Alternatives to Evidence Based Medicine

Alternatives to Evidence Based Medicine

I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.” New Zealand Medical Journal Vol 113 No 1122 p479

Homeopathy Flunks

It’s most unusual to see published trials showing that homeopathy is ineffective. The common term for this is “publication bias” where trials tend to be published only when they show something positive. One of the authors is GT Lewith, a long time apologist for homeopathy and that makes it even more remarkable. Should we give them one of our awards?

A double blind, randomised trial evaluated the efficacy of homeopathic immunotherapy on lung function. The conclusion: homeopathic immunotherapy is not effective in the treatment of patients with asthma. BMJ 2002;324:520-3

An accompanying editorial comments: “we believe that new trials of homeopathic medicines against placebo are no longer a research priority.”

All responsible health professionals must ensure that homeopathy is never funded by the health system. It would be grossly irresponsible to waste public money on “dilutions of grandeur”.

Ministerial Advisory Committee on Complimentary and Alternative Medicine (MACCAH)

Have a look at their Website: www.newhealth.govt.nz/MACCAH/. I have been visiting from time to time in keen anticipation of the result of their deliberations and to see what quackery will be introduced into our failing health system. The committee comprises a sociologist (chairperson), iridologist, doctor of medicine, naturopath, acupuncturist, paediatric nurse (and massage therapist), and teacher. The iridologist is David Holden who organised the International Iridology and Sclerology Conference that I mentioned in an earlier column.

Certain members of the committee have asterisks alongside their names as a reflection of a possible conflict of interest. Readers will recall that our organisation was unsuccessful in getting any skeptics on this committee. Would such a putative member have warranted an especially large asterisk?

There is a similar committee in the USA. It has become a scandal that the National Institute of Health (NIH) has distributed (wasted?) hundreds of millions of dollars on testing what Americans refer to as CAM, or complimentary and alternative medicine. They spent $1 million testing “magnet therapy”. The majority of the studies have been inconclusive and have led to the need for more tests. This has tended to give such quackery a spurious degree of acceptability. As critics point out, how many studies have been published showing that CAM doesn’t work? Read a very good critique of this area at www.washingtonmonthly.com/features/2001/0204.mooney.html

It is quite clear, given the US experience, that the MACCAH will produce nothing of any value and furthermore I predict that they will never publish a single article stating that any CAM modality is useless. I sincerely hope to be proved wrong.

Laying on of Hands

Every doctor of medicine knows the importance of properly examining patients even when they do not expect to find anything wrong. The act of touching people in a therapeutic context carries a very powerful placebo effect. This is a legitimate part of the "art" of medicine and when coupled with good communication leads to a good outcome. This effect is sometimes referred to as the “laying on of hands”, itself derived from the concept of mediated divine healing. For example, the King’s touch was supposed to cure scrofula, a cutaneous form of tuberculosis.

The extreme version of this is the absurd delusion of therapeutic touch where the patient is not actually touched but their energy fields are "corrected". Don’t laugh; this is part of mainstream nursing at Wellington Hospital!

The laying on of hands effect explains the apparent success of many physical treatment modalities such as osteopathy and chiropractic. They all do exceptionally well out of ACC-provided funding and it is no wonder that a recent provider survey found a high level of satisfaction from chiropractors (79%) and physiotherapists (76%). I once asked an ACC Colleague why they funded quackery such as osteopathy and chiropractic and his reply was that ACC didn’t care about anything except getting people back to work. Applying that logic I could set up a military consultancy (Boot Camp Rehabilitation Inc) and get people back to work by threatening them with military-style discipline.

Here is an extract from an advertisement from my local paper: "cranial osteopathy for babies and children to help with poor sleeping patterns, restlessness, crying and poor concentration". This quackery involves allegedly manipulating the bones of the skull to regulate the flow of cerebrospinal fluid. It is complete and utter nonsense that relies for its effect on the touching, a plausible patter and a gullible consumer.

ACC News October 2001 Issue 39

Bye, Bye, Bivalve

Trials of green-lipped mussel extract have been stopped after it was found that “the extract didn’t work.” (Marlborough Express March 11, 2002). Green-lipped mussel extract was marketed in NZ as Lyprinol and more than $1 million of the product was sold after it was claimed that it was a cure for cancer. Successful prosecutions were taken against those responsible for the scam.

The media frenzy showed that journalists had learned nothing from the Milan Brych affair.

I feed our cat (Gilgamesh) on green-lipped mussels, and as well as a lustrous coat he has shown no sign of developing cancer. I rest my case. In order to satisfy the most sceptical of journalists I enclose this picture as proof as he and Claire read the Lyprinol story.

Healthy Options

This is the title of a magazine that contains some of the most nonsensical rubbish I have ever seen. The editor is the woman responsible for promoting the Hoxsey quackery in Tauranga, which led to dozens of desperate cancer suffers taking one-way trips to Mexico to receive treatment. Tauranga travel agents made a killing in every sense of the word. This magazine should be read by all Skeptics in order to get a taste of what could be inflicted on the health system by the MACCAH. One ray of hope however – they mentioned www.quackwatch.com and stated that “this leads the public to believe that natural medicines are a fraud.” Well-enough said!

Possum Peppering

Is this delusion never going to go away? How many trials does it take to show that burnt possum testicles do not deter possums from eating vegetation sprinkled with said preparation? The Green party are already a bit of a joke and this latest nonsense makes me wonder whether they have all been partaking of ganja while worshipping with Nachos Tandoori. However, there is more to this than meets the eye, or testicle. I tried sprinkling some of a late relative’s ashes around our garden and I haven’t seen the mother-in-law for months. I rest my case. It must also be horribly lonely for all of those people living downwind of a crematorium – they never get any visitors at all!

Writer’’s last book entertaining and moving

Snake Oil And Other Preoccupations, by John Diamond. Vintage, 2001, $29.95

I recently reviewed for NZ Skeptic this author’s previous book (C: Because Cowards Get Cancer Too), which described his experiences of his throat cancer and its treatment. That was written when he was still unsure whether it had been cured, and I admitted to moist eyes on reading of the gruelling time he had.

The success of that book, and his steadfast convictions about cancer treatments, led him to write another book, which was to be “an uncomplimentary look at the world of complementary medicine”. Unfortunately the cancer was not cured, and, in the middle of writing chapter six, he was taken to hospital for the last time. His brother-in-law describes how, the day after his death, they found his computer still switched on, the last words he had typed were “Let me explain why”. That he was never to do so brought on in your reviewer another attack of unmanliness.

Wisely, and luckily for the many who appreciate Diamond’s views and style, his executors have published the unfinished material, 82 pages, and filled out the book with a varied selection of his weekly columns in several magazines. Of the 60 or so of these, almost half are connected to the “Snake Oil” theme, and widen the coverage of “C”. Read about the role of the tongue in swallowing (you never miss it until you haven’t got it), and the problem of replying to a hearty friend’s enquiry after your health (“Oh, fine thanks…..well,actually, no. I’ve got cancer”).

The other items are light-hearted, entertaining pieces, remarkably so considering the pain he was in during the writing. Try “Does my bottom look too big?” (wise advice for those outside, and inside, the changing rooms in ladies’ dress shops). Diamond (of Jewish birth) confirms the view that Jewish jokes are invented by Jews; “The week before you know when”, is a spoof “The night before Christmas” bemoaning the way Jews are missing the commercial opportunities.

Diamond’s skill with words is matched by the Introduction contributed by Dawkins, another master. The light-hearted but erudite tone of his writing is the more remarkable considering what he was enduring. All who read and admired the earlier book will be both moved and amused by this one.

A Century of Skepticism

When I spoke at the conference two and a half years ago, argument was rife as to when the next millennium would begin. Now, there is no doubt we are well launched into the third thousand-year period since something important was supposed to have happened.

To understand what skeptics thought a thousand years ago is difficult; the state of skeptical thought a hundred years ago is more accessible. We can consider what progress, if any, people like us have made in that time. My claim to cover this topic is based on my observation of the field during two-thirds of the period.

Some of my comparisons will reflect merely a change in taste or style, others the replacement of one superstition or fad by another. For example, then they had ectoplasm, now we have bent spoons; then table rapping, now psychokinesis. There is not time to look at every paranormal fad or pseudoscientific belief, so I will pick just a few examples to consider.

To start at the depressing end, consider the increase in acceptance of astrology. My reading of early skeptical literature suggests that our comrades of one hundred years ago did not rate astrology among the prevalent intellectual weaknesses of the population, and even fifty years earlier, a commentator thought that astrology and other nonsenses would die out once universal education was introduced. Even a cursory survey of the present position makes us far less optimistic, in spite of well over one hundred years of compulsory schooling.

“It is to be hoped that the day is not far distant when lawgivers will teach the people by some more direct means, and prevent the recurrence of delusions like these [haunted houses]… by securing to every child born within their dominions an education in accordance with the advancing state of civilisation… If ghosts and witches are not yet altogether exploded, it is the fault, not of the ignorant people, as of the law and the government that have neglected to enlighten them.”
C. Mackay, 1840s

Astrology and Palmistry

Rawcliffe, in the preface to his “Illusions and Delusions of the Occult of the Early 20th Century”, wrote dismissively “No attempt has been made to enter into the question of such groundless occult practices as astrology, palmistry or similar naive forms of divination”. Compare what a commentator of the present day wrote:- astrology is “The only “science” editors of British newspapers and television current affairs programmes seem to understand”.

I now turn to the matter of health. Then, as now, dubious or fraudulent medical treatments were concerning those of a critical turn of mind. During the century the vast advances in understanding of how our bodies work have caused a shift in emphasis; what have not changed are people’s yearning for health coupled with widespread ignorance of how to achieve it, and the hijacking of new scientific discoveries by practitioners of pseudomedicine.

Medical Vibrations

The discovery of radio waves, and the spread of broadcasting early last century, brought in their train a host of quacks trading on people’s fascination with new but poorly understood science. Foremost among these in the USA was Adam Abrams, a genuine doctor with a medical degree from Heidelberg, no less. His theory was that each disease had its specific vibration frequency, and cure required treatment with waves of identical frequency. (Where have we heard that more recently?) Very conveniently for the therapist, presence of the actual sufferer where the gadgetry was located was unnecessary, a drop of blood, or even a signature, could serve just as easily! A commentator on Dr Abrams in the late 1950s thought that this therapy would by that time have been laughed out of existence, and his gadgets found rusting in American rubbish dumps. How wrong he was! In recent years we have seen the “Dermatron”, a worthless gadget used by at least one medical person in New Zealand to ‘diagnose’ toxic conditions, and the equally useless “Quantum Booster” which so impressed us at our Conference two years ago.

Perhaps the only claim to progress we can make here is that the numbers of these devices are fewer than the thousands of those sold by Abrams and his imitators.

Apart from the increase in sophistication of the quackster’s approach, I notice also a greatly reduced robustness in the attitude of authority. Perhaps because he was a “genuine” doctor, the Journal of the American Medical Association carried an obituary of the above-mentioned Dr Abrams in 1924. Far from acknowledging him as “one of their own”, the obituarist described him as “the dean of all twentieth century charlatans”, and the same association was equally damning of many other “healers”. At that time also mail-order shopping was big business (who has not heard of the Sears Roebuck Catalogue?), so that prevention of passage of patent medicines, etc. through the mails could seriously dent the trade. In the USA such action was possible by virtue of a law against “using the mails to defraud”. So a determined Post Office official, if he could persuade his Head Office to act, could put a stop to the patent medicine producers. Compared with these attitudes, authority today appears very feeble.

Enter Radioactivity

To the list of pseudo-electromagnetic treatments used 100 years ago, in 1903 was added radioactive materials, with the award to Marie Curie of the Nobel Prize. Claims were soon made for the healing properties of “Radium Water”. One such medicine, claimed to cure rheumatism and cancer, was “Waters of Life”, from California. A large shipment was impounded by Federal agents on its way East, and was found to contain nothing but ordinary spring water (no radium, thankfully!). The decision to condemn this water as “misbranded” was upheld by the courts. Compare this with the reaction of our own government to a similar case in New Zealand, the “Infinity Moods of Yellow Remember”. The Commerce Commission intends to take no action, and the Health Ministry feels powerless because “water is not a medicine”, and so the advertising of this stuff does not breach the Medicines Act. In this instance, we have clearly slipped backwards.

“Oxygen” has been a word to conjure with for almost two centuries after its role in our metabolism had been discovered. Its essential nature was widely recognised, and this attracted many fraudulent therapies. Such a one was the ‘Oxydonor’ in the USA. A disc fastened to the patient’s body led by a wire to a metal rod, hollow but sealed, immersed in a bowl of water; the rod caused oxygen to flow into the body, so healing whatever malady the patient had been convinced he or she was suffering from. An unsporting skeptic opened some of the metal rods; some were empty, some filled with carbon.

Now, we have ozone and hyperbaric oxygen therapies, and even polyatomic oxygen therapy. It is claimed that ozone inactivates HIV and cures AIDS, and the allegation that there is a conspiracy between the Food & Drug Admin-istration and the drug companies to put the oxygen therapists out of business will be a familiar story to skeptics.

For about two centuries the world of pseudomedicine has flourished by the sale of “patent medicines”. This is an odd title; a “Patent” is granted by governments, a guarantee of exclusive rights in exchange for disclosure. These medicines, on the contrary, were prepared according to secret recipes, usually with a basis in herbs. Some patent medicines are directed universally, eg cures for “listlessness”, “sluggish liver”, etc., others were targeted to one sex, such as to “weak men” (we can guess what weakness was implied.). Or we can consider those referred to delicately as for “female complaints”, or even for “female irregularities” (and we can guess what those did). As usual, current science is used inappropriately in advertising these things. Then it was vague ideas about the liver, kidney or nerves, now we are bombarded by anxiety-causing tales of vitamin and mineral deficiencies.

The overriding concern of women today, according to the advertisers, is not irregularity, but shape. Here are a few headlines from the front covers of British women’s magazines (Table 1).

Table 1. Headlines from Women’s Magazines, 2001
Healthy Eating. 12 Diet Myths (read this and shed lbs).
English Woman’s Weekly, 24.8.01
Slim and Smiling! Together Danny and Jan lost 61/2 stone
EWW, 7.8.01
Last-minute Diet Plan. Lose pounds in no time at all!
EWW, 14.8.01
50 low-cal treats to help you slim.
EWW, 28.8.01
Low Cal Low Carb High Energy
Good Housekeeping, 6.01

Do not think that investigative journalism started with the Watergate men. Early in the last century SH Adams looked into the patent medicine racket in America, and his damning reports, published in Collier’s Magazine, caused such a stir the Food and Drugs Act was passed soon afterwards. The requirement to publish the ingredients exposed many of the dangers and hypocrisy of the patent medicines; the dangers could include high concentrations of opium (morphine), the hypocrisy was the presence of high concentrations of alcohol in medicines sold in “dry” districts, sometimes with the unknowing support of Temperance enthusiasts. Consider the analyses in Table 2.

Table 2. Alcohol content of a range of beverages
ALCOHOL CONTENT %
Beer 5-6
White wine 13.5
Sherry 18.6
Whisky, Brandy 37.5
Hostetter’s Bitters
(A popular USA patent medicine)		 47

Has the view of the psychic ability of animals changed in 100 years? Then, there were three widely reported examples, all from Germany! Clever Hans, the calculating horse, is probably best known, but there was also Muhamad, who could not only do simple arithmetic, he could work out square roots, hold a conversation, and knew his master’s telephone number.

Thirdly there was Lola, the super-intelligent dog, who held long conversations with his mistress by tapping her palm with his paw. All these, of course, are either entirely imaginary or the response of the animal to unconscious cues. Slightly different in recent times, is Sheldrake’s dog, who “knew” when his mistress left her work, and went to wait at the door for her. A careful observation of the animal revealed what Sheldrake had not troubled to find, that the dog was just restless, and went often to the door at times unrelated to what the absent lady was doing.

Some who are credited with the most astute intellects are taken in by simple fraud; brains are not the same as sense. Then, the creator of the super-sleuth Sherlock Holmes took for real the pictures of fairies cut out of a children’s book. More recently, children were able to convince an eminent physicist that they were “Gellerian” spoon benders. On the whole, though, I think there is improvement in this area. I know of no present day equivalents of William Crookes and Oliver Lodge, both scientists of the highest eminence, but both deceived by mediums into belief in spiritualism.

Conclusion

So we see that, though the detail has changed, credulity and gullibility have not diminished, despite the advances in education and knowledge which optimists predicted. New Zealand Skeptics is in no danger of running out of targets for our investigations. We need not disband and go home to put our feet up by the fire just yet.

Hokum Locum

Get in Now While the Getting’s Good

John Welch finds that the sexual abuse industry rolls on unabated.

Sexual Abuse Rort

ACC (aka “Aggrieved Clamouring Claimants”) has thrown the doors wide open for sexual abuse claimants. They have budgeted 60 million dollars for sufferers who can claim up to $175,000 “without having to complain to the Police or name their abuser.” Not surprisingly, a Christchurch Law Firm has shown commendable initiative in touting for business with a leaflet drop because “lawyers had a professional obligation to make the public aware of entitlements.”

It is highly significant that a Christchurch firm has seen fit to profit from this ludicrous state of affairs. Proof of sexual abuse has never been required in Christchurch, the Salem of the South Pacific. Dozens of families pocketed tens of thousands of dollars for sexual abuse that never happened while dedicated and talented Christchurch Civic Creche workers had their lives ruined.

I am not sure that James Randi would approve of my challenge but here it is. I offer my endorsement of any claimant who is prepared to claim for ‘ritual satanic alien abuse’, especially if it occurs in a parallel universe.

Given the refusal of the Minister of Justice to read Lynley Hood’s book on the Christchurch Civic Creche debacle, readers could be forgiven for thinking that he and key members of the legal profession currently inhabit a parallel universe.

Several years ago a man spent $80,000 defending himself against charges of sexual abuse “remembered” by his two daughters. He was acquitted as he was able to prove that the alleged abuse not only did not happen but it was impossible for it to happen. A reporter reasonably asked the question of ACC whether the two daughters would have to repay their compensation. “Oh no,” said the Spokesperson, “they are entitled to it for their suffering.”

The budgeted sum of 60 million dollars will experience a blowout version of “Welch’s Law” which states that claims expand to take up the amount of compensation available.

Marlborough Express 9 Jan 2002

The Vigorex Products – Oat cuisine?

These are homeopathic extracts of ‘avena sativa’ and contain nothing injurious to health. Readers familiar with homeopathic theory will know that such a product description is entirely true. Homeopathic preparations contain precisely nothing and placebo controlled trials of homeopathic preparations are in fact trials of one placebo versus another. This explains why placebo controlled trials of homeopathy will sometimes produce a result favouring the homeopathic wing of the trial. This led one wag to suggest that what was needed were “double-strength” placebos!

Vigorex is a product developed from oats. Readers will be interested in the admission that “skeptics have doubted the existence of an effective sex enhancer.”

Reports indicated that “some fell (sic) an increase in energy within one or two hours and use it instead of coffee to get going in the morning … some say they start taking it on a Thursday or Friday in anticipation of a sexual weekend.”

I decided to rise to the challenge, hopefully in every sense. After extensive product testing I have to say that my wife developed a headache which was not relieved by another homeopathic preparation.

The Scots have eaten porridge for years so there may be more to this than meets the eye.

Pamphlet Supplied

Homeopathy useless against Malaria

Because of conventional drug side effects, a woman decided to rely on homeopathic drugs for malaria protection whilst holidaying in Africa. These homeopathic products were made from “African swamp water containing impurities, algae and plants as well as mosquito slough, larvae and eggs.” Following her return home she became very unwell and was admitted to an intensive care unit with multiple organ system failure due to malaria infection.

There will be no claim for medicolegal liability because “the manufacturer, who has performed no clinical trials on this drug, declines all responsibility regarding its use.”

Homeopathic remedies should only be used for harmless self-limiting disorders that require no treatment, which is precisely what homeopathy is all about.

BMJ Vol 321 18 Nov 2000 p 1288

Kentucky Fried Medicine

The NZ Health Authorities recently had to warn all doctors that two Chinese herbal medicine capsules contained the potent corticosteroid betamethasone. These were Cheng Kum and Shen Loon. The Ministry of Health had earlier removed Cheng Kum from the market when it was shown to contain the antihistamine chlorpheniramine.

Since most Chinese herbal remedies are either useless or dangerous it is hardly surprising that they are incorporating effective Western drugs in a fraudulent attempt to demonstrate effectiveness. The same problem has occurred in the UK where random tests were still finding banned substances such as mercury, arsenic and steroids in traditional Chinese medicine. Some also contained parts from endangered animal species.

Why should we respect medieval beliefs that endanger the continued existence of magnificent animals such as tigers because superstition demands the use of their bones? The criminals responsible for these excesses should be ground up themselves and processed into traditional remedies, and in this spirit I have formed a company marketing a new herbal remedy for cats called Meow Zedung.

BMJ Vol 323 6 Oct 2001 p770; MEDSAFE 14 Dec 2001

Flux for Flux?

While in Ireland recently I kept a watchful eye for useful material and was not disappointed by an article in the Irish Examiner of 14-11-01. A company managed to sell to over 485 schools, a $70 magnetic clip designed to be attached to the underwear and claimed to “banish the misery of painful periods.” The device is the size of a 10p piece and it is claimed “sends out a magnetic field which penetrates up to 7 inches into the body.”

This device is a classic placebo and it is easy to see how successful it would be in a Priest-ridden country where the Catholic religion ensures young women are made to feel bad about their emerging sexuality.

The article goes on to make the following claim “…66 out of 100 painful period sufferers took significantly less medication when wearing the device during their periods.” If these young women received sympathetic advice and explanation about their periods in a climate of healthy acceptance, there would be an equally impressive improvement.

I know of a much better market for this device. Some enterprising person should promote it for male impotence.

Fad Allergies

Around 20 in 100 Britains believe they suffer from allergies and intolerance to dairy foods and wheat-based products. However, nutritional research reveals the true figure is less than 1 per 100.

This is an area rife with quacks conducting all sorts of unscientific tests and giving potentially dangerous advice. People are using food allergies and intolerance as an excuse for weight gain and niggling health problems such as every GP’s fear – TATT (tired all the time) syndrome. The very idea that you can have a food allergy and gain weight is preposterous.

The Daily Telegraph 5 Nov 2001

When Children are the Victims of Quackery

This Bravo Award-winning item originally appeared as the editorial in the March 23 issue of the New Zealand Medical Journal

Is it time for the government to investigate a glaring anomaly in our legislative approaches to the rights of children? In some areas, the child’s right to safety, autonomy and privacy, is clearly paramount, in others, it seems, it is not.

After the death of Liam Williams-Holloway, in October last year, paediatric oncologists Mike Sullivan and Robin Corbett made a complaint to the Health and Disability Services Commissioner, Ron Patterson, about the role of “alternative practitioners” in the “treatment” of Liam’s neuroblastoma, and the standard of care he received.

Early this month, the Commissioner declined to investigate their complaint, saying that Liam’s parents did not want an investigation into these practitioners and their care. He was reported as saying that, if “the person alleged to be aggrieved does not desire that action to be taken”, he has discretion to take no action.

But surely, in such a case, it is the child, and not the parents, who is the person most “aggrieved”? It is Liam who died. The Code the Commissioner upholds is the Code of Health and Disability Services Consumers’ Rights and surely Liam, and not his parents, was the “consumer” of health services in this instance.

Complications

There are further complications. Liam was a ward of the state at the time he received treatment at the Rainbow Clinic in Rotorua, and Child, Youth and Family Services – and not his parents – were his legal guardians.

In the eyes of the law, Liam’s parents deliberately flouted a court order which would have compelled them to allow his chemotherapy at Otago Healthcare to continue.

Otago healthcare specialists knew and stated (to Liam’s parents and to the court) that 50% of children with Liam’s condition responded favourably to chemotherapy. Despite this, Liam’s parents wished to avoid chemotherapy for their son and sought alternative, unproven treatment.

The vulnerability of parents whose children have been diagnosed with a potentially fatal illness is extreme and I do not wish to add to their grief at the death of their young son. But it is scarcely surprising that they do not want to have an investigation into the therapist and therapy they sought in defiance of the oncologists’ advice and the court order, and it seems nonsensical that Liam’s rights should depend on their decision.

It seems that the Code of Health and Disability Services Consumers’ Rights (HDC Code) does not provide for a child to have independent rights. Other legislation, including the Privacy Code, does. Yet which is more important, privacy or safety?

Practicality

The second issue is the practicality of investigating alternative practitioners, and the Commissioner accepts that the current situation is messy and difficult. In Liam’s case, Ron Paterson could have, if he had wished, investigated the alternative practitioner involved, Gerard Uys, who claimed in a May 1999 Listener interview that his quantum booster machine could cure cancer in a couple of weeks. Quote: “Yeah, leukaemia really is not too difficult. It’s just a mineral deficiency.”

But claiming to cure cancer is an offence under the Medicines Act, isn’t it? No. To advertise that one can prevent, alleviate or cure cancer for reward is an offence. And, according to the Ministry of Health, it is not “advertising” to make such a claim in an interview with a newspaper, because there is no payment involved.

So Gerard Uys, in telling the Listener that “one in four people on average have cancer and we can see it on this machine, but we never ever tell them. We just fix them up” is not “advertising” a cure for cancer, and is not legally liable.

And even if the HDC code were applied to him, it would hold few terrors. The code does not say anything about treatment being effective.

Rights in the Code

Right 4 of the code refers to the “Right to services of an appropriate standard.” The first two clauses say

  1. Every consumer has the right to have services provided with reasonable care and skill.
  2. Every consumer has the right to have services provided that comply with legal, professional, ethical and other relevant standards.

What are the “legal, professional and other relevant standards” that apply to “health services” provided by those who wave quantum boosters at their patients?

Are they simply to be measured against the standards of care provided by other quantum-booster-wavers?

One can understand the basic intent of the legislation – to measure like against like. It would not make sense, in a case of cardiac emergency, to measure the standard of care given by a GP in a small surgery against that given by a specialist cardiologist in a hospital. But if such an interpretation means that the code fails to protect the public from quacks and quackery, it is toothless and useless.

Right to Information

Right 8 of the code is the “Right to be fully informed” and includes such rights as an explanation of the consumer’s condition and an explanation of the treatment options available, including an assessment of the expected risks, side-effects, benefits and costs. How much protection does this offer?

What information about quantum boosters or any other “way-out” treatment will be given? What scientific validity will be claimed for it? And what “explanation” of conventional options, risks, benefits, side-effects, etc. can the quack provide? It seems the code only requires “conventional” medicine to provide information, evidence, and rigorous scientific investigation to substantiate its claims. Practitioners of alternative therapies may claim what they like.

The previous Health and Disability Commissioner, who produced the HDC code, was vocal in her support of Liam’s parents’ right to choose alternative treatment for him. She said that under the code, “parents and guardians must look at all the options available and make an informed choice.” Who could argue with that?

But how does any parent make an informed choice about an unproven device such as a quantum booster which has never been scientifically evaluated?

The reality is that the more highly qualified you are, the more the current HDC code requires from you, while leaving the public unprotected from unscrupulous quacks and their claims.

Commissioner Ron Paterson is on record as disagreeing with his predecessor’s views on this “let the buyer beware” philosophy, but he is still administering the same code.

So what can be done about the safety of our children, given an environment in which their parents exhibit a growing enthusiasm for alternative medicine?

Evident Concerns

The commissioner has evident concerns in this area. When announcing that he would not be investigating the complaint made by Drs Sullivan and Corbett, he advised them to take the issue to the committee advising the Minister of Health on complementary and alternative health therapies.

In the press release accompanying the terms of reference for the committee, Sue Kedgley, Green Party Health spokesperson, expressed her delight that the health minister had agreed to take this first step towards recognising properly registered complementary therapists and ensuring that consumers using complementary therapies are properly protected.

It will be wonderful if this is in fact an outcome of the deliberations of the committee. With exceptions, such as chiropractors, alternative practitioners in New Zealand currently are largely unregulated.

The International Scene

How does this compare with the international scene? In Britain, where the situation is similar to ours, a House of Lords select committee on science and technology released a report last year on complementary and alternative medicine with recommendations for improving the situation. The report recommends clearer regulation, with individual disciplines setting uptheir own regulatory bodies with codes of ethics and practice, and greater levels of education and training. It also calls for both conventional and alternative practitioners to engage in constructive debate about their roles, encouraging greater communication between practitioners and their patients.

In Europe and the USA there are few healthcare activities allowed without state authorisation. Even “mainstream” alternative practitioners such as acupuncturists, herbalists and naturopaths, have been prosecuted for practising without medical qualifications. As Simon Mills says in his paper “Regulation in complementary and alternative medicine” (BMJ vol. 322, 20 Jan 2001), “The increasing demand for alternative care across the developed world has sometimes been met by practitioners outside the law and without recognisable training, qualifications, professional standards or insurance.”

Accountability

We are seeing growing evidence of this in New Zealand and the accountability of these practitioners seems negligible. At the same time as the public and the media clamour for doctors to be more accountable, there seems to be widespread (and legislative) acceptance of people who practise alternative healthcare with inadequate education and training, and no legal or ethical responsibility for outcomes.

Doctors accept accountability. They also accept change, and many who were trained in conventional medicine now include some elements of alternative and complementary medicine in their practice. While it is important that they are trained, supported, ultimately accredited and regulated in these areas, their patients are protected because they are accountable to the standards expected of any medical practitioner. What protection is there for the patients – and especially the child patients – of the quack?

The government’s proposed committee has a huge task ahead of it. Research into, and clinical trials of, alternative treatments are difficult because of a variety of factors, such as lack of standardisation of treatments, difficulty in “randomising” patients and comparing treatments with placebo effects.

Will the committee share the commitment that doctors have to scientific study of any therapy, conventional or alternative?

Can any committee protect the public from unscrupulous quacks peddling “magic cures”?

We doubt it, but we welcome the remote possibility of improving the current situation.

Mike Sullivan and Robin Corbett have said they will put in a second complaint about alternative practitioners to the Health and Disability Commissioner. When they do, I hope he sees it as his responsibility to investigate any “health practitioner” who claims to cure cancer, or is irresponsible enough to advise diabetics to stop their insulin treatment.

I hope, too, that he will take a wider view and use his influence to ensure that our legislation is consistent in its emphasis on the rights of our children to life and health, regardless of their parents’ decisions about their treatment.

Hokum Locum

The Women’s Weekly and Other Medical Journals

Dr John Welch goes eyeball to eyeball with the iridologists, and takes a look at some famous faces

Chiropractic Treatment of Infertility

During idle moments I read medical journals such as the Australian Women’s Weekly. In this case the issue was March 1999 and I really must speak to the Librarian about the disgracefully outdated journals currently held by the medical library.

Following extensive investigations for infertility, our reporter consulted Dr Naomi Perry, an Adelaide chiropractor, who “was doing revolutionary work treating women with infertility by manipulating their spines.” The chiropractor discovered that “Concepta” (not her real name) had a spinal curvature (scoliosis). This is hardly surprising since chiropractors diagnose this disorder in 100% of their patients, it being a central tenet of the chiropractic theory of subluxations. After four months of manipulation a pregnancy was confirmed. If the writer had stood on her head for two hours every night , a pregnancy would have eventually occurred since this event is a function of time for most couples.

Gypsies have the greatest success in predicting pregnancy. This is because they have crystal balls and can see it coming.

The White Stuff?

I was disappointed to miss the International Iridiology & Sclerology Conference held recently in Auckland. Iridologists have now discovered new secrets of divination using the sclera (white of the eye). This immediately reminded me of Ken Ring’s demonstration of “reading” elbows, knees or any part of the body for that matter. As far as iridology is concerned it doesn’t matter whether the iris, sclera, eyelid or the nostril are “examined”. Given a gullible customer, iridologists can spout any old rubbish and they will be believed. Nevertheless, there were some inspirational papers: “Pupillary ruff phenomena in the iris” presented by a senior iridology lecturer at the South Pacific College of Natural Therapies, and “Emotional resistance patterns in the sclera” by a US visitor whose qualifications included a ND (doctor of naturopathy) and a PhD from the University of Wakula Springs, the same one attended by Tarzan. The rather alarming claim is made that “it (iridology) is poised to become mainstream within this decade in many countries like NZ”.

Given the composition of the Health Minister’s committee on alternative medicine, this is a distinct and unwelcome possibility.

Health Secrets of Your Face

Each of the five elements which form the basis of acupuncture-earth, fire, water, wood and metal-have a corresponding face shape which tells the analyst about a person’s talents, personality and potential health problems. Kate Winslet sought the help of a facial analyst when she needed to shed 25 kg of weight gained during her pregnancy. For her “wood” face she was told to “prune” back on sugar, wheat and dairy products. The diet worked so well she not only shed some ugly fat but got rid of her husband…

The face is viewed as a map with different areas representing parts of the body. For example, the forehead represents the bladder and the area between the eyes relates to the spleen and gall bladder. Never be tempted therefore, to squeeze any pimples in this area!

Catherine Zeta-Jones has a “metal-type” face that doubtless describes her attraction to Michael Douglas who is certainly “well-metalled”.

New Zealand Woman’s Weekly 15 October 2001

US cancer institute funds trials of complementary therapy

The Gonzalez regime is a program of dietary modification, supplements and “detoxification” using coffee enemas. The supplements include animal glandular extracts, vitamins, trace minerals, papaya and magnesium citrate. Gonzalez has based his treatment on pseudoscience and anecdotal evidence of success has seen US$1.4 million dollars wasted on a formal clinical trial. I predict that the treatment will be a complete failure but this will not deter Dr Gonzalez from continuing to promote this worthless treatment. Neither will this deter gullible individuals from wasting money on this fraud. Rectal coffee could well be dangerous as the following account will demonstrate.

British Medical Journal Vol 320 24 June 2001 p1690

Fatal heart attack from a health food product

A woman collapsed and died soon after drinking a “natural” health drink containing guarana and ginseng. She had a faulty heart valve as well as a history of palpitations and had been warned to avoid caffeine, which is a heart stimulant. Her blood caffeine level was 19mg/L, the equivalent of drinking about 20 cups of coffee. The caffeine concentration in the drink was 60 times greater than levels found in cola drinks. Guarana seeds contain about 5 percent caffeine.

Medical Journal of Australia 174:520-1, 21 May 2001

Dangerous Chinese Medicines

Traditional Chinese medicines are basically placebos and when they do seem to work it is largely due to the illegal insertion of potent western medicines such as steroids. They can also contain mercury and arsenic, as well as toxic herbs and even banned animal species.

An Indonesian man was brought to a Hospital emergency department and was found to be confused due to a low blood sugar. After an injection of glucose he recovered and was able to tell his medical attendants that he was taking a Chinese remedy called “Zhen Qi”. The label on the bottle listed the ingredients as ginseng, pearl, ram’s horn, bark and “frog extract”. Gas chromatography revealed that the mixture also contained glibenclamide, a potent oral hypoglycaemic agent used for treating diabetes!

For once I join with naturopaths, homeopaths and alternative health practitioners everywhere, in condemning this cynical attempt to make sure harmless and ineffective quack remedies actually work by the inclusion of dangerous but effective drugs.

British Medical Journal Vol 323 6 Oct 2001 p702, p770

Newsfront

Smile for the camera

Singaporean ghostbusters are turning to hi-tech equipment as they search for paranormal phenomena, reports the Evening Post (September 9).

Singapore Paranormal Investigators say they are taking a scientific approach to prove or debunk or unidentified flying objects. The team use digital video cameras, electromagnetic field meters and thermal guns. Many pictures suggesting paranormal shenanigans turn out to be the result of reflections, one has admitted.

‘God man’ warning

Three British men have died mysteriously after becoming followers of god man Sathya Sai Baba. The Dominion (August 28) reports his activities are being studied by the British Foreign and Commonwealth Office, which is considering issuing an unprecedented warning to travellers against the guru.

Three Britons, one of whom claimed being repeatedly sexually molested by Sai Baba, have apparently taken their own lives.

Scorn poured on Sorbonne

The Sorbonne has been denounced as a refuge for irrational academics lacking intellectual rigour. The criticism refers to the institution’s decision to award a doctorate to astrologer Elisabeth Teissier who has advised leading French personalities, such as former president Francois Mitterrand.

The Dominion (August 15) says a number of scientists have called for Mrs Teissier’s doctorate to be revoked and have poured scorn on her 900-page thesis, The epistemological situation of astrology through the ambivalence fascination/rejection in postmodern societies.

Spirit search

An international hunt for witches was launched last August – kicked off by a British medium who wants to contact the Scottish King Macbeth and lift the jinx said to overhang Shakespeare’s tragedy, according to the Evening Post (August 16).

“I’m looking for two witches,” said Kevin Carloyn, high priest of the 1600-strong coven of British white witches.

The idea was to get in touch with the real Macbeth to see if he has anything to do with the weird things which happen when the play is produced. By now, Carloyn and assistants will have been to Cawdor, Macbeth’s windswept home in the Scottish Highlands and tried to pacify the disgruntled spirit. Haven’t heard if it worked, but then plan B was to go to the top and contact Shakespeare himself.

Rebirthing tragedy

Two assistants in a rebirthing therapy session that led to the death of a 10-year-old girl pleaded guilty to criminally negligent child abuse resulting in death says the Evening Post (August 4).

The pair were assisting psychotherapist Connell Watkins in an unconventional treatment session in Watkins’ home. The girl was wrapped in a flannel sheet and told to break out to be ‘reborn’ to her adopted mother. She wasn’t breathing when she was unwrapped more than an hour later.

Oh dear…

Two Waikato researchers say deer velvet seems to have no effect on sexual performance, says the NZ Herald (July 2). The pair Helen and John Conaglen received funding by the maker of the product and were studying its effects as an aphrodisiac. The 34 men who used velvet in their experiment had hormone levels and sex drives no different from those taking placebo tablets. For more than 2000 years deer velvet, a furry skin on growing antlers, have been used in Asia to improve sexual function.

No getting away from it…

Traditional Chinese medicines are here to stay, say Chinese and US doctors in a report in the NZ Herald (July 2). Cao Zeyi, vice-president of the Chinese Medical Association said herbal medicines have worked for a thousand years on trillions and trillions of people but proof was needed.

He was at a week-long gathering of Chinese doctors and their US colleagues and delegates said they must redouble efforts to gain a Western scientific approach to prove that traditional Chinese medicines and therapies worked.

“If we can show clinical results I think my colleagues will open up to the possibility (that they work),” said Dr David Eisenberg, head of Harvard Medical School’s research on complementary therapies.

“This is a global phenomenon. Herbs and supplements are here to stay.”

He valued the worldwide supplements market at $112.93 billion in 1999.

Bad news for ghosts

Tony Cornell of the Society for Psychical Research in Britain reckons he knows why ghost sightings have tailed off in recent years – it’s cell phones!

“Ghost sightings have remained consistent for centuries. Until three years ago we had received reports of new ghosts every week,” said Mr Cornell, of Cambridge. Paranormal events, which some scientists put down to electrical activity, could be drowned out by the electronic noise produced by phone calls and text messages. (The Press, October 15)

Placebos All in Researchers’ Minds?

The placebo effect has long been of interest to skeptics for its presumed role in alternative medicine. The Skeptics’ Dictionary (http://www.skepdic.com) has a lengthy entry, describing a placebo as an inert substance, or fake surgery or therapy, used as a control in an experiment or given to a patient for its probable beneficial effect. It goes on to add the effect has at least three components.

The first is psychological, due either to a real effect caused by belief, or to a subjective delusion – “if I believe the pill will help, then it will help.” Alternatively, the effect may be largely illusory – an illness or injury will often get better by itself, whether it is treated or not.

As a third alternative, the process of treatment, involving attention, care, and affection may itself trigger physical reactions in the body which promote healing, regardless of the nature of the treatment.

The second alternative has received a boost from a study published in May in the New England Journal of Medicine. Danish researchers Asbjorn Hrobjartsson and Peter C. Gotzsche performed a meta-study of 114 studies in which the experimental design included a genuine treatment, a placebo, and no treatment at all. In these studies, they found a slight effect of placebos on subjective outcomes, such as pain, reported by patients, but no significant effect on binary outcomes. Even the slightly positive subjective outcome result could be a reporting effect – patients want to please the doctor, so say they feel slightly better.

Reaction to the report has been mixed. Some researchers have said it confirms what they’d suspected all along, there is no placebo effect, it’s an illusion due to the simple fact that people often get better without treatment. Others argue that the metanalysis used is inappropriate for such a disparate group of studies. But however it turns out in the end, the affair raises some interesting points. One is the origin of the oft-repeated claim that, on average, a placebo effect will help 35% of patients. This has attained almost the status of an urban legend, but Hrobjartson eventually tracked its origin to a single 1955 paper in the Journal of the American Medical Association. Its author, Boston anaesthesiologist Henry Beecher, based his claim on a review of 12 studies, and, like other articles read by Hrobjartsson, it did not distinguish between the placebo effect and the natural course of the disease.

It’s hard to accept there is nothing to the placebo effect at all. There are reports of people developing addictions to placebos, or demonstrating adverse side effects, and trials showing patients with placebos do better than others simply left on waiting lists. But it’s a complex, multi-faceted phenomenon. If we are going to assert that an alternative health treatment is “just a placebo”, we need to be careful about what we mean by that. Does it mean the patient is experiencing a subjective delusion, or genuine healing through care and support, or simply going through the natural course of an illness? The Danish study won’t be the last word on this subject, but it has very nicely focused an issue which has had some very fuzzy edges.

Annette's signature

Hokum Locum

Re-birthing Finale

A Colorado colour therapist was jailed for 16 years after being found guilty of causing the death of a 16 year old girl. It must have been quite traumatic for the jury who watched a videotape of the session in which the girl begged for air and screamed that she was dying”. What we need in New Zealand are equally tough laws that protect children from acts of omission, particularly where children are denied safe and effective medical treatment in favour of ludicrous quackery. (Dominion June 20th, Hokum Locum #59)

Weight-loss scam

The diet business is worth a lot of money and the latest scam has been to persuade people to part with up to $300 for a three month supply of plasters containing a seaweed extract guaranteed to “lose between two and four kilograms a week”. This degree of weight loss is not only unsafe but extremely unlikely as there is no possible mechanism for it.

I have been on a self-imposed diet which involves modest restriction of food intake and a modest increase in exercise and I have lost 7 Kg over a four month period. This is within dietitian’s guidelines that recommend no more than 500g weight loss per week. It has been easy and not involved spending any money.

It appears that all I need is a beard, a website and a catchy title for my diet (suggestions please) and hordes of gullible New Zealanders will pay me vast sums of money. The secret is to give no guarantees and avoid breaches of Consumer laws.

Dog-boy?

An enduring urban myth has been tales of children being raised by animals. The latest such story by credulous journalists appeared in the Dominion 20 June 2001. The 10 year old was alleged to have lived in a cave with wild dogs and suckled from one of the females. However, a Police spokesperson put an appropriate spoke in this suggestion by stating “we can’t tell whether he had been suckled or not.”

This story will now enter popular mythology along with all the other stories that have been repeated since the days of Romulus and Remus, two Roman orphans who were fed by flying pigs.

True lies

This is the title of an article appearing in New Scientist 7 April 2001. Experimental Psychologists found that 30% of a group of children recalled “uncomfortable touching” episodes which had not happened to them but were mentioned in a story scenario. Their recall accuracy was even worse when they were asked questions that required a yes/no answer.

This was the problem in the Christchurch Civic Creche case where faulty interviewing techniques were used by people (the new witchfinders) who had a particular belief structure and looked for evidence to prove their loony theories (aided by a loony complainant). In the process they ruined the lives of a group of children and their caregivers, and contrived to send Peter Ellis to prison. The Judicial review was laughable but carried out with the same careful examination of evidence as would have been accorded a claim of alien abduction.

The Australasian Journal of Integrative Medicine

I have forwarded my copy of Vol. 1 No. 1 to the Editor. It could become a valuable archival item in our reference collection.

I am not going to bother analyzing the content but one thing that bothers me is the array of recognized training for pseudo-scientific rubbish. Various Medical Colleges award re-accreditation points for courses on homeopathy, acupuncture and herbal medicine. It seems that as long as a training process has been set up it doesn’t matter about the content. Skeptics have already successfully attacked a proposal in New Zealand for a BSc in Naturopathy.

The overall method of practising alternative medicine is to spend about an hour with patients taking a detailed history which in itself is a form of psychotherapy and engenders a very powerful placebo effect. You then throw in a gimmick such as herbs, acupuncture, or homeopathy to add the “magic” which produces a grateful patient who “feels” better.

When skeptical investigators test all of these things by controlling for the placebo effect, they find no change in objective measurements of health parameters.

More on Buteyko Breathing technique (BBT)

This is a belief that asthma can be treated by deliberate shallow breathing which raises carbon dioxide levels in the lung. The respiratory rate is closely controlled by CO2 levels. When you hold your breath, CO2 levels rise and eventually you are forced to take a breath. If you deliberately over-breathe then CO2 is “blown off” and this causes people to feel dizzy and peculiar (hyperventilation).

Professor Buteyko believes that the fundamental cause of asthma is hyperventilation and his method is aimed at getting patients to deliberately hypoventilate. Several studies have been done and one would obviously expect to find raised levels of CO2 in people practising BBT. There was none.

Patients practising BBT felt better but there was no change in their use of asthma medication.

BBT produces a classic placebo effect which is what one would expect since the cause of asthma is known to be inflammatory changes in the airways of the lung.

Advertisements

I thought it would be interesting to review what’s on offer from the Sunday News on July 1st.

“Stop snoring or your money back”….not a good claim to make when it’s very hard to see how a “natural blend of enzymes and herbs” can possibly stop snoring. This preparation is marketed as “Dr Harris Snore Tablets”. Shouldn’t that be “anti-snore?”

Clive Clinics have been around for decades and their itinerant trichologists are promising assistance through hair analysis which “can indicate vitamin, mineral or toxic problems…” It is claimed that “your parents are the reason for your baldness” but there may be “treatments that block the genetic messages…”

The words and language in this advertisement illustrate how the promoters incorporate scientific advances into their sales pitch. The before and after photographs are great and I recommend readers check out the website <www.cliveclinics.com>

Dr Archer’s FATBUSTERS is a good example of the classic weight loss promotion. Using a new dietary supplement “more than 25 000 Nz’ers have lost weight!” The pills “soak up fat from food and stop fat being absorbed into the body…Just eat your usual meals”. This is an irresistible formula for the obese – an eating cure! Although there are two ‘before’ photographs of “Tania” and “Mike” there are no ‘after’ pictures. Could this mean that the product failed to work? Curious readers should call 0800-78-2000 to find out.

Because Cowards get Cancer too

Because Cowards get Cancer too, by John Diamond, Random House, 1998

So John Diamond is dead; at age 47 killed by his tongue cancer. He may not be well known in New Zealand, but was a popular newspaper columnist and broadcaster in Britain. Soon after developing cancer in 1997 he used his weekly columns in the Times and the Daily Telegraph to report the course of his disease. This book, written after he had endured some terrible experiences, appeared when he was still unsure whether he was “cured”. Of the many books I have reviewed, this is the first to bring tears to my eyes.

Of special interest to Skeptics is that, to put it mildly, he was critical of “alternative” therapies. “…where I stand on alternative medicine is roughly where the Pope stands on getting drunk on the communion wine and pulling a couple of nuns.” Because of his public position, his candour on this brought in many letters of advice and abuse. He was particularly enraged by those which told him to take “a positive attitude”, or to “take control of his illness”.

The trouble started with a lump. No need to worry, said the doctors, you have a 92% chance it’s harmless. Unfortunately, Diamond was of the other 8%. The lump became a tumour; no need to worry, said the doctors again, radiotherapy will give you an x% chance of a cure. Again unfortunately, Diamond was of the (100-x)%. And so, to the surgery, described in almost unbearable detail. Because of the effect of the surgery on his speech and ability to swallow, this man, who previously had spent much of his working day in a broadcasting studio or on the telephone, was reduced, in his words, to “a honking, dribbling fool”. A dreadful fate.

Despite the fact that conventional medicine did not, in the long run, save him, Diamond never accepted that alternative treatments would serve him better. Although he earlier admitted that, in extremis, he might visit “that well of alternative solace”, there is no sign that he ever wavered in his opposition to those he called “scatterers of pixie dust”.

Diamond’s writing is full of insights expressed with wit. What text-book could explain for the general reader the difference between cancer cells and normal cells as pithily as this:- “A cancer cell is the one that never grows up…[it] bears all the nastier traits of reckless youth…[a member] of some wacky religious cult obsessed with immortality.” And metastasis: “.. spreading the good word round the body…to share the secret of eternal cellular life with other cells.” These apparently light-hearted words were written by the “honking, dribbling fool”.

He disliked the warlike metaphors used in discussing disease; “battle” and “brave” he avoided in his writing, claiming that this stigmatised those who succumbed to the disease as cowards or losers.

The Canterbury Public Library has five copies of this book, and I have had to join a longish queue of borrowers. It is gratifying that the author’s views and experiences are being widely read; I hope readers are as impressed as I, and accept the message. No doubt some of us who hold “alternative medicine” in derision will also die of cancer. Let us look to John Diamond as our inspiration when courage and steadfastness may falter.

Telling Lies for Father Moon

Reviewed by Bernard Howard with acknowledgement to Ian Plimer

Icons of Evolution: Science or Myth? Why Much of What We Teach About Evolution is Wrong, by Jonathan Wells

This is an important book. Look out for it, for example, in places where young minds could be influenced, such as high school libraries, or other places where creationists might care to spend US$27.95. The text may be unremarkable, the usual misquotations, selective omission, distortions, etc. The important thing is the credentials of the author; surely the holder of a doctorate in biology from one of the USA’s finest universities cannot be wrong?

However, there is more to Dr Wells than his biography in the book tells. Thanks to some astute websearching on the part of the biologist who reviewed it for Nature, we are now aware of the following:

  1. Wells has been a member of the Unification Church (the Moonies) for upward of 25 years.
  2. He was chosen by the founder of the church, Sun Myung Moon, to study for a Ph.D., in preparation for his life’s work, destroying Darwinism.
  3. He appears to have gone through the entire post-graduate programme of course work and a substantial research project without his teachers or supervisor knowing of his beliefs and intentions.

Distasteful though it may seem, it could be possible for a student to go through an undergraduate course, passing examinations on existing knowledge without accepting its validity. The situation is greatly different when tackling a research project for a post-graduate qualification. Those of us who have been through this academic mill know the dedication required, not only of time, but of the mind, to the search for new knowledge. I find it hard to credit that one could do research in developmental biology, as Wells did, while believing that growth of a life is something quite different.

But perhaps one should not be surprised. With the example of Australian geologist Dr Andrew Snelling before us, who believes the Earth is billions of years old when writing for geological journals, but only a few thousand when concocting creationist literature, the capacity of creationists for deception or self-deception seems limitless.

In preparing this note, I am indebted to Dr J. Coyne, University of Chicago, for his excellent review in Nature, and for subsequent correspondence.

Healing Ways

A new book on alternative medicine has little to add

Last year, I wrote to the Minister of Health protesting at her plans to spend $600 000 on a Ministerial Enquiry into Complementary Medicine. Press reports quoted the Minister as saying that acupuncture was an example of an alternative technique that is now accepted as mainstream.

In my letter I said that acupuncture had never been shown to be better than placebo. Frank Haden followed up my protest with a supportive article in the Sunday Times and this is where the fun began.

A Dr Robin Kelly wrote criticising me, and accusing me of acting unethically. In my response to him I made an error of fact, which he pointed out to me. But the interesting thing about his reply was that he claimed I was losing the battle because of misinformation, a point that I will revisit.

On October 17 Dr Kelly was interviewed by Kim Hill on the National Programme in her Nine to Noon show. My name came up several times, for which I am, of course, very flattered. The interview was basically an advertisement for Dr Kelly’s new book, Healing Ways (Penguin New Zealand, 2000), but several points in the discussion intrigued me.

Kim Hill said she was sure Dr Kelly could explain to her how an anaesthetic worked. Now, I am a consultant anaesthetist with some twenty years experience, and if I could explain fully how a general anaesthetic worked I would immediately put in for a Nobel Prize. General anaesthesia is a complex process, and although many aspects are understood there are still large and fundamental gaps in our knowledge of exactly what happens during general anaesthesia. Maybe Dr Kelly can explain how an anaesthetic works, but I’ll lay a bet that he cannot.

Kim Hill then invited him to explain how acupuncture works. After several assurances that he would do so, Dr Kelly failed. He said that an acupuncture needle acts like an aerial, allowing contact from the outside to the inside. Well, in his explanation the needle sounds more like a conductor than an aerial. Is he saying that acupuncture needles must be metal, and not bamboo for instance?

Dr Kelly then told us that much research was proceeding at Monash University. Well maybe it is, but it is the results we want, not the assurance that the research is being done.

Dr Kelly stated that I would benefit from some acupuncture, though he did not state for which condition I needed it. He also said that what he was on about was enhancing the placebo effect. But hold on. Was he not criticising me for saying that acupuncture had not been shown to be any better than placebo?

You can’t have it both ways Dr Kelly!

Throughout his interview, Dr Kelly was at pains to say the material was covered in his book. I went and bought a copy of Healing Ways, much to my wife’s annoyance as she predicted it would be a total waste of money. How right she was (a very wise woman is Mrs Sharpe.)

I wish I could in all honesty say that I have read Healing Ways, but try as I did I just could not READ it. So Dr Kelly will be able to claim I have missed vital material. I was merely able to dip into it and read small sections.

To be fair, Healing Ways has some valid and potentially useful material. Dr Kelly emphasises the importance of listening to patients, and writes empathetically about dealing with dying patients and their families. I did not, however, find anything particularly new or startling in this material.

The rest of the book is a mix of many current trendy alternative claims. Acupuncture and Chinese Medicine, homoeopathy, applied kinesiology, Gaia hypothesis, healing touch, prayer therapy… you name it, it’s there!

I was particularly amused at the contention that Dr Benveniste is a leading researcher in water memory. Readers will remember the good Dr B. and his thoroughly discredited paper on water memory and homoeopathy in Nature back in 1988.

Another enjoyably silly section in the book deals with breathing. Apparently we should focus our breathing on our navels, because that is where we got our oxygen before birth. Dr Kelly advises that we watch how a baby breathes and learn from this natural breathing pattern. It is a pity that he does not revise his physiology lessons from medical school. Babies breathe the way they do for a number of reasons, but the end result is that the oxygen cost of breathing is proportionately much higher. Also, a baby does not have a functional reserve volume to the same extent that an adult does. Therefore any interruption to breathing in a baby is more likely to result in hypoxia. I do not think we want to run the same risks.

All in all, Healing Ways is an irrational collection of trendy claims, lacking any evidence of scientific validity.

What concerns me about Healing Ways is that I expect this to be typical of the “evidence” that will be presented to Annette King’s enquiry. I have told Ms King that the enquiry will be a waste of time and money. If I am correct about the material that will be presented, I will take no great pride in being proved correct.

I will however concede the final round to Dr Kelly. He said that I was losing the battle because of misinformation. Having heard his interview with Kim Hill, and read the greater part of his book, I am inclined to agree, with the proviso that we recognise that it is people like Dr Kelly who are providing that misinformation!