The Quackometer

Measles cases in England and Wales rose by 36% in 2008, figures show.

Confirmed cases increased from 990 in 2007 to 1,348 last year - the highest figure since the monitoring scheme was introduced in 1995.

Health Protection Agency experts said most of the cases had been in children not fully vaccinated with combined MMR and so could have been prevented.

Immunisation expert Dr Mary Ramsay said the rise was "very worrying", adding measles "should not be taken lightly".

Public confidence is still shaken nearly a decade after research hinted at a link between MMR and autism. That research has now been shown to be wrong and many subsequent large studies have failed to show any link. And yet, the myth that MMR causes autism will not die. Ben Goldacre is quite clear about it in his book Bad Science. He blames the media for perpetuating a hoax - journalists deliberately using the scare story to make sensational headlines and to attack the government.

It is a bit more complicated than that. The media is also full of self-indulgent, semi-educated 'humanities graduates' who know nothing of the world of science and are not afraid to show it. Ex-actor Jeni Barnett, of LBC radio, a London based talk radio station, is one such person. In an incredible virtuoso display of utter ignorance and arrogance, Jeni Barnett went forth on how the doctors were 'scare-mongering' people into vaccinations and how she did not want to see her little babes 'jabbed'. Her rant is a master-class in misinformation, canards, hostility to opposing views and flaunted ignorance.

Now, there is nothing wrong with holding a talk show about the issues surrounding MMR. There is nothing wrong with expressing fear and doubts. But there is everything wrong with allowing your own self-confessed ignorance to dominate a discussion on such a sensitive issue. The choices people make over vaccination not only have health consequences for their own children but for the children in their community too. To allow ignorance to triumph over informed debate is a crime. Jeni Barnett has sort of apologised for her rant on her blog. But it is only a sort of apology as you can read on her blog (strapline: "Acting is all about honesty, if you can fake that you can fake anything"). She blames the 'pro-MMR lobby' for the 'problems',

I find it interesting that the vitriol that comes out of the pro MMR lobby is precisely why Allopathic medicine is struggling. Most of us who seek alternatives allow others their position but often the 'others' have a real problem allowing us ours.

NHS BlogDoc: Jeni Barnett and LBC start the clean-up operation

Science Punk: LBC sic lawyers on Ben Goldacre over criticism of MMR show

Fuzzier Logic: MMR scaremongerer sicks the legal dogs on Ben Goldacre

Podblack Cat: Ben Goldacre - Will Not, Should Not, Be Silenced On Jeni Barnett.

jdc325: MMR Scaremongering From Jeni Barnett: LBC Use Legal Chill Tactics. Ugh.

Political Scientist: URGENT: The Joy of Law

The Lay Scientist: Jeni Barnett on MMR - The Complete Show.

A Drunken Madman: More medical mendacity.

Scattergum: Jeni Barnett is an idiot.

Orac: Help Ben Goldacre out...he's being sued again

 

and

 

An Artist wades in and gets it spot on: Julie Oakley

 

It hits the Mainstream media: The preposterous prejudice of the anti-MMR lobby The Times, David Aaronovitch

Labels: Ben Goldacre, Jeni Barnett, MMR

 

Labels: Ben Goldacre, chiropractors, edzard ernst, evidence based medicine, Gillian McKeith, quacks

 

How should homeopaths be regulated? I am not sure I have made up my mind yet about what I would like to see and I am not convinced there is a perfect solution. However, I hope some debate has been kicked off by all the goings on last year, here and on various other blogs and forums. One thing I am pretty sure of is that homeopaths have pretty much ruled themselves out of the discussion. Adults only from now on.

And the reason for this is that they have had their chance - and a good shot at trying to regulate themselves. Indeed, this was the stated aim of the Society of Homeopaths last year. Two of their annual goals were:

To facilitate the smooth handover of Society regulatory processes to a new regulatory and registration body

and,

To uphold and review The Society’s professional standards especially in relation to the development of a new regulatory and registration body (NRRB)

They failed miserably at both.

The farce of creating a single homeopaths' single register is being documented at gimpy's blog. Squabbling about money made sure the register did not get off the ground. I believe this reflected deeper rivalry between the various homeopaths' groups based on philosophical differences and also just plain old human power struggles.

The Society also demonstrated that their code of ethics could not protect the public from the worst delusional beliefs of their members. Their utter two-faced failure to tackle the problems posed by members offering anti-malaria advice led to the Society being prepared to directly misrepresent their own actions to the papers. They were also last year promoting homeopathic intervention in HIV people in Africa. It is difficult to think of more exploitative, deluded and dangerous actions.

So, to start off - what are we trying to protect against? Ben Goldacre has been quite clear about the dangers of alternative medicine - bullshit. And that bullshit manifests itself in a couple of dangerous ways with homeopaths. Firstly, they may delay a customers access to effective treatment - in the case of serious illness this can be fatal. Secondly, they may present themselves as serious alternatives to real medicine. We have found this most shocking when homeopathic missionaries tell vulnerable African people with HIV that they can treat them. Homeopaths use the denigration of medicine as a standard marketing tool. Homeopaths stand out in the alternative medicine crowd in their anger and hostility towards real doctors and medical practices. It is how they define themselves and what makes them most dangerous to the public. They most definitely are not a 'complementary medicine'.

It is not that I want people to stop visiting homeopaths and other therapists. People often do get benefit from the self-indulgent friendly chat that a GP is just not in a position to offer. Homeopaths ought to be in a prime position to offer this as I have said before. However, in visiting a practitioner, we need to consider how the public may be protected against two main problems we find in quackery: being exploited financially, and being given inappropriate and dangerous medical advice.

One potential solution is coming from Prince Charles and his Foundation for Integrated Health. FIH is looking into setting up a Natural Healthcare Council that will offer regulatory functions to the broad church of complementary and alternative therapies. The Times reports that this new voluntary register should be established this year and,

will be able to strike off errant or incompetent practitioners. It will also set minimum standards for practitioners to ensure that therapists are properly qualified.

Their hope is that,

all practitioners will be forced to join or lose business as the public will use the register as a guarantee of quality. The council will register only practitioners who are safe, have completed a recognised course, are insured and have signed up to codes of conduct.

Funnily enough, the homeopaths appear to be deeply hostile to this move. "The homeopathy profession has been unanimous in rejecting federalisation as an option for regulation" reports the Alliance of Registered Homeopaths. But, as I have said, I am not really interested in what they think - their only motives in discussing regulation appear to be self-interest and survival.

So, will the chief tree-talker's ideas be a good move? Should Prince Charles' organisation be allowed to succeed?

I have some serious reservations.

Firstly, by what standards will the Natural Healthcare Council set for competence and training? Professor David Colquhoun has documented the training dilemma of alternative medicine by noting that most alternative therapies are based on nonsense ideas that have no scientific and objective merit. "It cannot be expected that a universities will provide a course that preaches the mumbo jumbo of meridians, energy lines and so on... Can any serious university be expected to teach such nonsense as though the words [of alternative medicine] meant something? ". Since, homeopaths cannot even agree amongst themselves what homeopathy is and what are its essential elements (not surprising, as it is not based on reality) then the Council risks either alienating large swathes of practitioners or being completely arbitrary in its criteria. Either will not protect the public. Setting education standards for homeopaths is like trying to accommodate Hogwarts into the National Curriculum.

Secondly, by what standards will practitioners be judged in handling complaints and when upholding professional standards? Should we uphold a homeopath to standards of homeopathy, aromatherapy, reiki or - heaven forbid - evidence and science? This is important. In deciding whether a homeopath has crossed a line of ethics in offering malaria prophylactics, who will judge them? If homeopaths are involved, the the public will not be protected as they have dangerous and delusional ideas about their magic sugar pills. However, if they are to be judged by the standards of best evidence, then no homeopath will join the organisation as they know that they cannot practice within their strongly held beliefs. In either case, the Council will fail to protect the public. You might think that homeopaths would be willing to disengage from their wilder healing fantasies in order to gain the credibility of the name of Prince Charles, but all my experience says that homeopaths are fiercely proud, angry and determined not to be constrained by any external forces (probably orchestrated by 'allopaths').

And if the Council do uphold the strongest standards and do this in a transparent and accountable way, will the UK suddenly be free from rogue practitioners? Well, no. My recent example of the the ASA upholding a complaint against Osteomylogist, Robert Delgado, showed that even statutorily registering complementary therapists has big loopholes. This non-statutory and voluntary registered body, the Natural Healthcare Council, will have even less power over practitioners.

But what it will achieve is that Prince Charles' name will give credibility to all sorts of unproven therapies and wacky non-medically qualified people to go out there and pretend to be healers. And at the same time, offer no guarantee of protection to the public.

I don't think this is the answer and I think it will even lead to a greater threat to the public.

Labels: Ben Goldacre, homeopathy, Natural Healthcare Council, regulation, Society of Homeopaths

 

Well, I have had two conversations with homeopaths now about taking the challenge. Recap: its a simple challenge to see if a homeopath can determine which remedy is which out of a sample of six when they do not already know which remedy is which. If the claims of homeopaths are correct, it ought to be easy.

First up: Sarah K, who left comments on my blog to say she was up the challenge. Fantastic news. Unfortunately, quite quickly she appeared to get rather defensive and say she would not be rushed into things. And ultimately decided that she did not want to do it. A huge shame.

Some of her excuses were that remedies could take a long time to take effect and might interfere with each other. Fine. But she has the choice to decide which remedies to use. For example, I suggested Nelsons Insomnia remedy. Customers of Nelsons might expect their insomnia to be reduced in a few hours, not over several weeks, and they would expect no lingering side-effects too, which homeopaths claim do not happen. Oh well. So close.

Another homeopath appeared to contradict Sarah K in the most striking terms. Soroush Ebrahimi was up for the challenge, but unfortunately not mine - he had his own ideas. He wanted to give me a remedy and be able to seal an envelope with a prediction of what the remedy would do to me - a 'reproving'. I think it best to allow the IM chat to speak for itself...

(for explanation, Soroush has already challenged Ben Goldacre to a similar test. This is IM, so spelling and sentence order may be erratic)


SE: Hi - did you want me for something? Welcome to my group of friends

LCN: Just wanted to know if you were prepared to take the quackometer $100 challenge. If you claim you could guess ben g's symptoms from taking a single remedy, then this test ought to be a walk in the park and great public proof of homeopathic claims.

SE: Hi - I did explain that the quackmaster test involves to elements:

SE: 1- Is the homoeopath any good?

SE: 2- Does a potentised substance work?

LCN: yes i am happy with that - do you think you are good homeopath?

SE: So if the result is a fail you do not know whetehr the homoeopath was poor in his selection or whether potentised substance have no effect

LCN: sure. but if you succeed then you win!

SE: So my 'reproving' exercise is better, because it elliminates the uncertainty about the ability of the homoeopath

LCN: no it does not. it relies on both the homeopath to interpret the symptoms correctly and the subject to report them correctly - both subjective and so unlikely to yield a good result for anyone. Eitgher side could cry foul. With my test, no one can cry foul.

SE: Neither with my test - when they are in agony and asking for help, then we will know for sure!

LCN: well frankly - if you are prepared to inflict agony on someone then you are not fit to conduct such tests. and ben was quite right to refuse.

SE: Oh - so dilute potentised substance do have an effect?? Make up your mind

LCN: so, you want to induce agony in someone and then claim that homeopathy is right? I think you do not understand anything about obtaining objective evidence

LCN: you are telling me they do. i think ben was quite right to worry tha tyou might poison him. i would be. my test involves no such risks.

SE: Ben was QUITE wrong - because if you read my post, you would have realised that he would have had the substance tested for himself and my half of the remedy would have been in a safe-box only to be opened with both of us present

SE: You guys have to put your body where your mouth is

SE: Either a potentised highly dilute material has powers or it does not

LCN: i am happy to take homeopathic remedes - but not from someone who promises to have me in agony! it shows a lack of ethics in the trial that you would be prepared to do so.

LCN: i have no doubt that the homeopathy would do nothing. I just would not be prepared to take a pill forom you.

SE: So tell me do potentised highly dilute substance have any power?

SE: if not - you are just taking a sugar pill as you lot claim

LCN: i believe they do not. but can i trust you to give me a potentised highly dilute substance ?

I hope you understand my reluctance to take part. The conversation went on for a while more. Mostly, me repeating a question to ask Soroush to take my test or work out a better protocol for his own.


For the record, I would take such a test, but Soroush needs to think up a protocol to take into account the following:

• S should not be allowed near any pill I would take.
• We need end measures that are not subjective - if the test fails I do not want homeopaths accusing me I was misreporting symptoms.
• We need a quantifiable result. At present, a success for S would not give us any idea of the significance of the result. Could it have been chance? We have no way of quantifying that.
• If it is going to cost more than my proposed test, I want to know why it is a better test and worth the money.

Without these things, Soroush's test is just a circus stunt. And, if I may say so, a very disconcerting circus stunts. Like a scary clown juggling sheep's hearts.

It is remarkable than no one else has come forward. This is a basic test of homeopathy. Something that ought to be easy and yet nothing quite like it appears never to have been done. It would show basic evidence that homeopathy is not a delusion. And yet, homeopaths feel no shame in taking on the responsibility for sick people. A responsibility that cannot be grounded in reason or evidence and instead relies on fragile anecdotes. Homeopaths' preference to counter criticism is to sue people rather than provide argument and evidence.

I am offering the chance for some homeopath to give me a metaphorical bloody nose, humiliate me, and prove me wrong - all for the cost of some postage and and few remedies.

So far, none of them have the courage of their convictions.

Labels: $100 challenge, Ben Goldacre

 

In his Guardian article, Ben Goldacre wrote about how homeopaths respond to criticism:

Labels: Ben Goldacre, homeopathy, Society of Homeopaths

 

The Daily Mail have re-printed the Guardian's homeopathic spat between Jeanette Winterson and Ben Goldacre. Both articles (trimmed down) are now head-to-head.

But not all is at it seams. I have done some photo analysis on the pictures on that page and uncovered a disturbing truth. Look at the picture below. After some photo manipulation I have been able to reveal this...

Look at the picture close up. Who do you see? Now get out of your chair and look again from ten feet away.

Proof that this is a Big Pharma stitch up by getting novelist to defend homeopathy and make it look silly. Or was Goldacre behind the whole thing? Is Jeanette Winterson for real? Who can we trust? Is Jeanette Ben's nom-de-Friday-night after a hectic week at the hospital and delivery of his Bad Science copy?

Labels: Ben Goldacre, fun

 

I doubt we will ever see an X-Factor moment where a homeopath is forced to brutally confront the totality of their own delusions as they are exposed to a direct and uncompromising truth assault by a quackbusting Simon Cowell. Their emotional commitment to their healing fantasies is far stronger than their intellectual commitment to reason, truth and evidence. But I would have hoped that a homeopath's disregard for truth was limited to the truths of science, however, events in the last week or two have made me wonder.

Last week, Ben Goldacre wrote an article in the Guardian newspaper (Threats – the homeopathic panacea) about how the Society of Homeopaths had attempted to silence this site over its criticism of the Society's ability to protect the public from harmful advice from its members. This was highlighted by the BBC Newsnight/Sense about Science investigations into homeopaths giving advice about malaria prevention. As you might recall, at no point did the society try to contact me to explain their grievances - they used legal chill on my website hosts to silence me. The Society saw fit to respond the Guardian article and sent the editor a letter. To the best of my knowledge it has not been published. However, it is published on the Society web site and is the first insight into their thinking.

However, before exploring that, a number of things jumped out. In their letter of 22nd October 2007, they said (with my emphasis),

We contacted the programme makers directly to ask for their evidence that any Society members had given dangerous or misleading advice to members of the public. They were unable to provide a single example. The Society’s professional conduct procedures cannot be invoked without a specific complaint, an alleged offender or any evidence. In these circumstances, The Society was unable to investigate a specific case.

Elsewhere on their web site, they state that,

The Society of Homeopaths takes any alleged breach of its Code of Ethics & Practice very seriously and we must follow a due process when dealing with any allegation.

And,

The research conducted by Sense About Science failed to identify the homeopaths interviewed. Not all homeopaths are registered members of The Society. Nevertheless, any alleged breach by a registered member, of The Society’s Code of Ethics & Practice, will be investigated by our Professional Conduct Department.

Now, what I do not understand is how these statements can be made in light of the fact that I have an email from Paula Ross, Chief Executive of the Society of Homeopaths, addressed to the programme investigators (dated 22 August 2006), that starts,

"I am in receipt of your summary transcripts."

The transcripts contain two conversations between an undercover investigator and a named homeopath who just so happens to be a Fellow of the Society of Homeopaths. I will not name him, but I am happy to do so if the Society dispute this.


In the transcripts, the investigator asks if the named homeopath is able to offer a homeopathic alternative to her doctor-prescribed anti-malarials. The homeopath confirms that he is able to, and offers a consultation on that basis. In a subsequent transcripted conversation, when asked by the investigator why the Health Protection Agency web site says that you should not take homeopathy for malaria, the named homeopath laughs and replies “Of course they did. Right, if you are influenced by that go with whatever will make you comfortable.”


The investigator, still acting as a client, asks why the Faculty of Homeopaths says pretty much the same thing. The homeopath replies, “the faculty are all medics so they must more or less toe the medical line.” The homeopath constantly portrays this as an either/or choice for the client: either they stick with their side-effect inducing ‘orthodox’ treatments or go with homeopathy. The homeopath tells the investigator to do some research on the Society of Homeopath’s web site and on the What Doctors Don’t Tell You web site. When asked to confirm again that there is a homeopathic alternative, he replies, “The answer to that is yes, but not approved by orthodoxy. Plain and simply.”

(You can see a summary of all the transcripts here.)

So, what the hell is going on here? It is possible that the Chair of the Society of Homeopaths, Andy Kirk, who wrote letter to the Guardian, may not have been aware that the Chief Executive, Paula Ross, was in possession of the transcript evidence and had been given the name of the Fellow of the Society who gave the advice. Presumably, their complaints officer, Patricia Moroney, was also not in possession of the evidence. This would be fairly shambolic - a word I used in the first sentence of my 'banned' article.

It may also be possible that Paula Ross came to the conclusion on her own that the transcripts did not contain sufficient evidence of wrongdoing. However, the Society is quite clear that "we must follow a due process when dealing with any allegation". Was due process not undertaken? Again, they are quite clear: "the Society was unable to investigate a specific case." It is worth pointing out that Paula Ross is not a trained homeopath, nor is she trained scientifically. She is an English graduate who has a Post-Graduate Diploma in Management.

There are, of course, far worse interpretations of this situation. Unfortunately, it looks like we may never know why these contradictory statements have been made by the Society. Did an investigation take place? If not, why not? If it did, why no apparent action? And why make statements that suggest that it was the failure of the BBC/SaS team to hand over evidence and names that prevented the Society from taking action? They quite clearly did hand over the evidence required. I have written to the Society and Ms Ross twice now over the past week to help me clarify the issues and they have seen fit not to reply.

One reason they might not have replied is contained in their letter to the Guardian. Rather than highlight what they thought was defamatory in my blog post, they say,

Dr Lewis, in his article, stated as fact highly offensive comments about The Society and it is for that reason that The Society decided it had no option but to take action.

Due to the unpleasantness and surprisingly vitriolic nature of the postings on the Quackometer website and others, The Society has taken a conscious decision not to respond to these bloggers.

So first, offensive is not the same as defamatory. And, as Richard Dawkins put it so well, "offense is what people take when they can't take argument". Offense is so often the refuge of the unquestionably right. What I find offensive is the fact that a Fellow of the Society of Homeopaths is quite prepared to let a gap year student or young tourist travel deep into Africa with nothing but a magic fairy pill to protect themselves against a common and often fatal disease. And more deeply offensive is that his so-called regulatory body sees no reason to take any action at all and is even prepared to state untruths about the matter in a national newspaper and on their website. And unpleasant? I hear dying of cerebral malaria is unpleasant.

Vitriolic? Vitriol suggests I was abusive. That I was not. What I was, was shocked and angry at what I was discovering and I was forthright in my opinions. I was not the only angry person. It is always worth re-quoting Dr Peter Fisher - the Queen's Homeopath - on the affair, "I'm very angry about it because people are going to get malaria - there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice."

The vitriol undoubtedly came from a stream of emails from around the world to the Society following their attempt to silence me. I do not condone this abuse - reasoned argument is much stronger and it has given the Society a fig-leaf to hide behind. But their quoting of this vitriol is typical of homeopathic thinking - it has confused the nature of cause and effect. The vitriol was the result of their actions, not the prompt for them to take action.


And so, as Nick Cohen discussed in yesterday's Observer, we live in a society that sees organisations like the Society of Homeopaths as "a funny little alternative institute we too casually dismiss as quaint". But homeopathy is founded on a cavalier attitude to reason and truth and that makes the practice dangerous. Their propaganda tells us that homeopathy is safe, natural and effective. This is not true - and truth matters most when dealing with life and death issues. I do not favour heavy handed legislation to stamp out these practices - I still believe homeopathy could just about evolve into something genuinely useful. But maybe the zeitgeist is changing. Holding dangerous beliefs, that show such a lack of care for consequences, should be as seen as socially unacceptable and as selfish and as irrational as running a gas guzzling 4x4 for city school runs, or as dangerous and irresponsible as drink driving.

Labels: Ben Goldacre, homeopathy, Society of Homeopaths

 

The absence of the Bad Science column in yesterday's Guardian has all the makings of a bigger story than had there actually been a column. Ben Goldacre, writer of the column, has been one of the few voices in the British press that has reliably and careful pointed out the evidence against the assertion that the MMR vaccine causes autism in children. Last Sunday's appalling story in the Guardian's sister paper, the Observer, and the non-appearance of Ben yesterday, cannot be a coincidence.

• reporting unpublished research that has not gone through a proper peer-review and scientific analysis and promoting such reports as if it was reliable and important.


• feeling the need to report 'balance' by giving undue prominence to fringe views and small numbers of dissenting voices


• failing to properly report careful and sound science that could settle the issues and instead continue to look for a sensationalist angle.

Newspapers appears to misunderstand that good science reporting is intrinsically different from reporting financial issues, politics, fashion and sport. Science is not democratic. It is not about the fair counterpointing of opinions. It is not 'pluralistic'. It cannot be selective. Science reporting should not focus on the motives of researchers as its primary analysis. It should not be about conspiracies and shenanigan's as a matter of course.

And the reason is that science is the the best way, indeed the only way, that we know of finding out the truth about the world. And it is a truth that is deeper than the 'truths' of politics and the love lives of celebrities. Our wishes, aspirations, prejudices and world views make no impact on scientific reality, no matter what the post-modern educations of our media masters may have told them. Does MMR cause autism? This is a question that cannot be answered by readers' polls, a show of hands and an editorial in a paper. It is a question about the nature of reality; a scientific question that can be, and has been, answered by the meticulous collection of relevant evidence.

Understanding science is about understanding the evidence: about how that evidence has been collected, analysed and criticised. It is about the best conclusions we can draw from that evidence and how we might improve on that evidence to gain deeper insights. Reporting that concentrates on fringe views, that are in contradiction to reliably established facts, might do when we discuss base-rate changes, Spice Girl reunions or the size of Tony Blair's manhood, but cannot make the mainstay of scientific reporting. The end result is just a total distortion of what science knows and just adds to public mistrust of the reliability of science.

Now, of course there are very important human interest stories in the MMR controversy. Science is a human process too. But the process of science is different from the established conclusions of science. In science there are deceptions, intrigue, anguish and politics. These issues too need reporting. The charges that Andrew Wakefield will face need covering to counter the arguments in the mad press that this is just the 'establishment' hitting back. There are thousands of confused parents and many who are convince that MMR caused their children's problems, despite their beliefs being due simplistic and faulty reasoning. There are the quacks that seek to exploit the fear of MMR and offer their own self-serving money making schemes. But the science is different from the human ping-pong. The non-MMR/Autism link is as settled as any scientific question can be now. This ought to be the starting point of the stories, not something that can be played with like antics of Paris Hilton.

So, will the Guardian let Ben write what needs to be written? What is more important, can the Guardian and the Observer cover the GMC disciplinary hearings for Andrew Wakefield in a way that can start putting the whole sorry mess to bed? We desperately need newspapers that can do this. We do not need more sensationalist rags. I shall not be buying a paper this week. A small step, I know.

These things are important. As a society, we have forgotten how bad childhood illnesses can be. We have forgotten how they were feared by our grandparents. Instead we just just get idiots in the Daily Mail saying how we should not be too worried about immunising our children, because there are no cases of measles about.

---

.

Labels: Ben Goldacre, journalists, MMR

 

If you were to believe the Society of Homeopaths, the quacks that were handing out lethal advice to Newsnight investigators about malaria prevention, were just a few rogue and unregistered practitioners and unrepresentative of the profession.

Peter Fisher , the Director of the Royal London Homeopathic Hospital (currently funded by the NHS) told the programme that,

Fortunately for us, we do not have to subscribe to get an idea of what the ARH promotes through this journal. We have access to a list of contents and even some sample articles. A quick scan through shows one article entitled, Silent and deadly: Prophylaxis and treatment of malaria by Theresa Partington. Luckily, the full text is available for us to view. The article views the recommended homeopathic prophylaxis and treatment options as given by 'experts'. On prophylaxis it says,

All recommended [homepathic] prophylaxis for visitors. The 'African' homeopaths recommended Malaria Co Nosode 30 on a weekly basis for visitors, starting a week before arrival and continuing for a month afterwards, Jennie also recommends the concurrent use of China 30, following recommendations of Susan Curtis in ‘Alternatives to Immunisation’; Liz Hennel, who works in Nicaragua, uses Plasmodium falciparum nosode (available as a single nosode from Ainsworths) and China sulphuricum in areas where this type of malaria is prevalent, but otherwise Malaria officinalis and China.

The same type of advice is given for treatment. Shockingly, the article proudly reports how a homeopath is teaching people in high risk areas of Africa about the 'benefits' of homeopathy,

[Assie Pittendrigh] is working in the Great Lakes region of Africa, teaching homeopathy to local nurses and doctors who run charity clinics in the region. The project began at the end of January 2006 and has two purposes:

1) To introduce homeopathy for First Aid and Acute Diseases (her quick reference guide is being translated into the required language).

2) To run a professional clinical trial to test the effectiveness of malarial prophylaxis using homeopathy. The exact format of the trial will be agreed with the medical staff and this information will be made available as soon as is feasible.

In other words, according to Peter Fisher's above criteria, Assie (Alison) Pittendrigh is killing people. The title of this article is 'Silent and Deadly'. The denial of Peter Fisher, and the silence the Society of Homeopaths, and the ARH is indeed deadly.

Again, this failure to set boundaries for the profession is not limited to its views on malaria. Grace DaSilva-Hill MSc LCPH MARH MAAMET RGN has written, in the Winter 2006 edition, a two part essay on 'Treating acutes with homeopathy'. Fortunately again, the first part is available to us to read. DaSilva-Hill discusses the use of homeopathy in serious acute conditions, when the 'most common reaction amongst people is to take the patient to the hospital'.

She says after discussing a case of bacterial meningitis,

It requires a great deal of trust between patient and homeopath, for a serious acute to be treated solely with homeopathy.

Amazing. I would also add a great deal of stupidity, negligence and arrogance too. The only reason we do not see too many deaths from thinking like this is that the vast majority of parents would be at their GPs and casualty in a flash if a serious illness threatened their children. The danger is that a few hours delay while a homeopath picked their 'ultra-potentized' sweetie pills, could make all the difference between a favourable and tragic outcome. A parent taught by their homeopath that this is the safer and gentler route to health might be misplacing a lethal trust.

DaSilva-Hill pulls back from saying that she does treat without recourse to real medicine by saying,

I guess it’s the voice of my nursing background still lurking somewhere reminding me of professional accountability to a statutory body.

Her inference is thought, that others may not feel such a compunction. Homeopaths have no statutory body to make practitioners accountable.

The journal gives us another freebie article worth checking out: Vaccinations: what cost? By Christina Head. It is as if being in one area of alternative medicine, you are required to adopt a full credo of beliefs about the evils of real medicine and science. We find in this article the usual discredited MMR-autism story and a general distrust of all vaccinations. Head gives us sentence after sentence of the usual anti-vaccination canards, including,

I have in my practice about 500 unvaccinated children of all ages. They are much more straightforward to treat because they don’t have a ‘kinked up’ immune system. But they still have their inherited or acquired susceptibilities.

and

Treating unvaccinated children is truly creative medicine and provides a real base for good health in the future life.

Now, as you know, vaccinations have saved countless lives. But on their own do not guarantee immunity from childhood killers. A particular vaccination may only be 80% effective, say. Real protection comes when the vast majority of the infectable community are vaccinated. The infection can then not get a foothold in the population and spread. If the level of vaccination drops below a threshold, then the disease can spread, even to vaccinated children. Thus, Christina Head's advice not only endangers the children of parents who believe this rubbish, but all children too. Peter Fisher also supposedly believes that the homeopathic community supports vaccination. Is he in touch with his community?

It is easy to be lured into believing the homeopaths' platitudes that their practice is without side-effects and is harmless. What does not appear to be recognized, as Ben Goldacre pointed out in the Guardian last weekend, is that the effluent and discarded waste of alternative medicine is bullshit. And bullshit can be very dangerous, especially medical bullshit. Complementary medicine undoubtedly has beneficial roles in health care, but not if it is in the business of dishing out pseudoscientific nonsense, lies about real medicine and doctors, and over inflated claims about its own efficacy. Quackery kills.

Labels: Ben Goldacre, homeopathy

 

It's been a bad week for Gillian. The anti-quackery blogging brigade have been partaking in bouts of the great British pastime of uncontrolled Schadenfreude (why did we leave it to the Germans to coin that term?) after the Advertising Standards Authority stopped Gillian McKeith as advertising herself as 'Dr Gillian'. The Guardian printed a huge article by Ben Goldacre about how she is a 'Menace to Science' and how her particular brand of nutrionism is deeply anti-science and harmful.

Is there anything else left to say on the subject? One thing that Ben and Gillian's defenders have in common is their belief that, in many ways, it is immaterial by what title she calls herself. Obviously, her use of the title offends the many hardworking PhDs who have sweated and slaved to use their title in order to try to secure upgrades at airport check-ins. But if her advice leads to people eating more sensible diets then surely 'all's well that end's well'? That would be fine. But Gillian just speaks nonsense at people. Her thoughts on chlorophyll and food colour have been well addressed as non-scientific silliness. If people take her seriously, then how do they know what is good advice and what is rubbish? Therein lies the problem.

My contribution to the debate is going to be to show just how deep her embrace of anti-science is. I don't think even Ben has described just how far she is prepared to go. She does not just embrace the language of science in a pseudoscientific way, but is also quite prepared to get into bed with a deep anti-science agri-woo in order to sell her products. Let's just look at one of her products for sale on her web site: Veggie Vitality, available in 200ml quantities for £1.79. Her description reads...

Labels: Ben Goldacre, diets, Gillian McKeith, homeopathy, nutritionist, organic quackery

 

Regular listeners to BBC Radio 4's Womans' Hour will have recently heard nutritionist Suzi Grant extolling the virtues of so-called superfoods. Quackery, I say.

Labels: Ben Goldacre, diets, mckeith, nutritionist, Quack Words, qualifications, vitamins

 

A regular comment to me is to ask "why have I got it in for Nutritionists?" Surely, these are dedicated health professionals who do wonders for peoples' health by improving their diets and making sure people take the right supplements, if required. Well maybe. The problem is that so many nutritionists are not doing this and often resort to pseudoscience and quackery. This week's Quack Word blog entry will argue that the Quackometer is quite right (most of the time) in scoring highly a web page with the word 'nutritionist' in it.

So, a quick definition of 'nutritionist'. Whilst one should always take wikipedea articles with a sceptical eye, their definition of nutritionist is a good starting point:

A nutritionist is a person who advises people on dietary matters relating to health, well-being and optimal nutrition. Nutritionists should not be confused with dietitians. Dietitians are health care professionals who have received specialised formal accredited tertiary education and training, and undertake internship in hospitals, and who are required to adhere to their regulatory body's code of conduct. They are also the only non-medically-trained health-care professionals permitted to practise clinically in hospitals or health-care facilities. Many "nutritionists" appear on television, in newspapers and magazines, and write bestselling nutritional books.

Self-identified nutritionists have varying levels of education, and can be someone with little education up to someone who may have the equivalent of a master's degree in Physiology or Biology.

• It's not just about eating healthily. Bad diet is promoted as being the root cause of almost all diseases and conditions. Eating in a certain way can restore the 'balance'.


• It is not possible to get all your vitamins and minerals from food today because of modern farming methods. The nutriquack can sell you the right supplements.


• Organic is healthier.


• Claiming that a simple change of diet or popping a vitamin cure complex social issues, like omega-3 fish oil pills helping poorly performing kids in schools,


• Promoting radical diets which usually involve cutting out entire food groups.


• Promoting the health benefits of consuming huge volumes of vitamins.


• Advocating 'superfoods' that allegedly have remarkable health benefits.


• Obsessions with discredited and weird diagnostic techniques, such as examining stools.


• They use pseudoscience to sound knowledgeable. Talk of 'detoxification' is common.


• Selling weird made up foods with remarkable properties such as this nonsense salt seller and shrouding it in ridiculous claims.
  

All these things have in common is their overstatements and lack of evidence. Making health claims in this way is quackery. From now on, I will call such people the nutriquacks.

I think the problem of the nutriquack arises from the simple fact that good nutritional advice (for most people) is quite simple - eat a balanced, varied diet with a low amount of fat and lots of green stuff. You are not going to make a fortune with that mantra - even though getting people to follow it is quite hard sometimes. By making the whole thing appear more complicated though, the nutriquack is creating a market for their services. You cannot get enough antioxidants - my superfood berries (available on my website) will do it for you though! Register with my site, complete my questionnaire and I will personally compose your optimum nutrition plan and supplement mix. And so on.

What is happening is that nutriquacks are fetishising food and bamboozling people. Rather than enjoying food for its own sake, many people are led down the path of analysing everything they put in their mouth, jumping to conclusions about why they might be overweight or unwell and fruitlessly giving money away to people who do not deserve it. The real heroes of healthy eating for me are those people who try to instill a love of good food into people. Chefs and writers who try to excite about the benefits of buying good ingredients, how to source fresh ingredients inexpensively, how to be creative in the kitchen without needing top-chef skills and basically try to impart a joy about food. That is surely the route to people having a good, healthy relationship with their food and so end up getting a more rounded, varied and balanced diet. People like Jamie Oliver, Nigel Slater and Nigella Lawson spring to mind, but there are many more. These people do not resort to pseudoscience in order to justify what they do.

When science does make some well researched discoveries about the food we eat, this is often drowned out in the swamp of nutriquack baloney. It is often impossible to tell good science from nonsense in the popular press and TV. All this does is make people despair of the 'scientists' with their constantly contradictory advice and silly discoveries. It undermines a reliable source of knowledge for society that genuinely could help improve peoples' lives.

Nutriquacks operate in a legal void. Selling food is not illegal after all and vitamins and minerals are just food. However, make medical claims and use ingredients that might be medicinal in nature and you might end up in hot water. At least this is a curb on the excesses of nutriquacks, although it is seldom invoked.

However, such is the fate of arch-nutriquack 'Dr' Gillian McKeith. Today, the MHRA (the British organisation that is supposed to control the use of medicines) has ordered that McKeith stop selling illegal products. McKeith has been capitalising on her TV fame by selling all sorts of expensive and silly 'superfoods' to her fans. At last, the law has caught up with her, at least in a little way and she will have to re-think how she goes about her business now.

Labels: Ben Goldacre, detox, diets, Gillian McKeith, minerals, nutritionist, Quack Words, vitamins

 

UPDATE 12/2/07

Congratulations to Ben Goldacre and the crew at Bad Science for getting Dr Gillian McKeith banned from using the title 'Dr'. In today's Guardian she is fully exposed as a Menace to Science. The Advertising Standards Authority have agreed that her use of that cheaply acquired title is thoroughly misleading.

One down...

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Yes, I know. This is surprising quack word, but let me explain.

I'm not really writing about the word 'Doctor' but about titles and qualifications in general. More specifically, it is about using titles and qualifications, however acquired, to provide a sense of authority to healing claims when sound evidence is lacking.

'Trust me, I'm a Doctor.'

Quacks lack evidence for the effectiveness of their treatments or theories and so rely on a number of other techniques to convince you of their worth, including testimonials, anecdotes and baffling pseudoscience. However, one of the surest giveaways of quackery is the flaunting of titles and qualifications. The quack will proudly put 'Dr' before their name and 'PhD' afterwards. Normally, one or other of 'Dr' and 'PhD' will do. This is an 'appeal to authority'. It is solely there to impress. The quack is setting themselves up as a respected authority on a subject and so there is no need to look any further at any real arguments or evidence in favour of what they are saying.

Now of course, evidence-based medicine, and science in general, is full of Doctors, PhDs, Professors and diplomas. The difference is that, in general, these titles are not always flaunted. Look at any scientific paper in a prestigious journal like Nature and you will see just names and no titles. The authority of the paper comes from the strength of the argument and the rigours of the experiment, not the qualifications of the authors.

Qualifications do count, of course. They are part of the apprenticeship of science. But once the years have past, they become increasingly irrelevant. Look at how doctors tend to revert back to Mr/Ms etc as they become more experienced and advanced in their careers. Their reputation for excellent work is what matters, not their past exam success.

If you are still not sure, why not try a little experiment for yourself? Next time you are in a book shop, go and visit the popular science section. It is probably quite small, near the back and you may need a shop assistant to help you. Now look at the books and see how many titles you can spot on the covers. Names like Richard Dawkins, Steven J Gould, Hawkins, Dennett, Penrose and Pinker ought to leap out. All luminaries in their fields, but not a qualification in sight. If you look inside at the brief biography, you may spot the odd professorship mentioned alongside their stated appreciation of their family. Their titles, qualifications and awards are insignificant in the face of their arguments. If you do find a title, it is likely to be of a little known author.

Now go back towards the front of the shop until you end up in the 'Mind, Body, Health and Spirit' section. This won't be hard to find. It will be three to four times the size of the science section. In a bad bookshop, the science books might be mixed up with it. However, the actual useful contribution to human knowledge on those shelves will fit in a small shoe box. A waste of trees. Now look for qualifications. It won't take you long. They will be printed in huge, silver, embossed letters on the spine and cover. Looking at the Amazon best sellers at the moment we see names like Dr Gillian McKeith Phd, Doreen Virtue PhD, Jeffrey E. Young PhD and Dr Wayne Dyer. If the author hasn't got a title themselves, then they will get a forward written by someone who has and that will appear in big letters. Those embossed letters count for everything. Noel Edmonds is missing a trick here.

But surely these people must know what they are talking about? You can't just lie about your qualifications?

Well, you don't need to lie, but there are a number of ways of getting round the three to fours years of library work, fine tuning of experiments, paper writing, seminar giving, thesis writing, thesis re-writing, and tortuous examinations - all on a pittance of pay - that are the staple of postgraduate degrees, if you want to start earning big quack bucks fast.

Let us count the ways...

1. Swap Subjects
You could have mistakenly done all the hard work above only to find out that being a geologist does not make as much money a selling bucket loads of useless vitamin pills. I've written about this before. Even though you are now a nutritional 'expert' there is no need to make it clear that your PhD was in geology, economics or bongo playing. Flaunt those letters after your name!

2. Join a 'New University'
The massive expansion in higher education in the UK, and probably elsewhere in the world, has resulted in a deluge of former polytechnics, colleges and furniture shops now calling themselves universities. Even better is that, in the mad dash to attract students and, hence attract funding, the hard subjects of physics and chemistry have been dropped due to the difficulty of persuading students to take them. Far better to offer courses in homeopathy, nutrition and Madonna. Set yourself up as Professor of Reiki Studies and bingo, you're off.

3. Do a Cheap Correspondence Course through an Unaccredited American College.
This might involve a little work and at least cost you a fair amount of postage, but at least you will be able to defend yourself in a court of law that you are entitled to the letters after your name. Sometimes called the "looneyversities", these institutions often dole out pretty useless awards for little more than a fee. Proper academic standards are rarely upheld and are not subject to academic review by the usual authorities.

Paul McKenna PhD sued a journalist for saying his doctorate was not real. I quote from the Guardian:

Central to the case is an article published in October 2003 headlined "It's a load of doc and bull", in which Lewis-Smith wrote that McKenna's first PhD, awarded by La Salle university in Louisiana, was a sham. "I discovered that anyone could be fully doctored by La Salle within months (no previous qualifications needed)," he wrote, just so long as they could answer the following question correctly: 'Do you have $2,615, sir?'" This followed a number of articles dating from 1997 in which, among ther things, the columnist calls McKenna a "non-doctor", a "dildo" and compares him to Dr Crippen, the notorious murderer executed in 1910 for killing his wife.

In fact, La Salle university was not as it seemed: in late 1996 the former president, Thomas Kirk, admitted to the FBI that it was not officially accredited; the following year he was jailed for five years for fraud. McKenna told the court he knew nothing of the fraud when he enrolled for a doctorate in hypnosis in June or July 2005. While he admitted the revelation had "devalued" the qualification, he insisted he did not believe it rendered it "bogus"

The judge found in favour of Dr McKenna noting that "Mr McKenna was not, in my judgment, dishonest and, for that matter, whatever one may think of the academic quality of his work, or of the degree granted by La Salle, it would not be accurate to describe it as "bogus". So there. The title 'Doctor' is not protected, meaning anyone can pretty much call themselves this. The quality of any degree behind the title is irrelevant.

Perhaps, the most celebrated case in the UK is that of Dr Gillian McKeith PhD. Her credentials have been scrutinised by a number of observers, including the Sunday Mail with an article entitled Is Channel 4's latest food guru Dr Gillian really a Quack and a danger to our health? Perhaps the funniest analysis was done by Ben Goldacre in the Guardian who looked into her professional memberships that included the American Association of Nutritional Consultants (AANC). Dr Goldacre applied for the same membership for his recently deceased cat, Henrietta. It cost him just $60.

The qualifications of Dr Gillian have been well explored and I will give a reference shortly. It is fair to say though that she does have qualifications that everyone respects. They are in languages, business and marketing. All things she does very well and her education has obviously paid off.

Dr Gillian McKeith PhD is not afraid of legal challenges either, although sometimes they take a more 'out-of-court' route. If you Google "Dr Gillian McKeith PhD" you will find the following wording on the first page:

In response to a legal request submitted to Google, we have removed 1 result(s) from this page. If you wish, you may read more about the request at ChillingEffects.org.

Fortunately for posterity, I know the page concerned. You can find it here. This page is essential reading for all Gillian fans.

4. Start your own Institution or University and award Yourself Titles and Awards
Arguably the hardest work, but it can have big payoffs. The main one being that you can charge other people to get similar awards.

This is most often done in the US. The Beatles guru, Maharishi Mahesh Yogi, set up his own university so that lots of 'research' could be done on Transendential Meditation.

The UK has its own examples, including Patrick Holford BSc, DipION, FBant. Patrick is one of those people who you will have found in the Healthy Living section of the bookshop, in between 'Angel Healing' and 'The Photographic Kama Sutra'. Patrick styles himself as the "leading spokesman on nutrition, food, environmental and health issues".

Once again, Patrick's BSc was in psychology, not nutrition. His significant qualification in health matters is the DipION awarded by the Institution of Optimum Nutrition which was set up as a 'charitable and independent educational trust ' by none other than Patrick Holford himself. Hire a few rooms in some managed office space in Richmond, London and you can have an International Headquarters. Even better, get one of those new universities (say Luton) to accredit your course and you can expect a stream of fresh new students. Nevermind that the most recent official quality review of Luton (now Bedfordshire) concluded:

As a result of its investigations, the audit team's view of the University is that: limited confidence can be placed in the soundness of the University's current and likely future management of the quality of its academic programmes and the academic standards of its awards.

This has not gone too unnoticed. The Sunday Telegraph posted an article entitled "Is this the worst university in Britain?".

The Institute's philosophy is one of nutritional therapy, treating disease through what you eat, as highlighted by the quote on the front page of its web site:

"The Doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition"
Thomas Edison, c 1870

So Thomas Edison not only invented the light-bulb but was a pioneering nutritionist. It's a shame that the rest of science has not yet caught up with his thinking and adopted this in the way we have adopted the lightbulb. Maybe it is because the lightbulb is based on sound science and is useful?

Does any of this matter? Well, people do take Mr Holford seriously. He has been associated with comments that Vitamin C is better than AZT in the treatment of AIDS, where the evidence for that has been very poor. This is burning issue in South Africa now where the Health Minister believes you can treat HIV with potatoes. Someone is dying there every two minutes of HIV and AIDS. Also, the general public take him seriously. He last came to my attention when researching the QLink trinket that is sold as a way to stop 'harmful' EMF disrupting your life energy thingumajigs. He sells them on his website and provides this most fantastic endorsement:

There are many gadgets out there promising to protect you from electromagnetic radiation and give your energy a boost. I've investigated many and did not find any stacked up. The one exception is Q Link. The scientific proof is deeply impressive and that's why I wear one. I recommend you do the same.

So, all the other EMF pendants are quackery and nonsense, Patrick, except the ones you sell?Presumably, Patrick will be setting up an Institute of Optimum Quantum Physics as well now.

So why do the likes of Dr Gillian and Patrick see qualifications as so important to them? The key here is to see that they are both nutritionists and both sell food supplements of one form or another. The problem in selling these things is convincing people they need them; basic nutrition for most people is not hard. It's common sense - eat a balanced and varied diet, eat your greens and don't overindulge too often. Not much of a market for superfoods and vital supplements there. If, however, you make all this sound very complex, stress the importance of eating at an 'optimum', throw in some pseudoscience to make it sound like you know this stuff deeply, flaunt your qualifications and make it all sound too hard for the individual to keep track off, then you just might create a market for your overpriced alfalfa extract.

Dr Canard Noir Bsc(Hons.), PhD

Labels: Ben Goldacre, Gillian McKeith, nutritionist, Quack Words, titles