The random thoughts of a sceptical activist

The end of an era

Professor Edzard Ernst recently announced his retirement as Director of the Complementary Medicine Research Group. What does this mean for him and for the future of critical research into the evidence for alternative therapies?

I interviewed Prof Ernst to find out.


Professor Edzard Ernst is critical of many sorts of complementary therapies. But his views of what works — and what doesn’t — are informed by critical examination of the evidence.

Many of his detractors would have us believe otherwise and see any critical examination of their pet therapy as a biased attack. Nothing could be further from the truth as anyone who understands the scientific process would understand.

The whole field of science progresses because those who conduct research are self-critical and critical of the research and conclusions of others. It is that criticism that improves our understanding of how the world works. They build on previous knowledge by trying to break it and break it down, piecing it back together again, making sure all the parts fit together better than before. In the words most famously uttered by Sir Isaac Newton, “If I have seen a little further it is by standing on the shoulders of Giants.” By building on knowledge gained by others, we understand more and understand better.

If that wasn’t how scientists worked, if scientists weren’t critical and simply accepted what others said without thinking for themselves, it wouldn’t be science at all and our knowledge of the world would stagnate.

Doubt is not an agreeable condition, but certainty is absurd.

–Voltaire

Science allows us to make progress in this understanding, sometimes painfully slowly; sometimes in leaps and bounds; sometimes overturning age-old, but erroneous, beliefs of how and why things work. Sometimes we appear to take a backwards or sideways step rather than heading in the direction of a better understanding. But the overall direction is unrelentingly forward because mistakes and misunderstandings are closely examined and flaws found and exposed.

Similarly, any bias — accidental, through human failings or otherwise — should eventually be uncovered and we can head back to the correct path. Absolute objectivity is rarely achieved, but its relentless pursuit is paramount.

Certainty

We can never be absolutely certain of anything; but that should not and does not stop us asking yet more questions in pursuit of the very human trait of wanting to better understand. It is a common tactic of those who oppose science to go for this apparent jugular: science keeps changing its mind; scientists sometimes get it wrong; we don’t trust science or scientists. In their world, certainty reigns supreme; certainty that what they have been told or what they have seen with their own eyes is THE TRUTH and no one is ever allowed to disturb that dogmatic belief.

That is the antithesis of science. As Voltaire put it: “Le doute n’est pas une condition agréable, mais la certitude est absurde.” Doubt is not an agreeable condition, but certainty is absurd. Science thrives and grows on doubt; alternative therapies rot in unshakable certainties.

It was science and the scientific method that showed us the need for proper sanitation as well as giving us life-saving antibiotics and vaccines. It is science and the scientific method that allowed us to create the computer you are reading this on and allows many believers in alternative therapies to peddle their wares to the unsuspecting. Time and time again, science and the scientific method has demonstrated that it is an extremely effective and consistent method for understanding our world. It clears the fog of delusion, bias and dogma and allows us to see more clearly.

Things are different in the alternative world of complementary therapies. Self-criticism and introspection are rare and there is a general internal acceptance of all sorts of nonsense. Science is denounced as corrupt and evil; all criticism is rejected as biased and ulterior motives are impugned without any factual basis whatsoever.

And when all else fails, it’s not uncommon for utterly irrelevant personal insults to be hurled in the direction of anyone daring to question strongly held, yet erroneous, beliefs.

We are the only group who is doing full-time CM research not for proving that this or that therapy is effective and safe but for testing whether that is the case.

–Edzard Ernst

Rarely is there any critical appraisal of the evidence for many of these therapies. Critical appraisal of the evidence is helpful in all sorts of areas of life, but it is most important in healthcare. Here we may just be looking for a therapy that will reduce the average duration of a head cold from seven days to six, but we also need effective treatments for serious and life-threatening conditions, like cancers and AIDS.

What is the evidence for homeopathy? For acupuncture? For chiropractic? What’s the best way to find out whether these are the future medicine their proponents would have us believe? Is it to uncritically accept what their supporters tell us? Is it to accept the word of someone who recovered after taking that treatment? How do we know what appeared to work for one person actually was the reason for an apparent recovery and how do we know it will work for others? Will it work for everyone?

What should we base answers to these questions on? Guesswork? Intuition? Gut reaction? Assumptions? Anecdotes? No. We have to base important health questions on something far more rigorous, far more transparent and far more reliable.

The answer to these questions is blatantly obvious to anyone who has even a basic understanding of science and the scientific method. But this isn’t an answer that is restricted to some cabal of scientists — it is something that we all need to realise. The best way to understand if, how and why something works is to examine it with critical eyes and a critical brain. That means not accepting the prevailing dogma, but honestly, fairly and openly examining the evidence.

This critical appraisal is particularly necessary when considering complementary and alternative therapies. Time and time again, proponents of these therapies have shown that they are incapable of applying the necessary critical thinking skills to their cherished therapy. But if we are to find out what does and what doesn’t work, someone has to perform that vital role.

All too often, ‘critical appraisal of the evidence’ is presumed by alternative therapy supporters to mean ‘negative appraisal of the evidence’. It doesn’t. It means examining the evidence and following where that evidence leads, whether positive, negative or inconclusive. Doing anything other than this is what Ernst called “treating the evidence with contempt“.

Sir Maurice Lang

In 1993, Sir Maurice Laing, a supporter of complementary therapies, realised this and founded the Complementary Medicine Research Group, now at the Peninsula Medical School at the Universities of Exeter and Plymouth.

Sir Maurice Laing was a good and clever man. He wanted foremost rigorous research.

Edzard Ernst

Laing appointed Edzard Ernst, then chair of physical and rehabilitation medicine at the Medical Faculty of Vienna, to set it up and Ernst became the first occupant of the Laing chair in Complementary Medicine. In 2002 Ernst became its Director.

It is to the defining attributes of science and the scientific method that Laing wanted — and needed — Ernst to adhere.

In 2008, Ernst explained his attitude to alternative therapies:

For us [Ernst and Dr Simon Singh], there is no such thing as alternative medicine.

There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines.

Hopefully, in the future, the good medicines will be embraced within conventional medicine and the bogus medicines will be abandoned.

This was shortly after Enrst had been critical of misleading claims being made by Prince Charles’ beloved, but now defunct, Foundation for Integrated Health. It was this that heralded the end of Ernst’s career.

Retiring

A few days ago, Prof Ernst announced his retirement as Director of the Complementary Medicine Research Group.

To better understand the situation and future plans, I asked Prof Ernst some questions and he was kind enough to answer:

 

What does the Complementary Medicine Research Group at the Peninsula Medical School do and why?

From the early beginnings in 1993 we had defined our aims as follows.

  • To conduct rigorous, interdisciplinary and international collaborative research into the efficacy, safety and costs of complementary medicine (CM)
  • To be neither promotional nor derogatory but struggle for objectivity.
  • To promote analytical thinking in this area
  • The overreaching aim of all of our research is to maximise the benefit and minimise the risk of CM for the patient.

I believe that, vis-à-vis the high levels of usage and the abundance of misinformation bombarding consumers on a daily basis, these aims are important.

 

What was the original vision of Sir Maurice Laing?

Sir Maurice Laing was a good and clever man. He wanted foremost rigorous research. I’m sure he would have wished our results to have been more often positive, but he told me repeatedly that it was more important to conduct good research to a standard that would be acceptable even to sceptics, than to bend over backwards in an attempt to generate positive findings.

 

What have been the Group’s greatest achievements?

This is hard for me to say. There have been many. We published more than 1,000 papers in the peer-reviewed medicinal literature. Several independent reviews thus identified us as the most productive CM research group in the world. We also did a few books as a group; the most important two are The Desktop Guide to Complementary and Alternative Medicine. 2nd edition. Edinburgh: Elsevier Mosby. 2006 and Oxford Handbook of Complementary Medicine. Oxford: Oxford University Press; 2008.

We also created a journal, Focus on Alternative and Complementary Therapies. But these achievements are trivial compared to the fact that, I think, we changed the climate of CM research worldwide. When we started, there was hardly any critical thinking within CM at all. We have worked very hard to introduce this into CM through our articles, books, lectures, annual conferences, etc. I’m not saying that the field is known for its self-criticism. In fact, we are still the only centre that consistently does critical evaluations. But the principle has been established and will grow, I hope.

 

Why are you choosing to retire now as Director of the Group?

I am still two years before the official retirement age. Yet I am retiring because the £2 million donated by the Laing Foundation is running out. My University had signed a contract to match this sum, but fund raising was never successful. After Prince Charles complained to the Vice Chancellor about me five years ago, it stopped altogether. Instead of fulfilling their promise, the University told us that they will close us down in May 2011. It was only because I could persuade the new dean who started in September 2010 to reconsider that complete and final closure was averted. The ‘deal’ we struck was that I officially retire, then get re-hired half-time for a year to help find a successor and provide the continuity. Personally, I am over the moon with this solution. I have fought so many battles that the scars are beginning to show and I feel exhausted with all of this.

 

Why is it important that your Group continues its work?

We are the only group who is doing full-time CM research not for proving that this or that therapy is effective and safe but for testing whether that is the case. This is such an important difference! It is the difference between a scientist and a promoter. The latter we don’t need in academia, promoters; they already populate every other strand of society.

 

I understand you’ll be working part time for the next year to help find a successor. What qualities will you be looking for in your replacement?

I am looking for a person who is a good scientist with energy and enough courage to stand up against the often quite overpowering forces of quackery. The university wants someone who can bring in money — and that is, of course, equally important.

 

There has been a lot of speculation about the Group being closed down because of a lack of funding. How secure is its future?

Without money, it clearly will not work. The trouble is that it is relatively easy to get research funds if you have the reputation of being “sympathetic” to CM. If you are critical, it is much harder. But if you’re not critical, you are not a scientist — and, in that case, it is better not to do the research in the first place.

 

There have been a lot of very personal attacks on your integrity, impartiality and your qualifications to comment on complementary medicine. Has this affected you personally or the work you are doing?

Yes, of course! Over the years I have become rather thick-skinned. But it affects me nevertheless. The best strategy, I find, is to see the funny side of it. Homeopaths attack me for not having qualifications in homeopathy. Think of it! If that’s not really hilarious, I don’t know what is.

 

What will you do when you fully retire?

Become really outspoken about quackery and charlatans. I look forward to that. Hopefully, UK libel law has changed by then.

102 Responses to The end of an era

  • So, basically, Prince Charles’ inappropriate meddling caused the university to try and get around the terms of their contractual requirements?

    Shocking.

  • Adam C – Not shocking, but certainly wrong!

    Sad news!

  • It really does sound stupid when educated people say that there is no such thing
    as alternative medicine. There are alternatives to everything including medicines.

  • @Zeno

    The interruption of the search for truth is always a bad thing. Sadly prof Ernst has gained a reputation, rightly or wrongly, as being extremely biased and agenda driven.

    My understanding is that the reputation existed within his own university as well as beyond into the wider scientific community.

    I think the search for evidence should always be applauded but as an individual who believes themselves to be sceptical I cannot quite bring myself to be saddened by prof Ernsts retirement.

    It will be interesting to see who will replace him although I got the impression from twitter that he was trying to sort out a successor by virtue of who he wanted to replace him rather than who is right for the job, or is it the same thing?

    Anyway, I wish him a long, healthy and happy retirement, every man deserves that.

  • William said:

    It really does sound stupid when educated people say that there is no such thing
    as alternative medicine. There are alternatives to everything including medicines.

    There are, obviously, things called ‘alternative medicine’ by their proponents. The questions are: do those ‘alternatives’ actually work and are they safe?

  • @Tzspence

    “Sadly prof Ernst has gained a reputation, rightly or wrongly, as being extremely biased and agenda driven.

    My understanding is that the reputation existed within his own university as well as beyond into the wider scientific community. ”

    What on earth are you talking about? His reputation as one of the few ‘scientists’ involved in this area who actually is a scientist is something he should be proud of.

  • @phayes

    Vague ad-hom attack? Sounds like the Quack-Astroturfers have popped by

    @Tzspence

    DOX OR GTFO

  • It’s sad but predictable that apologists for magic medicine come to sneer, even on an occasion like this.

    In the alternative world, the one thing that is never allowed is to be guided by evidence. Belief (and income) are all that matters.

    Perhaps TZSence should produce some examples of “extreme bias” before making unfounded allegations.

  • Genuinly my best wishes to Prof Ernst and I hope a worthy successor continues his work. Regardless of differences in some of our views and conclusions, no-one can disagree that science must be done.
    Best regards,
    Stefaan

  • Zeno wrote:

    …Ernst had been critical of misleading claims being made by Prince Charles’ beloved, but now defunct, Foundation for Integrated Health. It was this that heralded the end of Ernst’s career.

    A timeline that captured the developments related to the above can be followed from post 112 onwards here:
    http://forums.randi.org/showthread.php?t=43150&page=3

    Readers might also be interested in learning that the new and highly dubious ‘College of Medicine’ asserts that Prince Charles has “no involvement” with it:
    http://www.collegeofmedicine.eu/faqs (see last line)
    Yet just last week the Prince apparently gave a talk on CAM at a dinner he hosted for it:
    http://www.facebook.com/notes/richard-brown-bca-president/college-of-medicine-pre-conference-dinner-st-james-palace/146837915384765
    Curiously, it hasn’t been published in the speeches section of the Prince of Wales’s website:
    http://www.princeofwales.gov.uk/speechesandarticles/index.html

    It’s also worth noting that despite the Duchess of Cornwall’s recent free speech defence, Prince Charles continues to enjoy a Royal FOI exemption
    http://www.ministryoftruth.me.uk/2011/05/12/a-right-royal-hypocrisy/

    Suffice to say I’m sure that there are a very large number of people who are looking forward to the day when the UK libel law reform process is complete and Professor Ernst is free to speak out loudly, frankly, and frequently about what’s really going on behind the CAM/integrated health facade.

  • Let’s hope one outcome of Simon Singh’s libel case is to give Prof. Ernst the freedom he so richly deserves to tell the truth , the whole truth and nothing but the truth- loudly!

    May his “retirement” be as productive of facts and fireworks as his invaluable work has been to date.

  • @ David Colquhoun

    To deny that Prof Ernst has a reputation of being biased and agenda driven in some quarters, both inside and outside of CAM, would be ridiculous and untruthful. Whether that reputation is the measure of the man will be up to an individual to decide.

    I am also not convinced anyone has come to sneer as you suggest. I believe, although opinions may differ on Prof Ernst and his work, that all would wish him the very best in his retirement.

  • I would like Prince Charles to commit himself to having nothing but alternative medicine when he is ill or injured. The bastard.

  • Professor Ernst has set the standard for research into complementary therapy claims. Thank you for this posting. Among the many interesting responses in your interview, I was particularly struck by Ernst’s comment on research funding:

    “The trouble is that it is relatively easy to get research funds if you have the reputation of being “sympathetic” to CM. If you are critical, it is much harder.”

    It appears that not only was his position compromised by Prince Charles’ complaint, but also that he had difficulties obtaining funding to continue with this important work. Looks a bit like CM research is agenda-driven?

  • @Tzspence

    “To deny that Prof Ernst has a reputation of being biased and agenda driven in some quarters, both inside and outside of CAM, would be ridiculous and untruthful. Whether that reputation is the measure of the man will be up to an individual to decide.”

    What do you, as an individual, think?

  • @William: “It really does sound stupid when educated people say that there is no such thing as alternative medicine. There are alternatives to everything including medicines.”

    And the alternative to medicine is:

    [drum roll]

    Not medicine.

  • @Mojo:
    Now you sound silly! Is an alternative road not a road? Is Tylenol not an alternative
    medicine to Aspirin or Ibuprofen or Naprosyn? Is Physiotherapy or medication not
    an alternative to surgery in some cases? Medicine has alternatives. You can argue
    whether some therapies are proven or not but there are alternatives even within
    what you call medicine.

  • @William: so your definition of alternative medicine includes Tylenol? That must make every conversation you have on the subject a riot of misunderstanding that Humpty Dumpty would approve of.

  • @WIlliam

    No, you sound silly. Look up the equivocation fallacy.

  • @Michael
    I’m fully aware of what ” Alternative Medicine” has come to mean. It sounds
    silly to say
    “For us [Ernst and Dr Simon Singh], there is no such thing as alternative medicine”.
    There already is a riot of misunderstanding otherwise these posts wouldn’t go on and on.

  • A very simple question would be:

    what is the definition of medicine?

  • @Tzspence
    Great question. Many definitions out there.
    The word medicine is derived from the Latin ars medicina, meaning the art of healing.[1][2]
    1.^ Etymology: Latin: medicina, from ars medicina “the medical art,” from medicus “physician.”(Etym.Online) Cf. mederi “to heal,” etym. “know the best course for,” from PIE base *med- “to measure, limit. Cf. Greek medos “counsel, plan,” Avestan vi-mad “physician”)
    2.^ “Medicine” Online Etymology Dictionary

  • TZspence

    Of course Professor Ernst had an agenda. Like most scientists (that’s not quacks, but proper scientists) it was to find the truth.

  • I, for one, will not miss his invective. Nor his bias, reductionism, ignorance, arrogance. I shall miss sparring with him, tho. Never mind, there’s plenty more like him to take his place.

  • @William

    I’m not sure why you’ve provided those definitions given that they help Ernst and Singh’s point and undermine yours.

    Those definitions imply that the word ‘medicine’ applies to something that actually ‘heals’. That’s what E&S say the definition of medicine should be. It follows that it is incorrect to refer to something that doesn’t or can’t heal as an alternative to something that can. Homeopathy, for example, is not an alternative medicine in the sense that aspirin is an alternative to paracetamol, or diet and exercise is an alternative to liposuction. It is bogus medicine that can only have a placebo effect. Therefore it shouldn’t be called ‘alternative medicine’. It should be called bogus medicine or simply placebo.

    Hope that clarifies.

  • @Isobel Yeomans

    I sense you weren’t keen on Edzard and I’m guessing that’s because his research exposed whatever brand of quackery you make a living from in a less than favourable light. Am I right or am I right?

    See, that’s what real arrogance looks like.

  • @skepticat
    I’m not sure why you’ve provided those definitions given that they help Ernst and Singh’s point and undermine yours.

    What have you presumed my point ( that’s been undermined )is ?

  • @William: “Now you sound silly! Is an alternative road not a road? Is Tylenol not an alternative medicine to Aspirin or Ibuprofen or Naprosyn? Is Physiotherapy or medication not an alternative to surgery in some cases? Medicine has alternatives.”

    Those alternatives are also medicine.

  • @mojo
     
    You said:

    ‘@Willlliam “Now you sound silly! Is an alternative road not a road? Is Tylenol not an alternative medicine to Aspirin or Ibuprofen or Naprosyn? Is Physiotherapy or medication not an alternative to surgery in some cases? Medicine has alternatives.”
    Those alternatives are also medicine.’

    Well actually  Mojo within the confines of the definition given by William and picked up on by skepticat I must ask you for clarification of your statement:  ‘ those alternatives are also medicine’,  why would you presume such a thing?

     Where is the evidence to support that comment with regards physiotherapy and in fact other ‘allied’ practices. One must assume that in order to be classified as healing something there surely must be robust evidence to support that that is the case. Of course this would exclude a proportion of medicine itself  if other posters on other blogs are to be believed.

    @skepticat

     Surely your vague ad hom attack on Isobel  Yeomans isn’t progressing the debate any. It is obvious that not everyone will be sad to see Professor Ernst go.  There is always two sides to a debate. If you want everyone to agree, put it on a private forum and send out invites, for surely a debate is not simply a denunciation of someone just because they hold a different opinion? But on a positive note, thank you for directing me towards other bloggers, it has given me a wealth of information I never had.

    @ Andrew Gilbey

    I totally agree that the search for truth is very important. It would also seem that many people out there also agree with your statement that Prof Ernst had an agenda. The difficulty and where a vast swathe of people, including it would seem other scientists may strongly disagree with you is whether or not the second seriously interfered with the first?

    Sadly I am not sure the two sides will ever find agreement. I am also not convinced that Charles was the ‘root cause’ of prof Ernst’s retirement, but rather and more simply, just the final straw in an ever growing bale of the stuff.

  • I mean that they are medicine rather than, as Dara O’Briain put it, a nice bowl of soup and some pot pourri,

  • So: an alternative medicine is a healing art (therefore medicine) that actually works in equal or better measure to another effective healing art (although one could argue this is a tautology-if it is healing it is effective as Skepticat points out) and in so doing become no longer an alternative but a medical option. Ergo alternative medicine must in order for it to be medicine of any kind be first and foremost medical in that it produces or promotes healing and can therefore be considered effective. The caveat being that evidence of efficacy must be produced prior to it being hailed as medicine, alternative or otherwise. Therefore the term “alternative medicine” is a redundant term.
    An alternative term that may be useful in denoting that which is believed by its supporters to have healing qualities but is not found to do so based on the available evidence could be “uncorroborated medicine”.
    The problem remains; what level of corroboration is the lithmus test for a procedure or process to be deemed substantiated by evidence and therefore worthy of considered to be healing and effective?
    That seems to me to be the nub of this argument, the root of any appearance of bias, the source of evocation of agendas… Is it fair to state that “something doesn’t work” JUST because it has no evidence in support (or against)? Or would it be more accurate and truthful to say that “there is no evidence in support or against? I for one would think it more truthful. Less sensationalist and polarisingly populist perhaps, but more truthful, definitely.
    So that leaves us with 3 rather dull-looking categories (if you want excitement, healthcare is not for you):
    -disproven medicine
    -uncorroborated medicine
    -proven medicine
    But, similar to the earlier question of “when is something proven?”: when is something “disproven”? Lithmus test please. Will the stalwart protectors of medicine please provide clearly deliniated and agreed standards and processes set in stone and agreed by all parties involved to be fair and representative of the procedure under scrutiny? Because if you’re going to set up a little club you must be certain to provide admission rules these days (admittedly not if you’re a private club, but I think the days of healthcare being an old boys club should be over by now) It is paramount for that to be done prior to any further debate otherwise we are just subject to a few people’s opinion and sentiments. Something rather unscientific, unfair, unjust and plain fascist in my view.
    I understand and appreciate the rule of science (yes, I do love Carl Sagan too) and understand when and how something can be deemed “proven”, but for something to be”disproven” is a hell of a lot harder isn’t it? Because after all, there has to be consensus that the test which showed to disprove the hypothesis is unequivocally representative of the practice under scrutiny. A problem much aroused in the current homeopathy saga or even Ernst’s latest post on pulse (ie you can’t prove or disprove something you can’t test because of failure on agreement of what that something represents).
    Is it how things “should” be? No. Is it clear? No. But then not much is in life and I think that those who persue a life in black and white are in for a very tough ride or are flirting with denial.
    Regards,
    Stefaan

  • ps I meant to reference Ernst’s post on Pulse of 6/04/2011 “there are only three categories of treatments”

  • @mojo

    You said: 
    ‘I mean that they are medicine rather than, as Dara O’Briain put it, a nice bowl of soup and some pot pourri’

    Now I totally agree with that but who decides who is in and who is out. What constitutes evidence and what does not. If my reading is correct physiotherapy amongst other modalities must be out by virtue of the simple lack of robust evidence. 

    Also are you implying that after the ASA has accepted there is evidence for the listing for chiropractors, that they should be classed as being part of medicine. OMG I hope not!

    I think to the general public, medicine is what doctors do, not physiotherapists, chiropractors or anyone else who wishes to latch on to that collective noun.  Education of the public would have to occur before  your concept, using prof Ernsts quote that there is ‘only’ medicine, would be accepted and most would laugh at the attempt.

    Hence I presume the term ‘alternative’ or even ‘ complementary’  may actually have a place and for me that includes all modalities allied to medicine. 

  • So Prince Charles can not only circumvent the democratc process but can corrupt and dictate scientific standards as well. Time to eliminate the royalty.

  • @tzspence

    “Surely your vague ad hom attack on Isobel Yeomans isn’t progressing the debate any.”

    “There is always two sides to a debate.”

    “for surely a debate is not simply a denunciation of someone just because they hold a different opinion?”

    How predictable that you should direct your comments at me and not at Isobel, to whom I was responding in kind. Isn’t that rather “bigoted” of you, to use your definition of the word?

    In what sense does Isobel’s drive-by ad hominem attack “progress the debate”?

    “But on a positive note, thank you for directing me towards other bloggers, it has given me a wealth of information I never had.”

    You’re welcome, Bruce, though I’ve no idea which bloggers you mean or how I directed you to them. I don’t doubt they’ve given you a wealth of information you’ve never had, though.

  • Ernst’s main fear was to be mocked by his medical colleagues as a “miracle worker!

    In the end, he lost credibility because people who were helped by alternative therapies and that is most of the public, just did not take him seriously.

    Let’s just hope that he stops doing damage to our freedom to practice all sorts of medicines together – which Henry VIII set up 500 years ago – in the future. We already lost herbalism which stood us in good stead for millenia. What madness is this?

    I was also personally getting fed up being referred to as the “gullible public” in his articles.

    To say that “alternative therapies should cease to exist” (unless they have hundreds and thousands of pounds for research) is the most authoritarian statement I have ever heard in my life. We live in a free country, let’s keep it that way!!!

    Goodbye and good holidays! (I heard Patagonia is nice)

  • @Liz Marsden

    “In the end, he lost credibility because people who were helped by alternative therapies and that is most of the public, just did not take him seriously.”

    The only people who don’t take him seriously are people trying to make a living out of quackery. As you include the most outrageous and unsupportable lie in your comment – that ‘most of the public have been helped by alternative therapies’ – we can safely deduce you are one of those people. Am I right or am I right?

    Your reference to Henry VIII is hilarious, by the way.

    Do any more quacks want to stop by and have a cathartic tantrum or is that it for now?

  • Below are some excepts from “cancerhelp.org.uk”

    “In the UK, up to one third of people with cancer (33%) use some sort of complementary therapy at some time during their illness. For some types of cancer, such as breast cancer, the number of people using complementary therapies is even higher at almost half (50%).”

    “..we are beginning to collect evidence for some types of therapy. For example, improved quality of life following mindfulness based stress reduction, and reduced chemotherapy related nausea in people who have acupuncture”

    “Despite the lack of evidence for many types of complementary therapy, many people with cancer say they gain a lot of benefit from using them.”

    “Helped by” does not necessarily mean “prevents or cures” and is not an affront to evidence based medicine nor a lie.

    I personally use evidence based medicine when I need it. But I will also use yoga when I feel stiff and TM when my mind feels like exploding. I add aromatheraphy oils to my bath. And I ask for epidural when I am giving birth and have x rays taken and wear a splint when I fracture my finger and go for regular check ups.

    Life is not about things being black or white but common sense.

  • @skepicat
    Do massage therapists deserve to make a living or are they all quacks as well ?

  • @Liz Marsden

    Common sense? Are you having a laugh?

  • @Liz Marsden

    Below are some excepts from “cancerhelp.org.uk”

    “In the UK, up to one third of people with cancer (33%) use some sort of complementary therapy at some time during their illness. For some types of cancer, such as breast cancer, the number of people using complementary therapies is even higher at almost half (50%).”

    And? In your first post you said most of the public have been helped by alternative therapies. Now you’re telling me fewer than 50% of cancer patients use complementary therapies. Do you think those two sentences mean the same thing or that the second one supports the first in some way? If so, you are wrong.

    “..we are beginning to collect evidence for some types of therapy. For example, improved quality of life following mindfulness based stress reduction, and reduced chemotherapy related nausea in people who have acupuncture”

    “Despite the lack of evidence for many types of complementary therapy, many people with cancer say they gain a lot of benefit from using them.

    And? Nobody has ever denied that some people feel better after using alternative therapies. The important thing is to find out what actual, measurable benefits alternative therapies have and whether there is any scientific evidence for the claims made for them. That is what Edzard has been doing and that is why he is so hated by people who feel they have to be deceitful in order to attract customers. But if the evidence for a claim falls short, then it is unethical to make the claim and that’s all there is to it.

    “Helped by” does not necessarily mean “prevents or cures” and is not an affront to evidence based medicine nor a lie.

    Depends on the rest of the sentence but if it’s something like “the following list of treatments may be helped by homeopathy” then it is indeed a lie and an affront to EBM.

    I personally use evidence based medicine when I need it. But I will also use yoga when I feel stiff and TM when my mind feels like exploding. I add aromatheraphy oils to my bath. And I ask for epidural when I am giving birth and have x rays taken and wear a splint when I fracture my finger and go for regular check ups.

    So you use orthodox medicine for serious physical issues and complementary therapies for exercise and relaxation. Me too. Nobody cares about you putting smelly oils in your bath or doing yoga, for crying out loud. What we care about is the fact that alternative therapists and making false and sometimes dangerous claims that they can treat specific disorders.

    Life is not about things being black or white but common sense.

    Then try using some – engage brain before hitting keyboard.

  • @William

    Do massage therapists deserve to make a living or are they all quacks as well ?

    Is that like a masseuse? Depends what claims, if any, they make for their therapy, obviously.

  • I feel terribly sorry for you skepticat and whatever went seriously wrong in your life. Perhaps a cathartic post about this would help you feel better, unblock you Qi and help you move on into a more fulfilling and happy existence. Metta

  • Skepticat:
    Who is having a cathartic tantrum now?

  • Seems Skepticat has been ripped off and violated by one of these faceless charlatans she seem hell bent on “bringing to rights”. I wonder if her and zeno have any children, usually that’s a source of extreme anger projected to everything and one around them. Perhaps a dodgy conception charlatan that waved a magic chicken around in the name of healthcare.

  • @Liz Marsden

    “Helped by” does not necessarily mean “prevents or cures”…

    No, but it is a form of weasel words used to imply that something prevents or cures.

  • Doctors suicide rate in the Western world is higher than the average. Female doctors suicide rate is 4 times of other women. Dentists and vets suicide rate is even higher than doctors.

    Some reasons suggested for this is maybe, they need to feel macho and not show that they are vulnerable and do not seek help for various reasons.

    Alternative therapies in general help people form contacts and a connection with other people when they are isolated. Makes them feel heard and cared for if nothing else. Also makes them more in control of their life at the least.

    I had a female friend who had a daughter who had ME and had not been out of the house for 2 years. I sent her a book on complementary therapies. Within a few months, she had read and tried a few things and was on her way to join her friends for the school prom. I received the hugest bunch of flowers in my office. And I didn’t even meet her!

    Did “helped by” mean “cured” in this case? Did I cure her without even setting eyes on her? Was it the therapies she tried did the trick? Which ones did she try? Should she have used them if they were not double placebo trialled? Did they work on a psychoneuroimmunological level?

    If scientists think all CAM is quack, think again. If your trials are not getting the results, maybe you are looking in the wrong places.

  • Did “helped by” mean “cured” in this case? Did I cure her without even setting eyes on her? Was it the therapies she tried did the trick? Which ones did she try? Should she have used them if they were not double placebo trialled? Did they work on a psychoneuroimmunological level?

    You have no way of knowing. Why the hostility towards people who try to find out?

    If your trials are not getting the results, maybe you are looking in the wrong places.

    If you say you have a dragon in your bathroom, I will look in the bathroom. If I don’t see one I will not assume that this is because I have looked in the wrong place.

  • @Liz Marsden

    We already lost herbalism which stood us in good stead for millenia.

    Herbalism “stood us in great stead for milennia” in the same way that bloodletting stood us in good stead for milennia.

    And what on earth do you mean by “we already lost herbalism”?

  • @Liz

    You might like to apply your mind to the difference between “responding to irrelevant and fallacious arguments by pointing out why they are irrelevant”, which is what I did, and “posting petulant comments containing nasty and unjustified attacks on an individual, in order to get it off one’s chest and feel better”, which is what you did in your first post here.

    The latter is a ‘cathartic tantrum'; the former isn’t.

    If I may say so, you seem to have trouble grasping what the issue is here. You have listed a number of benefits of altmed – none of them are surprising and nobody is denying them. But there is a also an enormous human cost to weigh up against those benefits. That is the fundamental issue here – perhaps you would care to address it?

  • @james/bemused

    There is no need to use a different name every time you post ad hominems against commenters who wind you up, especially when it’s the same ad hominem. ;-)

    Yep, you got it. Something must have gone seriously wrong in my life to want to prevent the needless suffering and death inflicted on people like these by people like you.

    Quack reasoning at its finest.

  • @skepticat
    I used the words “cathartic tantrum” because it amused me and made me feel good. The wittiest thing I heard on this page. It may come as a surprise to scientists but ordinary people do not care for scientific accuracy all the time if something makes them feel good. That is why they practice alternative therapies and do not care for Ernst calling them “evangelical believers in quackery” and do not need scientists permission to use them.

    How ridiculous is it to say “all alternative therapies will cease to exist” unless Edzard Ernst says so and has got approval in his lab? All living creatures have an intrinsic reward/punishment system built in them. They know what feels good and what does not and they do not need scientists approval to practice them thank you.

    Alternative therapies are what they are. They are not scientific, they never will be. People will use them once and if they get any benefit will use them again, if not they won’t.

    We spend upwards of £100 billion on health care in this country. If evidence based medicine worked for everyone as scientists claim it does, no one would be practicing alternative medicine and Ernst would not be spending £2 million of a builders money on testing them which would have been better spent building houses for the poor.

  • @ all

    It seems, if prof Ernst twitter post is accurate, that my posting on the subject was accurate. Dr Ernst and his work, obviously does not have the support that he or in fact some of the other posters on this blog would like us to think he has. Jump or pushed?

    EdzardErnst:
    http://www.ucl.ac.uk/Pharmacology/dc-bits/ernst-smith-130806.gif
    end of my uni’s investigation into the allegations by HRH in 2005
    about 2 hours ago from web
    Reply · View Tweet

    http://www.ucl.ac.uk/Pharmacology/dc-bits/ernst-smith-130806.gif

    @ mojo

    I am interested why you don’t debate, just through in a few ad homs here and there? In case you can’t find it, see below:

    Tzspence:
    Tuesday 17 May 2011 at 12:47
    @mojo
    You said: 
    ‘I mean that they are medicine rather than, as Dara O’Briain put it, a nice bowl of soup and some pot pourri’
    Now I totally agree with that but who decides who is in and who is out. What constitutes evidence and what does not. If my reading is correct physiotherapy amongst other modalities must be out by virtue of the simple lack of robust evidence. 
    Also are you implying that after the ASA has accepted there is evidence for the listing for chiropractors, that they should be classed as being part of medicine. OMG I hope not!
    I think to the general public, medicine is what doctors do, not physiotherapists, chiropractors or anyone else who wishes to latch on to that collective noun.  Education of the public would have to occur before  your concept, using prof Ernsts quote that there is ‘only’ medicine, would be accepted and most would laugh at the attempt.
    Hence I presume the term ‘alternative’ or even ‘ complementary’  may actually have a place and for me that includes all modalities allied to medicine. 

  • @Liz

    I used the words “cathartic tantrum” because it amused me and made me feel good.

    A bit like alternative therapies then? I’d stick to copying other people’s witticisms, if I were you. It’s a lot cheaper.

    It may come as a surprise to scientists but ordinary people do not care for scientific accuracy all the time if something makes them feel good

    Oh, I think scientists are well aware of that. That’s precisely why so many needless tragedies have happened.

    ……..All living creatures have an intrinsic reward/punishment system built in them. They know what feels good and what does not..

    Yes, I expect Lucille Craven, Russell Jenkins and Penelope Dingle said the same before they died.

    Why do you suppose their “intrinsic reward/punishment system” chose to punish them so cruelly for depending on altmed?

    …and do not need scientists permission to use them…..and they do not need scientists approval to practice them thank you.

    You know, I know, everybody knows this isn’t about ‘permission’ or ‘approval’. It’s about research. The purpose of research is to find out whether the claims made for therapies are true in order to provide people with the information they need to make an informed choice about whether to try something that might affect their health. You’ve already been asked why you object to this but you haven’t answered. Let me put the question another way:

    Do you think people are entitled to as much information as possible about any healthcare therapy they are considering trying? If not, why not?

    How ridiculous is it to say “all alternative therapies will cease to exist” unless Edzard Ernst says so and has got approval in his lab?

    Very ridiculous, which is why nobody is saying it.

    Alternative therapies are what they are. They are not scientific, they never will be.

    Thank you for acknowleding this. I take it you agree, therefore, that alternative therapists should not make scientific claims for the therapies they are promoting?

    People will use them once and if they get any benefit will use them again, if not they won’t.

    And if they’re dead because they used them instead of proper treatment that could have saved them, they won’t either.

    If evidence based medicine worked for everyone as scientists claim it does, no one would be practicing alternative medicine..

    I’m sure you know that scientists do not claim that ebm works for everyone, that scientists are well aware what conditions are currently treatable and to what extent. We all know that some people turn to altmed because they haven’t been helped by conventional medicine and others because they’re afraid of conventional medicine. None of this affects the truth or otherwise of the claims made for alternative therapies.

    If nothing else, I hope you are learning something from our exchange about how to reason.

    Ernst would not be spending £2 million of a builders money on testing them which would have been better spent building houses for the poor.

    You don’t think money should be wasted on products promoted as remedies for sick people to take? Are you serious?

  • Cigarette smoking and alcohol are a lot more dangerous than alternative therapies and the government is raking in huge revenues out of them. They are definetely known to kill people. Why the attack on Reike?

  • I find this site (and others like it) extremely valuable. When I want a reminder what it’s like to waste one’s life, I come and read the comments of skepticat and her friends. After a good distraction and remembering how bitter and twisted some people are, I close the webpage and go back to helping the many like her with my complementary therapy. But the most saddening thing for me is, seeing how hardened some of the people are here, that at times when they would benefit from my help the most, it’s already been cut off as an option.

  • @skepticat

    Come on Maria

    You talk as if alt med kills people on a regular basis I think to be fair, more people die by medical intervention and one would guess on a higher percentage per clinician than alt med ever will.

    Any death or injury is a sadness but they have to be put in perspective. Sadly you know all this but choose to throw in the odd martyr to the cause. I think it’s a but sad really and sad for all concerned.

    @ Liz

    To suggest that alt med doesn’t need scientific research or evidence is silly, if it’s dealing with peoples health and wellbeing, of course it does. It is the type of evidence and the bias of the researcher that people are calling into question…. From both sides of the argument.

  • @Tzspence:

    Sorry, I would have responded but it got a bit buried by further posts.

    I don’t know much about the evidence base for physiotherapy. A brief look at pubmed suggests that there isn’t an awful lot. On the other hand, it scores over many forms of CAM in at least having some basic plausibility.

    Also are you implying that after the ASA has accepted there is evidence for the listing for chiropractors, that they should be classed as being part of medicine. OMG I hope not!

    I’m not sure where you get the idea that the ASA is an appropriate body to decide what is “medicine”. All it does is to regulate the advertising industry, and to adjudicate on whether specific claims made in advertisementsare backed up by the evidence. I also don’t recall it making a finding that chiropractic works in general – the copyadvice website lists a number of musculoskeletal conditions, plus headaches if they are caused by neck problems and prevention of migraines, for which they consider there is enough evidence for chiropractors to mention them in their advertising. They also say that because chiroprcatcors are regulated by statute they can legitimately refer to conditions where there is sufficient evidence to do so, but this is purely on the grounds of their regulatory status. As long as chiropractors stick with making claims that there is evidence for, that’s OK, although it doesn’t include mention of the chiropractic subluxation, of course.

    I think to the general public, medicine is what doctors do, not physiotherapists, chiropractors or anyone else who wishes to latch on to that collective noun. Education of the public would have to occur before your concept, using prof Ernsts quote that there is ‘only’ medicine, would be accepted and most would laugh at the attempt.
    Hence I presume the term ‘alternative’ or even ‘ complementary’ may actually have a place and for me that includes all modalities allied to medicine.

    This is partly down to the success of “alternative” practitioners’ claims that medicine isn’t “holistic” and therefore doesn’t include this sort of thing. This isn’t the case – medicine should and does include everything from lifestyle and diet advice to drugs and surgery.

    But basically, there are things that work and things that don’t, whatever designation you give them. Research to actually determine what works and what doesn’t is surely a good thing.

    To go back to the start of your post:

    I am interested why you don’t debate, just through in a few ad homs here and there?

    Would you care to cite an example of an ad hom that I’ve used in this thread?

    And perhaps we could go back to the ad hom with which you entered the thread:

    Sadly prof Ernst has gained a reputation, rightly or wrongly, as being extremely biased and agenda driven. My understanding is that the reputation existed within his own university as well as beyond into the wider scientific community.

    You repeated it thus:

    To deny that Prof Ernst has a reputation of being biased and agenda driven in some quarters, both inside and outside of CAM, would be ridiculous and untruthful. Whether that reputation is the measure of the man will be up to an individual to decide

    I realise that you have carefully phrased this so that you are not actually stating it as your own opinion, but do you have any evidence for his having “a reputation of being biased and agenda driven” outside of CAM practitioners and proponents?

  • @Liz

    Cigarette smoking and alcohol are a lot more dangerous than alternative therapies and the government is raking in huge revenues out of them. They are definetely known to kill people.

    Non sequitur. Encouraging a faith in implausible and scientifically unsupported therapies has killed people. I’ve provided enough evidence of this and repeated that this is why it’s important that such therapies are researched so that people can make an informed choice about them. You have not so far given a reason why they should not be researched. Nor have you answered my very straightforward question bolded in my last comment.

    If you can’t find the answer in your head, trying looking into your heart. And forget about your pocket. (Same advice to you Laura Marshall).

    Why the attack on Reike?

    I don’t know which particular attack on reiki you are thinking of but, for the umpteenth time, nobody cares if reiki practitioners promote reiki as a nice experience. When they start claiming stuff like ‘Reiki Therapy Can Help Increase Fertility'(google it) when there isn’t a jot of evidence that it can, it becomes unethical. Please tell me I don’t have to explain why.

    @Laura Marshall

    Are you one of those cowardly hit-and-run posters? If not, please explain why you think it is “bitter and twisted” to want people to be truthful about what they are selling so that tragedies like the ones I linked to above stop happening.

    @tzspence

    I refer you to my latest blog post.

  • @mojo

    Just a quick response, I have just glanced your response, will read it further over the weekend.

    2 points,

    I am really pretty ambivalent about Dr Ernst’s retirement. I will neither pop a cork nor shed a tear.

    With regards those who believe him to be biased and agenda driven, like you I would presume members of CAM would believe that. Those outside of CAM who also believe that seem be being dismissed as being simple proponents of CAM. However on Dr Ernsts own twitter a copy of the bottom half of a letter suggested that the vice chancellor of his university, Prof Steve Smith considered disciplinary proceedings against him and although he didn’t discipline Dr Ernst he stated that he felt that he fell well short of standards expected from a senior lecturer at Exeter Uni. Any future failure to seek ethical clearance would in fact lead to disciplinary action. If I have got it wrong, I am sure someone will correct me but that is how it reads to me ( see my post above for the link) This situation and his inability to gain any funding whatsoever ( if the interview above is correct) would also suggest Dr Ernsts reputation may not have reached the heights some posters here would suggest. Of course I am sure there will be those that will suggest this situation is obviously everyone else’s fault.

    Maybe that is part of the problem you guys will have which is recognising that there are two sides to an argument and both believe they are correct. Interesting debate though.

  • @ skepticat

    You raise some valid points in you latest blog post.

  • “When you are having conventional cancer treatment, it may sometimes feel as though your doctor makes all the decisions about your treatment. It can begin to feel like you don’t have much control over what happens to you. Many people say that complementary therapies allow them to take a more active role in their treatment and recovery. You decide which therapy to use and how often you use it. Complementary therapies may also help people to feel more in control of their feelings and emotions.

    One patient who used complementary therapies alongside chemotherapy and radiotherapy said

    “I turn up for my appointment and someone injects the drugs into me, or shines radiation beams at me. Although I know all the staff care, I sometimes go away feeling very alone and not in control of my situation. But after a massage I feel less alone and more able to cope with things” ”

    The above excerpt is from Cancerhelp.org.

    I am not against research into CAM, All I am saying is that how do you trial “feelings”? Someone who is benefitting CAM just because it is not under the spotlight of medics may not get the same results in a trial situation. And a lot of CAM is about psychoneuroimmunology.

  • @Tzepence:

    The compaint to Exeter was not regarding alleged bias but about an alleged breach of confidence, and Ernst was cleared. You claim that Ernst has “a reputation … as being extremely biased and agenda driven” and that this exists in “the wider scientific community”. Do you have any evidence for this? A complaint about breach of confidence from the Prince of Wales’s Principal Private Secretary/chairman of the Foundation for Integrated Health which wasn’t upheld doesn’t really cut it.

  • @mojo

    Are you seriously suggesting that there are NO scientists or researchers from within CAM and in the wider scientific community itself who do not think that Dr Ernst’s work has bias or is agenda driven? Oh come on!

    As for the part of the letter that was put in the public domain by Dr Ernst, based on a complaint made against him, although you suggest that the complaint was not upheld and I did say no disciplinary action was taken, then it really doesn’t read as if he came out if it with his reputation totally intact. But maybe that is just my interpretation. What is yours?

  • @Tzepence:

    I am perfectly prepared to accept that there are plenty of people within CAM who, because he doesn’t produce the results they want, think Ernst is biased. But I haven’t seen any evidence of this reputation existing, as you claim it does, “in the wider scientific community”, Do you have any evidence for this opinion being held in the wider scientific community?

    The allegation that Ernst breached confidentiality (which as you say was not upheld) has no bearing on whether he has a reputation for being biased and agenda driven. It is not the same issue so it is irrelevant to your claim.

  • @mojo

    Sadly I am unwilling to give you a list of names to throw stones at but, if my recollection is correct, there have been papers written and published in peer reviewed journals which suggest Dr Ernst’s results were biased. I am sure if you are as active in all this as you seem to be, you wil be more than aware of them. The other problem of course is that you discount vast swathes of researchers because they are within the CAM community. Many of these researchers carry out research in non CAM related areas, albeit in some cases, in areas pertinent to CAM clinicians. These include the UK Beam Trial, the Bone and Joint Decade or the Quebec taskforce amongst others, yet although they are highly respected in their fields within the scientific community, you sweep them aside and discount them because they have CAM backgrounds.  Shame on you. No bias there then?

    You surely must realise, and the evidence points to this, is that there are definitely two sides of the argument. There are those who hold Dr Ernst in high esteem and hang on to his every word and others who definately don’t. These exist both inside and outside of CAM and if the letter is anything to go by, both inside and outside his own university. 

     I am also not convinced by your argument that CAM proponents disagree with Dr Ernst simply because of his results, but rather it would seem on how and why he reaches them, and that seems to be the problem. 

     But I am no researcher, so maybe he really is a great guy who will be missed by all,  I seriously doubt it though. I think once the College of Medicine sets out it’s guidelines for assessing evidence in healthcare , things may change. A lot of seriously good and highly respectable people from all walks of life in there, so we will see what the outcomes are.

    With regards the bit of the  letter Dr Ernst made public, and I  would be intrigued to see the full thing, for me it shows further evidence of someone who was progressively being seen as a liability rather than an asset. I may be wrong, so the readers can make their own minds up. 

    As I said before, I am genuinely ambivalent about his retirement but to paint a picture purely representing only one side of the story as this blog attempted to do, requires a little bit of balance. Hence my posts.

  • “…if my recollection is correct, there have been papers written and published in peer reviewed journals which suggest Dr Ernst’s results were biased.”

    If your recollection is correct you will be able to provide citations for them.

  • @ mojo

    Oh I’m sure you’ll find them if you look hard enough.

  • @Tzepence:

    I have no intention of going on a wild goose chase on your behalf. It is your claim – it is up to you to provide the evidence.

  • And tzspence can’t provide the evidence because it doesn’t exist. You’re on a hiding to nothing here, Bruce. You still don’t seem to have grasped that if you make a controversial claim, whether it’s that chiropractic can treat ear infections or whether its that a scientific researcher is considered ‘biased’ by people with nothing to lose, the burden of proof is on you. You need to provide the evidence, otherwise you just sound like a quack with a grudge and poor reasoning skills.

  • “There are those who hold Dr Ernst in high esteem and hang on to his every word …”

    Interesting that Tzepence complains of others “discount[ing] vast swathes of researchers because they are within the CAM community” while, in the same post, attempting to discount anyone who doesn’t think Ernst is biased and agenda-driven with this strawman.

  • @ skepticat

    Don’t be silly, you are vary much aware of the latest paper to talk of bias, I think I recall you commenting on, why deny it. Of course my statements are accurate. There are obviously those who think Dr Ernst is biased and agenda driven. I presume you don’t believe in the unfairness of wearing the bhurka for women, the holacaust or global warming either.

    @ mojo

    Actually all I have ever said is there are those who support Ernst and those who don’t. Unfortunately your spin doesn’t work when the information is there for all to see.

  • “Actually all I have ever said is there are those who support Ernst and those who don’t.”

    No, that is not all you ever said. You said that there are “those who hold Dr Ernst in high esteem and hang on to his every word and others who definately don’t.” This is quite different in tone, and it it is very easy to scroll back up the page and see it where you posted it.

    Still waiting for your evidence.

  • “Don’t be silly, you are vary much aware of the latest paper to talk of bias, I think I recall you commenting on, why deny it.”

    LOL! Digging yourself deeper, Bruce. Now you have two claims to back up:

    (1) that there are papers “written and published in peer reviewed journals which suggest Dr Ernst’s results were biased”;

    (2) that skepticat has commented on the latest of these;

    In fact, being a kindly soul, I’ll let you off the second one if you can point to any comment I have ever made about any paper concerning Ernst.

    Good luck with that.

  • @ mojo

    Yes, well. There are supporters and non supporters. Stop being silly. Do you just read your own posts or those that agree with you or do you read the other posts with opinions which suggest that there are obviously those out there who take a totally different stance from you. How difficult can this be?

  • “Do you just read your own posts or those that agree with you or do you read the other posts with opinions which suggest that there are obviously those out there who take a totally different stance from you. How difficult can this be?”

    Well, I’ve evidently read yours, because I was able to refresh your memory as to what you had actually posted. But all I see is your unsupported opinion that Ernst has a reputation for being biased and agenda driven within “the wider scientific community” and “outside of CAM”, You have failed to back this up with any evidence.

    You claim that there are “papers written and published in peer reviewed journals which suggest Dr Ernst’s results were biased”. To substantiate this claim, all you have to do is provide citations for them. How difficult can this be?

  • The above natter is a graphic example of why people go to scientists for accuracy and to alternative therapists for sympathy and healing of their souls and not vice versa.

    The scientific method requires logic and certainity and feelings do not come into it. The alternative therapists will coax the soul and nurture the spirit and sometimes a little exaggeration does not come amiss.

    Fortunately for all concerned, we need both.

    Good science unites and acknowledges the strengths and weaknesses of every method and tries to utilise each to the benefit of the people.

    As we come to the end of an era, lets try to practice more of good science and heal our bodies as well as our ailing spirits without trying to decide which one is superior as there is a constant interplay between both in our hectic lives.

    Nice talking to all of you and thank you Zeno for supplying this forum.

  • @liz there is no sympathy is good health care, there is and should only be empathy. you cannot be sympathethic to anyone and everyone’s situation unless you know exactly how that situation affects them and have experienced the same. Each person’s situation is unique, so what you can do is empathise with them and understand how their situation is causing them distress and offer them help. That is how it is done in the real world of good health care.

    healing of their souls? coax the soul and nurture the spirit? i am sure you have some way of proving that alternative therapists can do this beyond the ancedote or implausable theories based on nothing but wishful thinking.

    there is no contest of which is superior or not, there is just proven methods and unproven methods.

    maybe you need to read this section of your favourite source of info cancerhelp which says some good things about the safety of complementary and alternative therapies:

    http://www.cancerhelp.org.uk/about-cancer/treatment/complementary-alternative/about/harm/harmful-effects-of-complementary-and-alternative-therapies

    which finishes with your idea of alternative therapies being about a giving a bit of TLC and nothing else:

    “Remember that there is a big difference between a therapy having a physical effect on your cancer and it making you feel better.”

  • It would be interesting to make a study of people who had TLC and felt in control of their lives and therefore more inclined to change their lifestyles and the people who went home feeling lonely and fearful to see which one correlated with higher survival rates. Good point!

  • @liz how would that be a good idea?

    all you would end up doing is correlating life style changes with survival rates and presuming that TLC has a direct impact on survival rates.

    do you think psychotherapthy would improve survival rates?

  • A life style change that would not have happened unless the person had TLC and felt in control of their lives. Psychotheraphy is known to work but at a time when we are having records numbers of elderly to care for and facing budget constraints with the numbers of nurses being slashed, we need all the help we can get!

    Apart from that there are new studies into psychoneuroimmunology which show the immune system directly involved in stress so much so that the kind and duration of the stressor all have different impacts on the immune system. Prolonged stress is the worst offender and is thought to suppress the very cells that are involved in cancer immunology at a time when we need them the most.

    Anything that alleviates stress by producing a relaxation response whether it is scientifically proven or not is surely welcome and should be viewed in a more positive light rather than animosity of witch hunt proportions and ridicule. The fact is we know very little about the brain and its effects on the body and how all the different systems interrelate to each other.

    My personal view is, if the patient feels good, don’t knock it!

  • @Liz Marsden

    Just to clarify, do you think it is ethical for a homeopath to advertise that homeopathy treats heart disease and cancer? For a reflexologist to suggest that they can treat asthma and ear infections?

    These are specific claims about specific diseases that are designed to lure people with those diseases to spend their money on therapies which, while they might help patients feel relaxed, will not make an iota of difference to their cancer, their heart disease, their asthma or their ear infections.

    But you think it’s OK to make these claims and that those of us who are trying to get false claim are conducting a witch hunt. Is that right?

  • Well, would you say that going back in time for one week and experience the same clothes, wallpaper, etc would make some ailing elderly people young again or as the programme executive thought it all sounded completely mad and not necessarily in a good way?

    In an experiment conducted by Professor Ellen Langer and reviewed on the BBC on 14 September 2010, it did just that.

    “The atmosphere in the house changed from being a slightly sad retreat for some very nice elderly celebrities into being a dynamic, living, breathing space where collectively everyone was living as their younger selves.”

    The 88-year-old Liz Smith started walking for the first time since her strokes 18 months ago without sticks. Lionel Blair threw away his walking sticks and started tap dancing. The rest had similar improvements in their physical health markers and symptoms.

    When asked how did this all happen, Prof Langer replied, “It works through the placebo effect.” Slyvia Syms replied indignantly, “But the effects are real?” The volunteers left the experiment talking about how much hope it had given them for the future and how glad they were they’d taken part.

    There are now more people in the UK over 80 than there are under 16 in Britain. Maybe we should start looking into the placebo effects of alternative therapies more seriously in the future as everyone including the scientists think they work but are not sure about the morals of how and when to use it.

    Something to think about.

  • @Liz Marsden

    Do you think it is ethical for (1) a homeopath to advertise that homeopathy treats heart disease and cancer and (2) a reflexologist to suggest that they can treat asthma and ear infections?

    A straight ‘yes’ or ‘no’ will do. Then I’ll answer yours.

  • anything that brings about change is called an intervention not TLC. i think you and i are talking about two different things with TLC. mine is more about have a chat with someone over a cup of tea or pamper days like those spa breaks things. a bit of TLC in this sense does not constitue life style changes. the idea of making life style changes come from somewhere else. maybe you need to clarify what you mean by “a bit of TLC”. nothing in the post i originally replied even suggests life style intervention only stuff about healing spirits and the soul, not mention of life style changes. nthing on your favourite cancerhelp page about why people use them talks about lifestyle changes being made. lifestyle change is an artifact of your own creation.

    if people need a bit of spirtuality then there is a free service run by the chaplancy department or the spirtual care team as most of them are call now. its free and they like to chat about spirituality that can be outside of religon. if you want someone to pay for something then you to come up with better ways that using big words like psychoneuroimmunology as a way of reinforcing your point. maybe you could provide the recent research to see how it applies to spirit and soul healing?.

    unlike what you think psychotherapthy does not improve survival rates, hows that for psychoneuroimmunology . try reading: http://www.dcscience.net/coyne-psych-bul-07.pdf

    as for “Anything that alleviates stress by producing a relaxation response whether it is scientifically proven or not is surely welcome and should be viewed in a more positive light rather than animosity of witch hunt proportions and ridicule.”

    i am well aware that fishing, reading, having a bath, listerning to music, having a coffee and using my PC etc are just some of the ways that i relax and unwind after work. Do any of them have magical powers or work on levels of invisible energy..no. do they help maintain my positive mental wellbeing..yes. the wich hunt as you call it only happens when people make claims beyond what they have been proven to do. like skepticat asks:

    Do you think it is ethical for (1) a homeopath to advertise that homeopathy treats heart disease and cancer and (2) a reflexologist to suggest that they can treat asthma and ear infections?

    A straight ‘yes’ or ‘no’ will do.

  • @skepticat

    “Relaxation Response Training to Treat Hypertension: Effects on Blood Pressure, Biomarkers, and Endothelial Function
    Do you have hypertension? Would you like to participate in a mind body study?
    Volunteers needed to participate in a research study on the effects of Relaxation
    Response (mind body) training on hypertension (high blood pressure) and the function of blood vessel cells. .
    For further information, please contact Barbara Mahoney at 617-724-0406 or email
    MGHhypertensionstudy@partners,org.”

    The above advert is by Massachusetts General Hospital. The answer to your question is “Mind Medicine” is a fascinating new subject and there are no clear cut answers yet. I for one intend to keep an open mind and follow up the studies.

    I will be going on holiday tomorrow so this will be my last blog. I have really enjoyed talking to you and will carry “cathartic tantrum” with me forever! You are an incredibly talented writer! You should try your hand at writing a best seller. I also hope that I have brought in some fresh impetus to the debate.

    Have a nice summer!

  • @Liz Marsden

    I have really enjoyed talking to you and will carry “cathartic tantrum” with me forever!

    But you’ve forgotten about the suffering and needless deaths caused by people who promote alternative therapies already and call trying to stop these tragedies happening a ‘witch hunt’.

    http://whatstheharm.net/

    Shame on you.

  • I have no idea why you think most of what you’ve said has anything to do with this topic, but your last comment is bizarre: it is a recruiting advert for a study trying to find out if there are tangible benefits from relaxation. Yes, some relaxation techniques can be beneficial. However, they do not cure cancers, measles, infections or such like.

    Please address the topic, which is, essentially, about the need for critical evaluation of the evidence for all sorts of AltMed like homeopathy.

    Perhaps you could start by answering the questions Skepticat asked you?

  • mind medicine? have all the good sciencey sounding names been taken already so your left with that one.

    still no answer to the simple question of ethics i see.

  • One quick word before I leave. I never advocated CAM for all ailments all along. However there is strong evidence that it works by alleviating stress which suppresses the immune system and therefore helps the recovery. I can not give a straight yes or no on the basis that I have never heard of any deaths from CAM and can not comment on it. If there are rogue elements to it, of course they should cease to exist. And lastly, evidence based placebo is a contradiction in terms. I am merely referring to the practicalities of making a placebo evidence based. What I am suggesting however, is to use the positive effects of every kind of medicine to its maximum effect for the benefit of all of us.

  • Liz Marsden said:

    I have never heard of any deaths from CAM

    That’s because you haven’t bothered to research CAM properly nor read what has already been pointed out to you by Skepticat: .

  • @Liz Marsden

    I can not give a straight yes or no on the basis that I have never heard of any deaths from CAM and can not comment on it.

    Why do you need to know if anyone has died before deciding whether or not it is OK to make false claims that you can treat life-threatening illnesses?

    And how dare you say you have never heard of any deaths from CAM when in my comment above (Friday 20 May 2011 at 16:32), which was addressed to you, directly linked to the stories of three people – Lucille Craven, Russell Jenkins and Penelope Dingle – who had died because of faith in CAM and in my last comment above I gave you a link to a whole website full of such stories? Here it is again:

    http://whatstheharm.net/

    Of course, if you are going to wear blinkers and keep your hands glued over your ears and sing ‘tra la la’ at the top of your voice – which is exactly what you’ve been doing on this thread – then you are not going to see things from any other perspective than your own, in which case we can but pity you for your lack of human empathy and compassion.

    Go have a nice relaxing holiday, dear, and leave those of us who care about people suffering and dying needlessly because of people like you to get on with our work.

  • It would be interesting to make a study of people who had TLC and felt in control of their lives and therefore more inclined to change their lifestyles and the people who went home feeling lonely and fearful to see which one correlated with higher survival rates.

    The good old “bait and switch”. Associate CAM with something else that actually works, and then pretend that it is the CAM that caused the improvement.

    You are using the wrong comparator. You need to compare people who had TLC and changed their lifestyles with those who didn’t have TLC and changed their lifestyles.

  • @Skepticat
    Wow, strong words, just as well I took my laptop with me. If you read my blogs I have never advocated serious diseases to be only treated by CAM, EVER! However, there is a difference between damning unscrupolous use of CAM and calling all CAM quackery and mocking people who use it wisely to their advantage.

    As I have pointed out to you before, doctors think that CAM might be used in the treatment of hypertension for instance as in the above advert from MGH or they would not have bothered to go into the expense of undertaking trials.

    Unlike you, I look at the positive side of CAM as well and try to follow the latest scientific developments.

    Guilty as charged!

  • @Liz Marsden

    If you read my blogs..

    Link? If you want people to read something, it’s customary to tell people where it is, rather than just sanctimoniously using it to make a point. Either tell us where it is or leave us to believe that your blog is a figment of your limited imagination.

    I have never advocated serious diseases to be only treated by CAM, EVER!

    I didn’t say you had. But you have come here and attacked those of us who are working to prevent the kind of false and dangerous claims that have lead to needless deaths, while wilfully refusing to acknowledge there have even been any. In the scale of things, you’re not much better than those directly responsible for them.

    However, there is a difference between damning unscrupolous use of CAM and calling all CAM quackery and mocking people who use it wisely to their advantage.

    I agree. You are making a huge and unmerited assumption if you think we call all complementary therapies ‘quackery’. If you’d only read my comments properly, you will have seen that I use them myself – for exercise and relaxation. If you are going to accuse us of “mocking those who use it wisely” then the onus is on you to provide evidence of where we have done so. Which particular quote of mine would you like to cite in support of your accusation? Hmmmm?

    As I have pointed out to you before, doctors think that CAM might be used in the treatment of hypertension for instance as in the above advert from MGH or they would not have bothered to go into the expense of undertaking trials.

    Please do us all a favour and look up the term ‘non sequitur’. I have repeatedly pointed out that this is not about attacking potentially helpful treatments, it is about challenging false and potentially dangerous claims made about those therapies. Why are you having such trouble grasping this very simple point?

    Unlike you, I look at the positive side of CAM as well and try to follow the latest scientific developments.

    ROFLMAO! You mean you will happily cherry-pick any hint of anything vaguely sciencey-sounding that shows CAM in a positive light while posting ad hominem attacks on the person who has done more than anyone else to highlight what scientific evidence there is for CAM.

    So, as someone who ‘tries to follow the latest scientific developments in CAM’, what do you think of the latest FACT bulletin? It should have plopped onto your doormat a few days ago. I would be happy to discuss any one of the papers it contains with you.

    In the meantime, I’m sure you’ve got a suitcase to unpack. Is it a sun and sea holiday?

  • @skepticat

    Medics lack of knowledge about usefulness of beneficial CAM therapies which would be helpful to the patients to ease their suffering and fear and strenghten their immune systems may be the reason people are drawn to bad CAM in desperation. And I say this in the most constructive way.

    I have already unpacked, thanks for asking. Not much sun here though!

  • good CAM/bad CAM…reminds me of a episode of brasseye.

    what is bad CAM?

  • Misunderstanding about Eastern medicine stems from faulty research data that are still being stupidly committed today in research! Did you know that when Dr. Andrew Weil coined the phrase “placebo effect” for Acupuncture, he committed the ultimate crime against acupuncture research by stopping any other explanation? Oh, it works for us because it’s all in our minds, huh?

    Okay, let’s say that you were designing an acupuncture research with a control group and you happen to choose a “sham” acupuncture as the placebo group. DUH. Big mistake already made – you are comparing good apples to slightly dented apples, not apples to non-fruit. When the final results come in and there’s only a 15-30% difference between your “sham” group and the REAL acupuncture group, science can only claim that acupuncture does not work as “evidenced by the data yielding statistical insignificance with standard deviation.” Yes, any type of using acupressure on a point is still affecting the real acupoint. All students witnessed that in Acupuncture school.

    Meanwhile, do you know how long and hard I have been trying to get funded to do the right research with Acupuncture??? 30 grant proposal rejections later, and as a 4000 hours Masters degree, 2005 Award winning Teacher of Oriental Medicine, and I still have not been privy to conduct one.

  • How would you design an acupuncture trial, Lily Jou?

  • There is a wonderful article called “Placebos are getting more effective. Drugmakers are desperate to know why” by science journalist award winner Steve Silberman in Wired magazine on the net which may explain what is currently going on with placebo controlled trials. Lately the drug companies were in trouble because their inability to beat the sugar pills in trials. Even some products like Prozac were faltering in recent follow up tests.

    A Foundation for the National Institutes of Health is apparently seeking to stem the crisis. In parallel world to Ernst and Singh, there is William Potter, a psychiatrist and David DeBrota, an IT geek combing through drug companies databases of published and unpublished trials including the failed ones because of high placebo responses.

    What they uncovered was that drugs like valium and prozac performed differently in America to Europe to South Africa. Furthermore Potter and DeBrota discovered that the ratings by trial observers varied from one test site to another and the results were anything but consistent.

    Since then, they discovered that the placebo effect had a neurological foundation because some drugs like Nalaxone can block the effect of pain relief of placebos. The brain produces its own compounds called opioids under stress and these can be activated by placebos. They relieve pain and even modulate heart and respiration. Other mechanisms can “improve motor function, elevate mood, sharpen cognitive ability, alleviate digestive disorders, relieve insomnia and limit the secretion of stress-related hormones like insulin and cortisol.”

    It has its limits however, it will ease the discomfort of chemotheraphy but it won’t stop the growth of tumors so we still need medical intervention for those. And it will only work if the patient believes that it will work, a nocebo will negate the outcome.

    In this parallel universe the placebo effect has been elevated to terms like the “placebo response” and “therapeutic ritual”. It is no longer pc to call it “quackery”!

    The future seems to be “hybrid treatment strategies that exploit the placebo effect to make real drugs safer and more effective.” A group of German researchers have discovered that chemo effects like anticipatory nausea can be unlearned through the administration of a placebo, making chemo easier to bear.

    As to ethical use of placebos in clinical practice, the researchers told the volunteers that the pills they were taking were “known to reduce pain in some patients” which was not a lie!

    In US where they are now marketing to direct to customer advertising, Saatchi & Saatchi reportedly told a trade journal that associating a medication with a life style that promotes “peace of mind” like “being curled up on a couch” evokes positive associations and sets the scene for a positive placebo response by raising the patients “hopes of getting better and expectation of expert care, the primary placebo triggers in the brain.”

    Potter is apparently now a VP in Merck helping a huge data gathering effort called “Placebo Response Drug Trials Survey” acquiring decades of trial data to figure out which variables are responsible for the placep response.

    Potter in his interview with Steve Silberman has acclaimed that “to really do the best for your patients, you want the best placebo effect plus the best drug response.”

    And after his research Silberman concludes that in their quest to dominate the central nervous system, the big pharma found out how powerful the brain is and that it does not care if the “catalyst for healing is a triumph of pharmacology, a compassionate therapist, or a syringe of salt water. All it requres is a reasonable expectation of getting better. That is potent medicine.”

    And for his efforts, Silberman has won the “Kavli Science Journalism award for a magazine feature”.

    Placebo effect is here to stay and proven to be scientific and the variables that trigger it are investigated as we speak but what shape or form it will take in the future is anybody’s guess. Whether drug companies and advertisement firms will dominate the “ritual response” or leave room for CAM or work together remains to be seen.

    I personally think a good diet, exercise and positive mental attitude goes a long way to eliminate disease. But then, I seem to be in the minority as England overtakes others as the fattest nation in the Europe and 5th in the world.

  • The Ernster did no research of his own, he cherrypicked poor quality population biased jet trash and tried to transform it into evidence.

    It’s a shame he has gone, he was quite funny and the Daily Mail loved him, keeping all those dodgy types in one place was a good idea.

    Who said peer reviewed EBM was anything else but state sponsered marketing anyway, don’t know what all the fuss is about. Do people seriously believe self appointed people like this, that amazes me.

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