parents. (166,167)
We consider it important to report the uncertainty of medical management of infantile colic and to recognize manual therapy as a legitimate management option as actively utilized by mostly European medical doctors. Multiple case reports document the efficacy of manual therapy of infants. There is a distinct absence of original evidence contradicting the efficacy of spinal manipulative management of infantile colic and an absence of evidential contraindications for its implementation.
This paper reports considerable material in the European medical literature on the manipulative management of infants, particularly infantile colic. Although supportive in safety (150,158) and efficacy (145), the chiropractic literature on these topics was not the primary focus at this time. However in relation to safety, Funabashi and colleagues noted providers of spinal manipulation have similar or better dimension scores compared to the 2016 medical data base of the Agency for Healthcare Research and Quality. (158)

On balance we can state with confidence that the published, indexed evidence places conventional chiropractic management of infantile colic as safe and effective in the manner clearly documented as clinical methods in the European Medical literature.

I find it hard to decide where to begin. The problem is that there is almost nothing right with this review.

Let’s start with the title, MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. What do they mean with ‘other conditions’? As the review does, in fact, include plenty of non-European papers, this title is simply nonsensical.

Next is the objective: it states that there is good evidence for spinal manipulation as a treatment of infantile colic. The authors thus managed to disclose their bias in the very first sentence of their paper.

The rest of the abstract is similarly incompetent. Crucially, we do not learn what inclusion/exclusion criteria the authors applied and how they evaluated the methodological quality of the included studies. Remarkably, this information is also not provided anywhere else in the paper. Thus, this article lacks all the essential elements of a scientific review and turns out to be little more than a highly biased opinion piece. In fact, it is worse; the introduction, for instance, begins with what I can only call a rant: Within Australia there is a government-manufactured controversy regarding the management of infants by chiropractors…

The results section is equally remarkable. Here are a few direct quotes to give you a flavour:

Forty-five papers were accepted as valid clinical reports of the management of infantile colic by medical manipulation (Table 1). There are over 60 papers relating to infantile colic on ICL; we do not report these. The Chiropractic Resource Organisation (CRO) website essentially carries the same papers as ICL. Many of these listings are case reports and outcome-based studies. (33, 34) Reference lists were also obtained from indexed papers as well a range of medical and chiropractic textbooks. (35 – 37)

The truth is that the 45 papers are not ‘valid clinical reports’ but a mixture of comments, case reports, opinion pieces, observational studies and a few clinical trials. The latter are identical with those discussed in proper systematic reviews of the subject. There is thus no reason for arriving at different conclusions than these reviews. But, of course, the authors do exactly that, and they do not explain why. They claim that European doctors use spinal manipulation routinely for colicky babies; this is not true (I am a European doctor and have never seen this happening). They claim that unearthing the European literature revealed more positive evidence; this is also not true: this literature was not hidden but it simply does not measure up to the standard required for evidence and was thus not included in previous reviews.

The authors could not identify any original research study report that rejected spinal manipulation of infants for colic on the grounds of being unsafe or with negative clinical outcomes.

As the authors did cite a few (by no means all) review papers that clearly showed the risks of spinal manipulation, one must ask what this statement was intended for. Was it to give the false impression that chiropractic spinal manipulations are safe?

The criticism of commentators seems to be that chiropractic care for infantile colic is no better than a placebo (147), the same finding for a common colic medication. (148) In other words, chiropractic care is equal to or just as effective as placebo and medication and therefore becomes the preferred clinical option on
the basis of safety and the absence of potential adverse effects. (63,149-151)

I fail to understand the logic behind this argument. The authors seem to admit that chiropractic care is a placebo therapy. To any reasonable person, this means that any benign and cost-free intervention (such as a gentle massage or cuddle by a parent) is preferable to an expensive and potentially harmful chiropractic treatment.

Chiropractic has been examined with rigour and found safe. Our interpretation of this evidence is that there is virtually no danger to infants from carefully applied manual methods by qualified providers and perhaps the best of both worlds is concomitant care among chiropractors and medical practitioners.

This conclusion is not supported by the evidence presented, and the authors do not explain how they arrived at it.

In addition to such irrational passages, we find plenty of nonsensical or factually incorrect statements in the authors’ pseudo-review. Here are a few examples that I found amusing:

Spinal manipulation as it is known today was brought to European medical doctors by chiropractors and osteopaths, (105) and since then it has become an entrenched medical practice in most European countries, particularly Germany. In Europe, the use of spinal manipulation within the medical profession for the management of infantile colic has been a well-recognised procedure for some decades. (38,43,63,106)

The chiropractic vertebral subluxation is recognised in the medical literature (107) contrary to unsupported claims that it cannot be identified. It is this type of mechanical spinal lesion that has been identified to address as a vertebrogenic factor under this model.

However, my favourite bit is this direct quote:

The evidence is that “Infantile colic is an easily identified childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.”

The authors quote here from my own review, and remarkably it is the only quote from it. The authors otherwise ignore it completely and, crucially, they do also not list it as one of the 45 included papers. Why? To answer this question, we need to see what my review says. Here is its very short abstract:

Some chiropractors claim that spinal manipulation is an effective treatment for infant colic. This systematic review was aimed at evaluating the evidence for this claim. Four databases were searched and three randomised clinical trials met all the inclusion criteria. The totality of this evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials.

Call me biased, but I do believe that this is much closer to the truth than the lengthy pseudo-review above.

Let me finish this post by revealing who its authors are.

  • Peter Rome, Chiropractor, retired
  • John Waterhouse, Private practice of chiropractic
  • Glenn Maginness, Private practice of chiropractic
  • Phillip Ebrall, Tokyo College of Chiropractic

No funding was received for this study.

No author declared a conflict of interest (at least, this is what they claim).

No further contact details were provided.

My conclusion of all this:

We have to search long and far before we find a SCAM article that is more misleading and less competent than this one.

Let’s be clear: pseudoscience kills. And they are being employed with total impunity thanks to European laws that protect them.

They kill thousands of people, with names and family. People such as Francesco Bonifaz, a 7-year-old boy whose doctor prescribed homeopathy instead of antibiotics. He died in Italy [1]. People like Mario Rodríguez, who was 21 years old and was told to use vitamins to treat his cancer. He died in Spain [2]. People like Jacqueline Alderslade, a 55-year-old woman whose homeopath told her to stop taking her asthma medication. She died in Ireland [3]. People like Cameron Ayres, a 6-month-old baby, whose parents did not want to give their child “scientific medicine” [4]. He died in England. People like Victoria Waymouth, a 57-year-old woman who was prescribed a homeopathic medication to treat her heart problem. She died in France [5]. People like Sofia Balyaykina, a 25-year-old woman, who had a cancer that was curable with chemotherapy but was recommended an “alternative treatment”, a mosquito bite treatment.  She died in Russia [6]. People like Erling Møllehave, a 71-year-old man whose acupuncturist pierced and damaged his lung with a needle. He died in Denmark [7]. People like Michaela Jakubczyk-Eckert, a 40-year-old-woman whose therapist recommended the German New Medicine to treat her breast cancer. She died in Germany [8]. People like Sylvia Millecam, a 45-year-old woman whose New Age healer promised to cure her cancer. She died in Netherlands [9].

European directive 2001/83/CE has made –and still makes— possible the daily deceiving of thousands of hundreds of European citizens [10]. Influential lobbies have been given the opportunity to redefine what a medicine is, and now they are selling sugar to sick people and making them believe it can cure them or improve their health. This has caused deaths and will continue to do so until Europe admits an undeniable truth: scientific knowledge cannot yield under economic interests, especially when it means deceiving patients and violating their rights.

Europe is facing very serious problems regarding public health. Over-medicalization, multiresistant bacteria or the financial issues of the public systems are already grave enough, and there is no need to add to that gurus, fake doctors or even qualified doctors who claim they can cure any disease by manipulating chakras, making people eat sugar or employing “quantic frequencies”. Europe must not only stop the promotion of homeopathy but also actively fight to eradicate public health scams, which implicate more than 150 pseudo-therapies in our territory. Thousands of citizens lives depend on that. In fact, according to recent research, 25.9 % of Europeans have used pseudo-therapies last year. In other words, 192 million patients have been deceived [11].

Some believe there is a conflict between freedom of choice for a treatment and the removal of pseudo-therapies, but this is not true. According to article 25 of the Universal Declaration of Human Rights, every person has a right to medical care. Lying to patients in order to sell them useless products that could kill them breaks the right to true information about their health. This way, even if a citizen has a right to refuse medical treatment when properly informed, it is also true that nobody has the right to lie to obtain profit at the expense of someone else’s life. Only in a world in which lying to a sick person would be considered ethical, could we allow homeopathy—or any other pseudo-therapy—to continue to be sold to citizens.

Effective treatments being replaced by false ones is not the only danger of pseudo-therapies. Obvious delays in therapeutic care occur when a person gets false products instead of medication at the early stages of a disease. Many times, it is already too late by the time they get treated with proper medicine. Moreover, several of these practices have serious effects on their own and may cause damage or even death because of their side effects.

Many pseudo-therapists argue that “the other medicine” comes with side effects as well, which is true indeed. However, the difference resides in that pseudo-therapies cannot cure a disease or improve your health, and because of that patients assume risks in exchange of promises that are a scam, according to the full weight of the scientific evidence available. Lying to a sick person is not another type of medicine, it is simply lying to a sick person.

Every country has to face the issue with pseudo-therapies in its own ways. Yet it is not acceptable that European laws protect the distortion of scientific facts so that thousands of citizens can be deceived or even lead to their deaths.

We, the signatories of this manifest, therefore declare that:

  1. Scientific knowledge is incompatible with what pseudo-therapies postulate, as in the case of homeopathy.
  2. European laws that protect homeopathy are not admissible in a scientific and technological society that respects the right of the patients not to be deceived.
  3. Homeopathy is the most known pseudo-therapy, but it is not the only one nor the most dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology, biomagnetism, orthomolecular therapy and many more, are gaining ground and causing victims.
  4. Measures must be taken to stop pseudo-therapies, since they are not harmless and result in thousands of people affected.
  5. Europe needs to work towards creating legislation that will help stop this problem.

Europe being concerned about the misinformation phenomena but at the same time protecting one the most dangerous types of it, health misinformation, is just not coherent. This is why the people signing this manifesto urge the governments of European countries to end a problem in which the name of science is being used falsely and has already costed the life of too many.

Sign the manifesto

References:

[1] Homeopathy boy died of encephalitis. Redazione ANSA, 2017.http://www.ansa.it/english/news/general_news/2017/05/29/homeopathy-boy-died-of-encephalitis-3_13e02493-4e62-4787-9162-12d831121ef6.html

[2] Grieving dad sues over ‘cure cancer with vitamins’ therapy, The local. Emma Anderson, 2016.

https://www.thelocal.es/20160412/grieving-father-sues-naturopath-over-son-cure-cancer-vitamins-leukaemia

[3] Asthmatic ‘told to give up drugs’. The Irish News, 2001.

https://www.independent.ie/irish-news/asthmatic-told-to-give-up-drugs-26063764.html

[4] Homeopaths warn of further tragèdies. BBC News, 2000.

http://news.bbc.co.uk/2/hi/health/702699.stm

[5] Alternative cure doctor suspended. BBC News, 2007. http://news.bbc.co.uk/2/hi/uk_news/england/london/6255356.stm

[6] Футболист рассказал трагичную историю жены. Она умерла от рака в 25 лет. Sport24, 2018.

https://sport24.ru/news/football/2018-08-28-futbolist-rasskazal-tragichnuyu-istoriyu-zheny-ona-umerla-ot-raka-v-25-let

[7] Mand døde efter akupunktur – enke vil nu lægge sag an mod behandleren, TV2, 2018.

http://nyheder.tv2.dk/samfund/2018-01-23-mand-doede-efter-akupunktur-enke-vil-nu-laegge-sag-an-mod-behandleren

[8] The price of refusing science-based medical and surgical therapy in breast càncer, Science Blogs, 2012. https://scienceblogs.com/insolence/2012/08/30/the-price-of-refusing-science-based-medical-and-surgical-therapy-in-breast-cancer

[9] Psychic ‘misled actress to hopeless cancer death’. Expatica. 2004

http://web.archive.org/web/20070208144309/http://www.expatica.com/actual/article.asp?subchannel_id=19&story_id=4821

[10] Directiva 2001/83/CE del parlamento europeo y del consejo:6 de noviembre de 2001

https://www.boe.es/doue/2001/311/L00067-00128.pdf

[11] Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian Journal of Public Health. Laura M. Kemppainen et al. 2018.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989251/

Homeopathy is harmless; after all, the typical homeopathic remedy contains no active ingredient! Such claims can be seen abundantly. Sadly, however, they are not true. The remedies might be mostly (but, depending on potency and proper quality control, not totally) risk-free, yet homeopathy can and does kill patients. There is a depressingly long list of fatalities to prove this point. And here is another sad case that confirms it; this short article provides the essential facts:

The parents of a seven-year-old boy who died after they decided to treat his otitis only with homeopathy were convicted of manslaughter Thursday.

Francesco, from Cagli near Pesaro, died on May 27 2017 from bilateral bacterial otitis.

His parents were found guilty of complicity in aggravated culpable manslaughter.

They were given a suspended sentence of three months in jail.

The parents entrusted their son’s care to Pesaro homeopathic doctor Massimiliano Mecozzi, who is set to go on trial on September 24.

The homeopath advised treatment with homeopathic products instead of the antibiotics which would have saved him, the court found.

Francesco died after the otitis degenerated into encephalitis.

Another article offers a few more details about the case:

Francesco suffered from otitis media. The doctor Massimiliano Mecozzi (55) treated the child exclusively with homeopathic remedies. When the parents brought Francesco to the hospital a few days later, it was already too late: The boy died soon afterwards. According to “Corriere della Sera”, the parents decided to not give their child antibiotics since he was only three years old. Francesco’s illness had begun with a severe cold and fever, and his frequented the homeopathic doctor Mecozzi who discouraged the parents from bringing their child to a hospital. “He scared them by claiming that the doctors would give medicaments to Francesco that would make him deaf or would damage his liver. He promised them that Francesco will recover soon”, said grandfather Maurizio to “Il Mattino”.

But Francesco’s condition worsened over the course of the following days, and the infection spread to the head. When the parents brought their son to the emergency admission, a festering abscess had already formed. Francesco was brought to a hospital in Ancona for an emergency operation. An antibiotic shock therapy didn’t help at this point either, and the child died.

According the “Corriere”, the physician had a questionable career: After having been temporarily expelled from the physician’s association, he even worked as a doorman and as an allrounder in a supermarket. Then he came into contact with a religious community in Varese, whose founders have been accused of fraud. When the physician’s association in Pesaro inquired to his occupation as a homeopath, Mecozzi replied: “I have no interest in telling you about it.”

And a further article adds even more details: the 7 year-old boy was hospitalized in an intensive care unit at the Hospital Salesi of Ancona. The child, born in Cagli (Pesaro), had been treated with homeopathy instead of antibiotics and had arrived in hospital in a serious condition. The child subsequently went into a neurological coma; an EEG revealed the absence of electrical activity, and brain death was certified. The death occurred as the result of an ear infection treated with homeopathy.

Such cases are tragic but (hopefully!) rare. They are due to the neglect (failure to provide adequate medical care) by a homeopath. Obviously, such neglect does not always have to be fatal. I would guess that milder forms of medical neglect through homeopathy are, in fact, extremely common (nobody knows the exact figure). One could even argue that, by definition, homeopathic treatment amounts to medical neglect which falls into three overlapping categories:

  • In the majority of cases, it has no or very little symptomatic consequences. For instance, if a homeopath prescribes a homeopathic remedy for a self-limiting condition, such as a common cold, and the patient soon improves due to the benign nature of the condition (often thinking that homeopathy was effective). There is, however, invisible harm such as the expense of the remedies and the false trust into a bogus therapy created by this experience (which might prove to be extremely harmful later on).
  • In many instances, the neglect does cause unnecessary suffering of patients because the optimally effective treatment of their disease is not administered or delayed. Many doctor homeopaths would argue that this is not usually true because, for such patients, they also prescribe conventional treatments in parallel. But even if this were true, these clinicians would still cause harm through the waste of resources.
  • In a sizable but unknown number of cases, homeopathy does cause very serious harm and, as the above case shows, even deaths.

The point I am trying to make is this: we usually only hear of the dramatic cases of neglect through homeopathy (or other forms of ineffective SCAM). What we tend to forget is that such cases are only the extreme end of a much wider spectrum, and that all clinicians who prescribe homeopathy are guilty of neglect. The symptomatic harm done ranges from almost zero to 100%, and the damage caused is merely a question of degree.

 

 

 

 

PS

Before some homeopathy-fan comments, “but the harm from conventional therapies is sooooooooo much more significant!!!”, let me stop you in your tracks by recommending you consider the concept of risk/benefit balance.

Chiropractors, I have repeatedly found, are somewhat slow at learning lessons even from their biggest mistakes. A new paper seem to confirm my suspicion. The purpose of this study was to investigate the report by mothers of their infants’ condition before and after a trial of care provided by chiropractors in addition to ratings of satisfaction, cost of care, and reports of any adverse events. A second purpose was to report the demographic profile of infants who presented for care to 16 chiropractic clinics in the United Kingdom.

The authors prospectively collected reports by mothers of their infants’ demographic profiles and outcomes across several domains of infant behaviour and their own mental state using the United Kingdom Infant Questionnaire. Participating chiropractors were recruited through the Royal College of Chiropractors annual meeting in January 2016. A total of 15 UK clinics and the Anglo-European College of Chiropractic University College teaching clinic volunteered to participate.

In all, 2001 mothers completed intake questionnaires and 1092 completed follow-up forms. Statistically significant improvements were reported across all aspects of infant behaviour, including:

  • feeding problems,
  • sleep issues,
  • excessive crying,
  • problems with supine sleep position,
  • infant pain,
  • restricted cervical range of motion,
  • time performing prone positioning.

Maternal ratings of depression, anxiety, and satisfaction with motherhood also demonstrated statistically significant improvement. In total, 82% reported definite improvement of their infants on a global impression of change scale. In addition, 95% reported feeling that the care was cost-effective, and 90.9% rated their satisfaction 8 or higher on an 11-point scale. Minor self-limiting side effects were reported (5.8%) but no adverse events.

The authors concluded that mothers reported that chiropractic care for their infants was effective, safe, and cost-effective. Although the observational design makes it impossible to determine efficacy, the study’s findings indicate that, on average, the changes observed by mothers were positive and may be clinically relevant.

Where to begin? Let me try to list at least some of the most obvious flaws of this study:

  • The fact that mothers (where were the fathers?) reported positive outcomes is hardly surprising. After all, they chose to consult a chiropractor and paid for the treatments. Install yourself in a McDonald’s, ask customers whether they like hamburgers, and you get a similarly meaningless result.
  • Cost-effectiveness is measured in Bournemouth by asking people, ‘was it worth it’? I feel like going back there and teaching them some research methodology!
  • The observational design is by no means the only reason why ‘efficacy’ cannot be determined by such a study. What about the non-validated nature of the outcome measures?
  • Do the researcher mean effectiveness or efficacy? And do they know the difference at all?
  • What do they think is the difference between side effects and adverse events?
  • Do they think they can establish safety by asking the mothers of their patients?

So, does this study show anything useful at all?

Yes, perhaps.

I think it shows that, despite all the shameful and unpleasant history that severely damaged the reputation of chiropractic in the UK and beyond, chiropractors are still treating infants for conditions for which there is ‘not a jot of evidence‘. It seems almost as though they are ‘happily promoting bogus treatments’!

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