Complementary medicines’ problem with evidence

Evidence aplenty for complementary medicines-by ex-head of the AMA-Take THAT Friends of Science-enemies of truth!

Anti-vaccine lobbyist Meryl Dorey seizing legitimacy from Dr. Kerryn Phelps

Last week Dr. Kerryn Phelps wrote an article for The Australian defending the view that alternatives to medicine are in fact, a type of medicine.

The article’s heading, Evidence aplenty for complementary medicines itself touched on a unique feature of the massive Wellness Industry. Semantics. We have witnessed natural medicine become alternative medicine become complementary medicine become integrative medicine or more frequently complementary and integrative medicine. These are semantic costume changes designed to market integrity. To divert attention away from the fact that evidence for the efficacy of alternatives to medicine is lacking. Simply put, this is not medicine.

Dr. Phelps criticised Friends Of Science In Medicine [FSM], suggesting their “agenda was a declaration of war”. Yet I would conclude FSM are providing a long overdue and organised response to the rise of demonstrably non efficacious and potentially dangerous practices gaining undeserved academic credence. These have always shared a hostility toward evidence based medicine and science itself.

FSM president Professor John Dwyer writes:

We strongly support sound research to determine the effectiveness or otherwise of any biologically plausible areas of ‘alternative’ interventions. We do not seek to prevent consumers from making informed choices about alternative interventions, but wish to see the public better informed and therefore protected from false claims.

I do not doubt for a moment that Dr. Phelps and many other GPs who support alternatives to medicine are above reproach. Nor am I suggesting that all naturopaths and chiropractors (for example) are incapable of establishing a meaningful patient-focused reciprocal relationship with conventional medicine. What I am suggesting is that they are a minority and it is thus in error to suggest alternatives to medicine are generally based on evidence. Dr. Phelps’ insistence that these practices “compliment” or effectively “integrate” with conventional medicine is simply wishful thinking.

I strongly agree with Kerryn Phelps in that individuals taking more responsibility for their health is positive. I support and defend the right of patients to have more choice in managing their health. What I find deeply troubling is that once these two conditions are met, patients and wellness consumers are faced with bogus claims, unnecessary expense and a cornucopia of charlatans. That this is in no small part due to paper tiger regulation reflects that the system itself is broken and failing Australians.

That 19 of Australia’s 39 universities offer courses in scientifically implausible practices is alarming. The role of FSM in highlighting the perils of affording academic credibility to these practices is vital. It can be argued, as Dr. Phelps has previously, that universities will ensure rigid standards are met. Or as now, that FSM should support “an increase in university-based education for practitioners”. Sound reasoning to be sure. Until one considers that these very practices depend upon denial of the scientific method and graduates often emerge highly defensive of an ideology.

There is also an inescapable convolution of practice, integrity and accountability. A belief system associated with one modality may open the way for increasingly absurd practices. The anti-science, anti-medicine, post modernist culture so crucial to new age chiropractic is conducive to opposition, not integration.

This convolution raises the question of where the line is drawn. Few understand what constitute homeopathic principles beyond assuming they provide a “natural” therapy. Yet I would be surprised and disappointed if Dr. Phelps agued it had a role in medicine beyond placebo. Basic chemistry confirms there is no ingredient at all in homeopathic products, beyond expensive sugar. For those who seek to understand more about this “informed choice” there await increasingly bizarre claims most often concluding quantum physics will one day reveal all. This is the same mechanism behind theta healing – even remote theta healing.

For the purposes of this post it’s important to focus primarily on Dr. Phelps’ defence of chiropractic. But what type of chiropractor? John Reggars is past president of the Chiropractors Registration Board of Victoria and present vice president of the Chiropractic and Osteopathic College of Australasia. Focused on science, he is concerned by the rise of “ideological dogma” and the anti-scientific fundamentalist training that FSM have identified as problematic. In a paper by Reggars published in May 2011 he notes that in Australia the 1990s saw a resurgence of “chiropractic philosophy” and with it the belief in VSC, or Vertebral Subluxation Complex.

Reggars is highly critical of such chiropractic pseudoscience, pointing out misuse of diagnostic treatment, schemes to “double your income”, selling the notion of lifelong chiropractic care “to an ignorant public” and locking patients into contract plans. He also writes:

For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Belief in the unseen VSC is accompanied by the insistence all disease – including infectious disease – has its origin or cure in the spine. Chiropractic is the invention of 19th century magnetic healer Daniel David Palmer. Perhaps nothing reinforces the value of Friends Of Science In Medicine better than this modern scam of chiropractic. Represented in Australia by the Chiropractor’s Association of Australia [CAA] its aim is:

To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most cost efficient and effective health regime of first choice that is readily accessible to all people.

In other words they seek to displace the GP as the primary care physician. It is impossible to broach the many areas of medicine or do the same with the many pseudosciences chiropractic endorses to elaborate on this. Yet from vitamin therapy to homeopathy new age chiropractors have a positive word. Efficacy matters not. The CAA seem to instill fear and confusion about conventional medicine as a key mechanism in their “fundamental paradigm shift in healthcare direction”.

When we understand what seeking to usurp the family doctor entails, we can see that FSM can scarcely be accused of declaring war. The article Recent Controversies in Chiropractic and RMIT courses/clinic provides exceptional insight into the very concerns FSM seek to address with quackery in universities. Palmer argued humans have “a god-given energy flow” which when disrupted leads to illness. Exhuming such nonsense and contending that the doctrine is “evidence-based education and practice”, as suggested by Dr. Ray Myers, head of RMIT University’s School of Health Sciences is shameful.

One area the CAA has chosen to immerse itself in is the anti-vaccine movement. Many graduates emerge convinced that vaccination is a toxic medical trick. As one put it, raging on Meryl Dorey’s anti-vaccine Facebook page; “Of course we don’t support vaccination, it’s the biggest medical sham since bloodletting!”. The reason for his outburst was the article Doctors accuse chiropractors of selling anti-vaccination message.

To better understand why we must travel back over 100 years. In 1909 D.D. Palmer’s son, Bartlett Joshua (or B.J.) Palmer wrote (Ref; 2003), (Ref; 2014):

If we had one hundred cases of small-pox, I can prove to you where, in one, you will find a subluxation and you will find the same conditions in the other ninety-nine. I adjust one and return his functions to normal… . There is no contagious disease… . There is no infection… . ♠

Herein lies a major problem for Dr. Phelps who is under no such illusions about vaccination. As seen above Meryl Dorey has hitched a ride on Dr. Phelps’ reputation. On another email list Dorey simply copied the entire article and sent it off with the opening line, “If only we could get her to look at the vaccination issue as well… <sigh>”.

As well?! Dr. Phelps opined in The Australian about the “us and them” attitude. Yet these two words reflect just how rusted on and integral to many who entertain alternatives to medicine the “us and them” mindset is.

Some months back Dorey was also using Phelps’ prior role as AMA president, in the AVN attack on all conventional medicine. I wondered if Dr. Phelps knew of her unofficial patronage.

Past president of the CAA, Simon Floreani, has promoted homeoprophylaxis, showcasing Isaac Golden. Anti-vaccine activist and “paediatric chiropractor” Warren Sipser went as far as testifying in the family court against the immunisation of a five year old girl. Sipser informed reporters at the time “there is credible evidence they [vaccines] may do more harm than good”. Nimrod Weiner of Newtown Chiropractic ran anti-vaccine workshops using information garnered from the same AVN to whom Dr. Phelps is “diametrically opposed”.

Weiner informed pregnant mothers at a public talk that homeopathic immunisation (water) was superior to regular immunisation. That Andrew Wakefield’s fraudulent paper attempting to causally link MMR to autism was “scientifically good”. Last July Dr. Phelps tweeted:

WIN News Wollongong recently aired a comment from Meryl Dorey claiming that “all vaccines” are linked to autism in the medical literature. This is complete opportunistic nonsense and is now quite properly the subject of a complaint to ACMA. As Jonathon Holmes observed on Media Watch “there’s evidence and there’s bulldust” and that “Dorey’s claim about the medical literature linking vaccination and autism is pure, unadulterated baloney.”

Quite right. Which raises my point on convolution again. Where do we draw the line? Of the 222 listed professional members of Dorey’s anti-vaccine group over 60%, or 135 are chiropractors. The next largest is homeopaths with 16 members, or a comparatively small 7%. Naturopaths number 15 members. Then kinesiologists, then acupuncturists with 5 and 4 members respectively. Aside from one physiotherapist and one occupational therapist, all “professional members” sell alternatives to medicine of some description.

A US study published in Vaccine showed that parents who deny their children vaccination are four times more likely to see a chiropractor as the primary care physician. When Floreani was CAA president his chiropractor wife wrote of their newborn son’s pertussis. Including [bold hers]:

We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding. Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure.

Magically, it resolved within two weeks. Which means it wasn’t pertussis but a self limiting infection and all that woo did nothing but correlate to the illness. But I am sure Dr. Phelps would be the first to agree herbs, acupressure, homeopathy and so on would do nothing to manage pertussis. It is very dangerous misinformation with potentially fatal consequences.

So not only are unvaccinated children more likely to see a chiropractor and be subject to such abuse, but by not seeing a GP they are unlikely to become a recorded notification. Officially whilst only 5% of 0-4 year olds in Australia are not fully vaccinated for pertussis they make up 27% of cases. Thus, this figure may well be conservative. Dr. Phelps must ask herself; If vaccine deniers will choose chiropractors, might chiropractors influence parents to reject vaccination? The above rubbish is by Dr Jennifer Barham-Floreani – B.App.Clin.Sci, B.Chiropractic after all.

Australian Doctor wrote in part about the study in Vaccine:

Are naturopathic and complementary healthcare providers reinforcing parental concerns and ‘anti-vaccine’ opinions or promoting exemptions, or are they providing healthcare without emphasizing vaccinations?

I hope Dr. Phelps is asking herself that question also. As I stress above I’m sure Dr. Phelps and her colleagues are above reproach. But that’s not the point. The larger message being advanced here is that alternatives to medicine not only complement but “integrate” with conventional medicine. Not only does available evidence show this is not true but to generalise is to lend credence to dangerous charlatans.

This post has focused primarily on chiropractors, because they not only serve as a hub for health focused pseudosciences, but also seek to replace the family GP. I will contend that my point on convoluted overlap is valid. Once a patient is referred to one pseudoscience how does the referring GP control for pollution as it were? More material on the dubious ethics of new age chiropractic, including catastrophic neck injury and paediatric “improvement” by parental proxy can be found here.

St. John’s Wort seems to be trotted out in almost every article claiming alternatives to medicine have an evidence base. What is forgotten is that hyperforin, the antidepressant extract of St. John’s Wort, and other extracts are both inducers and inhibitors of P450 cytochrome enzymes. These liver cytochromes are involved in the metabolism of over 50% of marketed medication.

In the case of opioid pain relief studies have demonstrated a decrease of blood plasma levels of oxycodone of up to 50% and reduced half life of 27%. In the case of alprazolzm (a benzodiazapine), prescribed for anxiety and panic attacks a doubling of clearance rate has been documented.

Chronic pain is associated with depression and depression with anxiety. Opioids and benzodiazapines are causally linked to respiratory depression overdose death. Hence the clinical significance of any “integration” of serious pain management with a herbal choice for the depression it may cause is likely to be anything but “complementary” for the patient. Many patients choose not to inform their GP of herbal supplements.

Proper diagnosis following treatment with medication will be hampered by St. John’s Wort. Excessive doses of actual medication may be prescribed. Should a patient cease St. John’s Wort whilst on opioid, benzodiazapine or both medication regimes a spike in blood plasma of the active metabolites will ensue. More likely, as St. John’s Wort is improperly regulated and dose concentration varies widely a patient may unwittingly expose themselves to respiratory depression and possibly death with no change in their daily medication/St. John’s Wort routine.

In short whilst the concentration (dose) of actual medication is stable, the drug interaction outcome due to St. John’s Wort mimics an unstable medication dose. Patients may easily find themselves unsuitable to drive, work, operate machinery, bathe or sleep without potential for disaster. Consequently many medication regimes may be deleteriously effected by St. John’s Wort.

Thus the wider picture of evidence pertaining to St. John’s Wort is not quite the basis for “integration” proponents of alternatives to medicine would have us believe.

My response to the ongoing insistence that placebo effects derived from acupuncture constitute evidence is likely to be here in Acupuncture: essential facts about a major scam. Over and again it emerges that subjects who think they are receiving acupuncture, whether they are or not, demonstrate a response.

Findings aside, how would Dr. Phelps explain meridians, invisible forces, chakra or vital energies? It is too easy to point to apparently positive findings when the mechanism by which they arise is implausible, unknown or assumed to be related to endorphin release. The technology to manufacture acupuncture needles did not exist until the 1600s and the only nation to seriously try to ban acupuncture was China under the Chinese Nationalist Government. Western marketing has done much for this “traditional” Chinese medicine.

What of naturopaths who insist on Black Salve [2]? Or who use herbal balls from China with high levels of elemental mercury, arsenic and lead? What of poor hygiene and bacterial infection from acupuncturists or masseurs? The astonishing story of Monika Milka and non-sterile syringes used in biomesotherapy, leaving her patients seriously infected with mycobacterium chelonae?

Tragic cases like Penelope Dingle and Isabella Denley indicate that the notion of integration or proper supervision is seriously flawed. One point raised repeatedly by FSM is that whilst ill patients waste time being exploited by pseudoscience acting as a health choice, the chance of genuine care, full recovery or even survival is lost.

These are the real issues Dr. Phelps could constructively help Aussies understand before raging at FSM. How is it that so many various practices have come to exist that are beholden to ideology, not evidence? How is it they can convince parents to withhold treatment from their children and in doing so undermine the health of our entire community?

FSM exists to address an unacceptable situation in our educational institutions. They have taken a stand because those in a position to defend academia seemingly chose to act unethically. When it comes to “informed choice” there is an excess of non evidence based, expensive pseudoscience. It is pervaded by a combative, arrogant anti-science and anti-medicine mindset. It is amply equipped with scams.

This madness must stop and Dr. Kerryn Phelps is most welcome to clearly state just what aspects of non conventional medicine are high risk ideology and what is safe, effective and backed by evidence. Real evidence that can be trusted alone.

Presently, there appears to be a scarcity.

♠ This quote has been attributed to D.D. Palmer. However in 2013 the Journal of the Canadian Chiropractic Association, cited the author as B.J. Palmer.

Kerryn Phelps’ support for vaccination is timely and welcome

On January 30th this year Radio National Breakfast aired a lively discussion between Professor John Dwyer, co-founder of the newly formed Friends of Science in Medicine and Professor Kerryn Phelps, President of the Australasian Integrative Medicine Association and prior AMA head.

As it so happened the AVN were delighted with the interview, discussing it on February 3rd. They immediately set to work sculpting an armour for Dr. Phelps to wear into battle for “Health Freedom”. The AVN had no doubt. If you support alternatives you would never vaccinate, their president reasoned.

In answer to an anti-medicine anecdote, Meryl Dorey commented at the time:

It just shows you [redacted], that people will pay for health but you can’t give them sickness for free no matter how hard you try. Doctors hate the competition. They know that people like yourself have left mainstream medicine because you have found something that works better. But that can’t be allowed so the scientocracy that we live in will try to control the situation so you no longer have the choice. This is what we are fighting against and it has to be all of us – healthcare consumers and healthcare organisations. If you use a natural health practitioner, get in touch with them and ask them to find out what their national organisations (CAA, ATMS, etc) is doing about this situation. It’s not the time to sit on their hands and hope it goes away. It’s time to fight!
MD

The day Dr. Phelps and Dwyer were on air Dorey published on healthcare choice, falsely accusing FSM of seeking to shut down alternatives to medicine and drive consumers into the prison of her imagined Scientocracy. I didn’t expect to revisit this article so shortly. Nonetheless… In what may be mistaken for a description of Mordor under the whip of Sauron she began:

There is an organisation in Australia which hates every natural therapy. They hate the healthcare practitioners and they hate the healthcare consumers who ‘turn their backs’ on Western medicine in favour of a range of other modalities which put no money in their pockets and take away their prestige. Worst of all, they hate anyone who chooses not to use vaccines! That is the ultimate heresy, as far as they are concerned.

But it’s OK – because they have a plan and they have the money and media backing, they think, to bring this plan to fruition. This group, the Australian Skeptics, has been instrumental in setting up the organisation, Stop the AVN.

Now, they are working on a new initiative – and this one is more ambitious then just stopping a small, parent-run community support group. Now, their goal is to stop anyone in Australia (today Australia – tomorrow the world as far as this bunch of ratbags is concerned) from learning about or using natural therapies. Their mad campaign is getting plenty of publicity too!

They have just set up a new front group called Friends of Science in Medicine (FSM) which is behind the new effort to outlaw the teaching of any natural medicine course in University. This organisation ultimately wants to shut down homeopathy, chiropractic, acupuncture, naturopathy, herbalism, ayurvedic therapies and on and on. In their unspeakable arrogance, they claim that there is no evidence for therapies which have been used safely and effectively, in many cases, for thousands of years. Instead, they say, we should all be forced to exclusively rely on mainstream medicine with its dreadful record of poor safety and effectiveness!

By February 17th, Dorey was using Kerryn Phelps as a proxy figurehead for this nonsense. As someone who uses the term “alternatives to medicine” and cringes at the “integrative” semantics, I don’t agree with Dr. Phelps on many non conventional medical issues. Yet Dr. Phelps’ Uclinic is unmistakably professional. Was Dorey serious or just ripping off Dr. Phelps’ image? Was a prior head of the AMA honestly backing Dorey’s new attack on FSM? On conventional medicine? On vaccination?

I tweeted, and seven minutes later received an honest, slightly baffled reply:

Oops. Rather tactless of me. But, as Meryl had written on February 8th:

Excellent observation. It continued to come true.

Predictably, Meryl Dorey had forged a fiction around Dr. Phelps’ role as President of the Australasian Integrative Medicine Association. It must have chafed somewhat to be reminded Dr. Phelps is a GP, supporter of vaccines, proponent of necessary vaccination rates and “diametrically opposed” to the activities of the AVN.

A close follower of the #StopAVN tag, this must have shattered Meryl’s very black and white world view of health care and practice. One is either against the evil of medicine or a skeptic and actively involved in a plot to enslave humanity to illness. At least that’s the battle cry we see in place of actual evidence to challenge evidence based medicine.

Could it possibly get any worse for Dorey? Dr. Phelps wouldn’t retweet anything from strident Dorey critic, that nasty Mia Freedman would she?

Oh.

Poor Meryl has to absorb someone with extensive experience could be a GP, proponent of non conventional medicine and conventional medicine, opposed utterly to the AVN whilst actively supporting and promoting vaccination. Still Dorey peddles homeoprophylaxis and is fanatical about the long dead association between autism and vaccination.

Last night Dr. Phelps happened to tweet in conversation:

@Havenr64 is convinced vaccines do cause autism and took umbrage to an article Dr. Phelps had written in Medical Observer ♣. Entitled It’s time we objected to conscientious objectors, it is a splendid article with excellent timing. Most importantly however is that Kerryn Phelps is a real doctor, with actual research and a life time of genuine experience backing her.

Health consumers who are cautious of conventional medicine or interested in “alternatives” would do far better to seek similarly well balanced advice. Those questioning vaccination, and not trusting their GP, would also benefit enormously from seeking advice through the Australasian Integrative Medicine Association.

The last person to trust is Meryl Dorey or her Australian Vaccination Network. Dorey profits from ensuring you will not trust vaccination. In truth your “health freedom” or choice is abused from the moment you make contact. If you believe the path to making sound choices on vaccination is to donate money to fund a “fight” between imagined forces, you have been conned handsomely.

Nicola Roxon and Jenny Macklin announced the Stronger Immunisation Incentives last November. It was a poor read of the antivaccination movement. Dorey seized immediately upon the option of conscientious objection not being promoted as the primary variable by the government. Claiming details weren’t present at all in Roxon’s announcement, they were actually prominent in the centre of the text. Still, today Dorey has exhaustively promoted how to receive the immunisation incentive without having children immunised.

Kerryn Phelps writes:

HOW far are you prepared to go to engage with so-called “conscientious objectors” to childhood immunisation?

Everyone has a line they will not cross. The line for informed consent gets very blurry when it comes to the proxy consent provided by parents on behalf of their children. […]

As GPs we are convinced of the merits of immunisation against the vaccine-preventable infectious diseases that were so feared by previous generations who did not have the benefit of effective treatments or prevention. […]

I hesitate to even mention groups such as the Australian (Anti-)Vaccination Network.., but… I feel I can mention the harm they are doing to public health with their misinformation campaign aimed at scaring parents away from immunisation.

Parents have been encouraged through various government incentives to have their children fully immunised before starting school.

However, from 1 July the system changes. The PIP incentive for doctors has been scrapped and parents will need to document that they have fully vaccinated their child in order to receive the Family Tax Benefit Part A Supplement of $726.35 per child. […]

If parents want to claim the money, they have to demonstrate that their child is fully immunised, or have their doctor complete documentation that they are a conscientious objector.

One of my colleagues told me last week that she intends to be a conscientious objector to conscientious objectors. I must say the idea appeals to me.

When parents request that she fills in the government form indicating the child is exempt on the basis of parents being conscientious objectors, she will politely indicate that is against her principles and advice, and will refuse to provide the documentation. […]

It is a convincing argument. Ethically doctors wish to support their patients’ choices. Yet with vaccination, rejection of this nature is not a choice, but a clear mistake. A cursory grasp of the manipulation at play to scare parents off vaccinating their children is alarming. An understanding of the entire abusive scam should be regarded with concern and disgust.

Presently parents are objecting because many feel there is this attack on their freedom of choice. A read of Dorey’s material finds the same theme over and again. Forces seek to control. Why is the default position vaccination? You are being told what to do. Health fascism. Loss of health choices… etc. It’s an appeal to emotion, not intellect. Vaccination is cast as a mockery of individuality, of democratic freedom.

Fortunately Dr. Phelps is a voice of reason at a time when false dichotomies are used to fool those who seek more natural choices, to also fear vaccination. A wedge has been driven into Meryl Dorey’s fictional scheme. No longer is it simply “us and them” as her members pay dearly to hear. False balance need no longer be the only choice.

This isn’t unique. Most natural therapy organisations recommend conventional vaccination. Chiropractic and homeopathy are two that mislead clients about vaccination. What we certainly lack is a public voice bridging the unnecessary gulf between vaccination and non conventional medicine. It is certainly time to detach the choice of alternative medicine from refusal to vaccinate.

I for one am very grateful to Dr. Phelps for making her views known.

– ♣ Subscription to Medical Observer is free.

A response to the defence of chiropractic

Paul; your writings are amusing, but you have only 183 followers! My 14 year old daughter has three times that on a silly facebook page!

In the spirit of genuine laziness and as one of the “waspish witch-hunters of political medicine”, I’ve reproduced my response to a comment on the About page written by a giant in the art of selective topic pertinence.

Keith. Mate!

Your daughter has a bigger number than mine. On Facebook! Well, I’m sure that every one is a dedicated and true friend engaged in a deeply meaningful personal relationship. Or… maybe quality isn’t what matters, if I’m to take the meaning.

Yes I agree chiropractic will be around for years to come. Chiropractors will tweak and change to keep in line with shifts in superstition and trends in gullibility to ensure they maintain a large slice of the health scam market. They will also fight and defend like skilled con artists and fraudsters to hold onto the empty title of “doctor”, being only too aware of the psychology that drives the gullible to their doors. Mimicry of actual medicine and misuse of technology is vital to the illusion.

Also I agree on the history. Palmer certainly wasn’t the first person to rattle and dance, poke and prod whilst intoning godly laws about the human body and human health. He was however the first to market his touchy brand of magic as “science” and made liberal use of the most modern tools at his disposal.

I note your journey to last century to exhume the Wilk case. A splendid diversion. Yet since then, not only was your daughter born but chiropractic shifted into a fundamentalist ideology that denies every rule of medical science and the very laws of nature itself. Of its own accord it has become the “go to discipline” for glowing appraisals of alternatives to medicine and solemn condemnation of conventional medicine.

More so, it has again of its own accord inserted itself in serious health debates way beyond the beliefs ensconced behind the battlements of its extra-dimensional reality. The vaccination issue. Pre natal, neo natal and extended post natal proclamations designed solely to scare vulnerable and gullible new parents to sign those lucrative “treatment contracts”. Paediatric chiropractic – perhaps more amusing than you realise if not for the conclusive demonstrations of inefficacy.

To my knowledge the only scheme to actually provoke symptoms of Munchausens Syndrome By Proxy it is responsible for creating nervous wrecks and genuine psychological patients of innocent parents. The invention of “syndrome” after “syndrome” and the terrifying warnings of what awaits those who do not succumb to regular “maintenance”.

However as we read in Quacks galore in facade of quirky medicine:

SCIENTISTS spent $374,000 recently asking people to inhale lemon and lavender scents to see if it helped their wounds to heal. It didn’t.

The National Centre for Complementary and Alternative Medicine in the US also outlaid $700,000 to show that magnets are no help in treating arthritis, carpal tunnel syndrome or migraines.

The centre spent $390,000 to find that old Indian herbal remedies do not control type 2 diabetes and $406,000 to prove coffee enemas do not cure pancreatic cancer.

It’s the same story around the globe. One by one, weirdo treatments are being exposed as bunkum.

Why are people so gullible, handing over their hard-earned cash for unproven alternative therapies? […]

Latest research says dietary supplements and megavitamins, acupuncture and chiropractic are of little use – and may even be harmful. […]

Chiropractors have now been discredited by every reputable medical organisation from the Royal Society down, yet people still spend up on these bone-crunchers and state and federal governments seem unwilling to shut them down.

Recently I reported on two experts on alternative medicine who reviewed all the evidence and concluded chiropractic was “worthless”.

“Harmful, worthless, discredited by every reputable medical organisation from the Royal Society down”. Keith, mate! And that’s coming from proponents of alternatives to medicine.

Like all magical claims chiropractic has been sternly examined and found wanting. Claims of efficacy crushed under the simple application of RCTs and its claims of safety evaporate before a monumental collection of research into death, permanent injury and disability or injury and complications with frequent cases of lengthy recovery. To be sure this happens in medicine also but to those already on death’s doorstep, significantly ill, disabled or in need of life saving surgery. And they are well informed of the risks that apply to a strictly evidence based choice.

That chiropractors scheme and trick people who are absolutely perfectly healthy – indeed many fatalities in robust health, the prime of life – to believe they need attention is itself a grave insult to common altruism and a thunderously immoral application of psychology. That healthy and vital people can be killed or injured and experience levels of morbidity that equal high impact vehicle accidents is a statement about chiropractic no-one can ignore.

Again addressing your mine’s bigger than yours argument I note the “fast-dwindling group of activists” reference. Of course nothing could be more inaccurate. Advocacy for science based medicine and skeptical defence and examination of consumer rights in health and beyond, is at an all time high. But it is not quantity that matters, and your obsession with quantity reveals your lack of appreciation for quality.

It is evidence that matters. Including evidence explaining what drives the interest in so many health scams we have seen rise up of late. The search for Truth is indeed vital, but skeptics and other scientists will accept the evidence as it comes. This happens to include that which explains the manipulation of individuals to believe the equivalent of magic is fact. Should the evidence indicate an increase in the future this too will be sought for further elucidation.

To comment on evidence gleaned from the methods that can be trusted to inform us of our world is not to be waging war. Much less a “self created turf war” as you put it. Of course people will continue to believe in fallacy and illusion. Magic has been a feature of our species for countless thousands of years, yet today we can discern the mechanics by which false displays are executed and the primary role of the believer themselves.

Many things will persist with health scams. Wars, cults, belief in the supernatural and our disposition to internalise superstitious belief to name a few. People are hard wired to believe in fantasy. Yet in a democracy I would not have it any other way for it reflects on my freedom. Your real concern should be with a.) the lack of evidence for chiropractic and b.) the ultimate goal of regulators.

Seeking to impede exploitation of fellow community members when evidence irrefutably confirms this, is the democratic right of skeptics and science advocates. When perpetrators of scams confirm malignant intent by misrepresenting evidence it becomes a moral obligation – a duty to our species.

Of course, with real freedom we find expression and belief should not be inhibited. In this light the freedom to be stupid is your democratic right.

I too have found great amusement in this exchange.

I fear however, your return to the lives of schoolgirls on Facebook is perhaps well justified.

Here’s lookin’ at ya Keith.

Selling Dehumanisation To The Dehumanised

One aspect of the anti-science, antivaccination movement I find compelling is their need to sell the belief of being dehumanised, whilst at the same time mockingly dehumanising mainstream behaviour.

Added to this is implied alienation of followers who may manifest, sometimes quite trivial, independence. Thus the goal of an antivaccination lobby is to largely create the illusion that a threat to the Self exists.

Yet at the same time this threat must be far worse than the ongoing cost to the Self that followers already pay. Such as money, the cost of implied alienation, lack of independence, having no control over leadership or methods employed. 

A great deal of anti-science and particularly antivaccination rhetoric is devoted to the promotion of impending danger. Imminent compulsory vaccination. Financial entitlements being taken away.

Your “health choice” being under threat is bundled more and more with outrageous fantasies about modern medicine failing at every turn and personal attacks on the integrity of those who suffer because of vaccine preventable disease or from ignoring medicine.

The success and failure of meeting this goal also depends greatly upon how well followers can be fooled into thinking the greatest democracies on Earth are in fact dehumanising the public. Next comes selling the cost to Self as an investment, an escape from guilt, more fear or a way of belonging. Presenting themselves as persecuted helps to provoke outrage in would be donors.

Antivaccination, anti-science and anti-conventional medicine proponents:

  • Promote the notion that governments and science institutions dehumanise
  • Promote the notion that social conformity is a symptom of dehumanisation
  • Exert retribution (usually public ostracism) upon followers who seek to express independence
  • Convince followers through guilt and fear to contribute a material cost to themselves
  • Strive to trap followers between the illusion of dehumanisation and the reality of manipulation
  • Continually refer to “an enemy” when none exists
  • Succeed in prompting followers to act antisocially thus, actually dehumanise

A short while ago Mia Freedman wrote an article on the perils of favouring Google over advice from trained professionals. Meryl Dorey of the Australian Vaccination Network Inc. attacked her immediately whilst threats and abuse from antivaccination followers (Point 6 above) rolled into Mia’s social network and email accounts.

There’s no doubt that a number of parents concerned about vaccination wanted to have a say on the AVN Facebook page. Any comments that sought common ground were deleted and the person abused. The connotation was clear. There is no middle ground. No understanding, no compromise, no evidence. One member, who also enjoyed Mia’s work on Mamamia commented twice. The second included:

… why are you being so mean? You do realise that lots of people – genuinely curious people – will come to this page after reading Mia’s column? If I were you I’d be using the traffic to make a reasoned argument in a friendly forum. Mocking and insulting a well loved and popular writer (even if you disagree with her) is not doing your cause any good.

Both of this member’s comments are now gone.

In fact a thread of over three dozen comments has been culled down to 12. To top off application of Point number 3 above an administrator posted the image to the left, with a reminder not to “feed the trolls”.

One might guess it’s a bit of damage control. Having just banned genuinely curious readers and members who dared speak their minds it’s time to apply Point number 2 above.

Any reference to social responsibility or consideration of vaccination or even independence must be labelled “the enemy”. In this case the AVN want members to believe – and many do – that you could only query an AVN stance if already dehumanised. A mindless sheeple with nothing to contribute.

Another tactic to also convince members they should comply to demands for a “greater good” is the abuse of quotes from famous thinkers. I particularly like this once from scientist Albert Einstein, used to advance anti-science agendas by the AVN:

Quote abuse is simply rampant in conspiracy circles and Ms. Dorey is an obsessive user. This one from Margaret Mead is her favourite:

Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has

Of course a quote can be used in almost any context. Horribly, Andrew Wakefield and other “committed citizens” just like Dorey already have changed the world. If I were to use a quote by Mead it’d be Children must be taught how to think, not what to think, which is arguably the antithesis of the antivaccination approach. Much like severe religious adherents the in-group cult-like observance of the anti-science movement is on constant guard from the “dangers” of a world offering education, robust health, extended lifespan and complete freedom.

Filling their children’s heads with fear, alienation and nonsense is regrettably a symptom of deeper psychological issues that drive some parents to exploit what is a proxy of their own instability. We’ve all seen the photos of “unvaccinated and healthy” kids. Dorey is even calling for them to place on her website. Why? What type of person exploits children for a reason that a child cannot possibly understand?

The same who attend pox parties, intentionally seek out measles infection and crop their brand new babies life potential by fleeing hepatitis B immunisation despite certain maternal transmission.

Indeed it is the very presence of such bizarre movements that usurps the claim of genuine resistance against so-called foes. Foes who supposedly seek to suppress their rights of expression and choice, appear strangely absent. Consider Mike Adams “Vaccine Zombies” attack on the 90 plus percent of people who choose to vaccinate. So dehumanised are these sheeple they’re also made into zombies by the vaccine itself.

Added to the abuse of quotes is the association with giants of history, just in case you missed the nobility meme. They laughed at Galileo. The Vatican executed Giordano Bruno. Columbus was mocked as a madman.

But, then again, as Carl Sagan said:

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

Sagan reminds us of how ridiculous it is to believe that opposition is proof you are a genius who will one day be a household name. Or that those who patiently explain your errors are malignant forces. Yet how do you reason with groups like the AVN or Age of Autism who use terms like “health fascism”?

You’ll notice Meryl’s tags include “McCaffery”. Yes, with “Health Fascism”. Her gutter level record in attacking this family is truly shocking – as recent events indicate.

Age Of Autism

Meryl Dorey – AVN

Today Meryl Dorey managed to combine all the bullet points in one mad retributive “survey” in response to Have Vaccine Critics Made You More Of An Immunization Advocate? This piece offers some great insight into how antivaxxers are sabotaging their stated goal.

But then, what is their real goal? As is pointed out Adams makes millions from selling magical (but untested and impurity laced) “potions” and “solutions” purporting to reverse the damage vaccines do. Without vaccination his business would vanish. The amount of lead, arsenic and mercury found in “original” Chinese herbs is testament to their lack of quality control. He’s a typical con artist and crook, also harvesting and selling to spammers the email addresses readers must supply to finish his articles.

Dorey herself profits only from doom and gloom. Fighting funds abound. The more enemies identified the more reason to ask for money… to save oneself by keeping the AVN ready and willing to support your choices. Never mind that not one of these choices is under threat. From 2004 – 2010 $1.8 million in profit rolled in to the AVN. To my knowledge not one promised project  – not one – has been drafted much less completed. Where is the money?

So, wham scam thank you m’am, onto the survey.

A rather fascinating meander, is it not?

Parents who choose not to vaccinate are often better informed than their doctors on this subject. But today the effort to restrict our right to choose – not only whether or not to vaccinate but whether or not to have access to natural therapies – is being threatened like never before.

This is quite misleading. No data indicate such parents are “better informed”. Ms. Dorey has made that up. No threat to inhibit natural therapy choice exists beyond the growing requests to justify placebo based therapies (sold at exorbitant prices) with evidence.

Ironically it is a fact that the push for Conscientious Objection has backfired. Doctors actually are reporting that once provided with both sides – not just the antivaccination side – parents are significantly more likely to choose vaccination.

Yes some doctors are refusing to see non-vaccinating parents. And this is where I’m sick and tired of hearing Dorey use the terms “freedom” and “choice” specific to basic child abuse. This is not a choice being made. It is a mistake.

The survey itself is simply:

Again this is deceptive. “Informed vaccination choice” is once again code for child abuse. At best, code for “using my child to tell Big Brother to get lost”. Yet look at the final option: “I’m too scared to openly support the AVN”. I’ve no idea what it’s doing on an anonymous survey beyond pushing the notion of a non-existent enemy.

Whilst there are examples of mothers retracting stories from Facebook following attacks by Meryl, I’m not aware of the opposite trend. This is more clever manipulation to keep followers undecided, fearful of unseen and arbitrarily described “fascist”-like enemies whilst dehumanising devotees who actually believe their choices, freedoms and health are under threat.

As tragic as it seems this argument is moving on many levels well away from any dissemination of evidence. Appeals are being made to basic human instincts. Reward and ostracism of antivaccination followers is based almost entirely on acceptance and accusation respectively. Parents are being fed increasingly absurd deception, around increasingly irrelevant notions for demonstrably fallacious goals.

On the bright side, as annoying, offensive and nauseating as this now is it’s a change that will drive uncertain parents well away from the line of fire.

That of course, can only be a good thing.

Manipulation, not gullibility may be driving alternatives to medicine

We hear so much about what alternatives to medicine are not doing, it’s perhaps worth pondering what they might be doing.

Beyond producing a placebo effect, which I stress is nothing to sniff at, it seems we can articulate other accompanying features we would do well to understand. One usually thinks of prescription writing conventional doctors upon hearing expressions like “we expect a pill for every ill”. This is not without good cause. As we saw medicine leap forward and family consulting rooms multiply, the gap between symptom severity and seeking attention quite naturally narrowed.

Yet whatever was going on in our minds that modified our part in closing that gap is a restless beast indeed. Part worry, part suspicion, part urgency, part ignorance, part arrogance, part fear, part expectation, part assumed knowledge and more, it can play a role in convincing us we’re ill – or far more ill than we are. Doctors now know that pandering to this aspect can lead to over-prescription, self medication and hypochondriacs. As a result the medical profession has learned how to manage certain traits with placebo and/or skilled bedside manner.

However, the industry to far and away exploit the sole notion of people needing attention for absolutely no reason is the so-called Wellness Industry. It is aptly named, proffering entirely useless or arguably harmful potions, rituals, observances, gizmos, pokes, prods, states of mind and more, to the entirely well.

But why? As one woman informed ABC’s Lateline some time back as they examined the scams used by chiropractors, It’s “…maintenance… making sure everything’s working properly, making sure everything’s working at its best”.

Sure enough the chiropractor asked her to bend to the left, then right. “How that going for you?”, he asked in the tone real doctors might use when examining an actual problem. The woman gets a check up every 4 to 6 weeks. The question we need to ask is about the driving force for her to ask someone if she is in good health. Is it a type of hypochondria? Is it a type of “self medication” in which one seeks out excessive treatment? Is not this chiropractor simply pandering to a psychological state, when his best advice would be to encourage less dependence?

I’m sure she felt better after paying, because just like with Cold Reading all the action occurs within the patients mind. In this case a complex array of cues, sciency stuff, repetition, anatomy posters and models, machines that go “Bing!”, tones of voice and even payment lead up to a nice squirt of dopamine upon completion. The woman is simply conditioned to associate the entire hanky panky with feeling good and thus, better health.

Of course take away this experience without the woman’s consent, and the more time that passes the more anxiety will mess with critical thinking and the usual creaks and twangs she’d ignore become directly attributable to not making it to her “maintenance”. This is the truly brilliant aspect of Wellness Scams. Even when their “patients” are well away from them the urge to return is steadily growing.

People don’t need chiropractic rituals as “maintenance” of health. Thus to continue to exploit this woman is unethical abuse simply for monetary gain. Get them hooked on this notion and it’s easy money. When challenged for evidence of efficacy these visits are trotted out, as if volume of attendance equates to success.

This is why chiropractors, shady nutritionists, reflexologists, reiki magicians, homeopaths, traditional therapists/masseurs work so hard at reinforcing “hits” between their scam and the patient verbalising an association. In the case of New Age diagnostics – often combined with a “therapy” (say iridology and vitamin therapy) – it’s quite simple to create a syndrome that just might be about to run amok.

“Hmmm. We’d better double the selenium, calcium and vitamin E and get you to come in at least twice a week. Let’s see if we can’t nip this in the bud, shall we?”.

It is actually a welcome trait seeing individuals wanting to take more charge of their own health. Certainly that plays a role in the viability of ongoing pseudosciences that masquerade as health services. Perhaps combined with the highly visual and ritualised capers pretending to offer health people are feeling in more control of their health than with brief doctors consultations. It may be that in our present uncertain world of such frequent change to once permanent features, that one seeks out modes of reassurance.

What is certainly a concern is that as people seem intent on taking more control over, and playing more active roles in their own health management, there are charlatans highly skilled at taking advantage of human needs. Nothing is too  difficult for them, nothing cannot be understood, all can be managed and all will be well.

At the top of the scam pyramid reign chiropractors, at once tuning, “diagnosing” and “curing” entirely made up syndromes that engender fear, anxiety, poor decision making and dependence upon ritual in innocent people. So good are chiropractors at this that pregnant patients, fed lies about the needs of newborns, express an impatience for delivery. All so that their neonate can begin chiropractic and thus, start to overcome the abnormalities they believe all children are born with.

Chiropractors run workshops on increasing income. The malleable state of women in a state of hormone flux either side of gestation is well understood. Not for the “patients” benefit. For the benefit of profit born of maternal anxiety and parental fear. It becomes a matter of urgency. The longer left, the more “abnormal” the child will be. Antivaxxers make use of the maternal instinct also, as do renegade home birth groups.

It’s a trait that has served our species well. If mum receives bogus input suggesting the foetus or bub is under threat, no harm comes to either if mum acts upon it. But if mum hangs around to weigh up the risks or ignores constant cues for some time and the risk is real, the chance of this remaining as a successful evolutionary trait is zero. The strength of this trait is notable in that addiction to harmful substances can overrun it. Yet this is following changes in the reward-pleasure centre of the brain, that then initiate neuronal projections into the frontal lobe that serve to inhibit reasoning, decision making, self control and inhibition of behaviour.

Antivaccination lobbyist, AVN member, anti-medicine advocate, homeopathic immunisation promoter and chiropractor Simon Floreani who has children making up 60% of his client base once told Today Tonight:

Babies often come directly from the hospital. They’re referred from the obstetricians, the doctors, the pediatricians, the nurses because chiropractic care’s so safe for them. Many of the current medical procedures just don’t work and parents aren’t silly. They’re looking for good alternatives from people that care and are prepared to look into diet and lifestyle.

As one time Skeptic of the year, Loretta Marron contends, “what they are is faith healers”. Traditional chiropractor John Reggars insists it’s a case of self limiting conditions or perceived changes. From an evidence viewpoint there’s nothing to support chiropractic – even with sore backs.

Update: In fact studies of infant crying and chiropractic therapy suggest treatment reduces crying have a high risk of performance bias. Indeed as parents are the assessors the results may be shared by parental belief. This Cochrane review of infantile colic and chiropractic notes (p.2);

However, most studies had a high risk of performance bias due to the fact that the assessors (parents) were not blind to who had received the intervention. When combining only those trials with a low risk of such performance bias, the results did not reach statistical significance. Further research is required where those assessing the treatment outcomes do not know whether or not the infant has received a manipulative therapy.

There are inadequate data to reach any definitive conclusions about the safety of these interventions.

It’s important to realise that this review concluded the above based on “most studies”. It has consulted this RCT by Miller, Newell and Bolton (see p.25 of Cochrane review), and still found data to be inadequate to reach definitive conclusions.

Thus potentially, if parents think the infants are getting treatment they may be reporting improvement even if there is none. Conversely if they believe the child is not being treated when it is, they may report adversely. /Update

The Courier Mail reported recently:

SCIENTISTS spent $374,000 recently asking people to inhale lemon and lavender scents to see if it helped their wounds to heal. It didn’t.

The National Centre for Complementary and Alternative Medicine in the US also outlaid $700,000 to show that magnets are no help in treating arthritis, carpal tunnel syndrome or migraines.

The centre spent $390,000 to find that old Indian herbal remedies do not control type 2 diabetes and $406,000 to prove coffee enemas do not cure pancreatic cancer.

It’s the same story around the globe. One by one, weirdo treatments are being exposed as bunkum.

Why are people so gullible, handing over their hard-earned cash for unproven alternative therapies?

Why do usually sane people get sucked in by pseudo-scientific fiddle-faddle such as homeopathy, reiki, reflexology, naturopathy, aromatherapy, iridology and crystals? […]

Chiropractors have now been discredited by every reputable medical organisation from the Royal Society down, yet people still spend up on these bone-crunchers and state and federal governments seem unwilling to shut them down.

Recently I reported on two experts on alternative medicine who reviewed all the evidence and concluded chiropractic was “worthless”.

Professor Edzard Ernst and Peter Canter found no convincing data to support claims the technique was effective.

With the possible exception of the relief of some back pain – where spinal manipulation is as good but no better than conventional treatments – the technique is worthless, the review in the Journal of the Royal Society of Medicine concluded.

Another impacting feature is the “legitimising” tricks buffering complete rubbish. “Diplomas” in homeopathy. “Degrees” in chiropractic. The meaningless but very powerful use of the term Doctor. Flashy titles given to Boards or National Bodies. Misleading titles such as The Australian Vaccination Network that supports zero vaccines calling them “instruments of death”. “Pro-choice” groups. All this is strictly designed to mislead from the outset.

Yet I’m not sure asking only about gullibility is enough. Gullibility persists often due to a conscious decision to not examine criticism of what has become a comforting belief or set of beliefs. More so we are hard wired to seek out information that confirms what we think we know as fact and associate with people who reinforce our beliefs. Even internalising contradictory information about our beliefs can in time lead to reinterpretation that reinforces the opposite of the information we took in. Cognitive bias is a powerful master.

An admirable foe to conventional medicine who pops up here, Meryl Dorey, completely dismisses the findings above. Yet, when criticising vaccines she relies upon respect for the same scientific approach. “The gold standard of scientific research”, she argues, is the Randomised Controlled Trial. As RCT’s mow down alternatives to medicine Meryl insists that until vaccines are subject to RCT’s they cannot be regarded as “properly tested”. Although Meryl is beyond reason (as evidenced by this level of ignorance about how RCTs work) it’s a fine example of how belief can eliminate respect for evidence.

Perhaps we should be asking more about what leads people to internalise so much misinformation about the world we live in and the basics about how it works. So much of the market sustaining disproved alternatives to medicine also accept without question that our environment is highly toxic, it pollutes our health and natural new age “cures” are needed. They also believe conventional medicine, hiding the truth about “natural cures”, is irrevocably corrupt, peddles poison as medication and is ironically creating a world of sickness from which it profits.

Much of this is provided to them from so-called “alternative practitioners”. Detox’ is necessary. No, it’s quite dangerous. Medicines treat the symptoms not the cause. Quite true, I hasten to add in many cases. I’m just not sure why this is assumed to be a blanket flaw. Figures on medical mishaps draw concern. Yes real doctors are accountable and mishaps are still a small percentage. Adverse reactions from drugs prove medicine is lethal. Quite wrong. Primarily ADR’s underscore patient error, and again given the millions of scripts dispensed is another small symptom of accountability.

The truth is, Conventional Medicine is not peddling sickness and keeping you ill for profit. But Alternatives to Medicine are profiting from the false belief you need maintenance and from keeping you splendidly ignorant.

This continued misinformation about real medicine takes up an exorbitant amount of the message coming from the supposed “complimentary”, “alternative” or “integrative” chapters. From antivaccination messages to the vast bulk of alternatives to medicine the claim of “efficacy” is buoyed upon a childish notion. “We are good, because they are bad”. The more “bad” squeezed in the less the need for evidence to show Theta Healing could possibly work or that oscillococcinum isn’t plain nonsense.

Still this doesn’t explain everything and I don’t imagine I could. What causes one mother to accept antivaccination hogwash in a maternal embrace and another to sink her teeth into its carotid artery, so to speak? Personal experience can shape belief but even here outside forces tend to be the final decider. Certainly scientific literacy and the awareness that one must trust experts in certain fields is crucial to good decision making.

Alternatively, having “researched” every crackpot self affirming, disreputable source whilst avoiding reputable – indeed any source – material is intellectual sabotage. Likewise being affluent and highly skilled in one area doesn’t immediately make a person “educated” as the media insist on telling us.

At best one could argue that so many scams continue to attract patronage because they offer an emotional and psychological package of oneself taking control. Lengthy consultation sessions provide for bonding and a sense of loyalty.

Much of the practice or ritualised session is designed to instil reliance and dependence upon the so-called practitioner. Bogus symptoms and syndromes are tacked on whilst alienation from conventional medicine evoking feelings of betrayal and self-superiority sinks in. Reading material and other patrons readily reinforce this.

Some charlatans often claim their Wonder Woo is suppressed by Big Pharma, as was the case with Francine Scrayen, Dr. Death Sartori charged in multiple countries and QLD MMS wielding cancer curing, scam artist Jillian Newlands. Although most often this is announced to the very desperate and the most ill.

Ultimately it appears that if we are to push down this bubble of bogus practices we need to understand just why so many of us are seeking attention to our state of being. It is not last ditch desperation or even seeking treatment for obvious illness. People need attention and in seeking it they are being sold dependence.

Dependence upon forces, rituals, cleanses and superstitions they previously never knew existed. That so much of this comes with ready packaged insults toward conventional medicine instills distrust of the very regulators who must act for the public good.

Perhaps as more and more scams are shown to be clinically useless, those that have depended upon them need to be educated in how they’ve been manipulated.