Dec 17 2008

What’s the Harm?

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Comments: 28

This is a website I should have plugged before – it’s called whatstheharm.net. As the name implies, it is an answer to those “shruggies” who do not see unscientific or fraudulent medicine as a problem. The site catalogues cases of people harmed by so-called alternative medicine treatments. Most of the cases are due to refusing standard treatment as a result of misplaced faith in unconventional treatment.

For example, Jacqueline Alderslade was told by a homeopath to give up her asthma medication. She subsequently died of an asthma attack. This was a completely avoidable death.

I was reminded of this site by a recent case of a man who was convicted and will spend 6 month in jail for injuring his daughter. He decided to treat her with bogus supplements rather than seek appropriate medical care, resulting in her suffering heart and brain damage.

There was also this recent case of a couple convicted of abuse after their daughter died of complications of severe excema. They decided to treat her with homeopathic remedies rather than the recommended treatment – long beyond reason should have motivated them to seek medical care for their daughter.

Yes, these cases are anecdotal. Yes, there are plenty of stories of “medical misadventures” in standard medicine. These cases are not substitutes for scientific evidence regarding the safety and effectiveness of these treatments. But given that we can confidently conclude that homeopathy, for example, is worthless and without effect, these stories serve as legitimate cautionary tales. Eschewing proven standard of care medicine and placing unwarranted faith is dubious, implausible, and disproven therapies is not risk free.

Next time someone asks “what’s the harm,” point them toward this website.

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Remember, on Wednesday’s I also blog at science-based medicine.

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28 responses so far

28 Responses to “What’s the Harm?”

  1. DevoutCatalyston 17 Dec 2008 at 10:28 am

    CAM practitioners have an expanding universe of modalities and incompetence at their disposal, for example, their services may include cancer screening. I don’t see CAM trending towards becoming less irresponsible. Expect more of these stories.

  2. buffalodavidon 17 Dec 2008 at 11:29 am

    I check this site almost as much as I frequent this one. That is to say… a lot.

  3. Eric Thomsonon 17 Dec 2008 at 11:54 am

    Fantastic site.

    The section on the harms of creationism is sort of funny.

  4. tooth fairyon 17 Dec 2008 at 6:22 pm

    freat site but mostly i find people saying “what’s the harm?” using it as a complimentary alongside science based medicine, rarely would i encounter someone so stooopid to use this crap as a primary treatment.

  5. Karl Withakayon 17 Dec 2008 at 6:51 pm

    tooth fairy,

    Keep in mind that your experience of CAM being used in a complimentary role is anecdotal.

    I don’t know that we have good statistics on what percentage of CAM users defer, delay, or entirely bypass real science based medicine in favor of CAM, or for what conditions they do so.

    I don’t think it’s entirely unreasonable to assume that the numbers are higher than you might think, or that if the use of CAM becomes more mainstreamed, the percentages will grow.

    Even with science based medicine, it’s not particularly uncommon, for instance, for a cancer patient to choose surgery only, and opt out of chemo and radiation because they don’t want the side effects of those treatments; just ask Dr Gorski over at Science Based Medicine.

    I think you can expect to see a good percentage of the CAM users to think, “if it works in conjunction with other therapy, maybe it will be enough on its own.” and either delay or bypass medical treatment in favor of trying CAM.

    (While I’m at it, I’ll just throw out my proposal for what the term CAM should stand for: , Complete Alternative to Medicine)

  6. jcreighon 17 Dec 2008 at 8:51 pm

    I have very mixed feelings about this site because of its anecdotal nature. (I know that it has a section for studies, but the overwhelming majority of entries are anecdotes.) When people use anecdotes to support woo, skeptics invariably respond with some variation of “the plural of anecdote is not evidence”. And then we push this site which is literally a plurality of anecdotes, and say it’s evidence, or if not “evidence” per se, then at least worth seriously considering. How is that any different from what CAM proponents do?

    “But given that we can confidently conclude that homeopathy, for example, is worthless and without effect, these stories serve as legitimate cautionary tales.”

    But that’s the very thing that’s in dispute. That’s what CAM people disagree with; they say that homeopathy works. How do they know this? Because of all the anecdotes they have!

    I realize that it may be an effective tool to convince people who, eg, see that homeopathy is bunk, but don’t see the harm, but I don’t know if it SHOULD be an effective tool. Do we really want to engage in and encourage a style of discourse where whoever has the most anecdotes wins? Again, how is this different than what quacks and cranks do? What will we say when challenged about this? “Presenting anecdotes as evidence is okay when WE do it.”?

  7. tooth fairyon 17 Dec 2008 at 10:51 pm

    i like Can’t Adhere to Medicine :) thanks Karl good points, that is why it’s CAM though thankfully in the majority it is complimentary

  8. PaulGon 18 Dec 2008 at 8:36 am

    I’d like to add this anecdote for the little it is worth, it is personal and I can attest to it’s veracity.

    A few years ago, the wife of a close friend was diagnosed with with stage II, Hodgkin’s Lymphoma. During a fairly standard chemotherapy regime, she also adopted hypnotism, reiki and a number of other “practices”.

    In due course, the chemo’ did it’s job and she went into remission. Thankfully she has remained “clear” for more than seven years.

    She has however, stated on many occasions, that should it be necessary, she would rely entirely on hypnotism and reiki in the future.

    This I find worrying, not least because of how much I care for her and her husband, but because the usual rule of thumb means, “where there’s one, there’s many” and she has become a “teacher” and “practitioner” of this garbage, thereby spreading the idiocy.

  9. Steven Novellaon 18 Dec 2008 at 9:24 am

    jc – I see your point, which is exactly why I added the caviats. But, the purpose of this site is NOT to show that homeopathy (just to stick with that example) does not work, but rather to document what can happen when people rely on modalities that do not work instead of those that have been shown to be effective.

    It assumes these modalities are ineffective. My point is that this is a valid assumption. It is not in dispute scientifically whether or not homeopathy works – it doesn’t. Its proponents are pseudoscientists.

    Case histories are a valid part of the medical literature. They are not used as definitive evidence that a modality works (which is the error that CAM proponents make). They are used to show examples of the natural history of a disease, or the kinds of complications that can arise either from diagnosis or treatment. They can also be used as a starting point for future research. But they are not a basis of conclusions about efficacy.

  10. weingon 18 Dec 2008 at 9:33 am

    I’ve incorporated complimentary medicine into my practice. I always say something like “That’s a nice dress. Nice shoes. Hair looks great.” etc. Haven’t done any outcome studies on this modality.

  11. PaulGon 18 Dec 2008 at 9:40 am

    JC – Your point is well taken, but you might want to take a look at a good few of the posts on this site. When arguing a particular point, the people that post here commonly support their arguments with valid journal citations (case in point – look at the entry on Reflexology in UK Schools and at least one of my own posts).

    I posted an anecdote above, true, but my opening remarks stated “for the little it is worth”.

    On the whole, I’ve thought that the standard of argument, supported by evidence, on this blog has been of a high standard – and the majority of us know both the value of anecdotes, and the difference between an unsubstantiated anecdote and a factual case study.

  12. tooth fairyon 18 Dec 2008 at 6:05 pm

    Please go to Alphabiotics in the site and “read more” ……..

  13. SaraJon 18 Dec 2008 at 6:11 pm

    Some of those stories literally made me feel ill.

    The sad thing for me is that I know people who use acupuncture, detoxification, cupping, colon cleansing and things like that for their various and sundry ailments and weight loss. I always try to talk to them about the dangers of these “treatments”, but I always get back some variation of “what’s the harm?”

    I have one coworker who even went so far as to tell me that she KNEW the pain relief she felt from the acupuncture she was receiving for bursitis and TMJ was most likely a placebo effect and that pain-killer worked better most of the time. But she felt that if it relieved her pain for a short while without her having to take medicine, why shouldn’t she do it? I tried to explain the wasted expense, possibility for infection, etc., but she basically tuned me out. I think I will e-mail her the link to that site, but she’ll most likely tune that out, as well.

  14. DevilsAdvocateon 18 Dec 2008 at 6:40 pm

    I suspect there is a substantial number of people who partake of the usual suspects (acupuncture, reiki, TT, etc.) for the more minor maladies simply to be able to bring it up in conversation at social outings. To be ‘cool’ and current, I guess. I’ve overheard conversations where folks were upping each other on this.

  15. Fifion 18 Dec 2008 at 6:50 pm

    DevilsAdvocate – That’s generally known as “spiritual competition” – it’s basically around who’s the more evolved being (often measured by who’s spending the most and gotten closer to the guru, essentially a lot of yoga teachers and alt healers seem to have started to serve the same social function for wealthy women – and men – as hairdressers once did for ladies who lunch…they listen to confidences, whisper them in other people’s ears and tell you about other people’s private going’s on, fluff egos and, most importantly, make the person physically beautiful). It’s all about “purity” – in the religious sense but also in the general phobic sense of being scared of being “dirty” and therefore “bad”. It makes for some quite entertaining passive aggressive conversations sometimes – dualing angry niceness and moral superiority is really quite funny to watch!!!

  16. HHCon 18 Dec 2008 at 7:16 pm

    Weing, can I sign up somewhere for your style of complimentary medicine? Sure beats being told that your morbidly obese! I think these types of alternatives are useful… keeps the client focused on completing something in their lives, i.e. treatment from a concerned person. If the treatment is successful or a placebo works then the client becomes more self-reliant and less dependent on “medicine men”.

  17. PaulGon 18 Dec 2008 at 7:51 pm

    Tooth fairy,

    Did a quick search for “Alphabiotics” on here and didn’t get anything, can you provide a link?

    I think I’d stand by my last post, especially with the qualifications I made…

    “a good few of the posts on this site…” “commonly support their arguments…” “on the whole…” “the majority of us…”

    I think I was probably so vague, you could slot that post in on almost any science blog you care to mention (that may be a bit of an exaggeration, but you get the idea).

    But if I’ve missed a chunk of interesting anecdotes, then point me in the right direction and I’ll revise my opinion in the light of the evidence.

  18. jcreighon 18 Dec 2008 at 8:48 pm

    @PaulG: To clarify, by “this site”, I meant whatstheharm.net, not NeuroLogic Blog, and my comments about its anecdotal nature refer to that site, not this blog. I certainly did not mean to imply that the content of NeuroLogica Blog was primarily anecdotal in nature. Sorry for the unclear wording.

  19. PaulGon 19 Dec 2008 at 3:56 am

    Tooth Fairy,

    No problem. I’ll have a look – always interesting to read something pointless and lurid in the morning… in the UK, millions of people start their day with “The Sun”.

  20. suszennnon 22 Dec 2008 at 1:28 pm

    WHATS THE HARM

    An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient

    Medical errors account for more deaths in America than breast cancer, AIDS or car accidents annually.

  21. HCNon 22 Dec 2008 at 4:49 pm

    So, suszennn, what is your evidence that medical errors are so rampant and dangerous?

    According to this: http://www.disastercenter.com/cdc/ … accidents and adverse events is the leading cause of death for those under age 45, and it is heart failure and cancer for those 45 and over. Your cherry picked data does not seem to have a number that adds up to your dire number. Plus, it seems that many people are hospitalized because of some reason, what is the ratio of those who come out better than your dire (unreferenced) data?

    And along with providing some actual evidence, what do you propose as a solution? Do we avoid “harm” by avoiding hospitals? So if there is a car accident with injuries or a kid has a seizure, should we skip calling 911 and just hope that non-intervention would be better than going to the hospital? When a child gets whooping cough and has trouble breathing, do we skip the hospital and hope the home humidifier keeps the child alive? When a cancerous tumor grows big enough to cause harm, do you propose that we get a kitchen knife and cut out ourself instead of trusting the surgeons in a hospital?

  22. HCNon 22 Dec 2008 at 5:02 pm

    Oddly enough, I switched over to another blog and this “fear of medical” errors was being addressed:
    http://www.sciencebasedmedicine.org/?p=316

  23. tooth fairyon 22 Dec 2008 at 6:12 pm

    PaulG,
    i wasn’t directing it at you-i would provide the link but i’m using an office computer and the link wouldn’t bode well for my future here….it linked to a site with nothing to do with alphabiotics but a lot of girl on girl

  24. tooth fairyon 22 Dec 2008 at 6:25 pm

    suszennn;

    “An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors…” how do you define potentially preventable medical errors? i’m in total agreeance with HCN, with such bold claims please provide a link to such data. HCN’s findings are correct to my quick googleing. and

    “Medical errors account for more deaths in America than breast cancer, AIDS or car accidents annually.”

    even if this were true, it would just be a testiment to how well SBM has dealt with the risk of AIDS and cancer-without hospitals what would happen to the people that have car accidents then go to hospital and recover? Just sit there and bleed to death, that’s a preventable death to me anyday of the week.

  25. suszennnon 22 Dec 2008 at 11:04 pm

    i just love reading this blog because it makes me think…..i just googled and got the above stats…..
    i just went to the site that steve said to be sure to take a look whatstheharm.net. and found it to be lacking in any kind of science…..it was about a lawsuit of one really stupid person and something else i cant remember…….
    i am an advanced somatic therapist have been for 17 years…
    there is more to all this than black and white…its just to bad we cant work together….for the highest good of all humans….
    and some comments here…people just get these other treatments to be cool or social….which again i find no science in those statements…..
    and the comment on may-be we just shouldnt go to hospitals…again a juvenile response of course i would want a good doctor…..
    i have worked with so many children who who are autistic…most of which started after the 18 month shots….
    again i think kids should get vaccine’s….it is a double edge sword…… however there is a connection….and my wish and hope is some great scientist will find the answers for all of us

  26. suszennnon 22 Dec 2008 at 11:13 pm

    here is one

    Medical Errors – A Leading Cause of Death

    The JOURNAL of the AMERICAN MEDICAL ASSOCIATION (JAMA) Vol 284, No 4, July 26th 2000 article written by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health, shows that medical errors may be the third leading cause of death in the United States.

    The report apparently shows there are 2,000 deaths/year from unnecessary surgery; 7000 deaths/year from medication errors in hospitals; 20,000 deaths/year from other errors in hospitals; 80,000 deaths/year from infections in hospitals; 106,000 deaths/year from non-error, adverse effects of medications – these total up to 225,000 deaths per year in the US from iatrogenic causes which ranks these deaths as the # 3 killer. Iatrogenic is a term used when a patient dies as a direct result of treatments by a physician, whether it is from misdiagnosis of the ailment or from adverse drug reactions used to treat the illness. (drug reactions are the most common cause).

  27. HCNon 23 Dec 2008 at 1:40 am

    suszennn said ” just went to the site that steve said to be sure to take a look whatstheharm.net. and found it to be lacking in any kind of science…..it was about a lawsuit of one really stupid person and something else i cant remember…….”

    It is a collection of news reports, it was never meant to be scientific. What part of the following that Dr. Novella wrote in the 5th paragraph did you not understand:
    “Yes, these cases are anecdotal. Yes, there are plenty of stories of “medical misadventures” in standard medicine. These cases are not substitutes for scientific evidence regarding the safety and effectiveness of these treatments.”

    Which case out of the hundreds there did you look at? Was it the one about homeopathy and Isabella Denley? Or was the energy medicine used on Mitchell James Little or Debra Harrison?

    That 8 year old paper you referenced is reprinted here:
    http://drug-education.info/documents/iatrogenic.pdf … funny how you left that out. It turns out it is not a research paper, but a COMMENTARY!! That one commentary seems to show up lots in certain websites. Perhaps you should try something a bit more recent, and perhaps with the original data.

    In more recent news: deaths from cancer have been decreasing, which brings all other forms of death up higher in the ranks of severity.

    By the way, if you had read the ScienceBasedMedicine blog entry by Dr. Lipson that I referenced, you would have learned (from the about the 13th paragraph): “The document that has fed this conflagration of idiocy is a landmark study by the Institute of Medicine. One of its findings was that somewhere between 44,000 and 98,000 deaths yearly in the U.S. may be due to medical errors. That’s a lot. Of course, the lengthy report is somewhat more complex than a single statistic. Before and after the IOM report, there has been a great deal of research into medical error. I’ve written a bit about the topic, and the more I study it, the more complexity I see in the problem. But it’s not an insurmountable complexity. The question implied by the alties is, “if modern medicine kills so many, why bother with it at all? Wouldn’t it be safer to do [insert absurdity here]?””

    Which brings up the question: What kind of solution do you propose?

    You may call my question juvenile, but it is perfectly valid. So do try to answer it sensibly.

    And since over a dozen babies in the USA die from pertussis, I would really like you to answer the question about how to deal with a child who cannot breathe. Considering (according to you) I put my child in dire danger by taking him into the hospital at least four times when he had croup. He could hardly breathe, and his blood oxygen level at one time was very very low (about 70%). So please answer the question.

    Additional comment to your un-punctuated rant “i have worked with so many children who who are autistic…most of which started after the 18 month shots….
    again i think kids should get vaccine’s….it is a double edge sword…… however there is a connection”

    The reason is that many kids with autism are diagnosed at that time, even those who have NEVER been vaccinated. Again, you are making a declaration without evidence. There has been study after study showing no connection between vaccines and autism. Again, I repeat, over a dozen babies die from pertussis in the USA each year. Data included here:
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf

  28. tooth fairyon 23 Dec 2008 at 6:48 pm

    suzennn.

    fancy that! i’ve been practicing somatic therapy for years….i have my certificate from the somatic society (printed at home by my black and white cannon). Let me ask you a question, If you were sick with a physiological disease would you see another somatic therapist, seek other alternative treatments, or use SBM, or use both in conjuction?

    One point i feel HCN missed from the SMB post by Dr. Lipson regarding preventable deaths which needs to be shown here becasue it would seem obious suzennn is A) too busy to read the post because she is telling her patients to become aware of themselves or B) plainly ignored the data.

    Dr. Lipson writes;

    “Advances in the treatment of coronary artery disease, the number one killer of Americans, reduced the number of deaths by over 340,000 in 2000 alone. And that’s just one disease.

    So, in one year, medical errors may cause a few tens of thousands of deaths (and these are preventable deaths), but real medicine, in one disease alone, saves an order of magnitude more”

    so yes doctors do get it wrong, real time decisions aren’t always going to be done retrospectively as good as they could have been, but ask yourself what has SBM done over the last century-how many lives it has saved and lost and then ask yourself how many lives CAM has saved (then it’s very questionable if they were cured by the treatment administered or if it was coincidence) and how many it has condemmed, and finally what either holds for the future? CAM is a waste of time and money.

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