Why Do People Use Alternative Medicine?

By Darcy Cowan 26/03/2012 101


ResearchBlogging.orgI often read that the reason people are turning to complementary/alternative/integrative(take your pick) medicine is because they are dissatisfied with the care received from mainstream/conventional/”western”* medicine. This may be true for a small segment of the population, those with a chronic illness or with terminal cancer spring to mind. But is this generally true of altmed users? Those who pick up a bottle of homeopathic remedy from the pharmacy or occasionally visit a naturopath?

I don’t think it’s quite as simple as that. A study “Why Patients Use Alternative Medicine” published in 1998 in the JAMA looked at this question using a survey sent to randomly selected participants. 1500 participants were sent the survey and 1035 completed it. Not too bad for a survey response rate.

The survey was geared to look at the use of altmed based on three paradigms:

“1. Dissatisfaction: Patients are dissatisfied with conventional treatment because it has been ineffective,5-6 has produced adverse effects, or is seen as impersonal, too technologically oriented, and/or too costly.

2. Need for personal control: Patients seek alternative therapies because they see them as less authoritarian16 and more empowering and as offering them more personal autonomy and control over their health care decisions.

3. Philosophical congruence: Alternative therapies are attractive because they are seen as more compatible with patients’ values, worldview, spiritual/religious philosophy, or beliefs regarding the nature and meaning of health and illness.”

According to the survey results satisfaction, or lack thereof,  with conventional medicine did not correlate well with altmed use. 54% of respondents reported being “highly satisfied” with conventional medicine providers, of these 39% use alternative therapies. Of those who were highly dissatisfied (40%) only 9% were users of altmed.

It seemed as if those who were fans of medicine overall were more likely to participate in both camps. A sort of “the more the merrier” approach to health care.

What was predictive of alternative medicine use was personal philosophy. Those who considered there to be a strong mind/body/spirit connection as well as those who had had a “transformational experience” were more likely to use alt med than those who did not.

Education and health status also correlated with altmed use. Those with higher educations were more likely to use it, as were those who described themselves as having a lower health status.

The situation was slightly different for those who shunned conventional medicine altogether in order to embrace altmed. These folks tended to be distrustful of and dissatisfied with conventional practitioners, as well they desired a high degree of control over their health and believed in the importance and value of “inner experiences”.

This proportion of the population was quite small however – only 4.4% of the survey respondents fell into this group. Even so somehow the reasons for this group’s embrace of altmed has been generalised to the wider population.

The observation that users of altmed tend to be greater consumers of health services overall is also supported by the paper “Association Between Use of Unconventional Therapies and Conventional Medical Services“. This survey had a base of 16,068 individuals from which to pull data representing a 77% response rate from the 24,676 pool that was originally sampled.

According to this survey only 6.5% of the population use both altmed and conventional medicine** (and 1.8% using only altmed), with this group making more visits to their physician than those who used conventional medicine only. One possible reason for this is the so-called “worried well”, a portion of the population that focuses on their health to a degree higher than would be expected given their health status. Support for this is given within the paper:

“Compared with those with only conventional visits, those who used both types of care had significantly more outpatient physician visits (7.9 vs 5.4; P<.001), and used more of all types of preventive services except mammography. These groups did not differ significantly in inpatient care, prescription drug use, or number of emergency department visits.”

This on it’s own does not show a “worried well” connection but in the comments section of the paper it was noted:

“…there was no difference in any of the 4 self-reported health measures between respondents who had physician visits only, and those who had those visits in conjunction with unconventional therapy. Poor health status appeared to drive use of health services in general, that is, those using no services reported better health than those using either conventional medical services or unconventional therapies. However, poor health was not associated with increased use of unconventional therapies over and above conventional medical care.” [emphasis added]

So it would seem, at least in this sample, that dissatisfaction with conventional care cannot be the driving force for the majority of altmed users. More plausible is that altmed users seek to make the most of every perceived avenue for health.

Another survey published in 2001 also supported the general conclusion that dissatisfaction with conventional medicine does not lead to altmed use for most consumers. “Perceptions about Complementary Therapies Relative to Conventional Therapies among Adults Who Use Both: Results from a National Survey” surveyed 831 respondents who used both regular and alternative medicine.

Of these 70% would visit a conventional medicine practitioner as their first port of call. Only 15% went to a altmed provider first. There was also no significant difference in the level of confidence in altmed providers and regular medical professionals.

To quote the conclusion:

“National survey data do not support the view that use of CAM therapy in the United States primarily reflects dissatisfaction with conventional care.”

From a paper presented at the Proceedings of the 1997 Conference of
the Australian Association for Social Research and published in the Journal of Sociology; “Postmodern values, dissatisfaction with conventional medicine and popularity of alternative therapies“[PDF File download]:

“Those individuals who value natural remedies, are against chemical drugs, do not favour technological progress, and welcome variety in choice of therapy are more likely to have a positive attitude towards alternative medicine.”

These attitudes were enveloped under the “postmodern” rubric and were found to be a better predictor of altmed use than satisfaction levels with regard the conventional medicine.

To elaborate on that point, a further finding was that dissatisfaction with interactions with physicians rather than health outcomes was associated altmed use. This is a subtle point and worth dwelling on as it seems to be a valid criticism of the way in which conventional medicine is practised. It was not that altmed users were unhappy with the actual results of the care received via conventional medicines but the way in which they feel they are treated by doctors.

It seems that those turning to altmed may feel that conventional doctors do not give enough respect, time, don’t listen and are too authoritative. I don’t want to put too much emphasis on this perspective as it isn’t entirely consistent with the picture built up so far and the sample size of this survey was relatively small compared with the ones above (only 209 respondents), but it is worth considering.

In conclusion, while it might be true that some dissatisfaction does lead to an increase in the use of alternative medicine it seems unlikely to me that this is the main reason. I’m not sure why it has become the go-to reason trotted out by participants on both sides of the debate, ease I suppose. I could of course be wrong, perhaps there is a mountain of research out there that I’ve missed pointing in the complete opposite direction. I’m willing to grant that possibility, in the absence of such though I’ll have to go with personal philosophy being the largest contributing reason people use altmed.

——————————————————————–

*I hate with a passion the label “Western Medicine”, what? – people from other cultures can’t use science? Nonsense.

** I suspect that the wildly differing definitions of what constitutes “Alternative” medicine are to be blamed for the fluctuating figures around the proportion of users.
————————————————————————-

Astin, J. (1998). Why Patients Use Alternative Medicine: Results of a National Study JAMA: The Journal of the American Medical Association, 279 (19), 1548-1553 DOI: 10.1001/jama.279.19.1548

Eisenberg DM, Kessler RC, Van Rompay MI, Kaptchuk TJ, Wilkey SA, Appel S, & Davis RB (2001). Perceptions about complementary therapies relative to conventional therapies among adults who use both: results from a national survey. Annals of internal medicine, 135 (5), 344-51 PMID: 11529698

Druss, B. (1999). Association Between Use of Unconventional Therapies and Conventional Medical Services JAMA: The Journal of the American Medical Association, 282 (7), 651-656 DOI: 10.1001/jama.282.7.651

Siahpush, M. (1998). Postmodern values, dissatisfaction with conventional medicine and popularity of alternative therapies Journal of Sociology, 34 (1), 58-70 DOI: 10.1177/144078339803400106

Aditional reading:

Joy, J.M. (2004). Complementary and Alternative Medicine (CAM): Do Barriers to and Dissatisfaction with Traditional Care Affect CAM Utilization Patterns, Masters Thesis, Texas Tech University Health Sciences Center

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Filed under: Alternative medicine, Medicine, Psychological, Sciblogs, Science Tagged: Alternative medicine, Health and Medicine, Health care, Medicine


101 Responses to “Why Do People Use Alternative Medicine?”

  • Part of the problem is the definition of “Alternative Medicine.”

    Many papers include things such as yoga, Tai chi, diet and massage within the term. Personally I think that mild to moderate exercise, sensible dietary intake and sufficient rest and relaxation have been part of scientific medicine for many decades and are not part of CAM.

    I also wonder why the users of CAM don’t use alternative mechanics, alternative plumbers, alternative electricians, alternative flight, etc. After all, the reasoning required to use one is the same as the reasoning required to use the others.

  • It was not that altmed users were unhappy with the actual results of the care received via conventional medicines but the way in which they feel they are treated by doctors.

    It seems that those turning to altmed may feel that conventional doctors do not give enough respect, time, don’t listen and are too authoritative.

    This resonated with me.

    My fiance has a lot of problems with our GP mainly because he tells her things she doesn’t want to hear.

    From what she tells me when growing up in Malaysia she would usually be sent to various alternative health clinics. Once there she’d be treated very nicely. Her family would still opt for scientific medicine, but typically only if the alternative remedies failed or they were referred to a general practitioner by an alt-med consultant.

    The overall experience she had growing up left her feeling a lot better even if, as I suspect, the actual diseases for which she was receiving remedies were not actually being treated by those remedies. But as she explained it, for her $45 session with our GP she expects to be diagnosed accurately, prescribed a treatment that actually works and be made to feel better. If any of these expectations are not met then she feels cheated.

    This is one of the areas with which I strongly disagree with my wonderful girlfriend… But at the same time, I can see where she’s coming from and she does have a point.

  • Stuart, I agree with that; the figures reporting how many people use altmed can vary quite a bit depending on how this category is defined. Often “prayer” is also included which inflates the numbers quite a bit. From what I’ve seen if you just look at “hard core” altmed, things such as acupuncture, reiki, iridology, etc then the numbers drop to low single digit percentages as they do in one of the studies I present here.

    Daniel, I agree with you too, so nice to agree with everyone. There is a case to be made that conventional medicine is missing an opportunity to increase it’s rapport with the community and with that it’s general effectiveness by presenting a more personable front.
    As you imply, for it’s immediate task of treating the individual this may be superfluous, but it these time it is perhaps a necessary step to regain ground lost to altmed practitioners.

  • ‘Those who considered there to be a strong mind/body/spirit connection as well as those who had had a “transformational experience” were more likely to use alt med than those who did not. … Education and health status also correlated with altmed use. Those with higher educations were more likely to use it, as were those who described themselves as having a lower health status.’
    What is going on here? Clearly, the Dawkins “they must be stupid” approach to users of altmed misses the mark.
    I didn’t hear the RNZ interview with Alain de Botton yesterday about his new book “Religion for Atheists: a non-believers guide to the uses of religion” so I don’t know how useful it is, but I hope it stimulates some debate.

    • Lynley, true. Altmed users are not in the main stupid, but perhaps it is in the realm of “a little knowledge…”.

      It’s been known for a while that users tend to be relatively affluent and relatively educated. This might lead to two effects; first, having a decent wage means they have the disposable cash to spend on altmed, in addition they are less likely to have serious health issues so they could fall into the “worried well” category I use in the post.

      Second, being educated does not insulate you from flaws in reasoning. Indeed it may give you the mental resources to rationalise almost any action.

      These are just my own speculations of course, I’d love to see some work that explores these angles.

  • My impression is that people often turn to alt med to treat conditions that are not effectively treated by conventional medicine. For example with certain cancers which repsond poorly to current conventional treatments. Usually they are approached with a “whats the harm in trying?” philosophy, which is an understandable approach when dealing with a difficult to treat disease. The danger comes when pseudoscientific treatments are used to replace conventional therapies which are more likely to work, when the treatments drain the patient financially, or in the case of terminal disease make their last few weeks/months/years miserable, by for example, having regular enemas and having to swallow ridiculous amounts of supplements.

    To paraphrase Dara Obriain, “Just because science doesn’t have the answers, doesn’t mean you can fill in the gaps with whatever fairy tale takes your fancy”

  • My experience of Chinese TCM does imply some disease effect. Where western medicines don’t offer effective alternatives, interest in TCM can be high.

    Two examples of late are tiger bone for bone diseases- I’m afraid western medicine is still not very good at curing conditions like bad arthritis. The belief that rhino horn is an anti-cancer agent (especially in Vietnam) again is a case where demand for traditional medicines endures.

    OTOH, the visibility of traditional aphrodisiacs has shrunk dramatically. Those wanting to gnaw on a seal penis appear to have almost disappeared in favour of fake cialis & viagra pills.

    • ***Posted On Behalf of Lynley Hood***

      Thanks Darcy – that explains why I couldn’t find the review.

      I’m not suggesting that de Botton’s book has any merit – and since I haven’t read it I have no idea whether it has or not. I’m just suggesting that it would be great if it stimulates a debate on why smart people take altmed that goes beyond the “they must be stupid” response.

      it’s hard to take John Shook’s review seriously when he dismisses the book before reading it (“His title didn’t have a ghost of a chance with me”) and then puts up a straw man (“Even if his book explains his nuanced position, that atheists could benefit from some secular versions of religious forms of life, few will ever notice. Most religious people will only hear this message: * There’s Nothing Wrong With Religion *). Then he goes on to demolish his straw man. How clever.

      For me this question of why smart people take altmed is a continuation of the discussion on Grant Jacob’s Code for Life blog Vitamin C as cancer treatment – Sir Paul Callaghan reviews his trial, which then continues in the discussion on his blog We’re so used to getting a prescription that it’s surprising when we don’t.

      Saying that “altmed users are not in the main stupid, but perhaps a little knowledge…” isn’t an answer when the data shows a correlation between higher ed and altmed use. Sure there are stupid people with higher education, but you would need to prove that stupidity (ignorance, sloppy thinking) is more common among the highly educated than the rest of the population for your explanation to work.

      Suggesting that the better educated ‘are less likely to have serious health issues so they could fall into the “worried well” category’ may be part of the answer, but it’s not the whole answer. As discussed on Grant’s blog, highly educated people get incurable/fatal illnesses too.
      I wrote: “I suspect the belief that there must be a cure for everything and the often irrational drive to find it is a modern secular manifestation of the elemental motivation that has driven so much of human conduct since the dawn of time: fear of death and the quest for eternal life.”
      To which Grant replied:
      It’s hard to ignore that as the elephant in the room, at least in the cases of the so-called ‘terminal’ illnesses.

      So what are we going to do with the elephant? Attempts to kill it have failed dismally.

      • I haven’t read De Botten’s book either. Shook’s review of it is the only one I’ve read simply because it came up in one of my rss feeds. I really have no particular interest in it either way.

        With the “little knowledge” approach I was taking, your suggestion isn’t quite what I was getting at. Rather it seems to be that those who have higher education are more able to come up with reasons to fit their actions to their ideology. As well their education gives them the sense that they can understand complex subjects and can’t be fooled.

        I seem to recall noting that I’d like to see actual research in this direction as well. Perhaps it exists, I’ll try to look for it. Then we can try to settle this without simply speculating.

        I try to stay away from metaphysical elephants if at all possible.

  • Darcy, I suspect if you went into a health food shop or pharmacy and observed people who bought supplements you’d find they were just ordinary people.

    According to the MOH just on 50 percent of NZ adults use food supplements… even more when you add in herbal remedies etc.

    Most of your research cited is nearly two decades old… society has moved on… Natural Health Products are even more main stream now.

    People try things… sometimes they work, or appear to work, and sometimes they don’t. Most Drs I’ve ever been to say, “If this doesn’t work, come back and we’ll try something else.” Great business model. I’ve never been to a so-called alternative health practitioner, but one thing I have observed is that people who do seem to be satisfied… surely that counts for something.

    I am also aware that the medical insurance scheme in Australia went bust… the Government had to bail it out to the tune of hundreds of millions of dollars otherwise the whole health system would have had to shut down… alt-med insurance premiums are a fraction of medical practitioners. From my risk analysis work I know that the number of people harmed from visiting a medical practitioner are orders of magnitude higher than those harmed visiting alt-med practitioners… same for pharma meds vs alt meds…

  • Ron, the reason that those visiting alt practitioners tend not to be harmed is that the treatments have no effect, so of course the cannot cause harm (except when they cause people to avoid effective conventional treatments – in such case real harm can occur however, harm through not having a treat is not easily quantified.
    Like it all not, there is a (typically small) amount of risk with most conventional medication precisely because they do have an effect on the body.

  • Oops apologies for the typos in the previous post – using an iPad which seems to increase my number of errors.

  • Michael, the person who ultimately decides that the patient is better or not is the patient… if they are happy with treatment they will continue. For the record, harms associated with pharmaceutical medications are not ‘typically’ small… between 500-800 die each year in NZ from preventable harm due to pharma meds; roughly 2x the road toll. About 1,500 die each year due to preventable medical injury per se.

    Humanity can’t be redacted down to chemicals… there is no ‘average’ person… statistics apply to the masses… never the individual…

  • Ron, certainly those numbers are one’s that are of concern. However, it needs to be asked how many people are also saved by those same treatments which also can cause death.
    Alternatively can you imagine how many deaths would occur of all conventional treatments were replaced by alternative medicine? The death toll would be incredible – heart attacks, asthma attacks, septicemia, viral infections.

    The categories “preventable harm” and “preventable” medical injury are also quite broad categories. What is the source of your information? It would be interesting if one could dig deeper and find out for example how many of these deaths were charting errors, how many were patients misunderstanding their medications etc.

    I’m not quite sure what the point is you are trying to make when you state that “there is no “average” person … statistics apply to the masses … never the individual”
    What do you think this means in terms of treating patients?

    As far as I’m concerned my doctor treats me as an individual – he relies on the statistics which tell him what treatment is likely to work for me, but as you pointed out in a previous message, many doctors tell patients to come back if it doesn’t seem to be working.
    This does not mean therefore that alternative medicine is a valid alternative – if a certain asthma medication does not work for me that does not mean a bottle of magic water.

    Statistics around medications informa doctor of what is likely to work and also informs him or her of what the related risks are.

    Real medications come with risks because the interact with the body, ideally in a therapeutic way. Alternative medicines carry little risk in their use because they have no effect on the body.

    I don’t think anyone here considers that humans can be redacted down to chemicals – however statistics can inform us about what is likely to work and what is not. Statistics applied to most alternative medicines show that the do not work in any significant way.

  • Darcy, your ‘related articles’ article First Do No Harm is interesting. It claims that ‘First Do No Harm is not in the Hippocratic oath and then link to some persons modernisation of it. So what does that suggest, If we are not happy with something we just change it and then claim the new version is the one that we are all talking about?

    The classic version highlights the religious basis for medicine… it even highlights the importance of ?naturopathy… I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.n
    Although in the modern context ability and judgment seems to have diminished somewhat.
    http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html#classical

    Principles are often not spelled out verbatim in documents, but you recognise them when you see them… First Do No Harm oozes from the Hippocratic Oath… as does Cronyism and religious fervour.

  • Michael: “I’m not quite sure what the point is you are trying to make when you state that “there is no “average” person … statistics apply to the masses … never the individual”
    What do you think this means in terms of treating patients? ”

    A ‘scientific’ study is done using ‘standardised’, well people… usually adult, but not old… with a truck load of exclusions. Flu Vax is a good example… people with even moderate conditions are excluded. But who are the targeted/priority ‘consumers’ of flu vax? Mostly, those excluded from the studies.

    Drug B is tested and licensed at, say, 10mg per dose, twice a day. Now what is the weight of the person tested or being given the drug… body volume has a big role in both pharmacodynamics and pharmacokinetics. Standardising treatment may actually do more harm/less good than customising it.
    Drug C might improve a condition in 20 percent of patients. What that means is that it fails in 80 percent of patients. An average of 20 percent does not apply to the individual; 20 out of 100 will swear by the treatment, 80 out of 100 will say it is useless… If a discussion group started up and 20 percent voted it worked, and 80 percent voted it didn’t work, who is correct?

    IMHO they are all correct. But invariably the discussion then becomes polarised into two factions… the supportites and the disparagites… they set up their camps on opposite corners and snipe away at each other till the cows come home.

    I use one so-called ‘alternative’ on a regular basis. It’s called Tui’s Bee Balm. It is primarily bees wax with propolis, olive oil and a few bits and bobs. I’d being going to my GP for treatment of athletes foot (Ok, so I’m dillusional, I’m not a real athlete, though I do the Round the Bays, and ran a 1/4 marathon in good time in 2010). The problem is that despite the best of efforts, and a number of different potions nothing worked for more than a few days.

    Someone gave my wife (a nurse) a small bottle of TBB to try on one of her patients… she wasn’t allowed to so she asked e what was wrong with it. I couldn’t see any probs from the ingredients, noticed it mention AF and tried it. Guess what? It worked brilliantly. the AF returns after several months but as soon as I notice it I put TBB between my toes and it disappears for several more months. Is that scientific evidence it works? Absolutely… for me at least.

    You say, “Alternative medicines carry little risk in their use because they have no effect on the body.” That highlights either ignorance or myopathy. St Johns wort, Kava, propolis, any honey, red rice yeast, celery seeds, foiic acid, vitamin D, all have significant effects on the body or disease causing organisms…

    I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.

    “Alternative medicines carry little risk in their use because they have no effect on the body” is a scientifically proven false statement. Another skeptic’s paradox.

  • Michael: “however statistics can inform us about what is likely to work and what is not. Statistics applied to most alternative medicines show that the do not work in any significant way.”

    Michael, statistics applied to many pharmaceutical medicines show they do not work in any significant way. Influenza vaccine is a classic. Prozac/SSRIs is another…

  • a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’.

    The key words here would appear to be “caused by”. Homeopathic remedies, for example, would not of themselves cause very much at all since they contain no active ingredients. Wouldn’t it be more apt to be looking at the outcomes of using these ‘remedies’ instead of mainstream medical treatments? If someone is persuaded to drop their usual meds for a health problem in favour of (say) homeopathy, & subsequently dies of that health problem, surely the use of the alternative ‘treatment’ is implicated in that death?

    And by the way, neither folic acid nor vitamin D could be described as ‘alternative’ as both have legitimate uses in SBM.

  • Ron,
    I think we differ on our definition of what “alternative medicine” is. Many of the treatments you list have evidence to support their use (St John’s wart, honey, folic acid).

    When I talk about alternative medicine I mean those “remedies” which are unsupported by science and which have no evidence to support their use (e.g. homeopathy, and reikki).

    I understand your point about using statistics in drug trials, but this is why the use of a new drug is monitored carefully after it is first released to check that there are not effects that haven’t been picked up in the trials – also, while the early trials are carried out on standardised well people, later trials typically are carried out on a wider range of people, uincluding those who may be quite unwell from the disease being treated.

    ““Alternative medicines carry little risk in their use because they have no effect on the body” is a scientifically proven false statement. Another skeptic’s paradox.”

    I fail to see how this is a paradox.

    “That highlights either ignorance or myopathy”

    Do you really need to keep slipping insults into posts. If you continue to do this you will find very few people will be willing to respond to your comments.

  • Ron,

    “That highlights either ignorance or myopathy”

    FYI, myopathy is a muscular disease.

  • Michael: “FYI, myopathy is a muscular disease.”

    Good call… of course, this is not a peer reviewed scientific paper (even then, I’ve seen much worse!) Myopia was the word in mind… perhaps my body is suffering from myopathy… tx for pointing it out.

  • Michael: “I think we differ on our definition of what “alternative medicine” is. Many of the treatments you list have evidence to support their use (St John’s wart, honey, folic acid).

    When I talk about alternative medicine I mean those “remedies” which are unsupported by science and which have no evidence to support their use (e.g. homeopathy, and reikki).”

    Ahh… is that shifting goal posts again?

    So maybe the skeptic bloggers could do a post to clarify what they consider supported remedies.

    So where do we start? omega-3 fish oil, St Johns wort, Kava, propolis, any honey for wound care, active manuka honey for infected wound care, red rice yeast, celery seeds, foiic acid, vitamin D, then there are things like massage therapy, yoga, cats…

    Then a parallel list could be developed with pharmaceutical remedies whose use is unsubstantiated by evidence … eg, prozac, paracetamol for grisly kids, antibiotics for glue ear, then there is tonsillectomy, etc, etc.

    Then we’d be able to see where the differences were… skeptics claims that ‘natural remedies don’t work’ or even ‘alt remedies don’t work’ is not only unsubstantiated, it is patently false… many are scientifically validated.

  • alt med is not a health issue per se – its a consumer issue. Odd though it may be for me, I kind of agree with Ron – if the user goes away satisfied, what is the problem?

    We know that the vast majority of alt meds are not of themselves harmful – in fact they are for all intents and purposes inert, neither adding nor removing value (except financial). Same for alt med interventions eg accupuncture and diagnosis techniques eg iridology

    The proviso on that however has to be fully informed consent, or in consumertalk, full disclosure, and this is where alt med almost universally falls down. I’m not aware of any iridologist, colour therapist, homoeopath, etc who routinely provides research-based information on the efficacy of thier treatment.

    By and large then, consumer law, not medical, provides the best method for curbing the most outrageous activities of providers of woo.

  • Ron,

    It is not shifting the goal posts to provide my definition of what alternative medicine is – it is an attempt to try and make sure we are working from the same definition, so that we are not talking at cross purposes, which is bound to happen if two people have different definitions of a term.
    I find it irritating that you take my attempt to improve communication as “moving the goalposts”.

    I have never said that “natural remedies don’t work” (nor would I believe most sceptics) – I have taught natural products chemistry before and am quite aware of that most pharmaceuticals have been inspired by or derived from the natural world. However, this has also made me aware of “remedies” for which there is no evidence that they work (for example homeopathy, which is also theoretically implausible.

    Ashton,
    I would agree with your statement that “if the user goes away satisified, what is the problem” by adding two words “if the user goes away satisified and healthy, then what is the problem”
    I think there is a danger that alternative medicines (i.e. those which have been demonstrated to have no effect) could allow a health condition to deteriorate when the customer thinks it has been sorted.

  • Getting back on topic, the reasons why people use ‘alt med’. (Excuse this being note form – v. busy.)

    First up – thanks for the thoughtful look into the issue Darcy. It’s a fair point that ‘pampering’ the patient (for want of a better term) might be mainly cited as it’s easy to trot off the cuff rather than it being the actual main reason. It also seems me that’s more to do with continuing to use their service, not the initial decision (i.e. what prompted them to go to a consultation in the first place).

    “So it would seem, at least in this sample, that dissatisfaction with conventional care cannot be the driving force for the majority of altmed users. More plausible is that altmed users seek to make the most of every perceived avenue for health.”

    If “seek[ing] to make the most of every perceived avenue for health” is the main driving force it’d be interesting to measure the role/impact of marketing (or it’s casual attendant, gossip!) – consumer magazines and local rags are replete with advertising from people with offering these products or services, etc.

  • Michael, good point about the patient being healthy as well as satified. I have a post lined up that touches on this point as well.

    Grant, I have heard that direct-to-consumer marketing can have quite an impact on conventional drug use, I would think a similar (if perhaps smaller) effect would be be plausible for altmed.

  • The big problem with this discussion is that it is throwing everything into a pot and then taring everything with the same brush. It’s like trying to discuss safe modes of travel with all modes being bundled up together. Airplanes are super safe… mountain bikes are not.

    So-called alt-meds are quite different to so-called alt-practitioners. The risks and benefits are quite different so discussing them in the same breath is grossly unscientific… unless, of course, one is just trying to obfuscate the evidence/discussion.

    Regarding Natural Health Products (as defined [poorly, fwiw] in the Natural Health Products Bill) Let me state point blank… I am fully supportive of evidence-based claims and prosecutions when false claims are made. Having worked with more than a hundred NHP companies and practitioners over the past 14 years I know that the vast majority of the industry stakeholders agree. Even Professor Gluckman agrees with what industry has proposed [personal discussion with him and purview of his submission and oral evidence].

    The question then is what constitutes evidence. I developed a slightly modified scale of evidence based on EBM and the NZ MOH’s Clinical Guidelines Group. If you want to read it go to http://www.parliament.nz/NR/rdonlyres/42662BF9-7AF6-4BAC-B7FB-5CF50FAF3E7A/210291/50SCHE_EVI_00DBHOH_BILL11034_1_A222289_NewZealandH.pdf

    pg 35-36

    (n) Seven levels of evidence can be graded as A, B or C indicating strength of evidence: 29
    A. Good evidence:
    I. Evidence from large, well conducted Randomised Controlled Trials (RCTs)
    II. Evidence from small, well conducted RCTs
    III. Evidence from well-conducted cohort studies30
    B. Fair Evidence
    IV. Evidence from well-conducted case-control studies31 or traditional use
    V. Evidence from uncontrolled or poorly controlled studies
    VI. Conflicting evidence, but tending to favour the recommendation
    C. Weak Evidence
    VII. Expert opinion or testimonial evidence

  • For the record, it is illegal in NZ to make false claims… GlaxoSmithKline found that out with false claims made regarding Ribena
    http://www.comcom.govt.nz/fair-trading-media-releases/detail/2007/ribenavitamincclaimsfalseandmislea

    same with Zenith and Celluslim

    http://www.comcom.govt.nz/media-releases/detail/2005/commercecommissiondeliversforconsu

    So if these so-called alt-med companies are making false claims, how come the Commerce Commission isn’t all over them like a rash????

  • Darcy,

    One of the reasons I brought marketing up is that once you bring up marketing, it seems to me that you also bring up the question of why people fall for marketing in general – not alt. med. or not per se, but in general. One thing related to this, for example, is teaching critical thinking at schools, etc. Then of course these things probably regress endlessly! 🙂

  • StuartG asked, “I also wonder why the users of CAM don’t use alternative mechanics, alternative plumbers, alternative electricians, alternative flight, etc.”

    Firstly, most people do (apart from flight)… it’s called DIY.

    We just built an expensive new home… we had to use a registered plumber… rightly so you would think… turns out not one of the plumbers who did the work was registered… only the business owner who never set foot on the property but signed it off as compliant. They had to come back 4 times to get the hot water sorted… re plumb the over flow…

    Then, three years on, the toilet cystern started leaking… turns out it wasn’t installed correctly.

    The person who put the drainage in had to be registered… turns out the number he had was someone elses… Council knew he wasn’t registered… apparently he paid the registered drainlayer $500 for his number! And these were not ‘dodgy’ companies… the Plumbers are one of the so-called top plumbers around… but the ONLY registered plumber is the owner (they employ about 10… 5 worked on our place…

    The same is happening with builders who now have to be licensed… good people with 20-40 years of experience who can’t be bothered with all the red tape are now just contracting to a paper shuffler who has a ticket…

  • Grant, teaching critical thinking is one thing (and good IMO) but allowing it to work through in the real world is another… True story… Surgeon comes into operating theatre to do hip operation. Everyone is ready to go… patient is prepped and anaethetised for left hip to be replaced… surgeon enters and says it’s the other hip he is replacing… everyone knows he’s wrong, but no-one dares challenge him as experience has taught them not to. They switch the patient around and he does the op… Nek minit, a fourth year medical student who happened to be working in the theatre as an orderly presents a paper he’s written on said case to the charge nurse. The CN reads it, then turns to the lad and says, “If you have any notion of having a successful career in medicine, then I strongly suggest to get a shovel, and take this down to the bottom of your garden and bury it as deep as you can.

    Incident occurred in best practice private hospital in AK… The MOH knew… but did nothing of note.

    A few months later, the husband of a colleague of mine was about to undergo a knee replacement by same surgeon… he came in and had learned his lesson… he marked the knee where he was going to operate… wife comes to visit just before op,…asks slightly demented husband, “what’s that mark on your knee?” Husband says, “That’s where the surgeon is going to operate,” “Like Hell!” response the wife as she packs hubby’s bags, “It’s the other knee that’s stuffed.” Op was done elsewhere…

    My advice??? Don’t point the bone at so-called ‘alternatives.’ point the bone where most harm is done… oh, and critical thinking is not practiced to any degree in the health system… critical thinkers are by and large ostracized.

    ps… both cases were discussed at the MOH Expert Working Group that advised the MOH on the reporting and management of medical injury in the so-called ‘Health’ System… neither case concerned MOH particularly.

  • Not a good analogy Ron – alternative (insert name of trade here) still uses the same technology as a “real” (insert name of trade here) and doesn’t rely on metaphysics to explain why, for instance, laying hands on your taps will fix the leaky washer.

    Perhaps if you had referenced the leaky home debacle where unproven products were used in conjunction with unapproved methods you might have made your point better…

    The rest of your description is referencing error and/or incompetence which exists regardless of regulation and registration

  • OT alert

    Oh, and those same “good builders” with 30 to 40 years experience were building during the leaky homes era. Perhaps they have leart skills and techniques (not to mention responsiblity) in the interim, but I think they should be tested to be sure…

    Back to topic…

  • Ashton, most leaky homes have been due to faulty products eg between 80 and 100 per cent – of homes built with monolithic claddings (seamless-looking sheets finished with paint or plaster) would fail within 15 years. And yet Hardy’s hasn’t been held accountable… Architects designed houses without eves to enable bigger houses and circumvent council imposed rules re distance from boundary… some builders are dodgy… and will remain so… they are human… all trades, including the medical profession, have dodgy practitioners… more regulation can make things worse.

    The good thing is that regulations preventing DIYers from doing projects over $20,000 just means they do 2-3-whatever projects of $19,999… My wife & I built or first second home 30 years ago… it only leaked once… where a registered plumber put a pipe through the roof!

    In a sense this is on topic… there are over 30 laws/regs/codes of practice that regulate the NHP industry… the problem mainly is that they have not been enforced. If the Commerce Commission prosecuted more people then more/new legislation would not be necessary.

    Further to that, there is a law change going through as we speak… The Fair Trading Act is being amended to make it illegal to make unsubstantiated claims… ie, the evidence must be on hand when a claim is made… and that covers all of commerce.

  • I reckon that most people use alternative medicine simply because they are:

    #1) naive (or borderline stupid), for those in advanced/developed societies.

    #2) have no knowledge of science (& modern medicine) for those in 3rd world societies.

    #3) have some limited knowledge of science (& modern medicine) for those in 3rd world societies but have some misguided beliefs that modern medicine is more damaging than alternative (perhaps by listening to or believing people like Ron Law).

    In the island they fall into, point #2) and point #3) categories. When I was young in my village, I used all sorts of herbal traditional medicines given to me by traditional healers, simply because that’s the way of life. I can’t recall whether those treatments had any benefits or not (or they did, then it may have been placebo effects). Also I can’t recall that anyone died as a result of using traditional herbal medicines.

    Kau Faito’o:Traditional Healers of Tonga Part1

    Kau Faito’o: Traditional Healers of Tonga Part2

    Every time I visit my village, I encouraged people there not to use herbal medicines but go to the hospital first. The danger of relying on herbal medicines is that the locals have no clue when a medical conditions is serious, that urgently needs hospitalization. There were 2 cases in my village that I recalled back then, where the sick patients who were under the treatment of a traditional healer where the conditions of the patients deteriorated and were finally taken to hospital only to die there. One died after a few hours on arrival and the other one died after spending a day at the hospital. The hospital doctors told both families, that they brought them too late. But that’s usually how beliefs of the locals are misguided. They blame the hospitals for their loved ones deaths, because they view doctors as not doing their job properly.

    That’s exactly how the Ron-Law type of misinformation in the village (not only my village but other villages as well) arised.

  • Falafulu Fisi demonstrates the classic skeptics paradox well… he uses anecdote to argue a science-based argument… “here were 2 cases in my village that I recalled back then…” It’s anecdote… why do skeptics continually use anecdote to argue a science-based cause?

  • Ron,

    “Falafulu Fisi demonstrates […]”

    Still blindly flinging this one around? The problem isn’t that people use anecdotes in itself, it’s if they insist they an anecdote is evidence in the formal scientific sense. If they’re just presenting ‘case’ examples or ruminating, it’s just fine. Increasingly this looks, to me, like efforts to dismiss others without actually engaging with them.

    PS: the egs in your reply to me are examples of issues, yes, but of protocol, not critical thinking. (Your story also looks looks to be presented in a slanted way, with you having characterised MoH, but then that’s you always crusading against medicine as you have for decades particularly against the MoH.)

    PPS: Regards your remark “Don’t point the bone […]”, etc., you could try reply to Alison. I‘ve noted over several comment threads now you have not once replied to her while replying to pretty much everyone else – is there a reason for this?

  • Blindly? Not at all… if skeptics argue that anecdote is anecdote and the plural of anecdotes doesn’t make data, then it is hypocrisy to apply the skeptics paradox… you can’t argue against the use of anecdote by using anecdote to discredit anecdote…

    Rant says, “as you have for decades particularly against the MoH.” Grant, you have no idea what you are talking about… none whatsoever. Work I’ve done over the years is even used in Law Schools… “It may be that the exercise of a regulation-making power is so inappropriate or flawed that it represents an unusual or unexpected use of a regulation-making power. The New Zealand Food Standard, Amendment No 11, was one such example.”
    http://www.victoria.ac.nz/nzcpl/RegsRev/chapter7.aspx

    “The complainants alleged that there was insufficient scientific and technical evidence to support the safety concerns that the standard purported to address. The Committee agreed and found that Ministry of Health had acted on inadequate information and had failed to produce a substantive and comparative risk-assessment for all three products. As a result, the Committee felt that it was not possible that the Minister could have satisfied the requirement to consider the need to protect the public given that the information relied upon was inadequate for this purpose. The Committee stated that “while the Minister has a discretion in deciding the weight to be given to different considerations there must be evidence available to support the decision”.
    http://www.victoria.ac.nz/nzcpl/RegsRev/chapter5.aspx

    Regulations Review Committee “Complaint Relating to the New Zealand Food Standard 1996, Amendment No 11” [1999] AJHR I16Q.

    I was told at the time it was a first… and didn’t even use lawyers! My reward was being invited by the DG of Health herself to participate in the expert working group to advise her on the reporting and management of medical injury in the health system…

    Then their was the Minister’s scientific review of the bee products evidence… it found against the MOH and in my favour on all five terms of reference… as I said, you have no idea what you are talking about… you make slanderous claims out of ignorance! And then try and claim the moral high ground… and you call yourself a skeptic???? sheeesh, such actions bring any rational thinking group into disrepute.

  • Rant says

    Playing games with people’s names is childish (Ron has done this before). Not worth replying then. I can’t help note that since your poor behaviour on my blog resulted you in being banned from it you’ve been trying to puff yourself up.

    You didn’t reply to my question asking why you can’t/won’t reply to Alison.

  • Actually, Grant, it was a slip, but at least it gives you an excuse for backing out gracefully.

    I don’t reply to everyone’s comments… I have sent Alison a paper didn’t have but she had commented on the abstract elsewhere about another matter.

    I have no problem answering her previous post….

    There are three aspects to her comment… the risk inherent in the product, the benefit, if any, of any product (and this includes pharmaceuticals as well; and people’s choices regarding what they use/don’t use.

    Firstly, the evidence is beyond debate that as a class, pharmaceutical drugs are orders of magnitude greater than food supplements, herbal remedies, or most other natural health products.

    Secondly, depending on what the problem is, the success of most ‘treatments’ for most ‘ailments’ is determined by the consumer, not any practitioner. For example, if I go to my GP with a sore shoulder and s/he gives me potion x, it is me who decides whether my pain continues. If it stops I might assume (rightly or wrongly) that potion x did the trick… if I’m not satisfied, I may well decide to go back to my practitioner… etc, etc.

    The third point raised by Alison is more difficult to judge. If people choose to forgo treatment A that’s their choice… if they then decide to try something else, then that is their right. If they decide to forgo one treatment because they think something else is better then that’s another more problematic issue.

    Personally? I’ve always favoured free choice, ideally informed choice. In New Zealand we have legislation called The Fair Trading Act… if people sell something making false claims in the process they can be prosecuted and fined substantial amounts… such prosecutions have occurred in the past… eg, GlaxoSmithKline’s false claims about Ribena.

    My particular interest is in the use of evidence to support risk management decisions…

    I’m working on redacting a MOH claim regarding alleged risks of natural health products in papers presented to Cabinet… their claims are totally false… I got papers under the OIA… the date of their claim was wrong… I checked the alleged source of the original data; I now have on file an email from the Australian government confirming that their data is totally wrong… the Medical Association has made comment based on the MOH’s totally false claims… who regulates the regulator? But that’s another issue.

    So the answer to Darcy’s original question; why do people use alternative medicine… most don’t, most don’t desert mainstream medicine, a few do… An interesting observation of most ‘anti-vax’ folk who have contacted me is that nearly all of them were pro-vax… there child had a severe reaction following vaccination…. they were treated shabbily by the health system… they in turn had an adverse reaction to the system…

  • “Actually, Grant, it was a slip, but at least it gives you an excuse for backing out gracefully.”

    But rather than just say that you insist on ‘characterising’ what I did – I’ve nothing to ‘back out’ of and am not.

    “There are three aspects to her comment […]”

    Why address this to me? – shouldn’t this be addressed this to her?

  • Grant, I was addressing it to whoever… If you read it as being addressed to you, thanks for the complement… I hope everyone who reads it feels the same…

    As usual Grant, you don’t engaged the evidence… you engage the side shows… if you are a skeptic as you claim, then for goodness sakes engaged the evidence… the skeptic’s paradox is alive and well on sciblogs, for sure…

  • OK then, Ron – you don’t really appear to have addressed my previous comment here, which was in response to one of your statements (italicised):

    a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’.

    So here’s the comment again: The key words here would appear to be “caused by”. Homeopathic remedies, for example, would not of themselves cause very much at all since they contain no active ingredients. Wouldn’t it be more apt to be looking at the outcomes of using these ‘remedies’ instead of mainstream medical treatments? If someone is persuaded to drop their usual meds for a health problem in favour of (say) homeopathy, & subsequently dies of that health problem, surely the use of the alternative ‘treatment’ is implicated in that death?

    And by the way, neither folic acid nor vitamin D could be described as ‘alternative’ as both have legitimate uses in SBM.

  • Alison, in a forum like this words are used which may be reconsidered many times if one was publishing in a peer reviewed paper.

    In pharmacovigalence shoud work through a causality assessment which can conclude a number of options ranging from, more info required, unlikely, possible, probable etc.

    There are dozens of deaths associated with herbal use… just like there are dozens of deaths associated with vaccine use… there were four deaths of NZ children last year following influenza vaccine use…
    http://www.medsafe.govt.nz/profs/PUArticles/SeasonalFluVaccineMarch2012.htm

    These were flippantly dismissed as coincident. The report immediately before this related to someone who was admitted to hospital due to seratonin syndrome attributed to a single cup of st john’s wort consumed the day before starting a low dose SSRi.
    http://www.medsafe.govt.nz/profs/PUArticles/StJohnsWortMarch2012.htm

    I addressed your question regarding risk assessment in my previous post… any risk assessment of a product starts with risks related to the product…

    You ask, “Wouldn’t it be more apt to be looking at the outcomes of using these ‘remedies’ instead of mainstream medical treatments?”

    What are you suggesting? A police State that dictates what you can/can’t do?

    When I look at the risks associated with the use of so-called mainstream treatments it becomes obvious that net risks ramp up as the medical industry medicalises wellness… there have even been papers showing that more doctors increase risk/harm, rather than reduce it.

    Fortunately the vast majority of people view various treatments with a both/and mentality rather than an either/or mentality.

    You ask, “If someone is persuaded to drop their usual meds for a health problem in favour of (say) homeopathy, & subsequently dies of that health problem, surely the use of the alternative ‘treatment’ is implicated in that death?”

    I guess that depends on what you mean by, ‘usual meds.’ Plenty of people with terminal cancer have dropped their ‘usual’ meds because they want to die with dignity… if they give something else a go and die would you still implicate the alternative ‘treatment’ in that death?”

    You add, “And by the way, neither folic acid nor vitamin D could be described as ‘alternative’ as both have legitimate uses in SBM.”

    Folic acid was deemed as so-called alternative re NTD until the mid 1990’s… even in NZ scientifically established supplements are prevented from making scientifically proven health claims.

    Vitamin D use for a plethora of treaments/preventions are deemed ‘alternative’ by mainstream medicine despite a rapid emergence of scientific evidence.

    A sad aspect of medicine today, exemplified by skeptics on sciblog, is that it is still locked in the cold war era… it views things in black/white; right/wrong and ignores aspects of humanity.

    By the way, do you have a definition of SBM? Where does Prozac fit? What about amoxyl for glue ear? Or tonsillectomy for tonsillitis?

  • Alison, using your analogy, hi dose intravenous vitamin C saves lives… so why do skeptics deny the scientific fact?

  • You ask, “Wouldn’t it be more apt to be looking at the outcomes of using these ‘remedies’ instead of mainstream medical treatments?”
    What are you suggesting? A police State that dictates what you can/can’t do?

    Please don’t put words in my mouth, Ron. I was referring to the risk assessment you referred to at the top of this thread, so how about answering my question in that context instead of continuing to dodge it?

  • I haven’t dodged anything…. maybe you don’t understand risk management from a legal perspective so let me simplify what you are angling at…. but tell me if I’m wrong

    There are two aspects to the use of product x… one is the risk of the product itself… and the other is the risk of false claims.

    Fair Trading Law in New Zealand is the ultimate legislation for false claims… make false claims then get prosecuted… if there are no prosecutions then blame the regulators… unless of course there is evidence to prevent the likelihood of a successful prosecution… if one is regulating the products then one looks at the risks of the products. If one is regulating the use of products, especially claims, then fair trading law kicks in.

    In the case of medicines there are aspects of claims included in the medicines act as well as the food act… but rarely does the MOH or MAF prosecute… most prosecutions occur under the FTA.

  • Ron, rather earlier in the thread you said I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.
    My question related to that statement. Wouldn’t it be more apt to be looking at the outcomes of using these ‘remedies’ instead of mainstream medical treatments? That is (as I’ve already said), a remedy with no physiological effect (such as homeopathy) won’t of itself be harmful to the patient, but use of that remedy in place of an SBM treatment may well be harmful. So yes, you are dodging the question.

  • As I explained… these are two quite different issues… one relates to the risks associated with the products themselves… the other relates to claims/evidence. If people make false claims they should be prosecuted… that’s not too difficult… In fact the Fair Trading Act is in the process of being amended… it will become illegal to make unsubstantiated claims meaning that it would be illegal to make a claim without evidence on hand.

    As I’ve said before, looking at ‘these’ and ‘those’ in a black/white, right/wrong cold-war era mentality isn’t very scientific…

    What mainstream medical remedies are you thinking of? Prozac? Not very scientific, I know. I wonder how many people have died using that instead of something quite safe such as St John’s wort? Or were you thinking of the 50,000+ who died using that ‘scientifically’ proven, but fraudulent, Vioxx? Or maybe the “scientifically proven” harmless Heroin invented by a scientific pharma company? Or the ‘scientifically proven’ benzodiazipines killing thousands of older people each year? Or LSD? Or Xigris, withdrawn because of a lack of efficacy?

  • Alison, is this the sort of concern you have regarding inappropriate healthcare?
    http://www.brisbanetimes.com.au/queensland/dr-jayant-patel-guilty-of-manslaughter-20100623-yyft.html

    Obviously the is evidence that this modality is out of control and clearly should be banned. He attracted the nickname Dr. Death as a result of his actions… people knew but obviously most were too scared to say anything. Nurses even hid their patients from him when they knew he was in the hospital.

    He showed a poor regard for hygiene with claims that he responded to a nurse’s concern over his unwashed hands with doctors don’t have germs. He is linked to at least 87 deaths out of the 1,202 patients he treated between 2003 to early 2005, 30 of whom died while under his care. Hospital staff have also accused him of altering medical records to hide mistakes.

    I wonder why skeptics don’t bag rogues like this? Is it because they are blind to the obvious? Are they biased? Are they showing behaviour patterns associated with religions? ie, Blind Faith?

    Following two formal inquiries (actually it was nearly two as the first one down after it got too close to the bone… it was found that he had caused 13 deaths, and perhaps up to 21.

    Is that the sort of healthcare you have concerns about?

    Or maybe you are thinking of UK Dr Shipton with 218 murders being positively ascribed to him…. all committed under the nose of officials…

    Or maybe you are thinking of US Dr Swango. The FBI believes he may be responsible for as many as 60 deaths.

    Or are you thinking of rogues like Dr Ubani who only killed one or two?

    How do you proposed all of the above should be regulated? Oh, that’s right, they were properly regulated practitioners, practising SBM… I nearly forgot.

  • Ron, stop moving the goalposts. You’re the one who said that alt.meds have caused ‘only a handful of deaths’. Do you, or do you not, agree that if an alt.med (eg homeopathy) is substituted for an SBM treatment of known efficacy, & the patient subsequently worsens & dies, then the alt.med may be implicated in that outcome?
    If someone is on meds for, say, diabetes, is advised to change to a CAM remedy (& I’ve seen leeches recommended for this disease) & subsequently their condition worsens & they die (which in the case of leeches wouldn’t be surprising as there is 0 evidence for effectiveness on diabetes), then that alternative treatment should be implicated.

  • Alison, I m not expecting a response because, of course, those are extreme cases which reflect more on humanity than anything else. The point I am making is that effort and resoures should be expended where it will make the most difference. The day I see skeptics bagging rogue SBM (whatever that is) is the day I’ll believe there is some hope for an improved health/illness system. SBM is not about science… like all aspects of commerce, it is largly about maoney and protecting one’s patch… set up a system to establish technical barriers to new entrants and protect the system at all costs… that, in part, is what the original Hippocratic Oath was/is about… religion, nepotism, and protecting the brotherhood… skeptics would have much more success in improving healthcare outcomes if they worked on instilling integrity and transparency into the health system… and challenging the medicalising of wellness which is alive and well in all forms of delivery whether that be SMB (whatever that is), EBM, herbalism or homeopathy.

  • Alison makes a totally false claim when she says, “You’re the one who said that alt.meds have caused ‘only a handful of deaths’.”

    I have never made such a statement… you have…

  • Ron,

    I don’t want to get involved in what is someone else’s discussion but I have to agree with Alison, you are spending an awful lot of time shifting goal posts and evading what is a simple question.

    She’s not talking about legal avenues or policy (e.g. FTA rules) or various mainstream medications, or something about “inappropriate healthcare” or rogue doctors or other things you have sidetracked to.

    She is talking about your ‘survey’ as she explained quite clearly:

    “rather earlier in the thread you said I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.

    My question related to that statement.”

    Sidetracking to specific cases is besides the point too. She’s talking about a general procedure; whatever you do you’re going to have to have some general procedures that you apply to all cases (or you won’t be able to compare them).

    Her question is very straight-forward, let me re-cast it in yes or no fashion to make it simpler still:

    You claim you wish to assess the risk from alternative ‘remedies’ compared to mainstream medical treatment. Yes or no: wouldn’t it be more apt to be looking at the outcomes of using these alternative ‘remedies’ instead of mainstream medical treatments?

    Note the parallel between your aims and her question.

    Regards

    “Alison makes a totally false claim when she says, “You’re the one who said that alt.meds have caused ‘only a handful of deaths’.””

    Please see your own words that Alison quoted to back to you reiterated below (note emphasis):

    “rather earlier in the thread you said I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.

    Having said my bit I’ll let you and Alison carry on!

  • Grant, you are right, it’s not your discussion… and AGAIN, you falsify, deliberately or otherwise I don’t know, but you make up things that are factually false.

    I never claimed that i wish to assess the risk from alternative ‘remedies’ compared to mainstream medical treatment….

    Let me rephrase your yes or no question in a fashion to make it simpler still… are you going to stop falsifying what people say? Yes/No???

    I appreciate that this is not an area you have any expertise in, so what is it you do not understand about my original statement;

    I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms. ???

    I’ve asked Alison regarding a specific case… I’ll await her response so I can continue a meaningful discussion.

  • If you wished to politely say “I’m only looking at the alternative ‘remedies’”, fine. Throwing brickbats and silly accusations like that is childish.

    Even if you only wish to look at the alternative ‘remedies’ you’re still faced with her question and in many ways even more so.

    On that note: you are still avoiding answering Alison’s question.

  • Ron, I was quoting you when you said, on this thread, 4 days ago that I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.
    I would appreciate a retraction of the statement that I am lying (ie making a totally false claim

  • Grant, you keep falsifying what other people say… why do you do that…? It is hardly worthy activity for a self-proclaimed skeptic… Let me put this politely… comment on things that you are qualified to comment on and don’t create fiction when you do. I have never said, “I’m only looking at the alternative ‘remedies’”… you have…

  • Alison, I never accused you of lying… lying involves intent… You certainly have made a false statement… I don’t know if you lied or not… only you know your intent… it may just be ignorance… I never said, ” that alt.meds have caused ‘only a handful of deaths’.”… you did!

    I never said this on two counts…

    Firstly, I never referred to alt.meds (whatever they are) and
    secondly, it was not me who said it, but the UK’s Regulator, the MHRA.

    Their exact phrase is, “There have been a handful of identified UK deaths associated with use of herbal medicines;” see

    http://collections.europarchive.org/tna/20100509080731/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103566.pdf

    I’m in the process of getting detailed info from the MHRA… to date they have not been able to provide the evidence to even support that statement of ‘association.’ But I’m a patient person… I’ll wait.

    Now, Alison, back to the question at hand…

    do you mean a case such as this on that link ‘What’s the harm with homeopathy’ you gave in a post on another blog when I asked for evidence of deaths attributed to natural health products?

    Russell Jenkins
    http://www.whatstheharm.net/homeopathy.html

  • Ron Law,

    Alison pointed out you had used the phrase “handful (hand full)of deaths” in relation to natural medicine.

    You then denied this, and then quoted yourself using this phrase again.

    Can you not keep track of what you have said? And when it is revealed that you have been incorrect, would it not be polite to admit it?

    Also, you do seem to be shifting the argument from alternative medicine, natural remedies to malpracticing doctors and murderous doctors, to badly behaving pharmaceutical companies, and when you make any mistakes you just gloss over them and move onto the next subject.

    Seriously, if you wish to claim that alternative remedies are better, wouldn’t it be better to focus on providing such evidence rather than changing to irrelevant subjects?

  • You are quite right in pointing out that the use of some drugs has been overhyped. These need to be removed from the market and this is happening – which is why we know about them. A lot of the time it has been scientists and medical professionals who have pointed out the problems with these drugs.

    With regards to Vioxx – it is an extremely effective drug for the treatment of inflammation. The problem was that Merck, ignored the evidence indicating that it was increasing the likelihood of heart attacks in patients, and you are correct it did result in many thousands of deaths.
    However, there is reasonable evidence that Vioxx could still be safely used if there was better montoring and selection of the patients who would be using it. Of course after what Merck did no one wants to even consider this because their betrayal has left Vioxx tainted

    The fact that some pharmaceutical drugs do not work as advertised does not automatically mean that natural remedies are better or safer
    St John’s Wort, for example, because it does have active ingredients, is contra indicated for MAO inhibitors, severe depression, some forms of cancer, or while taking anti-HIV medication. Furthermore it should not be taken during pregnancy, while breast feeding etc.
    So, as a remedy, it certainly needs to be handled carefully, and I still have reservations about the consistency in amount of active ingredient in any natural product.

  • Michael, I’m surprised you have resorted to making false statements too… Alison never pointed out that I had used the phrase “handful (hand full)of deaths” in relation to natural medicine… even I didn’t say that..

    I didn’t deny it, because she never said it… Why can’t skeptics stick do facts? It’s quite ironic, really.

    Why does it seem normal practice for self-proclaimed skeptics to alter what was said????

    For the record, Alison said, ““You’re the one who said that alt.meds have caused ‘only a handful of deaths’.” among other false statements.

    Alison is well known for being a good communicator… why is she letting herself down here… is it the ‘skeptics curse’? Or just sloppyness… or worse…

    For the record, I said; “I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.”

    I look forward to Alison’s response so we can continue this deep and entertaining, if not meaningful, discussion…

    Alison, back to the question at hand…

    Do you mean a case such as this on that link ‘What’s the harm with homeopathy’ you gave in a post on another blog when I asked for evidence of deaths attributed to natural health products?

    Russell Jenkins
    http://www.whatstheharm.net/homeopathy.html

  • Ron,

    Ah, I see – you do not believe Alison’s statement carried the meaning of your original statement?

    “I have contacted health authorities including the MHRA in the UK. The best/worst I have got so far is ‘a hand full of deaths… ever’. I have reports showing that in the UK in 1999 there were 22 million consultations undertaken by CAM practitioners with no significant harms.”

    Of course as I tihnk Alison suggested earlier would it not be important as well to examine whether these 22 million consultations actually had any benefits? After all one could give 22 million people sugar pills and also see “no significant harms”.
    Such a treatment would be very safe, but of course it would have no benefit.

  • For the record, I wouldn’t have banned vioxx, or celebrex… I would have fined/prosecuted Merck & Pfizer and their marketing gurus gazzilions for fraudulent claims and deliberately falsifying data provided to regulators considering approval of the drugs… that is what is criminal. People, like my mum (and no, it did not harm her) spend hundreds of dollars thinking they were getting a more effective and safer drug… on the advice of their doctors I hasten to add.

    I agree with you totally when you say “The fact that some pharmaceutical drugs do not work as advertised does not automatically mean that natural remedies are better or safer.” I would go further and say, “The fact that some pharmaceutical drugs do work as advertised does not automatically mean that they are better or safer than natural remedies. There is no one-size-fits-all here. As a class, however, the evidence is unequivocal that industrially produced natural health products are orders of magnitude safer than pharmaceutical drugs.

    Regarding “St John’s Wort, for example, because it does have active ingredients, is contra indicated for MAO inhibitors, severe depression, some forms of cancer, or while taking anti-HIV medication. Furthermore it should not be taken during pregnancy, while breast feeding etc.”

    Most contra-indications are based on theoretical considerations relating to assumptions re effects on P450 liver enzymes. There are a truckload of foods that have similar effects, but for some unexplained reason never get caught in Skeptics Headlights desperately seeking out muck to tag natral health products with… this in itself highlights the biased mindset of said skeptics… another skeptic paradox perhaps…

    When is the last time skeptics waved the flag about old folk swilling their daily pharma-cocktail down with grapefruit juice??? It did hit the RSNZ alert in 1996…
    http://www.royalsociety.org.nz/1996/09/01/warning-on-deadly-grapefruit-juice-medication-cocktail/

    I suspect thousand are killed every year after swilling grapefruit juice… but not a single warning is put on grapefruit juice… why ever not? And no warfare cry from the skeptic paradoxers… Why ever not?

  • Ron,

    Just answer Alison’s question, eh? Making childish claims about me or trying to defer to a different question from yourself is just trying to sidetrack.

    (You said you were not looking at mainstream medicine, hence you were saying you were only looking at the alternative ‘remedies’ of the two. Like I said: if so, fine. My points were simply that you could have just said it politely and that it leaves you still wanting to answer Alison’s question, if anything more so. If by ‘falsifying’ you mean showing what the person (you in this case) said be wrong – then, yes, I was and it is a worthy activity when the statements are incorrect.)

  • Michael, I understand you are trapped in the skeptic belief system… I’m not… I did not believe Alison’s statement carried the meaning of your original statement… I know it to be a fact that I never said what she claimed.

    If skeptics stuck to fact rather than beliefs they would be able to discuss issues objectively… and perhaps engage, rather than antagonize their targets.

  • Grant, “(You said you were not looking at mainstream medicine, hence you were saying you were only looking at the alternative ‘remedies’ of the two.” A for effort… again you swan in making false claims… [Push ‘yawn’ button] and wait for Alison’s response re “Do you mean a case such as this on that link ‘What’s the harm with homeopathy’ you gave in a post on another blog when I asked for evidence of deaths attributed to natural health products?

    Russell Jenkins
    http://www.whatstheharm.net/homeopathy.html

  • With regards to grapefruit juice, Ron, I thought such warnings were fairly standard by medical professionals? I’ve sat in on a consultation with a friend who has cancer and was most impressed with how thorough the doctor was talking about contraindicating substance including foods.

    DO you have any evidence that doctors don’t warn patients who are taking drugs for which grapefruit juice is contra indicated? I certainly have never heard of any.
    What I am aware of is an acquaintance who used to willy-nilly recommend St John’s Wort to other people as something worth trying if they are feeling down. I can only hope that those working in places which sell it are informed enough to warn those buying it about its contra-indications

  • Ron,

    I understand you are trapped in the skeptic belief system

    Could you please explain what you mean by the term skeptic belief system?

  • Michael… good for the doctor… but alas, you have not understood what I said… I said, “I suspect thousand are killed every year after swilling grapefruit juice… but not a single warning is put on grapefruit juice… why ever not? And no warfare cry from the skeptic paradoxers… Why ever not?”

    Did the doctor mention broccoli?

    My involvement in this goes back to 2000 when I invited Stewart Jessamine (Now head of Medsafe) to Ak to undertake a risk assessment and consider risk management options. NZ was the first in the world to to consider this objectively and the industry had every product we could find in NZ labeled with an agreed caution statement within two weeks (ie, we met, we agreed on labellig, we got them printed, distributed to all companies/healthfoof stores/pharmacies etc and stuck on labels within two weeks!)

    The response can be seen on Medsafe’s website… have never seen a response like that for grapefruit juice… or broccoli… did the Dr advise your friend about the adverse effects of eating broccoli?

    http://www.medsafe.govt.nz/hot/media/media2000.asp#3%20April%202000
    (scan down and you’ll se YT’s comments…)
    http://www.medsafe.govt.nz/Consumers/leaflets/sjw.asp
    http://www.medsafe.govt.nz/Profs/PUarticles/sjw.htm
    http://www.medsafe.govt.nz/Consumers/leaflets/sjw.asp

  • “Could you please explain what you mean by the term skeptic belief system?”

    The SBS operates in a world view that sees things in terms of black and white; them and us; good and bad and often confuses fact from fiction… it also includes adherence to the skeptics paradox whereby believers use anecdote to discredit others using anecdote.

  • Ron,

    Your rhetoric does not reflect the reality of skepticism. The skeptics I know recognise that some aspects of life are a continuum of gray, however, this does not mean that objective statements cannot be made about the world around us.

    And as Grant, has pointed out several times there is a difference between using an anecdote to illustrate a point and using an anecdote as evidence. I am not aware of any skeptical argument that is based anecdote.

  • Michael says, “I am not aware of any skeptical argument that is based anecdote.”

    Earlier he said, “Furthermore it should not be taken during pregnancy, while breast feeding etc.”

    Upon what evidence is such an authoritative statement made? Anecdote? or just medical Chinese whispers? or just because… I’d be interested to see the evidence…

    You also state with authority that is contra indicated for MAO inhibitors.

    I’ve been working on SJW of late and I’d be interested in any evidence you have.

    I’m not saying you’re wrong, just asking you to front up with evidence to support the authoritative claims.

  • Ron

    Good point, that statement re pregnancy was phrased a little more authoritatively than I had intended. However, it is fairly typical to be cautious around the use of any type of medication during pregnancy and there is some evidence to suggest that St John’s Wort may have detrimental effects
    http://www.medicalnewstoday.com/releases/50001.php

    With regards to drug interactions the following is from:

    Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48

    “SJW has been shown to lower the plasma concentration (and/or the pharmacological effect) of a number of drugs including alprazolam, amitriptyline, cyclosporine, digoxin, fexofenadine, indinavir, irinotecan, methadone, nevirapine, simvastatin, tacrolimus, theophylline, warfarin, phenprocoumon and oral contraceptives. Induction of P-glycoprotein and/or cytochrome P450 (CYP) enzymes (particularly CYP 3A4) by SJW could explain such pharmacokinetic interactions. When combined with serotonin reuptake inhibitor, antidepressants (e.g. sertaline, paroxetine, nefazodone) or buspirone, SJW can cause serotonergic syndrome. SJW represents a herbal medicine with a high potential for drug interactions. Some of such interactions may have serious clinical consequences.”

    asd requested I have fronted up with evidence to support my comments and acknowledged that one claim was phrased a little more authorativiely than I had intended.

    Can I assume you will be fronting up, when others ask you for evidence to support your position on a topic?

  • Ron,

    You still haven’t answered Alison‘s question. Why is it that you can’t/won’t?

    again you swan [sic] in making false claims – no. Being in denial of what you have written then casting aspersions is just playing silly games.

  • Michael, thanks for that… but it’s a news report… and its 6 years old… the scientific paper is freely available at
    http://www.cjcp.ca/pdf/CJCP05-036_e268-e276F.pdf if you want to read it…

    It shows that any safety concerns are general… and mostly nil of note… of course, as always, pregnant women should be cautious, but shouldn’t be too worried re SJW… note they conclude the evidence re interactions is weak… I would tag that with a couple of exceptions… eg, transplant rejection drugs…

    The clip for the other article is from the abstract… have you read the full paper? If not, then I suspect you should. It’s easy to demonise things without the full picture. Getting something in print three times tends to get things set in stone… at least that’s my experience with medicine… people need to learn to critically evaluate what they stumble across… not take it at face value…

    As for responding to Alison… I’m waiting for her response to “Do you mean a case such as this on that link ‘What’s the harm with homeopathy’ you gave in a post on another blog when I asked for evidence of deaths attributed to natural health products?

    Russell Jenkins
    http://www.whatstheharm.net/homeopathy.html

  • I thought that was fairly clear from my earlier question, Ron. “Whatstheharm” lists (among other things) cases where patients were advised to give up their regular medications & subsequently suffered adverse effects, up to & including death. These would in many cases have been fairly predictable. Since ‘remedies’ since as homeopathy can by their nature have no physiological effects they are unlikely to do direct harm. However, substituting them for SBM meds for things such as asthma or diabetes is highly likely to cause harm nonetheless. Do you agree it is logical to attribute these adverse events to use of the alternative ‘remedy’, or not?

    (I’m beginning to wonder how many times I have to ask this question in order to get a straight answer.)

  • OK, now my response.

    1stly, this case is anecdote… as are nearly all of those I’ve looked at on whatstheharm.com so this is not evidence based… It’s no different from all the cases on similar website with score of children killed/maimed following vaccinations.

    2ndly, it’s not homeopathy as claimed.

    3rdly, on the face of it there is nothing wrong with suggesting using honey as a wound dressing… honey as a wound dressing is scientifically based.

    4thly, where this turns to custard is the fact that commonsense has been ignored… without more information regarding the wound, the initial advice (as noted in the article) and the use of honey is scientifically sound…

    This is not a case where anyone was advised to give up anything.

    You ask, “Do you agree it is logical to attribute these adverse events to use of the alternative ‘remedy’, or not?” My simple answer is maybe/maybe not…! I would put many of them down to stupidity and you can’t regulate stupidity. It is not the remedy that is at fault… it is the decision-making…

    In this case it is stupidity.

    Many of the cases cited on http://www.whatstheharm.net/homeopathy.html are garbage-science and I’m astounded that a skeptic would see this as a font of evidence to discredit anything… it says, ‘Here are 437 people who were harmed by someone not thinking critically….’ go down to Jeff Healey (musician) Age: 41 Toronto, Ontario, Canada
    Based on the article, do you honestly believe that homepathy caused his death? Is there any evidence at all that he was failed by anything other than so-called SBM????

    Unlike many skeptics on sciblogs, I’m not a believer in discrediting anything that is outside the square… and I’m certainly not into skeptic paradoxes… ie, using anecdotes to discredit anecdotes.

    Alison, pop over to building E sometime and chat to a colleague of yours… try and tell Professor Peter Molan that his 25 years of research into honey as a wound dressing is not a scientific and that honey is not a scientific-based wound treatment…. Maybe, before you go see him, you should read one of his latest papers…

    http://researchcommons.waikato.ac.nz/handle/10289/6095

  • Let’s see. You are saying that if people were stupid enough to use alt.med when they shouldn’t have (can’t disagree there) and they suffered as a consequence, the use of alt.med is not to blame because they were stupid to use the alt.med.

    Yeah, right.

    I can’t help get the impression that when faced with examples of use alt.med contributing to suffering (or death) you will find an excuse, any excuse, to dismiss alt.med from being a factor.

    Also, what’s with the weird focus on honey? There lots of examples there; only one mentions honey. (At least on the top page.) Perhaps you’re just jumping on the one case you think you can ‘dismiss’, ignoring the rest – ?

    (As an aside, there are some concerns over using non-sterilised honey as a wound treatment that are open to debate.)

  • Grant, I’m giving you the benefit of the doubt here… I’m assuming that as your comment was made at about 1.30am your brain is sleep deprived.

    You have a gift at being able to distort and fabricate what people say and then try and claim that you are the innocent party.

    If you knew one iota about honey as a wound dressing then you’d know that whilst it has a sound science base, the medical industry has been reticent to accept it’s use because it is not a pharma-solution. In New Zealand about 1,000 diabetes loose limbs due to gangrene etc, and about 500 die… each year…

    In the case above honet is only alt.med in your brain… and it is not at fault.

    You should comment on things you actually know something about… And there is no ‘weird’ focus on honey… I just used it as an example because it is something i know something about and I knew that the skeptics on here, such as yourself, would self destruct in thinking that it was ‘alt.med’ therefore ‘bad.’

    As for your comment about concerns about use of non-sterilised honey in wound care, that ‘concern’ is only in the minds of people such as you who have no clues about the evidence supporting honey use and don’t want to open their minds or eyes… Also, FWIW there are plenty of sterilised (gamma radiation) honey based wound dressings around…

    I appreciate you tag everything with the same brush… I don’t… I look at the evidence and then reach conclusions (although in many cases the conclusion is inconclusive.) It only takes one maggot to spoil a salad…

    You really should do your homework before jumping in and making comments about things you so obviously are ignorant about.

  • Ron, for someone who demands evidence from other posters and here, which you appear to dismiss without even thinking about it, I find it extraordinary that you would make a claim such as
    “I suspect thousand are killed every year after swilling grapefruit juice… but not a single warning is put on grapefruit juice… why ever not?”

    Do you have any evidence to support this?

  • Ron, if you’re going to keep putting words into other people’s mouths then there really is no point in attempting any further discussion with you. (It also makes you look rather foolish.)

    Nowhere have I said anything about the uses of honey, contrary to your attempt to make it seem that I have: Alison, pop over to building E sometime and chat to a colleague of yours… try and tell Professor Peter Molan that his 25 years of research into honey as a wound dressing is not a scientific wound treatment

    As it happens I know Peter rather well & I’m very aware of his work and the fact that he does actual research into the actual science involved. Which is not the sort of thing I was talking about earlier & I suspect you know that perfectly well. This is simply another attempt to move the goalposts & suggests that you have no real interest in a true discussion.

  • I note how you completely avoid the main point, latch onto an aside and accompany it with empty accusations. Let’s get your side-tracking out of the way then return to actual point.

    “at about 1.30am ”

    Someone still hasn’t adjusted for the end of daylight saving 😉

    “You have a gift at being able to distort and fabricate what people say”

    Spare us the empty, childish, accusations.

    “In the case above honet [sic] is only alt.med in your brain”

    I wrote pointing out that honey was not the only thing on the page. (I suggest you read carefully before making accusations – you do this a lot, rushing in and saying the wrong thing.)

    “and it is not at fault¯/i>

    I didn’t say it was or not either way. (Ditto to my previous point.)

    “You should comment on things you actually know something about…”

    And another empty childish accusation. Why bother?

    “And there is no ‘weird’ focus on honey…”

    It looks odd (to me) to reply about something with a wide range of ‘remedies’ to write only about one of them as if the original comment (from Alison) was only about the one.

    “As for your comment about concerns about use of non-sterilised honey in wound care, that ‘concern’ is only in the minds of people such as you who have no clues about the evidence supporting honey use and don’t want to open their minds or eyes… Also, FWIW there are plenty of sterilised (gamma radiation) honey based wound dressings around… ”

    Thanks for making my point, but trying to have it both ways is silly, ditto for tossing in yet another childish accusation. (And like the other accusations, incorrect too.) FWIW I only dropped this remark about sterilisation and use as a wound dressing in as an aside (it‘s in brackets) for those reading your remarks who might not realise that others (not me) have raised concerns over using ‘food’ honey off the supermarket shelf for wound dressing or other topical use.

    “I appreciate you tag everything with the same brush…”

    Yet another empty childish accusation.

    You really should do your homework before jumping in and making comments about things you so obviously are ignorant about.”

    Oh, and yet another empty childish accusation.

    (Besides that I raised the point about sterilisation—so it’s self-evident that I knew about it, right?—if you’d done your homework you’d know I’ve read & written on some research on honey’s antibacterial properties.)

    But enough deconstructing your sidetrack, back to what was my point, to repeat:

    “Let’s see. You are saying that if people were stupid enough to use alt.med when they shouldn’t have (can’t disagree there) and they suffered as a consequence, the use of alt.med is not to blame because they were stupid to use the alt.med.”

    I stand my my conclusion that “I can’t help get the impression that when faced with examples of use alt.med contributing to suffering (or death) you will find an excuse, any excuse, to dismiss alt.med from being a factor.”

    It’s important. If you’re doing a survey you have to assess the cases and test the hypothesis, not try find excuses to bias your data. If you’re not going to do this, then you’re not really doing a survey – you’d just be trying to prop up pre-held point of view by clearing away what you don’t like.

    [Started this before Michael’s & Alison’s comments; haven’t altered it.]

  • Michael, go down to the supermarket and have a look on the labels of grapefruit juice. Please report back if you find any with warning labels on… if you do, I stand corrected. Re the deaths, I said, “I suspect…” That is my suspicion… based on extensive literature searches and my knowledge of grapefruit juice effects on the P450 enzyme system… and it is based on world-wide use, not NZ.

    So I repeat, ““I suspect [my declared opinion based on my reading of medical literature] thousand are killed every year after swilling grapefruit juice… but not a single warning is put on grapefruit juice… why ever not?””

    Declared suspicion is not a very high level of evidence… in fact it is a low level… I wouldn’t start a war over it, but I would certainly start a conversation… it is scientifically plausible.

    Would you prefer “I suspect many are killed every year after swilling grapefruit juice… but not a single warning is put on grapefruit juice… why ever not?”??

    Read this paper and you’ll see my rationale…
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884539/pdf/bcp0058-0056.pdf

    Now I’m going to commit a cardinal sin… here is a newspaper articles showing risk… why do I use newspaper articles? Because that appears to be the level of evidence that skeptics thrive on based on that gold-standard ‘whatstheharm.com’

    http://www.dailymail.co.uk/health/article-1166909/Grapefruit-diet-warning-blood-clot-scare.html

    Here’s an industry review…

    It’s 31 pages and not too bad… and emphasizes the fact that most of the evidence is anecdotal and lab based, and the few clinical studies have often used unrealistic amounts of GFJ… I agree. I do not understand why science hasn’t undertaken an extensive clinical study given the potential serious adverse effects… including death.

    Hope this helps…

  • Oh, I see Grant, the open-minded one, had now banned me from his blog until late December… Grant… that is a very mature thing to do… big ups for you… No doubt I’ll get over it. Of course, I’ll miss the intellectual intercourse!

  • Grant, one day you’ll learn how to read what people say… What survey am I doing? Where did you get that fiction from?

  • Further evidence that the skeptic paradoxers’ source of SBM, whatstheharm.com is full of anecdata…

    http://whatstheharm.net/herbalremedies.html

    Skim down to Norman Ferrie

    Age: 64
    Invergowrie, Perthshire, Scotland

    Died (liver failure)
    July 3, 2004
    Norman suffered from arthritis, and decided to take an herbal remedy (glucosamine) to ease his pain. Only 2 months after starting, he died of a severe allergic reaction.

    Firstly, glucosamine is not a herb… factual error… secondly, the coroner/sheriff ruled that there was no evidence that glucosamine caused his death… if skeptic accepts anecdote as evidence of harm, then what is your take in this?

    http://iansvoice.org/default.aspx

    Can I ask a question… in terms of scientific evidence, which of these two sites is more scientific?

    http://whatstheharm.net/homeopathy.html
    http://iansvoice.org/default.aspx

  • What survey am I doing? Where did you get that fiction from?
    For others following this, way back at comment #19 Ron said:
    I am currently undertaking a risk assessment of deaths caused by industrially manufactured natural health products in the UK and EU… I have contacted health authorities including the MHRA in the UK.
    This does imply a survey of health authorities in order to get the information Ron requires…

  • Arhhhh, and here was me thinking I was doing a survey!!! Silly me… I was just searching for evidence of harm… I thought a survey was where one designed form with a whole heap of questions with open or fix response options and analysed the responses… Has Waikato University introduced Alternative Surveys?
    http://www.whatisasurvey.info/chapters/chapter1.htm

    If you went to your boss and asked for the number of students in your classes, would you call that a survey???? Doubt it. There is one Health Department in the UK… the MHRA is one section… the Food Safety is another; I asked them for some data… since when does that constitute a survey????????????? I do note, however, how skeptic paradoxers love hunting in packs… is it the perception of the scent of the phantom blood…?

  • Ron,

    I find it hard to imagine anyone thinking you have a sincere interest in this ‘study’ (insert whatever term you want) given the way you respond to people pointing out problems with what you’re doing. You are still avoiding the relevant points that have been raised (Alison‘s questions, the flaws in your reply, etc.) and sidetracking. Not to mention, in addition to the childish empty accusations, your ‘usual’ game of playing on different meanings of a word whilst avoiding the point being made – trolling, basically.

    Your response to Alison suggests you want to exclude data that doesn’t suit you – meaning whatever else you do with the (remaining) data will be biased by that.

    One correction, though, for other readers (i.e. not Ron, who already knows this, or should if he read properly):

    “had now banned me from his blog until late December […]”

    No, I put you on temporary leave for three weeks in response to your trolling, etc.; you (not me) extended it to December. I then decided as a practical matter as much as anything else to block you from Code for life permanently. (Link provided so that readers can verify it for themselves; this is the only comment on that matter in which I refer to a December date, so it must the comment Ron draws his account from, yet it clearly says different to Ron’s account quoted above.)

  • Good for you Grant… I can post any time I like on your blog… just use another computer and alias…

    FWIW, my terminating sin was an email I sent to Grant in reply to one he/his blog sent sent me…

    “Grant, who is the “someone who has some understanding offers an answer”???

    Your arrogance and sense of self importance is unending…

    Telling a mother that the vaccine isn’t the cause of her childs illness because your diagnosis of the child means the child could have some genetic problem which forgives the vaccine as a cause of the adverse reaction beggars belief.

    You forget, this mother is/was pro-vaccine… she may still be, but your arrogance certainly will tip the balance… good for you!”

  • Ron,

    Please don’t try argue or misrepresent what happen – or misrepresent me for that matter. (I did not do what you claim.) If anything was a final line, it was that it was increasingly clear you had an unhealthy focus on me – something I repeatedly pointed out to you before putting you on temporary leave. It would be an understatement to say that you had more than enough chances.

  • Grant, you absolutely did you what I claim… I don’t know why you are trying to deny it…

    I have the email to prove it.

    It is dated 28 March 2012 1:34:04 PM NZDT and for some strange reason came through at 4:41 this morning.

    Part of the long header is [IP address removed]

    Delivered-To: juderon@gmail.com
    Received: by xx.xx.xx.x with SMTP id xxxxxxx;
    Mon, 2 Apr 2012 09:41:17 -0700 (PDT)
    Received: by 10.182.114.3 with SMTP id xxxxxx.18.xxxxx;
    Mon, 02 Apr 2012 09:41:16 -0700 (PDT)
    Return-Path:

    snipped

    X-PHP-Script: sciblogs.co.nz/code-for-life/wp-comments-post.php for 219.89.62.112
    Date: Wed, 28 Mar 2012 13:34:04 +1300
    From: Code for Life
    Message-ID:
    X-Priority: 3
    X-Mailer: PHPMailer (phpmailer.sourceforge.net) [version 2.0.4]
    MIME-Version: 1.0
    MIME-Version: 1.0
    Content-Transfer-Encoding: 8bit
    Content-Type: text/plain; charset=”UTF-8″

    There is a new comment on the post “IAS talks about vaccination”.
    https://sciblogs.co.nz/code-for-life/2012/02/24/ias-talks-about-vaccination/

    As a skeptic you should stick to evidence… otherwise you just make yourself look silly.

  • Interesting… text in angled brackets didn’t go through…

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    Date: Wed, 28 Mar 2012 13:34:04 +1300
    From: Code for Life [Edited to remove personal email – Moderator]
    Message-ID: 2599f0e5b535d592e6a2eab063c8616f@sciblogs.co.nz
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    There is a new comment on the post “IAS talks about vaccination”.
    https://sciblogs.co.nz/code-for-life/2012/02/24/ias-talks-about-vaccination/

  • Ron,

    Could I suggest that you read back through this blog and then consider whether your comments could not also interpreted as being “arrogance and self importance”, as you have accused Grant of being?

    I have found some of your ideas and arguments to be quite interesting, however, exploring them further is difficult as they tend to be quickly obscured by the insults, sarcasm and changing of subject which often accompanies them.

    Do you really think posting email messages (if that is what you last couple of posts is about) is an appropriate thing to do?

  • “Do you really think posting email messages (if that is what you last couple of posts is about) is an appropriate thing to do?”

    Maybe Grant will reflect on that before making more false claims in the future… he can’t hide behind fibs for too long… he made a false claim… I had the evidence to prove his claims false.

    I would have thought a skeptic would appreciate evidence to infuse some objectivity.