The Quackometer

Iatrogenesis is not a concept that is confined to quackery, but like most of the words in my Quack Words series it tends to show up more often than not on quack web sites and so can be a good quackometer word.

Iatrogenic illness covers the concept of harm having been done by the healer. Harm could come from many quarters including mistakes in diagnosis or treatment, professional negligence, adverse reactions to drugs, infections acquired during surgery or in the ward, and mis-presciption. Undoubtedly, all these things happen and quite regularly too. But, the charge by quacks, when discussing iatrogenic illness on their web sites, is that medical greed and their 'addictions' to using toxic drugs kill hundreds of thousands of people unnecessarily. The conspiracy of 'Big Pharma' wants to keep us ill and sell us more toxic and harmful drugs.

Often figures are presented that are used to show that iatrogenic death is the third or fourth leading cause of death in the western world. A typical example is given here where figures for adverse drug reactions cause 106,000 deaths per year in the USA.

On this basis, doctors look like mass murderers. Their pursuit of profit and the monopoly of health care is causing genocidal-scale evil. By contrast, alternative medicine is presented as risk-free, gentle, holistic and free from commercial influences.

On the face of it, the charge is very serious. Is it that simple?

In short, the sort of analysis used by quacks to present real medicine as a terrible killer is completely devoid of the medical context of the supposed deaths and concentrate only on negative outcomes and ignore positive outcomes of treatment. These figures are unbalanced and deliberately misleading.

For example, looking at the first reference given in the link above (Lazarou et al), it is worth noting that the authors point out that the major cause of problems was due to known highly toxic treatments, such as warfarin. These sorts of drugs are given to people who are seriously ill and at risk of dying. If a small percentage experience an adverse drug reaction then that has to be balanced against the overall benefits of lives saved by the treatment. In considering seriously ill patients who would inevitably die without intervention one should be able to take risks with known drugs in order to save a high number of them. Deaths in this case are a special sort of failure - not a case of negligence or malpractice - but a part of the risks of doing real grown-up medicine. Hospitals have to deal with seriously ill people and sometimes have to be quite aggressive in their treatments. The alternative is certain death. Most quacks are spared this confrontation with reality as they treat their headaches and skin complaints.

Undoubtedly, the side effects could be reduced by better understanding of the drug and that is exactly why medical research is done, with trails and experiments. For anti-rational alternative medicine quacks to use such data as a way of highlighting the ‘evils’ of real medicine is an act of propaganda and scaremongering. It is shameful denigration of a profession that has to daily make life or death decisions with the most complex system in the known universe - the human body.

If you are not convinced, an analogy: ambulances are responsible for many accidents, injuries and deaths every year. They charge at high speed through populated areas, ignoring road conventions and distracting other drivers. If you were to publish a table of injuries and deaths due to ambulances, they would look quite starting. In fact, one source reports an average of one collision each day involving an ambulance in the UK. Not all result in death of course, but still a big number.

Would you ban ambulances and set up alternative, low pollution, holistic and carbon neutral cart and horse emergency transport? How about bicycle ambulances? Of course not. There is no such thing as alternative and complementary ambulances. Even quacks get in the ambulance after a bad road accident. The reason is that by taking appropriate risks, ambulances save thousands of lives every year. Seconds counts when hearts and lungs are failing or you are bleeding badly. The lives saved vastly outweigh the iatrogenic injuries caused. It is up to society to balance the benefit and risks and choose how ambulances should behave.

The same goes with medicine. The culture of informed consent requires doctors to discuss the risks and benefits of any treatment. Patients, doctors and society all have a role to play in deciding if the risks for a particular treatment outweigh the benefits. This is an open process. Mistakes are reported and outcomes monitored. The fact that quacks can find the statistics show this to be true.

But what about alternative medicine? Do quacks consider that they may too cause iatrogenic illnesses? Homeopathy is a classic example. The mantra is that their pills are completely side effect free and homeopathy is gentle and safe. At one level, I would agree. Sugar pills with no active content ought to be pretty safe for the same reason that they are also completely ineffective against anything. But manufacturing processes can go wrong. Some very nasty substances are used in some preparations including viruses, poisons and mobile phone radiation(!). Getting it wrong could risk the patient. Do homeopaths know that they get it right? What tests have been done?

One Italian study claims to have looked at this. "Harm in homeopathy: Aggravations, adverse drug events or medication errors?" reports that.

Out of 335 homeopathic consecutive follow-up visits between 1 June 2003 and 30 June 2004, nine adverse reactions were reported (2.68%) including one case of allergy to lactose, excipient of the granules.

You have to laugh, don't you?

Seriously, I would take this report with a pinch of salt, much as I would take any study of homeopathy by homeopaths with deep scepticism. What worries me far more is that homeopathic iatrogenesis is going to come from the skewed and twisted propaganda they dish out about the evils of real medicine and the power of their own 'gentle art'. Its the thinking that leads homeopaths, like the SHEAF charity, to go out to Kenya to set up homeopathic malaria clinics that scares me to death and undoubtedly ends in iatrogenic deaths of the most negligent and deluded kind.

Labels: homeopathy, Quack Words

 

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

 

Or 'How to be debunked by a nine year old schoolgirl'

In the special world of the quack, the crank and the pseudo-scientist the word 'Energy' holds the highest place in the league tables of misappropriated and abused language.

I often get complaints that the quackometer only spots quacks and lets cranks off the hook. That is deliberate on my part - one thing at a time. The crank is easy to tell from the quack: the crank seeks 'free' energy, the quack seeks 'healing' energy. The crank seeks an endless supply of useful energy from spinning rotors and magnets; the quack seeks an infinite source of healing energy from spinning arms and language.

Both cranks and quacks like to talk about 'energy' all the time. Energy has an everyday meaning that we can relate to (our 'energy' to do things) and a rock solid physics definition (the capacity to do work). Maybe that is why energy is such a useful pseudo-scientific concept as we have an intuitive grasp of what it means, but little idea of the scientific details. The crank/quack fills in the gaps for us with their own pseudoscience.

At least the crank has some capacity to understand what energy is - the capacity to do work - even if they have limited understanding of the laws of thermodynamics. The quack however, uses the word energy, just like any other word borrowed from the sciences, with little regard to establishing a definition or consistent meaning. Indeed, vagueness and slipperiness are essential in the quacks cause.

Quack Energy has many different forms, or manifestations, depending on the particular field of woo being considered, Quack Energy has explanatory roles in Reiki, QiGong, Touch Therapy, Biofield Therapy, Acupuncture, Homeopathy and just about any other 'discipline' where science suggests the technique ought to be nonsense. Quack Energy is used to corrupt and subvert logic. It is claimed that because science cannot explain the healing capacity of reiki/acupuncture/qigong then it must be due to a new universal life-force energy. It does not occur to the practitioner that there might not be anything to explain.

The names for Quack Energy are legion: Mana, Energy, Qi, Aura, Chi, Ki and so. In debating with woos, I like to lump them altogether as MEQUACK.

Although, MEQUACK has different origins within the different fake medicines, there are some common properties:

• The Energy is 'Subtle'. Indeed, it is often called 'Subtle Energy'. MEQUACK has to be subtle as no-one has proposed a way of measuring it or even detecting it. So subtle indeed, that it escapes all the very sensitive scientific instruments we have at our disposal.
• MEQUACK is a 'life force', or 'biofield'. Despite is being subtle, it somehow has a very important relationship to our health. Despite no instrument being able to detect it, somehow our bodies can.
• MEQUACK flows around our body in someway and can get blocked, or disrupted, causing illness. Sometimes the energy uses some sort of MEQUACK channel in the body, like a meridian, or is centred in special places in the body, like a Chakra. You've guessed it, none of these flows or centres have ever been found, detected or observed.
• MEQUACK can get disrupted by our modern lifestyles and surroundings. The electrical and magnetic fields in our homes, somehow can also interact with our biofield MEQUACK, even when our sensitive electrical and magnetic scientific instruments cannot.

What is so galling to anyone with a scientific background is that energy, as a concept, is so well understood. Energy comes in many forms: chemical, kinetic, nuclear, thermal, potential and so on. All are convertible from one form to another. Light a firework rocket and chemical energy is quickly converted to sound energy, thermal, electromagnetic (light) and kinetic energy as the fuel burns and the rocket launches upwards. Kinetic energy, under gravity, is then transformed into potential energy and back again as it descends to earth. At the end, all that chemical energy has been converted to thermal energy. No energy was lost or created - always conserved - and all in ways that are thoroughly understood by science with lots of maths to work out what will happen. We are expected to believe that in all the years of experimentation, a form of energy exists, that is vital to our bodies, that has never shown up in our accounting for what happens.

MEQUACK has no conservation laws, no conversion mechanisms, no mathematics, no means of detection, no capacity for harnessing in an engine and doing work - its properties tend to get very vague when examined. Still, somehow, it is vital for life and health. Despite the so-called ancient origins of the knowledge of MEQUACK, no physics or biology textbook denotes a sentence to it, let alone a chapter.

So, why do quacks keep on about it? Talk of MEQUACK is often given in attempt to justify otherwise ridiculous claims. A quick example: The QLink pendant. We have seen this bauble in previous posts. The floggers of this tat invoke 'resonating subtle energies' as an explanation of how it works.

In this ridiculous page, Dr. William Tiller explains how:

Scientists have long puzzled over force field phenomena that do not fit the four known forces: electromagnetic, gravity, weak and strong forces. These force field that do not fall into the classical four are sometimes labeled "subtle energies." They are called "subtle" because they cannot be observed or measured by any known instrumentation.

It's difficult to know where to begin, but the first question would be: "What field phenomena?" Science has done an amazing job of distilling all known phenomena into four forces! Secondly I would ask: "If they cannot be observed by any instrumentation, how do you know they exist?"

This is typical of the garbled quack nonsense speak. Dr Teller goes on to explain that:

Electromagnetic fields are composed of two basic types of energy wave packets:
electrons and photons.

The high school physicists amongst you will be able to spot the simple error in this statement. This is not even wrong, it is just nonsense.

If this example is typical, then we can see that talk of MEQUACK is not meant to explain anything - it is designed to deflect enquiry and bamboozle. It deflects enquiry by quickly getting into technical jargon that most people will not, or cannot, explore further. For those, with a slightly less credulous bent, it deflects enquiry by essentially postulating that all attempts to detect or measure MEQUACK are futile as it is too 'subtle' to be detected by clumsy, reductionist, non-holistic, closed-minded, arrogant scientists and their instruments. Invoking MEQUACK is an act of fraud and deception. My guess is though, that many of the practitioners and exponents of the many forms of MEQUACK have first utterly deceived themselves.

So, to summarise so far:

• MEQUACK is a supposed life force energy;
• it has never been detected;
• it has no theory to explain it;
• MEQUACK has conflicting explanations across quack disciplines;
• is supposedly under attack from modern lifestyles to give rise to illnesses that are not recognised, or have very poor evidence bases, such EMF-stress
• MEQUACK can be manipulated by 'healers' by shamanically waving their arms above you (reiki), sticking pins in you (acupuncture, voodoo), wearing the right colours (chakras), giving you 'energetically charged' pills (homeopathy), or wearing a christmas cracker trinket (the QLink).

With so little going for it, it is amazing that so many people believe so passionately in it. Maybe it is because there are consistent reports of people feeling warmth and tingling when undergoing some sort of MEQUACK non-touch 'healing' ritual, such as QiGong, Reiki or (the modern favourite) Bi-Aura. That is pretty powerful evidence! Being able to detect the warmth and tingling in your nerves! Wow!

So, if you can really feel MEQUACK, then maybe science ought to sit up and take notice. Indeed, such a simple demonstration ought to be easy and it would convince me straight away. Show me you can feel this 'energy' and the world will listen. It ought to be so easy, in fact, that a nine year old could do it.

In fact, a nine year old has done it.

The youngest person ever to publish a scientific, peer-reviewed paper in a prestigious medical journal was Emily Rosa. Emily wanted to test if energy therapists could really sense MEQUACK. Twenty-one therapists agreed to takes part; how could they refuse a sweet little nine year old doing a school project?

In the test, the therapist would put both their hands through a screen. Unseen, Emily would place one of her own hands over one the practitioners hands and the 'therapist' was asked to say which hand it was. All therapists claimed that they could perform this test - the results though showed that their guesses were no better than chance (they got 123 out of 280 trials right). Emily's parents helped her with the stats and the experiment was publised in the Journal of the American Medical Association (JAMA). The editors described the study as 'solid gold'.

Her conclusoins were;

Twenty-one experienced TT [Theraputic Touch] practitioners were unable to detect the investigator's "energy field." Their failure to substantiate TT's most fundamental claim is unrefuted evidence that the claims of TT are groundless and that further professional use is unjustified.

Naturally, many 'energy therapists' have cried fowl. A full list of rebuttals can be found on the quackwatch site. What is amazing is this study cost about $10 for the screen. Any 'therapist' could do this test themselves as long as they were intellectually honest enough to properly blind themselves and remove obvious sources of bias. I think this shows how little the advocates of strange bio-energy are interested in the truth. Only their comforting delusions are important, and in some case, their fraudulent money-making practices.

So what is going on with the therapists? Why do they really believe they can feel MEQUACK. Well, self-deception can be very powerful. Expectations can make you feel things that aren't really there. Now the little black duck is quite ticklish. Even the thought of being tickled can make me tingle. Maybe the MEQUACKists are feeling something similar: anticipation, expectation and wishful thinking? What is for sure, as Emily (aged 9) has shown, they do not feel a bio-energy.

Labels: energy healing, pseudoscience, qlink, Quack Words

 

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

 

I believe that organic food is a con, is not necessarily more healthy for you, tastes no different, and is damaging to the environment.

There, I have got that off my chest, but unfortunately I now feel like I have just admitted to being a child murderer, a racist or even a supporter of George Bush's foreign policy.

Let me explain...

The word organic is now synonymous with everything good, healthy and caring. To be against organic is to be seen to be almost evil. Organic food has huge sections devoted to it in our supermarkets, and its not just food - our shampoos, clothing and beer can all be marketed as 'organic'.

What does the word mean? Its original meaning was a scientific one. The chemistry of carbon-based molecules is described as organic chemistry. As such organic chemistry is the chemistry of life. In this definition, everything alive, and everything we eat, drink or wear (as long as it is natural fibres) is organic. In science, all apples are organic. Indeed all crops are organic. But that is not what the supermarkets mean when the flog us expensive 'organic' veg.

In this context, organic is used to denote crops that have been grown according to certain standards. Those standards are certified by the Soil Association. This body was set up in the forties by a group of people who wanted to turn away from the growing industrialisation of agriculture which they saw as damaging in various ways, environmentally, bodily and spiritually. Their philosophy had been heavily influenced by Rudolph Steiner who had a lot of mystical beliefs about the nature of soil. The basis of the philosophy was that farming should make use of local materials and maximise the use of manures and local grown animal feeds. Other beliefs involved planting at certain phases of the moon and encouraging 'elemental forces' into animals and seeking the help of 'non-physical beings'.

Now it does not really matter if some of the more unhinged ideas were clearly batshit. The Soil Association has continued with the ideas about using manure rather than fertiliser, limited pesticides and limited drugs. The reason for this is so that we have healthier food, more sustainable farming and other benefits like better tasting food and less impact on wildlife.

Great. But the big question is to ask if this is actually true. What evidence is there that organic farming is healthier, tastier, more environmentally friendly and more sustainable?

Now the Quackometer Project is about exposing exaggerated health claims and so I would like to focus on the health claims for organic farming methods. Dick Tavern in his excellent book, The March of Unreason – science, democracy and the new fundamentalism, devotes a chapter to exposing the myths of organic methods and points out things like:

• Tests conducted by independent consumer organisations show that people cannot taste the difference between organic and non-organic foods.
• The rules for pesticides and fungicides use have no 'rhyme or reason'. Older, more damaging chemicals like copper sulphate are allowed, but more modern and specific ones are not.
• If most farming became organic then we would have returned to a time when crops were vulnerable to large scale blights, high labour costs were required and low yields the norm. The poorest in the world would suffer enormously.
• Low yield crops need more land and that is damaging to the environment with more forest clearing and less land set aside.

So what about health? The main issue tends to focus on the 'evils' of pesticide residues. The problem here is that although pesticides can harm in large doses, there is no evidence that they harm at the minute quantities left on foods. As Dick Tavern points out in his book,

In fact every mouthful of food contains some poison, as does every sip of water. Carcinogenic' substances are routinely consumed by all of us in the form of natural chemicals made by plants to repel predators, but at amounts so low they do not harm us. ... There are some dioxons in every breath of air we take

It's all in the dose. Only homeopathists believe that insignificant doses have huge effects. Sir John Krebbs in Nature noted that a cup of [even organic] coffee contains natural carcinogens equal to a year's ingestion of synthetic carcinogenic substances found in the diet. Part of the problem is that our analytical measurement techniques can spot the tiniest traces of substances. But just because we can detect something does not mean that we need worry about it. Plants produce their own natural pesticides and we consume far more of that than the trace residues of the artificial stuff sprayed on. Concern about pesticide residue is just a modern phobia with no basis in evidence.

If there is little basis in fact for the claims made by the organic movement then it looks like the word organic is just one more advertising word used to push expensive, unnecessary products on us. Furthermore, and more damning, by focusing on organic production, our society pays less attention to farming methods and technology advances that really could improve health, protect wildlife and ensure a consistent quality and quantity of food supply. Rather than securing our health, the illogical worship of the word 'organic' could be damaging us all.

As such, I have no reservation in including the word 'organic' in the Quackometer Project. Promoting food that is grown according to 'organic' principles because it is supposed to be healthier for us is just one more form of quackery.

Labels: organic quackery, Quack Words

 

As you know, the quackometer works by counting words, or combinations of words, that strongly suggest the web site is full of quackery. I thought I would write about a few of those words and why they are dead give-aways.

So, 'Holistic' - not in itself necessarily anything to do with medicine, but this word is often used with medicine when quackery is at work. Why is this and what do quacks mean by it? Why is almost exclusively used by quacks? Spot this word and you spot a quack.

The word was coined by Jan Smuts, the South African statesman, in a work entitled "Holism and Evolution" and defined it as "the tendency in nature to form wholes that are greater than the sum of the parts". Holistic thinking involves an approach to systems where analysis of individual parts of a system may not adequately describe the behaviour of the whole. As such, it is a thoroughly respectable scientific concept that has recently seen popularity through the emergence of chaos theories. However, the word often appears to set itself up against science by appearing to be the opposite of 'reductionist' - the claim that science always tries to break phenomena down into component parts and so ignores the 'whole'. Whilst reductionist approaches have proven to be enormously successful in science, it would be not true that science is only concerned with dissection and dismantling. More of this later.

Alternative medicine advocates rarely describe what they mean by holistic is such terms though. Googling "define: holistic" throw up lots of alternative medicine definitions along the lines that holistic means to ' treat the whole person and not just the symptoms'. What this really means is not clear to me. Press a quack and they slip and slide (as always). However, what I guess is going on is that by using the word 'holistic' the quack is setting up a straw man argument about 'conventional' medicine and then knocking it down.

The Straw Man goes something like this:
- 'conventional' medicine is only concerned about treating symptoms
- it fails to seek 'underlying reasons' for illness
- it fails to look at the 'whole person', spiritual and physical.
- your medical practitioner never has time for these other aspects
My quack therapy, on the other hand, does treat the 'whole person'. Therefore, you should spend your money on me.

These are, of course, all canards. Since when is medicine concerned with only treating symptoms? Do antibiotics cover up the nasty effects of infections? Does chemotherapy just sweep under the carpet the misdoings of that cancerous growth? Do heart patients take aspirin to gently mask their next infarction?

Well, the quack argues, why did you get ill in the first place? Your 'energy levels', 'immune system', 'spiritual balance' is not right - or some further set of canards - I can set this right. Before you know it, you might be onto a never ending set of 'deeper causes'. The quack will intervene when the chain of causality intersects with their personal quack philosophy, whether that be meridians, Qi, auras, chakras or whatever.

Perhaps the only truths encountered in this chain of reasoning are to do with the impersonal nature of much modern medicine. The busy GP, the arrogant consultant and so on. The word 'holistic' is used as an advertising brand word as a shortcut to say that "We are none of these thing. You can count on us to give you time and some TLC."

The huge irony is of course that alternative medicine is as narrowly focused and reductionist in its outlook as its supposed enemies. Each type of alternative medicine has its own pseudoscience associated with it, its own explanations of illness and approach to cures. The more science-like it sounds, the more credence we are supposed to give it.

I would also argue that alternative medicine can be far less holistic than real medicine. For a start, you will never find an alternative medicine advocate who looks at all the evidence to support their claims. They will only look at the evidence that suits. Usually poorly executed, small studies that found a small effect. Big, comprehensive trials are ignored because they do no support their claims. Hardly holistic.

What is more, the lack of holism in alternative medicine can be positively dangerous and sometimes fatal. The recent example of the BBC Newsnight investigation into homeopathy practitioners' advice for malaria prevention showed how narrow and blinkered their approach was. All ten homeopathists, in the investigation, suggested using their little sugar pills for malaria prevention with no discussion of the need for proven prophylactics and no discussion of bite prevention measures (nets, sprays, clothing). Utterly unholistic, as Simon Singh pointed out to the spokesperson for the Homeopathic Society on the programme.

So, finding the holistic on a web page is surely worth awarding a 'Canard'. Meaningless rot.

Labels: homeopathy, Quack Words