More infighting over regulation from the homeopaths

The House of Commons Science and Technology Committee will shortly release its report on the evidence base for homeopathy.  The hearings and evidence submitted for this report have already been proven to be controversial and the outcome is eagerly awaited by homeopaths and skeptics alike.  The results of the committee are likely to affect arguments over the regulation of homeopaths.  There are effectively two current arguments within the homeopathic community for regulation, exemplified by the differing strategies of the two largest membership organisations, the Society of Homeopaths (SoH) and the Alliance of Registered Homeopaths (ARH).

The SoH are seeking registration with the Health Professionals Council (HPC), a statutory regulatory body, while the ARH would prefer to use the Complementary and Natural Healthcare Council (CNHC).  The HPC typically regulate real health care professionals, not alternative ones, and as there is no government support for the SoH’s application this route is unlikely to succeed.  The CNHC however, while more than willing to regulate homeopaths, may run into issues with the homeopaths themselves.  Simon Perry, of Leicester Skeptics in the Pub, has extracted an astonishing response from the CNHC in response to complains about alternative practitioners:

CNHC will tell practitioners to remove claims they cannot justify.

CNHC will conduct a review of evidence base for regulated therapies.

CNHC will contact all registrants to instruct them not to make claims without justification.

CNHC will contact complementary health course providers and authors to instruct them not to make claims without justification.

The homeopathic colleges and course providers will not be happy with being instructed not to make claims, such as curing cancer – as on the UCLAN course, without justification and the practitioners will be furious, no longer will they be able to claim they can treat malaria, that homeopathic vaccines work or that diluted duck liver can cure the common cold. This will be unacceptable to homeopaths.  So where will their regulatory arguments take them following the committee’s report?

I will make no predictions about the regulatory arguments but I am willing to bet on an outbreak of internecine war within the profession.  The SoH have not been cooperating with the ARH regarding their application to the HPC.  Karin Mont, Chair of the ARH, recently met with the HPC to discuss the following, according to the meeting summary:

How regulation would work for the profession / Impact of regulation on profession
Progress of Society of Homeopath’s application for regulation
How the Alliance’s views could be heard if the Society of Homeopaths applied for regulation
Discussion around apparent ongoing campaign against homeopathy by parts of scientific community
Information about the Alliance, how it works and what it does
Discussion about HPC processes and procedures

Regardless of the fact that without government support, lacking at present, the SoH application will fail it is fascinating to see that relations between the SoH and ARH are so bad that the SoH are not willing to consult with or inform the ARH on the progress of their HPC application.  Not only that it appears the ARH seem to verging on conspiracy, as recorded in official HPC records, in imagining that the scientific community is campaigning against them, no doubt funded by big pharma.

The SoH are also not getting involved with campaigns organised by other organisations to express support for homeopathy.  H:MC21, a pro-homeopathy lobby group, have organised a mass protest in support of the trade for later this month:

HOMEOPATHS, PATIENTS, SUPPORTERS!

come to

THE MASS LOBBY OF PARLIAMENT

WEDNESDAY 24 FEBRUARY 2010 at 2.30 p.m.

HOUSES OF PARLIAMENT, ST. STEPHEN’S ENTRANCE .

So far supporters include:

Alliance of Registered Homeopaths

Helios

Homeopathy Heals

South-West London Homeopaths

The School of Homeopathy

West London Homeopaths

Yorkshire Centre of Classical Homeopathy

as well as many individual homeopaths and patients

The SoH are noticeably not listed.  Perhaps this is because they have concerns over harassing authors, although this has not stopped them from using libel law to silence criticism, or perhaps they are appalled that H:MC21 have Jeremy Sherr, the homeopath who inspired the World Health Organisation to issues a statement against homeopathy, is a patron of H:MC21, except they funded him.  More likely it is because the SoH want to control the lay homeopathic profession.  This might be difficult as the ARH and other organisations represent around 40% of homeopaths.

It increasingly looks like lay homeopaths cannot and will not reach agreement on regulation.  Perhaps the only regulatory solution for homeopathy will be to ban the practice for individuals who are not on a credible professional register, that is, restrict its practice to medically qualified homeopaths.  That option though will depend on medical homeopaths demonstrating that they have higher standards than lay homeopaths.  Is anyone willing to bet that this will be the case?

10:23, homeopaths missing the point

Today at 10:23, there will be an event, organised by Merseyside Skeptics but taking place nationwide, in which homeopathic pills will be taken in large quantities to prove that not 0nly do they have no effect, but there is is nothing in them.  This fact, although probably known to most readers of this blog, homeopaths and skeptics alike, is not apparently as well known as it should be.

Homeopaths will insist that their remedies work by vibrational energies and quantum flapdoodle whereas skeptics, armed with metaanalyses, will declare quite simply that they don’t work and any perception that they do is due to a placebo effect, regression to the mean or other forms of cognitive bias.

Both homeopaths and skeptics will insist that taking large amounts of homeopathic pills is safe, skeptics because there is nothing in them, homeopaths because their beliefs say they work best singly and ritually.

What has interested me, and I have no involvement with the campaign, is the reaction of homeopaths to this harmless stunt.  Instead of laughing it off as the antics of silly skeptics (not a view I concur with), they have become increasingly nasty and vicious with attacks on proven medical therapies, personal slurs against individuals and spoof blogs that fail to engage with the issues. Not only that the professional societies have showed absolutely no understanding of why homeopathy is the target.

Over the last few years there has been a steadily increasing amount of blogging highlighting the ethical and professional failures of homeopaths, from claims to treat aids, homeopathic vaccinations and their deliberate denigration of conventional medicine (oddly unattributed in much mainstream coverage of 10:23, it’s shame that hard working bloggers are not given the credit they deserve).

The professional societies haven’t confronted this, preferring instead to bury their heads in the sand.  This has persisted with the press releases on the 10:23 campaign.

The Alian(ARH) claim (PDF):

The real question that needs to be addressed is not the safety of homeopathy, but why homeopathy is such an effective medical therapy, and why so many people throughout the world, and for over two centuries now, have used it with such success.
There are numerous high quality scientific studies that clearly demonstrate the effectiveness of homeopathy. The challenge facing the bona- fide scientific community is to discover why homeopathy is so effective.

This is best diplomatically described as bullshit (Shang et al disproves the statement above).

The Society of Homeopaths (SoH) have opted instead for the moral high ground:

The Society would not therefore expect any reaction to the proposed ‘overdose’ by this group unless, by chance, an individual in that group already had symptoms that matched that remedy at the time of taking it.

Chief Executive, Paula Ross, commented “This is an ill advised publicity stunt in very poor taste, which does nothing to advance the scientific debate about how homeopathy actually works.”

A publicity stunt in poor taste maybe, but when you are going to argue that it helps if you’re not funding homeopathic AIDS trials in Tanzania.  Some might argue that this is not only in poor taste but may in fact be tantamount to manslaughter.

The British Homeopathic Assoiation (BHA), representing medical homeopaths, also claim the moral high ground:

The Faculty of Homeopathy and BHA do not support the sole use of homeopathy for any serious disease when effective conventional treatment is available to, and tolerated by, the individual patient. Homeopathy is, however, often used with great patient satisfaction for support during conventional treatments.

It would be a catastrophe if a small minority of cynics stifle patient choice of access to what they find effective.  NHS patients have benefited greatly from homeopathic treatment at a very small cost – with approximately £152,000 per annum spent on homeopathic medicines, which is a mere 0.001% of the NHS drug budget.

The BHA have also forgotten/denied the findings of Shang et al.  Also they have never confronted lay homeopaths over their excesses so can be assumed complicit in these.

Meanwhile the Homeopathy Heals campaign group have launched a counter protest which intends to help skeptics take their pills.

Homeopathic Practitioners all over the UK, can also go and check out whether these Skeptics really do swallow a whole bottle of Boots homeopathic medicine.  I have found out that after you unscrew the top of a bottle of Boots homeopathic medicine, there is a little hole to dispense one pill at a time and this part does not lift off, so it would be impossible to swallow the whole bottle without cutting the bottle open.  Therefore some Skeptics will have to take them one at a time!

I was going to leave homeopathy alone for a bit, but as its exponents continue to demonstrate their inability to deal with substantive criticisms and as the professional societies contine to lie and deceive I’ve changed my mind.

I would like to thank Merseyside Skeptics for a well executed protest and the homeopaths for being so stupid.

Science So What – better at headlines than science

Science So What have recently released a report by Fast Future entitled ‘The Shape of Jobs to come‘(pdf) aimed at encouraging teenagers to consider careers in various exciting fields of human endeavour.  Despite positive media coverage this report has come under some criticism, as detailed by Evidence Matters, for its methodology, inappropriate job descriptions and inadequate references.  In addition to this, nanotech blog 10minus9 has made similar criticisms specific to the report’s handling of nanotech and penchant for plagiarism while Holfordwatch have covered their wholly inadequate response to criticism.

I have my own concerns with the report’s handling of biological science, particularly with respect to the very first future job on the list, that of body part maker:

1. Body part maker Advances in science will make it possible to create living body parts, so we could need living body part makers, body part stores and body part repair shops.

This struck me as a fantastical claim.  The concept of body part stores and repair shops, while a feature of some dystopian science fiction, would seem to be a little imaginative and owes more to a vision of science inspired by the films of Keanu Reeves than a sober real world analysis.  Of course there is nothing wrong with using the influence of science fiction to drive teenagers real world interests and future career choices.

However, this report is not presented as a work of fiction to indirectly inspire future scientists.  It is presented as a serious look at the near future, appearing to the casual reader to be an academic work with both a methodology and an ample bibliography cited in support of its claims.

This makes its claims about body part regeneration particularly worrying. By 2020 the following working day is suggested as being possible:

A Day in the Life
A day would typically start with scanning the most critical or urgent new requests for repairs and complete body parts, and checking on component deliveries to help schedule the day‘s work plan. Requests would be reviewed to determine whether entire limbs or organs were required or just component subsystems (e.g. a new kneecap) and where multiple copies were required e.g. for athletes and soldiers returning to combat. A visit to the incubator would follow to check on the progress of body parts currently being ‗grown‘ and to perform staged quality control tests of all existing growth culture batches. Starting new growth batches would be the next priority.
The body part maker works with computer aided design, including online DNA modelling and biomechanical simulations, DNA encoding and DNA modification. A core skill is the selection and combination of biological materials to grow organ parts on “scaffolding”, which is also modelled by the body part maker, based on computer-generated templates. While a typical organ such as a liver or kidney might be grown, other parts such as an arm would involve the complex integration of a nano-engineered skeleton, high performance robotic joints, fibre-optic nerves, artificially grown skin, synthetic flesh and muscles.
Much of the day would be spent working at the laboratory bench designing and assembling body parts and testing their performance under various conditions as specified by the owner. Throughout the day the body part maker would be engaged in video conferences with surgeons around the world to discuss their requirements, provide advice on appropriate body part design and review the results of past body part replacement surgeries. Dedicated time would also be set aside to review the latest information on new techniques and research provided by the body part maker‘s professional association.

The sole reference provided for this vision of the future is a CBS news report on, admittedly impressive, lab grown tissues.  Now organ regeneration is a fascinating biological phenomenon.  For example,  the planarian flatworm and starfish can be cut into multiple pieces, with each peice capable of growing a complete and viable body.  The salamander can regenerate limbs and some lizards can regrow their tail.  But by contrast, mammals aren’t so good at this, most species it seems can recover from severe liver damage by growing new tissue and there is some evidence that damage to bone, brain and other organs can stimulate the growth of new tissue, even if complete recovery is not possible.

The differences in regenerative capacities of different organisms are due to stem cells, cells of the body capable 0f dividing into different types of tissue, and relative complexities. The star fish and flatworm have sufficient numbers of stem cells as adults, as well as relatively simple bodyplans and internal structures, to regenerate complete bodies. The more complex salamanders have the capacity to induce the formation of stem cells from adult tissue and effectively mimic the process of limb growth in embryonic development to grow new limbs.  Mammals, meanwhile, have lost this capacity during their evolution.

Why different species have different regenerative capabilities is a fascinating biological question and one on which there is a considerable amount of research.  None of which was cited in the Fast Future report.  I contacted Rohit Talwar, CEO of Fast Future and lead author, to ask him if he could provide references to lend plausibility to this vision of the future, I also asked if this section of the report had been reviewed by experts in this field.

Mr Talwar could not provide references and confirmed that the report had not been reviewed.

Now even though the Fast Future report cost just £7,500 and was not an academic exercise or peer reviewed it was accompanied by quotes from the Prime Minister, Gordon Brown, and Science Minister Lord Drayson.

The Prime Minister Gordon Brown said:
“A priority for this Government is to prepare Britain for the economy of the future and to make sure our young people can seize the opportunities that innovations in science and technology will bring. The shape of jobs to come shows what might be on offer for the next generation. I hope it will inspire young people to gain the skills and training they will need to succeed.”
Science and Innovation Minister, Lord Drayson said:
“These jobs are no longer the stuff of dreams. Today’s schoolchildren could become our first generation of scientists to build a flying car or help reverse climate change! Science is moving at an incredible pace. My message to them is be part of it!”

Perhaps these heavyweight quotes were responsible for the rather credulous media coverage of the report, which largely accepted it at face value and, with the possible exception of the Today programme which asked Mr Talwar if it was a publicity stunt – ‘no, it’s not’, did not ask particularly or even slightly probing questions concerning the plausibility of the report.

Ironically, while the report and media coverage are credulous and owe more to fiction than to fact, a link from the Science So What page on this job takes you to a far more sensible site, with an unfortunate Anglocentric slant, from the Science Council that uses the example of Michael Owen’s ligament injury to describe scientific jobs that aided his recovery.  This site, while rather basic, does not stray beyond the borders of scientific reality and does a respectable job of linking scientific and medical careers to real world phenomena of interest to teenagers.

It may be rather cynical but I can’t help but wonder if the Fast Future report, drawn up commissioned by PR people, represents all that is wrong with science communication in the popular media.  This fictional, low quality and cheap report gathered vital airtime and newsprint for Science So What while providing a boost to the public profile of Rohit Talwar and Fast Future.  It is a shame that it did not communicate much science.  One wonders if the primary aim of the report was to invoke media interest and drive traffic to the Science So What website rather than educate the teenagers of Britain about careers in science?  If such cynical headline grabbing was not the intent then there is a worrying lack of competence in some aspects of the governments science communication strategy.

UPDATE

PodBlack has highlighted some mroe examples of plagiarism.  There is a minor correction in the text above with ‘drawn up’ being replaced by ‘commissioned’.

Baroness Greenfield, the Royal Institution and Science Communication

As Layscience points out, the recent dismissal of Baroness Susan Greenfield from the Royal Institution is unsurprising given pre-Christmas speculation.   Background information in The Times suggests that this is a move in response to £3m worth of debt following a £22m refurbishment.  Baroness Greenfield and the Royal Institution have now given statements on the matter.

The Royal Institution claim this is due to a review of their governance.

“The trustees of the Royal Institution of Great Britain have completed the first stage of a governance review and as a consequence have concluded, that the requirement for the functions of the role of director as currently defined has ceased to exist. We are therefore sad to announce that Baroness Susan Greenfield left the RI on 08/01/2010.

“Baroness Greenfield has played a leading role, not only in the development of the RI, but also in the wider scientific community through her work in popularising science. In her twelve years as director of the RI, she was the driving force behind numerous initiatives, notably, the recent visionary refurbishment project and the renowned Science Media Centre. Baroness Greenfield leaves with our thanks and we wish her all the very best in her future endeavours.

While Baroness Greenfield asserts that her understandable displeasure with this move is linked to the manner of her dismissal and sex discrimination:

“I was formally notified of the decision that the requirement for the functions of the role of director of the Royal Institution as currently defined has ceased to exist. I have taken legal advice from a leading QC in this field and am advised this is beyond the powers of the Council, as any decision to render redundant the role of director should at the very least be subject to the approval of the members at a special general meeting. This year is the 200th anniversary of the Act of Parliament which made the Royal Institution a members’ organisation.

“I am saddened and dismayed by developments and dispute the lawfulness of the current decision-making procedure. As well as contesting the legitimacy of the process, I will be presenting a claim in the employment tribunal which will include allegations of sex discrimination. I am the only female who has been appointed to this iconic post throughout the 211 year history of the Royal Institution and cannot see how this decision can be in the best interests of the organisation or its members.

“The holder of this office has always been a prominent scientist and has carried out a unique role in acting as a representative for the scientific community, not only within the organisation, but also to the public at large. I am not able to make any further comment at this stage.”

It is clear from these statements that the public debate on this issue will focus on the wisdom of the renovation and possible sexist behaviour from the Royal Institution.  This is unfortunate.  In their own words “The Royal Institution is an independent charity dedicated to connecting people with the world of science.”.  Science communication is at the core of what they do.  This seems to have been lost amongst the extravagances of their renovation.   Extravagances Baroness Greenfield was unlikely to have had complete, unmonitored, control over, so as a reason for sacking her it stinks. It does look like as if she may be a scapegoat for institutional failure.  In terms of science communication, like Aric Sigman, Baroness Greenfield seems to have an ideological opposition to the internet and new media that remains untethered by any evidence base.  Furthermore Baroness Greenfield has leant her name to an expensive piece of software, MindFit, whose claimed benefits were found wanting by Which magazine. For this Baroness Greenfield has been criticised by science communicators working in new media, such as Ben Goldacre and Mind Hacks.  Consequently, there is ample internet speculation that controversy over her outré ideas might play at least some part in her dismissal despite official protestations to the contrary.  It is unfortunate that neither the Royal Institution nor Baroness Greenfield seem prepared to talk about this, preferring bland compliments and accusations of sexism respectively.

However to dwell too much on such things might be to miss the point.  Looking back to a 2003 Guardian debate with Professor Jon Turney in three parts (the initial article, Turney’s response, Greenfield’s response to that) Greenfield identifies a problem with the modern media portrayal of science and its reception, somewhat at odds with her later opinions:

From the happy confidence of the 1950s and 60s TV ads, we have been plunged into brain-scrambling mobile phones, brain-gnawing prion diseases, contaminated foodstuffs, not to mention the underlying stealth of chemical and cyber-terrorism, let alone designer children, artificial wombs and human clones. Small wonder there is a simple knee-jerk to veto all this confusion and scary technology in one go. How can Joe Public, after a hard day at work, come home and be expected to tease out the pros and cons, weigh up the risks, consider all the implications, and differentiate the “yuck” from the reality. Wouldn’t it be much easier to sit back in a past where everyone was 100% human, with their human values and understanding: the post comes three times a day, there are no mobiles, emails, or videos, perhaps no planes – and, of course, no freedom from toothache, infections and early death.

A problem to which this solution is offered:

Surely, the only way to quell a fear of science, is not to stop doing it: after all, science is about being curious and curiosity is about being human. Rather, we need to empower ourselves with knowledge so we can evaluate the alarms and the excitements in equal measure. The methodology and jargon can be circumvented, so long as the media, the general public, and scientists, all strive to talk to each other.

It should be noted that Jon Turney does disagree with aspects of Baroness Greenfield’s article but concurs with the need for lines of communication between scientists and the public:

Work to promote scientific literacy so everyone is up to speed, empowered and ready to contribute to the great debates about science, technology and the future? No. Invite them to participate, and really mean it, and they will find the motivation to become as scientifically literate as you, or rather they, please.

I would urge people to read these articles in full as they provide a historical perspective on the state of science communication on the cusp of an age in which blogging and new media are forming part of the firmament of science communication.  Sadly Baroness Greenfield and the Royal Institution have not coped well with the rise of online science communication and the need to open up dialogues and consequently have often found themselves the target of bloggers scorn.  Now, as they become mired in infighting and recrimination, perhaps we should look back to the concluding paragraph of Baroness Greenfield’s final response in the above series:

If we in the business of helping the public come to terms with science and technology were less heated over semantics and internal spats, and more concerned with getting on with the job, surely our energies would be better spent.

I would urge bloggers not to become too infatuated with the gory details of Baroness Greenfields demise and the train wreck of the Royal institution’s finances but look instead to the job of developing better methods of science communication in the online age.

Aric Sigman and a problem with newspaper comment

Welcome to my first post of 2010, in which I identify and illustrate a problem with newspaper comment on matters of science.

Dr Aric Sigman is a popular author and presenter with a Phd on “The roles of attention in hypnotic and feedback control of heart rate” and an interest in blaming certain of societies ills on new technology and new media.  He has been criticised previously for his habit of cherry picking and extrapolating wildly in various publications exploring this concept.  In his latest comment piece on The Guardian’s Comment is Free site Dr Sigman constructs his thesis in fewer than 500 words arguing that:

What children see through product placement increases their sense of entitlement to what they see, which in turn increases their “pester power”, which in turn makes their parents’ job of mediating their children’s demands more difficult. Ultimately, this retards the development of our children’s capacity for deferred gratification, now referred to as “impulse control”.

Cited for support in this series of assertions are newspaper articles, from one and two days previous, reporting on criticism from a variety of bodies, including those representing healthcare, of a recent government consultation exploring a changing of the rules regarding product placement on television.

Following this opening argument Dr Sigman explores his interpretation of the implications of delayed development of “impulse control”.

However, impulse control is more than a behavioural pleasantry; it is a self-regulation skill that affects a wide range of childhood outcomes that go far beyond demanding a chocolate bar here and now. For example, the development of a child’s impulse control is uniquely related to early academic success and is now considered more important in early academic progress than measures of intelligence. And a recent study published in the British Journal of Psychiatry reported that acquiescing in the face of pester power is linked to later antisocial aggressive behaviour and convictions for criminal violence. The researcher concluded that giving in to a child’s demands may prevent them from learning to wait for something they want: “Not being able to defer gratification may push them into more impulsive behaviour, which is strongly associated with delinquency.”

This passage is notable for containing two references, the last in the article, that are in respectable academic journals and allow us to use them as a proxy to measure the breadth and depth of Dr Sigman’s scholarship.  Do they say what he says they do?

The first reference is in the journal Child Development* and is cited as showing “the development of a child’s impulse control is uniquely related to early academic success and is now considered more important in early academic progress than measures of intelligence”.  This paper studied “one hundred and forty-one 3- to 5-year-old children from low-income homes”, a small and narrowly defined cohort that should prevent extrapolation to general conclusions encompassing all populations of children, a point not lost on the authors as they conclude “An important direction for future work will be the replication with diverse populations of effects seen in these studies and assessment of the generalizability of training effects to academic ability.”.  Furthermore neither of the terms ‘impulse control’ or ‘deferred gratification’, used by Dr Sigman, are defined or mentioned by the authors, they use the terms “effortful control, false belief understanding, and the inhibitory control and attention-shifting aspects of executive function” in their investigations.  This work does not support the statement by Dr Sigman.

The second reference is in the British Journal of Psychiatry** and is cited as showing that “acquiescing in the face of pester power is linked to later antisocial aggressive behaviour and convictions for criminal violence”.  This paper reports on the link between childhood consumption of chocolate and violent behaviour in adulthood, there was “a significant relationship between eating confectionery at age 10 years and violence at age 34 years”.  The authors speculate in the discussion that:

Candidate mechanisms linking confectionery consumption to adult violence must account for enduring changes into adulthood. One plausible mechanism is that persistently using confectionery to control childhood behaviour might prevent children from learning to defer gratification, in turn biasing decision processes towards more impulsive behaviour, biases that are strongly associated with delinquency. Furthermore, childhood confectionery consumption may nurture a taste that is maintained into adult- hood, exposing adults to the effects of additives often found in sweetened food, the consumption of which may also contribute towards adult aggression

The speculative nature of these mechanisms is clear from the context and they are not considered as proven by the authors, instead warranting “further attention”.  This work does not support the statement by Dr Sigman.

However, unlike the first reference, a possible source of Dr Sigman’s misunderstanding can be easily found.  The press release from the Royal College of Psychiatrists contains a quote from the studies lead author, Dr Simon Moore:

“Our favoured explanation is that giving children sweets and chocolate regularly may stop them learning how to wait to obtain something they want. Not being able to defer gratification may push them towards more impulsive behaviour, which is strongly associated with delinquency.”

However this bold statement is qualified in the succeeding paragraph:

The researchers concluded: “This association between confectionary consumption and violence needs further attention. Targeting resources at improving children’s diet may improve health and reduce aggression.”

Like the paper itself, the press release makes clear from context the speculative nature of Dr Moore’s comment.  However, this was not sufficient to prevent articles, such as this in the Daily Mail, that take Dr Moore’s speculation as an assertion of fact.  This seems to have perturbed Dr Moore, and in an online response to criticism of his paper on the British Journal of Psychiatry’s website he writes (my bold):

The far ranging media interest stimulated by this paper ranged from deriding the work as a waste of money to one that could bring peace and harmony to a North American city, and possibly further afield. [...] as good Popperians behavioural scientists test null hypotheses: science progresses through the falsification of beliefs, and accordingly we reported the acceptability of the null probabilistically in the regression statistics. But the point remains that at least in the media such results are too often reported as facts when they are statements of belief looking to be challenged. Stating “what works”, inferring causality, and demonstrating “proof” are further examples of naivety that contributes to the disparity between academic and lay reporting.

Like the media, it is entirely possible that Dr Sigman has based his understanding of the paper on an incomplete reading of the press release alone.

In my opinion this basic failure of scholarship renders the arguments and conclusions in Dr Sigman’s article void of academic merit or extension by discussion.  So why was it published?

Matt Seaton, the editor of Comment is Free, in response to my enquiry as to if Dr Sigman’s article was checked for factual errors and if his references were read, has provided some insight into how these errors were missed by The Guardian.

1. Do we check references? Yes, and obviously we would query or correct a reference that appeared to be mistaken. But unless there is a glaring error, we do take a certain amount on trust from authors (unless special circumstances would lead us to do otherwise, which is not the case here).

2. Do we read in full the text linked to in a web reference? No, that would naturally be an impossible burden. In this case, Aric Sigman warned me that he could only provide links to abstracts, as the learned journals in question are subscription-only; to which my response was that this was still useful, in order to ’show his working’ and avoid the impression of making unwarranted assertions.

It is unreasonable to expect newspaper employees to have the time and expertise to examine references such as those used by Dr Sigman and I fully accept the need to trust an author.  That Mr Seaton expected Dr Sigman to “’show his working’ and avoid the impression of making unwarranted assertions” is a reasonable burden to place on the author of a comment piece, Dr Sigman failing to do this adequately is not The Guardian’s fault.  But the decision to publish was not Dr Sigman’s.

Some insight into the decision to publish may be gleaned from the comments in response to the article where it seems The Guardian’s online readers are more interested in having their prejudices confirmed or confronted rather than challenging the factual basis for Dr Sigman’s opinions.  This is clearly not a forum for disseminating knowledge but a platform where the uninformed can combat assertion with prejudice.  It is perhaps in The Guardian’s interests to attract the advertising revenues associated with a high volume of readers and they are simply given the readers what they want.  Not fact, but opinion.

Unfortunately it is environments such as these that provide resources for that peculiar species of commentator that prefers to advance their arguments by popular opinion than by peer review. It is worth noting that in the 1980s Dr Sigman produced a handful of papers on hypnotism and since then does not appear to have published anything that appears in an academic database.  Instead he has penned popular books and recorded less popular audio cassettes as well as performing research for commercial organisations on subjects outwith his, now dated, academic speciality.  It appears at no point has he sought professional appraisal of his opinions by submitting them to the rigours of peer review, therefore we cannot know what merit they may have when considered against evidence in the field.

There is a famous speech by Richard Feynman in which in rails against what he calls ‘cargo cult science’ and argues that proper science requires high standards of honesty, absent elsewhere, to avoid the human tendency to be fooled.

The first principle is that you must not fool yourself–and you are the easiest person to fool. So you have to be very careful about that. After you’ve not fooled yourself, it’s easy not to fool other scientists. You just have to be honest in a conventional way after that.

Dr Sigman, in his inadequate use of references and tendency to assert without proof, has perhaps demonstrated that he has fooled himself, and others, and is little more than a cargo cult academic.

If only this criticism was a cautionary tale of the dangers of misrepresenting scientific evidence in the popular press.  However, contrary to the conventions of the form, Dr Sigman has met no ill fate, only reward.  His books sell, his speaking services are advertised at £3-5k a time and he indulges his passion for travel.  These are not the perks of the average academic bound by research codes, ethical approval, peer review and the need to constrain opinion within the boundaries of available evidence, these are the perks of cargo cult academics.  Slipshod research sells.

The solution to this is perhaps more criticism and challenge from those in academia targeted at those who prefer their theories evade review while assuming the cloak of academic respectability through the shallow use of references and titles.

In the coming year I would like to see academics becoming more proactive in their challenge of misrepresentation of their research by those in the media and I would like to see the likes of Dr Sigman under closer scrutiny regarding the evidence base for their claims.  Here’s to a new year.

Dr Sigman was contacted for the purpose of this blogpost and did not respond.  I hope he will do so post publication and I will update accordingly.  I am grateful to Dr Simon Moore and Matt Seaton for their help and observations.

* Relating Effortful Control, Executive Function, and False Belief Understanding to Emerging Math and Literacy Ability in Kindergarten
Clancy Blair & Rachel Peters Razza
Child Development (78) 2: 647-663

Confectionery consumption in childhood and adult violence
Moore, Simon C., Carter, Lisa M., van Goozen, Stephanie
The British Journal of Psychiatry 2009 195: 366-367

Society of Homeopaths – Appetite for destruction, not regulation

In July the Society of Homeopaths (SoH) declared that they would be seeking statutory regulation via the Health Professions Council (HPC).  At the time I suggested that such a move would be problematic given homeopathy’s inability to train properly, analyse research and appreciate the value of ethics.  I also reported that the SoH had rejected Complementary and Natural Healthcare Council (CNHC) regulation, a non-statutory form, in strong terms:

The Board has carefully considered many other options, including joining the Complementary and Natural Healthcare council (CNHC). However, we are concerned that CNHC is not currently in a position to protect the standards already achieved within the profession. Statutory Regulation will not be a fast fix option but the Board believes it best protects standards already in place.

Sadly for the homeopaths it looks like the SoH’s drive for statutory regulation will not only be unsuccessful but it will actively prevent attempts by other homeopathic bodies to co-ordinate the professions attempts at asserting responsible behaviour.

According to a recently released FOI response the SoH have not made a formal application to the HPC and the HPC feel that they should be regulated by the CNHC instead:

I can confirm that the Society of Homeopaths has, to date, not made a formal application to us under our new professions process. We met with the Society of Homeopaths in June 2009 to talk about our new professions process and about regulation more generally.

Our legislation has provisions which allow us to make recommendations to Government about the regulation of new professions. We have established a set of ‘new professions criteria’. Normally an application for registration is made by a professional body or bodies representing an aspirant profession. They submit a formal application showing us how they believe they meet the criteria. This is then assessed and discussed at public meetings of our Council and a decision made. If the criteria is met, we can make a recommendation to the Secretary of State and Ministers in the devolved administrations about the regulation of that group. However, any decision about regulation is one for government and, ultimately, for parliament.

At present, the stated policy of the Department of Health in England is that a range of complementary therapies, such as homeopathy, should not be subject to ‘full blown statutory regulation’. Instead the Department has funded the CNHC to set up a federal,system of voluntary registration

In addition to this, at the recent Science & Technology committee ‘homeopathy evidence check’ Mike O’Brien the Minister of State (Health) confirmed that the SoH have a problem talking to the CNHC but ruled out any government sanctioned move to the statutory regulation of homeopaths.

Mr O’Brien: We do not propose at this stage to have statutory regulation. We did fund some work by the Princes Foundation for Integrated Health through £110,000 pounds over three years to set up some voluntary self-regulation. Basically the Complementary and National Healthcare Council was set up in 2008; it is still having some discussions, shall we say, with the Society of Homeopaths – or maybe sometimes not having discussions, because I still think there is some disagreement there – and the question is whether voluntary self-regulation in an area like this is the better approach. There is to some extent some statutory recognition, of course, of homeopathy, which is very limited, but the question as far as we are concerned is should we undertake a larger scale statutory regulation, and at this point we are not convinced that is the right approach.

Together this suggests that homeopaths joining the statutory HPC is not an option for the forseeable future.  I have no particular comment on whether or not this is a good thing.  It is impossible to judge how homeopathy could be statutory regulated without seeing a proposed mechanism that deals with the stated HPC criteria for aspiring entrants:

Aspirant groups must:

Cover a discrete area of activity displaying some homogeneity

Apply a defined body of knowledge

Practise based on evidence of efficacy

Have at least one established professional body which accounts for a significant proportion of that occupational group

Operate a voluntary register

Have defined routes of entry to the profession

Have independently assessed entry qualifications

Have standards in relation to conduct, performance and ethics

Have Fitness to Practise procedures to enforce those standards

Be committed to continuous professional development (CPD)

I do however suspect fulfilling these criteria might be difficult.

Additionally the SoH appear to be in denial about this, in their submission to the Science & Technology committee they stated that:

2.3 The Society is applying to the Health Professions Council (HPC) for the statutory regulation of homeopaths, following a survey in 2006 which showed that 65 per cent of our membership supported statutory regulation. [...] The move to statutory regulation is seen as a natural step forward for both The Society and the profession, most importantly to offer protection to the public as, under existing laws, someone without training can currently practise as a homeopath.

This strikes me as slightly deluded, at the point this was submitted the SoH would have been well aware that the HPC were not offering encouragement for an application for statutory regulation but, consistent with government policy, were stating that CNHC regulation was a viable route for regulation.  To suggest to a parliamentary committee that HPC supervised statutory regulation was a viable option is a far stronger conclusion than the evidence would suggest possible.  Additionally, although 65% of SoH members might be a plurality but it is not a majority of homeopaths, the Alliance of Registered Homeopaths (ARH), the second largest professional organisation in the UK, officially reject the SoH’s attempts at regulation.  The SoH cannot claim to speak for the bulk of the profession on this matter.

Talk of regulation, either via the HPC or CNHC is irrelevant though.  According to the CNHC, when asked about homeopaths being included in the list of professions they are prepared to regulate

Homeopathy is the only profession in the group listed which has not yet indicated an ‘in principle’ willingness to recommend CNHC registration to their practitioners. We would hope this situation will change over time. Individual homeopaths are already seeking registration with CNHC but until a PSB is in place for that profession, regrettably they cannot be registered.

This also represents a serious problem for the CNHC, the quackometer has argued that:

The Ofquack project was really dependent on the homeopaths to succeed. Homeopaths represent the largest group of alternative medicine cranks in the UK and if the various homeopathic factions had played ball, the CNHC could have been secure with subscriptions from many thousands of homeopaths.

So there you have it, the SoH will only settle for a form of regulation they have been told they will not get in the forseeable future, the ARH reject any form of regulation at all, other than their own, and the CNHC depend on homeopaths being regulated for their survival.  Unfortunately for them there is no appetite for the regulation of homeopathy in the UK, only it seems, an appetite for destruction.

Launch of National Campaign for Libel Reform

The Coalition for Libel Reform have put out a press release stating that:

“England’s libel laws are unjust, against the public interest and internationally criticised – there is urgent need for reform” this is the message performers, writers, poets, patient groups, legal experts, broadcasters, journalists and others represented by the Coalition for Libel Reform (English PEN, Index on Censorship and Sense About Science) are sending to politicians urging them to support a bill for major reforms of the English libel laws now, in the interests of fairness, the public interest and free speech.

Today at the launch of the National Campaign for Libel Reform, performers and others urged the public to sign a petition demanding reform of the libel laws, highlighting that for the first time in over a century we have an opportunity to change our unfair and repressive libel laws.

Today leading academics, medical and science editors, human rights activists and writers will be taking the campaign to Parliament to tell MPs and Peers what the public don’t get to hear under the English libel laws.

You can find out more about the campaign and sign the petition here:

www.libelreform.org

The press release has a plethora of quotes from the great, the good and those who work in journalism, demanding libel reform.  However, this is not a campaign for the benefit of those whose professional practice is limited by the nature of England’s libel laws, it is about removing barriers that restrict the flow of knowledge to the public and restoring the principle that all are equal before the law.  I have signed the petition and offer this campaign my full support and would urge others to do so too.

The FIH and AIDS denialism

The Prince’s Foundation for Integrated Health (FIH) is an organisation that promotes and purports to regulate complementary healthcare.  Set up by  Charles in 1993 the foundation is run on a day-to-day basis by a curious mixture of establishment figures and alternative health care advocates, both George Gray and Dr Michael Dixon, Acting Chief Executive and Medical Director respectively, have a long and fairly respectable history of working in the medical sector while Boo Armstrong, Head of Integration and Development, is founder and director of Get Well UK, whose Peter Hain endorsed ‘trial’ in Northern Ireland has come under some considerable sceptical criticism.

Boo Armstrong has a far more controversial past that either Gray or Dixon.  Boo Armstrong was a contributor to Continuum magazine, active in the 1990s, whose editorial position was that AIDS was not caused by HIV and that provided a home for prominent AIDS denialists including Peter Duesberg, Neville Hodgkinson, Eleni Papadopulos-Eleopulos and others.

Homeopaths use witchcraft to influence parliament

Recently I blogged the wholly inadequate response of H:MC21 to the upcoming House of Commons Science and Technology committee hearing on the evidence for homeopathy. Now it seems that the homeopaths have taken a look at the list of those giving oral evidence*, thrown up their hands and cried the familiar call of conspiracy that suits those that have no comprehension of scientific evidence coupled with insufficient insight to recognise the universal human trait of incompetence.  They have also turned to witchcraft.

BANT want permission to impersonate genetic counsellors

The British Association for Applied Nutrition and Nutritional Therapy (BANT) have recently expressed concern in their newsletter that moves by the Health Professionals Council (HPC) and Association of Genetic Counsellors and Nurses (AGCN) to support the statutory regulation of Genetic Counsellors may impact on their freedom to practice quackery.

We live in the age of the genome. Jeffrey Bland presented in his yearly seminar event in the UK on the subject of the genetic blueprint. BANT practitioners speak of ‘biochemical individuality’ and it is of this that we speak as being the major factor in how we approach individual help for clients. We are aware that a growing number of practitioners are using genetic testing, either the single gene or combined tests.
•     The first nutrigenetic tests appeared on the market in 2001 and have been used by nutrition counsellors since then.
•     In 2002 BANT representatives gave evidence to the Human Genetics Commission in its Genes Direct inquiry on genetic testing supplied direct to the consumer (defined as outside a medical consultation).
•     In 2008 BANT submitted evidence to the House of Lords inquiry into Genomic Medicine about nutrigenetic practice.

BANT is now aware that the Association of Genetic Counsellors and Nurses (AGCN) have applied for statutory protection of the title ‘Genetic Counsellor’ (GC). We are concerned that BANT members who already work in nutrigenetic counselling may be unable to continue to practise their profession without hindrance if the AGCN succeed in getting statutory regulation. In view of this fact BANT has written to the Health Professions Council to ask several questions relating to this topic. Namely;

•     can the HPC assure us that statutory protection will NOT impact on the use of ‘Nutrigenetic Counsellor’ as a title;
•     should BANT be making an immediate application to HPC to be considered alongside that of GCs;
•     should BANT representatives, as Nutrigenetic Counsellors, give a presentation to HPC at the same time as the AGCN present their case?

As mentioned earlier, BANT practitioners  work with biochemical individuality. Most students are now having modules on genetic testing in their studies and even more practitioners attend seminars on the subject. More practitioners are using these tests and it is right that BANT protects our rights to the use of these tests .  Please continue to check the BANT website for the latest information on this subject.

The ethics of genetic counselling are complex and the AGCN have an admirable code of conduct that takes this into account.  Genetic testing is a form of medical diagnostics looking at mutations in particular genes that can have profound and devastating implications for the patient and their family that may fundamentally change their life, such as Cystic Fibrosis, Sickle Cell Anaemia, and Phenylketonuria.  The role of the Genetic Counsellor is to inform the patient about the test and the implications throughout the process.

Genetic counselling is defined as ‘a communication process which deals with human problems associated with the occurrence, or the risk of occurrence, of a genetic disorder in a family

(American Society of Human Genetics, 1975)

A Genetic Counsellor is a highly skilled individual with either a primary qualification in nursing or midwifery or has completed a Masters degree in Genetic Counselling after obtaining a Bachelors in a relevant subject, in addition to this they must undertake at least 120 hours of specific counselling training as well as more general training for a period of around 2 years.  A nutrigenetic counsellor does not.  A nutrigenetic counsellor must hold a qualification, most likely not accredited, from an instituition approved by BANT and then must pay BANT a membership fee.  After this they may call themselves a nutrigenetic counsellor.
A Genetic Counsellor is expected to have a scientific understanding of genetic illness and testing, a firm commitment to evidence based practice and a commitment to a proper regulated professional relationship with a patient.  A BANT nutrigenetic counsellor undergoes dubious training, lacks effective regulation, belongs to an organisation that altered its code of ethics to allow commision to be recieved by members for products sold to customers and whose former ethics committe head pretended to be on a nursing register when she was not, a criminal offence.

The tests a Genetic Counsellor will advise on are of proven accuracy and are conducted in a carefully controlled environment.  The tests involved in nutrigenetics prompted this statement from the Human Genetics Commission (HGC):

Genetic tests that claim to be able to give nutritional health information, but have not been robustly and independently evaluated, are a concern for the HGC.

The HGC believes that test providers need to be able to provide evidence that the genetic tests they offer can reliably and accurately, predict what they claim to be able to predict. The link between a gene and a condition or trait should be proven for all genetic tests, including nutrigenetic tests, before they are sold to the public and proof of this link should be made available to consumers. The sale of genetic tests without this proven level of clinical validity can give rise to unnecessary anxieties about health or give an individual a false level of reassurance. With nutrigenetic tests in particular, this could lead to an over-consumption or avoidance of certain food groups, which could cause potential harm to the individual and lead to further costs to the NHS.

The HGC advises any individual who is thinking about taking a nutrigenetic tests to obtain the following information first:
• general information on genetic testing and specific information on the nutrigenetic test including the evidence of the link between the gene and the condition/trait and whether this link has been published in a peer-reviewed academic journal
• the measures the test provider will take to ensure the confidentiality of their biological samples and personal records
• how they will be provided with the genetic test results and who they will be able to contact if they don’t understand the results
• information on the limitations of the test so that they are aware of the level of significance that they can attribute to the results of the test
• whether their biological sample will be used for any secondary purposes or if their personal details will be passed on to any third parties

The Commission believes that individuals taking a test should be aware that the interaction between genes and environment factors, such as food, is complex and constantly changing which makes interpretation of nutrigenetic tests very difficult and in some cases impossible without knowing these environmental factors. Consumers should also understand that some nutrigenetic tests are less predictive than the results they might receive for other genetic tests.

These are not issues that BANT appear to have considered.  The following letter is the HPC’s response to BANT’s concerns about their use of the term nutrigenetic counsellor.

Thank you for your recent letter regarding the continued use of the title ‘Nutrigenetic counsellor’ by your members. Marc has passed your letter to me for a response.
As you note in your letter, the Association of Genetic Counsellors and Nurses have applied for statutory regulation and have proposed that the title ‘genetic counsellor’ should become a protected title. The Association is due to present at the HPC Council meeting in December 2009. If the Council decides that the new professions criteria have been met, they can make a recommendation to the Secretary of State for Health. However, any decision about whether that group becomes regulated in the future is one for government.
The 2007 White Paper Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ identified the priority groups for future statutory regulation including psychologists (regulated by the HPC from 1 July 2009), healthcare scientists, psychotherapists and counsellors, and other psychological therapists. We consider that it is unlikely that Government will proceed to consider whether to regulate further groups until at least 2011/2012 at the very earliest.
You may be aware that we have been undertaking a piece of work looking at the regulation of psychotherapists and counsellors. As part of this we have been considering with stakeholders in the field which titles should be protected and have considered whether it would be possible to protect the title ‘counsellor’ given it is widely used by practitioners undertaking therapeutic work with clients, and readily recognised by members of the public. However we have also acknowledged that the term is sometimes used, often as part of an adjectival title, by individuals practising in fields outside of ‘therapeutic counselling’. Examples include debt counsellors and financial counsellors.

In protecting a professional title the government has to be sure that that title is in wide usage by those it intends to regulate, and that protecting that title would not effectively bring into regulation others that it is not sought to regulate. With respect to protecting the title ‘counsellor’ as described on the previous page, we think that this title might be protected given its wide usage by ‘therapeutic counsellors’ but with provisions in legislation to ensure that this does not prevent its continued use by others outside of the ‘therapeutic counselling’ field. So the intention is that any future protection of the title ‘counsellor1 for the psychotherapists and counsellors part of the Register would not prevent the continued use of titles such as ‘debt counsellor’, ‘genetic counsellor’ and ‘nutrigenetic counsellor’.
With regards any potential future regulation of genetic counsellors and protection of the title ‘genetic counsellor’ it is very unlikely this would impact upon the continued usage of the title ‘nutrigenetic counsellor’ by your members. We apply out protection of title powers pragmatically and only take action where someone uses a protected title or implies their use of a protected title with the intention to deceive members of the public.
You do not need to make an immediate application to us. However, it is certainly very helpful to be aware of the use of this title in any subsequent discussions about regulation and we will highlight this to the HPC Council in their discussion about the genetic counsellors’ application. If government was to decide to regulate genetic counsellors at a future point, the decision to do so would be subject to a full public consultation at which point issues such as these could also be further considered.
Should you require any further information, please let me know.
Yours sincerely,

It is clear that BANT are not concerned with the need for proper regulation of genetic testing and those who advise on these tests but are simply seeking to protect their members business interests.  If they recognised the stark differences between Genetic Counselling and what they term nutrigenetic counselling they should feel obliged to come up with a description that more accurately reflected their members abilities and did not have the potential for confusing the public over the differences between highly qualified and capable Genetic Counsellors and those with dubious qualifications in nutrition.  The abbreviation ‘nutri’ does not translate into ‘unethical pseudoscientific nonsense, exploiting the uninformed and the gullible for personal gain’ in any dictionary I possess.

This is yet another sad illustration of how alternative therapists crave the respectability that comes with conventional medical practices but want nothing to do with the ethics, professionalism or evidence based practice.

Society of Homeopaths breach code of ethics on website – still

Professor Edzard Ernst has recently written a short article in the International Journal of Clinical Practice detailing the failure of the Society of Homeopaths (SoH) to apply their own code of ethics to their website.  A BMJ summary of the article contains an interview with Professor Ernst as well as providing a brief overview:

[A] review of some members’ websites showed a series of violations of the code that led Professor Ernst to scrutinise the society’s own website.

Despite there being no good clinical evidence to substantiate such claims, says Professor Ernst, the society’s website carried statements claiming that homoeopathy can help with various symptoms and illnesses, including fever, sore throat, toothache, arthritis, eczema, asthma, anxiety, insomnia, chicken pox, erectile dysfunction, and prostate problems.

“In my view, they [the statements] do ‘expressly or implicitly’ claim ‘to cure named diseases,’” writes Professor Ernst. “If this is so, they violate the SoH’s [Society of Homeopath’s] own Code of Ethics.”

He concludes, “If the SoH wants its members to behave ethically it should evaluate its own website carefully and deliberate whether it is responsible for a professional organisation to make health claims which are not supported by the current best evidence.”

The SoH response is also represented:

Paula Ross, the society’s chief executive, said she was grateful to Professor Ernst for highlighting his concerns and that the society would be investigating the concerns and making amendments “where appropriate.”

Long term readers of this blog may recall that I did infact make most of the points Professor Ernst has in October 2007, with the conclusion

[If] you keep banging on about your Code of Ethics and how that provides a reason to take homeopathy seriously then you should make sure that your website, your interface with the public, is absolutely rigorous in its adherence to your Code of Ethics. If you didn’t do that then people might begin to think that you don’t actually care about enforcing your Code of Ethics and your attempts to silence criticism through legal bullying wasn’t just a mistake but an active attempt to avoid responsibility.

It is my understanding that the SoH were informed of the contents of my blog shortly after I published it, over two years ago.  I will leave the reader to draw their own conclusions about the SoH’s competence, honesty and ethics.

HMC:21 – hammering the nails into homeopathy

The House of Commons Science and Techology Committee are holding an inquiry into the evidence base for homeopathy and government policy.  The deadline for written submissions was earlier this month and many individuals and organisations, from all sides of the homeopathy debate, will have submitted evidence.  Including among this are H:MC21, organisation dedicated to informing the public about homeopathy, from the perspective of homeopaths.

In their latest newsletter H:MC21 have proudly stated that:

We have sent a submission to a Parliamentary Innovation, Universities, Science and Skills Committee, which is looking at evidence for homeopathy as part of assessing the Government’s use of evidence in policy-making.

Unfortunately for H:MC21 the newsletter starkly lays out some of the most serious problems with homeopathy:

Low quality evidence

Support for unethical AIDS trials

A tendency to ignore criticism

Anti vaccine attitudes

House of Numbers backed by quacks

You may have heard that the Spectators screening of House of Numbers and the follow up debate have now been cancelled, however, I doubt those of us who follow the antics of alternative therapists will have heard the last of this film.  A major source of information for alternative practitioners is Mike Adams’ Natural News site, while this might at first glance look like the rantings of a lunatic fringe in reality Mike Adams is more a barber surgeon of alternative medicine, slicing and dicing science to transplant evidence with fear and paranoia* to fuel the sense of persecution of the online alternative health movement. Online forums and alternative health websites frequently cite Natural News as a source for their opinions.

Now he is plugging House of Numbers with typical appeals to paranoia and pushing the tropes of alternative health as a means to a cure:

The collection of immune suppression symptoms typically labeled “AIDS” could be far more effectively treated with naturopathic health strategies, including aggressive detoxification strategies, the removal of heavy metals, the avoidance of environmental synthetic chemicals (in foods, drugs, personal care products, homes and offices) and the addition of powerful immune-boosting herbs, foods and superfoods.

Essentially, AIDS can be cured in much the same way cancer can be cured: By radically altering food intake and lifestyle decisions to support a vibrant, healthy immune system.

This is nonsense.  Neither AIDS nor cancer can be cured by a change of lifestyle.  However, I think we will begin to see swellings of support for House of Numbers by alternative therapists as a result of this article.  A lot of alternative health practitioners believe in a big pharma conspiracy that suppresses information and creates disease to sell drugs, Mike Adams is simply validating what they believe they already know.  There is already considerable interest in listening to the opinions of aids denialists, with homeopaths organising seminars, ‘nutrionists’ such as Patrick Holford believing that vitamin C can treat AIDS and pro-alternative health lobby groups collaborating with the likes of Matthias Rath, whose views are in part responsible for in excess of 300,000 deaths in South Africa alone.

To those alternative therapists who read this blog I would urge you, rather than consider the opinions of Mike Adams, to read the content on this site from those misrepresented by House of Numbers instead.  Then you might learn it is not the scientists and drug companies who distort reality for their own ends but those who push fear, paranoia, deceit and denialism from within the alternative health movement.

 

 

 

 

 

* This link goes to the peerless orac who has the patience and the stomach to expose the twisted innards and tripe of Natural News.

Has Lionel Milgrom libelled Simon Singh?

Homeopath and former biochemist Lionel Milgrom has previously accused, erroneously, David Colquhoun of a lack of scholarship in an article on chiropractic and suggested that this questions his credibility.  This was shortly after Milgrom himself published an article whose scholarship is currently being elegantly dissected by apgaylard to expose a logical vacuum where the heart of an argument shoud be.  Now Dr Milgrom has possibly libelled the science journalist Simon Singh, who is himself being sued for libel by the British Chiropractic Association (BCA).  In an article published in the Journal of Alternative and Complementary medicine (JACM), ‘CAM, Free Speech, and the British Legal System: Overstepping the Mark?‘, Milgrom makes the claim in the abstract that:

The British Chiropractic Association recently won a libel case against the science writer and CAM ‘skeptic’ Dr Simon Singh for publishing an article in a British newspaper in which he accused them of promoting ‘bogus’ treatments.

This is not true, the case is under appeal over a definition of the word ‘bogus’ concerning its use in the alleged libellous article by Simon Singh but it has not gone to trial, there has been no verdict of libel and certainly no compensation paid as Milgrom claims later in the article.  It is false to claim that Simon Singh was found guilty of libel.  To claim otherwise could be seen as an attempt to damage the reputation of Singh with a false allegation, and thus, under Britain’s flawed libel laws, an accusation of libel could be made.

I doubt this will happen though.  Simon Singh has made a principled argument based on the need for scientific discussion to be carried out free of the threat of libel.  Milgrom’s article could be seen as a valid opinion on this particular argument.  Unfortunately though it is in part based on a demonstrably false observation. It is customary in science for an article to be retracted if it contains serious error and I believe that this article does.  Making false accusations that an individual has been find guilty of a offence in a court of law is undoubtedly a serious error.

I would urge Dr Milgrom to write to the editors of JACM and request that this article be retracted.

This article may be updated to include further comment.  Dr Milgrom was contacted with respect to this earlier today and I hope to carry a statement from him.

The Spectator and House of Numbers *update 2*

Fraser Nelson over at the Spectator Blog is justifying The Spectator’s forthcoming showing of ‘House of Numbers’ as follows:

Is it legitimate to discuss the strength of the link between HIV and Aids? It’s one of these hugely emotive subjects, with a fairly strong and vociferous lobby saying that any open discussion is deplorable and tantamount to Aids denialism. Whenever any debate hits this level, I get deeply suspicious.

The link between HIV and AIDS is indisputable according to the scientific evidence.  AIDS denialism has also contributed to the deaths of over 300,000 people in South Africa alone.

I am not sure what Fraser Nelson is suspicious of.  I suspect he is just drumming up support for the screening and debate.

However, the debate is extremely unlikely to be helpful to the public understanding of HIV, AIDS and the relevant pseudo-science.  Of the panel Richard Wilson has pointed out that:

all three ‘expert’ panelists have, at one time or another, adopted fringe views on HIV and AIDS, and been active in disputing the established scientific consensus. Of the five panel members chosen, only one [...] appears unambiguously to share the view held by the overwhelming majority of scientists currently involved in AIDS research.

I am not sure what the Spectator are aiming to achieve here.  Their senior staff are not fools and I find it difficult to believe they are unaware of the lack of credibility of ‘House of Numbers’.  This is likely little more than a misguided attempt at publicity.  What is likely to happen however, is that they will have large numbers of crazed AIDS denialists in the audience screaming and shouting at those who criticise the film, their blog comments will be overrun with cranks and quacks and they will be regarded as part of a healthcare problem.

*update*

In 2004 The Spectator carried an article title “AIDS denial costs lives“.  Perhaps Fraser Nelson can allay some of his suspicions by reading his own magazine.

*update 2*

The Spectator have apparently carried an article from Neville Hodgkinson in support of the film. Hodgkinson was the science journalist at the Times when they took a stance that questioned a link between HIV and AIDS in the late 80s/early 90s.

Raindance Film Festival Endorse AIDS Denialism Part II

Earlier I blogged on the decision by the Raindance Film Festival to show the AIDS denialist documentary ‘House of Numbers’ and the endorsement given to it by the festival through Xavier Rashid and Elliot Grove, the festival’s founder. Since then I have been in contact with Mr Grove and presented to him evidence of the harm the ideas behind ‘House of Numbers’ have caused and argued that its promotion risks further harm.  Mr Grove has agreed to allow me to publish the following, unedited, statement from him:

I chose and agreed to play House of Numbers for three reasons, all of which fit the Raindance Film Festival criteria:

- debut filmmaker
- quality filmmaking
- an extreme message which I decided after hours of research and debate with my team, deserved to be seen and heard.

I grew up in Somalia and have first hand knowledge of the destruction wrought on that continent by ‘aid’. I also live in the UK and witnessed the hysteria and misinformation wrought by the so-called swine flu epidemic

MAny of my closest friends are AIDS/HIV positive, and several have died as a result of AZT or other AIDS related illnesses.

I do not, not have ever denied AIDS/HIV. I feel that the arguments surrounding the AIDS issue amy not be exactly as I have been told, as indeed the real cause of the 9/112 tragedy might not be what they seem, as Charlie Sheen is saying.

I am glad we showed the film. I wish we had worked harder to reach more people with it. As a filmmaker, like the director Brent Leung,  it is difficult to balance the financial aspects of distribution with the economic realities of film production.

I think the postiive actions of showing House of Numbers, and the debate it has caused will help anyone concerned with issues of health and hopefully will enable anyone living under the curse of HIV/AIDS hope for a better life.

Elliot Grove
Founder
Raindance Film Festival
British Independent Film Awards

As well as the three reasons for showing the film that Mr Grove presents above I would suggest a fourth, money.  The following communication is from an independent film makers forum, and it clearly shows that there were concerns from some parties prior to Raindance of the wisdom of showing it but the financial benefits of doing so were the most immediate concern of Mr Grove.

Re: Is House of Numbers an AIDS denialist film?

I haven’t actually seen House of Numbers so I’m not commenting directly on it but it has certainly been causing a fair amount of concern, as in this article from Ben Goldacre in the Guardian:
http://www.guardian.co.uk/commentisfree/2009/sep/26/ben-goldacre-bad-s (…)
Worth a read. If he’s right about the distortion of facts, cherry picking of quotes and murky funding behind this film, then I’m not sure it isn’t a little irresponsible to be showing it, to be honest, given what’s at stake with this subject.

Mr Grove’s response:

We are getting legal letters, telephone calls, threatening emails claiming about the screening of House Of Numbers this Thursday at 2:30pm. Ive never never seen anything like it.
Legal letters delivered by courier from America – the whole 9 yards
They claim it’s about AIDS denialism – which anyone seeing the movie would realise it isnt. Or is it?
Question is, are we going to be able to sell anymore tickets?
A few still available, and the director has flown in from Canada.

Watch the film and see for yourself.

The power of cinema. Check it out: http://bit.ly/vTm98

And let me know
Elliot Grove Diretor 9and founder, goldarnit) of Raindance Film Festival

It is clear from the statement and the communication that Mr Grove is ignorant of the consequences of AIDS denialism, wilfully ignores the problems with ‘House of Numbers’ and is incapable of judging scientific evidence.  I also suspect that Mr Grove is enjoying the experience of being controversial, something his festival seems to deliberately set out to achieve – they seem very proud of an advert that was banned because of its treatment of suicide.  As the ruling on the advert shows film, as a medium, is capable of sending out very powerful emotional messages.  There is a danger, in particular with documentaries, that emotion can be used to gloss over or ignore awkward facts.  Emotion can also be used to incite anger and stir up settled and forgotten controversies.  This appears to be the case with ‘House of Numbers’, its supporters are extremely passionate and increasingly vocal and the film is sufficiently well made to fool otherwise sceptical thinkers.  However, the questions raised by ‘House of Numbers’ have already been answered by science, the tactics of denialists explored and the deaths from AIDS denialism established.  The only purposes the film serves is to suggest scientific controversy where there is none and to encourage support of discredited ideas, that is a poor contribution to public debate.

When contacted about this film a Terrence Higgins Trust spokesperson said:

“Worldwide more than 33 million people are living with HIV, the virus that – untreated – leads to AIDS. 88,000 of them are in the UK and every year about 7,500 more people are newly diagnosed here. Each of them, over their lifetime, will cost around a quarter of a million pounds to treat. In other countries, without modern antiretroviral treatments, people are still dying in droves.

“It’s a huge waste of life. But although the methods we currently have won’t stop AIDS completely, we can reduce transmission by condom use and by other means. Our main focus now and for the years ahead needs to be preventing the spread of HIV and supporting people already living with the virus.”

The methods of achieving this are what the public debate needs to be on, not to become distracted by settled controversies.  It is unfortunate that both Raindance and Mr Grove seem uncaring or ignorant of this, they clearly believe ‘there is no such thing as bad publicity’ when it comes to film promotion.

Incidentally, the full version of this paraphrased quote is ‘”There’s no bad publicity except an obituary.“‘.  Here are the obituaries of some of those who have died through AIDS denialism.

I hope there are no more.

Raindance Film Festival Endorse AIDS Denialism

Last month the editor of the New Humanist, Caspar Melville, magazine committed a sceptical faux pas and appeared to endorse some aspects of the documentary ‘House of Numbers’, a film whose purpose is to sow doubt where none exists on the theory that HIV causes AIDS.

Lets be absolutely clear.  HIV causes AIDS – the science is certain, Nobel prizes, not baubles awarded when doubt remains, have been won .  ‘House of Numbers’ is supportive of AIDS denialists, distorted the opinions of many interviewees, and presents utterly discredited researchers and journalists as holding valid opinions.  ‘House of Numbers’ is bunk, a denialist film, it has nothing constructive to say, and it deserves to be nothing more than a footnote in the annals of human stupidity.  Unfortunately it can seem convincing to an intelligent lay person.

Dr Melville is not an idiot, prone to taking irrational theories seriously or endorsing quackery yet he was fooled by a showing of ‘House of Numbers’ at the Cambridge Film Festival.  With admirable candour, and some bravery in facing the blogosphere, Melville has explained in depth how and why he was fooled in two blog posts, here and here.  As his blog posts show he is more than capable of understanding evidence and changing his opinions to fit with observable facts yet, like most of us, he can be persuaded by a convincing lie in an area that lies outside his comfort zone of knowledge.

This common tendency to be fooled is a robust argument against the uncritical promotion of AIDS denalist films such as ‘House of Numbers’.  The consequences of being wrong about AIDS can be lethal.  In South Africa, as a result of the endorsement of the discredited theories of Peter Duesberg, a contributor to ‘House of Numbers’, by the government of Thabo Mbeki, it is estimated that more than 300,000 people died unnecessarily.

Unfortunately film festivals have not done been careful in their coverage of ‘House of Numbers’.  The Cambridge Film Festival made an attempt, as detailed in Melville’s blogs, to conduct a critical discussion afterwards but as Melville proves this was not enough to prevent false information from appearing convincing.  It is hard not to disagree with Ben Goldacre that this was ‘attention-seeking smugness’ on the part of Cambridge Film Festival despite the explanations of organisers.

However, Raindance Film Festival have surpassed the smugness of Cambridge in their screening of ‘House of Numbers‘. Xavier Rashid, a programmer for Raindance is extremely proud of Raindance showing the film despite the protestations of scientists, lawyers, AIDS victims and others.  In fact he is so proud he has offered it his full endorsement and is plugging it on the film’s Youtube channel.

Likewise Elliot Grove, founder of Raindance.

This goes far beyond the smug behaviour of Cambridge, at least they were willing to debate the film rather than endorse it.  The atrocious behaviour of Raindance has now been compounded after criticism was made of their showing the film.

Ben Goldacre, using his common subjective ontological classification of cock-end or not, tweeted the following on Friday 2nd October.

Elliot Grove, founder of Raindance film festival, loves the Aids denialism: cock-end http://bit.ly/Btyd4

I retweeted this minutes later which was to be the start of a bizarre twitter exchange with @Raindance_Fest, the official twitter feed of the Raindance Film Festival, edited and presented at the foot of this page in reverse chronological order.

In this exchange, conducted with the usual decorum and subtlety of internet discourse and a 140 character limit, the lack of wisdom of Raindance was expressed as well as several links to sources of criticism of ‘House of Numbers’ and the dangers of AIDS denialism.  Sadly @Raindance_Fest rather than engage in constructive debate opted for the tired old arguments of ‘if you haven’t seen it you can’t criticise it’, cited the blog of a disgraced ex-policeofficer who thinks the beating of Rodney King was justified before finishing it off with a potentially libellous allegation that sceptical author Richard Wilson (twitter user @dontgetfooled) was in the pay of ‘big US drug companies’.  The last tweet on the subject from @Raindance_Fest following this exchange was this:

YouTube – House of Numbers reaction from Elliot Grove at Raindance http://bit.ly/2r1h4b

I think it is fair to conclude from this and the videos above that the Raindance have come out in firm support of ‘House of Numbers’, endorse AIDS denialism, have fallen prey to the delusions of conspiracy theorists and have contempt for their critics.  This issue is more important though than merely being a matter of twitter commentary and idiotic artistic posturing.  When asked for comment Richard Wilson made the following points:

Raindance are welcome to insinuate what they like about me on Twitter – what bothers me is the deadly damage which is done by perpetuating these tired old, long-debunked ideas about HIV and AIDS. We might have hoped that the media and artistic establishment would have learned their lesson by now – it does kind of feel like “Groundhog Day”. Back in the early 1990s Andrew Neil’s Sunday Times were being taken in by pretty much these same arguments [...] the damage caused by denial can’t always be undone. AIDStruth’s list of HIV-positive AIDS denialists who have died from the disease in the last few years makes for grim reading – my fear is that this list is only going to get longer until the media finally wises up to the real nature of AIDS denial.

The organisers of Raindance need to understand that their childish attempts at being artistic provocateurs are not big, not clever and certainly not something to be proud of.  They are endorsing a theory that has killed hundreds of thousands and caused untold miseries to millions as described in ‘Denying AIDS: Conspiracy Theories, Pseudoscience & Human Tragedy’ by Seth Kalichman..  There is no scientific justification for ‘House of Numbers’ and it is an act of careless immorality to endorse it.  I hope both Xavier Rashid, Elliot Grove and Raindance come to realise this.

Update

Raindance have linked to this blog post saying that:

Raindance founder Elliot Grove has been accused of being an AIDS Denialist (which he isn’t) because he dared to show House of Numbers despite over 100 thretening emails and legal letters.

I have made no such accusation against Mr Gove.  My argument is that he, and Raindance, endorse AIDS denialism through their support for House of Numbers.

Society of Homeopaths exploit death of child for their own gain

The tragic and preventable death of baby Gloria in Australia due to neglect by her homeopath parents has been reported in the news this week and has led to some debate on curbing the excesses of homeopaths.  The Quackometer has argued that it is the nature of homeopathy that allows cases such as this to develop, a rejection of modern medicine is inherent in the teachings of homeopaths and no amount of regulation will change this, and what we need is not regulation but criminal prosecution.  The Society of Homeopaths disagree and have issued the following press release.

The Society of Homeopaths is calling on MPs to support its application for the statutory regulation of homeopaths following the high profile case of a baby who died in Australia after her parents refused conventional medical help.
The move would offer better protection for the public in the UK as under current law, anyone without training can set up and practise as a homeopath.
The Society, the UK’s largest organisation representing professional homeopaths, is in the process of applying to the Health Professions Council (HPC) for statutory regulation.
Currently, 65 per cent of all registered homeopaths are members of the Society, which has long been committed to the highest standards for homeopathy, having run a voluntary regulatory system for the last 30 years and a course recognition process for the last 15 years. Further, it was the first homeopathy organisation to institute a Code of Ethics & Practice.
Ten years ago, the House of Lords’ Select Committee on Science & Technology published a report into Complementary & Alternative Medicine (session 1999-2000), which categorised homeopathy as a ‘Group One’ therapy along with acupuncture, chiropractic, herbal medicine and osteopathy.
Of the five, homeopathy is the only profession not yet in the statutory regulation process although the report acknowledged that “under The Society of Homeopaths, the non-medical homeopaths have organised themselves well and their professional organisation should mean the transition to statutory regulation does not present too great an upheaval(1)”
The House of Lords’ report also called for more research. By the end of 2007, 134 randomised controlled trials of homeopathy had been published in peer-reviewed journals. Of these trials, 59 were positive i.e. demonstrating that homeopathy has an effect beyond placebo; eight were negative and the remaining 67 were inconclusive.
On Monday September 28th, Sydney couple Thomas Sam, 42, a lecturer in homeopathy, and his wife Manju, 37, were jailed for the manslaughter of their nine-month-old daughter Gloria, who died of malnutrition and septicaemia in May 2002.
Chair of the board of directors, Jayne Thomas, said: “This was a tragic case where the parents concerned refused conventional medicine even though their daughter was seriously ill. Here in the UK, The Society’s Code of Ethics & Practice (sections 22 & 27) states that cases of a serious nature should be advised to stay in contact with their GP, that patients should be advised where another form of treatment may be more immediate and effective and that any symptoms suggesting an underlying condition should be referred for medical investigation and diagnosis.
“Statutory regulation is a natural step forward for homeopathy and builds on the work of the profession over the last ten years to independent regulation. The Society’s registered members have met our academic requirements, completed a registration process, hold comprehensive insurance and agreed to abide by a Code of Ethics & Practice. Statutory regulation will independently formalise this process and most importantly, offer greater protection for the public.”
For more information, or to set up an interview with Jayne Thomas, please contact Pamela Stevens at The Society of Homeopaths on 0845 450 6611 or pamela_stevens@homeopathy-soh.org
(1) House of Lords Select Committee on Science & Technology, Session 1999-2000, p52

The argument put forward by the SoH that regulation, specifically their Code of Ethics & Practice, would have prevented this case is thoroughly specious.  The sections cited by the SoH, 22 &27, state:

22 When dealing with cases of a serious and possibly terminal nature, ensure that the patient is fully aware of the advisability of keeping their GP informed of their condition.  Where possible and appropriate, ask for the patient’s permission to write to their GP concerning their progress.
27 A competent homeopath identifies those occasions when a patient’s condition is:
• beyond the present limits of their clinical competence and expertise.
• likely to receive more immediate, effective benefit from another form of treatment.
• showing signs and symptoms suggestive of an underlying condition which requires referral for investigation and other medical diagnosis.

22 does not place an obligation on the homeopath to inform the GP, only the patient.  Under this section the homeopath washes their hands of any responsibility for the patient informing their GP.  This is quite understandable, the homeopath is entering into a professional relationship with the patient, whatever you may think of the level of professionalism, action cannot be taken against the patients wishes.  This section would not have prevented the death of baby Gloria as the parents did not wish to see a GP.

27 is clearly ridiculous on the grounds that homeopaths are not medically trained so have no clinical competence or expertise and that because it doesn’t work anyway other treatments should automatically be preferred.  However, for the sake of argument, if we assume that homeopathy works, as homeopaths believe it does, then it still would not have prevented the death of baby Gloria.  This section only defines competence, it does not prevent incompetent homeopaths and thus would not stop an incompetent homeopath from causing harm. It would allow the SoH to label them as incompetent though, should that not be obvious.

It is clear that neither of these sections would have prevented the death of baby Gloria.  It is hard not to see this as an attempt by the SoH to exploit a tragedy to further their political aims of regulation, which are opposed by other professional societies.  This viewpoint is supported by the many examples of the SoH supporting similarly reckless behaviours in their own supporters, such as the SoH funded AIDS and malaria trials in Africa, the refusal to condemn homeopathic vaccines used at the expense of proper ones, and seminars by AIDS denialists to give just three examples.

In addition to this, as part of the professional development of homeopaths, the SoH have organised the following event.

Peter Smith – Investigative homeopathy and difficult cases This day is designed to introduce some different approaches into your practice when you are faced with puzzling cases. These days the world is a lot more complicated than in the days of Hahnemann, especially when we consider pollution and the environmental toxins that we all face. Peter will share some of the therapeutic tools that he has used during over 25 years in practice, including dealing with panic attacks, sorting out hiatus hernias, pregnancy and childbirth issues, treating the elderly in nursing homes and the importance of a home visit if you just can’t seem to make progress with a client. Participants are invited to bring along ‘tough cases’ for the group to discuss, with a view to finding different and more productive lines of investigation.

This clearly shows that the concept of keeping ‘tough cases’ within the homeopathic family is part of their training, they are encouraged to share their stories of clients who cannot progress and seek advice from the homeopath peers on new treatments to try.  After they have done all this and their patients still aren’t getting better then they may consider going to a doctor.  It is this behaviour that killed baby Gloria, not the lack of regulation.

The Quackometer article on baby Gloria concluded:

protecting future children like baby Gloria will require authorities to abandon the belief that they need to regulate homeopaths like medical practitioners and instead treat them according to the more accurate picture of them being a pseudo-medical and mystical cult with dangerous and irrational beliefs

I agree.

Gordon Brown makes unhelpful comment on cancer

All the political blogs are busy interpreting the nuance and debating the policy implications of Gordon Brown’s speech to the Labour conference.  I’ll leave them to do that.  I have a major issue with this particular part of his speech though:

And because we know that our investment in breast cancer screening works and early intervention saves lives, I am proud to announce that we will go much further.

We will finance a new right for cancer patients to have diagnostic tests carried out, completed and with results – often same day results – within one week of seeing your GP. That is our early diagnosis guarantee, building on our current guarantee of only two weeks wait to see a specialist.

And so with three major steps forward – early diagnosis, early treatment and our historic investment in research for cancer cures, we in Britain can transform cancer care; and our ambition is no less than to beat cancer in this generation

My bold.

Sadly it is a myth that there is a cure for cancer and that cancer can be beaten in a generation.  The best succinct explanation I have seen of this is from PHD comics (below).  I’m all for politicians making arguments for more research and healthcare, I’m less keen on them distorting public perception of the results of that research and healthcare.  It bothers me somewhat that this speech without doubt underwent a substantial number of revisions and likely had contributions from many individuals and not a single one of them noticed that this claim about cancer was remarkable.

http://www.phdcomics.com/comics.php?f=1162 (copyright Jorge Cham)

A recommendation to read part three of apgaylard on Milgrom

apgaylard has published Part III of his wonderful dissection of Lionel Milgrom’s article in Forsch Komplementmed, available here, analysing criticism of homeopathy.  All three parts are below:

http://apgaylard.wordpress.com/2009/09/06/a-homeopathic-refutation-part-one

http://apgaylard.wordpress.com/2009/09/13/a-homeopathic-refutation-%E2%80%93-part-two/

http://apgaylard.wordpress.com/2009/09/25/a-homeopathic-refutation-part-three/

apgaylard exposes numerous instances of poor scholarship in Milgrom’s analysis which thus far have gone unanswered by Milgrom, even though Milgrom is keen to highlight, mistakenly, flaws in other people’s scholarship.  Milgrom must be aware of apgaylard’s arguments as I have taken the liberty of emailing them to him, as I will do with this one.  That he has not responded suggests a disappointing unwillingness to engage and a fear of answering critics.  Sadly this attitude is all too typical of homeopaths.