In their talk on Saturday, Steve and Ben mentioned a number of books that are worth a read if you are interested in finding more about the research behind alternative medicine. Here are some of the books mentioned. Direct links to Eason’s and Amazon are provided if you are interested in purchasing these books or e-books directly.
This excellent book exposes poor and unscientific practices, no matter where they are to be found. Ben Goldacre pulls no punches and spreads his net very widely indeed. His targets include the cosmetics industry, homeopaths and quacks of all sorts, pharmaceutical companies, and so-called TV “experts” such as Gillian McKeith. It’s an excellent primer on how to distinguish the best medical practice from the worst.
Trick or Treatment by Simon Singh and Edzard Ernst
Simon Singh and Edzard Ernst consider the claims of alternative medicine from a scientific perspective, looking at the studies that have been performed on many well known alternative therapeutic practices such as chiropractic, acupuncture, homeopathy and herbal medicine.
Paul A. Offit, a national expert on vaccines, challenges the modern-day false prophets who have so egregiously misled the public and exposes the opportunism of the lawyers, journalists, celebrities, and politicians who support them. Offit recounts the history of autism research and the exploitation of this tragic condition by advocates and zealots.
In “Deadly Choices,” infectious-disease expert Paul Offit takes a look behind the curtain of the anti-vaccine movement. What he finds is a reminder of the power of scientific knowledge, and the harm we risk if we ignore it.
Mistakes Were Made (But Not By Me) by Carol Tavris and Elliot Aronson
This terrific book opens the lid on self-deception and cognitive dissonance: how we are hard-wired to justify our decisions and actions, even when it is plainly obvious to others that they were wrong, misconceived and sometimes malevolent.
Please let us know if you know of other books and we will take a look. We hope to do a book swap for books that are worth reading at forthcoming Cork Skeptics meetings, so please bring along your favourite books to our next meeting and feel free to take another one in return!
If you have other suggested titles, we will publish more reading suggestions soon.
Ben Makin has tried a complete alphabet of traditional, complimentary and New Age treatments and practices. She will take us on a rapid tour of alternative and complimentary medicine, from Applied Kinesiology to Zen Buddhism, and ask “Where’s the harm?”
Dr Stephen Makin will reply, looking at the evidence and discussing cases where real harm has been done by alternative practices, and explaining why skeptics should continue to fight against quackery and cons.
Ben Makin was raised on goats’ milk and home-made wholemeal bread and started her working life at Culpepper’s the Herbalist; she now maintains the Edinburgh Skeptics website.
Stephen Makin was raised on soya milk and meditation, and ran away to Medical School to become a doctor. He is a Clinical Research Fellow in Stroke Medicine at Edinburgh University who spends too much time arguing with proponents of woo on the internet.
Terracotta Warrior (via Mike Stenhouse/ Flickr / CC Licensed)
One of the great things about skepticism is its diversity. There is a skeptical angle in so many areas of human interest. All you need to do is look under the cover of the marketing and you are bound to find some strange ideas hanging around. Consequently, skeptics are interested in all sorts of things, ranging from ghosts, to conspiracy theories, to alternative medicine, to UFOs; as well as the psychology, the history, and the philosophy that accompany such strange and bizarre thinking.
It can be easy to dismiss skepticism as purely a fascination with exotic and extreme ideas, but there is also a very serious side to skepticism. It’s one of the reasons why there is a skeptical movement in the first place. The world of delusional belief sometimes clashes with the world of reality in a way that can cause real casualties.
Here is a brief list of some of these battlegrounds for skepticism. The list below is by no means exhaustive. You may wish to add some of your own. It’s sometimes the case that even the most innocuous delusion can have serious consequences when brought to an extreme.
Although arguments against vaccines are as old as vaccines themselves, a concerted effort to challenge their use took shape in the 1990’s, when Andrew Wakefield published his findings in the Lancet, a well respected medical journal. Wakefield asserted a link between the childhood MMR vaccine and the onset of autistic spectrum disorders. Although his findings were subsequently found to be fraudulent and the paper withdrawn, the cat was out of the bag. The paper gave impetus to a wide variety of people who preferred to believe in a simple cause for autism, rather than the complex reasons uncovered by researchers. Celebrities such as Carol Vorderman, Jim Carrey, Jenny McCarthy and Bill Maher have been to the fore of the vaccine denial movement while websites such as the Age of Autism link vaccines to all sorts of other disorders. The result has been a drop in vaccination, particularly in the UK, France and the US. Consequent with this is a rise in viral illnesses such as whooping cough and measles. While most children recover from these illnesses, a small percentage are seriously affected, with children dying in some cases. Vaccine denial has consequences to public health because some people – very young babies and people with compromised immune systems – depend on herd immunity to keep them safe from these diseases. A large number of follow up studies have been performed, none of which found a link between vaccines and childhood autism. The relative safety of vaccines has been shown in multiple further studies. The war simmers on, however, with anti-vaccine proponents taking more extreme and conspiratorial viewpoints as their evidence base is undermined.
Creationism is a belief that God designed all creatures on the planet to a plan and that species are immutable. More extreme (yet commonly held) creationist beliefs assert that the world is just 6,000 years old and that the Earth and everything on it was formed by God in literally seven days. This bizarre view flies in the face of evolutionary biology and a host of other scientific disciplines. To convinced creationists, evolution is cast as a godless nihilistic belief in dire conflict with the Bible. Although not particularly a problem in most of Europe (Turkey being a notable exception), battles continues to arise in areas where well-funded Christian or Islamic fundamentalists have a strong political influence. Successive attempts have been made in the US to permit creationism, or one of its many variants, to be taught in public schools. Most of these attempts have been rejected by various US courts and grassroots skeptical opposition. The issue is important, because it exposes the lengths to which powerfully connected religious organisations will go to interfere with science education and science policy if it conflicts with their dogmas.
Alternative Medicine (a.k.a. Alt-Med, Integrative Medicine and Complementary and Alternative Medicine [CAM]) is a hugely diverse area with many supporters and acolytes. It encompasses a large body of therapies and putative cures where there is either insufficient scientific evidence to establish their efficacy, or where the available science has shown them to be ineffective. Examples of Alt-Med include Chiropractic, Osteopathy, Acupuncture, Homeopathy, Naturopathy, Anthroposophy, Traditional Chinese Medicine, Chelation Therapy and Kinesthesiology to mention just a few. Although much Alt-Med predates modern medicine, it has experienced a come-back over the past few decades. This is, in some ways, a reaction to the systemisation of organised medicine and the inevitable side-effects or downsides of some medical procedures. With little objective evidence available to back up their claims, proponents liberally quote testimonials and anecdotes, antiquity and popularity as proof of effectiveness. Most Alt-Med therapies are promoted as completely safe, which is unsurprising as most of them are mere placebo. Apart from the fact that many Alt-Med proponents make wild, unsubstantiated claims to promote their remedies, there are some serious issues concerning its promotion and use. Alternative Medicine can needlessly prolong suffering. Irresponsible Alt-Med practitioners have, on occasion, dissuaded patients from more beneficial medical therapies. Alt-Med acolytes have been to the fore in preventing useful and necessary medical therapies from being implemented in places where they are badly needed, a harrowing example being the proliferation of AIDS in sub-Saharan Africa (see below).
Global Warming Denial
Scientists have known for a century that an increase in carbon dioxide can cause an increase in heat absorption in the atmosphere. Nevertheless, a convincing case for warming, and particularly man-made warming, has taken a long time to establish. Warming on a planetary scale is a slow and complex process, so a vast amount of data needs to be collected over decades. Even in the last 100 years, Earth’s temperature has fluctuated greatly, but the underlying trend is unmistakeable. Multiple lines of evidence point to a warming trend that can’t fully be explained through natural factors such as the sun, but which correlate very well with mankind’s increasing demand for fossil fuels. It used to be that global warming and climate change was a relatively uncontroversial part of the sciences. Due to recent international reports and agreements, it is now highly polarised and politicised, despite the fact that the great majority of climate scientists have become convinced by the scientific data now available. Climate scientists have been vilified by certain sections of the media while propaganda services, masquerading as independent think-tanks, receive massive funding from vested interests to cast doubt on the global warming findings. The tactics being used by deniers are almost identical to creationists, and tobacco illness deniers before them. Global Warming denial has become a statement of faith amongst the US Republican party, pitting science against ideology. Given the entrenched views, it could be decades before the issue is resolved: time that could be better used translating the scientific findings into useful action.
AIDS is one of the great scourges of our age. Caused by a fast-mutating virus with a long incubation period, it is a very difficult disease to control and manage. Left untreated, it is almost always deadly. According to the World Health Organisation, over 25 million people have died from the pandemic. Fortunately, anti-retroviral drugs have been developed that contain the illness, often offering many years of extra life to people infected with HIV. Despite this, AIDS researchers and activists have been engaged in a long battle with people who claim that HIV is not the cause of AIDS. These HIV deniers scored their biggest successes in South Africa, where, despite the epidemic growing to alarming proportions within the population, the Mbeki government refused to sanction or support anti-retroviral treatment for the illness. Given solid scientific and international support, HIV denialism has diminished as a major issue, with some of its more prominent supporters moving on to other fields of research.
Witch hunting is based on a belief that certain people are using magical powers or indulging in occult rituals in order to disrupt society. Accused people, blamed for everything from crop failure to illnesses or unexpected deaths, may be persecuted, ostracised, injured and sometimes killed – all because of a shared delusion among the community. As it is a “guilty until proven innocent” form of indictment, it can be enormously difficult for accused people to clear their name. Although widespread witch hunting disappeared from most societies many centuries ago, it continues to make its presence felt in some areas of the world. In the last decade, children, albinos and elderly people have been targeted as witches in Africa, often with tragic and fatal consequences. Similar stories have emerged in India, Saudi Arabia and the UK.
While we could lump it in with the rest of Alt-Med, cancer quackery deserves its own special place on this list. Cancer remains one of the greatest problems besetting humanity in this century. Although there has been some progress over the last 40 years in the fight against cancer, far too many people have had their lives cut short by it, or, more precisely, the many different afflictions collectively labeled as cancer. No-one is immune: from leading cancer doctors, to pharmaceutical executives, to cancer quacks themselves; belying the main contention of the alternative cancer cure lobby that somehow an elite group are keeping the best stuff to themselves. Cancer quacks prey on the most vulnerable people, often demanding huge fees, while providing no convincing evidence of efficacy. While it is understandable that people in such situations will be willing to try almost anything, often the only long term “positive” outcome is the enrichment of charlatans. Cancer, along with many diseases that are difficult to cure, is an enormous challenge for medical research. The doctors, researchers and specialists simply haven’t yet figured out how to treat and cure many of these diseases. The trouble is, neither have the quacks. They are just better at pretending they do, and they have lucrative financial incentives.
Psychics – people who claim to have supernatural knowledge or powers – come in many shapes and sizes. Psychics have made tidy fortunes through one-to-one counselling, as psychic performers in front of large audiences, or more recently through lucrative phone services. Psychics claim abilities that have never been verified through independent, objective testing. The techniques used are identical to mentalists, yet mentalists never claim to have psychic abilities. It’s easy to dismiss this as part of the normal patchwork of modern life, but in practice, psychics are often dealing with people who may be at a low ebb in their lives, or dealing with traumatic issues such as bereavement, illness or a relationship breakdown. They may benefit more, in the long run, from counselling by properly qualified professionals using evidence based techniques. Psychic counselling shares similar issues with alternative medicine in that there is a strong risk that valuable time is lost consulting psychics when potentially more fruitful avenues could have been used, or that psychics, convinced of their own powers, actively dissuade clients from other treatment options. There is a long list of people who have been manipulated and defrauded by psychics, or provided with information that has subsequently turned out to be utterly untrue.
At her talk last week, Rebecca O’Neill mentioned a number of websites that might be of assistance if you are interested in the effectiveness of food supplements.
The first website, an infographic from the Information Is Beautiful site, is particularly eye-catching. Above the “worth it” line is a relatively small list of the supplements that have been shown to be effective in particular defined cases. Below the line is a longer list of supplements where the jury is out on their effectiveness. Some of the same supplements appear in multiple places: so, while garlic can be helpful with blood pressure conditions, it has no proven link with the treatment of cancer. Clicking on any bubble brings you to a related study where you can get more information.
It should be mentioned that this is a starting point only. It goes without saying that if you suspect you have a medical condition, it is worth seeking assistance from a qualified medical professional before embarking on a course of supplements.
Donal O’Mahuna’s site, Bioethics Ireland, provides information on a large number of herbal remedies and alternative treatments. It’s a very useful source of information if you are looking for more facts on a particular supplement or remedy.
Mention should also be given to Edzard Ernst’s and Simon Singh’s bestselling book “Trick or Treatment” (Eason / Amazon / Waterstones) where alternative remedies are put under the microscope.
Finally, here is the audio of Rebecca’s talk to Cork Skeptics. It’s well worth a listen.
Confessions of a Former Health Food Shop Worker: Three and a half years behind the counter in a health food shop can be a learning experience in more ways than one. From vitamins and minerals to the latest celebrity-endorsed wonder supplement, no main street or shopping centre is complete without a purveyor of alternative therapies. Likewise, there are very few people who don’t associate vitamin C or echinacea with the treatment of colds or flu. If these ideas are so pervasive, one question is why? What is it about the sellers of these therapies that make them seem so valid or trustworthy?
Well, take it from a former believer: the answer is definitely not black and white.
The Irish Independent recently published an article purporting to show that acupuncture can aid pregnancy. To a skeptic, such news items also shows us why anecdote alone is often a bad indicator of extraordinary claims. Anecdote does not guard against the “Post Hoc ergo Propter Hoc” fallacy – the idea that if something was done before an event, then it somehow must have caused that event. This is irrational thinking on a par with rain dancing, throwing salt over your shoulder after spilling it and sacrificing a goat to prevent a volcanic eruption. As any scientist will tell you, determining causation is a tricky business. You need to eliminate other more likely competing causes, systematically reduce the effects of experimenter bias and have a big enough data set to see a universal effect. Failing this kind of experimentation you have two occurrences – the use of acupuncture and the onset of pregnancy – with the only connection being a strongly held belief that one event caused the other.
Brian Hughes over at The Science Bit has written a well argued piece on the Independent article where he looks at the evidence supporting acupuncture and increased fertility. It’s well worth a read.