Mozambique show how to regulate homeopathy in Africa

Via the quackometer’s twitterfeed, a story on the allAfrica news aggregation site suggests that the government of Mozambique are responding in a thoroughly sensible manner to alternative medicine practitioners, including homeopaths.

Health Minister Ivo Garrido argues that practitioners were operating in a ‘legal vacuum’ and thus it was necessary to regulate them by law.  One possible effect of this law is that:

Any practitioner of “alternative” medicine could be regarded as “professionally incompetent” since the remedies he prescribes have no scientific basis, and at best act as placebos.

Thus the new bill is not a blank cheque for medical frauds, but may instead restrict their activity.

Well done Mozambique.  I hope other countries follow suit.

[BPSDB]

A grumble on the poor quality of a libertarian discourse on passive smoking

Spiked presents itself as “an independent online phenomenon dedicated to raising the horizons of humanity by waging a culture war of words against misanthropy, priggishness, prejudice, luddism, illiberalism and irrationalism in all their ancient and modern forms.” – a statement of intent that in this wordy form oozes smirking superiority and arrogance but is attractive in principle. I am a firm believer in robust debate, wide ranging freedoms of speech and expression, including the right to be wrong, offensive and offensively wrong. I also believe that evidence is important in forming conclusions. I suspect that Spiked don’t, offering lightweight arguments of irresponsibility masquerading as concern for liberties instead.  Take this article by Suzy Dean on passive smoking for example. Dean is critical of arguments made by medical experts suggesting that the government should consider a ban on smoking in cars when children under 16 are present.
Dean sets out her case by arguing that the House of Lords Economic Affairs Committee published a report on the government’s management of risk concluding that environmental tobacco smoke (ETS) is not the threat it’s purported to be and therefore did not justify a ban. Before suggesting that “much of the science which makes up the passive-smoking case fails to mention that smoking-related illnesses – like lung cancer, cardiovascular disease and respiratory disease – are the product of a number of factors, such as genetics and diet, in addition to the amount of exposure to tobacco smoke.”.

The BCA have no evidence that chiropractic can help with ear infections

Based on this quote from Simon Singh the British Chiropractic Association (BCA) decided to sue him for libel:

“the British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.”

The BCA claimed that there was a ‘plethora of evidence’ supporting their position and disproving Simon Singh’s, the BCA have now released a statement and listed their evidence and make the claim that

This proves that far from there being “not a jot of evidence” to support the BCA’s position, there is actually a significant amount

A number of blogs have taken it upon themselves to assess the strength of the papers against the claims the BCA make for it.  I will be doing the papers on frequent ear infections of which there are three, suggesting that the BCA’s definition of plethora is even further estranged from that of the dictionary than Judge Eady’s interpretation of ‘bogus’.

The BCA claim that Mills MV et al (2003) ‘suggest[s] a potential benefit of osteopathic manipulative treatment [(OMT)] as adjuvant therapy in children with recurrent acute otitis media; it may prevent or decrease surgical intervention or antibiotic overuse’, an almost verbatim quote from the abstract’s conclusions.  However, the BCA have not explored the faults of the paper, many of which the authors draw attention to, such as using fewer patients than their preliminary statements suggest as necessary:

Results of power analysis suggested we would need 50 children in each group, on the basis of a predicted 50% decrease in antibiotic use, episodes of AOM in the group receiving medical treatment alone, and a 75% improvement in the group receiving medical treatment and OMT. With a type I error rate set at .05, we estimated an expected power of 85% if there were a 10% dropout rate and a power of 80% with a 20% dropout rate.

There were 25 patients in the intervention group and 32 in the control group considerably raising the possibility of a type I error, a false positive result, in the statistical interpretation of data.   This is likely to have happened given the range of variable assessed by the authors (Table 2 below).  Also the authors’, and the BCA’s, contention that this may decrease antibiotic overuse seems untenable given the lack of statistical significance regarding antibiotic usage during the study (P=0.13).

*update*

Richard in the comments points out:

That the Mills et al (2003) is smaller than their power test suggested was needed does not affect the type I error (incorrectly rejecting the null hypothesis). Instead it increases the risk of a type II error (incorrectly accepting the null hypothesis). As such, the small size of the study works against them.

The greater problem is that they make 23 tests without, apparently, correcting for multiple comparisons. This will massively inflate the risk of type I errors and it is not in the least surprising that they have a couple of apparently significant results.

The authors also did not use a placebo control:

The issue of whether to include a placebo control for the control group was considered. If we had included a placebo control, any presumed placebo intervention might have had an unintended treatment effect, introducing potential confounding variables and necessitating 3 groups: intervention, placebo intervention, and nonintervention. We chose instead for this study to report any difference in outcomes between 2 groups that were selected to be as equal as possible except for the application of OMT. Placebo effect due to the number of visits was minimized by the design of the study, leaving the influence of touch as potentially having a placebo effect. Larger studies are needed to replicate and elucidate the causal mechanisms of this effect.

The authors are acknowledging here that they cannot distinguish between the placebo effect of touching a patient and the OMT treatment.  Therefore their investigations cannot say whether OMT has an effect above placebo.  The study might suggest a benefit, but only if you throw caution to the wind and ignore chances of false positives and make the a priori assumption that OMT can have an effect on ear infections, in which case you would be bringing considerable bias into your interpretation. After all you would have to ignore the awkward fact that there is no conceivable way in which OMT could effect the immune response to infection or actively contribute to the reduction of infection in any other way.

The BCA claim that Froehle RM (1996) shows that ’93% of all episodes improved. The study’s data indicates that  … the addition of chiropractic care may decrease the symptoms of ear infection in young children’.  The study has no control group and is little more than a collection of case notes on the duration of ear infection, of which the author notes ‘very little data was found regarding the natural course of ear infections’.  Therefore the study says nothing about the impact of chiropractic care on the duration of ear infection compared to the natural course of healing but it does say infections get better over time.  This is not evidence supporting the use of chiropractic care in ear infection so much as supporting evidence for the old adage that time heals all wounds.

I cannot get access to the Fallon JM (1997) paper which the BCA claim of which ‘[t]he results indicate that there is a strong correlation between the chiropractic adjustment and the resolution of otitis media for the children in this study.’ as it is not listed in a PubMed indexed journal.

*update*

Thanks to everyone in the comments and others for providing the link to the abstract of this paper.  Looking at it it seems not to involve a control group, thus cannot tell us anything about the efficacy of chiropractic vs other treatment or placebo, and is more of an argument for the use of a measuring technique in assessing the impact of chiropractic rather than the BCA’s stated claim.  In fact, the BCA’s (and the author’s) claim about a correlation is disingenuous given that in the absence of a placebo control it is impossible to say if the correlation is due to a placebo effect, the BCA (and the author) would do well to remember that correlation is not proof of causation.

This ‘plethora’ of three trials, two of which are very badly designed and one of which is unavailable is available in abstract form only, does not constitute a ‘significant amount of evidence’ disproving Simon Singh’s claims.  In fact it strongly suggests that the BCA, in reaching into their basket of evidence, are picking cherries and clutching straws.  Frankly it is embarrassing, this is the equivalent of a child attempting to convince an adult that his colander on a stick is in fact a super intelligent robot, only without the innocence and charm.

*updates*

Details of other blogs covering these papers will be posted later. These links largely copied and pasted from Layscience, will add to later if I have time.

Jack of Kent – General commentary and legal background.
Prof. Colquhuon – Detailed look at the nine colic papers.
Ministry of Truth – General review focusing on three of the colic papers.
Andy – Comment on the BCA statement.
Evidence Matters – Review of the paediatric asthma papers.
Layscience – a review of the flaws in all the papers available
Phil Plait – An overview of the BCA statement and aftermath.
HolfordWatch – What would constitute good evidence?
Apgaylard – A more detailed look at the bed-wetting papers.
JDC – General comment on the BCA statement.
Think Logic – General comment on the BCA statement.

References

Mills MV, Henley CE, Barnes LL, Carreiro JE, Degenhardt BF. The use of osteopathic manipulative treatment in children with acute recurrent otitis media. Arch Paediatr Adolesc Med.  2003 Sep;157(9): 861-6

Froehle RM. Ear infection: a retrospective study examining improvement from chiropractic care and analysing for influencing factors. J Manipulative Physiol Ther 1996 Mar; 19(3): 169-77

Fallon JM. The role of the chiropractic adjustment in the care and treatment of 332 children with otitis media. J Clin Chiropract Paediatrics 1997 Oct; 2(2): 167-183

[BPSDB]

Homeopathic Research Institute’s Head of Clincial research fails to declare conflict of interest

I have signed up for emails from the Homeopathic Research Institute (HRI) as I have a strong masochistic streak.  I received the following the other day about the HRI’s Head of Clinical Research’s research:

We are delighted to be able to circulate to you the abstract of a trial of treatment by a homeopath for Fibromyalgia recently published in the Homeopath, journal of the Faculty of Homeopathy.

http://www.ncbi.nlm.nih.gov/pubmed/19358959

The lead author is Dr Relton, the HRI’s Head of Clinical Research.  She also works at the School of Health and Related Research, University of Sheffield, and the School of Healthcare, University of Leeds.

This study was a pilot pragmatic Randomised Control Trial which looked at the provision of treatment by a homeopath alongside usual care for Fibromyalgia.  It was shown to have clinical relevance and paves the way for a definitive study assessing the clinical and cost effectiveness of providing treatment by a homeopath for Fibromyalgia.

We also want to let you know that we are currently organising a fundraising event which will take place in London on 24th June.  If you are interested in funding the work of the HRI and want to learn more about it, or know of people who are in a position to do so, then please contact us at info@homeoinst.org for details.

Now the paper is not very good, it does not compare homeopathic pills with placebo pills but “the clinical effectiveness of usual care, compared to usual care plus adjunctive care by a homeopath, for NHS patients with a diagnosis of primary FMS who were under the care of consultant rheumatologists.” The control vs adjunctive care is described as follows:

The usual care group received one or more of the following: physiotherapy, aerobic exercise, analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), anti depressants. The homeopath care group received usual care plus an initial one hour in depth interview followed by up to four 30 min in depth interviews (4–6 weeks apart) with individually tailored homeopathic medicines prescribed at each interview.

In other words it assesses, not the efficacy of homeopathy, but the efficacy of a chats with a sympathetic person (who happens to be a homeopath) plus a dose of sugar pills – which can be considered placebo as homeoapthy is so implausible.  Any postive result would be better explained by the placebo effect from the chat than a treatment whose proposed method of action is impossible given current scientific understanding.  This is all very boring and is little more than homeopaths scratching in the dirty margins of statistical significance for nuggets of fool’s gold.  More interesting is the declaration of interest by the paper’s authors:

Conflict of interest

None.

This simply isn’t true.  Dr Relton works for the HRI and they are making an appeal for funds based on the findings of her research.  Her drawing positive conclusions about homeopathy in her research is linked to the financial survival of the HRI.  Dr Relton can be considered a shill for the HRI by not declaring this conflict of interest in the paper.  Once again homeopaths, who criticise their critics as big pharma shills and jump on any percieved conflict of interest, behave in the manner they are so quick to condemn.

McTimoney Chiropractic Association cut and run

Thanks to Andy Lewis and Richard Lanigan* I have come across this email from the McTimoney Chiropractic Association (MCA), one of the bodies representing chiropractors.

Date: 8 June 2009 09:12:18 BDT

Subject: FURTHER URGENT ACTION REQUIRED!

Dear Member

If you are reading this, we assume you have also read the urgent email we sent you last Friday.  If you did not read it, READ IT VERY CAREFULLY NOW and  – this is most important – ACT ON IT.  This is not scaremongering.  We judge this to be a real threat to you and your practice.

Because of what we consider to be a witch hunt against chiropractors, we are now issuing the following advice:

The target of the campaigners is now any claims for treatment that cannot be substantiated with chiropractic research.  The safest thing for everyone to do is as follows.

1. If you have a website, take it down NOW.

When you have done that, please let us know preferably by email or by phone. This will save our valuable time chasing you to see whether it has been done.

1. REMOVE all the blue MCA patient information leaflets, or any patient information leaflets of your own that state you treat whiplash, colic or other childhood problems in your clinic or at any other site where they might be displayed with your contact details on them.  DO NOT USE them until further notice. The MCA are working on an interim replacement leaflet which will be sent to you shortly.

1. If you have not done so already, enter your name followed by the word ‘chiropractor’ into a search engine such as Google (e.g. Joe Bloggs chiropractor) and you will be able to ascertain what information about you is in the public domain e.g. where you might be listed using the Doctor title or where you might be linked with a website which might implicate you. We have found that even if you do not have a website yourself you may still have been linked inadvertently to a website listing you or your services.

CHECK ALL ENTRIES CAREFULLY AND IF IN DOUBT, CONTACT THE RELEVANT PROVIDER TO REMOVE YOUR INFORMATION.

CHECK OUR PREVIOUS EMAILS FOR SPECIFIC ADVICE AND KEY WORDS TO AVOID.

KEEP A LOG OF YOUR ACTIONS.

1. If you use business cards or other stationery using the ‘doctor’ title and it does not clearly state that you are a doctor of chiropractic or that you are not a registered medical practitioner, STOP USING THEM immediately.

5.   Be wary of ‘mystery shopper’ phone calls and ‘drop ins’ to your practice, especially if they start asking about your care of children, or whiplash, or your evidence base for practice.

IF YOU DO NOT FOLLOW THIS ADVICE, YOU MAY BE AT RISK FROM PROSECUTION.

IF YOU DO NOT FOLLOW THIS ADVICE, THE MCA MAY NOT BE ABLE TO ASSIST YOU WITH ANY PROCEEDINGS.

Although this advice may seem extreme or alarmist, its purpose is to protect you.  The campaigners have a target of making a complaint against every chiropractor in the UK who they perceive to be in breach of the GCC’s CoP, the Advertising Standards Code and/or Trading Standards.  We have discovered that complaints against more than 500 individual chiropractors have been sent to the GCC in the last 24 hours.

Whatever you do, do not ignore this email and make yourself one of the victims. Some of our members have not followed our earlier advice and now have complaints made against them.  We do not want that to happen to you.

Even if you do not have a website, you are still at risk. Our latest information suggests that this group are now going through Yellow Pages entries. Be in no doubt, their intention is to scrutinise every single chiropractor in the UK.

The MCA Executive has worked tirelessly over the last week keeping abreast of development and contacting at risk members.  We have decided that this is our best course of action to protect you and the Association at this time of heightened tension.  This advice is given to you solely to protect you from what we believe is a concerted campaign, and does not imply any wrongdoing on your part or the part of the Association.  We believe that our best course of action is simply to withdraw from the battleground until this latest wave of targeting is over.

Finally, we strongly suggest you do NOT discuss this with others, especially patients, Firstly it would not be ethical to burden patients with this, though if they ask we hope you now have information with which you can respond.

Most importantly, this email and all correspondence from the MCA is confidential advice to MCA members alone, and should not be shared with anyone else.

Please be aware that the office phone lines are likely to be busy, so, if you need our help, please send an email to the office and we will get back to you as soon as we can.

Yours,

Berni Martin

MCA Chair.

Best wishes,

Nicki

Nicki Choules-Rowe

Administrative Officer – Executive Liaison

McTimoney Chiropractic Association

Crowmarsh Gifford

Wallingford OX10 8DJ

Tel : 01491 829494

It looks like the McTimoney school were aware that their members were promoting treatments unsubstantiated by research and promoting themselves as doctors as they admit that “Some of our members have not followed our earlier advice and now have complaints made against them”.  I also looks like they have contempt for fully informing their patients/customers about the furore over the evidence base for their claims, “we strongly suggest you do NOT discuss this with others, especially patients”.

This is astonishing.  This is an organisation representing chiropractors assisting them in hiding their dodgy business practices from prying eyes.  It looks like the culture of secrecy and fear of open debate that drove the British Chiropractic Association (BCA) to silence Simon Singh in the libel courts is widespread amongst the chiropractic community.  It also points to a schism developing amongst the chiropractic community, the MCA have decided to “withdraw from the battleground until this latest wave of targeting is over” – so much for supporting their fellow chiropractors.

It will be fascinating to see how this develops.

*Richard Lanigan has interesting opinions and an axe to grind regarding the GCC so caution is required when reading but his site is a useful resource.

Homeopaths plot to broadcast idiocies on twitter

So you belong to a profession that has recently come under some criticism for lacking an understanding of medical ethics and indulging in some frighteningly irresponsible pseudo-medical posturing, you’re concerned about shifting media attitudes, you feel there is a lack of support within society, what do you do?

Do you engage in a period of self reflection, invite serious commentary on and within the profession, encourage responsible behaviour and punish that which brings your community into considerable disrepute?  Or, do you just confirm every allegation of ignorance, irresponsibility and idiocy made about you by your critics?

Dear Leaders of Homeopathy

This is an action alert in response to the recent attacks on the validity of homeopathy presented to the World Health Organization.

http://www.guardian.co.uk/science/2009/jun/01/world-health-organisation-homeopathy-hiv

In an effort to have our positive messages heard in the media we ask you to send out the email below to your entire mailing list.

Sincerely

Debby Bruck, CHOM.

Founder of HWC Homeopathy World Community

http://www.homeopathyworldcommunity.com

———— ——— ——— ——— ——— ——— -

Dear Friends and Supporters of Homeopathy
This is an action alert in response to the recent attacks on the validity of homeopathy presented to the World Health Organization.

We are asking you to take these four easy steps to have our positive messages about homeopathy heard around the world. Using the micro-blog tool Twitter, you can help bring keyword homeopathy up in the search engines. It is very easy to use and we will help you get started. So do this right now without delay.

1. Go to http://twitter.com
2. Sign up by typing your real name without a space in between the first and last name and create a password
3. Upload your photo
4. In the “What you are doing?” window enter each of the posts below (copy & paste one at a time, clicking Update after each).

Oxford University Press study | #homeopathy medicines have effect on cancer cells & genes http://budurl. com/FBDA

81% of patients receive CAM treatments on referral from GP #homeopathyhttp://budurl. com/PCAM

Dr. Pawan Pareek Clinical Evidence | #Homeopathy Treatment http://budurl. com/Pareek

Research Supporting #Homeopathy http://budurl. com/19535

The threat of a global pandemic & evolving #homeopathy treatment strategyhttp://budurl. com/DrBhatia

____________ _________ _________ _________ ________

Thank you so very much for being part of this 24-hour Twitter Campaign Marathon. If everyone around the world posts these messages [and more if you are so inclined] then we will have started a great wave of positive energy creating awareness and educating the public.

Thank you,
Your Signature

a.. PS. If you run a homeopathic school please make it an assignment. It only takes a few minutes to make a tremendous impact.
b.. Seven Reasons Homeopaths Should Join Twitter
http://homeopathyworldwide.blogspot.com/
c.. Please join HWC http://homeopathyworldcommunity.com
———— ——— ——— ——— ——— ——— -

British Chiropractic Association tell their members to hide their sins from prying eyes

Via BlueWode I have come across the text of this letter, posted on ex- General Chiropractic Council (GCC) board member Richard Lanigan’s blog*, sent out by the British Chiropractic Association (BCA) on the 4th June.

The BCA would remind members of their obligations under the Advertising Standards Authority (ASA) section 50 (relating to Health & Beauty Products and Therapies: see

Members are strongly encouraged to review their current marketing materials (whether they are paper- or web-based to ensure that they are compliant with both ASA and GCC requirements. Note that the ASA has no jurisdiction over editorial materials placed on members own websites.

When reviewing your materials it may be helpful to consider the following:

1. Are there any claims made that cannot be justified by reference to evidence? Remember, the GCC requires chiropractors to practice evidence based care, which is defined as “clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners (which includes the individual chiropractor himself).

2. Be mindful of making promises that you cannot be sure of delivering on;

3. Be wary of listing conditions that are controversial and away from mainstream chiropractic care e.g. dyslexia/dyspraxia unless you have research to back this up. If you have made references to prolonged crying, sleep and feeding problems, breathing difficulties and frequent infections, as these are symptoms rather than condition specific, we suggest you remove these references.

4. Do not refer to yourself as a specialist in any particular form of chiropractic;

5. Do not use unfamiliar words for common conditions;

6. Do not unjustly criticise other healthcare professionals;

7. If you refer to subluxations, provide information to explain what they are.

8. Take care in the use of the Doctor title. Ensure that there is no way there can be any doubt that you are a chiropractor, and not a registered medical practitioner. Do not use the doctor title in paper advertising without explicitly stating that you are a chiropractor.

It is great to see the BCA finally taking responsibility to moderate the excess of their members but it is a shame it is a cowardly and pitiful PR exercise in response to their spectacular misjudgement in suing Simon Singh.  One of the reasons professional organisations, such as the BCA, should exist is to make sure professional values are upheld, there has clearly been a monumental failure in this regard if people are finding reason to complain to the ASA, GCC and Trading Standards.  Such failure is unsurprising however, the BCA point out to their members that “the ASA has no jurisdiction over editorial materials placed on members own websites”, which read as an implicit acceptance of members making false claims on their websites.  No wonder the BCA prefer to silence criticism through the courts.  False claims and misrepresentation seem to have been the bedrock of the profession since at least 1913

*update*

As Mojo in the comments points out, although the BCA claim that “the ASA has no jurisdiction over editorial materials placed on members own websites.”, the GCC’s code (C1.6) states that:

[chiropractors] may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority.

Therefore BCA members (who must be GCC registered) are obliged to uphold ASA rulings, even on their websites.  So are the BCA endorsing their members posting claims on their websites that the GCC prohibit?  Maybe, maybe not – but this does make the BCA look even more incompetent.

[BPSDB]

*Richard Lanigan has interesting opinions and an axe to grind regarding the GCC so caution is required when reading but his site is a useful resource.

Chiropractic – as modest today as in 1913?

I have come across this wonderful comment about chiropractic from the California State Journal of Medicine, 1913 [1].

I’m afraid I don’t have time today but if anybody fancies taking on a project to compare the claims made in this clipping with the first date research on them was published in a PubMed indexed journal then post your findings in the comments and I’ll transpose them to the article.  I suspect that the research to validate the claims was made some considerable time after the claims were found to be profitable.

[1] Cal State J Med. 1913 June; 11(6): 213.

[BPSDB]

Simon Singh to appeal libel decision

Simon Singh has decided to appeal the grossly unfair and astonishingly illiberal ruling from Sir David Eady in the libel case over an article he wrote in The Guardian newspaper brought about by the British Chiropractic Association.  The charity Sense About Science working with Simon Singh are launching a campaign to highlight issues raised by this case, I will be adding my name to the great and the good who have already signed the statement below, I hope you will too.

This is a risky and brave decision by Simon Singh.  There is no guarantee that he will win, British libel law is notoriously unfair, with success often decided by wealth than by ideals of fairness.  Nevertheless Simon Singh must be supported, science and science communication depends on the free and frank exchange of ideas and accepting criticism is a necessity, not a choice.  All too often we have seen those who peddle pseudoscience, nonsense and bogus treatments resort to threats and actions involving lawyers and libel in attempts to silence their critics.  A clear message needs to be sent that those who care about evidence, science and free debate will not stand for such behaviour.

The campaign website is below:

http://www.senseaboutscience.org.uk/freedebate

Sign the Support Statement.

Also, download the campaign button and add it to your website.

A rolling update of the blogosphere’s reaction to Simon Singh and the BCA is kept by Chris Kavanagh here.

The law has no place in scientific disputes

We the undersigned believe that it is inappropriate to use the English libel laws to silence critical discussion of medical practice and scientific evidence.

The British Chiropractic Association has sued Simon Singh for libel. The scientific community would have preferred that it had defended its position about chiropractic for various children’s ailments through an open discussion of the peer reviewed medical literature or through debate in the mainstream media.

Singh holds that chiropractic treatments for asthma, ear infections and other infant conditions are not evidence-based. Where medical claims to cure or treat do not appear to be supported by evidence, we should be able to criticise assertions robustly and the public should have access to these views.

English libel law, though, can serve to punish this kind of scrutiny and can severely curtail the right to free speech on a matter of public interest. It is already widely recognised that the law is weighted heavily against writers: among other things, the costs are so high that few defendants can afford to make their case. The ease and success of bringing cases under the English law, including against overseas writers, has led to London being viewed as the “libel capital” of the world.

Freedom to criticise and question in strong terms and without malice is the cornerstone of scientific argument and debate, whether in peer-reviewed journals, on websites or in newspapers, which have a right of reply for complainants. However, the libel laws and cases such as BCA v Singh have a chilling effect, which deters scientists, journalists and science writers from engaging in important disputes about the evidential base supporting products and practices. The libel laws discourage argument and debate and merely encourage the use of the courts to silence critics.

The English law of libel has no place in scientific disputes about evidence; the BCA should discuss the evidence outside of a courtroom. Moreover, the BCA v Singh case shows a wider problem: we urgently need a full review of the way that English libel law affects discussions about scientific and medical evidence.

Signed

Homeopaths organise mass letter writing campaign against Simon Singh and applaud BCA

Simon Singh is being sued for libel by the British Chiropractic Association (BCA) and has generated substantial levels of support for his predicament as many see this as an issue of free speech.  Sadly the Homeopathy Worked For Me organisation are not so fond of SImon’s freedom of speech despite being very much in favour of their own freedom to launch unsubstantiated criticism and personal attacks in a lenghty critique of Simon Singh’s and Edzard Ernst’s ‘Trick or Treatment’, of which Andy Lewis of the Quackometer comments

Its clumsy rhetoric and lengthy nitpicking is a disguise of the embarrassment that homeopaths have over the fact that they cannot produce any reliable evidence for the efficacy of their treatments and the validity of their hypotheses (not theories). This pamphlet may well please the homeopaths who continue to avoid acknowledging the genuine and urgent criticisms of their shabby trade (such as their refusal to condemn the practices of their colleagues who dish out sugar pills in Africa in order to ‘prevent’ malaria or treat HIV infection). More competent readers will not be impressed.

Homeopathy Worked For Me have a spectacularly snide piece up on their site that rejoices in mean spirited and inaccurate remarks about Simon Singh and doesn’t really seem to grasp the concept of free speech anyway.

Few homeopaths have found that Singh defends their right to free speech when they are attacked in the press. Indeed Singh has shown that he is quite happy to join with those who misrepresent the facts about homeopathy, the facts about medicine and the facts about science itself.

Clearly Homeopathy Worked For Me haven’t grasped that freedom of speech means the freedom to criticise.  In fact they have gone so far as to encourage their readers to submit complaints based on their template to the editor of the Observer who had the temerity to publish an article by Nick Cohen supporting Simon Singh.

Dear Editor

I am shocked/amazed/surprised to find that the Observer is willing to support Simon Singh in respect of the libel case brought against him by the British Chiropractic Association.

Simon Singh made his statements about the BCA on the basis of Trick or Treatment?, a book he co-authored with Edzard Ernst. A detailed study by Homeopathy: Medicine for the 21st Century has shown that this book ”has no validity as a scientific examination of alternative medicine”, which means that he had no factual basis for his remarks.

Alleging that an organisation “happily promotes bogus treatments” without having any evidence to back such a claim is not an issue of free speech, but of libel, and Simon Singh has justifiably been called to account. For a respected newspaper to defend groundless accusations as “free speech” is to make a mockery of its claims to report the world honestly.

We urge you to reconsider your support for someone who has shown himself prepared to refdefine[sic] science and to misrepresent the facts in order to defend his beliefs.

Yours faithfully

That last sentence alone would break even the strongest irony meter.

Homeopathy Worked For Me confirm once again that quacks are incapable of engaging with criticism in a reasonable and rational manner, preferring instead that debate be silenced.

[BPSDB]

The Green Party’s policies have the potential to destroy biological research

Science bloggers Frank Swain and Martin Robbins, of Sciencepunk and Layscience respectively, have an article on The Guardian website and in depth reportage on their own sites analysing the science policies of the various UK political parties standing in the forthcoming EU elections on 6th June.

The Green Party, one of the parties analysed by Frank and Martin, are expected to pick up protest votes from voters disillusioned with the Labour Party in particular.   I have concerns with Green Party policy in one area in particular, genetic modification (GM).  For those readers who do not know I am a researcher in biological sciences who performs  genetic modification for the purposes of academic research.  The Green Party manifesto states that:

ST360 The EU proposal to extend patents legislation to living matter is unacceptable on the following grounds:

1.The proposals imply a relationship between humans and nature where it is acceptable to manipulate life and to own living things;

2.The patenting of life raises ethical questions regarding the value of human life, notably with the transfer of human gene sequences to other species;

3.Farmers will become dependent on patent holders, primarily big industrial corporations. Monoculture will be reinforced and genetic diversity lost. Traditional animal husbandry will be economically and legally disadvantaged;

4.This legislation will increase pressure to release genetically engineered organisms into the environment, with unknown effects.

ST361 The Green Party would ban the use of bovine growth hormone BST (bovine somatotropin) used to boost milk production. There is no economic justification for the use of this product of genetic engineering. There are risks to the health and welfare of animals which receive it, and its effects on human health are unknown.

ST362 The Green Party accepts that certain aspects of genetic engineering may be benign and may lead to enhanced quality of life, but feels that there is an urgent need for informed public debate on the issues raised because of the economic, environmental and social control aspects of this technology.

ST363 Pending research into the effects of the release of genetically engineered organisms into the environment, the Green Party seeks a moratorium on such releases through agreement between industry, research establishments and government, as well as a ban on importation of such organisms into the UK. (see AR410)

AR410 Patents will not be granted on any animal and strict controls will be introduced to prevent genetic manipulation for profit or curiosity

I have concerns that these particular policies would abolish the use of GM animals and plants in scientific research. For those readers unfamiliar with modern biological research, much work involves the use of cells, bacteria or higher organisms whose DNA has been modified to remove, add or mutate genes.  Researchers regularly exchange these genetically modified organisms between labs, across borders and continents, as science is essentially a collaborative activity.  Preventing the use and exchange of these organisms would effectively end UK based research in the life sciences.  Concerned about this I asked the Green Party to clarify their policy to determine if they really intended to have such a devastating effect on scientific research.  They indicated that they were primarily concerned with the commercial use of GM and acknowledged they hadn’t forseen the consequences of ST363 in particular:

I must admit I don’t know what the purpose of that last part of ST363 is, since clearly there could be importation for research where there is no potential environmental problem, and I can’t see that there is necessarily a problem in the circumstances you describe.

We review our policies from time to time, and maybe we need to take a look at this one!

When pressed further about AR410 in particular, which appears to prevent GM research, and asked if they intended to consult scientists in the future when reviewing their policies they admitted that ‘perhaps [they] need to’.

I was astonished that a political party expected, including by themselves, to substantially gain from voter disillusionment with the mainstream Labour Party had not thought through the consequences of their science policies in any meaningful way nor appear to have consulted with experts.

Perhaps the Greens are betraying their political and intellectual immaturity, after all they have not been subject to the same media scrutiny as the main UK parties. This is a shame, as it now looks like they will benefit and be put in a position of relative legislative power with policies that fall apart under the slightest scrutiny.  Either their policies are going to be rapidly revealed as being ridiculous and they will become a laughingstock or worse,  they are listened to and wreck EU science.   A vote for Green is a vote against scientific research and for that reason they will not have my vote.

[BPSDB]

Harry van der Zee & homeopathy in the developing world

The Voice of Young Science (VoYS) have published a letter condemning a homeopathy conference, ‘Homeopathy for Developing Countries’, organised by Harry van der Zee and featuring blog regular Jeremy Sherr, in the Netherlands on the 6th June.  VoYS point out that:

Many people in developing countries urgently need access to evidence-based medical information and to the most effective means of treating these dangerous diseases. The promotion of homeopathy as effective or cheaper makes this difficult task even harder. It puts lives at risk, undermines conventional medicine and spreads misinformation.

VoYS will be shocked to read about the latest article from van der Zee in the online journal Interhomeopathy about his Amma project.  The Amma project is based on the belief that musical can be embedded with ‘resonances’ that can cure AIDS and malaria, this ludicrous idea has been presented at the Society of Homeopaths (SoH) conference in 2007 where it attracted considerable condemnation.  Van der Zee and his supporters have ignored this criticism and have now taken their ideas to the developing world.

I’m in Kenya and am just back from my second trip to Congo and Burundi. I cannot hide my excitement about the results I’ve seen there, nor do I wish to. Potentially this Amma concept can grow very fast as the investment in terms of time and funds to implement it in a clinic is minimal. The clinic in Congo is already planning to start mobile clinics for villages and to open more clinics in larger communities. Connections have been made from Burundi to Tanzania and Rwanda to also start clinics there. Among the nurses the interest to know more about homeopathy grows and a program with advanced courses to learn to also use classical homeopathy for all those cases where a genus epidemicus approach is insufficient will hopefully follow soon.

This, like Jeremy Sherr’s activities in Tanzania, is utterly abhorrent, immoral and profoundly unethical.  VoYS are right to draw attention to the madness of homeopaths whose belief in their abilities is evangelical rather than rational, a triumph of faith over reason and morality.

[BPSDB]