Everyone take a bow

The NZ Skeptics cast the net wide for the 2011 Bent Spoon.

The NZ Skeptics have awarded their annual prize for journalistic gullibility to all those media outlets and personalities who took Ken Ring’s earthquake prediction claims at face value, thereby misinforming the public and contributing to 50,000 people leaving Christchurch with all the inconvenience, cost and emotional harm that caused.

We believe that it is the business of the professional media to ask pertinent questions on behalf of the public when presenting material as factual. We even have broadcasting standards which call for accurate reporting. Many, many media outlets and journalists failed the basic standards of their profession in failing to ask “where is the evidence?” in the face of Ken Ring’s claims to predict earthquakes. They did us all a disservice.

The group Bent Spoon award is an unusual one for the NZ Skeptics, but we felt that so little was asked by so many that it had to be a broader award this year. That said, we did single out some reporters and commentators whom we felt had made particularly poor journalistic efforts in this area. They include:
Marcus Lush (RadioLIVE), for giving great and unquestioning publicity for Ring’s claims that Christchurch would have a major earthquake – “one for the history books” – on 20 March, and continuing to support Ring’s promotion as an earthquake predictor and weather forecaster.
Closeup’s Mark Sainsbury for giving Ring another platform to air his ideas with very little in-depth critique (12 July).

The best thing about Ken’s failure on March 20 was his long silence afterwards. Yet there he was back on what is supposed to be a credible current affairs show with more vague pronouncements and self-justifications. Surely Closeup had another Kate-and-William clip they could have played instead to maintain their level of journalistic quality.

The Herald on Sunday’s Chloe Johnson, who provided uncritical publicity for Ring which continued long after his failures had been well and truly demonstrated (26 June).

It’s been sad to see the Herald name devalued by the tabloid approach of the Herald on Sunday, especially when the spin-off can sometimes do good stuff such as its hard-hitting editorial headlined “Charlatan Ring merits contempt” (20 March).

Brian Edwards, described by one commentator as providing ” banal and rigourless equivocations”, including such gems as “the evidence that the moon has some contributory influence on earthquakes seems slight … however, it is not impossible that it does”.

We’ve seen Edwards cogently skewer sloppy thinking in the past, so it was surprising to see just how wishy-washy he was in this particular case.

And what of the notorious John Campbell interview where the television interviewer lost his cool and boosted sympathy for Ring by shouting him down? This has given us the unusual situation of seeing nominations come in to give Campbell both the Bent Spoon and the society’s Bravo Award for critical thinking.

We appreciate what John was trying to do – introduce a little evidence and call into question some very dubious claims – but we knew he’d blown it as soon as he started to talk over the top of Ken.

Bravo Awards

The NZ Skeptics also applaud critical thinking with a number of Bravo Awards each year. This year’s recipients are:
Janna Sherman of the Greymouth Star for her item “Sceptics revel in Hokitika ‘earthquake’ non-event” (14 March). Ken Ring predicted an Alpine Fault rupture and/or an extreme weather event which would require Civil Defense to prepare for gales and heavy rain at the Hokitika Wildfoods Festival in March. As Sherman’s report noted:

“The 22nd annual Wildfoods Festival on Saturday was held under sunny skies, with temperatures climbing over 20 deg C.”

In science, a lack of evidence or a failed prediction can tell us a lot; in the media, we rarely see any stories about a non-event. That’s why it was great to see Sherman and the Star cover Ken’s failure – pseudo-scientists and psychics alike will only trumpet their successes as part of their self-promotion. To get the real picture, you need to hear about their failures too.

Philip Matthews, writing in the Marlborough Express, for a great article on 1080 that actually says there is really only one side to the story rather than introducing an alleged controversy with token ‘balance’ (22 June).

We don’t ask the Flat Earth Society to provide balance for a story on the International Space Station orbiting a spherical Earth. Why should we give a false impression of evidence-based ‘debate’ in other areas such as 1080 or immunisation? In discussing the entrenched views regarding the use of 1080, Matthews wrote:

“One of those ‘entrenched views’ is the weight of science; the other, emotive opinion. The debate is done a disservice by suggesting the views are somehow equivalent.”

The NZ Skeptics also commend Dr Jan Wright, the Parliamentary Commissioner for the Environment, who, while not in the media itself, did a great job of evaluating the evidence on 1080 and presenting a report clearly outlining the evidence.

As always, the Bent Spoon was awarded telepathically by those gathered for the annual NZ Skeptics Conference.

Animal welfare issues whacked with Bent Spoon

Concerns over animal welfare issues on farms have seen Rural Women New Zealand and Fonterra rapped with the Bent Spoon, the annual recognition of gullibility and a lack of critical thinking awarded by the NZ Skeptics.

Rural Women New Zealand gave the Supreme prize in its Enterprising Rural Women Award to Homeopathic Farm Support, a company which follows the homeopathic practice of diluting substances until there is no active material left and then claiming that the water somehow “remembers” what was once in it. Homeopathic Farm Support provides a line of such products, claiming that homeopathy can be used to “prevent and treat symptoms of acute and chronic animal ailments” including mastitis, post-calving haemorrhage, pinkeye, scours, first aid and even emotional problems in livestock.

We had lots of members, including a number of vets, contact us very concerned that Rural Women New Zealand has applauded the use of magic water for treating serious cattle ailments, and that this potentially dangerous practice is apparently supported by a third of farmers supplying Fonterra. Rather than lauding the determination of the business owner to succeed in the face of little belief in alternative methods of healing, Rural Women New Zealand should be calling on their members to think long and hard about the welfare issues for their animals, and show that women can succeed in the hard graft of real farming. Fonterra should publicly distance itself from this or it will cop more criticism for tacitly supporting unacceptable New Zealand farm practices.

There have been many studies of homeopathy, but the only ones which show any convincing results are those produced by homeopathic businesses and other vested interests. This is akin to reading tobacco company journals which say that smoking is fine for your health. Studies that have been conducted by independent parties with proper controls and peer review, whether on animals or humans, have not found any benefit from homeopathic treatments. whatstheharm.net, a website tracking the physical and economic harm of a lack of critical thinking, has over 400 case studies of people who have died or been harmed by a belief in homeopathy.

We know that animals respond to human contact, and that this can certainly play a role in the stories of response to alternative treatments, in much the same way that people respond to such. But we can’t afford to let treatment of serious health issues reply on wishful thinking or the placebo effect. That’s clearly unethical.

A discussion paper on the ethics of homeopathics in veterinary use noted that “it would also seem clearly unethical to employ an unproven therapy such as homeopathy in cases where an acceptable and effective treatment already exists or where the patient is at risk for greater suffering if the unproven therapy fails.”

Others have raised the concern that the use of any substance, homeopathic or otherwise, without any actual data or evidence-based diagnostics, is a form of unapproved animal experimentation.

Fonterra has stated publicly that nearly 3000 of its 10,500 farmer shareholders are Homeopathic Farm Support customers, and Fonterra has worked with the company on organic programmes. Fonterra did not respond to repeated inquiries from the NZ Skeptics regarding their level of support for alternative treatments and the animal welfare issues that result.

Organic farmers don’ t have to buy into the wishful thinking of homeopathy in order to be successful. And if they want to build a serious export market, they can’t afford to ignore the welfare issues involved in treating suffering animals with nothing but water. Let’s hope that if there’s a foot-and-mouth outbreak we don’t have calls to treat it homeopathically – that could very well kill our country’s agricultural reputation for good.

A central principle of homeopathy is that every being is unique and the treatment must be tailored to the individual on all levels, physical, emotional and mental. The NZ Skeptics have previously called upon the New Zealand Council of Homeopaths to join them in criticising pharmacies for selling homeopathic products. NZHC did not respond to the request.

The Homeopathic Council should be concerned at products being flogged off over the counter with no questions asked other than ‘ do you want vitamins with that?’ We’ re appalled that you can sell water for $10 a teaspoon, and it’s distressing that this sort of exploitation is also being practised in our farming sector.

In addition to the Bent Spoon, the NZ Skeptics have praise for a number of attempts to encourage critical thinking over the past year.

Lynley Boniface gains a Bravo Award for her Dominion Post column, “Why psychics should butt out of the Aisling Symes case”, castigating TVNZ for giving airtime to self-proclaimed psychic Deb Webber to promote her national tour and speculate on the then-unfolding tragedy of the missing Auckland toddler.

We see distraught families exploited regularly by the psychic industry. It just adds insult to injury to see such exploitainment supported by our state-funded television.

3 News reporter Jane Luscombe gets a Bravo for her informative look at the belief that amber teething necklaces leach a substance to help babies with pain and depression.

All too often we see television reporters take the easy option and swallow claims with nary a raised eyebrow. It was great to see a report where some research had been undertaken to show the claims were unfounded and a clear warning that the practice itself was a dangerous one.

Kate Newton of the Dominion Post also gained a Bravo for her item on Victoria University’s embarrassment over the homeopathy course it was offering in its distance education programme. The NZ Skeptics have been concerned at the increasing willingness of universities to provide facilities for the promotion of touring psychics, neurolinguistic programmers and other purveyors of dubious services.

Kate Newton also took the trouble to point out that homeopathic products are watered down to the point where no molecules of active ingredients remain. The homeopathic industry is very careful to downplay that aspect in their products and services, and it’s an important point to get across to the general public. Most homeopathic users think they are getting something in the expensive sugar pills and water drops they are buying, but they aren’t.

The awards were psychically conferred at this year’s conference dinner.

Bravo recipient responds

Thank you kindly for the recent award for journalistic excellence I received from your society for my editorial in the NZ Medical Journal on alternative treatments. It was wonderful to be honoured by a society such as yours whose aims and intentions I absolutely support and whom I have always held in the highest regard.

With grateful thanks.

Pippa Mackay

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.