A Bitter Pill?

The risks of third-generation contraceptive pills have been much in the news. But assessing risk can be a tricky business.

Twenty-nine years ago, I was about a week into my first job as a doctor, as a House surgeon in orthopaedics at Guy’s Hospital in London. I had not had time to get to know the patients under my inexpert care and was on a very steep and stressful learning curve. Just before three in the afternoon as I was doing my post-operative round, my bleep went mad, warning me of some dire emergency. I hurried to the men’s ward to find an anaesthetist and another doctor working hard to revive a man who had suddenly called out and then fallen back pulseless. He had had a knee operation the week previously, before I had arrived on the job and I scarcely knew his face, let alone his name. My puny contribution to the efforts of the experts were to no avail and his circulation could not be restored. His wife was waiting outside and it fell to me to tell her that he had had some sort of heart attack and had died. You will not be surprised that it is her face rather than his that I remember.

Twenty-five years later, another patient in my charge, a young student of twenty, had puzzled two other doctors by her sudden attacks of loin pain over several weeks, first on the right side, then on the left and then on both sides. By the time she came to see me, she had had numerous blood tests, an emergency kidney x-ray and a chest x-ray. They had given no clues as to the cause of the pain. She had been seen in the Accident and Emergency department of the local hospital in the middle of the night. She had been seen by a colleague of mine at the weekend. The attacks continued, but in between them, she had been well enough to go out on Territorial Army manoeuvres. When she saw me, the pain was bad enough to make her catch her breath. Apart from severe muscle spasm and a raised pulse rate I could find no abnormality. I noted that “something strange is going on here.” I arranged for her to see a medical specialist urgently. Before she could keep the appointment, while walking from the library to the cafeteria, she fell pulseless to the ground and her circulation could not be restored.

Venous Thromboembolism

Post-mortem examinations showed that what both these unfortunate people had in common was deep venous thrombosis and massive pulmonary embolism, first elucidated by the great German pathologist Virchow, well over a hundred years ago. Venous thromboembolism, as it is often called, VTE for short, has vexed doctors ever since.

Most of you will know that blood outside the body clots. It is fortunate that while in the blood vessels it does not usually clot unless the vessel is damaged and then clotting is indispensable. The damage results in the release of substances that initiate a cascade of biochemical reactions that result in a tangle of a fibrous protein called fibrin, mixed up with platelets and red blood cells. This plugs the hole in the vessels and may plug the whole vessel. Virchow’s triad has stood the test of time as an analysis of what happens with abnormal clotting. He observed that the main influences are disturbances of the vessel wall, things that change the dynamics of the blood flow and things that change the components in the blood that initiate clotting. Let us return to my two unfortunate patients.

Contributing factors

In the case of the first, he had had an operation on a lower limb and his limb had been immobilised in plaster. The stress of an operation in itself increases the clottiness of the blood, muscle action would have been absent during the operation and reduced after it, leading to sluggishness of flow. We can imagine what happened in the veins of his legs with clotting extending from a vein, often starting in a valve pocket, and eventually extending into the main vein of the leg and thence even into the main abdominal veins. Eventually, a large piece broke off, was pumped through the right side of the heart, blocked the pulmonary trunk and brought circulation suddenly and permanently to a halt.

The second person was a fit and healthy young woman. Were there any known predisposing factors? Had she perhaps an inherited predisposition for her blood to clot easily? Her grandfather had had an uncomplicated deep vein thrombosis after an operation on his leg, but this is a known risk. Had she had any injury? Well, she had sprained her ankle on Army manoeuvres four weeks before she had started to get symptoms. Following her death, her Lt Colonel investigated this and there is nothing in his detailed account to suggest that she had anything other than a minor sprain.

She had not sought any medical attention for it. And three months previous to her death, she had started to take the contraceptive pill.

Popular Pills

The first major trials of the contraceptive pill took place in the late 50s and it quickly became very popular because of its ease of use and near 100 percent efficacy. It contains two hormones, progestogen to fool the pituitary gland into thinking the taker is pregnant, so that it has no need to send signals to an ovary to release an egg; and oestrogen to give cycle control so the taker can have a monthly pseudo period. The oestrogen component also reinforces in some way the contraceptive efficacy of the pill. The first pills used about six or seven times as much oestrogen hormone as modern pills and the first case histories suggesting an association between the pill and VTE appeared in 1961. A report to the British Medical Research Council in 1967 showed a clear link between pill use and VTE and further papers from Britain, Sweden and Denmark in 1970 concluded that the risk of thrombosis was linked to the oestrogen dose. By this time, the oestrogen dose was down to about 80 micrograms from an initial 180 to 200 micrograms and it was then recommended that the level at which risk became unacceptably high was about 50 micrograms of oestrogen.

Absolute Risk

Early case-control studies suggested that the risk of VTE was between two and eleven times greater in pill-taking women and the absolute risk was between three and six episodes per ten thousand women per year. A large study of 65,000 women in Seattle in the early eighties suggested a relative risk of 2.8. Healthy women not on the pill seem to have an absolute risk of about one per thirty thousand women per year, so the risk in pill-taking women is about one per ten thousand per year. I should make it very clear at this point that we are not talking about risk of death here, but only of deep vein thrombosis. If we take the worst figure, about one in fifty of people who get deep vein thrombosis will have a fatal pulmonary embolus, so the risk of death from this per year of pill use is about one in a quarter of a million per year. However, a further proportion of people who get DVT will have permanent damage to the veins of their legs and in some, multiple small clots breaking away will cause permanent damage to the circulation of the lungs. Pills containing progestogen on its own do not seem to have an increased risk of VTE, but are less effective and periods are irregular, so they are less popular.

Late in 1995 media reports began to appear that so-called third generation oral contraceptive pills carried a greater risk for VTE than the older pills. The third generation pills contain the progestogen hormones gestogene or desogestrel, which can be thought of as designer hormones. The state of the art of drug synthesis has advanced to the point where the properties of the hormones can be to some extent predicted from their structure, and vice versa, and these two hormones have fewer male-hormone like effects (such as causing acne etc) and less effect on fat and carbohydrate metabolism. They were promoted as being safer for the arteries, where blood clots also occur, as in heart attacks and strokes, and better for the skin. It was difficult for doctors to advise their patients as the papers on which the media reports were based had not been published, but three eventually appeared in the scientific medical journal, the Lancet, of December 16, 1995 and another one in the British Medical Journal in January 1996. They are not easy reading and I think it is safe to say that those most likely to prescribe the contraceptive pill, general practitioners, do not as a rule read the Lancet.

Literature Reviews

Fortunately for us, there was no shortage of secondary articles, and one appeared in the Ministry of Health’s Prescriber Update in February 1996. I have read the original papers and can say that the article is an excellent and balanced summary that accurately reports the findings of the originals and correctly reflects the views of their authors. The risk of VTE in second generation pills is less than previously reported. A healthy woman who is not a current user of the pill has an annual risk of VTE of about one in 26,000. A woman who takes the modern second generation pill has an annual risk of about one in 6 to 10,000. Someone who takes a third generation pill has an annual risk of between one in 3,570 and one in 5,000, so the risk of VTE in third generation pills is roughly twice that of second generation pills. The authors echo a Lancet Leading Article in stressing “that further independent study is necessary. The interpretation of the small increase in risk of VTE must be weighed against a possible decrease in the risk of other cardiovascular endpoints. Until the relative risk of other important health outcomes such as stroke or coronary artery disease.. is clarified, there is no sound basis for recommending any change to current contraceptive practice.”

British Response

In Britain, the response of the Ministry of Health was to advise that the third generation pills should not be used by women with additional risk factors for VTE and that doctors should prescribe them only for women who were prepared to accept the increased risk and who were intolerant of other combined pills. This led instead to widespread flight, not only from third generation pills but from contraceptive pills in general, with at least anecdotal reports of many accidental pregnancies and an increase in abortions. This may seem very strange to aliens like us who habitually think logically, but you will not be quite so surprised if I said that following a recent total solar eclipse in Britain, people sought advice as to whether viewing the eclipse on television could have caused damage to their eyes…

In New Zealand, the response was more muted. Doctors took the advice from the Health Department at its face value and received it as a reminder to check for risk indicators when prescribing the pill. In December 1998 we were told between January 1993 and June 1998 there had been six deaths from VTE in women taking the third generation pills whereas between 2.2 and 3.7 deaths in this time would have been expected. Of course, with such small numbers the figures could readily be accounted for by random variation and the article pointed out results from epidemiological studies are more reliable than Committee for Adverse Reactions Monitoring data. The waters were by now quite muddied and Sandra Coney jumped into them last year to further stir them up when the headline of her column in the Sunday Star Times read “Who’s to Blame for Pill Deaths?”

“My question is”, she wrote, “who is accountable for these deaths? Is it the drug firms who raised the spectre of legal action against the Ministry when it planned to issue warnings when the risk of these pills were first known?

“Is it the medical groups who pressure the Ministry by saying they would disassociate themselves from the advice? Or is it the various officials of the Ministry of Health who caved in under the pressure, selling New Zealand women down the river?”

She pointed out that “an astounding 75 to 80 percent of women” using the pill in New Zealand were on third generation pills. “This”, she said, “tells us something about the too-cosy relationship between doctors and drug companies in New Zealand.”

According to Coney, the Adverse Reactions Committee had advised doctors should preferentially prescribe the older second generation pills, but the pill manufacturers threatened the ministry with legal action and had “bombarded GP’s with dossiers contradicting the studies” and the Royal New Zealand College of Obstetricians and Gynaecologists said they would publicly dissociate itself from the advice. The Family Planning Association, another body that might be thought to have some expert knowledge too, “went about saying the studies…were affected by biases so that the results couldn’t be trusted.”

Rhetorical Questions

At the end of her article she asks questions that might be thought to be mildly rhetorical given the general tenor of the article. Of women using third generation pills she asks:

Are they warned of the risks?

Do they know that they could reduce their risk by using older forms of OC’s or even eliminate it by using another method?

Have their doctors explained to them the symptoms of blood clots?

Do they know they are at additional risk if they are immobilised because of illness, injury, surgery or a long plane flight?

What must we poor benighted doctors do as dossiers rain down about our ears from drug companies, as sticks labelled “informed consent” are waved at us by the Health Commissioner, as our expert bodies display their ignorance by echoing the advice given by other expert bodies throughout the world?

The publicity has had a beneficial effect in making us more careful in assessing people’s suitability for the combined pill, but it may have led us to practice a more defensive style of medicine. In a consultation I have about twenty minutes to impart quite a lot of information and know that seventy percent of what was absorbed at the time will have been forgotten by the end of the day.

Reduced Risk?

Could they indeed reduce their risk by using an older pill? One expert, Walter Spitzer, commenting in the Lancet on a World Health Organisation scientific summary writes “The summary of the conclusions plays down the controversies that have raged for the past two years about differences between second and third generations of oral contraceptives in risk of VTE. It also properly emphasises the rarity of all the three serious side effects.” He went on to point out that there is at least some evidence that third generation pills may have a smaller incidence of heart attacks in young women and that the order of risk for VTE and heart attacks is about the same. What we may gain on the swings of reduced VTE we may lose on the roundabouts of heart attacks.

If we look at risks in isolation we may reach conclusions that are both correct and yet which are absurd. Let us suppose that a sexually active woman decides that the risk of OCP is too great and so she uses no contraception at all. In a year she has a seventy percent chance of getting pregnant. During the pregnancy she has a one in 1600 chance of getting a DVT and during the week in which the baby is born a risk of about one in six hundred, roughly ten times greater than the worst risk for third generation pills – if the studies have reached a correct conclusion.

Symptoms

Every third year medical students knows the symptoms of blood clots. You get a painful swollen leg with tender calves. Unfortunately for us poor benighted doctors and unfortunately for our patients, most people with DVT don’t have these symptoms and most people with these symptoms don’t have DVT. Pulmonary embolus is even more difficult to diagnose without high tech help – except in the post-mortem room. Oh, if only the drug firms would distribute free retrospectoscopes instead of raining dossiers of propaganda on me! Still, I do tell patients, orally and in writing, about painful swollen legs; and chest pain with shortness of breath and spitting of blood; and about sudden loss of vision or use of limbs. If I set a test at the end of a week not many would pass. But I’ll be OK when the Health Commissioner comes calling.

Do I really have to tell them about additional risk if they are immobilised because of illness, injury, surgery or long plane flights? My elder daughter flew to Britain a few months ago. Would I as a doctor expect her doctor to suggest that she stop the pill (I don’t know whether she’s on it. It’s none of my business). First of all, long distance flying carries a risk of DVT that is independent of being on the pill, so I should also expect him also to warn her about the risk of cosmic rays at high altitude, the risk of side-stream smoke in the cabin, the risk of acquiring hepatitis A from eating airline food and so on almost ad infinitum. In any case, it’s a risk that she would run for a few days at most, so it would have to have a very high annual risk indeed to be of comparable significance to the annual risk from the pill.

To Sandra Coney and others the issues seem to be simple. One sort of pill carries twice the risk of another sort. Drug firms have bullied the Ministry of Health and have muted the voice of doctors and other experts by stopping their mouths, not with gold, the preferred substance for scoundrels down the ages, but misleading dossiers. A risk is a risk is a risk and no one should have to run it if it can be reduced. No matter that people vastly better informed and experienced in analysis of statistics comment about the “lack of clinical importance and public health significance of VTE” with its “very low absolute rate of occurrence, low morbidity and low case-fatality.” Nothing must get in the way of a good story.

The Global Messenger Hoax And The Misinformation Economy

At last year’s conference, John Scott spoke on the problems of mixing misinformation and medicine.

Early in my medical career I became aware of the enormous distorting forces which operate upon science in the real world. In my field the forces were those of Quaker Oats, Kellogg, Sanitarium, the diary industry, the AMA, elements within the cardiology camp, and the tobacco giants. I became an interested observer of some enormous investments in dubious research projects, many of which could only be termed con-jobs. More particularly, I realised that we scientists were very human creatures.

Together with many of my colleagues I plodded along trying to inculcate into oncoming generations of medical students a genuine understanding of scientific principles and methods. To be frank, my generation of teachers has failed, certainly as far as the bulk of medical graduates is concerned. Events over the past year in England, Europe and New Zealand have rammed that point home, often in painful ways, as far as I am concerned.

I do not wish to be seen to disparage many of the achievements of scientific and technological medicine over the past thirty to forty years. They have been massive. However, other huge investments in the health-disease industry deserved to be challenged and remain in that situation.

The central message so far is not news to this society. Bill Morris gave a paper at the Palmerston North meeting challenging much of the classical diet-coronary heart disease hypothesis. His voice was about as lonely as mine at that time. Science ultimately makes advances by gaining improved understanding of mechanisms. There is nothing wrong in doing one’s best with available knowledge until one obtains comprehensive understanding of a particular situation.

Coronary artery disease and arterial disease generally present very complicated problems. Fortunately and unfortunately, in an exquisite paradox, arterial disease is a very general phenomenon and becoming more so as countries become steadily more affluent.

There is enough knowledge to make a reasonably firm statement of dogma, that the causation is multifactorial and represents an interplay between environment and one’s genetic endowment. This statement doesn’t help a great deal about developing techniques for elucidating mechanisms. It does, however, provide wonderful protection for less competent scientists and technologists, and certainly, for industry generally.

New Technology

The cholesterol-saturated fat-diet-arterial disease hypothesis really took off when the 19th century concepts concerning the potential of computers were made possible through the development of transistors and printed circuits. In turn, epidemiology was provided with a tool it had needed. The autoanalyser had also been invented and thus mass biochemistry was now possible.

What amounts to an industry with a turnover through the decades of trillions of dollars was really set alight by a gentleman called Ancel Keys. He undertook studies in Europe linking what amounted to death certification and some relatively crude morbidity data with the local diet and estimates of cholesterol levels.

Here we get into what I term the “global messenger hoax”. On a simple arithmetical biaxial plot, Ancel Keys’ data, from his various countries, was the traditional dog’s breakfast. Subsequently one of his senior technicians, who was extremely troubled by what happened, published the truth.

In turn the technician’s article was immediately suppressed pretty effectively by the scientific juggernaut which had developed around this particular health-disease industry. Ancel Keys had selected a series of points which produced a straight line on a semilogarithmic plot or a gentle smooth curve on semilogarithmic axes.

I was aware of this at the time but didn’t get very far in quoting it, although, to his credit, the later Sir Edward Sayers accepted that Ancel Keys had at least been naughty. However, eventually a very prominent American nutritionist and professor of medicine, Dr Feinstein, published the original material plus Ancel Keys’ simplified extrapolated data which had set the whole bandwagon rolling. Feinstein came into the scene too late. He was too big a Don Quixote to be rubbished, so he was therefore largely ignored.

Now there is nothing particularly unusual about all that. As is eminently predictable, history is catching up with the epidemiologists who have continually reinvented the Ancel Keys wheel. Basic scientists, particularly anatomists, pathologists and immunologists, with their analysers and biochemistry, have begun to get at the common pathways upon which genetics and a complex environment interact to produce arterial disease. The gross simplifications have been exposed. Interestingly, however, the process continues of twisting results of recent research to fit the theory at each stage of the wheel reincarnation.

Alternative Interpretation

Most of you will know about the statin drugs which are very powerful reducers of cholesterol levels. Probably a majority of my colleagues believe that the advent of these drugs and their testing on a massive scale by people, including me, has vindicated the cholesterol hypothesis.

However, it might interest you to know that Brown and Goldstein, now working in Southwestern University of Texas, have a huge group of scientists and technologists exploring alternative interpretations.

If it was possible for physicians and epidemiologists to remove their dogma spattered spectacles, they would see what is obvious from most of the large statin trials, particularly the much hailed 4S or Simvastatin study. The effects of morbidity and mortality were proportionally just as great for the group at the bottom end of the scale of cholesterol elevation as they were for the top end.

If one thinks that through carefully and reanalyses the evidence, something else is going on than mere lowering of cholesterol and low density lipoprotein. There is no real surprise in that, when one looks at the nature of the intervention in the cholesterol synthesis pathway, and links that to the ubiquity of cholesterol as an essential structure which holds many biologically important molecules in a particular spatial pattern.

Cholesterol is involved in many biochemical processes and synthetic pathways. The statin drugs do many more things than just lower elevated cholesterol. But the message proclaiming the dogma is out there, and the messengers are not going to change their message in a hurry without carefully considering the shareholders’ interests. After all, the drugs do have a demonstrable effect and are eminently marketable even on the basis of partial evidence.

That brings us up against the real problem and my choice for the title of this talk. We live in an age of misinformation. Politicians seem oblivious to that as they play gleefully with the bubbly toy of the knowledge society concept.

Political games not withstanding, we are all in on this mass-deception exercise. When I thought about applying to the then Mr, now Sir Douglas Graham for legal aid to support the skeptics in a crusade against the pervading partial truths and cunning deceptions, I realised that he probably would remove his pipe temporarily and mumble something about the stability of societal constructs and the impoverishment of lawyers generally.

When more recently I wondered about approaching the Hon Tony Ryall, I realised that I might receive a lecture on fundamentalist thinking. He might use the biblical quote, “You who are not for us are against us.” Moreover, if I took my protests elsewhere I would be rapidly caught up with various religion-based aphorisms. You seek to be a prophet in your own country, haven’t you read the bible?

Shooting the Messenger

These musings sent me off on another trial as the green lipped mussel saga developed. I happen to know a lot about these tasty beasties, because work on them was undertaken in the Department of Medicine in Auckland during the time that Derek North and I were HODs.

Once again, it’s the messenger business that interests me. I happen to believe that Susan Wood is a more astute and intelligent anchor girl than Holmes, allowing for gender-bending bias. However, it rankled me that she and the editor of the New Zealand Herald both came out with the all-innocent line – “Why attack me, I’m only the messenger,” to paraphrase things. A spokesperson for the Ministry of Health understood that he was being snowed by Susan Wood but didn’t quite get his counter-attack launched correctly. The Herald seems to have got away with it more or less completely.

However, there is a huge message within that message. The media are not just the messengers. They are an integral part of the process of the misinformation economy. New Zealand is, for at least half its population, a comfortable consumer society, seemingly happy to buy more than it can afford. The United States is going the same way as evidenced by this month’s trade deficit.

If we analyse that situation further, it becomes pretty obvious that what might be termed scientific truth, in itself certainly not an absolute or a constant quality, is now a debased commodity. The concept of quality of information which members of the Skeptics believe to be an essential prerequisite for intelligent human advancement, is held in contempt by key players in the global economy.

Evidence of Efficacy

It is all very well for the Medical Council of New Zealand to pronounce that there is no difference between orthodox and traditional or nonorthodox therapies, their common attribute being that any claims they make shall be based upon evidence of efficacy.

That sounds fine but it flies in the face of reality. Unfortunately, the failure of people like me as medical educators receives poignant testimony from the increasing use of acupuncture, homeopathy and so forth, by so many of our graduates.

Moreover, the status of a critic of these mixed practice habits is weakened by the continuing paucity of sound justification for many so-called orthodox practices. However, thanks to the financial seduction of the messengers, downgrading of science is now a fashionable global activity.

Occasionally I tune in before the 6pm TV1 news and there is the lady representing Blackmores coaxing me into upsetting my gastrointestinal system with slippery elm and to exposing my nervous and renal systems to potential chaos as I ingest mixtures of herbs, some of which contain quite toxic compounds.

I have carefully avoided quoting from the genetic engineering debate but you all know that I am heavily involved in that as president of the Royal Society and in defending science and technology. In particular that society is trying to ensure that information across the spectrum of opinion is made available to the New Zealand public.

We have done a bad job in this, because we failed to estimate the strength, political nouse, and financial capacity of the opposition, that is, of the anti-biotechnology anti-genetic engineering lobbyists, particularly in Europe, England and now New Zealand.

Is this little diatribe of any relevance? I believe there are two important aspects to the great global messenger hoax and the misinformation economy. A lot of harm is being done to people who are not in a position to understand what is happening.

As soon as I make such a statement, I am immediately assailed by the various groups which benefit financially, or in terms of personal status and so forth, because I am becoming paternalistic in a traditional manner and seeking to impose my restrictions on their freedom of choice. However, let’s take that a wee bit further.

To me it is heartening to see Sandra Coney and Robyn Stent opposing one another publicly over the issue of patients’ rights in relation to Lyprinol. I further applaud Dr Pippa MacKay in joining the fray in the New Zealand Herald. I suspect that newspaper does feel guilty about its part in the $2 million one-day killing, but that guilt won’t last for long. Why then are these issues important?

Vaccination Alarms

In 1998 reports began to circulate that measles, mumps and rubella (MMR) vaccination might cause autism, possibly through a mechanisim involving changes in bowel function.

There were immediate notes of caution sounded but they were largely ignored. It was pointed out that the reported cases might have been due to what is termed temporal coincidence. There was certainly no convincing laboratory evidence for the contention. A specially convened United Kingdom Medical Research Council committee found the so-called clinical evidence unconvincing.

However, the media messengers got into gear and there was a definite drop in acceptance of MMR vaccination in the United Kingdom. That has spilled over into New Zealand and added fuel to the anti-vaccination campaign here.

This is what I mean by people being harmed by what I have termed the global hoax of purveying partial or pseudo scientific information, to gain readership or viewing numbers for the profit of the moment or for political advantage. Infants and children are in no position to give informed consent, their parents are well placed to be misled.

Information Ignored

I use this particular example because the press internationally ignored information available at the time of the initial sensational reports, which indicated that the measles virus was not the mechanism for the observed cases of inflammatory bowel disease (IBD). There was thus selective reporting for purposes of gaining sensation.

I believe that in June 1999 The Lancet laid the matter to rest with the advent of further information. The Lancet also says in its edition of June 12, page 1988 that:

Will the scientifically sound and essentially ‘negative’ results published this week garner the same media and public attention as the initial report of the MMR-autism hypothesis? It is unlikely, as evidenced by the renewed media frenzy last week in response to another report by the group that proposed the hypothesis. This report was of an increased risk of inflammatory bowel disease among individuals who had naturally acquired measles and mumps within one year of each other. The study had no data on MMR vaccine and the investigators specifically stated that they did not find a significant relation between monovalent measles vaccination alone and later IBD. Yet the popular media trumpeted the study as providing evidence that MMR vaccination may cause IBD. In such an environment it is critical to strengthen vaccine safety monitoring systems and risk-communication strategies to maintain public confidence in immunisation.

Lancet Editorial Comment, by F De Stefano and RT Chen, 1999, Vol 353, pp 1987-1988

Thus I believe the first important aspect of all this is that the misinformation distribution process can be harmful.

The second important aspect relates to what the whole process tells us about ourselves as a collective society. In a New Zealand which is seemingly increasingly non-numerate to an effective degree, and increasingly less literate in the classical sense, we do face a problem and may need more than legal aid to save our society from contemporary ridicule emanating from better educated international competitors, or worst fate of all, transformation into a nation dominated by a media worshipping cult.

I don’t blame the media for what is happening – I blame ourselves for our failure to anticipate the consequences which automatically ensue when the information technology explosion hits an unprepared, untutored, non-critical society.

We skeptics do have a role – we need to decide how to change the pattern of which I am, I believe, justifiably critical, such that New Zealand can reach democratic decisions on a basis of roundly presented, soundly analysed, best available information.

Can we, the skeptics, help disprove the hypothesis of HG Wells who wrote in 1920:

Human history becomes more and more a race between education and catastrophe.

Forum

I didn’t wish to begin a debate about the issues surrounding religion in the 16th and 17th-century, nor would I ever wish to stop anyone from taking in interest in history. All I wanted to do was to point out that history is an academic discipline the same as any other, and it is dangerous to make pronouncements of such a dogmatic nature in the subject in which one has not been trained. Little in Jim rings reply to my letter persuades me that I am wrong. I still think that the comment about Archbishop Laud implies that he was executed for burning heretics, otherwise why say while burning heretics was still a pious duty it could have unfortunate consequences, particularly for archbishops. However it is possible that in the area of toleration we are talking at cross-purposes. Toleration was strictly limited in its application in the 16th and most of the seventeenth century. Catholics for instance, were discriminated against for almost all of this time. Quakers and other minority religious sects were fiercely

Continue reading

Skepsis

In the wake of the green-lipped mussel debacle, the Australian Menopause Society (AMS) convened an expert panel of doctors to discuss controversial areas of menopausal medicine. Alternative therapies are a boom industry in Australia and New Zealand (worth in excess of $1 billion in Australia) with menopausal women the highest users.

Continue reading

Skepsis

Like Noel O’Hare, I attended the September Skeptics’ conference. Noel, winner of an NZ Skeptics Bravo Award “for critical analysis and common sense for his health column throughout 1997”, had a gripe (Shadow Of Doubt, Listener, 19 September 1998). He accused us of favouring “soft targets — psychics, New Age fads, alternative medicine, astrology.” “Poking fun at Creationists or crystal healers,” he wrote, “may produce a warm glow of superiority — but doesn’t change much.”

Continue reading

The Noble Pharmacist

NEW AGE theory holds that practically all cultures had a tradition of using medicines (mostly herbal) and that there is a danger that “Western medicine” will replace these, so losing irreplaceable knowledge.

Continue reading

Skepsis

Another “I’ve seen the light” American quack whizzed through New Zealand recently, spreading his own magical brew of antioxidants, lacto-vegetarian diets, bioFlavonoid herbs, and, wait for it, Maharishi Ayurveda compounds. Hari Sharma, Professor Emeritus at the Ohio State University, says that physicians are becoming pathogens, they are creating diseases. Like most saviours of the human race before him, he mixes scientific half truths and anecdotal stories to rubbish hundreds of years of painstakingly researched evidence-based medicine (GP Weekly, October 1997)

Continue reading