It seems like ages since I’ve laid into some form of -pathy, whether the homeo or naturo variety. And I miss it.
But there has been a lot of chatter recently about the role of the Australian tertiary sector in promoting all the various forms of quackery, which masquerades as ‘holistic’ medicine. In this article, we read that a group called the Friends of Science and Medicine, boasting some heavy hitters in the science and medicine, has been formed to lobby universities to review their courses, claiming that one in three universities offer some form of quackery as a course.
Some universities are actually achieving notoriety for the amount of quackery they are peddling. Here’s a recent article by Steve Novella at the Science Based Medicine blog, pointing the finger at one Iain Graham, of Southern Cross University’s School of Health, calling him out for his defence of the obvious quackery being taught. In this excellent discussion, Steve easily dissects the logical flaws in Graham’s pathetic attempts to sell us his nonsense.
When one digs a bit deeper, it turns out that Southern Cross University is actually a major offender in the peddling of quackery, having a whole faculty churning this stuff out. Is it any coincidence that Southern Cross is located in northern NSW and Southern Queensland? Only the other day I was pointing out that this region is a hot-bed of nuttiness – a rallying point for all your new-agey nonsense, including the perils of vaccinating children. So I guess it’s no surprise SC has a ready-made catchment for their expensive but worthless product.
In this great article from SansScience, we see examples of the courses being offered by SC, as well as a number of other similar institutions. The Mitchell and Webb sketch is hilarious and worth a look, too.
I’m particularly interested in the motivation of the universities, and the people in them who push the courses, as well as those who do the courses and graduate. Clearly, for the universities, it’s revenue – let’s not pretend otherwise. And for some senior people there, it’s a job. In the case of Iain Graham, he’s an Emeritus Professor, no less.
But do the people who learn this stuff – homeopathy for example – and then have to go out into the world to sell it – really believe what they are saying? Do they have any doubts at all? Or is it a case of having too much invested to tear it all down? Or perhaps the fear of losing face? No, it seems that they are in it, boots and all.
But there’s a major paradox at play, and an air of desperation about it all. On one hand these people are desperate to be good little academic citizens, publishing papers with impressive references, being cited, getting grants etc etc, while at the same time pouring cold water on the the science establishment that they are trying so hard to be part of.
As an example, I offer this paper, published by a group at SC, and available here. The abstract is as follows:
Evidence-based medicine (EBM) has been advocated as a new paradigm in orthodox medicine and as a methodology for natural medicines, which are often accused of lacking an adequate scientific basis. This paper presents the voices of tradition-sensitive naturopathic practitioners in response to what they perceive as an ideologic assault by EBM advocates on the validity and integrity of natural medicine practice. Those natural medicine practices, which have tradition-based paradigms articulating vitalistic and holistic principles, may have significant problems in relating to the idea of EBM as developed in biomedical contexts. The paper questions the appropriateness of imposing a methodology that appears to minimize or bypass the philosophic and methodological foundations of natural medicine, and that itself seems primarily driven by political considerations.
As the abstract implies, this paper is one giant bleat about how the science bullies are victimising them. We see these lovely terms like ‘tradition-sensitive’, and ‘vitalistic and holistic principles’, which are in themselves meaningless, but are turned into the basis of a paper. They imply that the ‘philosophic and methodological foundations’ are somehow relevant to the efficacy of the treatments they push. Well, they aren’t. I don’t care what the foundations are, I care whether it works.
Let’s have a closer look at the paper then, to give you a feel for the rank desperation of these people. As the last sentence of the abstract above says, their main aim is to cast evidence-based medicine (EBM) in a poor light, and to play the victim, claiming that EBM is playing politics.
From the outset, they say:
The authors’ position is intended to reflect the logic of different naturopathic modalities in showing how the idea of EBM is problematic for naturopathy and other disciplines and practices that deploy “evidence” in their texts and professional lives.
There are two startling things in this sentence. Firstly, referring to the ‘logic of naturopathic modalities’, when no such logic exists to my knowledge. Secondly, they seek to redefine the word ‘evidence’, describing how it is deployed in ‘texts and professional lives’. We later see that this is code for ‘our evidence is our experience’ – which is frankly not worth of a pinch of the proverbial. They go on to say:
… from a pro-EBM position, it has been suggested that the evidence accepted by naturopathic practitioners is less valid and less reliable than “science-based” evidence.* This is the kind of unresearched dogma that has stimulated the writing of this paper.
Unresearched dogma? Pot calling kettle black? Whenever reliable evidence has been called for, there is always some excuse why it can’t be provided. If it exists, where is it? Calling the opinion of the science world ‘unresearched dogma’ is simply emotive nonsense. How can you research something that doesn’t exist or is at least well hidden from view? In any case, I thought traditional evidence wasn’t relevant to the alternative therapy paradigm – so why be so indignant when the absence of this evidence is pointed out?
Get this statement:
Evidence and evidence-based practice needs to be understood as context dependent, and bounded by philosophic assumptions.
What? So your evidence is not objective, is that what you are saying? Actually, this is what they are saying:
natural scientific and medical reasoning are relevant and sometimes part of CAM and allied modalities, but they do not necessarily represent the dominant or preferred logic of these practitioners.
This is just more weasel words to indicate that if something approaching scientific evidence appears, we’ll use it, but if it’s not there, then we don’t need it because it’s not our ‘preferred logic’. And just to indicate how sensitive these guys are to criticism, how’s this footnote:
Rhetoric about the dangers of nonorthodox medicine has been so abundant in scientific medical journals, the media, and science dominated tertiary institutions, such that bashing the nonorthodox has virtually become common sense for medical doctors and professional scientists.
Note the term ‘bashing’. Such victimisation of poor, innocent alternative therapies. They have a real chip on the shoulder, don’t they?
Look, I haven’t even got past the Introduction; I could go on. Here’s a sample of some of the more ludicrous statements scattered throughout the paper:
…a hierarchy of knowledge that privileges the randomized controlled trial (RCT), “scientific objectivity”, statistically based “truths,” and other canards, runs counter to most naturopathic ideologies and practice.
…this paper suggests that the general incompatibility results not from a failure of reason or logic, but to differences in cosmology and methodology that stem
from the naturopath’s genuine commitment to holistic health and the idea of participation in complex systems.
Given that EBM involves elites, institutions, notions of progress, and much funding, it might be considered a hegemonic cultural movement generated as a continuation of the ascendency of medical dominance.
(They say of EBM) Attack the medical competition; show no intellectual tolerance; and only take those prisoners who can be converted.
Empiric evidence remains critically important, but science and the proponents of EBM need to be further educated about the wisdom of tradition.
(re naturopathy and homeopathy) Both modalities use evidence but in a holistic and vitalistic context.
The “evidence” of homeopathy is twofold and is specific to the individual case. On the one hand we have the “evidence” of the remedy as collected in “provings”—the symptoms produced by feeding carefully controlled doses of a substance to “healthy” human beings. On the other hand we have the “evidence” collected from the patient—an holistic picture of the totality of symptoms being experienced by the patient, constructed in a way that is readily comparable with the evidence of the provings.
1. EBM is antithetical to holistic and vitalistic approaches to health care; and 2. There is danger that EBM will be accepted uncritically in educational institutions.
One could go on at length about each of these statements, but I’ll leave it to you to fill in the blanks. Except for the last one. Oh, the irony of these guys talking about ‘uncritical acceptance’. What is ‘critical’ thinking about homeopathy if not asking the hard questions about its efficacy? And do they do that? No, they just blather on about vitalism and holistic and provings, none of which mean anything.
Don’t take my word for it – what does ‘vitalism’ even mean? According to Webster’s:
1: a doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces
2: a doctrine that the processes of life are not explicable by the laws of physics and chemistry alone and that life is in some part self-determining
As for their re-definition of evidence, based on their quotes above, their total evidence is that the patient feels better overall. So what does that mean if you suffering cancer and are in remission. Do you feel better? No symptoms? Excellent. Go home, don’t worry about it. That rotten tooth doesn’t hurt since you’ve taken pain killers? Feel better? Great, job done. Skin cancer, and no symptoms? No need to worry, drink this potion and you’ll never get it.
Overall, this is a lame attempt at a scholarly work, clearly motivated by self-interest and self-promotion. If these guys did as much research and analysis into the actual workings of the human body as they do into spinning words about the place of alt-med in society and how it’s being pushed back by the ‘elites’, we’d have a better outcome for society.
Oh, and if any of the authors happen to read this, and you can provide me with some real outcomes achieved by your therapies, I’d be happy to publish. I’m not even asking for randomised controlled trials, because I know you’ll baulk at those. I’m just asking for examples in which homeopathy has cured some disease or illness, as opposed to making someone ‘feel better’. Go ahead, let the ‘evidence’ flow in. I’ll warn the guys at WordPress to be ready with additional disk space.