Time for disclaimers on remedies?, "alternative" or not

By Grant Jacobs 12/01/2010 17

Two key areas in particular demand consumer protection in particular: when large sums of money are involved and medicines.

When people’s lives or livelihoods are at risk the naïve need protection to save themselves from themselves.

For smaller things, when “it’s only money”, I can understand a lack of consumer protection. But not when lives and livelihoods are at risk.

Here’s a few loose ideas about approaches that could be taken. (Don’t take the first too seriously…)

I’ve left my comments intentionally open and without details out to encourage discussion.


A while back, when I was writing about the “end of chiropractic” I was distracted with the idle thought that all remedies ought to come with disclaimers like those on cigarette packages.

Sample disclaimers for “alternative” remedies:

“This bottle contains only water.” (For high-dilution homeopathy solutions that use water as the solvent.)

“This remedy has been tested and found to offer no benefit.”

“There is no scientific evidence supporting the use of this treatment.”

Trouble is, even if the statements are perfectly correct the natural health industry would be up in arms. Of course, there’s money involved. (Much as some of their supporters like to point to the “evil money-greedy pharmaceutical companies, the same can be said of the “natural health” companies, too.)

This world is too PC allow to this happen. Regrettably.

The same should be applied to the likes of “conventional” cold remedies, too. One rule for all.

No false claims

A more sound approach would be to make it illegal to make false claims about medical products or treatments of any kind.

This should apply not just to bottled remedies, but such things on offer as “Chiropractic treatment as a “vaccine” for swine flu“, a kinesiology practitioner claiming to diagnose lactose intolerance in a young child (don’t laugh, I know of a case of exactly this) and so on.

This resembles parts of what I heard about the Labour Party policy that was being promoted prior to the last election, which was dropped. I’m not familiar with the details of what was on offer nor do I have time to backtrack and dig it all up. My interest here is with the basic principle, which seems perfectly sound and makes good sense from a consumer protection point of view.

I imagine that it’d be fairly hard to police. We’d quickly see the “usual” advertising tricks. Not stating things, only “implying” them. Clever wording to avoid making direct claims. And so on.

Even so, I think it’d be well worthwhile. It wouldn’t stop people selling things, just make them think twice before making claims about them that they can’t back.

Obligatory link to information

A more staid addition would be legislate that each bottle contain a short keyword that can be used to look up a description of the effectiveness of the remedy on a website.

I write ‘addition’, as this won’t prevent people making false claims so on it’s own it’s not a solution, but it may be a useful public education measure.

You will be familiar with the short keywords used in shortened links, like those at the end of each “tweet” in the “twitter chatter” section on the left portion of the main page of the sciblogs.co.nz website. (e.g. the ‘7sGeN0‘ portion of http://bit.ly/7sGeN0.) These are unique indices that are used to look up the actual entry. They’re compact and wouldn’t take much space on bottle labels or advertising material.

There is already a nacent (if abortive) website of this kind within New Zealand and there will be international counterparts. This website now looks defunct to my eyes, with the last entries from 2006 when the data was taken from the University of Otago effort.

One quibble I have with this website is that the “scores” could be better explained and that overall these sorts of efforts would do well to hire a science communicator!


There’s space for your thoughts below. Go for it. (You’re not that passive are you?!)

Other posts with a health/medicine theme on Code for life:

NZ biotech, Living Cell Technologies, wins research deal from US giant

GMOs and the plants we eat: neither are “natural”

The End of Chiropractic?

Neti pots now validated as sound science?

The chiropractor really should stick to bones

Genetic tests and personalised medicine

Autistic children and blood mercury levels

What the chiropractor said

Metagenomics-finding organisms from their genomes

Medical remedies-burden of proof lies with seller

17 Responses to “Time for disclaimers on remedies?, "alternative" or not”

  • I say we campaign for option 2 – legislation for no false claims – and if it doesn’t happen within a reasonable time frame, we start a campaign of surreptitiously sticking the disclaimers you suggest on the quack remedies sold in high street chemists.

    I wonder if that would be considered criminal damage.

  • For the first part of your suggestion—campaigning for legislation for no false claims—I’d be all for it. I’d want some legal eagle to spell out what the issues are so that it didn’t turn into a giant waste of time, though. Not much point in campaigning for something that people can just walk right through.

    For the second part—a campaign of surreptitiously sticking the disclaimers on quack remedies—I have to pause for thought… It doesn’t sound a smart idea, even though the publicity might be good! For one thing, you’d be fairly certainly that they’d object to you interfering with their business and you’d think that they’d have a point from a legal point of view.

    A deeper issue is that whatever is done should be applied equally across the board, “alternative” or not. It’d be much harder to find examples of misleading or false claims for conventional medicine, so it’d end up lop-sided, but not from a bias at the onset.

    This isn’t just being PC, it’s also strategic. It’s illogical for those “defending” the “alternative” remedies to refuse labelling that is also applied to “conventional” medicine; any attempt to defend only their patch would be hypocritical.

  • I’d also be keen.

    I’m amazed at how difficult it is to find ‘real’ information regarding alternative medicines and therapies – even for someone like me with postgraduate training in public health + access to expensive medical databases! I have a hobby interest in matching alternative medicines to the science – particularly herbal knowledge etc of indigenous peoples – because I believe that there is a lot out there that definitely warrants further research. The problem is that there is a dearth of it in reputable peer-reviewed journals, and most of the time I’m scraping the barrel to find almost anything on it at all, regardless of credibility.

    The problem? There’s no money in it! (Yet?) Scientists’ bias to playing with respectable chemical concoctions rather than associating themselves with dirty hippie traditional medicines?

    Legislating for scientific backing to claims will only lead to debate over what constitutes ‘real’ science when there is so little mainstream scientific research into many alternative and herbal therapies, and whether dodgy Homeopathic ‘Journal’ articles should count in the interim!

    This lack of research is not only a consumer protection concern, but a very real public health concern. Large numbers of people (I can’t find the percentage right now, but I do remember reading it!) are using alternative and herbal therapies, and few bother to tell their GPs about it – and few GPs think to ask about it. At best, alternative medicines can be harmless or even have some benefit; but at worst, they can be dangerous in themselves (internal lacerations during colon cleansing, liver damage from internal consumption of comfrey, etc), interact dangerously with other drugs (both conventional and herbal), or have unintended side effects that may cause or exacerbate existing health problems.

    So the first issues to address for raising both public AND scientific/medical awareness are the quantity/quality of research, and the availability of that research to both the scientific community and the public.

    It is also worth noting that the placebo effect can achieve around a 50% improvement in symptoms, so as long as the product isn’t actually harming the consumer (and they don’t have something like cancer) it may be worth just letting people get on with what works for them and what makes them happy. The information should definitely be made available for those who want to know what has scientific backing, but there’s no point in upsetting people by getting too militant about converting everyone to the saving power of science.

  • Thanks for your long comment Kelly! Your second-to-last paragraph in particular is well worth others reading.

    Hope you don’t mind me taking the opportunity to write an (even longer!) comment clarify a few things that occur to me reading your comment. I’m pretty sure you agree with these; I’m just trying to clarify here for other readers.

    Testing to try identify new treatments (based on, say, “herbal knowledge etc of indigenous peoples”) is one thing and testing what’s already out there on the market is another. They’re quite different issues, even if they might use similar approaches in the testing itself. (One catch being that wider “potential” doesn’t justify products already on the market, or making claims about them in the way than testing the potential of something that has yet to be used more widely.)

    As you’ll know, a problem is that while conventional medicine have to demonstrate utility before putting products out; “remedies” (or supplements) by-pass this, put a product out, make claims about them, without first testing their effectiveness, leaving them at best as “unknowns” and at worst scams or even dangerous some situations, like those you mention.

    Testing really ought to be done ahead of products being made available for wide release (i.e. available for consumers to buy) and certainly people shouldn’t be making claims in the absence of having something to back them, which most would agree with I’d think.

    This implies regulation of the products themselves, which I didn’t mention in the article for some reason (sigh). I should also point out that I mean to include the claims made of supplements.

    I think the lack of funding is a bit more complex that a simple “hippie” perception issue! :-)

    There is considerable interest in new treatments and quite a bit of research on them. As you’ll know there is nothing new in deriving treatments from studying natural systems and so on; essentially that’s the usual approach.

    One problem is that (detailed) studies want a plausible mechanism first. They need a justification to put the time and money in.

    Another part of the lack of funding may (I would say, would) be because the “natural health” industry isn’t paying for research in their own “patch” in the way that the pharmaceutical industry does. That, in turn, is likely to—at least in part—be due to the regulatory requirements that the pharmaceutical industry have to pass (which “supplements” avoid). (Quite a few scientists wouldn’t want to be associated with testing something of dubious merit either, to be fair, but that comes back to the plausibility thing.)

    There are also practical issues, such as if the prospective product is ever likely to be able to made into a larger-scale product or yield something useful. Plant products in themselves are difficult to control the amount of active ingredient, and you’ll appreciate that it’s a very long path from a plant to a drug. Grant review committees like to see plausible utility too.

    Taken together, you can understand the people are more interested in looking into things that are more likely to have something of substance to them, even if there is a slim chance of “potential” there.

    With all that said, of course the scientific community would always welcome more funding! (Anyone needing a computational biologist…?)

    Coming back to lack of reasonable mechanisms. Take for example the obvious case, homeopathy. Clearly there is no reasonable mechanism that a, say, 12C dilution is going to have anything more than the solvent in it. As a result, there is basically nothing to test, other than confirm the lack of plausibility of it.

    I’m not saying I there is no place for demonstrating negatives (I think there is place for a limited amount of it), but testing for a negatives is tricky in ways that testing for a positive isn’t and in many people’s eyes is seen as a waste of money; they’d rather see money spent on understanding the disease that was to be targeted. For example, I would much rather see money put into the new leads on autism, than “disprove” some of the sillier “treatments” on offer for it (as I’ve said in an earlier post on autism).

    There is an argument that the onus on testing (and paying for it) should be placed on the “alternative” remedy market, for e.g. as they are the ones profiting. Certainly they shouldn’t be able to make claims without having substance to their claims (hence my article). The extended argument here is that if they want to claim based on tests, they should back their words with their own funds, not demand others stump up the funding to put up the evidence that they need for themselves. (You can also argue “in the public good”; this goes both ways.)

    I may write a sketch outline of what conventional medicines go through, so that people appreciate better the need for a plausible mechanism, then small scale testing, then larger scale, etc. before a medicine (treatment) is released.

    It is also worth noting that the placebo effect can achieve around a 50% improvement in symptoms, so as long as the product isn’t actually harming the consumer (and they don’t have something like cancer) it may be worth just letting people get on with what works for them and what makes them happy. The information should definitely be made available for those who want to know what has scientific backing, but there’s no point in upsetting people by getting too militant about converting everyone to the saving power of science.

    Several quick points as this paragraph looks vulnerable to being misread. (I’ve got similar views, by only up to a point: care needs to be taken writing these things!)

    1. “It is also worth noting that the placebo effect can achieve around a 50% improvement in symptoms”

    The placebo effect is a perception of benefit where there is none, not a benefit that can’t be explained.

    Furthermore, this doesn’t justify products that claim to have effects they don’t.

    2. “so as long as the product isn’t actually harming”: but how will they know that? (Testing and being informed is needed for these too.)

    3. “they don’t have something like cancer”: fair point, but it also comes back to the claims made. There are people who claim products that treat this sort of thing… It also is dependent on people seeking sound medical advise first and following it through (and letting their doctors know what else they’re taking as you said.)

    4. “it may be worth just letting people get on with what works for them and what makes them happy”—trouble is, a lot of people, and the people we are concerned about, aren’t as careful as you and I. Remember this is for “saving people from themselves”, which comes back to informing people or even restricting the product’s availability.

    5. “upsetting people by getting too militant [‘concerned’ would be better I think] about converting everyone to the saving power of science”: a few hurt egos are preferable over false claims hurting others and wasting their money, I’d like to think. A few people are going to get bothered no matter what you do or don’t do. The “don’t do” bothers me, for example. (I don’t like the word ‘militant’, it’s a loaded word and can “frame” people; ‘concerned’ would be better, I think. I wrote about framing recently, too!)

  • Hi, interesting discussion, I’d like to point out that one of the difficulties with testing the therapeutic benefits of substances it that it cost s a lot of money. With supplements (which are not patentable), who would pay for such testing? No one company is able to claim supplements as proprietary, so unless testing is public-funded, I can’t see this happening.

    Also, about the placebo effect, I’d like to point out that the effect varies hugely depending on the condition that’s being treated. It seems to be most effective with pain conditions or other conditions which have a psychological/neurological component, where the placebo allows the patient to access abilities they already possess (such as the ability to block pain).

  • Recently I saw the product information for a homeopathic ‘remedy’ for insomnia (I think it was on the Little Black Duck’s ‘Quackometer’ blog). An insomnia remedy would be something to help you sleep, right? The small print said something along the lines of ‘this product will not induce drowsiness’. Truth in advertising, I guess…

Site Meter