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Iridologist’s treatment of cancer patient now at tribunal Grant Jacobs Aug 27

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Iridologist Ruth Nelson’s treatment of Yvonne Maine’s skin cancer—that invaded her skull and ultimately cost her life—is now finally facing a tribunal hearing.

As a ‘natural remedy’ practitioner her actions don’t come under the scrutiny of medical boards, but have been put before the Office of the Health and Disability Commissioner as a breach of human rights. (There is a Patients Code of Rights all practitioners must be adhere to.) Dr. Shaun Holt is expecting to be talking about this case on Radio Live today, around 3.10PM.

I’ve previously written on this case:

An earlier article in the media by Bronwyn Torrie closed by quoting Ruth Nelson,

“The mistake I made was not anything to do with the skills or knowledge, it was caring too much,” she told the commission.

I wrote at the time:

I don’t know about others’ opinions, but to me that’s awful in several ways.

- “the skills of knowledge” passage looks like trying to defend iridology in what reads to me as an indefensible way. Iridology certainly has its ‘limitations’. (My earlier article touches on this.) Furthermore, currently anyone can call themselves a naturopath (as the stuff article notes), so there are certainly skills and knowledge questions to be asked of naturopaths, including iridologists. The H&D Commissioner’s report touches on aspects of her keeping up her training, etc., too.

- Her thing of both saying that “her philosophy was to put patients’ wishes first” and offering in her defence that her mistake “caring too much” is excruciatingly bad. If she really cared for her patients she’d refer them on promptly. ‘Tough love’ if you like. “You want me to treat you?” “No, go see a doctor.” That would be to put the patients interests first, not their wishes, which can be ill conceived however well meant. Isn’t caring for patients is to do the right thing by them, not pandering to them?

A key issue has been not referring her patient on. The Health and Disabilities Commissioner’s report includes a description of events including the excerpt below (the practitioner, Ruth Nelson, is ‘Mrs C’; the patient is ‘Mrs A’; note the conflicting statements as to when Ms. Nelson recognised it as cancer):

Initial consultation regarding lesion
24. Ms B said that, in February 2008, Mrs A showed her the lesion, which she had previously kept hidden under a hat. Ms B had not seen it for months, and noted that it had grown and was infected. Mrs A stated in her complaint that she thought the lesion was “just a cyst” based on what she had been previously advised by her GP.

25. Ms B said that she made an appointment for her mother to see Ms B’s doctor because Mrs A was embarrassed to go to her own doctor as she had let the lesion get so infected. However, Mrs A decided to go to a pre-existing appointment with Mrs C before seeing the GP.

26. Mrs A said that she showed Mrs C the lesion on 12 February 2008, by which time it was eight to ten centimetres in diameter. Differing recollections of this consultation have been provided to this Office. Mrs C stated that Ms B was not present at the first consultation about the lesion. Mrs C told HDC:

“At the first consultation I said [the lesion] was cancer. But then I didn’t use the word cancer (even when [Mrs A] asked) because legally I’m not allowed to diagnose cancer. I said to [Mrs A] ‘you told me it was a cyst … you told me the doctor told you it was a cyst, so that’s what I’m treating it as …’. I didn’t speak of cancer except at the very beginning.”

27. In response to my provisional opinion, Mrs C said that Mrs A told her that her (Mrs A’s) GP had said there was nothing further that could be done about the lesion.

28. Mrs C also told HDC that the first time she saw Mrs A’s lesion, she was revolted by it, and told Mrs A it was cancerous, and that she could not believe anyone would leave it in that state. Mrs C described the lesion as “rotten and oozing pus … lots of cyst left growing” and it had “eaten half [her] head”. Mrs C advised that she said: “We’ll give it three months and if it’s not improved, you have to promise me you’ll go to the doctors and the hospital – and she agreed.”

29. Mrs A reported that Mrs C said she could heal the lesion, and that she would need three months to do so. Mrs A said that Mrs C asked her not to go to her doctor during that time.

30. Ms B said she was present at the consultation on 12 February. She said that when her mother asked, “Is it cancer?” Mrs C said “absolutely not”, and said, “It’s what your doctor said ─ a cyst.” In response to my provisional opinion, Mrs C denied that Ms B was present at this consultation.

31. Mrs A spoke of Mrs C as a “convincing lady”, and Ms B believes she and her mother were brain-washed by Mrs C. Ms B said: “We trusted her implicitly as every piece of advice we had got previously had ended in a good result.”

32. However, Mrs C stated that, despite telling Mrs A that she could not treat the lesion and that she did not want to treat it, Mrs A persisted, and Mrs C gave in. Mrs C maintained that Mrs A had assured her that she had sought conventional treatment, that the lesion had been cut out, although she told HDC this “seemed most implausible to [her]“, and that it would heal itself. Mrs C described her treatment as a “stop-gap measure … until [Mrs A] went to the hospital or died”. Mrs C recalled telling Mrs A that she could possibly grow some new skin around the edges, but would still require plastic surgery.

33. Mrs C told the media that it was not until a year after the initial consultation that she found out the lesion was 20 years old, and realised then that it must be more than a cyst, at which point Mrs C was concerned that she might be blamed for the situation.

Ms. Nelson seems to have applied a wide range of ‘alternative’ remedies. The media report notes “herbal poultices, oils and colloidal silver to the growing lesion” and lists at the end of the piece iridology, homeopathy, reflexology and the Bowen technique. It’s a pity to my mind that the article doesn’t point out the lack of evidence supporting these remedies.

Appendix: Summary of Health and Disability Commissioner’s report

1. In February 2008, Mrs A consulted Iridologist and Natural Health Practitioner Mrs C about a lesion on her head.

2. Over the following 18 months Mrs C provided treatment, which included cleaning the lesion, discussion around oral remedies, and applying topical remedies. No other health practitioner saw the lesion during this time.

3. Over this period, the lesion grew and was frequently infected. By the time Mrs A sought hospital treatment, the lesion was 10 x 11cm and some underlying bones were damaged. Mrs A was diagnosed with cancer and underwent major surgery. Sadly, she died in 2010.

Decision summary
4. Mrs C did not inform Mrs A of her opinions about her condition, and misled Mrs A about her qualifications. Mrs C therefore breached Rights 6(1), 6(1)(a)  and 7(1)  of the Code.

5. Mrs C did not adequately communicate and document that Mrs A’s situation was outside her expertise. She did not document her suggestion that Mrs A seek further advice. Mrs C acted unethically in failing to take appropriate steps when she had reached the limits of her expertise, and in forming an inappropriate relationship with Mrs A. Mrs C therefore breached Right 4(2)  of the Code.

6. Mrs C did not minimise the potential harm to Mrs A, and therefore breached Right 4(4) of the Code.

7. By discouraging Mrs A from obtaining further treatment Mrs C failed to ensure co-operation among providers to ensure quality and continuity of services, and so breached Right 4(5) of the Code.

8. Mrs C will be referred to the Director of Proceedings in accordance with section 45(2)(f) of the Health and Disability Commissioner Act 1994 for the purpose of deciding whether any proceedings should be taken.


Other articles on Code for life:

Time for disclaimers on remedies?, “alternative” or not

Homeopathy in NZ pharmacies revisited: Wartoff and more

Editors, producers, journalists: drop the false balance

Dear journalists and editors, (again)

Sources for medical information for non-medics and non-scientists

Eye sci with my little eye

Immunisation Awareness Society followers – what the new page rules show Grant Jacobs Jan 14

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On the rare occasions that I have written about vaccine ‘concern’ groups, my interests have been with the accuracy of their claims and how readers who are uncertain about the science can recognise inaccurate claims.

A related element is if the source is trustworthy.

Sometimes this is easier to deal with as you don’t need to grapple with the details of the science, but simply understand the group’s actions and aims.

My aim is to alert readers of the IAS what the ‘page rules’ in the end of the IAS Facebook ‘About’ page are setting out to do and why these rules show the IAS is not worth your trust.[1]

Realistically this article will probably be mostly read by my usual readers, but hopefully a few who have read the IAS page will consider what I have to offer. Don’t feel shy about writing and offering your thoughts. (Politely, of course!)

The thoughts offered below equally apply to other forums.

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Dear journalists and editors, (again) Grant Jacobs Nov 14

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Some time ago I wrote to you over your advocating unsound treatments in reporting fund-raising efforts.

I now find myself writing again on much the same issue, this time regards your advocating unsound services. The issues are so similar I find myself drawing on my earlier words.

Please, when you decide to ‘advocate’ for a service, check that it is sound.

Articles about services offering hope of treating illness no doubt sell copy, but with that comes responsibility.

These articles, with their details of how to contact the service provider at the bottom, effectively advocate the service to the reader.

Sure, you could argue whether the treatment is sound is for the reader to judge before giving them their money – but wouldn’t that be newspapers shirking their moral responsibilities?

If you put down details of the service in the article you’re effectively putting your weight behind it.

Editors, like most people, will be aware that articles in the press carry some weight of creditability, rightly or wrongly. There will be an expectation among many that the media has checked ‘the facts’.[1]

It seems to me either that this checking should done, and done properly, or the advocacy dropped.

My brief missive here follows from an article espousing the services of an iridologist published yesterday in the New Zealand Herald that was brought to my attention by my colleagues.[2]

Even the briefest of background research would have revealed that iridology is nonsense. Quaint, well-meaning nonsense, perhaps, but nonsense nevertheless.

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Guest post: Ruth and her cancer Grant Jacobs Oct 11

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Once in a long time I feel a comment, such as this written by Terry Given at Respectful Insolence, is worth offering to a wider audience. Minor edits, including using full names, were at Terry’s request.

My wife Ruth Given (neé Skelly) died on 23SEP2012, one week after our 6th anniversary and 5 weeks before her 46th birthday, of lymphangitis carcinomatosis. New Years eve 2008/2009 we found a lump in her breast. two days later we had it checked out at our GP – yep, it was a lump. the GP booked an emergency mammogram and told us the appointment would arrive in the mail shortly. Ruth was a Nurse and I’m an engineer. we figured that unlike fine wine this wouldn’t improve with time, so on the monday I took Ruth to a private breast clinic and had a mammogram. The next day we got the bad news – DCIS, a 65mm tumour in the L breast and a small lump in the R breast. we scheduled a mastectomy immediately, and argued the surgeon into a double. Ruth had both breasts removed on the thursday, and we found that the R breast was also cancerous. Fifty grand well spent.

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What kind of vegetable or fruit describes this NZ Herald article? Grant Jacobs Sep 17

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(Occasionally I just have to point out silly nonsense…)

Being such a short piece, I hope the NZ Herald can forgive my quoting most of the body of Top five: Foods matched to your body in full, which advises that readers should “Match foods to parts of the body for optimum health benefits”, going on to suggest:

1. Healthy Bones: Bony-looking foods such as rhubarb, rich in vitamin K, and celery, rich in silicon, are both good for bones and healthy joints.

2. Heart to Heart: Tomatoes have four chambers and are red, just like the heart and they are proven to reduce the risks of heart disease. Unlike many other fruits and vegetables, they are even better for you when cooked.

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Shaun Holt on iridologist Ruth Nelson’s treatment of cancer patient Yvonne Maine Grant Jacobs Sep 06

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Wellington professor of medicine, Shaun Holt, recently spoke to Radio Live about the Health and Disability’s Commissioner’s report into iridologist Ruth Nelson’s treatment of cancer patient Yvonne Maine:

YouTube Preview Image

One of the topic he raises is what might be done to avoid these cases from arising. Dr. Swee Tan, the surgeon who treated Mrs Main, suggested a registration scheme. I had mixed feelings at that:

My own thoughts, as a non-medical person-on-the-street, are that in one sense registration might legitimise the more moderate use of ’remedies’ like iridology, which grates given that many, if not most, of these remedies are nonsense under any use, but on the other hand registration offers some control over the worst extremes of misuse by obligating practitioners to adhere to guidelines.

Shaun felt there was no sense in registering practices that don’t work, comparing it to registering psychics. Instead he felt that the law should be used where practitioners make fraudulent claims or harm someone, including contributing to someone’s death.

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Iridologist’s treatment of cancer criticised by Health and Disability Commissioner Grant Jacobs Sep 03

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Today the TVOne website hosts a damning summary of a Health and Disability Commisioner’s report on an iridologist who,

… recognised from the beginning that the lesion “looked cancerous” and that it was beyond her ability to treat, the HDC said.

Despite that, the provider treated the lesion for 18 months.

TVOne goes on to write,

Despite being aware the lesion was likely to be cancerous, the provider did not inform the woman of her opinions about the severity of the woman’s condition or that the lesion was worsening during the course of the treatment, the HDC said.

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Bad science: baking soda, fungi, cancer, nuclear fallout, rosacea Grant Jacobs Sep 02

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Partly because it’s the weekend, partly because the NZ Skeptics conference is on, I wander through some examples where critical reasoning was absent.[1]

According this blurb for the second edition of the Sodium Bicarbonate e-book, baking soda is the cure-all. Titled Sodium Bicarbonate – Rich Man’s Poor Man’s Cancer Treatment, by Mark Sircus, merely fixing cancer was not enough for the second edition:

“The main thrust of the first edition was on the use of sodium bicarbonate for cancer treatment. This vastly expanded second edition extends coverage into important areas of kidney disease, diabetes, treatment of flu and the common cold, and other areas of general medicine. Truly sodium bicarbonate is a universal medicine that is nutritional as well as safe and is of help no matter what syndrome we are facing.”

Yes, that right, baking soda is the cure to end them all![2]

They’ve even recommend it for use to weather “the toxic [oil slick] storm that continues to build over the Gulf region.” (Clarification in square brackets mine.)

The blurb writes “This authoritative volume is the only full medical review available on the subject.” I’m not surprised, although not for the reason the author would like. I’d quibble at their use of the word ‘medical’, too.

I’ll let you entertain yourself with—as the blurb puts it—The Mightly Mallet of Baking Soda. You might also want to read the respectfully insolent case on this.

I found the book’s advertising blurb via a web forum, Beyond Vaccination, sidetracking while following leads on New Zealander Hilary Butler’s involvement with the Renatas after the death of their daughter, Jasmine - the subject of a recent coroner’s inquiry.[3] Hilary is also the founder of the anti-vaccine Immune Awareness Society. (This forum is also linked from Peter and Hilary Butler’s website Beyond Conformity: “We alse run an Oceania FORUM,BEYOND VACCINATION, where you will find more information, and people to talk to.”)

At Beyond Vaccination member ‘Barefoot’ posted a link to the book’s blurb titled ‘Knock out the Flu with Baking Soda’. That post was edited by Hilary Butler (aka ‘Momtezuma Tuatara’[4]).

Did she correct the forum member of the bad science on offer? No.

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Campbell Live on influenza vaccines Grant Jacobs Apr 19

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Last night local current affairs program Campbell Live ran a story comparing two staff members and their decision to vaccinate or not, ’of course’ choosing one ‘for’ and one ‘against’ for balance.

You can view the footage* and read the comments they quoted and subsequent comments on-line. (To get back to the quoted comments from the video footage, you’ll need to keep pressing ‘View previous comments’ until you’ve got them all displayed – there’s a few hundred of them now!)

Overall the story seems well done. We’ve discussed communication of vaccine issues before here – what do think of Doctor Cameron‘s efforts?

Here’s what Aspiring Health, from twitter, thinks: ’Seriously Dr Cameron on @CampbellLiveNZ is the jolliest GP ever!’ He certainly presents with gusto and exudes bonhomie. Personally, I think he did an excellent job.

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“We’re so used to getting a prescription that’s it’s surprising when we don’t” Grant Jacobs Mar 09

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Earlier in the year, in a discussion about those with illness that medicine cannot offer a treatment for, a commenter, Lynley Hood, offered the long and thoughtful comment copied below. I’m bringing it up as a guest post of sorts as I feel it deserves to be more widely read. You’ll want to read it to the end, it’s the final answer that I think raises something worth thinking about.

(Update: This is not about azoor. Replace azoor with any illness that has no accepted treatment. Consider a parent of a child being treating for cancer whose oncologist has told them they cannot do more for their child. Consider, even, something mild like a common cold.)

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