The Quackometer

The Adverting Standards Authority has today found that a homeopath advertised their asthma clinic for kids by making untruthful, unsubstantiated and irresponsible claims. Archway House Natural Health Centre holds an Asthma and Eczema clinic for children, run by Julia Wilson, a member of the Society of Homeopaths.

Inasmuch, this is not news. The ASA make judgments like this every week. Their weekly published list today contains all sorts of findings against chiropractors and related quacks. But what makes this interesting is that this advert, in the form of a leaflet, has already been subject to a complaint directly to the Society of Homeopaths, who claim to regulate their members. Over a year ago, I was concerned that the Society's Code of Ethics was being widely ignored by their membership and there was no evidence that they took any steps to uphold their code which is designed to protect the public. If so, this was pretty serious. People would be visiting homeopaths under the impression that their membership of the Society of Homeopaths ensured that certain standards would be maintained and that they would not be misled or endangered as a result of the consultation.

I picked on one homeopath from their register pretty much at random. Not only was Julia Wilson making claims to treat asthma (which would be in breach of the code) but also she has spent time in Kenya in a clinic that dishes out sugar pills to prevent malaria and to treat HIV. One would have thought that a responsible organisation would want to rein in such dangerous excesses. This homeopath appeared to be in breach of several points in their code including treating named diseases and advertising in a way that claimed superiority to real treatments.

You can read about the Society of Homeopath's response here. Julia Wilson defended herself by claiming that her adverts (see here) did not claim superiority of homeopathy over conventional treatment, that she made no stated or implied claim that homeopathy can treat asthma, and that no cure was implied. She also said that she could not be held responsible for the Kenyan clinic's claims on their website and that she did not claim to cure HIV or malria when working there. I would suggest you read the leaflet yourself and see if this defence merits any credibility. The Society of Homeopaths wrote to me to tell me that they were satisfied that no breach of their code had taken place and that "no action will be taken."

Well, the Society of Homeopaths did take action. Their solicitor wrote to my web hosts demanding that I take down web pages that commented on this and other aspects of their lack of concern for the dangerous practices of their members. When I wrote to the Society's CEO Paula Ross asking for an explanation, I got a threatening letter back from their solicitor. Naturally, bloggers on the web went crazy, reposting my articles and condemning the behavior of the society, calling them 'Cowards and Bullies".

The ASA read this leaflet and decided that on four counts it was in breach of the CAP rules on advertising for being unsubstantiated, untruthful and irresponsible. They decided the leaflet did imply a cure for asthma because it denigrated conventional treatment - "puffers can provide temporary relief, they're not offering your child a cure. Homeopathy is different...". They asked Archway House for evidence that their treatments 'helps alleviate the flaring skin and tightening lungs of your child's allergic reactions". They could not answer this to any degree of satisfaction. Most strikingly, the ASA found the leaflet was irresponsible because it was likely to dissuade parents from seeking medical advice. A testimonial read "I was frightened by how much my daughter relied on her inhalers". Damningly, Archway house could not provide any evidence that the testimonials on the leaflet were real.

I have emailed the Society of Homeopaths to ask why their conclusions were so different from the ASA. I have also asked if they will relook at the complaint and take action against their member as it is a requirement of their code that member's adverts do not breach Advertising Standards rules. Importantly, I have asked if the public can have confidence in their code of ethics and complaints process. (Update: response, so far, below)

Does this matter? Asthma is not a trivial disease. Asthma UK report that,

A person is admitted to hospital every 8 minutes in England because of their asthma. That's on average 185 people per day and one in six people require further emergency care again within two weeks, yet 75% of admissions for asthma are avoidable and could save the NHS in England an estimated £43.7 million a year.

It is estimated that there are 1,500 deaths and 74,000 emergency hospital admissions for asthma each year in UK. A child whose parents go a homeopathic route rather than following the management plan of their doctor is being put at risk. The Society of Homeopaths do not appear to care about this. But people in the UK quite rightly have choices. When homeopaths take their sugar pills to Africa and tell them that they are better and cheaper than medicine at preventing malaria and managing HIV, then the delusion of homeopathy becomes truly murderous. If you want to believe the homeopaths that they act responsibly over this, then you should see the latest newsletters from the Abha Light Foundation in Kenya where Julia Wilson worked. They are handing out homeopathic remedies to 1,500 families and telling them that they are malaria prophylactics. 34,000 people die in Kenya each year from malaria. Over a third of children die before their first birthday from Malaria. Telling families that magic water pills can protect them will reduce the likelihood that they will seek proven safe alternatives, such as mosquito nets for babies. The Society of Homeopaths have never spoken out against this terrible western delusion inflicted on Africa.

In the year 2000, the House of Lords looked into the question of regulation of Alternative Medicine and made a large number of recommendations about how various treatments should be controlled. Eight years on and the government strategy is in tatters. The homeopaths have actively campaigned to be exluded from greater regulation and decided that they can regulate themselves. This is clearly not true. The deluded cannot regulate the deluded if the public want to be protected. The government has set up the Complementary and Natural Healthcare Council (better know as Ofquack). This has failed for a number of reasons. Firstly, few alternative medicine groups have wanted to join. As Ofquack will have council members that are not part of the alternative medicine communities that they will regulate, none of the practitioners want to be judged by anyone who does not share their delusions. And secondly, as Ofquack has failed to get up and running and will be entirely voluntary, there has been no compulsion for quacks to subject themselves to any meaningful scrutiny.

Prince Charles has been deeply involved in trying to set up Ofquack. The Prince's Foundation for Integrated Health put one of their own people into a group that would try to unite the homeopathic profession and create a single register that could be effectively managed. The squabbling between homeopaths ensured this failed. Ofquack appears to have abandoned any pretense that it can now regulate vast swathes of the alternative medicine industry. The Society of Homeopaths have now stated that they intend to create their own 'single register' - a move that has angered the rest of the UK homeopaths and is doomed to failure too.

So, in the UK, when a member of the public seeks the services of an alternative medicine practitioner, they are likely to see someone with letters after their name and a web site that says that they are members of professional bodies with a strict code of conduct. This is a thoroughly misleading picture. Homeopaths and other practitioners may well sign up to a code of conduct, but in the knowledge that it will never be enforced.

In the Guardian recently, the same comment was made in an article entitled "A Question of Ethics". The article noted that one of the most senior member of the Society of Homeopaths was a strong advocate for providing homeopathic 'immunisations' - the belief that magic water can protect people from dangerous diseases. The arctile concluded, "It seems that codes of ethics are good for window dressing while pragmatism is better for profit. ". The Society responded with a press release,

The Society would like to advise Guardian readers that any suspected breach of The Society's Code of Ethics & Practice should be formally reported to its Professional Conduct Department where it will be fully investigated.

Investigated maybe. Enforced? Doubtful. The codes are an illusion and we are being taken for fools.

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Update

I have had a reply from Jayne Thomas, Chair of the Board of Directors at the Society of Homeopaths:

As we have not yet seen the findings of the ASA adjudication to which you refer, The Society of Homeopaths is unable to comment on the specifics of this case.

However, we would like to reassure you that due process was followed in the handling of this case.

By their own admission, The Committee of Advertising Practice (CAP), have been delayed in finding an expert to assess the evidence base for homeopathy, which was submitted to them earlier this year.

The Society of Homeopaths is therefore awaiting the outcome of this assessment to inform future guidelines to our members concerning the advertising of homeopathy

So, we will have to wait for a more detailed response. I must admit that I surprised that SoH have not seen the adjudication yet. The ASA release a preliminary report to all parties several weeks before publication to allow the advertiser to respond and make corrections. Did Archway House really not consult SoH both originally and on the preliminary finding? The advertiser would also have been aware of the final outcome about a week before publication too. How do the SoH know that the ASA could not find an 'expert' to help them? In what way have SoH been involved here?

Labels: ASA, homeopathy, Natural Healthcare Council, ofquack, Society of Homeopaths

 

The Advertising Standards Authority is one of the few regulatory bodies in the UK regularly prepared to tackle the untruthful and unsubstantiated claims made routinely in the alternative health industry. It is also one of the weakest regulatory bodies in the UK. Nothing could highlight that more than how Life Healthcare (trading under the url http://www.reverseageing.com/) dealt with an investigation.

Life Healthcare had made an advertising leaflet for a product called Thyroid Support Formula and had a heading on the front page that stated "New Scientific Studies Prove That There Is Hope, Read On, and You'll learn the Secrets That Your Doctor Might Not Be Telling You about an Under-Active Thyroid". Particularly worrying was the claim that,

But the truth is that conventional medicine does not have the best testing or treatment methods for an under active thyroid. Just because your test results have come back negative for an under active thyroid doesn't mean you don't have it.

A complainant to the ASA expressed concerns that a leaflet from Life Healthcare was

potentially harmful because it discouraged people from seeking proper medical treatment or from following the advice of their doctor

and doubted that,

the claims made in the ad for the product's efficacy could be substantiated

The ASA took a look a the advertisement and also challenged Life Healthcare if they had proper authorisations to market their products and whether the testimonials and photos included in the ad were genuine.

So, pretty serious charges. How did Life Healthcare respond? They didn't. They completely ignored requests by the ASA to explain themselves. The ASA upheld all complaints and said,

The ASA was concerned by Life Healthcare's lack of response and apparent disregard for the Code, which was a breach of CAP Code clause 2.6 (Non-response). We reminded them of their responsibility to respond promptly to our enquiries and told them to do so in future.

Their action was,

We told Life Healthcare not to repeat the claims in future advertising. We urged them to seek guidance from the CAP Copy Advice team before advertising again and asked CAP to inform its members of the problem with Life Healthcare.

I, for one, am not convinced that this direction will be adhered to.

Life Healthcare appears to make a business from evading legal restrictions on its practice. The from page of its website informs us,

With draconian EU legislation pending for the UK marketplace your right to buy optimum dose nutritional supplements may be limited, and some ingredients may no longer be available. Fortunately as we are based outside the EU (in the Channel Islands), Life Healthcare can continue to supply these high potency supplements that may have to be withdrawn from the UK and Europe in the coming months and years.

The current weakness of consumer protection laws in the UK will indeed be strengthened in the next few weeks as vastly improved consumer trading legislation comes into force. Whether this makes any difference to companies such as Life Healthcare remains to be seen.

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Postscript

It would appear that fleeing to the channel island might not be the get out of gaol free ticket Life Healthcare hope for. Yesterday in parliament, the Minister for Health Dawn Primarolo, responded to a question asking what the Government was doing about such loopholes. She replied,

The FSA continues to work with the Ministry of Justice, the Department responsible for the Crown Dependencies, and the administrations in the Crown Dependencies regarding implementation of the food supplements directive and Nutrition and Health Claims Regulation to prevent trade in food supplements that would be illegal in the United Kingdom.

Labels: ASA, regulation, vitamins

 

Today, the Advertising Standards Authority have upheld complaints against Equazen and their eye q™ products, finding them to have made untruthful and unsubstantiated advertising claims. This is about time. Their antics in promoting fish oil pills to school children have been well documented.

Equazen (now owned by Swiss pharmaceutical company Galenica) have been using local authorities to promote the idea that taking a daily fish oil supplement can boost children's' school performance. They call it the 'Clever Capsule' for your child. However, their evidence that could substantiate this has been hard to come by. Claims that the pills have been independently and scientifically tested in schools looked very weak with the only trials on record appearing to lack basic scientific controls, size or applicability. Nonetheless, the charge to sell loads of these pills to concerned parents has taken place in earnest.

Vitamin pill entrepreneur Patrick Holford has been pushing the pills on TV and through his Food for the Brain charity. Boots the Chemists have had displays extolling the virtues of the pills and their PR agencies have ensured that the credulous media, such as the Daily Mail, copy out the press releases as if it they were news.


All in all the message has been: you are an irresponsible parent if you are not shoving fish pills down your kids necks.


The ASA investigated whether the claim "A Hi-EPA fish oil formula that may help maintain concentration levels and healthy brain development" could be substantiated. Also they looked at the independence of the tests, the rigour of the test and whether the concentration and learning of all children would improve following supplementation. Equazen produced a huge amount of evidence to support their adverts but the ASA found that their claims could not be substantiated and they were misleading. The ASA instructed Equazen as follows:

We told Equazen to remove the claims "... may help maintain concentration levels and healthy brain development", "the Clever Capsule"Scientifically tested in schools", "proven in schools" and "proven by Science" from future advertising for eye q. We also told them to avoid implying in future that the advertised product could benefit the general population or that a trials results related to a product with exactly the same composition and dosage as the advertised product if that was not the case.

Now, I for one am mightily impressed by the ASA. This was quite a complex issue involving a lot of evidence and weighing of scientific viewpoints. This is something that many bodies wish to shy away from. We have seen the Guardian readers' editor this week talking about the difficulty of arbitrating readers disputes over scientific evidence. Some of the evidence was easy to dismiss, such as Equazen trying to pass off their adherence to the Food Labelling and Food Supplements Regulations as some sort of endorsement of the efficacy of their product. Other evidence required careful dissection of trial methodology to determine the applicability to their claims.


There is a problem in the UK of finding the right authorities to help in tackling the claims of quacks. If someone is making dangerous or misleading claims about a quack product then it is quite difficult to know who can help. Trading standards were set up to deal with dodgy plumbers and are run from local councils. The ASA is an industry run organisation with limited sanctions. The ASA deals with adverts only, but not web adverts. Trading standards are based in regional offices and may or may not have the experience to deal with more complex scientific issues. It is a bit of a mess.


The harm that the ASA ruling will have on Equazen is not a monetary one in the form of a fine. It is not the threat of legal action - it is rather a smack on the wrist from their peers. What they undoubtedly really fear is bad publicity and that is what an ASA ruling often leads to.


Far from perfect, and limited in scope and powers, the ASA appears to be remarkably willing to take on difficult issues and act on complex issues. I just wish that this approach could be applied more uniformly to challenge the problems society faces from quackery.

Labels: ASA, equazen, Patrick Holford

 

According to Allergy UK, they are "a national medical charity established to represent the views and needs of people with allergy, food intolerance and chemical sensitivity." Amongst their aims they say they are there to

Enabl[e] people with allergy, food intolerance and chemical sensitivity to receive appropriate diagnosis and treatment through education of healthcare professionals and the provision of dedicated services.

Allergy UK give awards to services they feel help promote their aims and "will generally benefit allergy sufferers and improve their state of health and wellbeing." They have given an award to YorkTest who are 'specialists in food intolerance testing'. They say,

The clinically validated York Test foodscan range represents a breakthrough in food intolerance testing. Using the Enzyme-Linked Immunosorbent Assay (elisa) method, the tests provide a rapid, accurate and reproducible way of determining food intolerance and identify which foods your body is and isn’t coping with properly from a pin-prick blood sample.

Patrick Holford gives similar endorsements to YorkTest,

My favourite laboratory is Yorktest Laboratories whose tests are clinically validated. Not only do they use this technology but they are the only lab to offer a home test kit for food and chemical allergies that requires a pinprick blood sample. This is sent back to YorkTest laboratories who then test you for sensitivity to all foods including gluten, gliadin, wheat and yeast. They send you a home test kit that enables you to take a pinprick of blood, so you don’t have to go to your doctor.

Yorktest have also carried out a number of ‘double-blind’ trials on their IgG test and have solid science to back up their claims of effectiveness.

His schools food charity "Food for the Brain" is supported by YorkTest.

Now what is funny is that the Advertising Standards Authority disagree with all this. Some mischievous member of the public complained about their adverts. The issues considered were:

The complainant challenged whether:

1. the claim "clinically validated" could be substantiated; and

2. the advertisers could substantiate the efficacy of the test

The ASA challenged whether:

3. the ads made claims that could lead to a mistaken diagnosis

All three complaints were upheld. YorkTest were found to be in breach for unsubstantiated claims, untruthfulness and for claims about Health and Beauty and Therapies.

This is about time. Misdiagnosis of allergies caused people to drastically and unnecessarily alter their diets in ways that may be harmful. It causes distress and may prevent them from seeking proper medical help. There is a huge industry out there preying on peoples concerns about allergies and food intolerances and it needs reigning in.

How long will it be do you think before Allergy-UK take away their award to YorkTest? And how long before Patrick Holford amends his web pages?

My personal guess is never. I may be wrong.

UPDATE:

A little dickie bird has just pointed out that a trustee of the charity Allergy-UK is a DR MICHAEL CHARLES MATTHEWS.

A Dr Michael C Matthews MB, BS, FHS was also a medical director of YorkTest.

Labels: Allergy UK, ASA, Patrick Holford, YorkTest

 

Paul McKenna, hypnotist, has fallen foul of the Advertising Standards Authority by claiming in print that his methods are " ... the most effective weight loss system available. Lose weight and keep it off ... ".

Today, the ASA upheld a complaint and told him not to repeat this claim as he had failed to produce satisfactory evidence to support his marketing. His claims were unsubstantiated.

All this is pretty standard stuff for the ASA. Today's rulings also slapped The Body Shop, for over the top health claims for various products, and an organisation called Ultimate Balance Ltd that offer hydrotherapy, a form of quackery that Charles Darwin was using 150 years a go.

Now, what struck me as interesting about this was that there is a school of thought that believes hypnotism depends totally on telling lies. Without the lies, hypnotism does not work. To understand this, we can look at the various opinions of what actually happens under hypnosis. In short, there are roughly two camps: the first contends that hypnosis induces some special state of mind in the subject that unleashes powers and capabilities that the normal mind state cannot tap into; the second camp contends that hypnosis is about inducing the belief that a special state of mind is being induced and that the subject acts out a role suggest by the hypnotist and the cultural expectations of hypnosis. With this second view, when therapeutic hypnosis is being employed, as with McKenna, hypnosis can be viewed as nothing other than a placebo, where the subjects' expectations of an effect are sufficient to create an effect. As such, and as with all placebos, a lie must be implicitly or explicitly told and believed, and the lie is that the hypnotists can unlock special mental powers within you.

It gets a little bit stranger than that, in that subjects may well be aware that they are acting out a role or, alternatively, may genuinely feel they have been in a different mental state. The comedy Little Britain lampoons this knowing complicity of subjects with the hypnotist with the sketch character Kenny Craig. Craig is an "obnoxious, charmless man, ...[who] has no worries about using his skills to get his own way". His victims act as if they are hypnotised so as to not offend Kenny, for their own ends, or out of sheer bemusement. Of course, in reality, it is very difficult to know what is really going on within the minds of individual hypnotised subjects. Can we trust anything subjects say about their beliefs under hypnosis as their whole experience is layered with play acting, expectations and suggestibility?

The hypnotist Derren Brown gives a very insightful view of what his experiences are with stage hypnotism and what we can reliable say about what is going on in peoples' minds. His scepticism makes refreshing and entertaining reading and is rare in this field. If this sort of thing interests you, I urge you to read his book Tricks of the Mind.

And so this ASA ruling presents a rather paradoxical and interesting view of how we should look at the claims of hypnotists. Maybe McKenna's courses do allow people to lose weight. But to do so, it is likely that this is because his clients believe hypnotism will really help, whether or not it actually does - if you see what I mean. Telling people that his course is "the most effective weight loss system available" can be viewed as part of the hypnotic act, as setting the required expectations and as the paradoxical lie that must be told in any placebo based therapy.

Now, I know that Paul McKenna is not afraid of using his legal routes if he feels that defamatory things are being said about him, so I would like to be quite clear that I have no idea if McKenna believes he is telling lies or not. He could really believe that hypnosis is inducing a special state of mind in people and that placebo-like effects have nothing to do with his results. McKenna was at fault, remember, for not being able to substantiate his claims, not for lying or being untruthful.

But, if there is no such thing as 'real' hypnosis, then 'sham' hypnotherapy can be viewed as just one more placebo based alternative therapy that is essentially based on a delusion. It works (to some degree) if you believe in it. And just as with pretty much all homeopaths, the best alternative therapists are those that have fooled themselves into thinking that they have special powers, potions and incantations. It is so much easier then to tell the required lies to your customers if you don't believe you are lying yourself.

Maybe many hypnotists really believe that what they are doing is nothing more than a placebo-based shamanistic ritual, and the required lies are justified to obtain a result. But within that stance is a whole other ethical minefield. Hypnotism presents the same dilemmas, as pointed out by David Colquhoun, regarding today's reporting of 'real' acupunture being no more effective than 'sham' acupuncture. The fact that 'sham' acupunture (or 'sham' hypnotherapy) has an effect does not mean that its use is justified as both requre a lie to be told.

Labels: ASA, celebrity quackery