After an interchange on Twitter about how blogs get noticed, I commented that the best thing for me was being thrown off the UCL web site by Malcolm Grant, and the subsequent support that I got from Ben Goldacre. I am a big fan of just about everything that Goldacre has done. So are a lot of other people and his support was crucial.
When I looked up his 2007 post, I found a lot of links were now broken, and some characters didn’t render properly. So, as a matter of historical record, I’m reproducing the whole post with updated links where possible.
Goldacre’s comments, of course, greatly exaggerated my virtues. But they were very useful at the time, they quadrupled my readership overnight, and I’m eternally grateful to him.
[Update: Letter from Provost below]
Saturday June 9, 2007
I’ve always said you’d get a lot more kids interested in science if you told them it involves fighting – which of course it does. This week, for example, Professor David Colquhoun FRS – one of the most eminent scientists in the UK – has been forced to remove his quackbusting blog from the UCL servers where it has lived for many years, after complaints from disgruntled alternative therapists.
They objected, for example, to his use of the word “gobbledygook” to describe Red Clover as a “blood cleanser” or a “cleanser of the lymphatic system”. Somebody from the “European Herbal and Traditional Medicine Practitioners Association” complained that he’d slightly misrepresented one aspect of herbalists’ practice. One even complained about Colquhoun infringing copyright, simply for quoting the part of their website that he was examining. They felt, above all, that this was an inappropriate use of UCL facilities.
Now I don’t want to get into the to and fro here, but it is striking that none of them engaged the Prof himself on the issue of the ideas. In fact, they all ran behind his back to the Provost, or rather, to teacher; and the Provost, after serving up a sterling defense of academic freedom in responses to them, quietly asked Colquhoun to take his blog elsewhere, on the grounds that it was bringing the university too much flak. Rousing defenses of Colquhoun have already been written by Professors from Stanford, and senior academics from the UK. [Some are linked here, I’ve got the rest archived. The provost’s initial letter was actually rather stirring]
This episode reveals some unfortunate contrasts. Firstly, in a world where most orthodox "public engagement with science" activity consists of smug, faux radical "science meets art" projects where ballet dancers watch each other prance about in brain scanners (and I am hardly caricaturing here) Colquhoun was showing the world what science really does.
He took dodgy scientific claims, or “hypotheses” as we call them in the trade, and examined the experimental evidence for them, in everyday language, with humour and verve. For all that being a world expert on single ion channels might make Colquhoun glamorous to me, I would say his blog is a bit more of a treat for the wider public, and arguably a rather good use of the time and resources of a public servant who has devoted his entire life to academia, on its relatively low wages, never once working for industry. Sharing ideas is an employment perk in academia.
Secondly, giving special attention to a blog shows that we may not have got to grips with new forms of social media yet. His blog is the problem in hand, but I’ve heard Prof Colquhoun speak about quackery in UCL lecture theatres. Was the electricity, the publicity material, the room rent, a misuse of public funds and resources? I’ve done talks myself, in universities and schools: are they all guilty of wasting public money on robust, challenging, childish and sarcastic discussion of ideas?
But lastly, if you’re worrying about the appropriate use of a science department’s resources, Prof Colquhoun is the bloke who made the fuss in Nature -the biggest academic journal in the world – about British universities giving away science degrees in quackery. The people who run the BSc "science" degrees in these pseudoscientific alternative therapies have still refused to answer questions from David, and from me, about what "science" they teach in their science degrees.
I notice that nobody is making the jokers behind these Quackery BSc’s take their gobbledygook -a word that sounds best being snorted through Colquhoun’s impressive nasal hair – off university webservers. Although courses in gobbledygook make money. And they are flattered by the Prince. And nobody can criticise them, because they actually refuse to tell us what they’e teaching. Now you tell me who should be booted out of a seat of learning.
Please send your bad science to email@example.com
Prof Colquhoun doesn’t really have impressive nasal hair, I just didn’t want the column to come across as too gushing. His quack page is definitely worth rooting about on:
And as you can see, he needs WordPress advice even more than I do. Also his politics feed is quite jolly and if I could work out, for example, how to link directly to the Greenhalgh story, I would. Rummage away.
[DC edit: one of the best side effects of the move was getting a proper blog, rather than a bloated web page. The old politics page is archived and the Greenhalgh story link now works]
Letter from Provost:
This is an email from the Provost to someone who emailed him this morning, which he has allowed me to post, I understand he will be sending something similar to those who email him. It’s very much worth reading. I believe – as you can imagine – that an emeritus professor of pharmacology in his seventies making the link between science and real world claims for free in everyday language is a treat, but of course I have absolutely no doubt that Colquhoun’s public engagement with science activity did pose difficulties for UCL.
These difficulties were thrown into sharp relief by the fact that those who disagreed with Colquhoun enacted their grievances through the Freedom of Information Act, UK libel law, copyright law, complaints about the use of academic resources, and efforts to lean on senior figures from the university, rather than engaging on the science, or contacting Colquhoun.
There is a balance to be struck on whether Colquhoun’s public engagement with science activities were valued enough to be worth defending (through the miracle ofinstant context you can decide for yourself) and that is of course a decision for UCL to make.
If you are going to write to the Provost I hope I can rely on you to be polite and understanding about this balance, and understand that he’s a busy man who has already been leant on over what ideally should never have been a Provost’s concerns at such an early stage.
If UCL had behaved in the way you seem to believe then your comments would be wholly justified, but of course it hasn’t.
Allow me to supply the missing facts. I;m copying this message also to Ben Goldacre and David Colquhoun.
Academic freedom is a fundamental precept of any institution fit to style itself a university. Like all freedoms, it comes with conditions, largely those that are necessary to underpin the freedoms of other people under the law, including criminal law, human rights, copyright, the laws of tort and contract, and statutory regulation.
When a university hosts a website it is taken to be the publisher of the material on it. That means that it is liable in law for any breaches of copyright, data protection and defamation. It is possible of course to engage in robust academic debate without infringing any of these rules.
But breaches of all of them have now been claimed in legal claims against UCL regarding David Colquhoun’s website, and with good reason.
A university can of course safeguard its position by moderating the content of the website. That is what I assume the Guardian does with its various blogs, and certainly is what it does with all its editorial content. Nobody sees that as a major assault on the freedom of expression of the press. To do this in a university would of course raise concerns that it constituted an incursion into academic freedom, and I also think it would be completely impractical.
Yet not to take appropriate action to protect UCL would be to expose us to potentially expensive legal action in respect of activity over which we have absolutely no control.
For the most part, academic websites don’t infringe the law. Indeed, in over 35 years as an academic this is the first such instance that I have any detailed knowledge of. If it has unlawful material that the author believes is essential for conveying his/her message, then there is no reason why they shouldn’t host it themselves and assume the consequences.
UCL has taken legal advice, which is to the effect that the website does contain material which breaks the law in several respects. Some of them have now been fixed: alleged breaches of copyright and data protection. But libel proceedings are now also in play, and Professor Colquhoun and I have a meeting on Monday with a senior defamation QC to explore the potential extent of UCL’s vicarious liability for certain statements on the website, and our possible options. There is also the question of Professor Colquhoun’s own personal liability, but of course a plaintiff will always prefer to go against a major institution because of our deep pockets.
On the basis of the advice that I receive then I shall have to determine UCL’s future course of action, and Professor Colquhoun likewise.
Just to be absolutely clear:
The item that has caused the fuss and complaint is this one. It has not been changed since the complaint, so you can decide for yourself how awful it is.
If you like what I do, and you want me to do more, you can: buy my books Bad Scienceand Bad Pharma, give them to your friends, put them on your reading list, employ me to do a talk, or tweet this article to your friends. Thanks! ++++++++++++++++++++++++++++++++++++++++++
The Yuletide edition of the BMJ carries a lovely article by Jeffrey Aronson, Patent medicines and secret remedies. (BMJ 2009;339:b5415).
I was delighted to be asked to write an editorial about it, In fact it proved quite hard work, because the BMJ thought it improper to be too rude about the royal family, or about the possibility of Knight Starvation among senior medics. The compromise version that appeared in the BMJ is on line (full text link).
The changes were sufficient that it seems worth posting the original version (with links embedded for convenience).
The cuts are a bit ironic, since the whole point of the article is to point out the stifling political correctness that has gripped the BMA, the royal colleges, and the Department of Health when it comes to dealing with evidence-free medicine. It has become commonplace for people to worry about the future of the print media, The fact of the matter is you can often find a quicker. smarter amd blunter response to the news on blogs than you can find in the dead tree media. I doubt that the BMJ is in any danger of course. It has a good reputation for its attitude to improper drug company influence (a perpetual problem for clinical journals) as well as for clinical and science articles. It’s great to see its editor, Fiona Godlee, supporting the national campaign for reform of the libel laws (please sign it yourself).
The fact remains that when it comes to the particular problem of magic medicine, the action has not come from the BMA, the royal colleges, and certainly not from the Department of Health, It has come from what Goldacre called the “intrepid, ragged band of bloggers”. They are the ones who’ve done the investigative journalism, sent complaints and called baloney wherever they saw it. This article was meant to celebrate their collective efforts and to celebrate the fact that those efforts are beginning to percolate upwards to influence the powers that be.
It seems invidious to pick on one example, but if you want an example of beautiful and trenchant writing on one of the topics dealt with here, you’d be better off reading Andrew Lewis’s piece "Meddling Princes, Medical Regulation and Licenses to Kill” than anything in a print journal.
I was a bit disappointed by removal of the comment about the Prince of Wales. In fact I’m not particularly republican compared with many of my friends. The royal family is clearly good for the tourist industry and that’s important. Since Mrs Thatcher (and her successors) destroyed large swathes of manufacturing and put trust in the vapourware produced by dishonest and/or incompetent bankers, it isn’t obvious how the UK can stay afloat. If tourists will pay to see people driving in golden coaches, that’s fine. We need the money. What is absolutely NOT acceptable is for royals to interfere in the democratic political process. That is what the Prince of Wales does incessantly. No doubt he is well-meaning, but that is not sufficient. If I wanted to know the winner of the 2.30 at Newmarket, it might make sense to ask a royal. In medicine it makes no sense at all. But the quality of the advice is irrelevant anyway. The royal web site itself says “As a constitutional monarch, the Sovereign must remain politically neutral.”. Why does she not apply that rule to her son? Time to put him over your knee Ma’am?
Two of the major bits that were cut out are shown in bold, The many other changes are small.
BMJ editorial December 2009
Secret remedies: 100 years on
Time to look again at the efficacy of remedies
Jeffrey Aronson in his article  gives a fascinating insight into how the BMA, BMJ and politicians tried, a century ago, to put an end to the marketing of secret remedies. They didn’t have much success.
The problems had not improved 40 years later when A.J. Clark published his book on patent medicines . It is astounding to see how little has changed since then. He wrote, for example, “On the other hand the quack medicine vendor can pursue his advertising campaigns in the happy assurance that, whatever lies he tells, he need fear nothing from the interference of British law. The law does much to protect the quack medicine vendor because the laws of slander and libel are so severe.”> Clark himself was sued for libel after he’d written in a pamphlet “ ‘Cures’ for consumption, cancer and diabetes may fairly be classed as murderous”. Although he initially tried to fight the case, impending destitution eventually forced him to apologise . If that happened today, the accusation would have been repeated on hundreds of web sites round the world within 24 hours, and the quack would, with luck, lose .
As early as 1927, Clark had written “Today some travesty of physical science appears to be the most popular form of incantation” . That is even more true today. Homeopaths regularly talk utter nonsense about quantum theory  and ‘nutritional therapists’ claim to cure AIDS with vitamin pills or even with downloaded music files. Some of their writing is plain delusional, but much of it is a parody of scientific writing. The style, which Goldacre  calls ‘sciencey’, often looks quite plausible until you start to check the references.
A 100 years on from the BMA’s efforts, we need once again to look at the efficacy of remedies. Indeed the effort is already well under way, but this time it takes a rather different form. The initiative has come largely from an “intrepid, ragged band of bloggers” and some good journalists, helped by many scientific societies, but substantially hindered by the BMA, the Royal Colleges, the Department of Health and a few vice-chancellors. Even NICE and the MHRA have not helped much. The response of the royal colleges to the resurgence in magic medicine that started in the 1970s seems to have been a sort of embarrassment. They pushed the questions under the carpet by setting up committees (often populated with known sympathizers) so as to avoid having to say ‘baloney’. The Department of Health, equally embarrassed, tends to refer the questions to that well-known medical authority, the Prince of Wales (it is his Foundation for Integrated Health that was charged with drafting National Occupational Standards in make-believe subjects like naturopathy .
Two recent examples suffice to illustrate the problems.
The first example is the argument about the desirability of statutory regulation of acupuncture, herbal and traditional Chinese medicine (the Pittilo recommendations) .
Let’s start with a definition, taken from ‘A patients’ guide to magic medicine’ . “Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety”.
It seems to me to be self-evident that you cannot start to think about a sensible form of regulation unless you first decide whether what you are trying to regulate is nonsense, though this idea does not seem to have penetrated the thinking of the Department of Health or the authors of the Pittilo report. The consultation on statutory regulation has had many submissions  that point out the danger to patients of appearing to give official endorsement of treatments that don’t work. The good news is that there seems to have been a major change of heart at the Royal College of Physicians. Their submission points out with admirable clarity that the statutory regulation of things that don’t work is a danger to patients (though they still have a blank spot about the evidence for acupuncture, partly as a result of the recent uncharacteristically bad assessment of the evidence by NICE ). Things are looking up. Nevertheless, after the public consultation on the report ended on November 16th, the Prince of Wales abused his position to make a well-publicised intervention on behalf of herbalists . Sometimes I think his mother should give him a firm lesson in the meaning of the term ‘constitutional monarchy’, before he destroys it.
The other example concerns the recent ‘evidence check: homeopathy’ conducted by the House of Commons Science and Technology Select Committee (SCITECH). First the definition : “Homeopathy: giving patients medicines that contain no medicine whatsoever”. When homeopathy was dreamt up, at the end of the 18th century, regular physicians were lethal blood-letters, and it’s quite likely that giving nothing saved people from them. By the mid-19th century, discoveries about the real causes of disease had started, but homeopaths remain to this day stuck in their 18th century time warp.
In 1842 Oliver Wendell Holmes said all that needed to be said about medicine-free medicine . It is nothing short of surreal that the UK parliament is still discussing it in 2009. Nevertheless it is worth watching the SCITECH proceedings . The first two sessions are fun, if only for the statement by the Professional Standards Director of Boots that they sell homeopathic pills while being quite aware that they don’t work. I thought that was rather admirable honesty. Peter Fisher, clinical director of the Royal Homeopathic Hospital, went through his familiar cherry-picking of evidence, but at least repeated his condemnation of the sale of sugar pills for the prevention of malaria.
But for pure comedy gold, there is nothing to beat the final session. The health minister, Michael O’Brien, was eventually cajoled into admitting that there was no good evidence that homeopathy worked but defended the idea that the taxpayer should pay for it anyway. It was much harder to understand the position of the chief scientific advisor in the Department of Health, David Harper. He was evasive and ill-informed. Eventually the chairman, Phil Willis, said “No, that is not what I am asking you. You are the Department’s Chief Scientist. Can you give me one specific reference which supports the use of homeopathy in terms of Government policy on health?”. But answer came there none (well, there were words, but they made no sense).
Then at the end of the session Harper said “homeopathic practitioners would argue that the way randomised clinical trials are set up they do not lend themselves necessarily to the evaluation and demonstration of efficacy of homeopathic remedies, so to go down the track of having more randomised clinical trials, for the time being at least, does not seem to be a sensible way forward.” Earlier, Kent Woods (CEO of the MHRA) had said “the underlying theory does not really give rise to many testable hypotheses”. These two eminent people seemed to have been fooled by the limp excuses offered by homeopaths. The hypotheses are testable and homeopathy, because it involves pills, is particularly well suited to being tested by proper RCTs (they have been, and when done properly, they fail). If you want to know how to do it, all you have to do is read Goldacre in the Guardian .
It really isn’t vert complicated. “Imagine going to an NHS hospital for treatment and being sent away with nothing but a bottle of water and some vague promises.” “And no, it’s not a fruitcake fantasy. This is homeopathy and the NHS currently spends around £10million on it.”
That was written by health journalist Jane Symons, in The Sun . A Murdoch tabloid has produced a better account of homeopathy than anything that could be managed by the chief scientific advisor to the Department of Health. And it isn’t often that one can say that.
These examples serve to show that the medical establishment is slowly being dragged, from the bottom up, into realising that matters of truth and falsehood are more important than their knighthoods. It is all very heartening, both for medicine and for democracy itself.
Declaration of interests. I was A.J. Clark chair of pharmacology at UCL, 1985 – 2004.
1. Aronson, JK BMJ 2009;339:b5415
2. Clark, A,J, (1938) Patent Medicines FACT series 14, London. See also Patent medicines in 1938 and now http://www.dcscience.net/?p=257
3. David Clark “Alfred Joseph Clark, A Memoir” (C. & J. Clark Ltd 1985 ISBN 0-9510401-0-3)
4. Lewis, A. (2007) The Gentle Art of Homeopathic Killing
5. A.J. Clark (1927) The historical aspect of quackery, BMJ October 1st 1927
6. Chrastina, D (2007) Quantum theory isn’t that weak, (response to Lionel Milgrom).
7 Goldacre, B. (2008) Bad Science. HarperCollins
13. BBC news 1 December 2009 Prince Charles: ‘Herbal medicine must be regulated’.
14. Oliver Wendell Holmes (1842) Homeopathy and Its Kindred Delusions.
15. House of Commons Science and technology committee. Evidence check: homeopathy. Videos and transcripts available at http://www.viewista.com/s/fywlp2/ez/1
16. Goldacre, B. A Kind of Magic Guardian 16 November 2007.
17. Homeopathy is resources drain says
There is a good account of the third SCITECH session by clinical science consultant, Majikthyse, at The Three Amigos.
16 December 2009.. Recorded an interview for BBC Radio 5 Live. It was supposed to go out early on 17th.
17 December 2009. The editorial is mentioned in Editor’s Choice, by deputy editor Tony Delamothe. I love his way of putting the problem "too many at the top of British medicine seem frozen in the headlights of the complementary medicine bandwagon". He sounds remarkably kind given that I was awarded (by the editor, Fiona Godlee, no less) a sort of booby prize at the BMJ party for having generated a record number of emails during the editing of a single editorial (was it really 24?). Hey ho.
17 December 2009. Daily Telegraph reports on the editorial, under the heading “ ‘Nonsense’ alternative medicines should not be regulated“. Not a bad account for a non-health journalist.
17 December 2009. Good coverage in the excellent US blog, Neurologica, by the superb Steven Novella.’ “Intrepid, Ragged Band of Bloggers” take on CAM‘ provides a chance to compare and contrast the problems in the UK and the USA.’
18 December 2009. Article in The Times by former special advisor, Paul Richards. “The influence of Prince Charles the lobbyist is out of hand. Our deference stops us asking questions.”
“A good starting point might be publication of all correspondence over the past 30 years. Then we will know the extent, and influence, of Prince Charles the lobbyist.”
Comments in the BMJ Quite a lot of comments had appeared by January 8th, though sadly they were mostly from the usual suspects who appear every time one suggests evidence matters. A reply was called for, so I sent this (the version below has links).
After a long delay, this response eventually appeared in the BMJ on January 15 2010.
It’s good to see so many responses, though somewhat alarming to see that several of them seem to expect an editorial to provide a complete review of the literature. I ‘ll be happy to provide references for any assertion that I made.
I also find it a bit odd that some people think that an editorial is not the place to express an opinion robustly. That view seems to me to be a manifestation of the very sort of political correctness that I was deploring. It’s a bit like the case when the then health minister, Lord Hunt, referred to psychic surgery as a “profession” when he should have called it a fraudulent conjuring trick. Anything I write is very mild compared with what Thomas Wakley wrote in the Lancet, a journal which he founded around the time UCL came into existence. For example (I quote)
“[We deplore the] “state of society which allows various sets of mercenary, goose-brained monopolists and charlatans to usurp the highest privileges…. This is the canker-worm which eats into the heart of the medical body.” Wakley, T. The Lancet 1838-9, 1
I don’t think it is worth replying to people who cite Jacques Benveniste or Andrew Wakefield as authorities. Neither is it worth replying to people who raise the straw man argument about wicked pharmaceutical companies (about which I am on record as being as angry as anyone). But I would like to reply directly to some of the more coherent comments.
Sam Lewis and Robert Watson. [comment] Thank you for putting so succinctly what I was trying to say.
Peter Fisher [comment]. I have a lot of sympathy for Peter Fisher. He has attempted to do some good trials of homeopathy (they mostly had negative outcomes). He said he was "very angry" when the non-medical homeopaths were caught out recommending their sugar pills for malaria prevention (not that this as stopped such dangerous claims which are still commonplace). He agreed with me that there was not sufficient scientific basis for BSc degrees in homeopathy. I suppose that it isn’t really surprising that he continues to cherry pick the evidence. As clinical director of the Royal London Homeopathic Hospital and Homeopathic physician to the Queen, just imagine the cognitive dissonance that would result if he were to admit publicly that is all placebo after all. He has come close though. His (negative) trial for homeopathic treatment of rheumatoid arthritis included the words "It seems more important to define if homeopathists can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response” . [download
the paper]. When it comes to malaria, it matters a lot.
Adrian White [comment] seems to be cross because I cited my own blog. I did that simply because if he follows the links there he will find the evidence. In the case of acupuncture it has been shown time after time that "real" acupuncture does not differ perceptibly from sham. That is true whether the sham consists of retractable needles or real needles in the "wrong" places. A non-blind comparison between acupuncture and no acupuncture usually shows some advantage for the former but it is, on average, too small to be of much clinical significance . I agree that there is no way to be sure that this advantage is purely placebo effect but since it is small and transient it really doesn’t matter much. Nobody has put it more clearly than Barker Bausell in his book, Snake Oil Science 
White also seems to have great faith in peer review. I agree that in real science it is probably the best system we have. But in alternative medicine journals the "peers" are usually other true believers in whatever hocus pocus is being promoted and peer reveiw breaks down altogether.
R. M. Pittilo [comment] I’m glad that Professor Pittilo has replied in person because I did single out his report for particular criticism. I agree that his report said that NHS funding should be available to CAM only where there is evidence of efficacy. That was not my criticism. My point was that in his report, the evidence for efficacy was assessed by representatives of Herbal Medicine, Chinese Medicine and Acupuncture (four from each). Every one of them would have been out of work if they had found their subjects were nonsense and that, no doubt, explains why the assessment was so bad. To be fair, they did admit that the evidence was not all that it might be and recommended (as always) more research I’d like to ask Professor Pittilo how much money should be spent on more research in the light of the fact that over a billion dollars has been spent in the USA on CAM research without producing a single useful treatment. Pittilo says "My own view is that both statutory regulation and the quest for evidence should proceed together" but he seems to neglect the possibility that the quest for evidence might fail. Experience in the USA suggests that is exactly what has, to a large extent, already happened.
I also find it quite absurd that the Pittilo report should recommend, despite a half-hearted admission that the evidence is poor, that entry to these subjects should be via BSc Honours degrees. In any case he is already thwarted in that ambition because universities are closing down degrees in these subjects having realised that the time to run a degree is after, not before, you have some evidence that the subject is not nonsense. I hope that in due course Professor Pittilo may take the same action about the courses in things like homeopathy that are run by the university of which he is vice-chancellor. That could only enhance the academic reputation of Robert Gordon’s University.
George Lewith [comment] You must be aware that the proposed regulatory body, the Health Professions Council, has already broken its own rules about "evidence-based practice" by agreeing to take on, if asked, practitioners of Herbal Medicine, Chinese Medicine and Acupuncture. They have (shamefully) excluded the idea that claims of efficacy would be regulated. In other word they propose to provide exactly the sort of pseudo-regulation which would endanger patients They are accustomed to the idea that regulation is to do only with censoring practitioners who are caught in bed with patients. However meritorious that may be, it is not the main problem with pseudo-medicine, an area in which they have no experience. I’m equally surprised that Lewith should recommend that Chinese evaluation of Traditional Chinese medicine should be included in meta-analyses, in view of the well-known fact that 99% of evaluations from China are positive: “No trial published in China or Russia/USSR found a test treatment to be ineffective” . He must surely realise that medicine in China is a branch of politics. In fact the whole resurgence in Chinese medicine and acupuncture in post-war times has less to do with ancient traditions than with Chinese nationalism, in particular the wish of Mao Tse-Tung to provide the appearance of health care for the masses (though it is reported that he himself preferred Western Medicine).
1. Lord Hunt thinks “psychic surgery” is a “profession”. http://www.dcscience.net/?p=258
2. Fisher, P. Scott, DL. 2001 Rheumatology 40, 1052 – 1055. [pdf file]
3. Madsen et al, BMJ 2009;338:a3115 [pdf file]
4. R, Barker Bausell, Snake Oil Science, Oxford University Press, 2007
5. Vickers, Niraj, Goyal, Harland and Rees (1998, Controlled Clinical Trials, 19, 159-166) “Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials”. [pdf file]
15 January 2010. During the SciTech hearings, Kent Woods (CEO of the MHRA) made a very feeble attempt to defend the MHRA’s decision to allow misleading labelling of homeopathic products. Now they have published their justification for this claim. It is truly pathetic, as explained by Martin at LayScience: New Evidence Reveals the MHRA’s Farcical Approach to Homeopathy. This mis-labelling cause a great outcry in 2006, as documented in The MHRA breaks its founding principle: it is an intellectual disgrace, and Learned Societies speak out against CAM, and the MHRA.
22 January 2010 Very glad to see that the minister himself has chosen to respond in the BMJ to the editorial
Rt Hon. Mike O’Brien QC MP, Minister of State for Health Services
I am glad that David Colquhoun was entertained by my appearance before the Health Select Committee on Homeopathy. But he is mistaken when he says, “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense.”
Regulation is about patient safety. Acupuncture, herbal and traditional Chinese medicine involve piercing the skin and/or the ingestion of potentially harmful substances and present a possible risk to patients.
The Pittilo Report recommends statutory regulation and we have recently held a public consultation on whether this is a sensible way forward.
Further research into the efficacy of therapies such as Homeopathy is unlikely to settle the debate, such is the controversy surrounding the subject. That is why the Department of Health’s policy towards complementary and alternative medicines is neutral.
Whether I personally think Homeopathy is nonsense or not is besides the point. As a Minister, I do not decide the correct treatment for patients. Doctors do that. I do not propose on this occasion to interfere in the doctor-patient relationship.
Here is my response to the minister
I am very glad that the minister himself has replied. I think he is wrong in two ways, one relatively trivial but one very important.
First, he is wrong to refer to homeopathy as controversial. It is not. It is quite the daftest for the common forms of magic medicine and essentially no informed person believes a word of it. Of course, as minister, he is free to ignore scientific advice, just as the Home Secretary did recently. But he should admit that that is what he is doing, and not hide behind the (imagined) controversy.
Second, and far more importantly, he is wrong, dangerously wrong, to say it I was mistaken to claim that “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense". According to that view it would make sense to grant statutory regulation to voodoo and astrology. The Pittilo proposals would involve giving honours degrees in nonsense if one took the minister’s view that it doesn’t matter whether the subjects are nonsense or not. Surely he isn’t advocating that?
The minister is also wrong to suppose that regulation, in the form proposed by Pittilo, would do anything to help patient safety. Indeed there is a good case to be made that it would endanger patients (not to mention endangering tigers and bears). The reason for that is that the main danger to patients arises from patients being given “remedies” that don’t work. The proposed regulatory body, the Health Professions Council, has already declared that it is not interested in whether the treatments work or not. That in itself endangers patients. In the case of Traditional Chinese Medicine, there is also a danger to patients from contaminated medicines. The HPC is not competent to deal with that either. It is the job of the MHRA and/or Trading Standards. There are much better methods of ensuring patient safety that those proposed by Pittilo.
In order to see the harm that can result from statutory regulation, it is necessary only to look at the General Chiropractic Council. Attention was focussed on chiropractic when the British Chiropractic Association decided, foolishly, to sue Simon Singh for defamation. That led to close inspection of the strength of the evidence for their claims to benefit conditions like infant colic and asthma. The evidence turned out to be pathetic, and the result was that something like 600 complaints were made to the GCC about the making of false health claims (including two against practices run by the chair of the GCC himself). The processing of these complaints is still in progress, but what is absolutely clear is that the statutory regulatory body, the GCC, had done nothing to discourage these false claims. On the contrary it had perpetrated them itself. No doubt the HPC would be similarly engulfed in complaints if the Pittilo proposals went ahead.
It is one thing to say that the government chooses to pay for things like homeopathy, despite it being known that they are only placebos, because some patients like them. It is quite another thing to endanger patient safety by advocating government endorsement in the form of statutory regulation, of treatments that don’t work.
I would be very happy to meet the minister to discuss the problems involved in ensuring patient safety. He has seen herbalists and other with vested interests. He has been lobbied by the Prince of Wales. Perhaps it is time he listened to the views of scientists too.
I’m a bit late on this one, but better late than never.
|The opinionated and ill-informed actress turned talk show host, Jeni Barnett, spent an hour or so endangering your children (and hers) with what most surely be one of the worst ever accounts of measles vaccination.
Chart from BBC report
She was abominably rude to a well-informed nurse who phoned in to try to inject some sense into the conversation.
The LBC tried to stop Ben Goldacre from publicising this horrific show by legal action.
Blogs are the new journalism. The response has been wonderful. People of all ages sat up late into the night transcribing the entire broadcast. Unlike the doubtless highly-paid actress, they did it as a public service. They were not paid by anyone. It is all rather beautiful.. Within a day of the legal notice being sent to Goldacre, the offensive broadcast has spread like wildfire over the web.
The result of all this hard work is that if you type ‘Jeni Barnett MMR’ into Google, every item but one on the first page links to the sites that are highly critical of Barnett’s irresponsible and ill-mannered rant (at 7 am on 7 Feb).
The many people who have put work into this effort are listed, for example, on Ben Goldacre’s own site.
Holfordwatch lists many links, and also lists previous attempts of lawyers to suppress science.
When will people learn that lawyers are not the proper way to settle matters of truth and falsehood.
Dice, n . Small polka-dotted cubes of ivory, constructed like a lawyer to lie on any side, but commonly the wrong one. [ Bierce, Ambrose , The Enlarged Devil’s Dictionary , 1967]
The condemnation extends far beyond the usual bad medicine writers. Anyone who wants to speak the truth as they see it sees legal actions like these as a threat to freedom of speech. A side effect is that I learned about several new blogs.
One, with a name as good as its content is A Somewhat Old, But Capacious Handbag, written by (you guessed it) Miss Prism, has Today’s irresponsible tripe courtesy of Jeni Barnett.”
Another one that was new to me is the Black Triangle blog, written by Dr Anthony Cox (a pharmacovigilance pharmacist). He writes in Conspiracy?
Anti-vaccinators have exploited the internet for years. Websites, blogs, and forums are widely used by activists to promote their wrong-headed cause. However, when the pro-science pro-vaccine lobby use similar methods a common accusation is leveled at them. Here it is posted at JABS, the UK’s leading anti-vaccine website.
“There is no way all of this could have happened so quickly without Pharma backing.” “
That is really priceless. These anti-vaccination fanatics just don’t seem to be able to grasp that there is a big army of people who care so much about the public interest that they do all this for no money and a considerable cost to themselves in time and lost sleep.
Besides which, anyone who thinks that a big corporation could whip up so much support and activity in 24 hours obviously has a rather better opinion of the efficiency of big companies than I do. They’d need 25 meetings and an awayday in Majorca before anything happened . Even a university can do better than that (perhaps only 20 meetings and an awayday in Uxbridge). One does wonder why, then, universities are always being told to be more like businesses. But that is another story.
Anthony Cox also deals with another of my favourite topics in The Today Programme’s irresponsible MMR interview. I listen to the Today Programme, I listen every morning. But I do wish they could bring their medical reporting up to the same standard as their political reporting. Their policy of ‘equal time for the flat earth society” is not my idea of impartiality.
The Sunday Times for 8th February, by coincidence, has a major article by the excellent investigative reporter, Brian Deer.
An excellent summary has appeared already Dynutrix on Holfordwatch.
“However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal. “
Part 2. MMR: Key Dates in the Crisis .
Part 3. Most shockingly Hidden records show MMR truth
“A Sunday Times investigation has found that altered data was behind the decade-long scare over vaccination ”
Let’s hope that some of the original documents appear on-line soon.
The Times on 10 February carried a beautifully hard-hitting column by David Aaronovitch: The preposterous prejudice of the anti-MMR lobby
“Last week there was a bust-up in blogland.”
“Last week, justifying herself on her blog, Barnett invoked the spirit of the insurgent ignoramus. Yes, she said, she should have been ready with facts and figures on MMR.”
“That’s why I’m passionately for Goldacre, and why I find myself wondering whether we can file a class action against LBC for permitting a presenter to inflict her preposterous prejudices on her listeners, to the detriment of someone else’s kids.”
Jeni Barnett: have you lost something?. Well well, first Jeni Barnett removed the critical comments from her blog. Then she removed the blog altogether. Seems she isn’t interested in debate at all.
Stephen Fry left a comment (#223) on Goldacre’s site.
“The fatuity of the Jeni Barnett woman’s manner – her blend of self-righteousness and stupidity, her simply quite staggering inability to grasp, pursue or appreciate a sequence of logical steps – all these are signature characteristics of Britain these days. The lamentable truth is that most of the population wouldn’t really understand why we get so angry at this assault on reason, logic and sense. But we have to keep hammering away at these people and their superstitious inanities. We have to. Well done you and well done all you supporting. I’ve tweeted this site to my followers. I hope they all do their best to support you. Publish and be damned. We’ll fight them and fight them and fight them in the name of empricism, reason, double blind random testing and all that matters.”
London Evening Standard on 11 February. Nick Cohen on How my friends fell for the MMR panic.
Press Gazette covered the start of the srory on 6th February, here.
MSNBC TV broadcast by Keith Olberman votes Andrew Wakefield as “today’s worst person in the world” on February 10th. Click in video “Vaccine lie puts kids at risk”.
Write to your MP to ask him/her to sign Early Day Motion 754, MMR Vaccine and the Media
David Aaronovitch writes again in the Times, February 14th, “We need an inquiry into how Andrew Wakefield got away with it“.