Fraud and greed can cause enormous harm

We have repeatedly discussed the journal ‘Evidence-Based Complementary and Alternative Medicine’ (see for instance here and here). The journal has recently done something remarkable and seemingly laudable: it retracted an article titled “Psorinum Therapy in Treating Stomach, Gall Bladder, Pancreatic, and Liver Cancers: A Prospective Clinical Study” due to concerns about the ethics, authorship, quality […]

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A new RCT of craniosacral therapy … for once, I am really embarrassed

Cranio-sacral therapy is firstly implausible, and secondly it lacks evidence of effectiveness (see for instance here, here, here and here). Yet, some researchers are nevertheless not deterred to test it in clinical trials. While this fact alone might be seen as embarrassing, the study below is a particular and personal embarrassment to me, in fact, I am shocked by it and write these lines with considerable regret.

Why? Bear with me, I will explain […]Read the rest here: A new RCT of craniosacral therapy … for once, I am really embarrassed

This RCT of a Chinese herbal mixture makes a mockery of science and medical ethics

Difficulties breastfeeding?

Some say that Chinese herbal medicine offers a solution.

This Chinese multi-centre RCT included 588 mothers considering breastfeeding. The intervention group received the Chinese herbal mixture Zengru Gao, while the control group received no therapy. The primary outcomes were the percentages of fully and partially breastfeeding mothers, and a secondary outcome was baby’s […]

Read the rest here: This RCT of a Chinese herbal mixture makes a mockery of science and medical ethics

How should we advise patients on alternative medicine?

This is a question most clinicians must have asked themselves. The interest of patients in this area is enormous, and many do seek advice from their doctor, nurse, pharmacist, midwife etc. In a typical scenario, a patient might pluck up her courage (yes, for many it does take courage) and ask:

What about therapy xy […]

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Ethical issues in alternative medicine [we neglect them at our peril]

In 2017, Medline listed just over 1800 articles on ‘complementary alternative medicine’. If you find this number impressively high, consider that, for ‘surgery’ (a subject that has often been branded as less that active in conducting research), there were almost 18 000 Medline-listed papers.

So, the research activity in CAM is relatively small. Vis a […]

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Is Colleen Huber a cancer quack? And more legal thuggery - Naturopathic Diaries

A couple weeks ago, I got a second cease and desist letter. Bastyr University sent the first, but the latest was sent by a naturopath in Tempe, Arizona by the name of Colleen Huber. Just so you know right away the type of person I’m dealing with, she’s been claiming that “her clinic, Nature Works Best Cancer Clinic, has had the most successful results of any clinic in the world.”...

Read on: Is Colleen Huber a cancer quack? And more legal thuggery - Naturopathic Diaries

Pharmacists’ responsibilities vis a vis alternative medicine: the violation of healthcare ethics continues.

Alternative medicine differs from conventional medicine in numerous ways. One important difference is that patients often opt to try this or that product without consulting any healthcare professional at all. In such cases, the pharmacist might be the ONLY professional who can advise the patient who is about to purchase such a product. 

This is […]
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Refreshingly honest words from a pharmacist: ‘Homeopathy could be pharmacy’s saviour’

David Needleman, a pharmacist at Wilkinson Chemist in Barnet, UK, has published a brilliant article explaining that complementary medicine such as homeopathy, nutrition and aromatherapy could make smaller pharmacies “more viable and competitive”, as they look to “survive” the funding cuts across England. In doing so, he made it clear that retail pharmacists are shop-keepers, not healthcare professionals, as previously assumed. […]

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INFORMED CONSENT IN ALTERNATIVE MEDICINE: ethical imperative + practical impossibility

Before starting to treat a patient, all health care professionals – including of course alternative practitioners – have to obtain informed consent. This is not optional but an ethical and legal imperative. Informed consent must usually include full information on: 

• the diagnosis 
• its natural history 
• the most effective treatment options available 
• the proposed therapy 
• its effectiveness […]

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Adverse events of (chiropractic) spinal manipulations: the unethical behaviour persists

How often have I pointed out that most studies of chiropractic (and other alternative therapies) are overtly unethical because they fail to report adverse events? And if you think this is merely my opinion, you are mistaken. This new analysis by a team of chiropractors aimed to describe the extent of adverse events reporting in published RCTs of […]

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Informed consent in alternative medicine? | Edzard Ernst

Informed consent is a basic ethical principle and a precondition for any medical or surgical procedure (e. g. a therapeutic intervention or a diagnostic test). Essentially, there are 4 facets of informed consent: 

1. the patient must have decision-making capacity, 
2. the patient’s decision must be free from coercion or manipulation, 
3. all relevant information must be disclosed to the […]

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The (lack of) ethics in alternative medicine | Edzard Ernst

Medical ethics are central to any type of healthcare – and this includes, of course, alternative medicine. The American Medical Association (AMA) have just published their newly revised code of ethics, AMA Principles of Medical Ethics. 

It has long been my impression that, in alternative medicine, ethics receive no or far too little attention. Some alternative […]Read on: The (lack of) ethics in alternative medicine

Homeopathy as a way of reducing antibiotic use in livestock ? | Edzard Ernst

The UK petition to ban homeopathy for animals has so far achieved well over 3 000 signatures. Remarkably, it also prompted a reaction from the Faculty of Homeopathy which I reproduce here in full:

Response to petition calling on the RCVS to ban homeopathy Homeopathy has a long history of being used successfully in veterinary practice for […]

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The end of quackery…it’s amazingly easy!!! | Edzard Ernst

Who – apart from quacks – would not want to get rid of all quackery, once and for all? It would be a huge improvement to medicine, save thousands of lives, and reduce our expenditure for health care considerably. But how?

How can we possibly get rid of something that is as ancient as medicine itself?

Simple! […]

Read on: The end of quackery…it’s amazingly easy!!!

How much of alt med research is unethical? | Edzard Ernst

Medical ethics comprise a set of rules and principles which are essential for all aspects of medicine, including of course research. The main issues are: Respect for autonomy – patients must have the right to refuse or choose their treatments. Beneficence – researchers and clinicians must act in the best interest of the patient. Non-maleficence – the expected benefits of interventions must […]

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Homeopathy: no sense, no science and no ethics | Edzard Ernst

Conventional cough syrups do not have the best of reputations – but the repute of homeopathic cough syrups is certainly not encouraging . So what should one do with such a preparation? Forget about it? No, one conducts a clinical trial, of course! Not just any old trial but one where science, ethics and common sense are absent. Here are […]
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When will pharmacists finally stop selling homeopathic remedies? | Edzard Ernst

I have argued since many years that pharmacists should not be selling or promoting homeopathic and other remedies for which there is no proof of efficacy – the last time I published my view on this matter is even less than a week ago: Personally, I would go another step further and remind pharmacists who sell homeopathic remedies to the unsuspecting public that it is unethical to pretend they are more than placebos...

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A gentle ethical defence of doing nothing

I’m going to tell you about an amazing new alternative therapy that you should consider. It’s called procrasteopathy, and its treatment modality is exactly what the name suggests: procrastination. For whatever condition you believe you have, the treatment is simply to find something else to be getting on with. Licensed procrasteopaths work with patients to find exactly what sort of procrastination will fit best with their lifestyles. Unlike boring, reductive Western medicine, practiced by boring, reductive colonialists, procrasteopaths target their treatment specifically to you as a whole person. They are treating the whole you, not just your disease...

 Read more: A gentle ethical defence of doing nothing by Tom Morris

Homeopathy as the treatment of choice for ‘heart sink’ patients? | Edzard Ernst

Recently, I was invited to give a lecture about homeopathy for a large gathering of general practitioners (GPs). In the coffee break after my talk, I found myself chatting to a very friendly GP who explained: “I entirely agree with you that homeopathic remedies are pure placebos, but I nevertheless prescribe them regularly.” “Why would anyone do that?” I asked him. His answer was as frank as it was revealing. […]

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Acupuncture research: I am afraid, much of it is unethical abuse | Edzard Ernst

There must be well over 10 000 clinical trials of acupuncture; Medline lists ~5 000, and many more are hidden in the non-Medline listed literature. That should be good news! Sadly, it isn’t.

It should mean that we now have a pretty good idea for what conditions acupuncture is effective and for which illnesses it does not work. But we don’t! Sceptics say it works for nothing, while acupuncturists claim it is a panacea. The main reason for this continued controversy is that the quality of the vast majority of these 10 000 studies is not just poor, it is lousy.

“Where is the evidence for this outrageous statement???” – I hear the acupuncture-enthusiasts shout. Well, how about my own experience as editor-in-chief of FACT? No? Far too anecdotal?

How about looking at Cochrane reviews then; they are considered to be the most independent and reliable evidence in existence? There are many such reviews (most, if not all [co-]authored by acupuncturists) and they all agree that the scientific rigor of the primary studies is fairly awful. Here are the crucial bits of just the last three; feel free to look for more...

Read on:  Acupuncture research: I am afraid, much of it is unethical abuse | Edzard Ernst