Jan 21 2010

Victory Against Homeopathy in Australia

My skeptical comrades down under have been kicking A and taking names. They demonstrate that skeptical activism can have concrete positive effects. Most recently they issued a complaint to the Therapeutic Goods Administration (the Australian equivalent of the FDA) about the claims being made on two homeopathy websites (“Homeopathy Plus!” and “www.d-n-h.org”). Specifically the cites claimed that homeopathic immunization (there is no such thing) was as effective as real immunization for the prevention of infectious diseases. They report:

Dr Ken Harvey, a lecturer at Latrobe University School of Public Health, who authored the complaint, objected to claims on the website that “homeopathic immunisation is effective against poliomyelitis, chicken pox, meningococcal disease, hepatitis (all types), Japanese encephalitis, HiB, influenza, measles, pnuemococcal disease, smallpox, typhoid, cholera, typhus whooping cough, rubella, mumps, diptheria, malaria, tetanus, yellow fever, dysentery and many other epidemic diseases”.

To support these claims the research of Isaac Golden was referenced, but the study referenced was in fact negative – without statistically significant results.

The panel who heard the complaint came back with a favorable finding:

The findings from The Complaints Resolution Panel stated that although the complainant cited references for homeoprophylaxis, they “did not provide complete copies of the papers cited” and that the material was “misleading”, “unverified” and “abused the trust or exploited the lack of knowledge of consumers”.

That last bit could apply to just about all of so-called “alternative” medicine.

The ruling is another hopeful sign that we can turn the tide against pseudoscience in medicine and the legitimizing of health fraud through clever marketing. Homeopathy is pure bunk and has no place in a science-based health care system. But the promoters of dubious health claims have been successful in distracting the public, regulators, and even some academics with pleasant sounding but ultimately misleading rhetoric.

Here is a recent example – a press release about what is ultimately a worthless study.

The team of UCLA and UC San Diego experts in the fields of CAM, integrative medicine, Western medicine, medical education and survey development created a novel 30-question survey and sent it to 126 medical schools throughout the United States. In return, the team received 1,770 completed surveys from a pool of about 68,000 medical students nationwide, roughly three percent.

Three percent – that means that the results of this survey are uninterpretable – worthless. This is such a highly self-selective response that it tells us nothing statistical about the attitudes of medical students toward CAM. Further, the questions asked in such surveys can be phrased to produce a positive result – and in this case ambiguity as to what is considered “CAM” makes the questions themselves almost too vague to be of any use. This study is so bad that it should not be publishable in the peer-reviewed literature. However, CAM proponents now have their own journals in which to publish worthless studies that are only useful for propaganda purposes. This one will be published in Evidence-based Complementary and Alternative Medicine.

From the press release:

“Complementary and alternative medicine is receiving increased attention in light of the global health crisis and the significant role of traditional medicine in meeting public health needs in developing countries,” said study author Ryan Abbott, a researcher at the UCLA Center for East-West Medicine. “Integrating CAM into mainstream health care is now a global phenomenon, with policy makers at the highest levels endorsing the importance of a historically marginalized form of health care.”

I disagree with just about every assertion in this statement – this is the cover, the distraction, the equivalent of “ignore that man behind the curtain.” The first sentence begs the question as to whether or not CAM in any way will be helpful to the global health crisis. The World Health Organization recently had to admit that homeopathy, for example, has no role in the real health crises faced by third world countries. Unscientific medicine is a sure way to waste resources and worsen the global health crisis.

Then there is the attempt to portray CAM as “traditional” and “marginalized”  – appealing to cultural sensitivity.

Then the press release dives into the core CAM propaganda:

CAM, which includes therapies such as massage, yoga, herbal medicine and acupuncture, is characterized by a holistic and highly individualized approach to patient care. It’s emphasis is on maximizing the body’s inherent healing ability; getting patients involved as active participants in their own care; addressing the physical, mental and spiritual attributes of a disease; and preventive care. While interest in these fields has increased dramatically in the United States in recent years, information about such therapies has not yet been widely integrated into medical education.

CAM is not “holistic”. Most CAM modalities take a very narrow view of health and illness by focusing on the “one cause of all disease” or a simplistic philosophy-based notion of health. Treating all illness as if it were a deficit in the flow of life energy does not treat a person as a whole biological organism. Most CAM treatment is also not individualized – but rather applies cookbook style remedies.

The press release also repeats the common canards that CAM is preventive medicine and patient-centered medicine. These concepts, however, have their origin in mainstream medicine. It is simply historical revisionism for CAM to claim that they innovated the notion of prevention. It is also simply not true that CAM treatments are truly preventive of anything. Of course, if you are willing to simply make up claims, like homeopathy can be used as an effective vaccine, then you can claim to be preventive.

But scientists and skeptics can resist this trend by refocusing attention on what really matters – what are the claims, and what is the evidence. We would also like scientific plausibility restored to its proper place, but that is a larger battle.

In the meantime, we can at least encourage existing regulatory agencies to do their job – police fraudulent health claims. This is where skeptical activism comes in, and has been increasingly successful. The WHO statements were in response to a complaint by Sense About Science, a UK skeptical group. The Australian Skeptics have successfully opposed anti-vaccination campaigns, and now have scored against homeopathy quackery.

Our core premise is hard to argue with, and is the premise of much existing regulation – health claims should be backed by sufficient evidence. In fact, it is easy to promote this premise when dealing with mainstream medicine – the claims of physicians and “big pharma”, for example. All we want is for the same standards of evidence to apply to all claims. CAM is about creating a double standard – it is the curtain behind which unscientific remedies are trying to hide.

Almost daily I get e-mails from readers and listeners who are faced with a situation in which unscientific medicine is being promoted at their workplace, at their school, in their family, on the web, or elsewhere, and they want to know what to do. For a long time many skeptics felt as if they should just keep their head down, lest they be accused of being closed-minded, culturally insensitive, or even a shill for some evil industry. CAM proponents have become very aggressive at silencing their critics – as they must if they are to promote their pseudoscience.

This is where culture comes into play – pseudoscience in medicine will be tolerated as long as we tolerate it. But if we stand up for science and reason in medicine whenever and wherever necessary I think most people will find that most people agree with the basic principles of science-based medicine, and they too were just keeping their head down because they were unsure about what was actually being claimed.

So speak up. Don’t be afraid to ask questions and defend science in medicine. And take advantage of the regulatory agencies that already exist (in the US that’s the FDA and FTC). Governments will respond if the public demands that they do their job.

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