The Quackometer

As I write this, two married Australian homeopaths are spending their first nights in gaol as they begin prison sentences for six and four years respectively for the manslaughter of their baby daughter, Gloria.

This is a tragic, not least for the convicted parents. A nine month old baby died unnecessarily in the most horrific way because of her parent’s belief in the superiority and power of homeopathic sugar pills. Gloria suffered from severe eczema where the sores became severely infected. She constantly cried in pain and her skin became broken and oozing with fluid. She became malnourished and died.

This case has very important implications for those who are seeking better ways to regulate the so-called ‘complementary and alternative medicine’ (CAM) sector here in the UK. Understanding the nature of this tragedy will highlight the shortcomings of the approaches being taken by the government.

The parents of baby Gloria Thomas have been branded “cruel”, “arrogant” and “irresponsible”. The couple wept in the dock and it is easy to understand why. It is not just the loss of their daughter, or their impending incarceration, but almost undoubtedly their complete failure to understand what has happened to them.

This gulf may be difficult to grasp by those who do not understand the nature of homeopathy and see it just as a natural and safe complementary medicine. It is nothing of the sort. Whilst its pills are completely safe (they are just sugar pills), the homeopathic belief system is quite dangerous. Homeopathy does not define itself as complementary. It is not designed to assist treatments by real medicine. Homeopathy defines itself as ‘a compete system of medicine’ in its own right and, importantly, it defines itself in conflicting opposition to what homeopaths call ‘allopathy’ – or mainstream medicine. Homeopathy is strictly alternative.

The founder of homeopathy, Samuel Hahnemann, was keen to discover the universal laws of health and to create general and complete principles of healing. Homeopathy is the result. Indeed, Hahnemann saw chronic disease as actually being caused by other forms of non-homeopathic treatment and that deviations from the strict homeopathic doctrines as being disastrous for health. The Society of Homeopaths describe homeopathy on the front page of their site as a “complete system of medicine”. It describes how homeopathy can treat “all a patients symptoms”. This is a system that is not presented as a complement to other therapies, but a full system in its own right.

These belief systems persist for many interesting reasons. In two hundred years, the homeopathic principles have not been underpinned with an evidence base of any reliable sort. Worse, the principles have been shown to be in direct contradiction with well established principles of physics and chemistry. Homeopathy is magical in its nature, not scientific. The beliefs persist not because of their veracity but because they are taught within a cult-like atmosphere. The homeopath, Michael Bridger writes that,

The unwritten rule is not to be critical or try to define. No one has to publicly burn the books; you simply deify the inane and render critical thought unfashionable. Politically, this is a sophisticated form of authoritarianism; medically and clinically, it is the seeds of psychosis.

Recently, another homeopath has commented on Gimpy’s blog about the cult like nature of homeopathy. She describes it as a ‘pyramid scheme’, and like all successful pyramid schemes you need to ‘sell the dream.’ In her words, “We alone care about health – everyone else (Big Pharma, allopaths, EU, WHO, in conscious conspiracy, only wish to destroy health.” and, importantly for the case of Gloria, “You can be a part of saving the world’s health – but you have to be brave enough to tackle any case”.

I have recently received in the post some lecture notes from a UK homeopathy school accredited by the Society of Homeopaths. The notes describe a case of someone with a notifiable disease who was treated homeopathically without alerting the authorities, on the basis that the homeopath’s conscience dictated that he should not. To legally notify an allopath would be to alert the enemy, no doubt. When treating cancer homeopathically, the students are told to ‘trust and wait’. I will be writing more about this soon. Being trained to avoid medicine and trust only in homeopathy is mainstream thought in homeopathy, not exceptional.

The other cult-like aspect of homeopathy is its insistence in believing in a spiritual force that is being manipulated by the pills. According to Hahnemann, it is the ‘Vital Force’ that needs help with the pills. This is a vitalistic belief system with no place in modern science. As such, homeopathy is a spiritual belief which requires adherents to accept this quasi-religious world view.

In this light we can see that the parents of Gloria were doing what they were trained to do by the cult of homeopathy. If they had been trained well and had bought into the whole Hahnamanian philosophy then to take their seriously ill baby to an ‘allopath’ would have put it in danger. The only method to treat Gloria was with sugar pills. Homeopaths are taught that symptoms inevitably get worse when treated homeopathically. An ‘aggrevation’ is the remedy working the illness out of the body. No doubt as Gloria deteriorated, their training would have told them that this was a ‘good thing’ and that they should ‘trust and wait’. Her death must have been quite unexpected.

The parents of Gloria Thomas are not an exception. They are not an extreme. They have been good homeopaths and have merely been unlucky and had the misfortune to have the courage to stick with their beliefs. We can see on homeopathic discussion boards that tensions exist about resorting to real medicine when things look bad and that the choice of sticking with homeopathy is a question of “staying strong”. I have written before about the prominent UK homeopath Grace Da Silva-Hill MSc LCPH MARH MAAMET RGN who says about the fatal childhood illness of bacterial meningitis that “It requires a great deal of trust between patient and homeopath, for a serious acute to be treated solely with homeopathy.” Grace also is a supporter of homeopathic treatments for malaria in West Africa.

The implication in all of this is that even with very serious illnesses the homeopath has to stay true and believe in their cult and not betray their beliefs by accessing the outside world and their allopathic ways. Their education is full of denouncements of mainstream medical practice. It is a fundamental part of the creed that vaccinations are harmful and that chemotherapy is a killer. Medical drugs are a collection of side effects and not effective in their own right. Conspiracy theories abound about how ‘Big Pharma’ is out to destroy homeopathy. Harald Walach, Research Professor in Psychology at the University of Northampton has written that homeopaths should “Be proud, not afraid, fight back and don’t duck.” in light of the conspiracy theory that ‘Big Pharma’ is attacking them for homeopathic ‘successes’. Robert Davidson, a founder of one of the London homeopathy schools, describes how Pharmaceutical companies are trying to eliminate things like vitamins “to ensure sickness, so that everyone has to take drugs with no other choices available”. He says they are “evil, so totally evil”. Cults need their evil opponents to survive.

How many Gloria Thomas’s are there out there? It is difficult to know. We hope Gloria is at the extreme end of cases. But how many cancer patients needlessly delay treatment? How many chronic illnesses remain untreated due to such beliefs? Part of the problem is that homeopaths themselves do not collate the sort of records that would help us answer these types of questions. Sites such as What’s the Harm gathers news stories but these must be the tip of the iceberg. In Africa, where missionary homeopaths use homeopathic pills prophylactically to prevent malaria or even treat HIV we can have little idea how much harm is being done. The homeopathic belief is absolute. The current regulatory bodies such as the Society of Homeopaths refuse to discipline their members or even criticise them for taking part in such activities. Understanding homeopathy as a cult makes it easy to see why.

So how can we protect other Glorias? The homeopaths themselves will do nothing. There will be no response to this tragedy from the Society of Homeopaths, the medical Faculty of Homeopaths or even Prince Charles’ Foundation for Integrated Health. When criticism of homeopathy strikes, these organisation most often engage in bluster and obfuscation – or simply ignore the problem.

But, the government recognises that harm can be done by alternative medicine and that some sort of framework needs to be in place to protect the vulnerable. There could be no more vulnerable victim than Gloria, and indeed future infants like her deserve protection. And it is not just homeopaths we need worry about. Chiropractors display similar cult-like attitudes, and indeed much of alternative medicine appears to use similar anti-medical rhetoric to define itself and lock its members into cultish denial. You need only look at at sites such as What Doctors Don’t Tell You to understand the mentality of people attracted to such beliefs.

Unfortunately, UK government, like many other governments, appears to believe that regulating such practices is best done in a way similar to medical practitioners: registration and accreditation of training.

The folly of this is to believe that in doing this you are regulating health care professionals. You are not. You are trying to protect the public from health-threatening cultish beliefs. This is not medicine – it is pseudo-medicine with deluded practitioners. We do not protect people from Scientologists by formally recognising their leaders and giving their ‘Bishops’ seats in the House of Lords. And neither should we protect people from homeopaths by giving them protected title and a stamp of official approval from the Health Professions Council.

The government has pumped lots of money into a new organisation called the Complementary and Natural Healthcare Council (Ofquack) that claims its primary goal is to “protect the public by means of regulating practitioners on a voluntary register for complementary and natural healthcare practitioners”. It does this by ensuring their members have “undertaken a programme of education and training which meets, as a minimum, the National Occupational Standards for that profession/discipline”. It appears to think that by ensuring that an alternative therapist has been through training then people are protected. Gloria’s legacy should be to show us that this is not the case. Training is the problem, not the solution.

The National Occupational Standards scheme has tried to draw up standards for homeopathic education. These standards are to ensure that practitioners have the right “knowledge and understanding”. But as Professor David Colquhoun says, “no attention whatsoever is paid to the little problem of whether the “knowledge and understanding” are pure gobbledygook or not.” The problem is caused by the fact that these standards were set up in consultation with the Society of Homeopaths; the very people whose members’ beliefs the next baby Gloria needs protecting from. I once complained to the Society of Homeopaths about a homeopath who set up an eczema and asthma clinic. Despite obvious breaches of their own code of ethics, and that the Advertising Standards Authority concluded that this homeopath made “untruthful, unsubstantiated and irresponsible claims”, the Society decided there was no case to answer. The Society of Homeopaths believed that their time was better spent attempting to sue me.

In France, it is illegal to practice Homeopathy without a medical license. There is no such thing as lay homeopathy there and the Society of Homeopaths would be an illegal organisation. How much this protects people though is debatable. France has an enormous over-the-counter homeopathy trade through pharmacies, with Boiron, a homeopathic sugar pill manufacturer, making hundreds of millions of Euros from their big vat of sugar pills. The French self-medicate with homeopathy and their doctors are free to dish them out, although the state is fortunately reducing the amount it reimburses people for sugar pills. At least if a doctor prescribes a sugar pill when a placebo treatment is not required, then the regulatory bodies could well step in.

In the UK, we appear to be moving in the direction of legitimising various forms of quackery through various forms of state approval and recognition through statutory regulation. It is a disastrous move. There are currently reviews taking place for the regulation of acupuncture and herbal medicine. The same problems exist there with degree courses in Chinese medicine teaching students how to weasel word around regulation when making claims to treat cancer. Regulation of this style will put people at risk. The chiropractors have already achieved protected title and statutory regulation. This may not last much longer though as the regulator buckles under the weight of hundreds of complaints about chiropractors bogusly claiming to treat children’s illnesses in the light of the Simon Singh affair.

I believe a significant part of the answer is already with us. We do not need new regulation and statutory recognition of pseudo-medical cults. We need prosecution.

We already have the laws that say you cannot make false claims when selling goods and services. The Trading Standards laws are explicit in saying you cannot make false medicinal claims. What is not happening is enforcement of these laws as Trading Standards do not appear to have the training to go after these sorts of breaches. I would think it would be far more cost effective to provide this training rather than set up useless regulatory regimes for registering quacks.

The other change that would greatly help is for the Medicines and Healthcare products Regulatory Agency(MHRA) to drop its ridiculous stance on believing you only have to ensure homeopathic medicines are safe. No one disputes sugar pills are intrinsically safe – there is nothing in them. The MHRA though allow homeopaths to submit pseudoscientific ‘traditional’ evidence for a pill’s effectiveness so that they can make claims on packets. The MHRA legitimises dangerous quackery with homeopathy and it undermines its authority in doing so.

In summary, protecting future children like baby Gloria will require authorities to abandon the belief that they need to regulate homeopaths like medical practitioners and instead treat them according to the more accurate picture of them being a pseudo-medical and mystical cult with dangerous and irrational beliefs.

Labels: CNHC, Complementary and Natural Healthcare Council, homeopathy, ofquack, Society of Homeopaths, SoH, the law

 

It cannot be a good week for Adrian Pengelly. He has been subject to quite a damning BBC Watchdog investigation about his business activities. Adrian claims to be a “Visionary Healer, Energy Worker, Teacher and Psychic” and declares that he is well known for his “work with terminal illnesses and cancer”.

If a so called ‘Psychic Healer’ is giving some sort of emotional or spiritual support to ill people then we might leave people to get on with their lives. However, Watchdog showed Adrian Pengelly claiming to be able to diagnose and treat horses, cure cancers and even deal with haunted houses. I understand that at least the former two are illegal. When filmed secretly, Pengelly claimed to be able to cure sixty five per cent of terminal cancers. When an actor* woman secretly filming asked him about his success rate he not only made such claims but also, shockingly, said that his success rate would be higher if the person was not taking chemotherapy.

Giving people false hope is bad enough, suggested they decline what might be their only hope is truly terrible. Adrian charges £30 and claims to see up to 120 customers per week.

When confronted by an interviewer, Pengelly appeared to change course and claim that he never promised to cure people. He made excuses about his failure to diagnose a horse despite claiming a 99/100 success rate. He also managed to assemble quite a crowd of people claiming to support his activities.

It would be very easy to dismiss Pengelly as a charlatan and fraudster. Indeed, the usual ‘stars’ on BBC Watchdog can be described as nothing other, being cowboy builders, rogue holiday companies and identity thieves. Indeed, the BBC list Pengelly under their list of scams. However, in my opinion, this simplistic description of Pengelly’s actions is almost certainly wrong.

Adrian Pengelly would appear to believe passionately in what he does. Merely being shocked by what he does and exposing it on television will not change his beliefs. Of course, it would look as if he does make himself vulnerable to a few pieces of legislation if someone wanted to prosecute. But again, he may well continue whilst ensuring what he says does not fall foul of the law.

Of course, if there were critical articles on the web then people could evaluate his claims with a bit more balance, but the web appears to be rather devoid of mentions. One clue is in a rather credulous Daily Mail interview that suggests Adrian will be taking legal action against the BBC. I can understand this action. If Pengelly really does believe he is a Psychic Cancer Healer then he may very well feel aggrieved and want to take any action possible to remedy the perceived wrong.

I also understand that it would not be the first time that Pengelly has resorted to legal action against criticism. The web site Bad Psychics have written a number of articles about Pengelly. One of their writers let me know about one of their article last April. It is no longer available on the site. In total four articles were on the site. All gone. I am told that Pengelly’s lawyers have been on to the site and I have been warned that if I write about him, they may well be on to me too.

This is dreadful. Adrian, if you are reading I would like to say a few things to you,

Adrian,

From what I can see you genuinely believe that you can help people with cancer. The people that meet you may well gain the impression that you can help where their doctors cannot. They may well even go away believing that their rather unpleasant chemotherapy will interfere with your ‘gifts’.

This is serious stuff. People’s lives are on the line here. As you might gather, other people seriously doubt you can have any effect on the course of cancerous illnesses. If you are wrong then you will be doing a great harm – a very big harm. Relying on your own personal experience without engaging with other opinions is a recipe for delusional disaster in any walk of life.

This potential for harm applies to all medical beliefs. In attempting to do good, you may well end up doing harm. Medicine is full of terrible mistakes, false promises and dashed hopes. The way we can tell good medicine from bad is by open discussion of the available evidence and science behind what you do. This applies as much to you as it does to any surgeon or doctor. Using libel laws to remove criticism about you does your customers no good. It puts them at risk. You might well be wrong.

Your critics may be wrong too. I do not believe so. But they should have the right to be able to voice their concerns about your work and you should be obliged to answer them as best you can. People can then judge what you say in that light. You may feel that people are lying about you or spreading misinformation. The answer is to correct them with your version of what is going on, not to threaten them with England’s terribly unjust libel laws. The lives of your customers are far more important than your reputation. By using libel laws, you protect the latter and put at risk the former.

By using the libel laws you look as if you are not willing to discuss what you are doing. If your success rate is as high as you claimed on camera, it should be fairly simple to demonstrate your powers.

There is of course another danger of using libel laws – that of unintended consequences. The British Chiropractic Association are currently suing writer Simon Singh following an article in the Guardian. There followed, what the legal blogger Jack of Kent described as a ‘Quacklash’. The claims of the BCA have come under massive scrutiny across the web and now hundreds of their members are under investigation by the General Chiropractic Council as a result of people’s outrage at the use of libel laws to silence debate.

There is a now a very large campaign to reform English libel laws. I would hope that it was something that all reasonable people could support. Perhaps you, Adrian, could do your bit by withdrawing from any legal actions you may be engaged in, allowing people to publish their criticism and you responding to it without legal threats, and allowing people to engage in a proper discussion about what it is you do.

Could you use your powers to do that? It would be a sensible place to start.

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Correction

*The woman in the film was not an actor but genuinely had cancer.

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Labels: Adrian Pengelly, the law

 

This afternoon, Richard Dawkins will speak about the insidious nature of English Libel Laws as a guest speaker at the Liberal Democrats Conference in Bournemouth.

Professor Dawkins (along with me, coughs) was one of the first signatories to the campaign to keep libel laws out of science. This campaign was inspired by the rather shocking story of how science writer Simon Singh is being sued by the British Chiropractic Association after he wrote in the Guardian that the BCA were promoting chiropractic for common childhood complaints when there was no good evidence that these treatments were effective.

There is now a very compelling case that English libel laws are a fundamental threat to free speech in Britain and even the world. This is not just about science, although science might be hit particularly hard by these unjust laws.These laws prevent writers, whether in the mainstream media or eve non blogs, from voicing concerns and opinions where vested interests may want those opinions suppressed.

Richard Dawkins will say,

The effects of England’s libel laws are especially pernicious where science is concerned” and that action must be taken to stop the law being “ridiculed as an international charter for litigious mountebanks. I urge the Liberal Democrats to support the call for reform, and hope that Labour and the Conservatives will follow, so that we can get cross-party support on this vital issue.

The fundamental problem here is that a claimant in a libel case has a massive advantage. It does not matter if the writer has been thoroughly careful in checking what they have written and that what they write is demonstrably true. Even if they win the case, it can cost a huge amount of money to the defendant. If they lose, they will be financially ruined, even if the nature of the damages are small.

The government appear to be taking notice, but as Dawkins points out, cross party support for changes is important given that we can expect a general election soon. The case for change is overwhelming, but the best we can see at present is some preliminary discussion of changing the way that libel law can apply to online publications. In general, there is a time limit of a year for bringing a case after publication. However, each fresh ‘click’ or download is counted as a new publication effectively meaning there is no limit for liability for online publication.  This is an important concern, but minor compared with the gross injustice of the libel system. The system is fundamentally flawed and tinkering will not work.

Libel reform is important. Singh is being persecuted for daring to discuss matters of public health. The BCA could have simply published their own account and defended their actions in print. Instead, they chose to attempt to financially ruin a writer for criticising the approach to health. Far more worrying is how oil company Trafigura have tried to cover up an African pollution disaster by threatening any publication that dared to write about their business. They have now offered to pay compensation to 31,000 African people affected by their illegal dumping activities. People died and many more made ill. And anyone who wrote about it was threatened with legal action. The BBC reports,

It has until now denied compensation claims, and its lawyers repeatedly threatened anyone worldwide who sought to contradict its version. It launched a libel case against BBC Newsnight, forced an alleged correction from the Times, demanded the Guardian delete articles, and yesterday tried to gag journalists in the Netherlands and Norway with legal threats.

These threats tend to work in most cases.

The government have a chance to turn this around and make Britain a safe place to have full and frank debate about all manner of important issues, no matter what vested interests may be harmed. Instead, Britain can be viewed as a willing collaborator with rogues and charlatans, polluters and criminals, the rich and connected, against the writer and journalist, the activist and campaigner, the blogger and even twitterer. Free speech is reduced to a meaningless freedom as long as it does not effect business interests, political ambitions and dogmatic beliefs.

It is time for a change. It is time for us to be free from fear when voicing our concerns.

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In the next day or so, I will be writing about how a UK healer has been threatening bloggers with claims for writing about them and the impact this has on honest debate.

Labels: British Chiropractic Association, the law

 

The Dutch sceptics group, Vereniging tegen de Kwakzalverij (VtdK - The Society against Quackery) have managed to overturn a important court ruling that was preventing them calling quacks quacks. In a remarkable case, that in many ways closely parallels the BCA vs. Simon Singh case in the UK, a judge has decided that using a narrow definition of the word ‘Quack’ that a previous ruling was forcing the group to defend in a libel case, was incompatible with Article 10 of the European Convention of Human Rights.

The Society against Quackery claims to be the world’s oldest sceptics group. Its first newsletter was published in 1881 (Google translation) and has campaigned ever since against the misleading claims of alternative medicine.

In 2000, their magazine published an article “Quacks of the 20th Century” that looked back over the last 100 years and wanted to ‘preserve the history’ of the characters that had dominated, in their view, the world of quackery. They published a score card of how they had arrived at the top twenty quacks and stated that this list was “not meant to belligerently settle scores” but provide ‘insight into the personality of the healers of this period”.

In publishing their top 20 list, the Society were quite careful to explicitly define what they meant by the word ‘quack’. They said, (Google translation)

‘Quackery is:
(a) any professional act and/or the extending of advice or assistance related to the state of health of either man or animal;
(b) which is not founded on contemporary and/or empirically tenable hypotheses and theories;
(c) which is actively propagated among the public (“over-promotion”);
(d) which has not been tested on efficacy and safety within the professional group;
(e) which is (usually) performed without consultation of fellow practitioners.’

Now, you may not agree with this definition. And that is fine. But it is important to note that this is what the Society explicitly said about the meaning of the word. The Society also made it quite clear about what they thought about the honesty of such people:

As has been made clear by the Society & co, being labelled a ‘quack’ does not in the least imply bad faith or fraud: in practice, it is hardly possible to establish this. Therefore, nominees on the “long list” need not feel they are accused of immoral behaviour; the only thing they are accused of is quackery and nothing else!

I quite agree with this. In my explorations with the Quackometer, I can say that one of my biggest discovered undertsandings is that there are very few people out there practicing alternative medicine that fit into a simple categorisation of ‘fraud’. Most people sincerely believe that what they practice is genuine and are sincerely trying to help people. They are not deliberately misleading people, they are just mistaken in their beliefs. And why they are mistaken is much more fascinating and insightful into human behaviour than mere trickery and con-artistry. And when I do suspect genuine fraud, it is impossible (bar a few exceptions) to prove that this is the case. As the Dutch Society make clear, “it is hardly possible to establish this”.

At number seven on the list was a doctor by the name of Maria Sickesz (Google translation) who claims to be a “doctor of Orthomanual Therapy”. Sickesz believes that she has “developed a unique method to correct misalignments of the spine and the pelvis. She pays attention to the individual misalignment of each vertebra and noticed that they followed specific patterns.”

Misalignments of the bones in the back can be responsible or add to all sorts of diseases according to her. She claims to be able to treat “syndromes such as lung and digestive disorders, problems with the menstrual cycle, ADHD, autism, multiple sclerosis, Parkinsonism”. According to the VtdK, she has claimed to be able to treat “anorexia, asthma, autism, bipolar disorder, dementia, depression, diarrhea, eczema, palpitations, high blood pressure, fever, stomach pain, menstrual complaints , migraine, neck pain, tinnitus, psychosomatic stomach, schizophrenia” all by manipulation and hammering of the spine. She says that “The connection between these seemingly unrelated conditions and the spine is that the nerves, which serve all areas of the body, can be irritated directly or indirectly by spinal disorders.”

Yes. Sickesz has developed hew own brand of chiropractic or osteopathy. Indeed, a paper by her describes her subluxation based theory of why children develop colic. It is pretty indistinguishable from the sort of nonsense promoted by British chiropractors.

Displaying what we now know to be a typical chiropractic response to criticism, she decided to sue the VtdK for calling her a quack. An initial ruling by a district court said that the Society had not acted unlawfully and rejected Sickesz’ claim to prohibit the society from calling her a quack. However, on appeal, this decision was overturned and the Society was told not to repeat the claim and to issue an apology in De Telegraaf, a popular daily newspaper. It would appear that the main reason was that a major Dutch dictionary, “Van Dale, Groot Woordenboek der Nederlandse Taal” described quackery as follows: “

Someone who applies useless remedies to cure some disease or other or claims knowledge of remedies for all kinds of diseases, and/or someone who offers such remedies for sale, usually with a lot of noise; - unqualified practitioner of medicine, (fig) someone who wants to take the public for a ride, syn. cheap swindler, fraud, trickster.

This is a far more negative definition that the one offered by the Society in their article and the court decided that it is this meaning that the ‘ordinary’ man would ascribe to their article despite the Society being explicit about what they meant.

The Society decided to appeal this decision as it had far wider implications than just this case. Indeed, it would make it very difficult to talk about quackery in the Netherlands at all if courts were to take it as fact that an accusation of quackery meant that the Society were calling someone a “cheap swindler, fraud [and] trickster.” Fortunately, at appeal last May, this decision was overturned by the Supreme Court of the Netherlands. A number of very interesting things were said.

The Society claimed they had a duty and a right to warn the public about medical treatments that claim to be effective but are not supported by science. They believed there was no scientific evidence to back up Sickesz' claims. They claimed the treatments met with fierce criticism from academic circles and that the treatments could even be dangerous,

Five experts in the fields of neurology, internal medicine, lung diseases and psychiatry, when asked for their scientific opinion, said: ‘the answers not only show that there is not a jot of scientific backing in serious medical literature for the opinions of Sickesz, but also that experts cannot even imagine that OMM could have any efficacy for their professions.’ The Society & co also have concerns about the safety of the manipulations. They have placed Sickesz on the list not just because of her claims concerning neck and back complaints, but mainly because of her other claims.

The court looked at the case from the perspective of the European Convention on Human Rights. They had to balance Article 8 that gave Sickesz a right to personal privacy against Article 10 that gave the Society a right to free expression. The court had to decide between a “colliding of fundamental interests interests in determining what level of carefulness should be practiced in society towards one’s fellow man.”

The Supreme court found in favour of the Society against Quackery. The court decided that the definition of ‘quack’ must follow the Societies own definition if it is to protect its right to free expression. That an average reader might not have the same definition cannot be blamed on the Society. Furthermore, there was substantial important public interest in the publications of the Society and so the publication of the list with Sickesz name on it cannot be “unlawful or grievous towards her”.

No justice is done to this freedom when no attention is being paid to the content that the Society & co themselves have given to the term and the context in which the term is used. The [previous] court has also failed to take into account that the publication with the list of quacks comes from a society with a serious character and a serious aim and the circumstance that in the medical world a treatment is considered quackery when it is claimed that it can cure something while there is no scientific evidence to support this claim.

It was also noted that the publication did not say anything about Sickesz private life but only discussed aspects that were matters of public interest and should as a matter of principle be part of a public debate. As such, the court said that “there must be sufficient room for freedom of expression in situations like these”.

This freedom of expression was characterized by the European Convention of Human Rights as 'one of the essential foundations of a democratic society and one of the basic conditions for its progress and for each individual's self-fulfilment' and consequently: ‘must be narrowly interpreted and the necessity for any restrictions must be convincingly established.’

This court hearing only overturns a decision by a previous court that the Society should defend itself on the basis of the dictionary definition rather than their own definition. My understanding is that the full case is yet to be heard.

What does this mean for the current British Chiropractic Association vs. Simon Singh case in the UK? I present this here simply as a parallel and a reflection on how other countries might view such cases. Simon Singh is in quite a different situation at the moment.

The Dutch case has very much depended on the court allowing decisions to be appealed. Simon has of yet no such luxury and must defend his article on the definition of the word ‘bogus’ handed to him by Justice Eady – and that definition is that ‘bogus’ implies dishonesty. As Simon made his own meaning of the word bogus quite clear in his article as referring to chiropractic’s lack of evidence, he has to defend his position on a basis that quite obviously he himself does not believe.

Simon also has currently no platform to defend his case on European Human Rights grounds. But it is worth noting that the laws considered by Dutch judges are also applicable in the UK. Whether, a similar conclusion can be come to in this British case I will leave to better qualified commentators although my amateurish perspective would suggest that Simon would have very similar grounds to appeal.

Simon Singh must decide this week how best to move forward either with an oral appeal or some other route. This decision will undoubtedly rest not just on the apparent injustice being done but also on the financial and emotional drain placed on Simon (Defending English libel law may cost a hundred times more than most European proceedings, plus Simon has to defend his article on his own.)

My own commentary would be this:

Science is so successful because of one central feature: its self correcting nature. Ideas in science get better over time. Ideas that do not match reality are discarded and those that do survive testing are refined and become more useful. The Dutch sceptics are in the fortunate situation they find themselves because the legal decisions so far have been subjected to several bouts of scrutiny and refinement. Everyone in the Netherlands should have confidence that those decisions have got better with each legal iteration.

Simon Singh has not been so fortunate. He has been refused permission to subject the current ‘bogus’ ruling to any scrutiny under an appeals process. He is currently subjected to the tyranny of the man on the Clapham omnibus where the meanings of the words he has written has been decided by one man who appears to believes he can have definitive and infallible insight into the mind of the ‘common man’. There is currently no mechanism to question that ruling and so Simon is being forced to defend his words in the terms of a definition that is quite arbitrary, at the extreme of possible interpretations and in contradiction with Simon’s own stated definition.

And even if Justice Eady’s is right (and many doubt it is), then what the Dutch decision shows us is that by forcing Simon to accept an opinion about quackery that Simon would himself believe to be ill informed and ignorant of the true nature of alternative medicine then he is being denied a legitimate right to free expression about an issue of important public health. The ordinary man on the Clapham omnibus may indeed view quackery as simple fraud, but it is vital for public health for people to appreciate that it may be a little more complicated than that. And laws that force Simon to accept this situation are fundamentally unjust and oppressive according to rights that are now enshrined in European law.

The more I look at how English libel law operates the more convinced I am that such laws are an anachronism. Born in an age where a gentleman needed his honour protected against the tittle-tattle of the popular press, they now serve as a source of oppression where the powerful, the wealthy, the corrupt and the vested interest can close down democratic discussion. We now live in an age where we are all publishers, not just the press. The law is out of step and if the BCA vs Singh case causes fresh thinking about how we mediate the various rights involved in free speech then a great good will have been done.

With thanks to Cees Renckens (pictured) of Vereniging tegen de Kwakzalverij and to Jo van Ringen for translating the court papers (my Dutch is limited to ordering a beer at the bar). I must add that the opinions and interpretations discussed are mine alone.

Labels: British Chiropractic Association, chiropractors, Simon Singh, the law

 

This is an open letter to all homeopaths in the UK.

It has been a bit of a surprise to me to learn that the Society of Homeopaths is wanting to lobby the Health Professions Council to include homeopathy within its regulation remit. As such, you will receive protected title (only registered homeopaths will be able to call themselves that) and be held against a code of standards and ethics.

Why do you want to do this? I can guess some of the reasons.

Homeopathy has always battled to be recognised – both as a science and as a healing profession. Deep within the homeopathic mindset is a belief that you hold a valuable principle of healing, if not the fundamental theory of healing. Over two centuries you have battled to gain acceptance and validation against what you see as a hostile (even conspiratorial) medical profession. You call the medical profession allopaths and define yourselves in opposition to your own picture of them.

Undoubtedly, you see that statutory regulation will put yourself at least on a par with doctors. You will no longer legally be invisible in the healing professions. But there are other more economic reasons too. Being statutorily registered will make it easier to gain referrals from the huge source of cash that is the NHS. It will also make it easier to get payments from private health insurers. You won’t have to pay VAT, although I doubt many of you make enough to have to worry about that. Universities have recently said that they will not teach BSc courses to train homeopathic practitioners unless they achieve statutory regulation.

So, the prize appears to be huge. Recognition, financial gain and the secured future of your profession through accredited education. The Society of Homeopaths can free itself of the tedious burden of having to pretend to regulate you and instead become something like the BCA and concentrate more on trying to sue its critics.

But what of the cost? Such rewards will come at a price – and I am amazed that the Society of Homeopaths believes you will wish to pay that price.

First, before we look at what this might all mean for homeopathy, I would suggest that the path to Statutory regulation will not be easy. I am sure you are aware that there are many people who think such a step would be absurd, myself included. Homeopathy has failed in two hundred years to make any progression in showing that it is nothing other than a inert treatment based on pre-scientific and magical thinking. The basic science to show that your principles are true is not there. My own simple challenge to homeopaths to demonstrate their fundamental propositions has not been taken up in 85 weeks. More damningly, in the two hundred years since homeopathy was invented, our scientific understanding of medicine, chemistry and physics has moved on enormously and it clearly shows that homeopathy is not just implausible but is utterly contradicted by everything we know about the world. Homeopathy lies outside of reason and science. It is a pseudo-medicine and is just a placebo therapy. It is just not tenable to hold any other position.

To gain statutory regulation, you will have to demonstrate that it is indeed possible to have meaningful standards in education and training for a pseudoscientific subject. That is not impossible – the current government has on the whole failed to see the problem with regulating absurd treatments. It is funding Ofquack, the Prince Charles backed Complementary and Natural Healthcare Council, as a voluntary regulator for a rag bag of quack practitioners. The government does not appear to see that upholding such people to high degrees of training and competence is problematic when such people believe in absurdities. I would suggest though that the HPC may well be tougher judges than Prince Charles.

So, onto the costs. In order to appreciate what such regulation might mean for homeopaths it is worth looking at what it has done for other statutorily regulated alternative medicines. Chiropractic would be a good example.

The regulation of chiropractic was not without its controversy. The Society of Homeopaths claim that 65% of its members support the route to such regulation. The Society of Homeopaths only represents 65% of homeopaths, so we can only be sure that 42% of homeopaths support such a route. Even then, this survey was taken in 2006 and a lot has changed since then. I would be very surprised if this support has grown. Are the majority of you in favour of this move? Chiropractors were also split when the Chiropractic Act was brought in. Many saw it as an attempt to control their practice and restrict what they could do. Chiropractic philosophy appears to embrace a libertarian stance and many resented passing control of their work to people who may not share their beliefs and views. Some were worried that the move had conspiratorial overtones of the medical community trying to suppress an alternative to them. There were quite a few who refused to be registered and had to cease calling themselves chiropractors and instead called themselves simply spinal manipulators or even the grand sounding osteomyologists.

Over a decade later, the political infighting still continues. Many resent that the McTimoney Chiropractors were let into the exclusive regulated club. McTimoney is seen as a chiropractic heresy where bones are not cracked so violently and training takes place through part-time courses. It is not seen as being real chiropractic and the practitioners as being undertrained – through cheaper courses. It represents a threat to the chiropractors who will have invested well over £40,000 in fees for their training at one of the other two ‘real’ chiropractic colleges.

The General Chiropractic Council, the regulatory body, appears to be popularly despised by the ordinary chiropractor. It is seen as heavy handed in its regulation, costly and not in tune with chiropractors’ needs (to be left alone). It has no duty to promote chiropractic but only to protect the public and enforce its code of conduct. It is also increasingly dominated by lay representatives – chiropractors are getting a smaller voice in its running. Much of this resentment has been well documented on the chiropractic blog chiropracticlive.com.

When the British Chiropractic Association decided to sue Simon Singh for criticising the lack of evidence base for the treatments it was promoting, I doubt they understood the difficulty they would be putting their members in because of the very fact that they were statutory regulated. The ensuing debate has exposed the non existent foundations of much of chiropractic care and this has led to an unprecedented number of complaints being made to the GCC about chiropractors misleading the public on their websites for the effectiveness of the treatments they offered. There are now perhaps 20-30% of the entire chiropractic profession undergoing statutory complaints procedures which could result in the loss of their registration and their ability to practice.

The mistake the government and chiropractors made in accepting statutory regulation was allowing it to go ahead before chiropractors could demonstrate that they were not simply a vestigial remnant of Victorian back cracking quackery. Now, chiropractors find themselves being held to the highest forms of professionalism and practice without an evidence base for pretty much anything they do. It is now possible that chiropractic in the UK will not survive the current onslaught of professional complaints and trading standards investigations being pursued against them. What will come out the other side is pretty much anyone's guess, but I am pretty sure it is not a situation that the majority of chiropractors would have wished for in their quest for recognition.

And this is what I find extraordinary about the attempt by homeopaths to join the HPC. At present, the nightmare that is happening to chiropractors cannot happen to homeopaths. Despite what you say, you have had the freedom of living without any form of genuine regulation. The Society of Homeopaths has never ruled against a homeopath for the way they practice when when faced with clear breaches of the code of ethics. Homeopaths have been free to indulge in whatever delusions they fancy without fear of sanction. You have claimed to treat malaria and AIDS and have done so without a single voice of censure from within the lay homeopathic trade. You have no idea what it is like to be regulated and to be subject to a real code of ethics and practice. I suggest you pop along to your nearest chiropractor to find out what it is like.

And I must say that chiropractors have it fairly easy. Their treatments (at least for lower back pain) have an air of plausibility and some evidence for effectiveness. Homeopaths lack these luxuries of plausibility and reliable evidence for anything. What makes your situation worse is that your belief set is acutely in conflict with those who will become your statutory medical colleagues. You regularly undermine public healthcare messages about childhood inoculation and believe your sugar pills are an alternative. You show no sense of boundaries for what you can reasonably hope to achieve and make claims to be a superior treatment for everything from asthma and swine flu to autism and cancer. Do you really believe you could continue with your alternative beliefs in a statutory world? And they are alternative. Whilst you denounce the side effects of real medicine as being avoidable by homeopathy you pitch yourself against the medical world. And I doubt that a regulated profession could last long with such rhetoric.

Homeopaths. You have never had it so good. And you do not realise it. You are pretty much free from any constraint on what you say and do. You may moan about the continuous criticism you get from people like me – but that is the worst you have to suffer at the moment – criticism. If by some fluke you do manage to achieve full regulation, expect your cosy world to come crashing down very fast. Your quest for regulatory recognition will be hubris. It took over fifteen years for the chiropractors to realise they had been practising on borrowed time. Your regulatory nemesis will come much quicker.

Labels: British Chiropractic Association, chiropractors, CNHC, Complementary and Natural Healthcare Council, homeopathy, regulation, Society of Homeopaths, SoH, the law

 

 

“The law has no place in scientific disputes”

Simon Singh is to appeal the absurd and astonishingly illiberal ruling made by Sir David Eady in the libel case brought about by the British Chiropractic Association. This is a brave decision by Simon, but an important one as there are issues at stake that go well beyond one case.

Today, the charity Sense about Science is launching a campaign to highlight the issues raised by the Simon Singh libel case. I am very please to support this campaign and be one of the first signatories to the following statement:

We the undersigned believe that it is inappropriate to use the English libel laws to silence critical discussion of medical practice and scientific evidence.

The British Chiropractic Association has sued Simon Singh for libel. The scientific community would have preferred that it had defended its position about chiropractic for various children's ailments through an open discussion of the peer reviewed medical literature or through debate in the mainstream media.

Singh holds that chiropractic treatments for asthma, ear infections and other infant conditions are not evidence-based. Where medical claims to cure or treat do not appear to be supported by evidence, we should be able to criticise assertions robustly and the public should have access to these views.

English libel law, though, can serve to punish this kind of scrutiny and can severely curtail the right to free speech on a matter of public interest. It is already widely recognised that the law is weighted heavily against writers: among other things, the costs are so high that few defendants can afford to make their case. The ease and success of bringing cases under the English law, including against overseas writers, has led to London being viewed as the “libel capital” of the world.

Freedom to criticise and question in strong terms and without malice is the cornerstone of scientific argument and debate, whether in peer-reviewed journals, on websites or in newspapers, which have a right of reply for complainants. However, the libel laws and cases such as BCA v Singh have a chilling effect, which deters scientists, journalists and science writers from engaging in important disputes about the evidential base supporting products and practices. The libel laws discourage argument and debate and merely encourage the use of the courts to silence critics.

The English law of libel has no place in scientific disputes about evidence; the BCA should discuss the evidence. Moreover, the BCA v Singh case shows a wider problem: we urgently need a full review of the way that English libel law affects discussions about scientific and medical evidence.

Please visit the campaign web site at http://www.senseaboutscience.org.uk/freedebate and give your own support. As you can see, there are one or two names on the list who are even more eminent and famous than me. Every one from the Poet Laureate to Harry Hill has signed. (I believe that Harry has suggested there is only one way to settle this – FIGHT!)

Sign the Support Statement.

Also, download the campaign button and add it to your website.

The Quackometer wishes Simon Singh all the best in his appeal. He may still yet lose. The legal shenanigans involved are tough. What is quite clear though, in that appealing, the absurdity of the chiropractic position will be made public, and the injustice of the law brought to the full attention of the media. The BCA could still do the best thing and back down. At the very least they could publish the scientific evidence that they believe they have to support their position. Their silence on the matter of evidence is damning.

Good luck and here’s to greater public awareness of chiropractic absurdity and even a change in the law.

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What some people have said about this:

Stephen Fry, Broadcaster and Author:

“It may seem like a small thing to some when claims are made without evidence, but there are those of us who take this kind of thing very seriously because we believe that repeatable evidence-based science is the very foundation of our civilisation. Freedom in politics, in thought and in speech followed the rise of empirical science which refused to take anything on trust, on faith, on hope or even on reason. The simplicity and purity of evidence is all that stands between us and the wildest kinds of tyranny, superstition and fraudulent nonsense. When a powerful organisation tries to silence a man of Simon Singh's reputation then anyone who believes in science, fairness and the truth should rise in indignation. All we ask for is proof. Reasoned proof according to the established protocols of medicine and science everywhere. It is not science that is arrogant: science can be defined as ‘humility before the facts’ — it is those who refuse to submit to testing and make unsubstantiated claims that are arrogant. Arrogant and unjust.”

Professor Richard Dawkins, FRS, University of Oxford:

“This splendid manifesto hits so many bullseyes, I feel like adding my signature to every line of it. The English libel laws are ridiculed as an international charter for litigious mountebanks, and the effects are especially pernicious where science is concerned.”

Jonathan Heawood, Director, English PEN:

“You know there's something badly wrong with the libel law when a serious scientific writer is dragged through the courts for something he didn't even mean to say! Simon Singh's only mistake was not to distinguish clearly enough between ineffective and fraudulent treatments - both of which might equally be termed 'bogus'. The real culprit here is the rich English language and the arcane law of libel.”

Professor Richard Wiseman, Professor of the Public Understanding of Psychology, University of Hertfordshire, and author:

“England's strict libel laws can deter individuals from speaking out against bad science, even when they have strong evidence for their argument.  Simon's campaign deserves the support of everyone who cares about fighting pseudoscience.”

Diana Garnham, Chief Executive, The Science Council:

“Delivery of professional health care should be based on science, not libel laws.  It goes without saying that all professional health care scientists must be expected to base their professional practice on scientific methodology, encompassing both a rigorous evidence base and open peer review.”

 

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An Impressive List of Signatories:

 

Science

Professor Jim Al-Khalili OBE Professor of Physics and of Public Engagement in Science, University of Surrey

Dr Sabine Bahn Cambridge Centre for Neuropsychiatric Research, University of Cambridge

Harriet Ball Voice of Young Science network

Professor Michael Baum MB FRCS ChM MD FRCR Emeritus Professor of Surgery and Visiting Professor of Medical Humanities, University College London

Professor Jocelyn Bell Burnell FRS University of Oxford and President, The Institute of Physics

Willem Betz Emeritus Professor, Vrije Universiteit Brussel and Chair, SKEPP

Susan Blackmore Visiting Professor, School of Psychology, University of Plymouth

Professor Colin Blakemore FRS University of Oxford

Sir Tom Blundell FRS University of Cambridge and President, The Biochemical Society

Jean Bricmont Professor of Theoretical Physics, University of Louvain and Honorary President, Association Francaise pour l'Information Scientifique

Tracey Brown Managing Director, Sense About Science

Professor David Colquhoun FRS University College London

Professor David Cope

Professor Brian Cox University of Manchester

Dr Tim Crayford MB BS MSc FFPH FRSA Former President, Association of Directors of Public Health

Professor Richard Dawkins FRS University of Oxford

Professor Edzard Ernst MD PhD FRCP FRCP (Edin) Peninsula Medical School, Exeter University

Professor Elizabeth Fisher FMedSci Institute of Neurology, University College London

Dr Ron Fraser Chief Executive, The Society for General Microbiology

Carlos Frenk Ogden Professor of Fundamental Physics, Durham University

Diana Garnham Chief Executive, The Science Council

John Garrow MD PhD FRCP FRCP (Edin) Emeritus Professor of Clinical Nutrition, University of London and Former Chairman, HealthWatch

Professor David Gordon President, Association of Medical Schools in Europe

Professor Hugh Griffiths FREng University College London and Chairman and on behalf of The Campaign for Science and Engineering in the UK

Dr John Haigh Former Reader in Mathematics, University of Sussex

Professor Martin Humphries University of Manchester and Chair, The Biochemical Society

Sir Tim Hunt FRS Cancer Research UK

Roland Jackson Chief Executive, The British Science Association

Professor Steve Jones University College London

Dr Stephen Keevil King’s College London

Professor Sir David King FRS Former Chief Scientific Adviser to the UK Government and Director, Smith School of Enterprise and the Environment, University of Oxford

Dr Chris Kirk Chief Executive, The Biochemical Society

Professor Sir Peter Lachmann FRS FMedSci University of Cambridge and Founder President, Academy of Medical Sciences

Jennifer Lardge Voice of Young Science network

Armand Leroi Professor of Evolutionary Developmental Biology, Imperial College London

Dr Robin Lovell-Badge FRS FMedSci MRC National Institute for Medical Research

Daniella Muallem Voice of Young Science network

Professor Dame Bridget Ogilvie FRS FMedSci Former Director, Wellcome Trust

Professor Clive Orchard University of Bristol and President, The Physiological Society

Professor Ole H Petersen CBE University of Liverpool

Lord Rees Professor of Cosmology and Astrophysics, University of Cambridge

Les Rose Clinical Science Consultant

Dame Nancy Rothwell FRS MRC Research Professor and President, Biosciences Federation

Alan Sokal Professor of Physics, New York University and Professor of Mathematics, University College London

Professor Beda Stadler University of Bern, Switzerland

Dr John Stevens DMS President and on behalf of The Institute of Biomedical Science

Professor Ian Stewart FRS Mathematician and Science Writer

Professor Raymond Tallis FMedSci Emeritus Professor of Geriatric Medicine, University of Manchester

Lord Taverne Chair, Sense About Science

Hazel Thornton Independent Advocate for Quality in Research and Healthcare

Sir Mark Walport Director, The Wellcome Trust

Professor Robin A Weiss FRS University College London and President, The Society for General Microbiology

Tom Wells Voice of Young Science network

Robin Wilson Professor of Pure Mathematics, Open University

Richard Wiseman Professor of the Public Understanding of Psychology, University of Hertfordshire and Author

Journalism and Publishing

David Aaronovitch Columnist, The Times and Author

Yasmin Alibhai-Brown Journalist and Columnist

Wendy Barnaby Editor, People and Society

Rosie Boycott Former Editor, The Independent and Independent on Sunday

Geoffrey Carr Science Editor, The Economist

Duncan Campbell Journalist

Dr Philip Campbell Editor-in-Chief, Nature

Sir Iain Chalmers Editor, The James Lind Library

Nick Cohen Columnist, The Observer

Clive Cookson Science Editor, Financial Times

Nick Davies Journalist and Author of Flat Earth News

Kendrick Frazier Editor, Skeptical Inquirer

Professor Christopher C French Head, The Anomalistic Psychology Research Unit, Goldsmiths University and Editor, The Skeptic Magazine

James Gleick Science Writer and Journalist

Dr Ben Goldacre Writer, Broadcaster and Medical Doctor

Nigel Hawkes Director, Straight Statistics and Former Health Editor, The Times

Mark Henderson Science Editor, The Times

Roger Highfield Editor, New Scientist

Dr Richard Horton FRS FMedSci Editor, The Lancet

Alok Jha Science and Environment Correspondent, The Guardian

Rohit Jaggi Columnist, Financial Times

Barry Karr Skeptical Inquirer and Committee for Skeptical Inquiry

Dr Karl Kruszelnicki Author, Broadcaster and Scientist

Sam Lister Health Editor, The Times

Brenda Maddox Journalist and Biographer

Dr Margaret McCartney Columnist, Financial Times and GP

Robin McKie Science Correspondent, The Observer

George Monbiot Journalist

Andrew Mueller Journalist and Author

Steven Novella Editor, Science-Based Medicine; Director of General Neurology, Yale University School of Medicine and Author

Vivienne Parry Science Writer and Broadcaster

John Rennie Former Editor-in-Chief, Scientific American

Nick Ross Journalist and Broadcaster

Ian Sample Science Correspondent, The Guardian

Ariane Sherine Comedy, Writer and Journalist

Michael Shermer Publisher, Skeptic Magazine; Columnist Scientific American and Author of Why People Believe Weird Things

Rebecca Smith Medical Editor, The Daily Telegraph

Bill Thompson Technology Journalist

Arts, Humanities and Entertainment

Martin Amis Novelist

Joan Bakewell Broadcaster and Journalist

Antony Beevor Historian

Jo Brand Performer

Derren Brown Psychological Illusionist

Alain de Botton Author

Carol Ann Duffy Poet Laureate

Peter Florence Director of The Guardian Hay Festival

Stephen Fry Broadcaster and Author

Ricky Gervais Writer and Performer

Anthony Grayling Professor of Philosophy, Birkbeck College University of London

Dave Gorman Writer and Performer

Harry Hill Performer

Robin Ince Performer

Tim Minchin Performer

Dara O'Briain Performer

Penn Jillette Illusionist, Juggler and Libertarian

Libby Purves Broadcaster, Journalist and Author

David Starkey Historian

Teller Illusionist, Juggler and Libertarian

Sandi Toksvig Broadcaster, Comedian and Author

Dr Richard Vranch Performer and Ex-physicist

Skeptics and Campaign Groups

Australian Council Against Health Fraud

Australian Skeptics Inc

Peter Bowditch Editor, www.ratbags.com

Neil Denny Little Atoms podcast

Rachael Dunlop Reporter, Skeptic Zone podcast

Jonathan Heawood Director, English PEN

Narisetti Innaiah Chairman, Center for Inquiry, India

Andy Lewis Blogger, quackometer.net

Ronald A Lindsay President and CEO, Center for Inquiry, USA

Simon Perry Founder, Skeptics in the Pub (Leicester)

Dr Philip Plait President, James Randi Educational Foundation, USA

James Randi CEO, James Randi Educational Foundation, USA

Padraig Reidy Index on Censorship

Sid Rodrigues Chairman, Skeptics in the Pub (London)

Amardeo Sarma Chairman, German Skeptics (GWUP)

Eran Segev President, Australian Skeptics Inc

Law

David Allen Green Solicitor

Jonathan Morgan Fellow in Law, University of Cambridge

Baroness Helena Kennedy QC Barrister and Labour Member of the House of Lords

Labels: chiropractors, Simon Singh, the law

 

 

The University of Oxford recent completed a report into the comparative costs of defamation proceedings across Europe. Its conclusions were that the costs of libel proceedings in England and Wales are about 140 times higher on average than those found across Europe. The reasons for this boil down the large number of lawyers that get involved, the length of the proceedings, the adversarial nature of English law, and the take up of Conditional Fee Arrangements (CFAs), “no win no fee”.

The result of this is that the legal costs involved are likely to be hugely disproportionate to any potential damage done. Defending a case of libel, even if the damages only amount to a few thousand pounds, could result in the losing party facing legal bills of six or seven figures.

The specifics of English libel law make the situation even worse. The entry costs to make a libel claim can be very low. Conditional Fee Arrangements allow a lawyer to take on a case where they will only receive payment if they win. And because of the risks involved their fees may well be double that if there were no CFA. There is also a double whammy in that the legal barriers to starting libel proceedings are very low. All the complainant has to do is show that they have some sort of reputation worth defending and that the accused party has made a statement that has defamed them. There is no requirement to show that this statement is untrue or not fair comment. Nor indeed is there indeed any requirement to show that you have suffered any loss.

The effect of this is that English libel law can be easily used to silence criticism. The complaining party essentially has to take no risk of costs and take on no burden to prove their case. The huge risks and burdens of proof are passed almost entirely to the defendant. So what should someone do when faced with a libel claim against you? A game theory approach might suggest that, since you can never be certain of success, no matter how well justified you might believe yourself to be, there can only be downsides by defending yourself and that you should seek to apologise and settle as soon as possible, regardless of the strength of your case. Defendants may well end up having to pay large amounts of money no matter if they win or lose.

This Oxford report talks about how such a situation has serious free speech issues in the British press. Newspapers are heavily dissuaded from defending libel claims, regardless of their merit. This undermines the role of the press and results in self-censorship where articles criticising wealthy or powerful interests may be dropped or watered down. Our libel laws were essentially created to enable the powerful and the elite to preserve their reputations against the tittle-tattle of the press. As the press grew more powerful, CFAs were brought in to allow ordinary people to take on the press when they do not have access to large amounts of money.

In 1995 Lord Woolf, identified three problems with libel law,

a. litigation is so expensive that the majority of the public cannot afford it unless they receive financial assistance;
b. the costs incurred in the course of litigation are out of proportion to the issues involved; and
c. the costs are uncertain in amount so that the parties have difficulty in predicting what their ultimate liability might be if the action is lost.

CFAs were brought into address point a. However, it would appear that they have also exacerbated the other problems. Whilst CFAs have allowed the less powerful to take on the more powerful, they have then, in the conclusion of the report, denied justice to the defending side.

The report suggests that CFAs and the libel law are not compatible with Article 6 – Access to Justice - and Article 10 – Freedom of Expression -  of the European Human Rights declaration. It states,

Based on those findings it is therefore reasonable to develop the following hypothesis: The CFA scheme increases access to justice for litigants bringing CFA-based defamation claims while eliminating financial incentives and thereby denying access to justice to media outlets, which leads to an interference with the right to freedom of expression. Such a hypothesis must be considered in terms of the ECHR’s Article 6 regarding the right to access justice and Article 10 regarding freedom of expression.

The huge and disproportionate costs of defending libel, the unpredictability of outcome and the burden of defence have all hit hard upon one of Britain’s best science writers. This week we have seen Simon Singh having been placed in a rather kafkaesque position where he is now unable to defend himself against a libel charge as he has been told he must prove something that he clearly does not believe to be true. Libel law hinges around the defamatory meanings of words and the judge in this case has decided that the word ‘bogus’ can only mean ‘fraudulent’. Due to the strict requirements of the pre-trial hearings, Simon will now not be able to defend what he wrote under any reasonable terms. Simon has made it quite clear, and the article made it clear too, what he meant by ‘bogus’. But he will not be able to put that case forward to the judge because of the humpty dumpty nature of the courtroom.

The British Chiropractic Association brought the charge of defamation against Simon Singh after an article appeared in the Guardian criticising the lack of evidence for many chiropractic practices and how the BCA continue to promote such treatments when the scientific evidence appears to be so low. Of course the BCA may well have some evidence that is not readily available, they may be unaware of the lack of evidence, but the judge has ruled that Simon meant they are being fraudulent in promoting these ‘bogus’ treatments.

Already the BCA have succeeded in that the discussion now going on is about the various meanings of the word ‘bogus’ and not about the effectiveness of chiropractic treatment. If Simon decides to appeal then we could see many more months of wondering what ‘bogus’ means to the man on the street. Costs will escalate rapidly.

With such a blatantly unjust set of laws, those who seek to bring defamation cases against individuals must surely already be on the losing side of morality.  The costs for the defendant can only be crippling for the average person. And libel is about reputation, and the clearing of reputations if they have been defamed. Libel laws should not be about exacting revenge, huge cash awards and legal fees, and the silencing of criticism – and that is exactly what they are in the UK. Of course there is a need for defamation laws. But when there are straightforward alternatives to the lumbering and unpredictable giant of the courtroom, then these should be taken. Clarifications, debate, discussions of evidence are still available to the BCA.

And let us remember what this libel claim is about. It is not about claims that some MP or businessman had their fingers in the till. Nor is it about a footballer allegedly seen coming out of a nightclub with someone other than their WAG. This is about a award winning science writer penning a comment piece in a respectable paper about a matter of public health. It is questioning the amount of evidence for an alternative and doubtful practice and highlighting the unspoken dangers of such treatments on children. It is exactly the sort of article that our papers ought to printing and is undoubtedly an important matter of public interest. The central point of the article is that chiropractors promote their trade for children’s ailments, such as asthma, when there is no plausibility that their techniques work, poor evidence that they do, and all with significant risks of harm. That is a charge that a responsible profession would answer.

Simon Singh may well have made an unfortunate choice of words or may well have been unlucky with the trial judge. The article he wrote could have easily been slightly edited to get around the current problems and the substantive criticism he made of the chiropractic trade could have remained. And this highlights how unjust this whole process may be. If the BCA want to clarify that they are not fraudulently promoting treatments and that they believe they work (for whatever reason) then they could have written a letter to the paper. Even better, they could have presented scientific evidence of their efficacy – if it exists. But by pursuing Simon Singh, they are using unjust laws to potentially financially cripple a critic.

Simon will be deciding over the coming days if he wishes to appeal. The logic of current English libel law would suggest he should not. But I know that Simon is a principled man and that the principles involved here are well worth fighting for. The libel law is a serious threat to free speech and it is a serious deterrent to engage in debate where vested interests may wish you to remain quiet. My guess is that in the end this will have to be decided by Europe. The UK government appears to be slow to act. One reason may well be that the main victims of this injustice appear to be the press and correcting this may well not be in the best interests of politicians. One only has to look at the news today to see how the press and MPs are not the cuddliest of friends. Also, so many MPs come from a legal background, and lawyers are the major winner in this mess.  However, it is an injustice that effects us all and it may well take a lone and principled campaigner to do something about it. Perhaps Dr Simon Singh is that man.

Labels: British Chiropractic Association, chiropractors, Simon Singh, the law

 

Barbara Nash is a nutritionist based near Oxford. Dawn Page was overweight and sought the advice of Nash. It is alleged she was put on a 'detox diet' which included drinking lots of water and consuming no salt. If true, the result was very predictable.

Mrs Page suffered 'uncontrolled vomiting and a fit' and was rushed to intensive care. The Oxford Mail now reports she has brain damage. Her husband sued Dawn Nash and her insurers have paid out £810,000 in a settlement for compensation.

It is worth noting that Nash's barrister said she was a.

"privately trained nutritionist", and emphasised she continued to deny she was in any way to blame for what happened.

Barbara Nash appears not just to offer detox diets but also sells on her web site kitchen smoothie makers, blenders and juicers that cost more than a thousand pounds.

Anyone can call themselves a nutritionist. Only Dietitians are guaranteed by their training and professional memberships to be fully competent in what they do. Sadly, the proliferation of under trained and badly trained nutritionists is growing unchecked. Universities are in on the act taking money from students to train them as 'nutritional therapists'. Such degrees, from the likes of the University of Westminster School of Magic, are a disgrace. Privately owned colleges appear to offer legitimate diplomas, but their standard of training is unchecked.

But the TV and the Sunday supplements are full of the stupid and dangerous advice about detox and vitamin pills and superfoods and allergy tests. It is quack nutritionists, rather than medical dietitians, who own the media and the attention of the public. It is a handy commercial partnership of supermarkets, quacks, health shops and pharmacies selling pills and tonics and books and over prepared foods.

And the government is not helping. Their new Prince Charles sponsored body Ofquack intends to regulate nutritional therapists. It will give them a veneer of professionalism without protecting the public one little bit. Ofquack refuses to regulate the practice of their members (what they believe and do) and only certify that they have been trained by other quacks and carry insurance.

Personally, I think the British Dietetic Association cannot escape some blame here for the growing rise of nutriquacks. This is the proper organisation that regulates real dietitians. They should be as mad as hell that their turf has been invaded by anti-science know-nothings. I am sure their members have to deal with the catastrophic results of patients who have been misinformed by nutritionists everyday. Where is the noise they ought to be making? Why are they not telling the public and government that something is terribly wrong here with they way we view food and the self-appointed gurus who profit from our confusion?

Until this is sorted out, I expect we will be seeing an ever increasing number of stories just like this.

Labels: barbara nash, detox, Natural Healthcare Council, nutritionist, ofquack, the law

 

If you are worried about the activities of an alternative medicine practitioner, there is not an easy way to find the right authority who might look into it. The Advertising Standards Authority are very effective at investigating complex matters, but can only really rap knuckles and leave traders to carry on pretty much unharmed. Often, the only damage is an ASA ruling placed well down in the Google result list. The ASA can only also look into a narrow range of promotional material; they cannot touch web sites, for instance. Trading Standards have deeper powers and can criminally prosecute, but are not too well geared up to look into false medical claims. They are regional in their authority and have a shed load of complicated legislation to work within. The MHRA are probably quite rightly mostly concerned with the evils of Big Pharma. And the regulatory authorities that provide standards of behaviour and codes of ethics to alternative medicine practitioners are a hollow sham: can you find one example where a self-regulatory body has disciplined one of its members and documented the result?

But, the world of quackery is about to be shaken and I am being nice to them by giving them the 'heads up'. The infighting about how best to regulate homeopaths may well become moot as legislation being brought in will allow direct consumer redress against many practices that mislead.


The complexity of trading standards legislation is being largely swept away and replaced with generalised laws to clamp down on unfair sales and marketing practices. The act is a incorporation of an EU directive into English law and so will be applicable throughout the EU area.


The regulations will cover a whole raft of,

Misleading practices, like false or deceptive messages, or leaving out important information.

Now, a lot of alternative medicine is full of that. Have a look at David Colquhoun's blog about Boots and their new wonder drug, CoQ10. Within the act, there will be specific restrictions on certain practices. The ones I am going to be interested in are:

Falsely claiming accreditation
1. Faking credentials
Claiming to be a signatory to a code of conduct when the trader is not.
2. You’re not who you say you are.
Displaying a trust mark, quality mark or equivalent without having obtained the necessary authorisation.
3. Your endorsement is not real
Claiming that a code of conduct has an endorsement from a public or other body which it does not have.
4. Not being true to the terms of the endorsement
Claiming that a trader (including his commercial practices) or a product has been approved, endorsed or authorised by a public or private body when he/it has not or making such a claim without complying with the terms of the approval, endorsement or authorisation.

Specifically, if a alt med trader claims to be governed by a code of conduct and their behaviour does not comply, then they will be guilty. To me it looks like it is immaterial as to whether the governing body actually adjudictates on the traders compliance. That should be interesting, given the widespread practice of alternative medicine governing bodies not enforcing their codes of practice. It does look like it will be illegal for the providers of codes of practice to do so if it misleads the consumer.


Specifically, it will be an offense if,

• the trader has undertaken to be bound by a code of conduct (or code of practice), and indicates that he is bound by it,
  AND
  • the trader fails to comply with a firm and verifiable commitment in that code,

Next:

10. Scare tactics

Making a materially inaccurate claim concerning the nature and extent of the risk to the personal security of the consumer or his family if the consumer does not purchase the product.
That is a stock trick of the trade. What would Clarins make of this? Should homeopaths be telling their patients about the evils of medical science anymore? What about anti-vax advice from homeopaths?

20. Pyramid schemes
Establishing, operating or promoting a pyramid promotional scheme where a consumer gives consideration for the opportunity to receive compensation that is derived primarily from the introduction of other consumers into the scheme rather than from the sale or consumption of products.

There goes Reiki, where practitioners typically only make money by 'tuning' new recruits.


But most interestingly,

11. Over promise, under deliver
Falsely claiming that a product is able to cure illnesses, dysfunction or malformations.

Now, what is going to be interesting is to what extent words like 'cure' are interpreted. The good news is there is going to be a 'man on the Clapham omnibus' principle here. What are the 'reasonable expectations of the average consumer' when they engage with a trader. It does not matter is a weaselly homeopath uses words like 'treat' - if it is reasonable that the customer expects to get better after the specific treatment then the homeopath could well find themselves on the wrong end of a guilty verdict.


The courts are going to demand that traders are going to be able to substantiate their claims. And we have a good idea of what they will make of anecdotal and testimonial based evidence.

It also looks like that there will be no need to establish there is an intention to deceive. The trader will be expected to undergo sufficient due diligence about their claims. It will not be sufficient just to wander around with your head in La La Land to escape the law.

Traders will also not be able to give false or misleading information is "the typical consumer takes, or is likely to take, a different decision as a result." Such information concerns things like:

(a ) the existence or nature of the product
(b) the main characteristics of the product
(n) specification of the product

Will homeopaths be able to get away with saying things like 'contains small amounts of natural remedies'? Probably not. I am sure the list is endless.

Also, the use of titles and credentials is likely to come under scrutiny. It will be an offense to mislead about the 'nature, attributes and rights of the trader or his agent' which include:

(c) qualifications
(d) status
(e) approval
(f) affiliations or connections
(g) ownership of industrial, commercial or intellectual property rights, and
(h) awards and distinctions.

Wow. That could be fun.

The new regulations will come in to force in a few months. As always with new legislation, we will need to see how the act is interpreted and how effectively it is enforced. But it does look like it might be much simpler to complain about certain practices and seek action.

So, if you are running a web site where you imply you are a doctor and you are not, and you claim to part of a regulated profession and you are not, and you offer healing practices that mislead, then you probably need to rethink your business. And you had better be nice to me.

Labels: regulation, the law

 

There are many laws in the UK that ought to make trading in quackery difficult. In practice though, the laws are often skirted around or side-stepped by careful wording of claims and marketing tactics. Those of us who prefer to pop off a complaint to Trading Standards rather than watch Eastenders find it quite a frustrating business.

One of the main problems in the UK is that there is no joined up approach to dealing with the type of fraud and issues posed by quackery. If a claim is made in print media then you can complain to the Advertising Standards Authority. But if it is on the web then you may have a little more difficulty. Trading Standards operate within local councils are are primarily set up to deal with dodgy builders and fly-by-night tour operators. The web crosses these boundaries and finding a trading address may be hard. If you are worried about multi-national operations then you really have problems. Respectable companies like Google or e-Bay flout anti-quackery laws in the UK with impunity.

Take Bionetics: a company run from Camberley in Surrey. The company sells a hair testing process and claims to be able to diagnose and treat the underlying causes of many illnesses from a few strands of hair. We have seen Patrick Holford, with his Food for the Brain 'charity', make similar claims, but Bionetics take it one stage further into deep quack land by claiming they are measuring the 'energies' in the hair follicles and can measure 'toxins', pathogens, food allergies, and nutritional needs. It is the same scam as Hair Mineral Analysis but 'new-aged' up a bit with talk of applied kiniesiology and that old black box of nonsense, radionics.

The American Medical Association condemn similar practices as just a fraudulent way of selling mineral supplements. And so we see Bionetics offering a load of food supplements to correct your imbalances with some magic herbal and homeopathy pills. Customers using the service get doubly fleeced: first, on the test fee (£48-£78); and then on the subsequent course of useless pills you are supposed to take. If you are unfortunate enough to be 'diagnosed' with a food intolerance or allergy then you may be advised to take unnecessary and potentially harmful dietary changes.

Last year, someone complained to the ASA about Bionetics and they were found to be making untruthful and unsubstantiated claims,

The ASA noted the positive customer testimonials and the training undertaken by the supervising practitioner. Nevertheless, we considered that, without robust clinical evidence to support them, the claims that Bionetics methods of hair testing could "establish whether or not your body has become intolerant to 123 of the most common problem foods and ingredients" and "report on ... accumulations of toxins, problem pathogens and nutritional deficiencies" were not justified. We concluded that testimonials alone were not sufficient to substantiate the efficacy of the testing methods and told Bionetics to consult the CAP Copy Advice team before advertising the test again.

Well, that told them. The action that had to be taken by Bionetics was that 'the ad should not be repeated in its current form.' Whilst this is obviously the right finding, the decision makes essentially no difference to what Bionetics can do with their business. They can still advertise in print, but just have to be little more careful with their wording in the future, and of course the ruling makes no difference to what they can claim online. In short, Bionetics are free to carry on trading with a untruthful and unsubstantiated business that sells gobbledygook and nonsense to the public.

If you want an idea of the nonsense that Bionetics are peddling then their 'science' page is a good start,

The birth of Newtonian physics heralded a change in conventional medical thinking. Newton’s laws related only to physical matter, and ignored the “energy” factor. Opinion of the day backed Newton’s theories and modern medicine as we know it was born.

Therapies that could not easily be explained by reference to Newton became portrayed as quackery.
...
First, is the now generally held view that the cause of many of today’s most common medical problems can not be explained by conventional Newtonian theories.

So, Newton had nothing to say about energy? That will be news to physicists. And medical therapies that do not use F=ma are quackery? Utter gobbledygook.

And, the best bit,

First fact – scientists have now proved that the basic component of the universe is energy, and not physical matter. Quantum physics has replaced the Newtonian belief that the smallest building blocks of all matter are physical objects - protons and neutrons, and proved that spinning energy vortices are actually at the source. Everything is based on energy.

Second fact - scientists have proved that collections of atoms (molecules) all radiate their own energy patterns or vibrations. Everything, living or not, including our bodies and everything in them, radiates a unique energy pattern.

Third fact - scientists have proved that the body constantly communicates both internally and with the outside world through the interaction of these energy patterns. Experiments have shown that protein receptors on the cell membrane pass signals to the nucleus (DNA) when stimulated by external energy signals.

I wonder who wrote all of that? Its only intention can be to bamboozle since it is just comic book physics, innacurate and unrelated to anything medical whatsoever.

Since trading in nutritional supplements, homeopathy and herbal remedies is legal, the problem with this site revolves around the claims made regarding their diagnostic techniques and their ability to tell you which of these 'remedies' you 'need'. (Answer: none). Most trading standards officers find this whole area totally alien to them. They are much more likely to be clued up on the ins and outs of extended warranty or the return of faulty goods. A ripped off pensioner with a badly tarmaced drive is an obvious injustice. Quackery is a more insidious form of harm and more difficult to pin down.

If someone was to pay me to police the quacks of the world (where are you Big Pharma and World Government when I need you?) I would set up a Minority Report style control room and I would wear a techno-glove to move quackometer screens around my transparent display wall. I would mash up my quackometer scan results with Google Earth and direct black helicopters full of elite troops into the homes of quacks, arrest them and force them to work as orderlies in the laundry rooms of large hospitals for the rest of their natural lives. Mwa ha ha ha.


In the meantime, we must rely on Consumer Direct.

.

Labels: quantum quackery, the law, vitamins