Trick or Treatment (36 page)

So how did we get into a position whereby each year we are spending £40 billion globally on alternative therapies, most of which are as senseless as homeopathy, and many of which are a good deal more dangerous? In the penultimate section of this book we will look at the ten groups of people who are most responsible for our increasing enthusiasm for alternative medicine. In each case, we will explain the role that the group has played in giving alternative medicine undue credibility, and moreover we will suggest how each of them can correct the prevailing overly optimistic, uncritical and misguided view of alternative medicine. What follows is an analysis of what has gone wrong over the last quarter of a century, coupled with a manifesto for re-establishing the role of evidence-based medicine.

Top ten culprits in the promotion of unproven and disproven medicine

1 Celebrities

This 1ist is compiled in no particular order, so celebrities are not necessarily the worst offenders in terms of the unjustified promotion of ineffective alternative medicine, but they have certainly played an important role in recent decades. When Professor Ernst and his colleague Max H. Pittler looked for articles published in 2005 and 2006 which involved well-known people using alternative medicine, they discovered several dozen famous figures who were being linked with various unproven therapies. The celebrities ranged from fans of homeopathy, such as Pamela Anderson, Cindy Crawford and Cher, to devotees of Ayurvedic medicine, such as Goldie Hawn and Christy Turlington. These high-profile names give alternative medicine a greater level of credibility among the public, because they are clearly people who can afford the best medical treatment. In other words, these treatments may be perceived as superior to mainstream treatments because they are bought at a premium by the rich and famous.

In addition to actors and singers, there are also many sportsmen and sportswomen who have indulged in alternative medicine, such as Boris Becker and Martina Navratilova. These sporting celebrities deliver extra credibility, because they are role models. We assume that they take special care of their health and have excellent advisers. The truth is that wealthy sportsmen and their coaches can afford to waste money on extravagant placebos, while also spending large sums on the very best that conventional medicine has to offer.

The US homeopath Dana Ullman clearly believes that celebrities help sell alternative therapy to the public, because his latest book,
The Homeopathic Revolution
, is subtitled
Why Famous People and Cultural Heroes Choose Homeopathy
. He tries to convince readers that homeopathy must work on the grounds that it has been used by some of the most famous figures in history, including eleven American presidents, seven Popes, Beethoven, Goethe and Tennyson, as well as Axl Rose, the lead singer of Guns N’ Roses.

All these uninformed or ill-informed celebrities would do the public a service if they stopped endorsing useless therapies. Better still, celebrities should arm themselves with the best available evidence and condemn faddish, flawed and dangerous treatments. The singer Kylie Minogue did exactly this in 2005 when she issued a statement regarding rumours that she was using alternative therapies to treat her own cancer: ‘She has asked her fans please not to believe stories of dramatic weight loss and desperate searches for alternative therapy. Kylie has made it clear to her representatives that she doesn’t want fellow sufferers to be misguided by the false stories regarding her condition and her choice of doctors.’

Even more impressively, the actor Richard E. Grant exposed a dangerous scam involving goat serum as a life-saving treatment for HIV/AIDS. Having been brought up in Swaziland, Grant was invited to endorse goat serum in Africa, but his reaction was not the sort of thing that the vendors of goat serum had been looking for: ‘Dead people are now Lazarused from the grave – Bullshit!’ Grant acted responsibly and notified journalists working for BBC
Newsnight
, who publicized the fact that goat serum is just snake oil.

2 Medical researchers

This category may surprise many of our readers. After all, throughout this book we have relied upon medical researchers to investigate alternative medicine. It is only thanks to their efforts that it has become apparent that so many of these treatments are ineffective. Not only have they conducted research into alternative medicine, they have also done their best to disseminate the disappointing truth about the various therapies. However, most medical researchers do not investigate alternative medicine, but rather they focus on developing conventional treatments – our criticism is reserved for them.

There has been a general tendency for researchers to focus on their own speciality, perhaps developing new antibiotics, vaccines or surgical techniques, while ignoring the fact that alternative practitioners are often undermining their work by scaremongering about conventional medicine and overhyping their own alternative treatments. In other words, too many medical researchers have stood by and silently watched the rise of alternative medicine and the crackpot theories behind them.

There have been only a few shining examples of academics who have gone out of their way to highlight the contradictions, exaggerated claims and falsehoods within much of alternative medicine, but in many cases the consequences have been quite remarkable. In 2006, a loose coalition of like-minded scientists wrote an open letter to chief executives of the National Health Service Trusts, who are ultimately responsible for allocating funds for healthcare. The signatories, who included only one specialist researcher in the area of alternative medicine (Edzard Ernst), simply argued that homeopathy and many other alternative therapies were unproven and that the NHS should reserve its funds for treatments that had been shown to work: ‘At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence.’

The letter generated a front-page headline in
The Times
, which then led to radio and television coverage. For the first time, many members of the public were being informed about the false claims of homeopaths and were learning that their taxes were being wasted on bogus remedies. Moreover, the chief executives of the NHS Trusts seemed to pay some attention to the letter and reviewed their policies towards homeopathy – by mid-2007, 21 trusts continued their funding for homeopathy unabated and 40 trusts had not disclosed their spending on homeopathy, but 86 trusts had either stopped sending patients to the four homeopathic hospitals or were introducing measures to limit referrals strictly. Hilary Pickles, director of public health at Hillingdon Primary Care Trust, explained his view on funding homeopathy in
The Times
:

A group of vets embarked on a more satirical campaign against the use of homeopathy by forming the British Veterinary Voodoo Society in 2005. They were outraged when the Royal College of Veterinary Surgeons decided to publish a list of vets who practised homeopathy, which would effectively promote and tacitly endorse the practice. These anti-homeopathy vets, whose main concern was that animals should receive the best available treatments, were arguing that homeopathy was on a par with voodoo when it came to evidence and efficacy. Their campaigning has helped to persuade veterinary societies to behave more responsibly, and the Federation of Veterinarians in Europe (FVE) now urges its members ‘to work only on the basis of scientifically proven and evidence-based methods and to stay away from non-evidence-based methods’.

Activism among medical researchers can be effective, so more need to stand up and be counted. A word of warning, however, because those who dare to question the value of alternative medicine can easily become the target of attacks on their reputation and integrity. They are often accused of being in the pay of the big pharmaceutical corporations. The only defence against such criticisms is to highlight the fact that medical researchers are generally driven by the desire to cure disease and increase both the quality and length of human life.

For instance, Professor Michael Baum, who is a specialist in breast cancer and a signatory of the 2006 letter arguing against unproven treatments in the NHS, has adopted the following approach when lecturing on the subject of evidence-based medicine: ‘I often introduce myself as a son of a mother, a husband of a wife, a brother of a sister, a father of two daughters and an uncle to seven nieces. My mother died tragically from breast cancer and my sister is a long-term survivor.’ In other words, Professor Baum has both a personal and a professional interest in identifying the best treatments for breast cancer, and in particular the death of his own mother has inspired his dedication to saving lives.

3 Universities

Science degrees have always been a treasured commodity. Students who have successfully completed a Bachelor of Science (BSc) degree have demonstrated that they have grasped the general principles and foundations of a particular discipline and are ready to study at a higher level. By earning a science degree, graduates have shown that they understand the knowledge derived from previous experiments and are close to conducting their own research. Or at least that is what science degrees used to represent. Today, some universities have decided to devalue the significance of the BSc by demeaning the traditions of science and prostituting the integrity of scholarship.

Universities around the world are now offering degrees in various forms of alternative medicine, which undermines everything that a university should stand for. How can a university offer a BSc degree course in alternative medicine teaching the principles of Ch’i, potentization and subluxations (key concepts in acupuncture, homeopathy and chiropractic therapy respectively), when they make no scientific sense whatsoever? Such degrees do a disservice to students, who are given the false impression that they are learning the science behind a system of healthcare. At the same time, patients can also be misled, because they may hear that alternative medicine is being taught at university and will then assume that it must be effective. In short, universities give alternative medicine an undeserved level of credibility.

The completely crass nature of alternative-medicine degrees is easily demonstrated by a question posed in 2005 to students taking the ‘Homeopathic Materia Medica 2A’ examination at the University of Westminster, London: ‘Psorinum and Sulphur are Psoric remedies. Discuss the ways in which the symptoms of these remedies reflect their miasmatic nature.’ This question is a throwback to the Dark Ages of medicine, when it was believed that disease was caused by
miasmas,
which were poisonous vapours – this idea became obsolete in the late nineteenth century when scientists developed the more accurate and useful germ theory of disease.

Professor David Colquhoun surveyed the state of play in Britain in 2007 and discovered that there are sixty-one degree courses in alternative medicine, of which forty-five are BSc degrees, spread across sixteen universities. Five of the BSc degrees specialize in homeopathy – this means that students spend three years studying a subject that we have demolished in this book in a single chapter.

The worst offender seems to be the University of Westminster, which offers fourteen degrees in alternative medicine. This university offers many degrees in more respectable subjects and its staff in other departments have generally good reputations, so why has it started to offer meaningless degrees in phoney subjects? According to Colquhoun, the problem is that universities that offer courses in unproven therapies have prioritized profit above integrity:

It is time for those in responsible positions in universities to change priorities. Academic standards must not be sacrificed for financial considerations. A strategy that mainly aims at profit is shortsighted; it may be successful in the short term but in the long term it will undermine the integrity of our institutions of higher education.

4 Alternative gurus

It is strange that we live in an era when alternative practitioners are more famous than conventional practitioners. For example, the US health guru Deepak Chopra is a world-famous promoter of Ayurvedic medicine and other alternative therapies, and there is no conventional doctor who can match his global celebrity status.

Chopra and his fellow health gurus have been spreading the gospel of alternative medicine for well over a decade, achieving major press coverage, appearing on the most popular TV shows and lecturing to vast audiences. Their undeniable charisma, coupled with corporate professionalism, has meant that they have had a major impact on the public’s perception of alternative medicine. In general, they have simply added to the often exaggerated and misleading claims surrounding these therapies.

For example, Dr Andrew Weil is one of America’s most successful proponents of alternative medicine, having twice adorned the cover of
Time
magazine and regularly appearing on
Oprah
and
Larry King Live
. He labels himself ‘Your trusted health advisor’. He does have a background in medicine, so some of his advice is sensible, such as encouraging more exercise and less smoking. However, much of his advice is nonsense, and the problem for his legions of followers is that they may not be able to tell the difference between the sensible advice and the nonsense. In
Natural Health, Natural Medicine
, published in 2004, he actively discourages readers from using prescription drugs for treating rheumatoid arthritis, even though some drugs can indisputably alter the course of the disease and offer the chance of preventing crippling deformities.