Archive for the ‘Pseudo-science’ Category
British pharmacy chain reprimanded for quack medicines
Leave a CommentAn Open Letter to Alliance Boots
by the Merseyside Skeptics Society †
The Boots brand is synonymous with health care in the United Kingdom. Your website speaks proudly about your role as a health care provider and your commitment to deliver exceptional patient care. For many people, you are their first resource for medical advice; and their chosen dispensary for prescription and non-prescription medicines. The British public trusts Boots.
However, in evidence given recently to the Commons Science and Technology Committee, you admitted that you do not believe homeopathy to be efficacious. Despite this, homeopathic products are offered for sale in Boots pharmacies – many of them bearing the trusted Boots brand.
Not only is this two-hundred-year-old pseudo-therapy implausible, it is scientifically absurd. The purported mechanisms of action fly in the face of our understanding of chemistry, physics, pharmacology and physiology. As you are aware, the best and most rigorous scientific research concludes that homeopathy offers no therapeutic effect beyond placebo, but you continue to sell these products regardless because “customers believe they work”. Is this the standard you set for yourselves?
The majority of people do not have the time or inclination to check whether the scientific literature supports the claims of efficacy made by products such as homeopathy. We trust brands such as Boots to check the facts for us, to provide sound medical advice that is in our interest and supply only those products with a demonstrable medical benefit.
We don’t expect to find products on the shelf at our local pharmacy which do not work.
Not only are these products ineffective, they can also be dangerous. Patients may delay seeking proper medical assistance because they believe homeopathy can treat their condition. Until recently, the Boots website even went so far as to tell patients that “after taking a homeopathic medicine your symptoms may become slightly worse,” and that this is “a sign that the body’s natural energies have started to counteract the illness”. Advice such as this directly encourages patients to wait before seeking real medical attention, even when their condition deteriorates.
We call upon Boots to withdraw all homeopathic products from your shelves. You should not be involved in the sale of ineffective products, because your customers trust you to do what is right for their health. Surely you agree that your commitment to excellent patient care is better served by supplying only those products whose claims can be substantiated by rigorous scientific research? Or do you really believe that Boots should be in the business of selling placebos to the sick and the injured?
The support lent by Boots to this quack therapy contributes directly to its acceptance as a valid medical treatment by the British public, acceptance it does not warrant and support it does not deserve. Please do the right thing, and remove this bogus therapy from your shelves.
Yours sincerely,
Merseyside Skeptics Society
If science knew everything…
When responding to someone’s extraordinary claims with a little bit of critical thinking and perhaps some contradictory science, a common retort is that “science doesn’t know everything”. I believe this stems from a terrible misconception of science and perhaps a mistrust of the scientific establishment. If science did know everything, there would be one very large book called “Science” with all of the answers to all of our questions. As a more concise person than I put it “if science knew everything, it would stop” 1. The reason we have scientists is that there are many many unanswered questions and even more cropping up all the time.
Quackery 2
Someone used this gambit against me the other day when I contradicted their belief in the efficacy of homeopathy by referring to the fact that properly conducted scientific trials have never been able to show that it works †. I had also pointed them to some useful resources where they could find the same lack of supporting evidence. But the tired old statement was dragged out once more, like some reluctant freak led out on a leash in a circus sideshow: “but science doesn’t know everything”.
Science has tested alternative medicines such as homeopathy, despite the fact there there are no apparent mechanisms by which they might possibly work, other than the placebo effect. The results: no therapeutic benefits compared with the placebos in test after test. The scientific method has failed to show that it works; it simply hasn’t been shown to heal people. This doesn’t mean that it cannot possibly work, just that we have no reliable evidence to support the claim that it does.
The fact that science does not prove that it cannot work is to some people a license to say, once again, that “science doesn’t know everything”, and to somehow use that as a justification for prescribing quack medicine to patients and telling them it will make them better. Perhaps these people think science should keep testing their “medicines” until it gives them the answer they want to hear. And for how long should they continue to test? A decade, a century, a millennium? Or should science pursue more reasonable avenues of research with medicines that do appear to work?
Science does not have all the answers and neither is it perfect. Advocates of complimentary and alternative medicine (CAM) often cite the fact that conventional medicine sometimes gets it wrong. I must agree. Despite rigorous testing, conventional medicines are rarely perfect, but we can at least have some faith in the system because it is self correcting. It continually tests and re-examines its drugs and therapies, sometimes reversing long established policies and procedures when mistakes or poor practice are revealed. You can not have the same faith in alternative medicines, which are all too often completely unregulated, especially those whose roots are a couple of hundred years old and whose fundamental principles have not changed in that time. With new evidence, science based medicine adapts, but when tests reveal no evidence for the efficacy of a drug or therapy, there is a point at which the most rational thing to do is to abandon them in favour of pursuing those that appear more worthwhile.
Just because scientific knowledge is incomplete and its medicines far from perfect, does not make it permissible for every form of quackery and nonsense to be put on an equal footing with science based medicine. When the alternatives are shown to work, they might then achieve equal status. Or to put it another way, alternative medicines will simply become known as medicines.
References and notes:
1) Homeopathy & Nutritionists vs Real Science!
2) Image by Maxey (Creative Commons attribution)
† Clinical trials should be double blinded, use control groups and involve a large enough data set to provide statistically significant results. The research should also be peer reviewed and the results reproducible before it has any credibility. Advocacy groups sponsoring such research often fail to conduct trials in the proper manner and will only publish a favourable result which supports their claims. Make sure they are using the scientific method correctly before drawing your own conclusions.
Homeopathy muscles in on the flu scare
There have been a series of thuds recently, the result of my head hitting the desk in despair each time I come across some piece of nonsense or stupidity in the newspaper, online or on the TV. In particular I am referring to health advice from practitioners and advocates of what they like to call alternative medicine.
I don’t make a habit of exposing myself to too much of this, because there are better ways to waste time and the headaches are rather unpleasant, but it really does bother me because such advice can be harmful (see Homeopathy couple jailed over daughter’s death) and these people are either deeply misguided or are exploiting the gullibility of people I care about, for their own gains.
Take this recent article by Susan Drury in the Vancouver Observer, for example, in which she recommends the use of homeopathy to ward off the flu, citing her own anecdotal evidence in a vague attempt to support her claims.
What homeopaths do is take a substance which provokes a similar response to the ailment in question, for example caffeine for insomnia, and then dilute it in water until nothing of it remains. The water is then administered directly or in sugar pill form.
Clinical trials, published in the best peer-reviewed journals in the world, have shown these drugs to be no more effective than the placebos they’ve been tested against. For such an ancient “medical system”, evidence showing the efficacy of homeopathy is long overdue.
Advocates cannot even come up with a good theory on how the treatments might possibly work. They sometimes talk about the memory of water and wave their hands in the air, drawing on words such as quantum and entanglement, but this only serves to baffle the enquirer and explains nothing.
At best the homeopath will take our money and leave us to consume harmless water; at worst, they might steer people away from the best and most thoroughly researched drugs and therapies available.
This morning I came across an advertisement from Access Natural Healing in a parenting magazine, offering homeopathic vaccines for “drug-free children”. They are very safe apparently, which is no doubt because they contain absolutely no active ingredients whatsoever, but in my mind this is only one interpretation of the word safe. Is it safe to “treat” children and their families with homeopathy at the expense of them not getting properly vaccinated against H1N1 or the seasonal flu? Whether or not it was there intention, their use of the term “drug-free children” certainly appears to advocate this approach, and therein lies the biggest danger of all.
Alternative cures can be attractive when confusion and contradictions abound, which is the case with H1N1 flu right now. And it takes no effort to state that a magic vial of water or a special brew of herbs and plant extracts can cure your ills. It is small wonder that there are so many “miracle cures” around, all trying to cash in on the uncertainty (see also this recent Globe and Mail article).
Beware of easy answers. Important decisions on how to tackle a potentially fatal illness should not be made lightly. Contagious diseases put you, your families and your communities at risk. Having said all that, if you really want an easy answer, try this: If an alternative medicine can be shown to work, it is just called medicine.
Recommended reading:
The end of homeopathy?
Homeopathy – Still Crazy After All These Years
Homeopathy Awareness Week
Interpreting the bogus
The legal battle between the British Chiropractic Association (BCA) and the science writer Simon Singh slogs on. The BCA brought the libel case against Singh for his article in the Guardian which referred to certain chiropractic treatments as bogus (see Science misjudged).
It looks like a David and Goliath fight between the freelance journalist seeking the truth and the menacing power of an entire organisation with a lot of self interests to protect. One wouldn’t have blamed Singh if he had bowed out of the fight as soon as his mighty opponent entered the ring; this legal farce has probably cost him dearly and it is still ongoing. But the crowd is definitely on his side, cheering him on at every hook and jab, many of whom have given their support in a petition to see the English libel laws changed. One high-profile advocate is Richard Dawkins, who recently spoke at the Liberal Party conference in England calling for reforms to the law.
The latest turn of events came on the 14th of October at the Royal Courts of Justice, where Lord Justice Laws rejected the interpretation of Singh’s article by Mr Justice Eady. Eady’s interpretation was that Singh had alleged the chiropractics were knowingly practising treatments for which they knew there was no proof of efficacy. The new interpretation is that the article was fair and in the public interest, which now grants Simon Singh the right to appeal the earlier ruling.
It’s not over yet, but there is reason to be optimistic, not only for the diminutive science writer as he stands in the shadow of a mightier adversary, but for all who see this as a fight that should be fought in open debate, with good evidence as the gentlemanly weapons of choice.
Further reading:
[Times Online] Simon Singh legal victory
Jack of Kent’s blog
[The Guardian] Science writer Simon Singh wins ruling in chiropractic libel battle
Mocking the pseudo-sciences
Here’s Dara Ó Briain using stand-up to tell it like it is. Not for pseudo-scientists and people who don’t need evidence to live their lives by.
Simon Singh interviewed
For those following the legal battle between the British Chiropractic Association and Simon Singh, you can hear more about it from Simon himself. In a recent interview on the Nature Podcast, he explains how this story goes beyond a personal legal case and that English libel laws are in need of reform. He argues that, as they stand, these laws present a serious threat to open scientific debate and free speech.
Chiro running for cover
The British Chiropractic Association (BCA) has opened up a whole can of worms and now chiropractors are struggling to contain the wriggly onslaught. By taking legal action against Simon Singh for what they call a libellous article in the Guardian newspaper, they have succeeded in attracting a very large and public spotlight onto themselves.
That was probably the last thing they wanted to happen. Their intention was most likely to silence an outspoken and respected scientist who doubted some of their claims, and thereby dissuade anybody else from having the audacity to do the same. Simon Singh and his supporters state that there is no scientific evidence for the efficacy of chiropractic spinal manipulation in treating certain disorders, such as colic and asthma. At great personal risk to himself, Simon is standing by this and will fight the case. As such, the BCA have succeeded in fanning the flames of criticism and invited even more bad publicity.
Chiropractors now have an unruly and hostile mob at their door, causing many to run for cover. The McTimoney Chiropractic Association (MCA) have called it a witch hunt, in a letter advising all their members to take urgent action and avoid the burn of the torch. On Saturday the Guardian newspaper published an article by Chris French, in which he discussed this letter and the so-called witch hunt. He reports how Witch-Hunter General Simon Perry took it upon himself to report UK chiropractors to their local trading standards offices, if they had claimed to be able to treat the specific disorders which Simon Singh referred to as bogus. In response to such pressure, MCA members are now being told to remove certain claims from their websites and other literature, so as not to risk prosecution in this campaign against them.
I came across this supposedly confidential letter from the MCA when it was first posted on the Quackometer website, but I had my doubts over its authenticity. It reads like someone whose home is on the battle lines, knowing it is just a matter of time before the place is razed to the ground and urging all inside to save themselves. If the letter is genuine, as it now appears, this is an indication that these people really are running scared.
A homeopathic wolf in sheep’s clothing
The US Food and Drug Administration, the FDA, apparently turns a blind eye when it comes to homeopathic remedies. Why? Perhaps for the simple reason that there is nothing to regulate. An active ingredient so diluted with water that not a single molecule of it is left, added to a sugar pill and then packaged up in a shiny box – where is the harm in that?
Aside from the cases where patients take homeopathic treatments, which show no efficacy whatsoever in scientific trials, while their conditions go untreated by actual medicine with proven therapeutic benefits, there is another reason to take these so called medications seriously: some homeopathic drugs do actually contain active ingredients.
Zicam is one such example and just yesterday the FDA published an advisory that people not use their range of nasal products. The manufacturer, Matrixx Initiatives Inc., have also recalled the products in question. The reason: you may be at risk of losing your sense of smell.
Mistakes are made and recalls happen, but this case highlights the inadequate regulation of products which claim to be medicinal. Unfortunately, the FDA does not expect homeopathic remedies to meet the same standards as prescription drugs and over-the-counter drugs.
In this case the product was labelled homeopathic and it might fairly be presumed to contain nothing at all. Not so. It contains a substantial amount of zinc, the only active ingredient, for which there is some scientific evidence to suggest it may be beneficial in treating the symptoms of the common cold. How they get away with classing this as homeopathic I do not know, because the pseudo-scientific thinking behind homeopathy is that something that can cause the ailment, such as caffeine for a sleep disorder, be diluted until it disappears altogether and the remaining water constitutes the cure.
In light of many complaints about Zicam nasal products, it came to the attention of the FDA that they did not qualify to be waived on through as homeopathic treatments usually are, but are actually misbranded drugs which require FDA approval before they can be released to market. The jury is still out regarding their safety, but at the very least I hope this case steers the unblinking eye of scrutiny to focus clearly on the whole homeopathic industry.
Be aware, be very aware… of homeopathy
Sugar pills†
If you haven’t given it much thought recently, well this is the week when perhaps you should, because it is homeopathic awareness week, brought to you by your caring friends at the British Homeopathic Association.
To learn about homeopathy, its origins and the fact that there is no scientific basis to justify its claims, I will direct you to Dr. Steven Novella’s excellent post on the subject, over at the Skeptic Blog.
Armed with this wealth of information, go out and make others aware of the truth behind homeopathy. Perhaps you can educate a friend who loves their child dearly and yet treats their ills with these otherwise empty sugar pills, or an ageing relative on a tight budget, who occasionally tries these so called remedies when nothing else seems to work. Lets make it a homeopathic education week.
