Where's the harm?

It's a question that's often asked about natural alternatives to pharmaceutical medicines and often there is no harm. (That doesn't mean there's any benefit either, but that's for another day.)

But that's not true in this heartbreaking case from Australia.

If the death of a child isn't hard enough, living with the knowledge you could have done something to save them must be a burden which can never be shaken off.

Unfortunately for Thomas and Manju Sam that is the reality. They've both been jailed for the manslaughter of their daughter Gloria because they didn't care for her as they should have.

Essentially they treated a very treatable condition - eczema - with homeopathy and ignored advice to get her seen by a real doctor.

This ended with the death of the nine-month-old in May 2002.

Now I have very little sympathy for the Sams. They obviously didn't set out to have their daughter die a slow and painful death so it may be that I appear heartless.

But when you read that Thomas Sam had "an arrogant approach to what he perceived to be the superior benefits of homeopathy compared with conventional medicine" then I find it hard to feel sorry they're spending time in prison for this.

And the reason I feel like that is because in the wide spectrum from conventional treatment to full-on woo, homeopathy is as psuedoscientific as they come.

My own (anecdotal) surveys have found people don't tend to know exactly what homeopathy is. They appear to know it's natural and have some vague idea it might be something to do with herbs.

But it's way worse than that.

At it's heart homeopathy uses the idea "similia similibus curentur" or let likes be cured by likes.

This premise came after the founder of homeopathy, Samuel Hahnemann, developed symptoms of malaria after swallowing some quinine-containing cinchona bark (quinine is a drug used to cure malaria).

This may sound vaguely plausible, and is often confused for the effect that allows vaccinations to work, but that is different.

In vaccinations a foreign antigen is used to provoke a response from the immune system meaning the body is prepared should the disease be encountered.

But that antigen isn't just any old thing which causes the same symptoms of the disease - often it's simply a weakened or inactive form of the actual pathogen.

And it gets worse. Homeopathy also works on the premise that the more dilute the sample the stronger its effect, something which is counter to all logical thinking.

Here's the excellent Science-based Medicine's take on the so-called law of infinitesimal doses.

The law of infinitesimal doses also runs contrary to chemistry, pharmacology, and thermodynamics. Homeopaths today use dilutions of substances which essentially remove all traces of the substance from the final dilution.

There is not likely to be even a single molecule of the original drug in the final remedy which is given to the patient.

Homeopaths conclude from this fact that the substance is transferring its essence to the water into which it is diluted. The more it is diluted, the more potent is the water.

They offer, however, no possible explanation for how simple water molecules can contain the essence of far more complex substances.

Modern homeopaths have also tried to rescue the notion of infinitessimals by invoking the concept of water memory. They claim that water molecules can form a structure that contains the information of the homeopathic remedy.

However, such claims are fanciful to the point of invoking magic and are devoid of any evidence. Water structure is very transient and ephemeral.

They last moments and could not survive repeated dilution, let alone ingestion, absorption into the body, and transport to whatever their alleged site of action is.

Essentially this means in all likelihood the solution you buy from the health shop or pharamacy is simply a sugar pill or a solution of diluant - most likely water.

It's no surprise, then, that I would never recommend homeopathy as a means of curing anything - bar thirst.

And I would certainly never allow anyone who recommends homeopathy to treat any of my friends and family if they were ill.

Anyway, humour is often an effective means of getting the message across and this clip from That Mitchell and Webb Look sums it up pretty well:



Unfortunately any examination of homeopathy and its place in treatment of 21st century diseases is too late for poor wee Gloria Sam.

Should you want to read more in-depth information about homeopathy then here are some excellent resource:

Science-based Medicine
Science, Reason and Critical Thinking
Skepdic
Homeowatch

Skeptical, not cynical

First up, I'm incredibly excited about the launch of Sciblogs. My experience of New Zealand as an immigrant leads me to believe we often punch above our weight and it's great to see the Science Media Centre continuing that in an area close to my heart.

There are many great Kiwi bloggers writing about science and how it impacts on our lives and to have so many aggregated in the one place is a great achievement.

I was honoured to be asked to contribute to Sciblogs and delighted to be able to accept. For one thing in such esteemed company it's a nudge for me to write many more posts and keep a high standard.

We have our own scientific challenges in Aotearoa (just listen to talkback radio for a week and hear how many pseudoscientific adverts, advertorials and comments there are) and I look forward to writing about many of them in the future.

So welcome to a fantastic new phase for nz skeptic!

I hope many of you will be reading this blog for the first time so feel free to browse some of the (small) archive to get a better idea on what I write about.

But today I want to deal with one of the things skeptics are often accused of - and that's being overtly cynical rather than skeptical.

Of course there are many cynical skeptics - but this is a good time to point out one of the basic tenets of science, that correlation does not mean causation.

I could spend three hours writing and re-writing exactly why I think a cynic and skeptic aren't interchangeable but this passage from the Skeptic website's A Brief Introduction section says it far more eloquently than I could:

Some people believe that skepticism is the rejection of new ideas, or worse, they confuse “skeptic” with “cynic” and think that skeptics are a bunch of grumpy curmudgeons unwilling to accept any claim that challenges the status quo.

This is wrong.

Skepticism is a provisional approach to claims. It is the application of reason to any and all ideas — no sacred cows allowed.

In other words, skepticism is a method, not a position. Ideally, skeptics do not go into an investigation closed to the possibility that a phenomenon might be real or that a claim might be true.

When we say we are “skeptical,” we mean that we must see compelling evidence before we believe.

Of course requiring evidence brings skeptics into direct conflict with anyone or anything that has or requires faith, but let's not jump too far ahead just yet.

I'll be writing about many things which will undoubtedly annoy people and provoke a strong reaction. This isn't my intention. I'm merely sharing the opinion I've formed based on my reading and research.

But the greatest thing about the internet is that people can disagree with me and we can debate the issues.

So when we get into the substantive posts about homeopathy, psychics and other woo areas then feel free to comment and tell me why you disagree with me.

And, being a skeptic rather than cynic, it means if someone points me to new information then I may even be forced to change my mind.

Now there's a challenge!

Supporting Simon Singh

I can't state my support for Simon Singh enough. While I don't know the man personally, nor have I ever spoken to him, what he's going through in the name of science and skepticism shows a man whose principals put him head and shoulders above those in the various woo industries.

For those who don't know Simon is being sued by the British Chiropractic Association after he wrote a column in the Guardian. You can read more here.

In the meantime, like various other bloggers around the world, I'm republishing this article today. By doing so I show my support of both Simon and the desire to keep libel laws out of science.

Beware the spinal trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”.

In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor.

This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency.

Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic. In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches.

These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors. More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks.

This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures. Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain.

So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death.Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years.

Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck.

That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse.

She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature.

This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

New Zealand immunisation disgrace

I heard a disturbing statistic on TV3's news last night - only 77 per cent of New Zealand's children are immunised. That puts us way behind the US and Australia (according to the story - I'm trying to find exact percentages) and puts us in real danger of a whooping cough (pertussis) and/or measles epidemic.

The good news is this information came from a Ministry of Health media release which quotes statistics for 2005. These were gathered, in part, as a baseline measurement before the implementation of a National Immunisation Register, and is a count of full immunisation of two years old.

New figures are due out any day now, and - fingers crossed - should show an increase in this amount.

The bad news is that, even in my wildest dreams, it's going to be nowhere near the 95 per cent required to make sure herd immunity covers all of the potentially devastating illnesses vaccinations usually cover.

But what really grinds, what really makes me sick to the bottom of my stomach, was the appearance of Sue Claridge from the Immunisation Awareness Society.

These are her exact quotes:

“For example in 2005 only 13 children died from infectious diseases. There were 90 children who died from car accidents. there were 30 children who died from cancer.

“If we're spending our public health dollar, where can we best spend it to improve the health of our children and prevent mortality."

Hey Sue? Sue? Do you think that the 77 per cent of children who are fully immunised actually stops some deaths? Actually, I don't want to even guess what her answer would be to that question. I hope no parents of the 13 who tragically died were watching.

As so to the Immunisation Awareness Society. Aside from the fact that their website is hideously broken in Firefox on Ubuntu 9.04, it sets out to present itself as a pro-choice website - they want parents to have the full facts before immunising their children.

Who could disagree with that, eh?

Ah, but there's a clue on the home page. Yes, it's a quote from a man named Archie Kalokerinos, or Dr. Archie Kalokerinos, M.D. as he's advertised there.

Apparently he was a proponent of Linus Pauling's discredited 'high vitamin C doses cures lots of illnesses' theory, and believes vaccination is a deliberate genocide against indigenous Australians and used to spread HIV in Africa.

Yes, that sends a positive, pro-choice message doesn't it?

Anyway, there are small sections of the site which support pro-choice, but overall it's an anti-vaccer's heaven. - there's even a quotation from anti-vaccine activist and author Eleanor McBean which says the only reason immunisation is still done is because all of the big pharmaceutical companies make too much money to stop. Ah, where would we be without conspiracy theories.

Oh, I almost forgot. There are some links to pro-vaccination websites on their site, but they're right at the bottom - underneath the Alternative Medicine section, including homeopathy.

Anyway, I'll keep digging, and I'll post the updated statistics on New Zealand vaccination once they're released.

In the meantime, hopefully anyone reading this can help pass on the pro-immunisation message.

Note: I have two children, one aged six and one aged four. Both are fully immunised and suffered nothing other than a sore arm and a little grouchiness post-injection. Just to prove I walk the walk, so to speak.

Addendum: I should, of course, have praised TV3 for actually covering this issue. I'm hopeful that this is the first of many times vaccination is covered in the New Zealand media.

Skepticism is hard

The hardest thing about skepticism and critical thinking, for me, was giving up some of the ideologies I thought were positive.

The best example I can give is probably with politics. Traditionally I'm what you call a liberal - a left wing kind of guy who would traditionally vote for the furthest left standing for election.

In New Zealand that probably puts me in the Green camp. But the scientist in me finds that an intolerable position.

Not only was their opposition to the trans-Tasman amalgamation of medicine regulators TGA and Medsafe based on beliefs that were just plain wrong, their over-arching love of 'natural' products often invokes a huge amount of pseudo-science.

But the biggest thing is probably their anti-nuclear stance. I listen to the wonderful Brian Dunning's Skeptoid podcast, and I listened to his nuclear power podcast with a great deal of well. . . skepticism.

But in 10 minutes I was forced to face a firmly held belief and read more about the issue. The more I read, the more I realised the likelihood that New Zealand's anti-nuclear stance is probably based on information that is years, if not decades, old and any debate about nuclear power should be about the science as it is, not was.

I still think there's some validity in a country willing to push it's clean, green image for tourism purposes, but in a country which will face electricity shortages in the future it's madness not to debate the issue in a proper fashion.

The same is true for genetically modified crops. It only took 10 minutes to make me realise my long-held position against the crops was not only logically flawed but probably ignorant as well.

Of course, like a true skeptic I didn't just take Brian Dunnings word for it. Nor would he expect anyone to, I imagine.

I read, and - probably for the first time in my life - I'm making decisions solely based on critical thinking rather than because of where I am in the political spectrum or what I was brought up believing.

And you know what? It's not comfortable. Sometimes this puts me in the same box as right-wing politicians I would normally disagree with every ounce of my being.

Thankfully the internet - and Facebook and Twitter in particular - means a skeptic never needs to stand alone any more. And for that I'll be forever thankful.

Patrick Holford on Radio New Zealand

I'll save further comment until I've actually had time to listen to Kim Hill's interview with alternative nutrionalist Patrick Holford from Saturday's programme. It would be unfair of me to comment completely after listening to less than 10 minutes of the bollocks.

Thankfully the Holford Watch website are on to it and have provided some thoughtful analysis of this man (who's thoughts on HIV and autism, amongst other things, are way out of the mainstream).

If you can bear to listen to it, here's a link to the Radio New Zealand website for the day in question so you can download it.

As an aside, this is the first time I've really felt a real part of the skeptical community. I want to thank The Skeptic Zone's Kylie Sturgess for getting the links to me in the first place - I obviously need to improve my New Zealand skeptical digging.

Dr Rachie (Rachael Dunlop) then tweeted about it, saying if she may try and critique the part of the interview which deals with her specialist area. I won't hold her to that because I'm not sure how anyone involved in The Skeptic Zone finds time for anything. I must ask them all for time management tips.

But the positive thing for me is the fact that there are so many tools which can mobilise the skeptical community quickly. It really is a privilege to live in the technological era.

As per Kylie's suggestion, I forwarded the links to NZ Skeptics and I'm now waiting to see if they will make any response. NOTE: Added April 28 - No response from NZ Skeptics, not even an acknowledgement of the e-mail. Disappointed.

(As of now, I'll just do normal hat-tips for anyone who sends me links, but I felt the first time deserved special comment.)

A NZ newspaper article against pseudoscience?

Apologies for the lack of updates. I get pretty severe depression and it takes it toll. Thankfully watching '30 Rock' and taking prescribed drugs helps and so I'm back on my feet. Funnily enough, I"m not taking any homeopathic remedies like these guys suggest.

And talking about homeopathy. . .

I was surprised (and delighted) to see this Guardian article on the demise of complementary medicine courses in UK universities being reprinted in today's Sunday Star Times.

Unfortunately the Sunday Star Times has often been on the wrong side of the pseudoscience debate, with past features on television psychics and the like, so it's nice to see a pro-science article featured heavily.

Hopefully this is a positive sign for the future, and BSc degrees (like I have) can once again become a bastion of science rather than pseudoscience.

But I won't hold my breath - water homeopathy solutions are available in most of the pharmacies I've visited in New Zealand. A friend was even recommended a homeopathic remedy for a broken neck (not by a pharmacist, thankfully!).

And finally, I had a recent door-knock from the local Jehovah's Witnesses. Standing with by straggly beard and Iron Maiden t-shirt I obviously looked right for saving. When I told them I was an atheist, the lead wanted to know why. So I told her. I was rather surprised when she told me a growing number of scientists agreed that the order in the world demanded a designer to explain it.

'Not any credible ones,' I suggested and politely bade them farewell.