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As in 2014, “right-to-try” laws continue to metastasize in 2015

As in 2014, “right-to-try” laws continue to metastasize in 2015

Last year, I did several posts on what I consider to be a profoundly misguided and potentially harmful type of law known as “right-to-try.” Beginning about a year and a half ago, promoted by the libertarian think tank known as the Goldwater Institute, right-to-try laws began popping up in state legislatures. Both Jann Bellamy and I wrote about how these laws are far more likely to do harm than good, and that is a position that I maintain today. The idea behind these laws is to give terminally ill patients access to experimental drugs—in some cases drugs that have only passed phase I testing—that might help them. It’s an understandable, albeit flawed argument. After all, it’s perfectly understandable why terminally ill patients would fight for drugs that give them hope, and it’s just as understandable why politicians and the public would see such a goal as a good thing. In practice, as I will explain again in the context of this update, such laws are far more likely to harm patients than help them. Indeed, as you will see, in the year since the first wave of right-to-try laws have passed, not a single patient that I can find has obtained access to experimental drugs under a right-to=try law, much less been helped by them.

Unfortunately, given how effectively “right to try” has been sold on grounds of providing terminally ill patients hope and as a matter of personal freedom, it’s clear that this wave is not going to abate. Since Colorado passed the very first right-to-try law almost exactly a year ago today, a total of 17 more states now have passed passed similar legislation, the most recent being Tennessee, and 22 others have introduced legislation. It’s a good bet that right-to-try will pass in all of those states, because, as I’ve explained many times before and in many interviews, if you don’t understand clinical trial ethics and science, opposing the concept of right-to-try comes across like opposing Mom, apple pie, and the American flag, and leaves opponents open to false—but seemingly convincing—charges of callousness towards the terminally ill on the order of enjoying drop kicking puppies through flaming goalposts.
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Posted in: Clinical Trials, Pharmaceuticals, Politics and Regulation

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The measles vaccine protects against more than just the measles

Vaccines Protect

One of the disadvantages of writing for this blog is that sometimes I feel as though I spend so much time deconstructing bad science and pseudoscience in medicine that I’m rarely left with the time or the opportunity to discuss some interesting science. Of course, even when I do that, usually it’s in the context of that very same bad science or pseudoscience, and this post won’t be different. Still, there was some interesting science with respect to vaccines published last week in Science, and I think it’s worth looking over. The only thing that surprises me is that the antivaccine movement hasn’t jumped all over it yet. On the other hand, its press coverage was relatively minimal, and I didn’t really notice it until an article appeared on (sadly, yes) The Huffington Post entitled “The Measles Vaccine Can Protect Against Much More Than Measles, According To New Study“:

A new study suggests the measles shot comes with a bonus: By preventing that disease, the vaccine may also help your body fight off other illnesses for years.

It’s long been known that contracting measles weakens the immune system for weeks or months, putting people, especially children, at increased risk for potentially fatal infection by a host of germs.

Now, scientists find that this vulnerable period goes on much longer than thought, up to three years. So the benefit of avoiding measles also extends longer than was appreciated. Researchers also found that measles vaccination campaigns were followed by a drop in deaths for other infectious diseases.

Experts said the work is a wake-up call to parents who don’t vaccinate their children out of unfounded fears about a link between vaccines and autism.

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Posted in: Basic Science, Vaccines

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“Science.” You keep using that word. I do not think it means what you think it means.

Science

I’ve discussed on many occasions over the years how antivaccine activists really, really don’t want to be known as “antivaccine.” However, if there’s one thing that rivals how much antivaccinationists detest being called “antivaccine,” it’s how much they detest being called antiscience. To try to deny that they are antiscience, they will frequently invoke ridiculous analogies such as claiming that being for better car safety does not make one “anti-car” and the like. It is here that the Dunning-Kruger effect comes to the fore, wherein antivaccine activists think that they understand as much or more than actual scientists because of their education and self-taught Google University courses on vaccines, that their pronouncements on vaccines should be taken seriously. If there are two antivaccine blogs that epitomize the Dunning-Kruger effect, they are Age of Autism and, of course, the most hilariously inappropriately named The Thinking Moms’ Revolution (TMR). It is the latter of these two that late last week produced a tour de force of Dunning-Kruger, coming, as the most hilariously off-base posts on TMR usually do, from the “Thinking Mom” known as “The Professor.” I shouldn’t be surprised, given her history, but nonetheless it’s worth taking a look at her latest post, Anti-science: “You Keep Using That Word. I Do Not Think It Means What You Think It Means.”

Actually, it does. And if The Professor is going to spend nearly 7,000 words riffing on a bit of dialogue from The Princess Bride, surpassing in verbiage all but a small minority of my posts, it almost makes me want to make this post 8,000 words.

Fortunately, for you, I resisted that temptation and instead merely retort: “Science. You keep using that word. I do not think it means what you think it means.” Then I demonstrate why.
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Posted in: Science and Medicine, Vaccines

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A journey to alternative and integrative medicine apostasy

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

I’ve been blogging for over a decade now, a fact that I find really hard to believe looking back on it right now. I’ve told the story before, but it’s worth briefly recounting again because doing so will explain why the story I’m about to discuss caught my attention. My “gateway drug,” if you will, into skepticism was discovering Holocaust denial in the late 1990s on Usenet, a vast and sprawling conglomeration of thousands of discussion forums that began to fade away at the turn of the century with the rise of web-based forums and Google providing an interface to it to make it Google Groups. The forum where I first discovered Holocaust denial and learned to combat it, alt.revisionism, still exists, but long ago degenerated into a cesspool of racism, spam, and trolling. A couple of years later, around 2000 or so, I discovered quackery and the antivaccine movement, thanks to a Usenet newsgroup known as misc.health.alternative, which is where I honed my early skills applying science to medical claims. It’s also where I first encountered Peter Moran, a regular commenter here who greatly inspired me back then with his full-throated criticism of cancer quackery and his website that taught me reasons why cancer quackery could appear to work even when it did nothing to impact the progression of the cancer.

In December 2004, intrigued by all the news stories about blogging and having discovered a number of good blogs, I decided on one dark, gray Saturday afternoon to dip my toe in the blogosphere. On the spur of the moment I created the first iteration of my not-so-super-secret other blog on—what else?—Blogger. Much to my own amazement, over the course of a year I got my little hobby noticed, to the point where I was invited to join a blog collective; by late 2007 I had become prominent enough to be invited by Steve Novella to join this very blog at its founding, where I have remained for seven years, with no plans to move on any time soon. During my early days, though, there was one person who also inspired me, helping me to learn about the pseudoscience that undergirds the antivaccine movement and, in particular, the quackery making up what is known these days as the “autism biomed” movement. His name is James Laidler, and he was one of the ones who introduced me to this topic which I’ve written about many times both at my not-so-super-secret other blog and, of course, right here on SBM. In doing so, over the years I’ve catalogued why “autism biomed” seems compelling to many parents with children with autism, how antivaccine groups use fake “medical conferences” to sell autism biomed by giving a patina of medical respectability to rank quackery like bleach enemas, and providing a place where those selling unscientific treatments can find willing customers and where disreputable discredited “scientists” like Andrew Wakefield and Mark Geier can find adoring fans who believe their quackery.

I bring this up because last week WIRED published an excellent article about Jim Laidler, “An Alternative-Medicine Believer’s Journey Back to Science.” Appropriately enough, it’s by Alan Levinovitz, an assistant professor of religion at James Madison University. I say “appropriately enough” because, as has been noted here on a number of occasions, there are many religion-like aspects to alternative medicine in general but to the autism biomed movement in particular. Indeed, the two are often tied together, with the motivation for some alt-med being explicitly religious and belief in alt-med sharing some major characteristics with religion, particularly belief in miracles against evidence, charismatic leaders (like Andrew Wakefield) who can do no wrong, and mutually-supportive communities of believers who reinforce each others’ beliefs and ward off skepticism. Add to that the magical thinking, and it’s not for nothing that I’ve referred to the central dogma of alternative medicine as being that wishing makes it so. Indeed, it’s for good reason that I frequently point out that most “energy medicine” (particularly reiki) is basically faith healing that substitutes Eastern mysticism for Judeo-Christian religious beliefs.

In Levinovitz’s profile of Jim Laidler, we see a lot of this, and I learned some details that I didn’t know about Laidler before. Levinovitz also grasps the religion-like nature of alt-med by starting the article bluntly saying:

Jim and Louise Laidler lost their faith on a trip to Disneyland in 2002, while having breakfast in Goofy’s Kitchen.

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Posted in: Health Fraud, Neuroscience/Mental Health, Vaccines

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Bill Maher: Still an antivaccine crank after all these years

Bill Maher (right) pays rapt attention to Robert F. Kennedy, Jr. (left) as he gives pointers about how to be a crankier antivaccine crank.

Bill Maher (right) pays rapt attention to Robert F. Kennedy, Jr. (left) as he gives pointers about how to be a crankier antivaccine crank.

It is with reluctance that I decided to write about this topic again, given how many times I’ve written about it over the last decade, both here and at my not-so-super-secret other blog and given how little his fans seems to care when I do. I’m referring to the antivaccine stylings of comedian and political pundit Bill Maher, something I’ve been writing about for over a decade now. Indeed, a little more than five years ago, I stirred up a bit of trouble in the skeptical community through some particularly harsh criticisms of Bill Maher, in particular of the Atheist Alliance International’s (AAI) decision to award Maher the Richard Dawkins Award. More than once, I’ve likened 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.

Arguably Maher reached his peak of antivaccine advocacy through his weekly HBO talk show, Real Time With Bill Maher, five years ago, when the H1N1 pandemic was going on and public health officials were working hard to persuade people to get vaccinated against H1N1 influenza. Indeed, it got so bad that his own guests, such as Bill Frist and Bob Costas, were openly dissing him on his own show for his antivaccine views. Perhaps my favorite example came from Bob Costas, who in response to a wild claim by Maher that he doesn’t worry about getting the flu, even in the crowded confines of an airplane because of his superior lifestyle that apparently made him immune, blurted out, “Oh, come on, Superman!” Even worse, a friend of Maher, Michael Shermer, published an “Open Letter to Bill Maher on Vaccinations” in—of all places—The Huffington Post, which led Maher to respond, both on his show (in which he referred to vaccination as a “risky medical procedure”) and in a post on HuffPo himself entitled “Vaccination: A Conversation Worth Having“. It was, as a certain “friend of the blog” put it, a pyre of stupidity.
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Posted in: Science and the Media, Vaccines

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“America’s Quack” strikes back

Wile E. Coyote or Dr. Henry Miller? You be the judge!

Wile E. Coyote or Dr. Henry Miller? You be the judge!

Those of you who read my not-so-super-secret other blog (or who follow the news) familiar with this, but I feel that what happened over the last couple of weeks with respect to a man to whom I like to refer as “America’s Quack” is worth posting right here, in modified form.

Last week, a group of ten doctors led by Dr. Henry Miller, most of whom were affiliated either with the Hoover Institution or the American Council on Science and Health (ACSH)—or both—wrote a letter to Lee Goldman, MD, the Dean of the Faculties of Health Sciences and Medicine at Columbia University complaining that Dr. Mehmet Oz shouldn’t be faculty at Columbia University because of his “disdain for science and for evidence-based medicine, as well as baseless and relentless opposition to the genetic engineering of food crops” and “an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.” The letter produced a fair amount of media attention a week ago. I originally mildly approved of it, but over the course of a few days after the letter was released, my opinion on it soured. The reasons were several and included a profound distaste for threatening letters sent to a person’s employers, admittedly based in part on my own experiences having been at the receiving end of such intimidation tactics, as well as a concern that the letter had been written with no clear purpose behind it other than as a publicity stunt to embarrass Dr. Oz and Columbia. When I learned that Dr. Oz was planning to answer the letter on his show this week, there were predictions that this particularly bone-headed publicity stunt would backfire spectacularly. And it did.
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Posted in: Herbs & Supplements, Homeopathy, Science and the Media, Traditional Chinese Medicine

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Stem cells versus Gordie Howe’s stroke, part 3

Gordie Howe in his Red Wings days.

Gordie Howe in his Red Wings days.

Here I am in Philadelphia attending the 2015 American Association for Cancer Research (AACR) meeting to imbibe the latest basic and translational science about oncology. So what am I doing in my non-conference time? I’m holed up in my hotel room near Rittenhouse Square writing a DoD Grant and this post. Fortunately, I am nearly done with the grant, with nothing I can do until I receive one last letter of support from a person who, as much as he’s my bud, is incredibly annoying and always makes me sit on pins and needles waiting for his letter of support. (Those of you who’ve applied for a lot of grants know what I mean.) Then tomorrow I will have to assemble the PDF package to get to my grants office two days before the deadline, which is pushing it to make sure they get it uploaded to Grants.gov in time. Fun times.

With the Stanley Cup playoffs just getting underway (complete with the ugly faux “Stanley Cup” made out of garbage cans our next door neighbor’s son puts on his lawn every year, bathed in red light for the Red Wings), it’s also the perfect time to revisit a story I’ve written about a couple of times before right here on this very blog. I’m referring (this time) to the story of hockey legend Gordie Howe and news stories of his “miraculous” recovery from a serious stroke suffered back in October due to treatment at a stem cell clinic in Tijuana back in December. Of course, when I looked into it, there were a lot of holes in the story and clearly a lot of hype on the part of several parties: Howe’s son Murray Howe, whose love for his father apparently blinded him to some rather obvious issues with the care that his father was receiving and whether it was responsible for his recovery; Stemedica, the American stem cell company based in San Diego that sells its stem cells to a dubious Mexican stem cell company, Novastem, for use outside its U.S. clinical trials; and, of course, the credulous sports media, led by that most credulous of the credulous (with respect to Gordie Howe), Keith Olbermann, who was none too pleased with a certain not-so-pseudonymous “friend” of SBM and completely embarrassed himself in the process of attacking anyone who questioned whether stem cells caused Howe’s recovery. The whole story did have one salutary effect, though. It introduced me to a real stem cell scientist, Paul Knoepfler, who did a guest post for us.

It’s been a couple of months since I last paid attention to what was going on with Gordie Howe’s recovery. Fortunately, our very own Scott Gavura tweaked me by sending me a story by Avis Favaro and Elizabeth St. Philip that appeared over the weekend in the Toronto Star, entitled “A closer look at the startling recovery of Gordie Howe.” Accompanying the story is a broadcast on CTV’s W5 entitled “Gordie’s Comeback”. (See part 1, part 2, part 3.) Also accompanying all of this is a press release discussing how a Canadian stem cell researcher visited Novastem and left unimpressed.
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Posted in: Clinical Trials, Neuroscience/Mental Health, Science and the Media

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Integrative medicine, naturopathy, and David Katz’s “more fluid concept of evidence”

The Integrative Medicine Wheel

The Integrative Medicine Wheel

Dr. David Katz is undoubtedly a heavy hitter in the brave new world of “integrative medicine,” a specialty that seeks to “integrate” pseudoscience with science, nonsense, with sense, and quackery with real medicine. In fairness, that’s not the way physicians like Dr. Katz see it. Rather, they see it as “integrating” the “best of both worlds” to the benefit of patients. However, as we’ve documented extensively here, on our personal blogs, and even in the biomedical literature (plug, plug), what “integrative” medicine means in practice is indeed what I characterized, the infiltration of woo into medicine. This infiltration seems to have started mainly in academia—hence the term “quackademic medicine” and “quackademia”—with the steady infiltration of nonsense into medical schools and academic medical centers, but has since metastasized to the world of community hospitals. This “integration” (or, as I like to refer to it, “infiltration”) has become so pronounced that a few years ago The Atlantic published an article entitled “The Triumph of New Age Medicine“, and just last December the Journal of the National Cancer Institute (JNCI) published a monograph full of articles touting “integrative oncology,” including guidelines recommended by the Society of Integrative Oncology (SIO) for the “integrative” treatment of breast cancer symptoms.

I mention Dr. Katz for two reasons. First, he’s taken another broadside at us at Science-Based Medicine in blog entry at The Huffington Postwhere else?—entitled “Holism, Holes and Poles” that I’ve been meaning to address for a while. But before I address Dr. Katz’s most recent complaint against science-based medicine (SBM), it’s necessary to step back and look at some history.
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Posted in: Clinical Trials, Homeopathy, Medical Academia, Naturopathy

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Angelina Jolie, surgical strategies for cancer prevention, and genetics denialism (revisited)

Angelina Jolie

Angelina Jolie

Sometimes, weird things happen when I’m at meetings. For example, I just got home from the Society of Surgical Oncology (SSO) meeting in Houston over the weekend. Now, one thing I like about this meeting is that, unlike so many other meetings these days—cough, cough, ASCO, I’m looking at you—at the SSO there wasn’t a single talk I could find about “complementary and alternative medicine” (CAM) or, as its proponents like to call it now, “integrative medicine.” It’s also a great chance to get caught up on new science and clinical guidelines in cancer surgery, as well as to see people I tend only to see at these meetings.

However, I must admit that by the last day I tend to be “meeting-ed” out and sometimes my attention wanders. Unfortunately, there are ample ways to indulge that attention deficit. Actually, it’s my iPhone. And it’s Twitter. So it was an odd coincidence that right after a talk by Dr. Deanna Attai about whether surgical oncologists can or should offer genetic counseling services to their patients, when I somehow let myself get into an exchange with Sayer Ji, the “natural health expert” responsible for GreenMedInfo, over BRCA1 mutations and the risk of breast and ovarian cancer, in other words, exactly the sort of thing that Dr. Attai had just discussed. For example:

After a bit of back-and-forth, I got fed up:

This minor Twitter exchange came about because of Angelina Jolie’s announcement in a New York Times op-ed last week entitled “Diary of a Surgery” that she had had her ovaries removed to prevent ovarian cancer due to her being a carrier of a high-risk mutation in BRCA1. As you might recall, I wrote about Jolie’s case two years ago, when she first announced in a NYT op-ed entitled “My Medical Choice” that she had undergone a bilateral mastectomy with reconstruction to decrease her BRCA1-related risk of breast cancer. Although I had discussed the story before, I thought it worth doing again here in a bit more detail. (more…)

Posted in: Basic Science, Cancer, Surgical Procedures

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On the “right” to challenge a medical or scientific consensus

Jenny McCarthy flaunting her "expertise" at the antivaccine "Green Our Vaccines" rally in Washington, DC in 2008

Jenny McCarthy flaunting her “expertise” at the antivaccine “Green Our Vaccines” rally in Washington, DC in 2008

The major theme of the Science-Based Medicine blog is that the application of good science to medicine is the best way to maintain and improve the quality of patient care. Consequently, we spend considerable time dissecting medical treatments based on pseudoscience, bad science, and no science, and trying to prevent their contaminating existing medicine with unscientific claims and treatments. Often these claims and treatments are represented as “challenging” the scientific consensus and end up being presented in the media—or, sadly, sometimes even in the scientific literature—as valid alternatives to existing medicine. Think homeopathy. Think antivaccine views. Think various alternative cancer treatments. When such pseudoscientific medicine is criticized, frequently the reaction from its proponents is to attack “consensus science.” Indeed, I’ve argued that one red flag identifying a crank or a quack is a hostility towards the very concept of a scientific consensus.

Indeed, I even cited as an example of this attitude a Tweet by Jane Orient, MD, executive director of the American Association of Physicians and Surgeons (AAPS). This is an organization of physicians that values “mavericky-ness” above all else, in the process rejecting the scientific consensus that vaccines are safe and effective and do not cause autism or sudden infant death syndrome (SIDS), that HIV causes AIDS, and that abortion doesn’t cause breast cancer, to name a few. Along the way the AAPS embraces some seriously wacky far right wing viewpoints such as that Medicare is unconstitutional and that doctors should not be bound by evidence-based practice guidelines because they are an affront to the primacy of the doctor-patient relationship and—or so it seems to me—the “freedom” of a doctor to do pretty much damned well anything he pleases to treat a patient.
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Posted in: Critical Thinking, Science and the Media, Vaccines

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