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The SkeptVet vs Dr. Shawn—A Paradigmatic Kerfuffle
Posted: 15 February 2010 04:17 PM   [ Ignore ]   [ # 31 ]
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scepticeye - 15 February 2010 04:09 PM

“I suggest that the only valid element of this anti CAM hysteria is to have products labeled as not scientifically proven. I can live with that I suspect that most people would.”

That is meaningless without the further stipulation that the products cannot be labeled as treating or curing disease, either, and that includes homeopathic treatments. (Which are typically excluded from these labeling laws, at least in the US and I believe in Europe as well). After all, if it’s not proven, it should not be labeled as though the product were effective. This is marketing 101.

I don’t know if you have the same advertisements we have in the US, but they are literally everywhere here, blaring headlines about curing this or that ailment, and in unreadable print at the bottom the disclaimer to the effect that, “These assertions have not been tested by the FDA”. That doesn’t cut it. Nobody reads the fine print.

Now, if the labeling was simply as to ingredients, and there were regulations that said that the ingredients had to be the same as on the label (not the case with CAM medications, in fact), then assuming the ingredients weren’t actually harmful, I’d have no problem with them being on sale. Certainly, homeopathic medications are just water and sugar pills, so there’s nothing that could be illegal in selling that.

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Posted: 15 February 2010 04:20 PM   [ Ignore ]   [ # 32 ]
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scepticeye - 15 February 2010 04:13 PM

This strikes me as far too smart an answer for someone so intelligent.  You know well what I support as I made it clear in my post. Can we dial back the level and let it sit ?

OK, well then I’ll take that as saying that you didn’t mean exactly what you said in the statement I quoted. Fair enough, of course.

At any rate, dialing back the level here, I think that Brennen’s point in the OP and similar topics here on the site are mostly about providing scientifically correct information about treatments that work and those that don’t. And that should be seen by all of us as a very laudable project, even if CAM were allowed to be just as available as it is now. Correct information is always a good thing.

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Posted: 15 February 2010 06:09 PM   [ Ignore ]   [ # 33 ]
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All decisions about regulation and law are political, it is a nonsense to suggest that any law or any regulation of medicines, poisons, drugs, foods, products, toys are taken on some kind of pure scientific or rationalism basis. Your supposed attempt to get to the core of my views and slur them by proxy is ridiculous.

No, you’re missing my point. My point is that your ideological opposition to government regulation trumps your skepticism and rationalism. There is clearly nothing rational about alllowing people to freely sell harmful or ineffective medical therapies. It is a source of direct and indirect harm and a waste of resources. You see it as the lesser evil compared to allowing the government to control what people do or say, and that’s your perogative, but again this has nothing to do with what this thread is about, which is the scientific illegitimacy of most CAM and the weak ethics behind providing unsupported or outright quack therapies to people. You jumped into the thread on the offensive claiming that you were “tired of sceptics who feel a religious kind of zeal to attack and do away with alternative medicines” and that almost all CAM had “absolutely no potential harmful effects” and then characterizing the discussion in terms of religious “zeal” and “abuse.” My response was simply intended to point out factual errors and also that your own anti-government “zeal” seems to be motivating you to make claims and assertions that are either incorrect or irrelevant to my efforts to properly critique CAM for its scientific and ethical failures.

As for my reference to caveat emptor I’m afraid I applied it too liberally, and I agree that it is not the approach you are suggesting. I still believe it is ethically wrong to allow the sale of harmful or useless medical remedies even with disclaimers, but I accept that you at least agree deliberate fraud should be prohibited, though you don’t seem to feel it is a significant problem which I think is incorrect. I think it is important then to consider what constitutes an adequate disclaimer. I cannot imagine anyone selling (or buying) a product that clearly said “There is no evidence to demonstrate this product is safe or effective” or in cases such a herbal medications “There is no evidence this treatment is effective and an uncertain but significant potential for harm associated with its use.” Yet those are true statements regarding many CAM therapies.

People are notoriously risk averse, and they exaggerate risks all the time, particularly dramatic risks that get a lot of media attention. Reading the list of potential risks associated with a well-studied pharmaceutical can scare anyone, and yet those are products for which the risk/benefit ratio is usually well understand and favorable overall. The only way people can take therapies that have no sound evidence to support them is because they think a) there’s a reasonable chance they will work, which is ususally the result of something positive they’ve been told or read, b) they think they’re safe, which is often but not invariably true, and c) they think they will be able to accurately assess the effectiveness of the therapy for them based on their experiences with it, which is demonstrably false. So my role as I see it is to try and explain why these assumptions are not reliable so people can make free decisions with adequate and accurate information. I also would not mind if the government got involved in doing more of that work, but again that’s a somewhat separate political question.

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Posted: 16 February 2010 11:38 PM   [ Ignore ]   [ # 34 ]
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I read somewhere that most (70%) modern manufactured medicines are available in nature and were used by natives from their natural sources for thousands of years. If anything, the refinements made through experience alone, would provide a (non controlled) date base for the use of certain plants, roots, and other naturally occurring chemicals for the treatment of a variety of diseases. Thus to say that natural medicines have no value is perhaps a little dismissive of history. Was there not a proposal to include garlic as an official medicine? Its beneficial properties have been known for thousands of years.
Moreover, when I see advertisements for new modern medicines, why are the side effects of some treatments almost as bad as the the disease itself. Case in point: If you have acid reflux, use (brand name) to find relief. Side effects may be, upset stomach(?), nausea (?), kidney damage, liver damage, and in rare cases death. Consult with your doctor if this is the proper treatment for your acid reflux and live a fuller life. Seems to me that we are being asked to trade one discomfort for another, for which there surely is another remedy, again with its own side effects. And round and round we go. I have had acid reflux on occasion and a glass of water was a very effective cure.
I am making this observation purely as layman, without any claim to medical knowledge, but some of these ads struck me as ironic.

[ Edited: 16 February 2010 11:59 PM by Write4U ]
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Posted: 17 February 2010 05:04 AM   [ Ignore ]   [ # 35 ]
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Write4U - 16 February 2010 11:38 PM

I read somewhere that most (70%) modern manufactured medicines are available in nature and were used by natives from their natural sources for thousands of years.

I’d like to see the source for that information. I find it highly dubious.

If this means 70% by weight, it might be true, simply due to the popularity of aspirin. Certainly not true for “most” individual medicines, which are highly engineered and/or refined.

As for garlic, which beneficial properties are you referring to?

[ Edited: 17 February 2010 05:06 AM by dougsmith ]
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Posted: 17 February 2010 05:48 AM   [ Ignore ]   [ # 36 ]
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dougsmith - 17 February 2010 05:04 AM
Write4U - 16 February 2010 11:38 PM

I read somewhere that most (70%) modern manufactured medicines are available in nature and were used by natives from their natural sources for thousands of years.

I’d like to see the source for that information. I find it highly dubious.

If this means 70% by weight, it might be true, simply due to the popularity of aspirin. Certainly not true for “most” individual medicines, which are highly engineered and/or refined.

As for garlic, which beneficial properties are you referring to?

Sorry, I heard this a long time ago, but here is a site that confirms 40%. Still a significant number.
http://www.medicinehunter.com/plant_medicine.htm

Of course I recognize that there are many very sophisticated manufactured medicines, but I believe one should not ignore the importance of some very exotic and effective medicine from natural sources.

Garlic is one of the oldest medicines known to man. It was used in time long before the pyramids and due to its beneficial properties for curing a variety of ailments, which at that time were considered to be evil spirits. In fact some varieties of garlic have been so domesticated that they are unable to reproduce on their own and must be hand aided.

Maybe of interest: The first recorded labor strike in history was over garlic. During the time of the pyramids garlic was part of the daily ration for the workers and craftsmen who were building the pyramids. This was in part to keep the workforce strong and healthy. After a very poor garlic harvest, the rations for the workers were cut. In protest they informed the foreman that they refused to work unless given full rations of garlic. This daring demand was in no small part superstition driven. The foreman reported this strike to the pharao’s architect and this protest was duly noted by a scribe. Thus, the first recorded labor strike was about garlic. Not a bad history for a smelly little plant.
http://www.ahrq.gov/research/may01/501RA27.htm
http://quanta-gaia.org/reviews/books/powerOfGarlic.html

[ Edited: 17 February 2010 05:57 AM by Write4U ]
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Posted: 17 February 2010 06:07 AM   [ Ignore ]   [ # 37 ]
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Write4U - 17 February 2010 05:48 AM
dougsmith - 17 February 2010 05:04 AM
Write4U - 16 February 2010 11:38 PM

I read somewhere that most (70%) modern manufactured medicines are available in nature and were used by natives from their natural sources for thousands of years.

I’d like to see the source for that information. I find it highly dubious.

If this means 70% by weight, it might be true, simply due to the popularity of aspirin. Certainly not true for “most” individual medicines, which are highly engineered and/or refined.

As for garlic, which beneficial properties are you referring to?

Sorry, I heard this a long time ago, but here is a site that confirms 40%. Still a significant number.
http://www.medicinehunter.com/plant_medicine.htm

That does not confirm your original claim, above, that these medicines “are available in nature and were used by natives from their natural sources for thousands of years.” What it says, instead, is that “Plants are the original source materials for as many as 40% of the pharmaceuticals in use in the United States today. This is to say that either the drugs currently contain plant-derived materials, or synthesized materials from agents originally derived from plants.”

Neither plant derived materials nor materials synthesized from plants would have been “available” to native peoples for thousands of years. Typically such materials are highly refined and processed.

Write4U - 17 February 2010 05:48 AM

Garlic is one of the oldest medicines known to man.

This assumes what needs to be demonstrated: viz., that garlic is a medicine. As of yet I see no evidence to support such a claim.

Write4U - 17 February 2010 05:48 AM

http://quanta-gaia.org/reviews/books/powerOfGarlic.html

That site is pure quackery. Any claims about “boosting your immune system” are the signs of the quack. There is no way to “boost your immune system”, other than by getting a vaccination.

Re. colds and flus, see HERE: “There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. ... Claims of effectiveness appear to rely largely on poor quality evidence.”

The only other two syndromes that Cochrane has for garlic are peripheral arterial occlusive disease and pre-eclampsia and its complications.

Re.  peripheral arterial occlusive disease, see HERE: “One small trial of short duration found no statistically significant effect of garlic on walking distance.”

Re. pre-eclampsia and its complications, see HERE: “There is insufficient evidence to recommend increased garlic intake for preventing pre-eclampsia and its complications. Although garlic is associated with odour, other more serious side-effects have not been reported. Further large randomised trials evaluating the effects of garlic are needed before any recommendations can be made to guide clinical practice.”

Re. reducing cholesterol, see HERE: “There were no statistically significant effects of the 3 forms of garlic on LDL-C concentrations. ...None of the forms of garlic used in this study, including raw garlic, when given at an approximate dose of a 4-g clove per day, 6 d/wk for 6 months, had statistically or clinically significant effects on LDL-C or other plasma lipid concentrations in adults with moderate hypercholesterolemia.”

Nothing to speak of.

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Posted: 17 February 2010 07:20 AM   [ Ignore ]   [ # 38 ]
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Write4U - 17 February 2010 05:48 AM

Of course I recognize that there are many very sophisticated manufactured medicines, but I believe one should not ignore the importance of some very exotic and effective medicine from natural sources.

Well, I would ignore it. A friend of mine kept some plant in her kitchen to treat her burns and cuts until one day I found her plant was infected with some kind of fungus; she had no idea. Compare that with another friend of mine who designs packaging for pharmaceutical companies and has to wear all the the protective clothing when going for a press-check to make sure the medicine stays as free of germs as possible. It is probably safer for you to chew on that little paper in your box of pills that putting yourself at risk of treating your illness with god-knows-what.

These are only personal anecdotes but Doug has already answered everything else that needed to be said.

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Posted: 17 February 2010 07:43 AM   [ Ignore ]   [ # 39 ]
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I should say, I do enjoy garlic in food, and would love to hear that it was a panacea. But the evidence is sorely lacking.

More from the Berkeley Wellness Letter HERE:

Bottom line: There’s no clear evidence that garlic pills are beneficial. ... But there’s no harm in eating more garlic—though cooking garlic at high temperature destroys potentially active components.”

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Posted: 17 February 2010 07:52 AM   [ Ignore ]   [ # 40 ]
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dougsmith - 17 February 2010 07:43 AM

I should say, I do enjoy garlic in food, and would love to hear that it was a panacea. But the evidence is sorely lacking.

More from the Berkeley Wellness Letter HERE:

Bottom line: There’s no clear evidence that garlic pills are beneficial. ... But there’s no harm in eating more garlic—though cooking garlic at high temperature destroys potentially active components.”

I found it interesting to hear that raw garlic can be harmful to dogs. Small to moderate amounts of cooked garlic (such as that added to highly processed dog food that is cooked at high temperatures) is supposedly OK, probably for the reason you mentioned above. I’m not sure what chemical component of the garlic is dangerous to the dog.

Sorry a little off topic.  grin But when you mentioned the cooking destroying components of it, that reminded me of what I’d read.

What does our resident Vet think of the garlic/dog topic? I have heard people say garlic wards off fungal skin infections and even fleas in dogs, but I always ignored it. (They used to say the same thing about brewer’s yeast.) It seems that people claim garlic as a cure for not only people, but animals, too!

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Posted: 17 February 2010 10:07 AM   [ Ignore ]   [ # 41 ]
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Writ4U,

I have little to add to Doug’s responses above excpet to point out that you take as given a number of dubious or outright mistaken propositions and then proceed to argue from there. The difference between discovering medicines by investigating and testing chemical found in plants and pretending the plants themselves are medicines is the precise difference between science-based and alternative or traditional folk medicine that is the point of these discussions.

The other point Doug didn’t address was you question about listed side effects for pharmaceuticals. This ften creates uneccessary fear and suspicion. The way the regulatory sytem works, anything bad that happens to anyone during testing of a new drug ust be reported as a potential side effect whether or not is has anything to do with the drug and whether or not it occurs at the same rate in subjects taking the drug and taking a placebo. And the frequency of such side effects doesn’t alway have to be reported. So if a stomach virus runs through a clinic where some test subjects are being evaluated and a few of them experience vomiting, this may very well end up on the label as a possible side effect. This is an extreme precautionary-principle kind of approach, and while it isn;t necessarily a bad thing it does tend to create inaccurate perceptions of the liklihood of a particular person taking a drug experiencing a given side effect. With prescription drugs, the best thing to do is talk with your doctor and ask which of the listed side effects are rare or theoretical and which you truly should watch out for.

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Posted: 17 February 2010 02:23 PM   [ Ignore ]   [ # 42 ]
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^^ Good info on those side effects, Doc, I thank you. It’s always been a source of both amusement and confusion - not to mention derision - to me when the list of possible side effects is longer than the positive aspects listed in a TV commercial for some medicine or other. Especially when the side effects are so closely related to the very condition it’s intended to help! Now I have a bit more persective on it. And it’s even funnier.

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Posted: 17 February 2010 04:03 PM   [ Ignore ]   [ # 43 ]
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dougsmith

Neither plant derived materials nor materials synthesized from plants would have been “available” to native peoples for thousands of years. Typically such materials are highly refined and processed

I am not arguing against modern medicine. Obviously our ability to extract beneficial properties from plants has reached great sophistication. But that does not negate the fact that plants can and do yield usable medicines. What is synthesizing? Many everyday beverages are extracted (synthesized) from plants or other available natural substances for their beneficial properties. Coffee, tea, rootbeer, lemonade, yoghurt, yeast, are some basic examples of home remedies with known beneficial properties and results. I hope I am correct that “medicines” is a generic term with an enormous range of application, from quelling a stomach upset to rocephin for acute life threatening infection. 
To say that plants do not have the ability to provide sufficient quantities of their beneficial properties is too exclusive. Alkaloid rich plants yield extremely powerful (even dangerous) drugs, which can be used with a minmum of manipulation. This is why we have volumes of warnings of poisonous plants (proof that there are powerful chemicals which are easily extracted). To make a blanket statement that chewing, cooking, grinding, combining plants with reinforcing properties, cannot yield sufficient medicine is not true. Many spices, such as curry, nutmeg, cinnamon, sage, thyme are known for their beneficial properties. This is probably also the reason why they are so prized over centuries of practical experience. These cannot be dismissed as not having medicinal benefits. However, they may fall more in the niche of preventative medicine rather than curative.
Finally, I am not arguing for herbal medicines, most of these are available in more concentrated synthesized form and cheaper over the counter in the western world. But I don’t want to be too dismissive of serious herbalists, who try to give relief to some 80% of the worlds population with knowledge and ethics. To say that all these doctors are quacks sounds presumptuous to me. I saw a program where a 100 year old medicine man (in apparent excellent health) in the jungles of the Amazon who had an apprentice studying under him for 40 years and learning the identification and the precise mixtures of various plants and roots for some very specific ailments. In Germany one can receive a degree in herbal medicine. Apparently they recognize a place for herbal medicine in the grand scheme of medicine. In the US, a 6 year medical degree does not insure infallibility, even with our wondertful advancements in technology. People still die from bad modern medical practices or suffer from complications of overusing synthetic drugs. I say this with deepest respect and appreciation for our medical professionals. My wife is a nurse.
Just trying to keep it real and if at all possible, natural.

p.s. has anyone here ever researched the history of Hyaluronic acid (HA)?
http://www.docstoc.com/docs/5060683/Hyaluronic-Acid-“The-Molecule-of-Youth”

[ Edited: 17 February 2010 06:36 PM by Write4U ]
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Posted: 18 February 2010 05:59 PM   [ Ignore ]   [ # 44 ]
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mckenzievmd - 15 February 2010 06:09 PM

All decisions about regulation and law are political, it is a nonsense to suggest that any law or any regulation of medicines, poisons, drugs, foods, products, toys are taken on some kind of pure scientific or rationalism basis. Your supposed attempt to get to the core of my views and slur them by proxy is ridiculous.

No, you’re missing my point. My point is that your ideological opposition to government regulation trumps your skepticism and rationalism.

I would submit that there is no such thing as scepticism and rationalism in a vacuum. The use of our scepticism and our rational thinking enables us to form views on things such as political views and government regulation. In my case this is how I think. So your assertion is incorrect. I, on the other hand, could form the view that the vehemence of your opposition to CAM appears to be dominated by your own ideology and doesn;t seem rational to me.

There is clearly nothing rational about allowing people to freely sell harmful or ineffective medical therapies.

I simply do not agree with this assertion. Firstly you have lumped two extremely different actions together.  There is a world of difference between harmful and ineffective. Yet you seem to refuse to recognise this difference.
Secondly you fail to convince that these CAM producst are harmful except in indirect ways discussed below.

It is a source of direct and indirect harm and a waste of resources.

Ineffective medicines cannot do harm if they are ineffective. Ineffective medicines cannot do harm if they are labelled as unproven. Wastage of resources by whom ? why is that grounds for government legislation ?

You see it as the lesser evil compared to allowing the government to control what people do or say, and that’s your prerogative, but again this has nothing to do with what this thread is about, which is the scientific illegitimacy of most CAM and the weak ethics behind providing unsupported or outright quack therapies to people.

Firstly I don’t see any clash with the first post which was extremely vague in how it defined this thread so that’s a bummer to start with.  You are right however when you say that I oppose people who want to tell people what they can and what they cannot do unless there is good evidence that they need it. I don’t see this evidence.

You jumped into the thread on the offensive claiming that you were “tired of sceptics who feel a religious kind of zeal to attack and do away with alternative medicines” and that almost all CAM had “absolutely no potential harmful effects” and then characterizing the discussion in terms of religious “zeal” and “abuse.” My response was simply intended to point out factual errors and also that your own anti-government “zeal” seems to be motivating you to make claims and assertions that are either incorrect or irrelevant to my efforts to properly critique CAM for its scientific and ethical failures.

It is a little amusing to refer to my zeal. You guys are the ones campaigning and trying to get this CAM banned. I am simply reacting and opposing. ‘Zeal’ is over hype to the extreme.
You did indeed point out what you believe are factual errors but they simply don’t stand up. My statement about Medicine’s history was essentially correct and you agreed despite your reading far too much into my comment.  You then posted a series of links. Firstly links are not argument. My life is far too short and enjoyable to spend it following links. If you have something to say then say it or quote it please. Your links point to opinion pieces in general and also to claims that refer to the fact that actions by users of CAM can lead to them missing out on better and more effective scientific medicines and also having worse health.
I simply do not accept this as grounds for banning CAM. Not even close. This is the Nanny State gone mad. Alcohol and smoking are harmful to our health a thousand times more than CAM. yet we don’t ban them. This is for good reason. People are well aware of the risks they are taking and that is their democratic right. This is a fundamental right we have in our societies. We can chose to take actions that are not good for us; that can lead to worse health; that can ultimately kill us.

As for my reference to caveat emptor I’m afraid I applied it too liberally, and I agree that it is not the approach you are suggesting. I still believe it is ethically wrong to allow the sale of harmful or useless medical remedies even with disclaimers, but I accept that you at least agree deliberate fraud should be prohibited, though you don’t seem to feel it is a significant problem which I think is incorrect.

Wrong I never under stated my opposition to deliberate fraud. What I did say is that I don’t see it in the vast majority of the CAM industry and therefore don’t believe it is grounds for a ban. It is grounds for prosecution and regulation.

I think it is important then to consider what constitutes an adequate disclaimer. I cannot imagine anyone selling (or buying) a product that clearly said “There is no evidence to demonstrate this product is safe or effective” or in cases such a herbal medications “There is no evidence this treatment is effective and an uncertain but significant potential for harm associated with its use.” Yet those are true statements regarding many CAM therapies.

When I buy CAM products in shops in Ireland this is what is said on products on at the entrance to shops. I also don’t really think it is necessary most of the time for the same reason it doesn’t appear on beer bottles or whisky bottles. It is thoroughly well known by the massive majority of people. Either way ... it is easily corrected by a suitably visible and not intrusive label. This is a far more likely campaign to succeed than seeking a total ban which people simply won’t support.

People are notoriously risk averse, and they exaggerate risks all the time, particularly dramatic risks that get a lot of media attention. Reading the list of potential risks associated with a well-studied pharmaceutical can scare anyone, and yet those are products for which the risk/benefit ratio is usually well understand and favorable overall. The only way people can take therapies that have no sound evidence to support them is because they think a) there’s a reasonable chance they will work, which is ususally the result of something positive they’ve been told or read, b) they think they’re safe, which is often but not invariably true, and c) they think they will be able to accurately assess the effectiveness of the therapy for them based on their experiences with it, which is demonstrably false. So my role as I see it is to try and explain why these assumptions are not reliable so people can make free decisions with adequate and accurate information.

I agree with a lot of what you say and respect your role.

I also would not mind if the government got involved in doing more of that work, but again that’s a somewhat separate political question.

I wouldn’t mind either.  My post and my ‘zeal’ is against people who want to ban CAM altogether and having spoken to many people this week about the silly overdose stunt, it backfired enormously. They all thought they were loonies.

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Posted: 19 February 2010 05:44 PM   [ Ignore ]   [ # 45 ]
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skepticeye,

Well, as far as the politics I suspect we see the world so differently, we’re not going to find much common ground. I see useless as just as bad as directly harmful. If your child is dying of cancer and someone sells you a useless treatment with the implication or direct statement it will help, you and your child have been harmed as much as if they sold you something toxic in and of itself, and such should be unlawful. Alcohol and tobacco are apples to oranges because they are sold as recreational products, not as medicine. I’m all for allowing people to poison themself recreationally as long as they don’t do harm to me or drive up the cost of my health insurance, but that’s a totally different ethical issue than allowing people to sell as medicine stuff that is no such thing.

You keep claiming I want to “ban CAM alltogether” and that isn’t my position. My position is that one should not be allowed to make false or unproven claims when marketing a medical therapy. DSHEA bans “prevent and treat” claims, though this is often ignored by CAM providers and certainly rarely enforced by the FDA. However, even within the lettter of the law are many claims that are false and misleading, and as far as I’m concerned constitute lying for profit (aka false advertising), and I don’t see the legitimacy to the argument that such deception is a right to be protected from government interference. I’m not for banning CAM if it can demonstrate it does what it claims. Chiropractic reduces idiopathic lower back pain, acupuncture can reduce the perception of pain and nausea, and there’s nothing wrong with selling or using these CAM methods for these purposes. But homeopathy doesn’t prevent malaria or treat AIDS, and selling it for this purpose is unethical and should not be legal.

As for the issue of direct harm, if you’re not willing to look at the evidence I provide then you’re simply choosing to believe what you want to without considering the arguments against your position, which is not a skeptical or rational approach. If you prefer that I post the individual citations directly in the thread rather than a link to them, I can do that, but there are hundreds of them and if you really wish to evaluate the quality of the evidence for itself you’re still going to have to read the articles. If you don’t care to do so, then I submit you shouldn’t make strong claims that CAM is overwhelmingly harmless because you haven’t fairly looked at the evidence against those claims.

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