When I first heard, years ago, that there was a Professor of Complementary Medicine at Exeter University, I was quite excited. At last, I thought, academia is taking complementary approaches seriously! Should have known better, shouldn’t I?
Edzard Ernst is NOT a Professor of Complementary Medicine, because he only ever professes against it! He is also a member of the Medicines Commission of the British Medicines Control Agency (MCA), and one of the thirteen apostles of the pharmaceutical industry that were signatories to the now-infamous open letter calling for complimentary therapies to be dropped by the NHS in 2006, before they got a chance to prove effective and start encroaching on the territory ‘owned’ by Big Pharma.
Edzard Ernst has written extensively about problems and supposed dangers in the complementary field, whilst publishing so little in favour of any CAM therapy that it is obvious to anyone in our field that the Laing Chair in Complementary Medicine really exists as a platform from which to profess against alternative approaches, whilst suggesting that so-called ‘evidence-based medicine’ (EBM) is safer and superior , as if that were a matter of fact. Well we all know from the recent drug trial scandals that this is very far from the truth.
Who sponsors the Laing chair? How did it come into existence? Because I will tell you one thing for sure, it has nothing whatever to do with those of us who actually practise alternative and complementary methods. Ernst is a scientist, and only this morning I heard him on BBC Radio 4 calling for The Prince’s Foundation for Integrated Health to withdraw a booklet they first published three years ago, because (he said) it made claims for acupuncture and homeopathy that could not be substantiated.
So he claims. And obviously, if that’s what you want to believe anyway, it is effortless to assume that Ernst’s work finally proves it, ’scientifically’, and that is the end of that. Which indeed it would be, if Ernst’s methods were sound, exhaustive, and beyond reproach - but they’re not.
Dumb Mistake No.1
Ernst has been gifted a title which makes him seem - to some - like the world’s greatest authority on complementary medicine! This is laughable, because the real experts are the best-trained and most talented and experienced full-time practitioners in the active field itself. Are these people drafted in to help Ernst to discover just how useful their talents are? No. Instead, it is assumed that the best people to carry out studies into the effectiveness of highly skilled therapeutic procedures like hypnotherapy or acupuncture are… scientists.
Dumb Mistake No.2
If you are just testing a new pill, and the pill is the sum total of the medical intervention, then a blind controlled trial makes sense, provided you look at ALL the evidence that results (not just the bits that seem promising), and follow up the results for long enough to be sure the success is lasting success. But with some CAM therapies - and this is particularly true of hypnotherapy - there is bound to be a very significant difference between the way people respond in real therapeutic settings… when the whole procedure is all about them… and the way they feel in a controlled scientific trial which is not all about their outcome, but the general efficacy of the method, which is then necessarily in question. This may even create a form of ‘performance anxiety’ in which the subject feels obliged to respond well, and therefore is not able to simply respond normally. Put simply, the setting is abnormal, which affects everyone involved in a negative way, just as attempting a tonsillectomy in the car park of a busy motorway service station would. This factor is multiplied if the ’surgeon’ is not really a professional, but a scientist who wants to find out for himself if operations like this are really as safe and easy as surgeons claim. To ignore such factors is simply unscientific, but here is a link accusing Ernst of adopting methods that virtually eliminate the crucial factor of real expertise and professional experience - not to mention 99% of the actual trial evidence available to him! (Link)
Dumb Mistake No.3
Edzard Ernst has been criticised not only by CAM practitioners, but by the scientific world too. One newspaper report suggested that “this must mean he is getting something right”, ignoring the rather more obvious conclusion that maybe he isn’t getting anything right. In that article, Ernst stated that he isn’t troubled by getting flak from both sides, but what would trouble him, he remarked, was if someone said the science was wrong. Enter Robert Verkerk, to trouble him with this: (Link)
Recycling Old Rubbish
Most people would probably assume that the work Ernst has been doing, in his capacity as the World’s First Professor of Complementary Medicine, will have been new experimentation investigating those complementary approaches as they are actually practised, and using the best modern methods - making full use of the skills of the real practitioners, the experts people actually consult on a daily basis. How else can you ascertain the true value of the therapies as they are practised in reality?
Actually, this is not the case at all. Scientific trials cost an awful lot of money, and although governments used to fund a lot of scientific research half a century ago, they don’t now. In fact, the only organisations who still put large amounts of cash into new experimentation are the big drug companies. They don’t want to spend a dollar unless there’s a chance of it making them some profit, so obviously all that research goes into new drugs.
This means that so few trials have ever been undertaken into methods like hypnotherapy and acupuncture by Western medical scientists, and it was mostly done so long ago (and often clumsily) that the entire scientific evidence-base is tiny when it comes to complementary therapies, and it ain’t likely to get much bigger any time soon. Why would drug companies fund studies into hypnotherapy? They can’t sell that!
So what scientists actually do, when they ‘research’ complementary therapies, is they sift through old studies and cherry-pick which of those they are going to regard as “significant” or “relevant”, according to what they want to conclude, and then review that bit, leaving out whatever they prefer to leave out. This is highly selective, and basically means you can organise particular elements from the overall evidence which are then presented as if they can be regarded as representative of the overall picture, and if those elements did not indicate anything exciting or significant (that’s why they were chosen), you can claim that this evidence indicates “no significant evidence of the efficacy of these methods”, without mentioning any other evidence at all.
In fact, you could do exactly that with all therapeutic or medical methods, and make it seem as if nothing works. All very amusing, but it’s not science.
Watch out for the word ‘Review’
Most scientific dismissals of complementary approaches will use this expression: “A review of all the relevant evidence from a number of research trials found no significant evidence of efficacy…” Those who hear that, and were already skeptical, will instantly accept that statement as if it were scientific proof that the methods don’t work. But it is not research. It is selective reporting, organised in such a reductive manner that it is often useless and sometimes very misleading.
True science is supposed to be objective, but men like Ernst are not objective, they are on a mission. For some skeptics, like Richard Dawkins, it is a personal mission to disprove anything that doesn’t square with his own personal view of the world. Nothing wrong with that, we need diverse views and that one serves an intellectual purpose, just as other views can. But men like Ernst are fakes because they pretend to be something they’re not.
He claims that his work will help complementary methods gain credibility by “proving what works and what doesn’t”. All he is really proving - and crucially, without most people realising it - is that if you go about this in ways that seriously distort the usual manner in which these things are REALLY done by the true experts in these matters, you make it look as if the methods aren’t much good, which is worse than not investigating it at all.
Imagine a Professor of Surgical Medicine who only ever seemed to publish papers warning everybody about the potential dangers of surgery. Constantly questioning its efficacy, and pointing to cases of surgical error, but hardly ever mentioning all the marvellous successes? Mentioning just a few though, to make it look as if this was truly an objective procedure. Surgery is successful more often than it is not, generally speaking, but a professor behaving like that would create the opposite impression, would he not? How could Surgery possibly be advanced in that way?
In my own hypnotherapy practice, I know that hypnotherapy is also successful more often than it is not. I cannot speak for chiropractors, acupuncturists or homoeopaths in this regard, but I do hear the familiar warnings and dismissals from the likes of Ernst, using the same language constructions such as the phrase above (”a review of all relevant studies found no significant evidence” etc.), as we find in material routinely dismissing methods like hypnotherapy, published by the Royal College of Physicians, A.S.H., and other similar bodies closely tied to the pharmaceutical giants. I KNOW hypnotherapy works very well, so why are they getting it so wrong? Either they are just incompetent - which is bad - or they’re choosing to screen out/ignore any evidence to the contrary.
So Ernst may not be a fake scientist, but his methods are certainly questionable. To those of us who are proud to be practitioners in the field of alternative medicine (if we must call it that), he is certainly a fake Professor of Complementary Medicine, because he has clearly and consistently established himself as one of a number of key professors against it. They warn against the ‘dangers’ of methods that people have been using for centuries, whilst we note that they have nothing to say about the horrors caused by “evidence based” medications which kill thousands. Instead they expend all their efforts suggesting we should all be deeply suspicious of traditional therapies that are really quite popular and don’t kill thousands of people. That imbalance is NOT scientific objectivity, obviously - it is ideological bias, prejudice and (at the end of the day, just as it was at the start of the day) all about power, profit and influence.
The Chief Executive of The Prince’s Foundation for Integrated Health, Kim Lavely, conducted herself admirably in that interview, and was unmoved by Edzard Ernst’s claims against alternative methods. Why was he speaking out now, when that booklet has been out for ages? Well it’s not the first time he has attempted to thwart attempts to integrate drug therapies and alternatives, not by a very long way. But the timing is significant, because all the press lately has been against Big Pharma, hasn’t it? So they’re rolling out their big guns, trying to win back some of the ground they’ve lost through recent scandals involving so-called ‘evidence-based medicines’ which turned out not to be, actually, because they had so little regard for efficacy in reality that they withheld some of the actual evidence.
Nicotine Replacement Poisoning isn’t truly ‘evidence-based’ either, as all the real evidence in my book - and on this site - proves beyond doubt. In that Radio 4 interview, Ernst said: “If anything in healthcare is misleading, it is dangerous.” Might that apply to publishing boasts of 90% ’success’ for South West Kent Primary Care Trust’s Stop Smoking Services in the Department of Health’s press release dated 9th July 2004, when we now know the real, long term outcome for those methods is 6%? That’s about as misleading as you can get, mate. Nicotine is also very poisonous, frequently causing heart attacks, strokes and thrombosis in thousands of people every year.
So, Edzard, if you really believe - as you claim - that the same standards should apply to both alternative methods and drug therapies when it comes to approving them - or indeed dropping them, as you called for in 2006, with regard to alternatives in the NHS - will you now join me, as I’m sure any real Professor of Complementary Therapy would, if one existed, in calling for nicotine-based products to be dropped by the NHS? After all, the evidence of their long-term effectiveness is now known to be so dire that they function very poorly even as a placebo - with the unusual drawback, as placebos go, of also being highly poisonous?
Of course you won’t. Because you are a fake, and everyone in the field of complementary medicine knows it. You’re just another lackey of the pharmaceutical industry, with no more real regard for the truth than they have. It’s not hypnotherapists, acupuncturists or homoeopaths who are killing people by the thousand every year. It’s your so-called ‘evidence-based medicines’. Those are the facts, so how dare you suggest that we are the ones that are posing a danger to the public? You are ridiculous, and if anything is particularly “misleading in healthcare”, it’s you!
Filed under: Drugs on Trial, The Campaign by Chris
3 Comments »
