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The Central Dogma of Alternative Medicine

Steve still happens to be galavanting about Australia, spreading science, skepticism, and, of course, science-based medicine Down Under. Given that, he has been unable to produce new content for today. Never one to let such an opportunity pass, I decided to take advantage in order to do a little shameless self promotion.

A week and a half ago, I gave a talk at Skepticon 7 in Springfield, MO, entitled “The Central Dogma of Alternative Medicine”. It has now been posted on YouTube:

Because some of the sound didn’t come through as well as one might hope, I’m also including the full video of Kim Tinkham that I used early in the talk to illustrate a point. I only used about two minutes’ worth of it, but here is the whole thing, in case you’re interested:

Let me know what you think! And don’t forget to donate to Skepticon, to keep the skeptical goodness coming next year and beyond.

Posted in: Cancer, Religion, Science and Medicine

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Ontario fails to protect the life of a First Nations girl with cancer

First Nations

A few weeks ago, Steve Novella invited me on his podcast, The Skeptics’ Guide to the Universe, to discuss a cancer case that has been in the news for several months now. The case was about an 11-year-old girl with leukemia who is a member of Canada’s largest aboriginal community. Steve wrote about this case nearly a month ago. Basically, the girl’s parents are fighting for the right to use “natural healing” on their daughter after they had stopped her chemotherapy in August because of side effects. It is a profoundly disturbing case, just as all the other cases I’ve discussed in which children’s lives are sacrificed at the altar of belief in alternative medicine, but this one has a twist that I don’t recall having dealt with before: The girl’s status as part of the First Nations. Sadly, on Friday, Ontario Court Justice Gethin Edward has ruled that the parents can let their daughter die.

The First Nations consist of various Aboriginal peoples in Canada who are neither Inuit nor Métis. There are currently more than 630 recognized First Nations governments or bands in Canada, half of which are located in Ontario and British Columbia. This girl lives in Ontario, which is basically just next door to Detroit, just across the Detroit River. Unlike previous cases of minors who refuse chemotherapy or whose parents refuse chemotherapy for them that I’ve discussed, such as Sarah Hershberger, an Amish girl whose parents were taken to court by authorities in Medina County, Ohio at the behest of Akron General Hospital, where she had been treated because they stopped her chemotherapy for lymphoblastic lymphoma in favor of “natural healing,” or Daniel Hauser, a 13-year-old boy from Minnesota with Hodgkin’s lymphoma whose parents, in particular his mother, refused chemotherapy after starting his chemotherapy and suffering side effects, there’s very little information about this girl because of Canadian privacy laws. I do not know her name. I do not know anything about her case except that she has acute lymphoblastic leukemia, that she started treatment but her parents withdrew her because of side effects.
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Posted in: Cancer, Faith Healing & Spirituality, Politics and Regulation, Religion

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Fear mongering about vaccines as “racist population control” in Kenya

KenyaVaccine

There are many conspiracy theories about vaccines, and they circulate almost continuously. Some are relatively new, but most are at least a few years old. They all tend to fall into several defined types, such as the “CDC whistleblower” story, which posits that the “CDC knew” all these years that vaccines cause autism but covered it up, even going so far as to commit scientific fraud to do so. Of the many other myths about vaccines that stubbornly persist despite all evidence showing them not only to be untrue but to be risibly, pseudoscientifically untrue, among whose number are myths that vaccines cause autism, sudden infant death syndrome, and a syndrome that so resembles shaken baby syndrome (more correctly called abusive head trauma) that shaken baby syndrome is a misdiagnosis for vaccine injury, the antivaccine conspiracy theory that vaccines are being used for population control is one of the most persistent. In this myth, vaccines are not designed to protect populations of impoverished nations against diseases like the measles, which still kills hundreds of thousands of people a year outside of developed countries. Oh, no. Rather, according to this myth, vaccines are in fact a surreptitious instrument of population control designed to render people sterile, for whatever nefarious reasons the powers that be have to want to control the population.

You might recall how a few years ago antivaccinationists leaped on a statement by Bill Gates that “if we do a really great job on new vaccines, health care, reproductive health services, we could lower that [population] by perhaps 10 or 15 percent.” They used it to accuse Gates of being a eugenicist and that vaccines were in actuality an instrument of global depopulation. It was a ridiculous charge of course. In context, it was clear that Gates was referring to how the expected population increase from 6.8 billion to 9 billion could be blunted by providing good health care, including reproductive care and vaccines, to impoverished people in regions where the population increases are expected to be greatest. He was clearly referring to decreasing the expected population increase by 10% or 15%, meaning that instead of going up to 9 billion the population would only increase to between 7.65 and 8.1 billion. In other words, he was referring to how good health care could decrease the expected rate of population growth, not how vaccines could be used to depopulate the world. However, because of the prevalence of the myth that vaccines are sterilizing agents intended for global depopulation, the charge that Gates is a eugenicist, as obviously off base as it is to reasonable people, resonated in the anti-science world of antivaccinationists. Similar claims, namely that there is “something” in vaccines that results in infertility and sterilization, have been unfortunately very effective in frightening people in Third World countries and have played a major role in antivaccine campaigns that have delayed the eradication of polio.
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Posted in: Religion, Vaccines

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NY federal court hands triple loss to anti-vaccination ideology

vacccine preventable disease plane ride away

The state of New York allows religious and medical (but not philosophical) exemptions from school vaccination mandates. New York City has a policy of excluding unvaccinated schoolchildren from classes when there is an outbreak of vaccine-preventable disease reported in a particular school. Two sets of parents whose children had religious exemptions sued New York City and the state in federal court when their children were temporarily excluded from school under the policy, in some cases for up to a month. In other words, they were demanding that their unvaccinated children be allowed to attend even though there was an outbreak of vaccine-preventable disease at the school.

These cases were consolidated with another filed by parents, the Checks, who claimed their child had been improperly denied a religious exemption. The parents had applied for a medical exemption, which was denied, as well as a religious exemption, which was granted, but then revoked. (The record is somewhat confusing on this sequence of events, but that sequence is not relevant to our discussion.) The unvaccinated child was ultimately sent to a private school, even though she should have been excluded from admission under New York City law there as well.

Last week, a federal judge dismissed all three cases (they had been consolidated and assigned to one judge) in an opinion holding that neither the students’ nor the parents’ constitutional rights were violated, including their First Amendment right to free exercise of religion. The plaintiffs have filed an appeal. (more…)

Posted in: Critical Thinking, Legal, Politics and Regulation, Public Health, Religion, Vaccines

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A tale of quackademic medicine at the University of Arizona Cancer Center

Quackademic medicine.

I love that term, because it succinctly describes the infiltration of pseudoscientific medicine into medical academia. As I’ve said many times, I wish I had been the one to coin the phrase, but I wasn’t. To the best of my ability to determine, I first picked it up from Dr. R. W. Donnell back in 2008 and haven’t been able to find an earlier use of the term. As much as I try to give credit where credit is due, I have, however, appropriated the term “quackademic medicine” (not to mention its variants, like “quackademia”), used it, and tried my best to popularize it among supporters of science-based medicine. Indeed, one of my earliest posts on this blog was about how quackery has infiltrated the hallowed halls of medical academia, complete with links to medical schools that have “integrative medicine” programs and even medical schools that promoted the purely magic-based medical modalities known as reiki and homeopathy. It’s been a recurrent topic on this blog ever since, leading to a number posts on the unethical clinical trials of treatments with zero or minimal pre-trial plausibility, the degradation of the scientific basis of medicine, and the acceptance of magical thinking as a means of treating patients in all too many medical centers.

One strong candidate for quackademic ground zero, if there can be such a thing for the phenomenon like quackademic medicine, which is creeping up like so much kudzu in the cracks of the edifice of science-based medicine (SBM), is the University of Arizona. U. of A. is, of course, the home of one of the originators of the concept of quackademic medicine and one of its most famous and tireless promoters, Dr. Andrew Weil. Dr. Weil, as you might recall, has even been the driving force for creating a highly dubious “board certification” in integrative medicine. Sadly, apparently this new board certification has been so popular among physicians wanting to “integrate” a little quackery into their practices, that its first examination has been delayed from May to November 2014, so that the American Board of Physician Specialties can figure out how to accommodate the unexpectedly large number of applicants.

So what happens when a patient arrives at U. of A. for treatment? I found out last week when I received an e-mail, which led to a fairly long e-mail exchange, with a man whose son was diagnosed with leukemia and is being treated at the University of Arizona Cancer Center (UACC). Although this man gave me permission to use his name, I am going to decline to do so because there is a child involved, although anyone involved in his case at U. of A. will likely quickly be able to identify who the man is. It turns out that he is a professor at U. of A. in a humanities department (which is why I’ll refer to him henceforth as the Professor), and, even though he is not a scientist, he clearly knows how to think (which would not be surprising if you knew what department he was in). In his e-mail, he told me how appalled he was at the sorts of treatments being offered to his son:
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Posted in: Acupuncture, Cancer, Chiropractic, Energy Medicine, Medical Academia, Religion

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When healing turns into killing: religious and philosophical exemptions from parental accountability

Parents have a fundamental right to guide the upbringing of their children protected under the Due Process Clause of the U.S. Constitution. This includes the choice of medical care for the child. They also have a First Amendment right to the free exercise of their religious beliefs, including the right to care for their children in accordance with the tenets of their religion. In a better world, these rights would be exercised in a manner that is consistent with a reasoned selection of medical care among choices supported by the best available scientific evidence. If, for example, deeply religious parents choose to forego a treatment that had only a minimal chance of extending their child’s life and terrible side effects in favor of palliative care because they believe that their child would be better off in heaven we could all agree that their choice is constitutionally protected.

Unfortunately, that is not the case. Religious believers and those whose “philosophy” favors pseudoscience in child medical care (surveys bloviating about the popularity of CAM to the contrary) are in fact a tiny minority of the American population who influence public policy in a manner that far exceeds their actual numbers. This influence allows these special interest groups to cause needless suffering and death among children and their families. As well, their actions siphon off medical and legal resources that could more properly be directed toward the common good when states and medical institutions are put in the position of having to go to court to protect children from their parents. And, by giving parents false choices between a belief in magic and standard medical care, unnecessary complications are introduced into what are already difficult and heart-wrenching decisions by parents who truly want to act in the best interests of their children. (more…)

Posted in: Cancer, Epidemiology, Legal, Medical Ethics, Politics and Regulation, Religion, Vaccines

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Washington State’s Unconscionable, Unconstitutional Child Protection Law

I recently wrote about the conflict between child protection and the religious freedom of believers in faith healing. That issue has reared its ugly head again in the state of Washington.

Washington law currently denies the children of Christian Scientists equal protection under the law governing child abuse and neglect, and it grants a special exemption from criminal prosecution for abuse and neglect to that one specific religion and not to any others. Even if you supported religious exemptions in principle, there would be no excuse for the preferential treatment of one single religion. This law is clearly unconstitutional. (more…)

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

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The sad saga of an Amish girl with a curable cancer whose parents are refusing chemotherapy in favor of “natural healing”

Over at my not-so-super secret other blog, one common type of story that I’ve blogged about has been that of the “chemotherapy refusenik.” It’s a topic I write about here not infrequently as well. People like Suzanne Somers and Chris Wark come to mind, mostly people who had effective surgical therapy for their cancers and then decided to forego adjuvant chemotherapy in favor of quackery. Not surprisingly, they attribute their having beaten cancer not to the surgery that saved them but to the woo du jour that they chose instead of chemotherapy, not understanding that such chemotherapy is not the cure; it only reduces the risk of recurrence after surgical extirpation of the tumor. What I haven’t discussed as much here as I have over there are cases of children with cancer whose parents refuse effective chemotherapy to treat their malignancy (other than Daniel Hauser). Because most childhood cancers are not treated with surgery, chemotherapy ± radiation therapy really is the primary therapeutic modality for most of them; so refusing it has a very high probability of resulting in the unnecessary death of a child. Generally pediatric cancers have an 80-90% five year survival, and recurrences after five years are rare, which, as I described recently, is an enormous improvement over 40 years ago.

Sadly, there have been many such cases, such as the aforementioned Daniel Hauser, Abraham Cherrix, Kate Wernecke, and Jacob Stieler. All of these are stories of children who were diagnosed with highly curable cancers who refused either chemotherapy or radiation therapy and were supported in that decision by their parents. Indeed, of these, Cherrix, Hauser, and Wernecke ran away with their parents to avoid chemotherapy. They all came back, but with different results. Hauser came back, started chemotherapy again, and is doing well. Cherrix ultimately came back, but the court made a deal with his parents that let him be treated by an “integrative medicine” doctors who treated him with low dose radiation and a bogus “immunotherapy.” As a result, several years later his tumor recurred, and he was last seen earlier this year asking for money for treatment. His battle in the courts in Virginia also inspired the passage of a supremely bad law that basically allows open season on teens for quackery. Wernecke disappeared when her parents refused radiation therapy after having undergone chemotherapy and took her for intravenous high dose vitamin C. In 2007, her cancer recurred, but the recurrence appeared to have been treated successfully. It’s not clear how much conventional therapy she had received, at least as of 2010, which was the last time I could find anything about her online.

The latest of these cases that has come to my attention is the case of a 10-year-old Amish girl from Medina County in Ohio named Sarah Hershberger, who developed T-cell lymphoblastic lymphoma, an aggressive form of lymphoma, underwent chemotherapy for a few weeks, and then decided she didn’t want it anymore. Her parents, convinced that the chemotherapy was killing her, instead of insisting that she undergo potentially curative therapy, which her doctors estimated to have an 85% chance of eliminating her cancer, refused to let undergo any further therapy. This led to a court case in which Akron Children’s Hospital (ACH) sued to obtain medical guardianship of the girl in order to make sure that she would undergo curative chemotherapy. The first ruling in the case in a Medina County court was for the parents. Then on appeal the 9th District Ohio Court of Appeals ordered Medina County Judge John Lohn to take another look at the case, ruling that he had failed to weigh adequately which course would best serve her interests — the decision of her parents to withhold treatment (at her request) or to appoint a limited guardian to make medical decisions, as proposed by Akron Children’s Hospital. Amazingly, Judge Lohn reiterated his previous ruling, finding that appointment of a guardian would interfere “with Sarah’s need and desire to be cared for by her loving parents” and stating that “the guardianship will not promote Sarah’s interests.” One month ago, Judge Lohn’s decision was reversed on appeal to the 9th District Ohio Court of Appeals, which caused everyone’s favorite quackery supporter to lose his mind in rage.

Since then the case has only gotten stranger, as hard as it is to believe. Indeed, it’s hard to know exactly what is going on, although discussing the case allows me to discuss a both the science and ethics of treating children with cancer using science-based modalities.
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Posted in: Cancer, Medical Ethics, Religion

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Naturopathy Embraces the Four Humors

The ancient Greeks posited a system of health and disease based on the four humors: blood, phlegm, black bile and yellow bile. According to this system, health is defined as a harmony of these four humors and disease is caused by an imbalance among them. Restore the balance, and health is restored. Bleeding is a familiar example of humoral medical treatment based on a diagnosis of an “excess” of blood. Fortunately, the humoral system of diagnosis and treatment died out with the advent of modern scientific medicine.

But as David Gorski asked (sarcastically, of course) in his presentation on quackademic medicine at CSICon in October, if supposedly ancient philosophies of diagnosis and treatment such as Traditional Chinese Medicine and Ayurveda are so beloved by CAM proponents, despite their implausibility and lack of evidence of effectiveness, why not the humoral model of health and disease? Why not include humorism in the CAM practitioner armamentarium?

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Posted in: Faith Healing & Spirituality, History, Naturopathy, Politics and Regulation, Religion, Traditional Chinese Medicine

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CAM and Creationism: Separated at Birth?

Over the past weekend, I had the opportunity to attend CSICon in Nashville, Tennessee. The Committee for Skeptical Inquiry (“CSI”) combats all sorts of pseudoscience, including creationism/creation science/intelligent design and alternative/complementary/integrative medicine. Our own Team SBM was ably represented by Harriet Hall, David Gorski and Kimball Atwood, whose presentation highlighted the credulous acceptance of CAM in some medical schools, and by Steve Novella, who gave a talk on the placebo effect and its exploitation by CAM proponents. Among many other presentations were those on the Mayan calendar and the end of the world, unmasking of (supposedly) paranormal events, and the neurobiology of memory. Pseudoscience was given a well-deserved thrashing by rational minds.

On Saturday, I once again had the pleasure of hearing Eugenie Scott ,Ph.D., the virtually one-woman anti-creationism campaign who founded and heads the National Center for Science Education (NCSE). As I listened to her talk I couldn’t help but being struck by a number of similarities in the weaknesses apparent in arguments for creationism/ creation science/intelligent design (or “ID”)and those for alternative/complementary/integrative medicine (or “CAM”). I doubt the two groups like to think of themselves as ideological twins, but gosh, they sure do look alike.

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Posted in: Evolution, History, Religion, Science and Medicine

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