Archive for July 15th, 2008

Black is white.. day is night.. less is more.. nothing is everything (yes, homoeopathy again)

July 15, 2008

One of the more reliable sources of online laughs recently has been the comments thread following a ludicrous letter criticizing the rather wonderful Professor Edzard Ernst that appeared in the Times Higher Educational Supplement a couple of weeks back.

The letter was penned by Michelle Shine, a London homeopath. Shine is criticizing Ernst for applying critical appraisal to CAM therapies (well, she would, wouldn’t she?).

Apparently, in Michelle’s view, this is not what a Professor of Complementary Medicine should be doing. He should be “giving leadership”…

Hmm. You might think this is precisely what Ernst is doing. He is leading by example, demonstrating to the “CAM community” that, if they really want to be integrated with the mainstream of medicine, they have to adhere to the same standards of evidence we demand for other treatments.

Sounds like leadership to me.

It also sounds like what academics are supposed to do – serious investigation, critical analysis, and trying to get to the root of what works, and what doesn’t – and how what does work, works.

But apparently that isn’t leadership (according to Michelle). Or what a Professor of Complementary Medicine is supposed to do (according to Michelle).

Professor and PR – they both begin the same way? Errm?

From the tone of her letter, Michelle Shine thinks Ernst’s job is not to study CAM. Rather, his job is to promote it. We can infer, I think, that this means uncritically promote it, which is what homeopaths like Michelle do for homeopathy. As many different Bad Science bloggers have recounted, the non-medical homeopaths mostly think that homeopathy is an “entire self-consistent healing philosophy”, and can treat anything, from asthma to major depression to cancer to HIV/AIDS. Oh, and it can prevent malaria as well [not] [1].

Rather more shamefully, Michelle Shine implies that by studying CAM, rather than promoting it, Ernst is “betraying” the ideals of the person who funded the Exeter Complementary Medicine Chair – the late building magnate Sir (John) Maurice Laing (1918-2008).

Shine writes:

“Sir Maurice Laing originally funded the chair that bears his name at the Peninsula Medical School in Exeter because he was passionate about CAM. His wife, Hilda, had suffered for years from tuberculosis and was cured of this serious disease through the use of a CAM discipline, very possibly homoeopathy.

There is a significant body of high-quality scientific research supporting homoeopathy, which can now be added to more than 200 years of case histories – all of which verifies homoeopathy as a valid system of medicine.

Consequently, Ernst’s “interventions” on behalf of homoeopathy/CAMs must be causing Sir Maurice to turn in his grave.”

Why the THES printed this snide personal attack at all escapes me.

Apart from anything else, it is not true. Even the bit that implies Laing must have wished he had hired a PR man.

A quick google through the THES archive reveals an obituary for Laing, published earlier this year. The piece includes quotes from Edzard Ernst’s reminiscences at a Memorial Service for Laing.

“Interestingly, while much of the research carried out by Professor Ernst was at odds with Sir Maurice’s strongly held belief in the value of alternative medicine, [Sir Maurice] never pulled the plug on the post, instead stumping up yet more money when it was needed.

After ten years, the £1 million endowment ran out and Professor Ernst turned to him for more funding after promises of money from other sources fell through. Sir Maurice sent a cheque in the post for another £500,000, made out in his name.

“It took him no time at all to comprehend and respect that I had no plans to promote anything and was devoted to scientifically testing these treatments,” Professor Ernst said. “He began to hear from numerous sources that I was not sufficiently supportive of the field, but he kept encouraging me to do the rigorous science.”

Which suggests that Laing, unlike Michelle Shine and her homeopathic friends, understood that University Professors are supposed to be serious scholars, and also that establishing something as a viable treatment in medicine requires evidence that it works.

Last week Edzard Ernst responded directly in the THES to Shine’s jibes. His response is worth reproducing in full.

“In our book Trick or Treatment? Alternative Medicine on Trial, Simon Singh and I evaluate the evidence for or against some 40 alternative therapies. We stress that several are backed by encouraging evidence while others are not.

In the case of homoeopathy, we conclude that “there is a mountain of evidence to suggest that homoeopathic remedies simply do not work”, which should not be surprising because they “typically do not contain a single molecule of any active ingredients”.

Homoeopaths have reacted by stating that:

  • we misrepresent data
  • we are bought by big pharma
  • I was fired by the General Medical Council
  • I am a bad scientist, a fraud and a quack.

Now Michelle Shine has added to this long list of insults and lies by claiming that I am “falling short of (my) job remit” and that I cause Sir Maurice Laing (who endowed my chair) “to turn in his grave” (Letters, 3 July).

During many meetings, Sir Maurice encouraged me to conduct the most rigorous research possible, regardless of what it might find. Shine points out that my remit is to “speak for complementary medicine to government, the public and within the university”. But this is precisely what I have done during the past 15 years, publishing about 1,000 articles in medical journals. However, to speak “for” a subject does not mean telling untruths. We all seem to have got used to homoeopaths misleading the public, but British scientists and academics are bound to insist on the best evidence available to date.”

So Ernst is a man of integrity, as was Sir Maurice Laing.

Unlike, one is forced to conclude, many homeopaths.

In the meantime, the comments thread below Shine’s letter has featured, over this last fortnight, a selection of bad science people (supporting Ernst, and pointing out the falsehoods in Shine’s letter) and of homeopaths giving Shine their vocal support.

One homeopath who showed up is William Alderson:

William trained at The London School of Classical Homoeopathy. He had originally sought homeopathic treatment out of desperation, but it was not simply the success of the treatment that convinced him of the importance of homeopathy. When he read Samuel Hahnemann’s Organon of Medicine and discovered that this was a medical system with a sound scientific basis, he determined to find out more, and ultimately to train as a homeopath himself. (emphasis mine)

Goodness. As William Alderson’s bio reveals, he is a man of many and varied talents. Unfortunately, the ability to tell whether something has a “sound scientific basis” is clearly not among them.

I especially had to laugh when I read Alderson’s comment that:

“The effects of [homeopathic] potentised remedies are highly implausible only if you limit your scientific approach to that of chemistry, and if you rigorously use an inappropriate test. If a wider range of scientific investigatory techniques are used, and if appropriate tests are used, then the results have the chance of according with the clinical evidence – 200 years of clinical evidence.”

Ho hum. And day is night, and black is white. At least in William Alderson’s homeopathic parallel universe (homeoverse?).

A brief recap. It has been repeated ad nauseam that, for homeopathic remedies to have biological actions, one would have to explain how “no molecules” can do more than “some molecules”. “Potentised” means, or course, “diluted with shaking, which shaking is believed by homeopaths to impart magical healing properties”. Following the dilution, there are no molecules of “remedy substances” left. None.

For this potion to do something, one would also have to explain how water magically “remembers” having once had something dissolved in it, when that stuff is not there any more. Water molecules “jostle” one another on a molecular scale at such a speed that any “space” left by a substance that was once there would be gone in a matter of a picosecond (a millionth of a millionth of a second) at the very most, and probably much quicker.

In addition, absolutely no credible science exists to show that a homeopathic remedy is distinguishable from pure water. James Randi famously offered a million dollars to anyone who could credibly demonstrate a “paranormal phenomenon” (homeopathy would qualify, see the noted Horizon programme a few years back), while Edzard Ernst and Simon Singh have recently offered ten thousands pounds of their own money to anyone who can show by any scientific method that homeopathic remedies are distinguishable from water.

No claimants have shown up to claim Ernst and Singh’s prize, and Randi still has his million bucks.

Finally, the homeopathic canard about “sceptics don’t use proper tests” (put another way: “Double blind trials to test our healing power? No fair!”) has been magisterially debunked by Ben Goldacre in his definitive pwning of homeopathy, and in many other places too.

So everything – everything – in Alderson’s ringing statement is…. well, frankly, rubbish.

As an academic used to correcting students’ misconceptions, I thought I ought to re-phrase Alderson’s statement to make its breath-taking ludicrousness a bit clearer. Or better still, I will correct it along the lines of a student project report or thesis, to make it clear what Alderson is really saying:

Key:

Bold black for Alderson’s original words

Blue for the new edits to clarify the meaning

Red for deletions

“The effects of potentised remedies are highly implausible only if you limit your scientific approach to that of using all the known laws of physics, chemistry and biology, and if you rigorously use an inappropriate test the same established tests proven over decades of experience to be the best way to test medical treatments.

If a wider range of scientific and pseudo-scientific investigatory techniques are used, including techniques that are inadequately controlled and or/spurious, and if inappropriate tests are used that do not rigorously exclude experimenter, observer and reporter biases, then the results have the chance of coming out apparently positive – according with the subset of the available “clinical evidence” that we homeopaths like to bang on about, namely 200 years of anecdotes, famously the least reliable kind of medical evidence there is. We will ignore the more rigorous clinical evidence that does not suit our a priori belief-based position, namely all the blinded trials and meta-analyses that demonstrate that homeopathy is simply an elaborate placebo.”.

Incidentally, it is not terribly surprising that William Alderson has appeared to fight Shine’s corner, as they seem to be close associates. Both are, or have been, associated with a recently set up charity HMC21, or “Homeopathy: Medicine for the 21st century”. Michelle Shine, according to this homeopathy website, was formerly Chair of the group, while William Alderson is the secretary.

HMC21 says its purpose is to:

“promote homeopathy, and to defend the right of people in the UK to choose homeopathy as a therapy within the National Health Service”

Obviously the way to do that is for people like Michelle to accuse Edzard Ernst of being dishonest, and for Alderson to back her up with 42-carat nonsense.

Let’s hope their squeakings are treated with the derision they deserve.

Are you listening, Vice Chancellors?

And… is it too much to hope that the Vice Chancellors of those Universities offering “B.Sc. degrees” in Homeopathy and other belief-based nonsense might be reading these exchanges in their THES? And getting a reminder of the difference between scholarship and education on the one hand, and promotion and pseudoscience on the other?

Thought for the day

Finally, before I sign off, I thought I would try my hand at writing an advertising blurb for HMC21, and for the many homeopaths who seems to be able to achieve a stunning level of unconscious quantum doublethink when it comes to their preferred brand of belief-based wibble.

“Don’t like the physical laws of this universe? Insist on being judged by the laws of a parallel one you thought up specially!

Choose Homeopathy now!”

Just don’t expect me not to complain if you are trying to spend my taxes on promoting your parallel reality.

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1. Over at his Thinking Is Dangerous blog, Dr* T recently celebrated the 2nd anniversary of the Simon Singh / Sense About Science BBC Newsnight investigation of homeopathic practitioners and pharmacies who recommended homeopathic malarial prophylaxis to people proposing to visit malaria-endemic countries. The anniversary has now triggered a series of other badscience bloggers to post comments about the British Royal Family’s favourite quackery. Enjoy.

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