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Evidence-based medicine v alternative therapies: moving beyond virulence

More heat than light is being generated by the resurgence of the debate on orthodox evidence-based medicine versus the so-called pseudo-science of alternative therapies. Unfortunately the voices of medical…

The answer is not more rigid insistence on the primacy of biomedicine, in spite of its great contribution to saving lives. CALI.org

More heat than light is being generated by the resurgence of the debate on orthodox evidence-based medicine versus the so-called pseudo-science of alternative therapies.

Unfortunately the voices of medical historians and social scientists, along with those of consumers, seem to be muted. As both a researcher and user of health services, three aspects of the Friends of Science in Medicine’s’s current campaign and commentaries on it seem remarkable to me.

The absent patient

First, they disregard what is now commonly discussed as the patient experience – so here’s mine. In the early 1970s, I knew little of chiropractic. But when I consulted my local general practitioner about recurrent headaches, I was prescribed anti-inflammatory medication to no useful effect. A friend recommended seeing her chiropractor.

I took her advice and came away absolutely astonished at being asked about diet, constipation, lifestyle and having my eyes and mouth scrutinised as well as my back adjusted. My headaches eased as I was taught to attend more to posture and diet.

LadyOfProcrastination/Flickr

In late 1979, I became ill with what was (once they had a name for it) chronic fatigue syndrome (CFS). Over the years, I consulted several fine doctors known to be interested in managing CFS with whatever medication seemed to work for particular individuals. Success was limited.

In 2002, I first attended an extraordinary medical doctor. Over time his detailed diagnosis, strict dietary regime, vitamins and homeopathic treatments worked. Evidence-based? Friends and colleagues commented on my transformation. I lived the evidence, but not in the eyes of the mainstream medical profession.

This doctor had been a suburban GP for some 20 years but was frustrated with not making people with today’s lifestyle and chronic conditions really well. Instead, as he puts it, he was being an unpaid salesman for the pharmaceutical industry.

So one day he just walked out and started again, retraining in several alternative modalities. His very busy practice is now based on a quite different ontology and epistemology than those of orthodox biomedicine.

Rather than a “curing disease” perspective, it aims to support the intrinsic energy system of a living body, just like chiropractic, to make people better. This is in stark contrast to the paradigm underlying modern medical science.

Lack of critical reflection

The second problem with recent debates, then, is the lack of critical reflection on philosophies of health and the politics of medicine. As medical philosopher Drew Leder has pointed out, historically, medicine’s model of knowledge was based on a dead rather than a living body, that is, on studying cadavers.

Rafal Kiermacz

Following Descartes, the mind and body were largely seen as separate. The goal of modernist or Enlightenment science was to seek truth through objective (read mental) and systematic knowledge.

But most modern scholarship asks critical questions about what knowledge is, and who defines evidence – as well as in what context and in whose interests the answers are.

Gaining and maintaining medical power is clearly a highly political process of “shoring up the troops” and fighting off other contenders. Evan Willis has documented such struggles and exactly how the Australian medical profession achieved public legitimacy in spite of internal conflicts. Doctors’ organisations either subordinated (nursing and midwifery), limited (physiotherapy, optometry) or discredited other forms of clinical practice (homeopathy, chiropractic).

Other scholars, such as James Gillespie and Paul Starr, have demonstrated that professional self-interest and corporate influence as well as altruism have been at work in the rise of modern medicine.

Evidence-based medicine

The third issue is critical analysis of the evidence-based medicine movement itself. Lively debates about the movement’s claims continue among medical philosophers, such as Andrew Miles, in publications, such as the Journal of Evaluation of Clinical Practice.

The peer-reviewed journal Social Science and Medicine even published a special issue on the topic in 2006.

These critics argue that simplistic over-emphasis on the evidence generated within the experimental, quantitative paradigm of Enlightenment science is inadequate because it diminishes clinical practice. Waymack and Charon, for example, point to the importance of patients’ subjective narratives and the “biopsychosocial” processes involved in interactions with care givers.

Tony Dowler

The randomised-controlled trials and systematic reviews espoused by evidence-based medicine are also increasingly recognised as inadequate or inappropriate for many aspects of health care. And some medical practitioners (such as Greenhalgh) have moved on from the dominant scientific paradigm, emphasising new understandings of human bodies as complex adaptive systems.

Humanistic medical approaches support a holistic understanding of the dynamic human body more compatible with the claims of alternative modalities. They’re also consistent with the growing strength of the patient-centred or, more radically, person-centred care movement in quality improvement circles.

Finally, critics such as Claire Wendland and Helen Lambert go further. Why do some findings, such as the now discredited obstetric term breech trial, get taken up rapidly while others do not? And how does medicine interface with the interests of the corporate sector?

Investigations such as those by Harriet Washington, Marc-André Gagnon and Joel Lexchin, and Ken Harvey (among others), into the politics of research funding and publication, make it clear that modern medicine is not squeaky clean. Rather, in line with the history of modern medicine, they show the insidious effect of Big Pharma’s influence.

Most of us want health care that has been critically scrutinised by accountable institutions and shown to work rather than cause harm. Some alternative treatments no doubt can be found wasteful or otherwise wanting. But mainstream health care also has significant problems, such of drug utilisation and medical error.

The answer lies not in more rigid insistence on the primacy of biomedicine, in spite of its great contribution to saving lives (including those of two members of my family recently). Instead, more attention to history, politics and philosophy, along with a large dose of humility, would allow us to move beyond outdated forms of professional territorialism and provide better care that responds the needs of patients.

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215 Comments sorted by

  1. Mateus Ferraz-Souza

    logged in via Facebook

    What an awesome article!!! It is amazing how many more people are getting to know the benefits of alternative care, and, of course, chiropractic is righteously leading this change.

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  2. alexander j watt

    logged in via Twitter

    @ peter fox "anecdote" insofar as it is the experience of a patient undergoing healthcare, is a perfectly valid basis for understanding what treatments are effective. I think the point of this article is that if you divorce the patient experience, the anecdote (the thousands of anecdotes), then what you are left with is a 'cadaver'.

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  3. Anne Cooper

    Osteopath

    John Dwyer and the FoS are on shaky ground and may end up shooting themselves in the foot. Sure there is little evidence to support some health approaches, because sufficient research is simply not done. Chiropractors osteopaths and acupuncturists etc do not have the access to NHMRC funding and don’t get the financial support, subsidized dinners or dinky anatomical models that medical practitioners enjoy. Their work is by definition one on one and is therefore unsuitable for mass market sales and…

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    1. Citizen SG

      Citizen

      In reply to Anne Cooper

      @ Anne Cooper. Quote: "Sure there is little evidence to support some health approaches, because sufficient research is simply not done" . I'm presuming that the client gets informed consent in this process and it is explained to them that their therapy " has little evidence to support it"?

      The obverse, of course, is that practitioners in these fields you mention are clearly experimenting on their clients and/or are unsure whether their therapy will a. have any effect whatsoever, or b. have a…

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    2. Anne Cooper

      Osteopath

      In reply to Citizen SG

      Now Sean no twisting of words or intent please! As I wrote, all clinicians of all types use a combination of knowledge, skill, gut and luck. (Show me an orthopod who hasn't used his living patients to 'experiment' upon!) That is not to say we don't have a very good idea of what our ministrations will achieve. I didn't write that we have 'little or no knowledge of a procedure' and I imagine you also mean, a modality. There is plenty of reputable research on the efficacy of spinal manipulation, and…

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    3. Citizen SG

      Citizen

      In reply to Anne Cooper

      Anne,
      Granted, my contention that "you have little or no knowledge of a procedure you practice" was misplaced. It came from an edited sentence... I should have scrutinised it more. What I was attempting to write was "little or no knowledge about the degree of efficacy". I am sure you are great at osteopathy, but if you admit that there are no quantified benefits than that's where I assert that either you should inform your patient that you don't know what will happen next or not start the procedure…

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    4. Anne Cooper

      Osteopath

      In reply to Citizen SG

      There you go again, wondering when I stopped bashing my wife. I have no problem accepting modern medicine, so please don't imply that I do.
      I stated, and reiterate, that I am grateful for modern medicine. Neither do I feel persecuted; I have a great practice, deeply rewarding work and a sufficient income made honestly and without imposing tricks or duress. Its not for the practitioner to drop her modus operandi; its for researchers to discover what and why it works. or not. There is good medicine…

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    5. Citizen SG

      Citizen

      In reply to Anne Cooper

      It is indeed tiresome. But if I don't stick with it we'll have another generation of nurses unable to discriminate between efficacy and anecdote.

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    6. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Anne Cooper

      Actually Anne, that's not true. There is currently a large NHMRC funded trial for acupuncture being run by RMIT. See http://www.rmit.edu.au/chinese-med/acupunctureforpain.

      And in 2009, RMIT received four grants from the NHMRC for acupuncture and one for yoga. http://www.rmit.edu.au/browse/Research%2FAwards%20and%20successes%2FNHMRC%2FSuccessful%20NHMRC%20Grants%202009/.

      These was part of the 2006 federal government's $5 million National Health and Medical Research Council (NHMRC) Special Initiative Research Grants for complementary medicine and the inclusion of complementary medicine in the 2007-2009 NHMRC triennial strategic plan.

      In addition, the National Centre for Complementary Medicine was established with $4 million from the Australian Department of Health and Ageing and $0.6 million from the NSW Office for Science and Medical Research (OSMR). http://www.nicm.edu.au/component/option,com_frontpage/Itemid,1/

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    7. Anne Cooper

      Osteopath

      In reply to Rachael Dunlop

      I think that nurses will always value anecdote AND efficacy, despite your heroic efforts. They are not mutually exclusive, and one has no less value than the other. And therein lies the limitation of your own argument.

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    8. Citizen SG

      Citizen

      In reply to Anne Cooper

      Anne, are you from the Department of Having the Last Say?

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    9. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Anne Cooper

      Anne, I'm not sure what you mean by this comment "So instead of the FoS attempting to take a high moral ground, and at the same time appropriating the term ‘medicine’ (not to mention the title ‘Dr’)." You are aware that anyone can use the title of Dr in Australia? Since 2009, the title is no longer protected.

      The Health Practitioner Regulation National Law Act of 2009 placed specific restrictions on the use of the title “medical practitioner”, but failed to place any restrictions on the use of the title doctor.

      And in any case, chiros and osteos are legally allowed to use it, as long as they do not infer they are an MBBS or PhD. Thus, it must appear next to their title, eg., Dr Weiner (Chiropractor).

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    10. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Anne Cooper

      Hi Anne,

      Can you supply a ref. for the BMJ student physio / spinal manipulation LBP study? Cheers

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    11. Sue Ieraci

      Public hospital clinician

      In reply to Anne Cooper

      "Chiropractors osteopaths and acupuncturists etc do not have the access to NHMRC funding and don’t get the financial support, subsidized dinners or dinky anatomical models that medical practitioners enjoy. "

      Chiropractors charge for their services - why don't they use some of their profits to fund research in their own field? Isn't there such an entity as "continuous improvement" in this field?

      As far as homeopathy goes, the profit margins on "remedies" that contain no detectable amount of the "mother tincture" makes so-called Bog Pharma profits pale into insignificance - especially as homeopathic "remedy" manufacturers put so little into research. ANd again, most homepaths prescribe and then retail the remedy. AMongst all this is ample opportunity to fund research - only the will and commitment is needed.

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    12. Anne Cooper

      Osteopath

      In reply to Sue Ieraci

      Yes of course we get an income. Don't you? Don't we all? Are you saying that we, as private practitioners, who pay tax, registration and so on, should pay for research out of our own pockets?
      Do you?
      Or is there something inherently despicable about private practice? If so, where do the PT's stand? Or the consultants?
      By the way can we all stop lumping all allied, complementary, alternative and frankly loopy practitioners together? I know how to fix an acute neck but cannot read an aura or mix n' shake a homeopathic remedy. I know of quite a few loopy medical doctors, and plenty of mad nurses...

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    13. Sue Ieraci

      Public hospital clinician

      In reply to Anne Cooper

      Do I get an income? Of course I do? And do I spend my own time both performing and learning about research? Well, yes. It's an expected part of my profession.

      In orthodox health care, there is a requirement for registration to maintain ongoing education. This holds for practitioners in all locations - the obligations are the same for private and public. Surgeons, for example, are required to maintain an audit of their outcomes - independently of where they work. Audit and research are normal parts of practice, leading to continuous improvement and ongoing learning. And yes, one is expected to bear some of the cost and effort.

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    14. Sue Ieraci

      Public hospital clinician

      In reply to Citizen SG

      There must be many frustrations being a nurse, but having an Osteopath lecture a nurse educator about the nursing profession must surely be one of them...

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    15. jerry sprom

      logged in via email @gmail.com

      In reply to Sue Ieraci

      Sue,
      I know you have heard of the Australian Spinal Research Foundation. Virtually all funds have been provided by donations from chiropractors. This organisation funds research into chiropractic care. I am not sure of the exact figure but funds raised are around the $2mil mark since inception. (I stand to be corrected on this figure). Not bad given that there are only around 4000 chiropractors in Australia.

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    16. Sue Ieraci

      Public hospital clinician

      In reply to jerry sprom

      Jerry - yes, I have heard of that organisation. I had trouble finding the research output - perhaps you could direct me to the papers?

      I certainly do recognise that Chiropractic pracitioners are highly trained in their field, and work within a regulated system. This is one of the problems with having the umbrella term "CAM", which includes both a physical therapy such as chiro and a range of "therapies" that are unregulated and not science-based.

      I still maintain, however, that any science-based therapy needs to be continually evolving as research reveals more and more about human physiology. All tenets of a particular practice need to be continuously tested and reviewed. We now have sophisticated methods of diagnosis and imaging, which all disciplines can benefit from.

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    17. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Sue Ieraci

      The ASRF have invited anti-vaccine lobbyist Meryl Dorey and purveyor of misinformation about the safety and efficiacy of vaccines to speak at their conferences more than once IIRC. If this is the standard of information they are disseminating to their members, I don't hold out much hope for the quality of their research.

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    18. Grendelus Malleolus

      Senior Nerd

      In reply to Rachael Dunlop

      Having just spent several hours browsing through the papers and statements over at the ASRF I feel as if I have spent a month in Mos Eisley.

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    19. jerry sprom

      logged in via email @gmail.com

      In reply to Sue Ieraci

      Sue,
      I agree they are difficult to find. I am sure you have taken a look at their website which gives a list of currently funded research. If you are interested, I would contact the ASRF directly for published papers.

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    20. Grendelus Malleolus

      Senior Nerd

      In reply to jerry sprom

      Jerry - I was concerned to find that under the "focus on research" section of the publications the most recent work was from 2006. Much of the work in other publications was either actively attacking evidence based medicine or defending alternative medicine - as opposed to actual research into the efficacy.

      Indeed in the most recent of the "Illuminate" Newsletters, the headline, front page and a nearly full following page as well as the editorial were entirely devoted to what was essentially an attack on evidence based medicine.

      It is then rather hard to swallow appeals from people for "acceptance of alternative medicine" when it is quite clear that large CAM 'research' organisation are unwilling to accept EBM.

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    21. jerry sprom

      logged in via email @gmail.com

      In reply to Grendelus Malleolus

      Grendels,
      My reading of the article was that it was a criticism of EBP being confined to RCT’s and meta analysis at the exclusion of other forms of research. This is not a new criticism and can be found in both the medical literature and chiropractic literature and I suspect other science literature.
      Further to the article, if you read on, which I am sure you did, the author explains that “Some have read my work and deduced that chiropractic research does not need to occur. It is not good enough…

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    22. Grendelus Malleolus

      Senior Nerd

      In reply to jerry sprom

      You are correct, I did read on and was somewhat dismayed that the author left open a opportunity to suggest research methods beyond what she was describing as the failure of EBM. It is fine to criticize but better to have some ideas for progressing the agenda otherwise it seems like blowing off steam alone.

      If I were a chiropractor donating money to that organisation I would be principally concerned about two things. First is the very public stance by some of the members of the board that "allopathic" medicine is ineffective (Nimrod Weiner in particular and his position on vaccination), the second is that even the annual report is sketchy on what actual research is being conducted and there is very little recent research work apparent on the website.

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  4. Yuri Pannikin

    Director

    Why are we even talking about this? So a 'one-rat study' is the basis for scientific medicine?

    For a start, most alternative health practitioners are not trained sufficiently (or at all) in diagnosis. Second, their treatments, for the most part, have no evidence base.

    What's to like?

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  5. Mateus Ferraz-Souza

    logged in via Facebook

    Peter Fox and everyone else criticizing this article. YES, Big Pharma holds the puppet strings of Allopathic doctors. I, used to hold some of those strings. For their credit, Allopathic medicine is only good for acute conditions - car accidents, heart attacks, etc ( highly profitable care/ treatment). For chronic conditions such as high blood pressure, diabetes, asthma, obesity, celiac disease, etc, etc, etc, they don't know how to treat and eliminate the CAUSE of the condition, only treat the symptoms! Not effective at all! Well, there is no money in Primary Care!

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Mateus Ferraz-Souza

      Mateus - you repeat the common canard that orthodox medicine is allegedly "only good for car accidents and heart attacks". Well, I have two questions:
      1. What about the myriad of other conditions that are treated effectively every day - the most common would probably be infection. For type 1 diabetes, insulin is life-saving and there is no alternative offered. FOr Type 2 diabetes, diet is the cornerstone of management - every diabetic clinic journey starts with the dietician. Dieticians work within orthodox medicine.

      2. Why is it that no other "therapist" makes themselves available to treat people with "car accidents and heart attacks." Why practice a therapy that doesn't cover these areas? Is it the poor working hours or the lack of remuneration?

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  6. Kelly Latta

    logged in via Facebook

    You said, "...In late 1979, I became ill with what was (once they had a name for it) chronic fatigue syndrome (CFS)." Actually the name was myalgic encephalomyelitis in 1979 and had been for about twenty years. It is characterized by post exertional malaise lasting 24-hours or longer, unrelieved by rest and upon minimal exertion combined with a pattern of symptoms such as objectively proven cognitive issues. If PEM isn't present or there isn't a specific pattern the good news is you probably have…

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    1. Bruce Moon

      Bystander!

      In reply to Ken Harvey

      Ken

      Your comments largely reflect what I felt/thought when reading Kareen's article.

      I suggest there is an implicit set of associations in Kareen's article (and your reply) that when articulated, assist in clarifying the matter.

      First, and as you rightly say, mainstream or 'orthodox' medicine has no monopoly over either health care knowledge nor treatment methods.

      Second, again as you say, the current regime of alternate / complimentary approaches to health care empowers impropriety…

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    2. jerry sprom

      logged in via email @gmail.com

      In reply to Ken Harvey

      "In addition, the lack of educational standards and national registration for most alternative / complementary health practitioners means that anyone attending a weekend course can use titles such as naturopath, homeopath and iridologist "

      So how would removing these therapies from the university setting, as FSM is demanding, improve this?

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    3. Bridget Hewitt

      Project Manager

      In reply to jerry sprom

      Well Jerry - you are truly MIS-INFORMED. To be able to become registered to legally use the terms 'Naturopath', 'Homeopath' or 'Iridologist' now entails completing a 4 year health science degree, then gaining accreditation through a national association.
      I have never in my life seen weekend courses for these modalities that claim you get to call yourself a practitioner at the end. A little research into this would have given you the facts - which you should get straight before putting them in writing.

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    4. jerry sprom

      logged in via email @gmail.com

      In reply to Bridget Hewitt

      Hi Bridget,
      I think you will find that I was quoting Prof Harvey and the question I posted was directed at him.

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    5. Joel Mayes

      Bicycle Mechanic

      In reply to Bridget Hewitt

      Can you quote the legislation for this? the National Herbalist Asoc. of Australia disagrees with you, from their FAQ

      What is the current situation regarding regulation of herbalists and naturopaths?

      Currently, there is no protection for the public from untrained, poorly trained or bogus practitioners. Anybody with or without training or just the desire may call themselves a herbalist or naturopath and begin to practice. The NHAA

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    1. Bridget Hewitt

      Project Manager

      In reply to Sue Ieraci

      You seem to be ignoring the point made that controlled clinical studies are often not appropriate for testing non-orthodox medical modalities. In complex systems such as classical Chinese Medicine, for example, each individual presents with a mix of presenting issues, and each person's prescription and treatment regime will be carefully tailored to this mix. Clinical trials cannot capture this nor test it, because it is based on a one-must-fit-all approach. So if you got together a group of people…

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Bridget Hewitt

      Ms Hewitt - I am not "ignoring" the point about controlled clinical studies - I don't agree with it. I find it unusual that so many people cite classical Chinese Traditional Medicine as some sort of a standard - as classical Chinese health outcomes were poor. In modern China, those who have access to orthodox medicine use it. INdeed, the Chinese are leaders in many aspects of modern health care.

      Therapies that are individualised can still be tested for effectiveness. The reverse argument would…

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    1. Laurie Willberg

      Journalist

      In reply to Peter Bowditch

      Many medical associations utilize the word "allopathy" on a regular basis, so your criticism is unwarranted and unnecessary. Your philosophical ramblings are hardly a match for the calibre of this article.
      C'mon Peter... "pretend medicine", "sympathetic magic", "pseudomedicine"?
      This type of pseudoskeptic emotive rhetoric is old, tired, and boring.

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    2. Laurie Willberg

      Journalist

      In reply to Peter Bowditch

      This article is like a breath of fresh air.
      The works of medical historian Harris Coulter are also extremely revealing for those who wish to explore the evolution of the medical establishment and those who have shaped it.
      In China a medical practitioner isn't entitled to collect payment unless/until they have cured the patient, just as a mechanic isn't entitled to collect payment until s/he's fixed your car.
      Anyone want to guess what would happen to medical incomes if that practise became universal…

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    3. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Mr Willberg - I am not aware of those "Many medical associations utilize the word "allopathy" on a regular basis" - can you point out which ones they are?

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    4. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Laurie Willberg

      <<In China a medical practitioner isn't entitled to collect payment unless/until they have cured the patient, just as a mechanic isn't entitled to collect payment until s/he's fixed your car.
      Anyone want to guess what would happen to medical incomes if that practise became universal?>>

      It would result in services being cut for people who most need it - those with chronic illness and complex needs. Ridiculous suggestion.

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    5. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Laurie Willberg

      As a medical practitioner who reads widely on the publications of various medical organisations, I have only recently come across the term "allopathy" in the context of the discussion around CAM teaching in Universities. I am also very interested to hear which medical associations use this term.

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    6. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Laurie Willberg

      For an article that discusses evidence based medicine, the author seems to lack understanding about what is evidence and what is anecdote. She also seems to lack a strong understanding of what evidence based medicine encompasses.

      EBM is not just RCTs and nothing else. When we consider the sum of evidence behind a therapy or intervention, RCTs have the advantage of taking into account the placebo effect (therefore they give a better feel for the true effect of the intervention). However, there are situations which are not amenable to RCTs for various reasons. Other well constructed studies - eg cohort studies, observational studies - also have their place in the body of evidence.

      Utilising EBM is not dichotomous with good patient engagement and respect for the patient experience; one person's anecdote of a poor patient expreience with conventional medicine does not make it so.

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    7. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      So many fallacies in that last post, Mr Willberg.

      "In China a medical practitioner isn't entitled to collect payment unless/until they have cured the patient" - That may have been true in ancient China, but then ancient Chinese health outcomes were nothing to boast about, modern CHinese who have access to effective orthodox medicine don't hestitate to use it.

      "users of non-conventional/alternative medicine take charge of their own health and research alternatives for themselves." Often quite…

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    8. James Jenkin

      EFL Teacher Trainer

      In reply to Sue Ieraci

      Hi Sue

      I couldn't agree more with your argument, but I'm not confident that attitudes to traditional medicine in China are changing quite so quickly.

      Most people I worked with at Chinese universities seemed to go to a traditional doctor first, and believed in notions like 'hot' and 'cold' foods.

      Once on English TV they interviewed a doctor who works in the 'Emergency Department, Chinese Traditional Medicine Hospital No 1'!

      Maybe it's nothing more than Australians going to a naturopath, however?

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    9. jamie jardine

      Acupuncturist

      In reply to James Jenkin

      "Most people I worked with at Chinese universities seemed to go to a traditional doctor first, and believed in notions like 'hot' and 'cold' foods."

      Maybe it's because they get results, and also tell me that you could eat a plate of chillies and not sense a feeling of heat, or maybe ice cream and feel a sensation of cold? Food is medicine in China and for three thousand years the properties and effects of different foods and herbs have been observed and well documented, this is not a belief.

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    10. Sue Ieraci

      Public hospital clinician

      In reply to James Jenkin

      James - here is an interesting paper: http://www.hindawi.com/journals/ecam/2011/204137/
      The investigators compared the attitudes of a Chinese cohort vs an Anerican cohort in attitudes to Chinese Traditional Medicine (TM). Here are some of their findings:

      " studies in China examining attitudes toward TM reported a more favorable attitude toward TM by individuals who were older, less educated or those holding traditional health beliefs [48–50]. These findings may suggest cultural differences in…

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    11. James Jenkin

      EFL Teacher Trainer

      In reply to Sue Ieraci

      That's really interesting Sue - so educated Australians are moving towards TM, and educated Chinese away from it!

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    12. James Jenkin

      EFL Teacher Trainer

      In reply to jamie jardine

      Hi Jamie - yes indeed, Chinese have been theorising about the effects of foods for thousands of years, and this tradition should be taken seriously. It shouldn't be wrapped in cotton wool or explained away with metaphysics. It should be rigorously tested.

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    13. Sue Ieraci

      Public hospital clinician

      In reply to James Jenkin

      I have never understood why some ancient and traditional practises are discarded when new evidence replaces them, and others are revered despite the evidence.

      Modern medicine has moved away from "humours" because we have learned so much about how the body works - from a macro level to electron microscopy, from the lab to the MRI.

      Ancient China and India had populations that were largely rural, and impoverished. Their health outcomes were terrible in comparison to ours. Why, then, would we want to accept their ancient health practices without finding out which bits work and why?

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    14. Laurie Willberg

      Journalist

      In reply to Sue Ieraci

      So many misconceptions supporting your bias...
      The only real advance in mainstream medicine has been in emergency trauma care. The technological gagetry is fascinating and delivers up some amazing diagnostic information, however if one steps back and looks at the overview of the overall impact on patients it's usefulness is certainly debateable.
      Mainstream medicine focusses on placing a named diagnosis on a patient's condition, which certainly lines the pockets of the technology folks, however…

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    15. Laurie Willberg

      Journalist

      In reply to Tracy Soh

      Conventional drugs exert more harmful effects than positive on those with chronic illness and still don't cure the problem. Even drug company statistics show that drugs may only exert this one positive effect in only about 40% of patients.
      Mainstream medicine has not shown itself to be focussed on cure, just symptom suppression. Every RCT conducted by drug companies is focussed on suppressing one symptom and is deemed positive based on that one symptom suppression despite the numerous negative effects…

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    16. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Mr Willberg - that comment is loaded with fallacies:

      "Conventional drugs exert more harmful effects than positive on those with chronic illness... " Not true - look at heart failure, COPD, diabetes...

      "...and still don't cure the problem." - well - that's the definition of a chronic disease.

      "Even drug company statistics show that drugs may only exert this one positive effect in only about 40% of patients." Not so. What do you mean by "drugs"? Antibiotics? Antineoplastics? Vitamins? Insulin…

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    17. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Mr Willberg - you seem to have a very poor misunderstanding of mainstream medicine - what is your contact with it?

      "The only real advance in mainstream medicine has been in emergency trauma care. " I answered this nonsense above. If your child gets leukaemia, or meningitis, you may think differently.

      "The technological gagetry is fascinating and delivers up some amazing diagnostic information, however if one steps back and looks at the overview of the overall impact on patients it's usefulness is certainly debateable.(sic)" Oh - so no benefit from endoscopic surgery? laparoscopic surgery? Laser?

      The rest of your post goes on and on - one fallacy after another.

      Perhaps you need to spend some time reading history. Look at the infant mortality, life span and maternal deaths in those "ancient cultures"... "Revisionist mythology" - what nonsense.

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    18. jamie jardine

      Acupuncturist

      In reply to Sue Ieraci

      Sue said - Their health outcomes were terrible in comparison to ours. Why, then, would we want to accept their ancient health practices without finding out which bits work and why?

      The health of the ancient Chinese isn't as bad as you might think, up until a hundred years ago it was probably the most effective form of treatment going. Ancient medical texts put the average lifespan at around 70 - 80 years of age with reports of many living to over a hundred. The reason I find most people seek alternative treatment is either because they want to improve or maintain their overall health by taking a proactive role, avoid pharmaceutical drugs which have undesirable effects or have tried conventional medicine without result.

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    19. Sue Ieraci

      Public hospital clinician

      In reply to jamie jardine

      "The health of the ancient Chinese isn't as bad as you might think, up until a hundred years ago it was probably the most effective form of treatment going. Ancient medical texts put the average lifespan at around 70 - 80 years of age with reports of many living to over a hundred. "

      Jamie - These assertions seem to reflect a type of cognitive error called "spectrum bias." DO you have sources for these assertions? Perhaps a few very privileged ancient Chinese lived a long life - the overwhelming…

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  7. Michael Shand

    Software Tester

    wish wash bullshit, I see the point you were tryign to make but as soon as you lend credence to "Homeopathy" your done

    Sure patient experience is important but all you did was give weak anecdote's that no one here can reference to find out whether they are true or not (We just have to believe you) and you expect people to take you seriously?

    Why? Why should we care about your personal experience especially when you thought it was a good idea to go to a homeopath??

    Good critical analysis of a complicated issue...oh wait, no it wasnt

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  8. jamie jardine

    Acupuncturist

    Why don't we look at doing more outcome trials, where a group of people with a particular condition i.e. migranes or back pain are randomly assigned to a particular treatment such as conventional care, chiro, naturopathy, acupuncture, osteopathy or homeopathy. We follow them for for 6 months comparing the effectiveness and cost (inc. side effects) of each these treatments. What we want to know is what works best for a particular condition, what is the most cost effective and has the least amount of side effects.

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    1. Marcello Costa
      Marcello Costa is a Friend of The Conversation.

      Professor of Neurophysiology, Department of Physiology at Flinders University

      In reply to jamie jardine

      What a wonderful idea Jamie. Is being done in some limited cases? Why limited? Because there is no 'prescribed' treatment by any of the alternative therapies. If you look for a guide for indications of treatments by any of these 'disciplines' you will be disappointed. Even a textbook on Clinical Naturopathy recently published by two Australian authoritative naturopaths gives a mixture of dietary and life style advices, a few herbal remedies borrowed from the ancient European traditions. If you were to ask all these practitioners what treatment should be used you would have an infinite variety like the astrological predictions for the day in the thousands of daily magazines.
      If those practitioners were to accept the very principle of reasonable testing you propose would have already abandoned their "practice". Those who do, may well join modern medicine with all its real difficulties in understanding the various causes of migraines and thus prevention and cure.

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    2. jamie jardine

      Acupuncturist

      In reply to Marcello Costa

      The reasons Marcello that the prescribed treatments vary in treatment is because holistic medicine treats the person not the disease. How people experience a condition such as migraines varies, therefore treatments are always individualized. Take for example Chinese medicine (which I study), we don't diagnose migraines, we identify patterns of disharmony in an individual, symptoms of their pattern cause them to experience what is termed by biomedicine as migraines, but they may also be experiencing abdominal pain and loose stools, they may not be sleeping well and experiencing night sweats, they might also have trouble controlling their anger or feel depressed. We look at the whole person, not just a specific pathology.

      Anyway, line them up I reckon, let's see what works and what doesn't.

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    3. Grendelus Malleolus

      Senior Nerd

      In reply to jamie jardine

      Jamie - how would you design your outcome trials? Not saying it is a bad idea, just curious about the approach you would use to ensure that the alternative modalities you are trialling are effective.

      Also - last time I went to my GP I described a range of symptoms, fairly broad, described my emotional state and life circumstances. The GP accurately diagnosed my condition and treated it effectively - the approach is pretty much what you described as 'holistic'. I know a lot of people don't share that GP experience - and yeah, clinics are often very rushed, but just because it is Medicine rather than alternative medicine does not mean that the diagnostic process is as simplistic as you seem to ascribe to it.

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    4. jamie jardine

      Acupuncturist

      In reply to Grendelus Malleolus

      Grendel, I have much repect for the medical profession, it saddens me that these types of conversations always end up as an us against them thing. One thing that I have had drummed into me as a student studying CAM is to show respect to all practitioners and types of healing and medicine whatever the modality, this isn't always recipricated as it turns out.

      With regard to my outcomes study idea it is simple, observe a population over a period looking at all the variables, cost, effectiveness, side effects, adverse reactions etc. Although not being an expert in research design I'm happy to have others who are chime in with advice on how they could be run.

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    5. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Marcello Costa

      I agree with Marcello on this one. I heard exactly the same thing from a cranial osteopath the other day - that it is difficult to do research because methods differ significantly between practitioners.

      I recently reviewed a study of External Qigong for pain. See http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7166.2011.01091_13.x/abstract

      In the study procedures, the authors state ‘there are no specific methods for EQT’ – some therapists touched the patient’s body whilst others use the…

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Grendelus Malleolus

      Jamie, in order to test a therapy you need to start with a standard idea of what you are treating. Therefore, the condition you are treating would need to be measurable or observable in some way. If your therapy includes subjective symptoms that cannot be validated, you will need to choose an observable condition - such as wound or fracture, an infection - something whose course can be observed and tracked.

      Then, you would need a subset of those people to consent to have orthodox treatment withheld during the trial. Both patients and therapists would ideally be blinded to the therapy, and improvement would need to be documented by an objective, verifiable measure or observation.

      Lastly, you will need to seek funding and resources for a trial. I find it surprising that big Homeopathy mulitnationals like Boiron spend so little on R&D - perhaps they should be encouraged to fund testing of their own products.

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    7. jamie jardine

      Acupuncturist

      In reply to Sue Ieraci

      "Both patients and therapists would ideally be blinded to the therapy"

      Hmm, not going to be possible with manual therapies, I suppose the reason Boiron don't test their remedies is because they are not required to, but then again it's not my field so I'm not sure what happens there.

      My interest is acupuncture which has shown to be promising as a treatment for many conditions esp. chronic pain. In China acupuncture is generally practiced in hospitals at a very low cost to patients, they are…

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    8. jamie jardine

      Acupuncturist

      In reply to Rachael Dunlop

      That is true Racheal with most oriental modalities of healing, many practitioners spend many hours a day working on their own energy and health through practices such as qigong and meditation. In Chinese medicine the practioners own health or 'qi' is vital to outcome, yet these practitioners generally don't participate in research, it's like that old saying those who can do, do those who can't teach (or participate in research). Anyway, I expect a barrage of negitive responses and scoring now so I'll be off sipping my Milo and finishing the study I should be doing instead of posting here..

      All the best..

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    9. jamie jardine

      Acupuncturist

      In reply to jamie jardine

      BTW Racheal my comment on researchers is not meant to be disparaging towards what you do ( I just saw your job description, woops!), I'm referring specifically to TCM practitioners (which many who participate in studies are students)..

      Oh, and I mispelt negative, woops again!

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    10. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to jamie jardine

      " "Both patients and therapists would ideally be blinded to the therapy". Hmm, not going to be possible with manual therapies...."

      Jamie, there may be some ways through this conundrum of blinding, at least in part. Some ideas include -

      Olafsdottir, Forshei et al: “Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation”. Two groups – “treatment” and “no treatment” (control) group. Participants – babies – were randomly allocated to either group through…

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    11. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Rachael Dunlop

      Mmm Rachael, that "cranial osteopath" would be me I think, although I don't recall ever saying that I was anything but an "Osteopath" and that I happen to "practice a lot of cranial osteopathic techniques". (I'm not trying to nit-pick - it's just that I see the distinction as important). Cheers, J.

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    12. Sue Ieraci

      Public hospital clinician

      In reply to Joyaa Antares

      There are other potential scientific approaches to evaluating practitioner-dependent therapy - for example, this has been done to test the efficacy of Cognitive Behavioural Therapy.

      It is important to attempt to isolate which aspects of therapy are effective, and attempt to reduce variability by encouraging every practitioner to use the elements that have been shown to be effective.

      One could start by selecting a group of leading practitioners in a particular field and asking them to treat…

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    13. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Sue Ieraci

      Thanks Sue - I've just seen your reply. Food for thought and appreciated

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  9. steve jenkin

    logged in via LinkedIn

    Noting Conflicts of Interest...

    A number of people commenting on this piece haven't alerted readers to their positions.
    This seems unethical practice to me.

    The Friends of Science in Medicine is funded by Australian Skeptics Inc and their members compromise the Executive.

    Dr Ken Harvey has co-authored papers with the FoSiM CEO, Loretta Marron.
    Prof Marcello Costa is on the FoSiM Executive.
    Peter Bowditch is both a well know member of the Australian Skeptics and also the principal of "The Australian Council Against Health Fraud", active from 2003-2011 pursuing the same agenda as FoSiM.

    Others I do not know.

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    1. Grendelus Malleolus

      Senior Nerd

      In reply to steve jenkin

      Steve - why is membership of those organisations a conflict of interest? Are their views as expressed in comments here somehow inconsistent with their public membership of FSM or Australian Skeptics?

      Do you have any affiliations that are relevant that we need to know about in determining whether your comments have validity? Do I?

      Disclosure of affiliations is important for authors of articles - not so much for commenters.

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    2. John Carney

      Web Developer

      In reply to steve jenkin

      Not sure how these qualify as "conflicts of interest". How do they stand to benefit from commenting on this article? Who are they exploiting?

      Perhaps we should instead be noting ad hominem attacks?

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    3. William Bennett

      Lecturer in Environmental Chemistry at Griffith University

      In reply to steve jenkin

      Not sure I would call it unethical practice. Should every commenter who happens to be a member of the FoSiM need to disclose that at the beginning of their comment? That could get very tiring.... Anyway, I, too, am a member of FoSiM and am very happy with the work they are doing. I also fully support the work that the Australian Skeptics does, which is based on scientific skepticism, not "conspiracy theory" skepticism.

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    4. steve jenkin

      logged in via LinkedIn

      In reply to Grendelus Malleolus

      "Our goal is to ensure the content is not compromised in any way. We therefore ask all authors to disclose any potential conflicts of interest before publication."

      Readers need full disclosure to be able to evaluate all authors: those who write comments as well as article author.

      People with a direct interest in this debate, those either directly or closely involved in either side, like the Osteopath above, should be identifying themselves to comply with the site's objective on Disclosure Statements.

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    5. Grendelus Malleolus

      Senior Nerd

      In reply to steve jenkin

      I think your definition of an 'author' is at odds with the Editor's.

      Comments following any article do not carry the same authoritative potential since anyone can comment but only those affiliated with universities or research institutions can author.

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    6. steve jenkin

      logged in via LinkedIn

      In reply to steve jenkin

      Another FoSiM member:

      Ken McLeod Co-founder, Stop the AVN, Australian Skeptic of the Year 2010 Award

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    7. Peter Bowditch

      logged in via Facebook

      In reply to steve jenkin

      I've been outed!!!

      I fail to see what relevance the revelation about me has to do with anything. I'm hardly anonymous and it's pretty easy to find out what I think about pseudomedicine.

      A conflict of interest only arises when someone speaks for some sort of gain. I see no more reason why anyone should have to admit to membership of FSM when speaking out about quackery that that they should have to say which football team they follow. It simply isn't relevant. If someone is gainfully employed in the industry then that should be mentioned however, so that we can weight their opinions.

      For the record I signed up to go on the list of FSM supporters about five minutes after I heard that it existed, I have been on the radio with Loretta Marron and I introduced Professor John Dwyer to the audience when he won the Australian Skeptics' Skeptic of the Year in 2000. And according to my wife and for the sake of domestic peace, I support the Parramatta Eels.

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    8. Ken McLeod

      logged in via Facebook

      In reply to steve jenkin

      Sorry Steve, some corrections to your post concerning me are needed here.

      I am not a founder of Stop the AVN. The founder was Daniel Raffael. Stop the AVN is simply a Facebook group, and when I joined, 3 months after it was founded, there were about 380 members, from memory.

      I was not Skeptic of the Year 2010. I was awarded, with Wendy Wilksonson, the Australian Skeptics' Thornett Award for the Promotion of Reason.

      The Australian Skeptics' 2010 Skeptic of the Year Award went for the first time to an organisation instead of an individual – the Stop the AVN group.

      A requirement for a declaration of interest for commenting on websites would be a world first.

      (See http://www.skeptics.com.au/latest/news/skeptics-2010-awards/)

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    9. Citizen SG

      Citizen

      In reply to Rachael Dunlop

      Just to make it clear... I have no affiliation with Aust Skeptics, but it does sound like a damn fine organisation. I'm also not a member of Fosim... I don't know if they accept nurses (we may be the enemy). I was, however, born after the Enlightenment.

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    10. Paul Rogers

      logged in via Twitter

      In reply to Citizen SG

      Sean wrote: "I have no affiliation with Aust Skeptics, but it does sound like a damn fine organisation."

      Well, maybe . . . except they seem to write in support of David Gillespie's book "Sweet Poison".

      Oh dear, what a bungle!

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    11. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Paul Rogers

      Hi Paul,

      I'm not sure where you got the idea that we "support" "Sweet Poison". Here is what Aust Skeptics Eran Segev said about this,

      "As to the fructose debate: our position has been very clear; we gave David the opportunity to make his claims and allowed Chris Forbes-Ewan the stage to debunk David’s claims. I thought it made for a very good read, and in any case I would hope that we can rise above publishing only self-congratulatory articles and ones that just about every single one of our…

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    12. Citizen SG

      Citizen

      In reply to Paul Rogers

      Really, haven't heard of this one... What happened?

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    13. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Paul Rogers

      Paul, the opinion of one person from The QLD Skeptics does not dictate the position of the NSW Skeptics (of which I am a VP), or any other branch for that matter, so I don't see why I need to concede it. In any case, that piece also describes the negative feedback the writer received when she invited Gillespie to speak, partly because his book was viewed by some as pseudoscientific.

      Indeed, I was in the audience for that talk and David was hammered in the questions at the end and subsequently…

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    14. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Paul Rogers

      I forgot to add, also on our website is this article http://www.skeptics.com.au/latest/news/david-gillespies-errors-a-summary/ which links to a 5 page document written by Chris Forbes-Ewan which critiques the book page by page.

      He concludes, "In summary, Sweet Poison does not reflect the current state of scientific knowledge with respect to the health effects of dietary fructose".

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    15. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Citizen SG

      I'm not really sure that anything happened! The article that Paul is referring to was published in 2010 and based on a conference that happened in 2009. Also in 2010 (I think) two side by side articles were published in The Skeptic - one from Gillespie and one from Forbes-Ewan, critiquing Gillespie's claims. Some people complained that we published it at all. As Eran said, and I quoted earlier, "I thought it made for a very good read, and in any case I would hope that we can rise above publishing only self-congratulatory articles and ones that just about every single one of our readers would agree with, as long as we place them in context and ensure any misinformation is countered." That's it.

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    16. Paul Rogers

      logged in via Twitter

      In reply to Rachael Dunlop

      Yes, Chris is correct, and your member should have been more circumspect before launching into a defence of the book. This is not both sides of a fine argument, this is a person representing the Skeptics supporting an idea that has, with even a cursory glance at the literature, very little scientific basis.

      This is what your correspondent wrote:

      "Since then, I’ve been waiting for someone to show me that the ‘science’ behind what David is saying about how sugar is metabolised in our system is bollocks. At this point in time, I am still waiting."

      This is, frankly, outrageous. I trust your correspondent knows better now.

      I do concede, though, that you do not have control of what other members write on web sites.

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    17. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Peter Bowditch

      Hi Peter (& Others),

      I'm not sure that I agree with Steve Jenkin about not declaring one's position as being a "Conflict of Interest", but I do think he has a good point to make.

      There has been one occasion within the Conversation's pages (and there may have been others) when it would have been helpful to both the author and certainly to other readers to have known of someone's position. I have in mind Phillip Ebrall's article of 6-Dec-2011 at https://theconversation.edu.au/theres-no-place-for-pseudo-scientific-chiropractic-in-australian-universities-4576

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    18. Grendelus Malleolus

      Senior Nerd

      In reply to Joyaa Antares

      Joyaa - can I recommend Google as a way to satiate your curiosity?

      If you Google Eran's name it is quite clear that he is the President of the Australian Skeptics. Rather than evade the question perhaps he was just hoping people would go look stuff up. The same is true for many people here - even those, who like me, use Screen Names. If you follow back to twitter you will find I have a profile there, and a little googling will find my blogs, all of which make a fairly comprehensive profile.

      Googling Peter Bowditch is even more revealing (and thoroughly entertaining).

      Google is your friend.

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    19. John Carney

      Web Developer

      In reply to Joyaa Antares

      Hi Joyaa,

      I skimmed through that entire comments thread and I think you might be confusing "position" meaning "stance on a particular topic" with "position" meaning "office, or occupation".

      The closest I could find was this from Phillip Ebrall:

      "As for your point 2, I do not know your field of speciality and therefore at this time I do not understand your expertise in reading, understanding and interpreting the clinical and neurophysiological evidence that does exist."

      Which appears questioning…

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    20. John Carney

      Web Developer

      In reply to steve jenkin

      Looking at that list, I think it's simply worded confusingly. I'm guessing Ken is a co-founder of FSM, and simply a member of Stop the AVN. You'll note that there's a comma separating "Co-founder" and "Stop the AVN". Also, in various other entries, people are listed as "Founder OF ...".

      So in that list it seems that "founder" or "co-founder" on its own should be read as for "[co-]founder of FSM".

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    21. John Carney

      Web Developer

      In reply to steve jenkin

      PS. I still don't see how it's relevant, let alone a "conflict of interest". What is your point, exactly?

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    22. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to John Carney

      Hi John. Thanks for taking the time to respond.

      I sort of see what you are saying but - probably much like two people who have just seen something (a murder, a cricket match, whatever) take place in front of their eyes, we perceive it in different ways.

      Yes, PE wrote " I do not know your field of speciality and therefore at this time I do not understand ..." and perhaps wrongly I took this to be an implicit question. In response ES wrote, "I'm not a scientist" but confidently adds" ... you…

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    23. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Grendelus Malleolus

      Thanks Grendels. I love the name BTW.

      Sadly I barely have time to keep up with a couple of "Conversations" let alone Google every commentator for their profile. For folks like me The Conversation includes a "profile" for us to enter a word or phrase here.

      I did click on ES's name, which took me to a facebook page, which wasn't very informative in relation to my search for information about a professional setting.

      I've just clicked on your Twitter - we both like good coffee - if you have a second to email a more relevant link to me (joyaa@...) I'll be happy to take a look.

      Merlo

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    24. John Carney

      Web Developer

      In reply to Joyaa Antares

      By my reading, the "ignorant moron" comment was simply making the point that his qualifications were irrelevant to the argument at hand. If I was to read between the lines here, I would say that he felt, rightly or wrongly, that Phillip was angling towards an argument from authority. Either way I don't see it as evasive and in any case he was being asked about his qualifications, not his interests.

      Anyway, it's my observation that people commenting on the Conversation are generally open about who they are and where they're coming from, so it seems that you're arguing about a problem that doesn't really exist.

      I did a short public speaking course once. The "know your audience" rule means "do your research" :)

      In the interests of transparency, I'm a web developer with a keen interest in science. I'm not a member of any skeptics group, but I did meet Eran Segev once. I recall that he didn't think much of my choice of mobile phone.

      Cheers :)

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    25. Grendelus Malleolus

      Senior Nerd

      In reply to Joyaa Antares

      Thanks, I've had this name online for quite some time now - 15 years at least. Coffee is my hobby and I used to maintain a blog called Cafe Grendel but work has put a slow down on personal interests for a while. My interest in evidence based medicine came about when my oldest child was diagnosed with autism and I was suddenly inundated with waves of contradictory information. I am fortunate to have a background in information analysis and techniques that allow me to sort, categorise and evaluate…

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    26. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Grendelus Malleolus

      Hi Grendel(s). Apologies for taking so long to respond.

      Thanks for sharing some background. I really emphathise when it comes to "autism": a complex disorder - or range of disorders - or even set of different disorders one or more of which have their own "spectrums".

      I won't claim "expertise" in this field, but I do know a little about it and bearing in mind our topic, "evidence-based-medicine vs alternative therapies: moving beyond virulence", I'd like to make a few observations.

      It…

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  10. Peter Clarkson

    logged in via Facebook

    This website is usually filled with articles with a reasonable amount of academic rigour, but there's been a rash of articles recently about non-medical treatments which are not supported by evidence. Presenting these ineffective treatments as a valid alternative to medicine can kill, and is incredibly irresponsible.

    The article starts with a personal anecdote "I used a non-evidence-based therapy and I happened to recover", then presents a strawman argument, criticising evidence-based medicine…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Peter Clarkson

      Peter - perhaps there is a simple explanation here: in an attempt to introduce "balance" into the discussion, the editors have failed to find an author who can defend the validity of non-science-based therapies in a coherent and dredible way. Perahps it is not possible to do so.

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    1. jamie jardine

      Acupuncturist

      In reply to William Bennett

      You have to be joking, there have been on this site so far a handful of articles that address the avalanche of vilification directed towards CAM. As practitioners of CAM modalities we have been labeled quacks, decievers and scam artists and you think it is unfair that the other side doesn't get to respond, what a joke. Just wait and see the negative score this post attracts, not to mention anyone else who posts advocating CAM, our viewpoint here is well the minority. Thank you to the editors for allowing it to be heard.

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    2. Citizen SG

      Citizen

      In reply to Steve Payne

      Steve,
      Great comment by the way. But I disagree that this stuff shouldn't be aired. As disappointing as it is to see a paucity of critical analysis in some of these articles, the comments that ensue are helpful in showing the lack of understanding in EBM and the scientific method.
      It's also useful for demonstrating why a liberal arts education is so important... maybe it's time to reintroduce philosophy into all degrees (I don't mean talking about old men with beards I mean the construction of arguments, reasoning, argumentation, cognitive biases etc.)

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    3. John Carney

      Web Developer

      In reply to jamie jardine

      To be fair Jamie, I have heard CAM practitioners level some pretty nasty accusations at conventional medicine practitioners. One of the most common being that they're all in the pocket of "Big Pharma", but there are many other canards that are routinely trotted out.

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    4. John Carney

      Web Developer

      In reply to William Bennett

      William, this *is* a response from an opposing viewpoint. It is in response to an earlier article arguing that Universities should not be teaching Alternative Medicine.

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  11. Mateus Ferraz-Souza

    logged in via Facebook

    James Jenkins, your comparison of a car to a human body is just...lets say, limited.

    Bottom line is, no one can take away the benefits that hundreds of my patients have experienced with my care. We all can get lost on the semantics of measuring/quantifying the end result. Perhaps, we will never get to the real truth of the matter. What if the "measuring tool" is the problem?
    I agree, no one can take one positive experience, or a negative one for that matter, and quantify the benefits of a specific alternative care. However, I do believe that thousands of patients I've seen getting better are not random results. They are real successes.

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    1. Citizen SG

      Citizen

      In reply to Mateus Ferraz-Souza

      Mateus,
      The point is what would have happened if they didn't see you? And the next point is what if half saw you and half had a placebo?
      Look up cognitive bias on wikipedia.

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Citizen SG

      And this is where the fallacy of many "alt" therapies to be self-empowering is shown clearly. It is possible that the vast majority of minor illnesses are self-limiting, and need no therapy at all. By encouraging multiple visits and giving "therapies" for conditions that will heal anyway, these practitioners are encouraging therapist dependence. It's a new kind of paternalism with a friendly face.

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    3. Laurie Willberg

      Journalist

      In reply to Sue Ieraci

      Sue, you are again confusing acute and chronic illness, and engaging in mere speculation. Suppose you provide evidence that integrative/alternative medical practitioners encourage multiple visits for conditions that will, in your opinion, "heal anyway".
      Now you're proposing that you have the capability to diagnose every patient everywhere and pronounce that all of their health issues will just vanish if given enough time... Great. Now everyone can just stay home and avoid medical treatment of any sort, if for no other reason than to validate your opinions about "alt therapies".

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    4. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Mr Willberg, I am not confused at all about acute and chronic illness - I have been involved in assisting people with both for almost thirty years.

      There is abundant proof for various therapists encouraging long-term dependence. Here is just one example:
      http://www.newtowncommunitychiropractic.com.au/Newtown_Community_Chiropractic/regular_visit.html

      "Now you're proposing that you have the capability to diagnose every patient everywhere and pronounce that all of their health issues will just vanish if given enough time..." No - not at all - please point out where I have proposed that.

      "Now everyone can just stay home and avoid medical treatment of any sort." Well - for most upper respiratory tract infections, just staying home and avoiding medical treatment is the best thing you can do. Why buy a homeopathic remedy when you will get better anyway?

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  12. wilma western

    logged in via email @bigpond.com

    Interesting discussion. Some GP's seem to be almost as credulous about "alternatives" as the general-public adherents of same. As one GP wrote to The Age, she had never heard of homeopathic treatment causing a reaction!

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    1. John Carney

      Web Developer

      In reply to wilma western

      This is exactly what scientific studies have found, much to the chagrin of homeopaths.

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    2. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to wilma western

      In order for a homeopathic treatment to cause a reaction, it must first have an effect. This is an oft repeated argument from proponents of homeopathy, that it is safe because it is free of side effects and this is true (in most cases) because it has no effect. Homeopathy, there's nothing in it.

      However, because homeopathy is not regulated, either here nor in the US, there have been cases when it has directly caused harm (not to mention the harm it can cause from delaying efficacious treatment…

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    3. Laurie Willberg

      Journalist

      In reply to Rachael Dunlop

      Your claim that it has "directly caused harm" is pure speculation. Until conventional medicine can give patients iron-clad guarantees that is can cure their health problems this line of reasoning is complete nonsense. If it could give patients guarantees and provide results there would be no need for any other medical modalities.
      Apart from the grandstanding antics of pseudoskeptics gobbling vials of Homeopathic remedies in one shot claiming that there's nothing in it, pick any Homeopathic remedy you wish and take 4 doses daily for 2 weeks. Then tell us that nothing happened...

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    4. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Laurie Willberg

      What part of causing permanent loss of the sense of smell is not direct harm?

      FDA Advises Consumers Not To Use Certain Zicam Cold Remedies
      Intranasal Zinc Product Linked to Loss of Sense of Smell
      The U.S. Food and Drug Administration today advised consumers to stop using three products marketed over-the-counter as cold remedies because they are associated with the loss of sense of smell (anosmia). Anosmia may be long-lasting or permanent.

      The products are:
          --Zicam Cold Remedy Nasal Gel
          --Zicam Cold Remedy Nasal Swabs
          --Zicam Cold Remedy Swabs, Kids Size (a discontinued product)

      http://www.fda.gov/Newsevents/Newsroom/PressAnnouncements/ucm167065.htm

      Laurie, this is not speculation, it is an effect directly linked to this homeopathic product. As a journalist, I would expect you to know the difference.

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    5. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      "Until conventional medicine can give patients iron-clad guarantees that is can cure their health problems this line of reasoning is complete nonsense. If it could give patients guarantees and provide results there would be no need for any other medical modalities."

      Mr Willberg, any "therapist" who provides "iron-clad guarantees" is lying. Do you prefer dishonesty to uncertainty? My guess is that many people (subconsciously) do - reassurance and certainty are powerful motivators - even if dishonest.

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    6. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Rachael Dunlop

      Hi Rachael,

      Just so I am clear - which part of this "homeopathic product" is thought to be causing partial or total anosmia? You seem to be implying it is the homoeopathic part, but I am not certain this is what you mean...

      Cheers, J.

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    7. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Joyaa Antares

      Ho Joyaa, from my understanding the fault was that the product was not actually "homeopathic" i.e., it was not diluted to homeopathic concentrations, thus there were high enough concentrations of zinc to cause nerve damage. The problem this highlighted was that homeopathic products are not tested by the FDA (or the TGA) because they're deemed too dilute therefore very low risk, but obviously in this case there was a manufacturing problem. Cheers, R

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    8. Laurie Willberg

      Journalist

      In reply to Rachael Dunlop

      Professional Homeopaths would not utilize a product like Zicam as it does not comply with the Homeopathic principle of individualized treatment... In any event, conventional OTC nasal sprays can do just as much or more harm.
      But aren't you contradicting yourself? You take the position that Homeopathic products are "just water" and "ineffective".
      In any event, there are Homeopathic remedies that can antidote/reverse the damage done, and people who have suffered adverse effects should seek treatment from a professional Homeopath.
      But you expect this to be a major issue compared to the number of fatalities from drugs like Avandia or Vioxx?

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    9. Laurie Willberg

      Journalist

      In reply to Sue Ieraci

      This line of reasoning should be the goal of all forms of medicine, but unfortunately it's not.
      An experienced clinician can give a patient reasonable odds of success. In many instances "therapists" who have flatly declared that a patient would never walk again have been proved wrong -- after the patient used one of those "ineffective" forms of alternative medicine.
      Why do you wish to force a choice between dishonesty and uncertainty? I'll take option (c) none of the above.

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    10. Grendelus Malleolus

      Senior Nerd

      In reply to Laurie Willberg

      Do you have documented evidence of these miracle cures? Patients incapable of walking who can suddenly walk again are of great interest to Today Tonight, but also to government. If there was an alternative modality that cured people as you suggest then government would fund it regardless of the objectins of pharmaceutical companies because the cost of maintaining the care and support of someone with a disability is high, long term and complex.

      The govenment money goes where the evidence of success is. Treasury officials are pragmatic bastards, but evidence based bastards.

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    11. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      "Why do you wish to force a choice between dishonesty and uncertainty? I'll take option (c) none of the above."

      The, Mr Willberg, you are out of touch with reality. In human health, there is always uncertainty.

      Your response does support my conjecture that people flock to "therapists" who give simple messages with an illusion of certainty. The problem is, it's dishonest.

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  13. David Driscoll

    Exercise Physiologist, Dietitian

    Re: The absent patient
    Me and my friend had exactly the opposite experience to you. Does my two anecdotes trump yours or do we conclude that everything works?

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    1. Ilijas Milišić

      logged in via Facebook

      In reply to Bridget Hewitt

      Such a strange question. Just thought of how one might apply this question after popping a bit of acid. You may experience the sight and sound of purple winged horses flying.

      The people around you just see you smiling. No horses. No wings.

      I won't guide you any further, Bridget. I think you get my drift.

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  14. Luke Weston

    Physicist / electronic engineer

    "Noting Conflicts of Interest...

    A number of people commenting on this piece haven't alerted readers to their positions.
    This seems unethical practice to me.

    The Friends of Science in Medicine is funded by Australian Skeptics Inc and their members compromise the Executive.

    Dr Ken Harvey has co-authored papers with the FoSiM CEO, Loretta Marron.
    Prof Marcello Costa is on the FoSiM Executive.
    Peter Bowditch is both a well know member of the Australian Skeptics and also the principal of "The Australian Council Against Health Fraud", active from 2003-2011 pursuing the same agenda as FoSiM.

    Others I do not know."

    I also have it on good authority that they are funded by the CIA to undermine Australian mining interests, that they control the British Crown, and keep the metric system down.

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  15. Justin Case

    Gardener

    Logical fallacies and so-called sceptics?
    Isn't FSM the most glaring and abusive ad-hominem argument from authority (argumentum ad verecundiam) that contemporary Australian society has ever seen?

    Must be a fine time in all those uni medicine departments with all these profs hanging around with so much time to sit around and just winge about others, who appear to be enjoying greater success than some doctors are prepared to ever accept or acknowledge.
    Guess some so-called medical researchers have to fill in time between junkets with something.

    A largely pathetic and abusive campaign that appears to have very little kudos outside the echo chamber of astroturf like commentators on threads such as this.
    Does anyone really think that abusive and derogatory unscientific campaigns really serve any public interests? I'm sure the public does not think so.

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    1. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Justin Case

      Abusive? Derogatory? Unscientific? I think you had better provide some evidence for that Justin. And whilst we're on the subject, what's not derogatory about this comment? "Guess some so-called medical researchers have to fill in time between junkets with something." As a research scientist I find this comment extremely offensive Justin (if that even is your real name).

      To be clear, FSM support

      • Teaching about the history of the concepts and treatments that are embraced under the CAMs but…

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    2. Laurie Willberg

      Journalist

      In reply to Rachael Dunlop

      Agree with Justin.
      Real scepticism is based on an individual reserving judgment about an issue due to a lack of information. What FSM and other pseudoskeptic groups are proposing is that no one should have access to anything that they don't agree with. It's not science, it's Scientism.
      These "skeptic" organizations indoctrinate their members with canned ideology and phraseology intended to denigrate anything that does not support the status quo.
      In the meantime they parade notions of being "free thinkers". These Orwellian mental gymnastics are rather transparent, however the public deserves to know that their motives are far from ethical.

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    3. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Ian Musgrave

      LOL! The ability of the average Australian to laugh at ourselves is surely one of our greatest assets! (Of course the same is true of the Brits, but then I would say that)

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    4. Ian Musgrave

      Senior lecturer in Pharmacology at University of Adelaide

      In reply to Rachael Dunlop

      "..[althernative therapy].. aims to support the intrinsic energy system of a living body..."

      Well, there's a problem right there, there is no such thing as an "intrinsic energy system" in any living body (unless this is a fancy way of saying the Krebs-citric acid cycle, but supporting this won't have any effect on disease unless you have been poisoned by fluoroacetate)

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    5. Ian Musgrave

      Senior lecturer in Pharmacology at University of Adelaide

      In reply to Rachael Dunlop

      "historically, medicine’s model of knowledge was based on a dead rather than a living body, that is, on studying cadavers."

      What, you mean like in 1628, when William Harvey used a combination of dissection and observations of _living_ bodies to prove that blood circulated?
      http://www.vascularcell.com/content/1/1/3

      Seriously, although dissection of cadavers revolutionised our understanding of the body and paved the way for effective surgical techniques (see the biography of John Hunter "the…

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    6. Ian Musgrave

      Senior lecturer in Pharmacology at University of Adelaide

      In reply to Rachael Dunlop

      "The randomised-controlled trials and systematic reviews espoused by evidence-based medicine are also increasingly recognised as inadequate or inappropriate for many aspects of health care."

      Increasingly by whom? The whole issue is that people are good at fooling themselves, and we need a rigorous way to stop fooling ourselves.

      For good examples of why we need evidence based medicine see
      https://theconversation.edu.au/how-do-we-know-what-works-systematic-research-reviews-5979 and
      http://www.cochrane.org/about-us/history/our-logo#explanation

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    7. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Laurie Willberg

      @Laurie W

      <<What FSM and other pseudoskeptic groups are proposing is that no one should have access to anything that they don't agree with. It's not science, it's Scientism.
      These "skeptic" organizations indoctrinate their members with canned ideology and phraseology intended to denigrate anything that does not support the status quo.>>

      I don't believe I've heard of any moves to restrict people from accessing whatever sort of service they chose to seek. If you have heard of anything amongst your sources I would be very interested to see it.

      This entire issue started because there were Universities that were planning to teach non science based therapies within medical and health science faculties. The FSM position in the original open letter was that if a therapy is not based on good scientific evidence then don't teach is as science.

      There really are no conspiracies here...

      What are your reasons for believing that there are unethical motives?

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    8. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Tracy Soh

      ...try again... the computer has cut off more than half of my last post...

      In response to the statement "What FSM and other pseudoskeptic groups are proposing is that no one should have access to anything that they don't agree with. It's not science, it's Scientism.
      These "skeptic" organizations indoctrinate their members with canned ideology and phraseology intended to denigrate anything that does not support the status quo."

      I have not heard of any moves to restrict people from accessing…

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  16. Luke Weston

    Physicist / electronic engineer

    @William B:

    "The Conversation, you need to be a bit more rigorous with which articles you decide to publish, even if the author is from a University. Perhaps a better model for controversial topics like this would be to include a response from the opposite viewpoint...at least then the audience has a lower chance of being misinformed..."

    I bloody hope not!

    The only thing The Conversation could possibly do worse in terms of trying to save their scientific integrity would be to fall into that…

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    1. William Bennett

      Lecturer in Environmental Chemistry at Griffith University

      In reply to Luke Weston

      Luke, I definitely see where you are coming from. In no way was I suggesting that the creationists need to be included in a debate about evolution. I simply meant that IF The Conversation desires to keep publishing flimsy opinion pieces like this one, the least they could do would be to include a representative from the science/medicine field.

      The problem here is that you refer to The Conversation as "science journalism", which it is not. There are a lot of very unscientific articles floating around on here, which is a shame...

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Luke Weston

      This misunderstanding with "balance" pits an expert in a particular field against a casual observer. That is not "balance." A "balanced" discussion legitimately occurs where there are divided opinions AMONGST a group of experts, and both then put their case on the basis of their understanding of the evidence and practice within their profession or area of expertise.

      Having a research scientist "balanced" by someone who has never studies science but thinks they are a logical person is a sad substitute for "balance." And where the general opinion of experts in a field is consistent, and backed up by evidence, what is the purpose of so-called "balance"?

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    3. John Carney

      Web Developer

      In reply to Sue Ieraci

      Sue, I think one of the aims of The Conversation is to promote inter-disciplinary discussion, and I think there's great value in that. Indeed, the history of medicine is a rich and fascinating topic and I had hoped on reading the teaser for this article that the author would offer some historical insights on this debate.

      Sadly that is not what we got.

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  17. Miriam Goodwin

    Research management consultant

    The various parties in this conversations clearly have different views on the knowns and unknowns when it comes to medicine. The taxonomy of ignorance can be useful here.

    1. There are the things that we think we know but we don’t. My exposure to the taxonomy of ignorance was in the early 1990s (well before Donald Rumsfeld made parts of it famous) in its use as a teaching tool for medical students, to point out how much what is today being taught will be later be shown to be unsubstantiated…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Miriam Goodwin

      "Much of the argument being used to say that alternative medicine should not be taught in university is, in fact, why it /should/ be taught there, so the elements that have no rigorous basis can be tossed out in favour of well-founded professional practice."

      Ms Goodwin - that sounds like a good aim - if only it were true. The best example I know is that chiropractic, which does have some evidence for its efficacy as manipulative therapy for low back pain, still teaches students about "subluxation theory". SUbluxation theory is not science, and is in discord with our growing knowledge of human physiology. Being taught at university has not removed the pseudo-science.

      And another comment about your "taxonomy of ignorance". One of hte big issues in our current society can be summed up as "don;t know what you don't know."

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    2. jerry sprom

      logged in via email @gmail.com

      In reply to Sue Ieraci

      Sue,
      What exactly do you mean by 'subluxation theory'? Are you referring to the 5 component model of the subluxation complex, or the 33 principles, or innate intelligence or the philosophy of chiropractic (ie:vitalism,holism etc),

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    3. Sue Ieraci

      Public hospital clinician

      In reply to jerry sprom

      Jerry - I am referring to any aspect of chiropractic theory that postulates the effect on organs of an entity called "subluxation".

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    4. jerry sprom

      logged in via email @gmail.com

      In reply to Sue Ieraci

      Thanks for the response Sue,
      Does that include organs like the brain and spinal cord and muscular system? And when you refer to 'subluxation' what do you mean by that? I am interested to know what and how you think chiropractors are being taught about the subluxation at university.

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    5. Sue Ieraci

      Public hospital clinician

      In reply to jerry sprom

      Quote from a previous thread on CHiropractic training:

      As a recent Chiropractic graduate from Macquarie University, I feel I can openly add to this discussion.

      Yes John, we were comprehensively tested on anatomy, physiology, physics, chemistry and biochemistry etc - all those core science subjects that form the basis of a Bachelor of Science degree.

      We were also given lectures which referred to the subluxation theory. From my interpretation, the term was a theoretical concept…

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  18. Graeme Hanigan

    logged in via Facebook

    Kerreen,

    During the course of my life I was once an ill-informed health consumer and attended chiropractors, osteopaths, homeopaths and naturopaths in the mistaken belief that I would gain some benefit from the therapies offered.

    My experience was I received no benefit from any of the numerous attendances to these practitioners and so I suggest that your 'it worked for me' endorsement of so called 'alternative therapies' is negated by my 'it didn't work for me'.

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  19. Alan Schmukler

    Homeopath

    Kereen makes her point clearly yet it seems to give rise to so much defensiveness (attacks) that it makes me wonder whether people can ever really learn "new" information. Regarding evidence based medicine, I would recommend this article by Steve HIckey

    http://hpathy.com/scientific-research/evidence-based-medicine-neither-good-evidence-nor-good-medicine/

    Something is very wrong when we deny people's personal experience and instead trust studies by pharmaceutical companies who stand to gain billions by the results. Time and again this "evidence based medicine" has produced killer drugs that leave thousands injured or dead (Vioxx killed 60,000 Americans, the same number who died in Vietnam.) Listen to those ads on TV (eg. Abilify) and the horrid side effects. Is this science? Is this healing?

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    1. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Alan Schmukler

      Hi Alan, you're in the States right? We don't have advertising for pharmaceuticals to consumers here - it's illegal. And how much does Big Homeo make from selling distilled water and sugar pills? You're not giving your treatments for free are you?

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    2. Laurie Willberg

      Journalist

      In reply to Rachael Dunlop

      Funny how conventional medicine is incapable of curing anything but the relative costs are idiotically high and governed by what "the market will bear". The first aim of Homeopathy is to cure. If that's not possible, then it's possible to palliate, all with no adverse effects.
      Sorry you have such a pathological disbelief, however only a pseudoskeptic makes claims that homeopathic remedies are either water or sugar pills.
      Hopefully Aussies investigate the total effect picture of the drugs their GP wants to prescribe and ask very pointed questions about "treatment outcome". Considering that Homeopathy is growing by over 20% a year annually worldwide, patients are voting with their feet.

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    3. Paul Rogers

      logged in via Twitter

      In reply to Laurie Willberg

      Laurie wrote: "Considering that Homeopathy is growing by over 20% a year annually worldwide, patients are voting with their feet."

      And certainly not with their brains.

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    4. Rachael Dunlop

      Post-doctoral fellow at University of Technology, Sydney

      In reply to Laurie Willberg

      Laurie, homeopathic remedies are either sugar or water because they are diluted beyond Avogadro's Constant (greater than 10 ^-23). When conducting a serial dilution, after each dilution step, fewer molecules of the original substance remain, thus eventually the solution will be diluted beyond any likelihood of finding a single molecule of the original substance.

      In a common homeopathic dilution known as 12C (meaning it has been diluted 100 times serially twelve times, approximately equivalent…

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    5. Citizen SG

      Citizen

      In reply to Laurie Willberg

      Laurie,
      It seems that you possess the credulity to believe that a substance can be potent enough to effect major disease states but not potent enough to cause any adverse effects.... want to buy a used car off me?

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      "Funny how conventional medicine is incapable of curing anything...."

      Want to back up that statement, Mr Willberg, or just let it sit there?

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    7. Sue Ieraci

      Public hospital clinician

      In reply to Alan Schmukler

      Mr Schmukler says: "it makes me wonder whether people can ever really learn "new" information. " This, from a homeopath, who practises an outdated theory expounded by one person in the nineteenth century, based on principles that are considered immutable? Truly?

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    8. Laurie Willberg

      Journalist

      In reply to Sue Ieraci

      Suppose you tell us what chronic illnesses conventional medicine is capable of curing? Celiac disease, diabetes, Alzheimers, just for starters? You have to face up to the fact that drugs are merely an attempt to suppress one symptom or another.
      Homeopathy is not based on "outdated" theory, it is a competitive/opposite theory to symptom suppression which is the cornerstone of mainstream theory. Symptom suppression does not cure, never has, never will. In fact it only leads to further complications.
      It's actually your idealogy that keeps proving over and over again that it's a crap-shoot.

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    9. Ian Musgrave

      Senior lecturer in Pharmacology at University of Adelaide

      In reply to Laurie Willberg

      None of those can be cured by homoeopathy either, let alone ameliorated. But in type I diabetes insulin injections allow people to live full and productive lives, instead of dying in childhood. One day we will be able to replace the lost pancreatic cells which result in diabetes.

      But homoeopathy can do *nothing* to either treat or cure diabetes.

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    10. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      "Suppose you tell us what chronic illnesses conventional medicine is capable of curing? "

      Mr Willberg - do you understand the term "chronic"?

      OTOH, medicine cures a myriad of acute diseases - from infections to injury and childhood cancers. Homeopathy takes money from people with mild, self-limiting symptoms.

      Please show us the evidence that homeopathy is capable of curing anything.

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    11. Laurie Willberg

      Journalist

      In reply to Sue Ieraci

      You didn't answer my question -- what chronic illnesses is conventional medicine capable of curing? I listed some examples and there are hundreds more. Don't confuse the notion that applying diagnostic tests and coming up with a named diagnosis for a problem and then dispensing drugs to treat symptoms is a "cure".

      Unfortunately pathological pseudoskeptics choose to wilfully ignore any evidence they don't happen to agree with and would rather posture with philosophical rhetoric. Asking for "evidence…

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    12. Ian Musgrave

      Senior lecturer in Pharmacology at University of Adelaide

      In reply to Laurie Willberg

      I will repeat: None of those on your list can be cured by homoeopathy either, let alone ameliorated. But in type I diabetes insulin injections allow people to live full and productive lives, instead of dying in childhood. One day we will be able to replace the lost pancreatic cells which result in diabetes.

      But homoeopathy can do *nothing* to either treat or cure diabetes.

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    13. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Mr Willberg - are you being intentionally disingenuous? The very definition of a chronic illness is that it has no long-term cure. Once cured, it is not longer "chronic".

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    14. Joyaa Antares

      Prospective Researcher, Osteopath (Australia), UCL Alumni (Stats)

      In reply to Sue Ieraci

      I wonder if we have a simple misunderstanding here?

      Sue, my understanding of "chronic" (and I am happy to be informed otherwise by others) is that "chronic" is simply time-related. For example, "chronic lower back pain" is a problem that has been around more than 3 months, or 6 months, etc., depending on the definition used within any particular study.

      "Chronic" coming from the Greek word Kronos (= Time). I recall it being drummed into me at College that when a problem is considered "chronic…

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    15. Sue Ieraci

      Public hospital clinician

      In reply to Joyaa Antares

      Thanks, Mr Anatares - that is certainly the meaning of the word "chronic" - as in "acute" vs "chronic". You are certainly correct about "chronic" pain, for example.

      The term has come to cover conditions that have an ongoing course, and in that sense are "incurable" - such as TYpe 1 diabetes, SLE, rheumatoid arthritis - various other autoimmune diseases, which can be "suppressed" by medication. NO therapy has so far "cured" these conditions, although ongoing research attempts to.

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  20. Tony Linde

    retired geek, now arty-farty type

    "dynamic" tick,
    "holistic" tick,
    "intrinsic energy system" tick, ...

    Author forgot "quantum".

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  21. John Bundock
    John Bundock is a Friend of The Conversation.

    Retired Solicitor

    Belief in homoeopathy is a belief that a curative substance can be diluted in water so many times that not an atom of the original substance remains but when the water is then shaken by a local witchdoctor it acquires magical healing properties. If someone with the critical-thinking skills required to develop that belief was able to obtain a social science degree it would be a sad reflection on university education in Australia.

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  22. Ken Harvey

    Adjunct Associate Professor, School of Public Health and Preventive Medicine at Monash University

    Bridget Hewitt said, “To be able to become registered to legally use the terms 'Naturopath', 'Homeopath' or 'Iridologist' now entails completing a 4 year health science degree, then gaining accreditation through a national association”.

    Not correct! The above titles are not “reserved” for practitioners that have completed a 4 year degree and are accredited by a national association.

    Indeed, even the term “doctor” is no longer reserved for registered medical practitioners, see: http://www.riskequip.com.au/chiropractors/is-there-a-doctor-in-the-clinic

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  23. Mateus Ferraz-Souza

    logged in via Facebook

    This discussion has reached a level of insignificance and stupidity. Trying to discredit alternative health care professions, as I have seen in here, is not worth anybody's time.
    I just came from a full day seminar on hormone imbalance where a Chiropractic physician taught to over 100 health care professions, to include, over a dozen Medical Doctors. And, yes, we all include science as a backbone to support our claims.
    I guess, in Australia, this particular group of skepticals are many years behind common, sense. I feel sorry for all Australians! Well, here in America we have those who believe, dearly, that Elvis Presley is still alive, that earth was created 2,000 years ago, etc.

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Mateus Ferraz-Souza

      You feel sorry for all Australians? Well, we feel sorry for all Americans, who are forced to survive without universal health coverage and with longevity and infant mortality well behind ours...

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  24. Magdalena Luciuk

    Philosopher; Pharmacology research student at University of Sydney

    There is still so much to know about how the body works that it may be immoral to disregard a therapy as ‘pseudoscientific’ and ‘foolish’. At the same time, it is may be immoral to prescribe an alternative therapy to an ill person when a conventional therapy exists, perhaps even more immoral if the person in terminally ill. This, I think, is the problem. Defining ‘evidence based science’ is very difficult, such a definition exists within a social and subjective discourse which in fact is paradoxical…

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    1. Grendelus Malleolus

      Senior Nerd

      In reply to Magdalena Luciuk

      "What is interesting is that what was recently considered ‘pseudoscience’ (for example, meditation and eating fish oil) is now entering mainstream medicine (scientists have found that meditation alters the structure of the brain, and fish oil is being given to adolescents who are ‘at high risk’ of developing mental illness)."

      Magdalena the key phrase there was "scientists have found" and thus what you described as pseudoscience has become an accepted part of science. So what does this tell us…

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Grendelus Malleolus

      Therapies that start as "alternative" but are shown scientifically to be effective just become "therapies". Orthodox medicine has embraced treating peptic ulcer disease with antibiotics because it was shown scientifically to be both biologically feasible and effective. That;s how science works.

      Contrast a practice like homeopathy, which is still based on a set of principles expounded by a single person in the nineteenth century - when we knew so much less about physiology and pharmacology. How does it make sense to practise an outdated theory that has been outgrown by scientific knowledge?

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    3. Grendelus Malleolus

      Senior Nerd

      In reply to Sue Ieraci

      Sue I am not sure if that was a comment for me or for Magdalena, but either way, I agree with you!

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    4. Stephen Lehocz
      Stephen Lehocz is a Friend of The Conversation.

      Interested public.

      In reply to Magdalena Luciuk

      Thank you Magdalena.

      You are someone in the pharmacology camp that talks real sense. I know there is a lot like you, but not many putting some common sense into the whole argument like you are. There is a lot of data to be exchanged from both sides, that would enable some real advances in the healing sciences if more people had your attitude.

      People who have the extremely unreasoning attitude of "the other side of the argument is totally wrong" as demonstrated in some of the above comments, are obviously working to another agenda and not working to find a good outcome for a patient, or patient outcome is a secondary consideration.

      Anyone totally and fanatically on one side of an argument (and ignoring the other side) are just blinding themselves. And by blinding themselves make themselves ignorant of a lot of workable knowledge.

      They do make themselves obvious by constantly attacking the other side. Many of these names occur again and again.

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  25. Father Æthelwine

    Priest and researcher.

    As I read this article and the comments I am reminded of my friend Atul Shah. He is a fully qualified Pharmacist and also a fully qualified, and leading, UK Naturopath, so he knows both sides of the 'pharma' story. So why is he now practising Naturopathy when he is a fully qualified Pharmacist? As he puts it in brief - because he prefers helping people to live healthy lives rather than killing them.

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  26. Mark Sindone

    Self Storage Franchisee at Archive Storage

    Medical science is considered to be mainstream and is the channel that people turn to when illnesses strike because it is made so easily and widely available to everyone and that is the reason why people turn to it when the need arises. Another factor is the advanced technology and the reputation that it has built all these years due to the storage of past success stories like cure for cancer, surgery mechanism breakthroughs and many more that have gained people's trust. That is why people are more inclined to seek medical science help rather than traditional medicine or homeopathy and other alternatives.

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    1. Father Æthelwine

      Priest and researcher.

      In reply to Mark Sindone

      Mark, what planet are you living on? Here in the UK it is forbidden by law to say you can cure cancer, alopathic or alternative, Alopathic quacks in the USA, prescribing your wonder drugs are now responsible for some of the worst life expectancies in the developed world. I am very open to alopathic ideas if they work.

      For my money mainstream doctors get better and better every year at human plumbing, scaffolding, and wiring - amazing advances, amazing skill, but until they realise that we are what we eat, then we will be exposed to the joys of big pharma when we just feel ill.

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