Iridologist's treatment of cancer patient now at tribunal

By Grant Jacobs 27/08/2013

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

0 Responses to “Iridologist's treatment of cancer patient now at tribunal”

  • A new article about the on-going tribunal hearing, by Talia Shadwell, published at 1:04pm includes:

    “Under cross-examination this morning, Taylor [Maine’s daughter] claimed Nelson said she could rid Maine of the infection within three weeks, and “heal” her in three months – if she promised not to see a doctor.

    “Defence counsel Andrew Beck challenged this account, telling the court Nelson would deny in her testimony, which is yet to come, that she ever told her client not to see a doctor .“

    The article goes on to quote Taylor claiming Nelson encouraged Maine not to seek professional medical treatment.

    On another note, again I would like to see these reports state that the remedies lack evidential support. “She practises iridology, which involves examining a person’s eyes to assess their health.” leaves open to readers as to how ‘valid’ iridology is.

  • And this from the Herald just now, Grant:

    “Iridologists are natural health practitioners who examine a set of muscles in an individual’s eye – the iris – and then deduce the the health of other parts of the body from what they see.”

    Journalists need to stop stating nonsense like this as if it were fact!

    How the hell is Nelson supposed to have ‘examined a set of muscles’ in her victim’s eye? It’s sheer idiocy!

  • All got from “Naturopath NZ” apparently.

    Good to see the journalists are using evidence based websites……

    Stop the Presses: Hmm..Just checked the Herald and Dompost websites. The reference to these other quack remedies is now gone.

  • Mythbuster,

    Thanks for the heads-up to the new piece. Perhaps they mean the muscle fibres around the iris – ? (These control contraction & dilation of the eye.)

    My first article on this case (An horrific case of natural health treatment of cancer) looks at the validity of iridology briefly. Ernst’s review of the evidence for iridology concluded that deducing the health of other parts of the body from the eye is doubtful as no studies found evidence of benefit.

    I presume the journalists (or their editors) think they are being neutral in not offering an ‘opinion’ on the medical value, or not, of the remedies. I’d rather they put the remedies in perspective. After all, one point is that it is not just the behaviour of the practitioner that is questionable — the medical and scientific communities would also question the remedies themselves too. To be fair this is implied through their quoting Professor Tan; I guess I prefer it directly stated, rather than implied.

    The NZ Herald piece mythbuster refers to can be read on-line. The article has this to say about the case taken against Mrs. Nelson –

    “The Human Rights Commission, which is taking the case against Mrs Nelson, allege the 72-year-old breached the Code of Health and Disability Services Consumers’ Rights in her treatment of Mrs Maine by misrepresenting the effectiveness of her treatment, misleading Mrs Maine about the treatment she could receive from a doctor by playing on her fears and providing treatment which was beyond her expertise and inappropriate in the situation.”

    and later this tidbit,

    “On one occasion, when asked by Mrs Maine whether she should go to hospital, Mrs Nelson replied: “You can go if you want but you know you’ll get swine flu,” Ms Taylor said.”

  • Ross,

    “The reference to these other quack remedies is now gone.”

    You’re right. Looking back, the new article at Stuff by Talia Shadwell, published at 1:04pm I referred to in my first comment actually replaces the one referred in my article—I thought it was an additional piece at the time—and this has dropped the reference to the other remedies. To my memory, the reference to “herbal poultices, oils and colloidal silver to the growing lesion” that I quoted in my piece now sits within a different sentence. (Talia’s piece has been further edited at approx. 2pm according to the information on the page. It seems the live, dynamic, changing presentation of media stories is interesting! I can assure readers I haven’t altered my piece. Yet!)

  • This is good. It’s time the journalists got called to account. It’s an awful story though. Reminds me of the late Penelope Dingle – and her homeopath Francine Scrayen, who is facing similar proceedings in Australia – or at least she was. I must check and see what ended up happening there.

  • Even assuming the iridologist is correct in that the patient was demanding and did not want to go to a doctor, to continue to watch the infection/cancer grow and to continue to treat it, thereby giving the patient a flase sense of security is so wrong.
    And the fact that the iridologist didn’t realise the severity of the condition shows how dangerous a little “medical” knowledge is, particularly when it is tied up with lots of pseudoscience

  • Hi Michael,

    My feeling is that this comes back to doing right the thing by her patients, not pandering to them.

    My initial thoughts were to wonder why she didn’t pick up a phone and ring the appropriate hospital, a GP, whatever. She almost certainly can’t ‘force’ the patient on, but she could have paved the way.

    In one account she defended a question about her training—if she had any—saying that her uncle (a doctor) taught her. By training I would think the hearing will have meant a formal qualification. You could read her reply as a tactic admission that she has no formal qualification or formal training.

  • While it’s nice of Dr Malpas to stick up for Nelson, her argument is baseless. The ‘healer’ knew that her treatment was just tooth-fairy stuff in the face of a genuinely serious condition, so she had certain moral obligations. Given it was baseless nonsense, if the victim still didn’t want to present for science-based treatment, the so-called naturopath or iridologist should have simply walked away – or at least asked for guidance from a competent medical professional. Frankly, she could even have called the police if she was being ‘manipulated’ so badly. I have no sympathy whatsoever, sorry.

  • Unfortunately, I think if one gives sympathy for this situation, the end result is likely to be more patients having similar treatment.

    A lot of people think there is no harm in seeking alternative medical treatment, however, clearly there is great scope for harm. It’s tragic that Yvonne Maine suffered and died, but it would be even worse to allow dangerously ineffective treatments of this type to continue.

  • This is utterly horrifying. I am just appalled, and my deepest sympathy lies with the victim’s daughters. While Maine may have ‘got off’, I hope she will agonise over this for the rest of her life. It’s no excuse to say the victim begged her to apply her woo. She really could have turned right away and refused to partake.

  • On the face it, from what that article says, it seems a curious ruling. I want to see the actual ruling myself rather read the meaning from snippets taken second-hand but it’s not yet up on their website. (I presume it has been given out to media under some prior arrangement – ?)

  • Interested readers may read for themselves the rulings (PDF file):

    and a ‘headnote’ which relates to media coverage during the hearing (also a PDF file):

    (I may return to this when I find time to read these myself, but I have other writing I would like to attend to first.)

  • Grant – this is not the decision, as it has not yet been published on the website. These are the applications and responses for in court media coverage in April. If you email me, I will send you a copy of the actual decision.

  • It’s been pointed out to me that the first document is actually the application, not the ruling. What I get for trying to juggle to many balls in a hurry…! My apologies. I gather the ruling is yet to be made available on their website.