ACC Decisions
The recent decision to award compensation to a lawyer who suffered depression because his bank loan was turned down is but one example of increasingly bizarre decisions by the ACC (Anything-goes Compensation Corporation). Money has also been paid out to victims for “memories” of childhood sexual abuse but in one recent case the alleged offender was aquitted and we are still waiting to see whether ACC will ask for their money back. (see Skeptic 34).
I obtained information about a court judgement involving ACC who awarded compensation to an employee of the Fire Service, one of a number of people affected by mass hysteria after the ICI Chemical Fire. Advising doctors said that his condition was not considered to be due to chemical exposure but his emotional state could be attributed to some stress surrounding attendance at the fire. The judge had no alternative under current law to do anything other than award full rights to compensation.
Not only do these decisions show a lack of common sense, they also illustrate what happens when no one is prepared to stand up and resist such claimants, who will continue to come forward as long as there is money available. This prevailing community belief that everyone is entitled to compensation for their “pain” whatever it is, is not limited to New Zealand. There is a worldwide growth in anti-medical science groups with self-denied psychiatric conditions. In the UK a sufferer from chronic fatigue syndrome (see Skeptic 21, 26) was awarded compensation because the stress of a car accident in which he received no physical injuries, made his symptoms worse!
Hoxsey Cancer Quackery
Bruno Lawrence recently went public with the fact that he is suffering from lung cancer and plans to make a TV documentary about his treatment at a Hoxsey Clinic in Mexico. About the same time, a syndicated article appeared in my local paper with the news that a Tauranga herbalist intended setting up such a clinic and applying to the local area health board for approval.
Hoxsey (1901-1973) developed a secret recipe of herbs and spices which he used to treat cancer patients. This followed an observation that a horse with cancer cured itself by grazing on certain plants. Hoxsey fought prolonged court battles with both the American Medical Association (AMA) and the FDA before taking his quack therapy to unregulated Mexico. He died from cancer despite self-treatment with his quack remedy.
His original nurse, Mildred Nelson, was still administering this quackery as recently as 1988. The American Cancer Society (ACS) has extensively investigated Hoxsey’s cancer quackery and I quote from the last paragraph of their report which I am happy to supply free to any reader as long as you send a stamped SAE: “In summary, the Hoxsey medicines for cancer have been extensively tested and found to be both useless and archaic. The ACS does not recommend their use by cancer patients.”
Quackery often follows a pattern as follows:
- An apparently profound observation or emotional experience — in Hoxsey’s case, a sick horse, and in the case of iridology certain patterns in the iris of a sick bird. Doctors often revert to quackery following either job stress or a seemingly profound success with a new treatment such as acupuncture, homeopathy etc. (usually a placebo response).
- An element of paranoia is useful, because this heightens the belief of the quack that the particular treatment is valuable and “everyone’s out to get me!” and leads to…
- Conspiracy theory. In the case of Hoxsey, he developed the theme that doctors and the AMA had cornered the cancer market (is there one?). This is a very useful strategy for discrediting conventional medicine.
- The quack remedy should be completely safe and quite expensive because patients will show improvement in proportion to money spent. Distilled water is cheaper and more convenient than homeopathic remedies and is already an accepted consumer fraud.
- Reliance solely on testimonials and strict avoidance of clinical trials or any form of testing of the quack remedy. Testimonials are personal, entertaining and are excellent advertising, unlike the prosaic clinical trial which will show that the quack remedy is for the ducks. If a clinical trial or, in the case of Milan Brych, a court case, proves quackery, then all is not lost. Off-shore operations will ensure patients keep on coming, which is what hundreds of people did even after Brych was shown to be a complete fraud and actually in prison at the time he claimed to be at medical school. (I can think of a few doctors I would like to see in prison but that’s another story.)
Finally, the above information is subject to intellectual property rights and I expect a commission from any readers who set up successful cancer quackery clinics.
Psychopathology
An article in the BMJ (Vol 309 p883, “The dangers of good intentions”) caught my eye, as it is a devastating example of the psychopathology so evident in the helping professions. In 1939, 700 delinquents were randomly assigned to either a treatment group or a control group who received no treatment but were followed up 30 years later.
The treatment group received counselling, home help and other community assistance. After 30 years it was the treatment group who were sicker, drunker, poorer and more criminal! This shows that nothing can be taken for granted when trying to influence people’s behaviour, and often such programs create dependency. Our own welfare state is a classic illustration of this problem.
Psychobabble revisited
In Skeptic 33 I made a plea for hard data on the popular new condition of post-traumatic stress disorder (PTSD). Like any alleged medical condition it must be refutable, ie. capable of being proved wrong. A writer in the BMJ (Vol 309 p873) sharply criticised a case presentation on PTSD in a patient who was a heavy drinker. He pointed out that 40% of all patients diagnosed as having PTSD drink heavily and their symptoms (frightening ideas, nightmares) subside when they abstain. I am still cynically waiting to find out whether PTSD is described in populations which do not have compensation.
In Canada, a man was aquitted of stabbing to death his parents-in-law because a psychiatrist testified that the man was sleep-walking and therefore had not been responsible for his actions. The fact that the accused was also a gambler who had been caught embezzling money did not seem to be quite so important to the court!
Psychiatry as a specialty relies on rather soft science, and some psychiatrists are guilty of the most absurd psychobabble — eg, “Continuing success will reflect [the patient’s] ongoing committment to healing the wounded child within, which is the result of the experience of the poisonous pedagogy.”
Doctors’ signatures can certainly be very valuable. As far as patients are concerned, it means another ten paid weeks off work. Some 85,000 people have been collecting such benefits for more than one year and ACC is hoping to save $400 million by referring all cases to an independent medical panel.(GP Weekly, 22 Feb 95)
In the Australian Capital Territory (ACT) a new law allows people to use cannabis on a doctor’s prescription provided that the doctor keeps “research notes.” The ACT Health Minister described the new law as a “radical drug experiment”. I describe it as radical stupidity, as there is no evidence that cannabis is useful for the conditions proposed and I doubt the ability of individual GPs to conduct research. Here is my prediction: patients will flock to certain doctors who have found by research that their signature on a piece of paper is of considerable benefit to both the patient and the doctor’s bank manager. Buy ACT cannabis futures now! (GP Weekly, 22 Feb 95)
In the UK, a housing authority allowed preferential allocation for housing on receipt of a note from the doctor outling health reasons. However, they were able to revert to their normal process of allocation because everyone on the list had a note from their GP! All processes such as this become debased and degraded when subject to abuse.
Eau Dear!
Along with other legitimised quackery, the French government recognises a stay at a spa as a legitimate medical treatment. The National Audit Court pointed out that not only is there no proven scientific justification for spa treatment, but many carry bacterial health risks. Some spas have even been adding tap water to their natural mineral waters.
I seem to remember an investigation in New Zealand showing that certain “mineral waters” were indistinguishable from tap water. (New Scientist, 28 Jan 95)
Alternative Medical Remedies
The Medicines Act is being re-written, and already quacks are whining that the costs of licensing their remedies could force them off the market. Quacks also fear a ban on advertising that they can offer relief from various conditions. I don’t see any problem with the proposed law changes, as herbal remedies should come up to set standards of quality and safety and any claims of efficacy should be tested in randomised trials. (GP Weekly, 14/9/94)
After reading this I was intrigued to find a letter in the Lancet (Vol 344 p134) which looked at the ginseng composition of 50 commercial ginseng products. The authors found that 44 preparations ranged from 1.9% to 9.0% of ginsenosides, the active components. The remaining 6 preparations contained no ginsenosides at all. They also quoted a case of an athlete who failed a drug test. He thought he was only taking ginseng, but not only did his preparation not contain any ginseng, it consisted mainly of the banned performance-enhancing drug ephedrine.
Would anybody buy an aspirin that might contain either no aspirin at all or anywhere from 100mg to 500mg of the active drug? The authors conclude that “quality control is urgently needed for natural remedies with suspected or assumed biological activity.” I see a compelling case for continuing with a robust overhaul of our Medicines Act.
Face Lifts and Hair Growth
A Wellington plastic surgeon was critical of a recent proposal that GP’s could learn to do chemical face peels after watching a training video (Dominion, 15/9/94). GPs can buy a kit which contains enough chemicals and equipment to make a profit of $380 per patient for half an hour’s work. The process involves using glycolic acid to induce peeling and, by an unspecified process, cosmetic improvement. Just the thing for boosting the flagging profits of any North Shore Auckland medical practice where there are already so many doctors the place is in danger of turning into a ghetto.
I don’t intend watching the video, but the thought had crossed my mind that I could treat my vain patients in our RNZAF electroplating bay. A short dip in something caustic would give anyone’s face a good lift (off) or how about dermabrasion with a wire brush from the metal shop?
A much safer money-earning prospect is the exciting new treatment of electrotrichogenesis for bald men. I hope our editor can reproduce the advertisement which shows a futuristic looking chair with a hood poised to administer rejuvenating current to the recalcitrant scalp. [Unfortunately it’s a bit too dark to reproduce well — but it looks fascinating…]
Why not fill the waiting room with these chairs and invite balding males to pay for treatment while they wait to see the doctor on other matters. Even more doctors will be able to afford to go into practice on the North Shore!
