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Risibility. The Superior Therapeutic Intervention?

Dad always thought laughter was the best medicine, which I guess is why several of us died of tuberculosis.

~Jack Handey, “Deep Thoughts

We have a saying in medicine that you can’t kill a jerk.  Not that we try to kill anyone, but that particularly unpleasant individuals, rife with psychopathology, survive whatever illness comes their way.  The corollary is that particularly nice people are prone to having horrible diseases with unpleasant outcomes.  We all know intellectually that it is not true, but there is an ongoing feeling in health care providers that somehow patient personality determines the consequences of their diseases.  As an aside, I am often  left with the explanation for patients that the reason for their odd infection comes down to bad luck.  Everyone responds something to the effect that “Typical. I get all the bad luck.”  I have never had a patient say, “That’s odd, I am usually so lucky.”

On the question of nurture versus nature, raising two children has convinced me of the relative lack of importance of nurture in the personalities of my children.  While abusive/pathologic environments will certainly lead to pathologic personalities,  for the average child raised in middle class America I can’t help but think that, to quote Popeye, “I yam what I yam and that’s all what I yam.”  I expect to be schooled in the comments on that subject.  Yes, I read the Blank Slate and have some understanding of the literature.  And yet.  My kids, my friends kids.  I watch them grow in what is (and isn’t) a similar environment and end up with diverse personalities that often appear present before they can speak.  I am well aware of the multiple logical fallacies that lead to that conclusion.  Parenthood and medical practice (where people seem to do the same damn stupid things over and over) have lead me to the conclusion that free will is mostly a myth and we are mostly programmed to behave the way we do. Discuss.  It is not the main point of the post, but my bias.

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Posted in: Clinical Trials, Faith Healing & Spirituality, Humor, Science and Medicine

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NDE Update

Back in 2008 I wrote on Near Death Experiences (NDE’s). I have an interest in this topic as I have frequent exposure to near death; my wife has a predilection for watching Judge Judy. Since 2008 there have been a few studies on the topic of NDEs as researchers try and find evidence that consciousness transcends the brain, if that is what a NDE represents. I have also been ill for most of the last week and have not had the usual time to spend generating typos to drive some readers to distraction. Fortunately, I have a miracle cure that is 100% effective in resolving all my self-limited illnesses: time. It passed and with it the illness. As a result I am about 10 days behind in the commitments in my life, so this will be a shorter than usual post.

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Posted in: Basic Science, Faith Healing & Spirituality

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Faith Healing

Faith healing is based on belief and is about as far as you can get from science-based medicine, but it is not exempt from science. If it really worked, science would be able to document its cures and would be the only reliable way to validate its effectiveness. Miraculous cures continue to be reported on a regular basis: what are we to make of them? In the Healing Rooms Ministry of Bethel Church in Redding, California, people regularly claim to be healed of cancer, broken bones, multiple sclerosis and many other ailments. Page after page of testimonials of cures are listed on their website. Are these cures real? If not, what is going on?

Amanda Winters, a journalist doing a series of articles on Bethel Church, interviewed me for a scientific view of these faith healings. She asked me some very incisive questions and understood my answers. She wrote what I thought was a balanced article, quoting me fairly and at more length than reporters usually allow.

Her article features a patient who believed his flat feet would be healed (bones would crack and form an arch). Healers poked him, blew a shofar at his feet, and covered him with a blanket when he collapsed on the floor. When he got up, his feet were unchanged. But

his faith was not shaken, he said, because he felt so loved and maybe the physical healing was secondary to the spiritual experience he had. (more…)

Posted in: Faith Healing & Spirituality

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The Mythology of Larry Dossey

A “Double Standard”?

Last week I had planned to write a comprehensive critique of a recent comment by Larry Dossey. He had posted it on Val Jones’s betterhealth website in response to Dr. Val’s essay, “The Decade’s Top 5 Threats To Science In Medicine,” originally posted here on SBM. Much of what Dr. Val had identified as the top threats involved recent dalliances, by government, medical schools, and the media, with the collection of implausible and mostly nonsensical health claims that advocates have dubbed “CAM.” As uncontroversial as Dr. Val’s assertions ought to have been—similar to suggesting that closing one’s eyes and “using the force” would be a threat to safe driving (even if some might quibble over the top threats to science in medicine)—Dr. Dossey demurred by distraction:

Your article implies that conventional medicine is grounded in evidence-based research and that CAM is not. This is grossly overstated, and suggests that a double standard is being applied to these fields.

Dossey trotted out familiar arguments: “Much, if not most, of contemporary medical practice still lacks a scientific foundation”; “the Congressional Office of Technology Assessment (OTA) found that only an estimated 10 to 20% of the techniques that physicians use are empirically proven”; hospital care is “the third leading cause of death in the United States,” accounting for hundreds of thousands of deaths each year.

He concluded with an appeal to fairness, rationality, and collegiality:

Overwhelming evidence reveals that conventional medicine is, on the whole, woefully unscientific. It’s fashionable and easy to deny this, but the facts say otherwise. So, by all means, Dr. Val, be critical of CAM – but do not fall into a double standard. Let us ruthlessly apply science to ALL we do as physicians. Let us challenge ALL areas of medicine to a higher standard. On that, I’m pretty sure we can agree.

Keep up the good work.

Sincerely yours,
Larry Dossey, MD

I procrastinated with my own rebuttal, and in the meantime David Gorski responded to similar language found in an article by Dossey (and two other magical thinkers) titled “The Mythology of Science-Based Medicine,” published by the Huffington Post. I’ll not repeat Dr. Gorski’s able rebuttal in any detail, and I’ve already written about much of what this matter brings to mind. Examples are here, here, and here on the perils of conflating science-based medicine and Evidence-Based Medicine (EBM); here on the false dichotomy of modern medicine vs. “CAM”; here on a concise definition of “CAM”; here and here on the mischief spawned by demands to “ruthlessly apply science,” in the narrow, EBM sense of the word, to implausible health claims; here (point #7) and here regarding the tu quoque fallacy, the “10-20% empirically proven” claim, and the risks of modern health care; here (scroll down to “this week’s entry”) and here, regarding some of Dossey’s own opinions about science and the future of medicine.

For now I’ll elaborate on a few points. These pertain not only to Dr. Dossey but also to myths common to the advocacy of pseudomedicine, so I hope to provide some useful information.

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Posted in: Energy Medicine, Faith Healing & Spirituality, History, Medical Academia, Politics and Regulation, Science and Medicine, Science and the Media

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“Move along. Nothing to see Here”- F. Drebin

I am, I think, the slowest writer in the  SBM stable.  I start each entry about 10 days before it is due, and work diligently on it through the week.  As such, I run the risk that events may make my work pointless. Case in point.  I have been slogging away at this entry for the last week and had the final draft up and ready to go, only to find this morning that the Health Care Reform bill no longer carries the language that was the crux of this entire post.  So what is a poor, slow, SBM writer to do? Chuck the whole thing?  Repost my 12 reasons you are a dumb ass not to get the flu vaccine yet again? Leave a hole in the SBM line up? No.

Lets pretend we are in a parallel universe, perhaps an evil universe  where I have a goatee, and the language was not removed from the bill. Lets all pretend that this post is still relevant. Since the Christian Science Church has indicated they will try to get the bill amended to reinstate payment for their services, this post may be relevant again.

Or you could go read  Respectful Insolence instead. Don’t say you were not warned.
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Posted in: Faith Healing & Spirituality, Humor, Politics and Regulation

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When Loud Wins: Will Your Tax Dollars Pay For Prayer?

Today the LA Times described a bizarre and troublesome healthcare reform bill provision that would require Medicare to pay for Christian Science Prayer as a medical treatment:

…a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

The provision was inserted by Sen. Orrin G. Hatch (R-Utah) with the support of Democratic Sens. John F. Kerry and the late Edward M. Kennedy, both of Massachusetts, home to the headquarters of the Church of Christ, Scientist.

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Posted in: Faith Healing & Spirituality, Politics and Regulation, Science and the Media

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Beware religious meddling in the latest version of health care reform

Every so often, as the health care reform initiative spearheaded by the Obama Administration wends its way through Congress (or, more precisely, wend their ways through Congress, given that there are multiple bills coming from multiple committees in both Houses), I’ve warned about various chicanery from woo-friendly legislators trying to legitimize by legislation where they’ve failed by science various “alternative” medicine practices. This began much earlier this year, when I pointed out how Senator Tom Harkin (D-IA) invited the Four Horsemen of the Woo-pocalypse to the Senate to testify. These included Dr. Andy Weil, Director, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ; Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA; Dr. Mark Hyman, Founder and Medical Director, The UltraWellness Center, Lenox, MA; Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY. This occurred after Harkin had famously complained about the National Center for Complementary and Alternative Medicine, the Center in the NIH that he, more than anyone else, had created, because it had not validated enough quackery. (Yes, I know he didn’t use those words, but that was what he had done.) Most recently, Harkin tried to insert language that would mandate that the government and health insurers pay for quackery, as long as it was from licensed practitioners. Given that some states license naturopaths and even “homeopathic physicians,” such an amendment, if it stayed in place, would open the way for paying for all manner of nonscientific quackery.

However, there is another bit of chicanery that legislators are pulling, this time with the Senate version of the bill, that I have been made aware of by Rita Swan of CHILD and fellow SBM blogger Kimball Atwood. This time, the threat is religious, with Senators trying to insert measures into the health care reform initiatives that will pay for “religious” treatments, such as Christian Science prayer. Indeed, one of these, S.1679, entitled Affordable Health Choices Act requires the government or private party insurers to pay for faith-based therapies:
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Posted in: Faith Healing & Spirituality, Politics and Regulation, Religion

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Health Care Bills: More Mischief in Washington

Forgive the departure from my usual verbosity. I’m on my way to a meeting, and I don’t have the time. Today I’ll report disturbing content found in health care bills that are competing for passage in Washington. Thanks to Linda Rosa for keeping our attention on language in one of the Senate bills: S.1679 – Affordable Health Choices Act,” sponsored by (guess who?) Senator Tom Harkin (D-IA). According to Linda, Harkin and supporters will attempt to merge his bill with Baucus’s. Here are some of the choice passages in Harkin’s 800+ page bill (emphasis added):

SEC. 2713. NON-DISCRIMINATION IN HEALTH CARE.

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.

SEC. 212. GRANTS TO ESTABLISH COMMUNITY HEALTH TEAMS TO SUPPORT THE PATIENT-CENTERED MEDICAL HOME.

…(4) ensure that the health team established by the entity includes an interdisciplinary, interprofessional team of health care providers, as determined by the Secretary; such team may include medical specialists, nurses, nutritionists, dieticians, social workers, behavioral and mental health providers (including substance use disorder prevention and treatment providers), doctors of chiropractic, licensed complementary and alternative medicine practitioners, and physicians’ assistants;

…(c) Requirements for Health Teams- A health team established pursuant to a grant under subsection (a) shall–

(1) establish contractual agreements with primary care providers to provide support services;

(2) support patient-centered medical homes, defined as mode of care that includes–

(A) personal physicians;

(B) whole person orientation;

…(F) provide coordination of the appropriate use of complementary and alternative (CAM) services to those who request such services;

…(H) provide local access to the continuum of health care services in the most appropriate setting, including access to individuals that implement the care plans of patients and coordinate care, such as integrative health care practitioners; (more…)

Posted in: Faith Healing & Spirituality, Health Fraud, Politics and Regulation, Religion

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Bill Maher endorses cancer quackery

Over the last five years or so, I’ve often asked, “Is Bill Maher really that ignorant?” I’ve come to the conclusion that he is, and a couple of weeks ago laid out the evidence why right here on this very blog. (Lately Maher has been issuing Tweets that call people who get flu shots “idiots.”) Indeed, I even included in the post perhaps the most hilariously spot-on riposte to Maher’s crankery. This occurred when Maher proclaimed that he never gets the flu and wouldn’t get the flu on an airplane, which his guest Bob Costas to exclaim in exasperation, “Oh, come on, Superman!”

Bob Costas won my respect that day. My favorite part was when Maher looked at his guests, who were shifting in their seats, all embarrassed and unsure of what to say, and observed, “You all look at me as though I’m crazy.”

Why, yes, Bill, we do. Let’s put it this way. When Age of Autism likes you, you have a serious problem when it comes to being credible about medical science.

In that same post, I complained about Maher’s being awarded the Richard Dawkins Award by the Atheist Alliance International (AAI). I liken giving Bill Maher an award that lists “advocates increased scientific knowledge” anywhere in its criteria, not to mention being named after Richard Dawkins, to giving Jenny McCarthy an award for public health, given that, at least when it comes to medicine, Maher is anti-science to the core. Along the way, I’ve ruffled the feathers of some of both Dawkins’ and Maher’s fans.

I regret nothing.

Not only do I regret nothing, but on September 18, a mere two weeks before the AAI Convention, Maher provided me with more ammunition. In fact, this is probably the most blatant bit of crankery I’ve seen from Maher in a long time. Watch and learn. The “alternative medicine” nuttery begins at around the 0:50 mark:

Laetrile? Really? Laetrile?? How 1970s cancer quackery!
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Posted in: Cancer, Faith Healing & Spirituality, Health Fraud, Science and the Media, Vaccines

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Woosceptibility: A Brief Interview With James Randi

James Randi, perhaps better known as “The Amazing Randi” has spent most of his life performing magic shows. In 1996 he created the James Randi Educational Foundation (JREF) designed to expose the fraudulent claims made by psychics, faith healers, and snake oil salesmen. The ultimate goal of the JREF is to create a new generation of critical thinkers – people who will not be hoodwinked by the aforementioned hucksters.I had the good fortune of interviewing Mr. Randi briefly at the recent conference known as “The Amazing Meeting.” I was eager to pick his brain about human behavior and magical thinking. This is what I learned…

Randi identified certain groups of people who seem to be more susceptible to magical thinking and/or belief in the paranormal. According to him, the top two are:

1. News reporters. Although at first I wasn’t sure if Randi meant that reporters like a good story versus they believe a good story – he told me that in his experience, they were some of the most gullible people on earth. In fact, they were more interested in implausible stories than true ones – and Randi said that the more fantastical his explanation for phenomena, the more likely they were to believe it and write about it.

2. Academics. This surprised me since I assumed that this group would actually be less susceptible. Randi suggested that they are more likely to be taken in because they are single-minded about phenomena. They are over confident in their ability to understand how things work, and when something cannot be explained in their framework, they’re willing to attribute it to the paranormal.

Who are the least susceptible? Children. Why? Because they are simple thinkers, and harder to distract. The art of magic is in distraction of the sophisticated mind. Children tend to be very concrete, so they don’t expect things to happen with hand-waving and flourishes. They keep their eye on the coin (or other item being transferred from hand to hand), and are more likely to know where it is at all times.

To wrap up our short interview, I asked Randi if he could explain why people believe in magic, fantasy, and the paranormal? He responded plainly:

Ultimately it’s not about intelligence or lack thereof. It’s about people not wanting to accept that life is random, suffering is inevitable, and there is no good reason for bad things happening.

What do you make of Randi’s observations?

Posted in: Faith Healing & Spirituality, Health Fraud, Neuroscience/Mental Health

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