Archive for the ‘Medicine’ Category

Also posted on That’s the Way the Banana Crumbles.

I was asked to write a post about Chiropractic. I am (obviously) not a medical professional, and so I won’t deconstruct any of the studies pointing to specific things that chiropractic can and cannot do. Instead, I’ll attempt to look at broader trends within chiropractic. Wikipedia has been used (and linked to), but for definitional purposes only.

Chiropractic is a minefield for any skeptically-minded person. On the one hand, the entire institution was founded on theories of health and disease which have been thoroughly discredited, and are obviously wrong. On the other hand, unlike faith healing or homeopathy, chiropractic involves an actual physical mechanism, which can plausibly affect the body. Regardless, the people who continue to practice chiropractic based on false beliefs and discredited theories of sickness and disease (i.e. “straights“) are dangerous, due to their lack of understanding of what they’re doing, and the inherently dangerous nature of manipulating peoples’ spinal cords.

Fortunately, amongst chiropractors, this group is slowly shrinking. The growing trend in the field of chiropractic seems to be one where genuine medical diagnoses are mixed in with vestiges of the old vitalistic belief system. These “mixers“, though not as dangerous as their “straight” counterparts, are still a few subluxations short of being medical professionals.

As with anything that can affect/be done to/be inserted into the human body, if you look hard enough, you will find claims that chiropractic can cure any disease — from headaches to cancer. However, this would be disingenuous to chiropractors, as the ones making these claims are part of a small (radical) fringe group. At the other end of the spectrum, there’s very little controversy over the studies and claims that show that chiropractic manipulation can ease lower back pain, or help treat other chronic pain-related conditions. In this way, chiropractic is somewhere between physical therapy and massage therapy in its efficacy.

So where does that leave us with chiropractic? Realistically, it’s disingenuous to talk about chiropractic as a unified organization (or profession) in the same way we might talk about neurosurgeons. There’s no unifying philosophy, standards of practice, or professional ethics that are upheld by all chiropractors.

Some who argue in defense of chiropractic might point to the developmental history of the medical profession. Medicine as it was practiced a century ago doesn’t resemble modern medicine at all. If medicine had not been given the benefit of the doubt, it never would have reached its present state, so shouldn’t we extend that benefit to chiropractic as well?

The medical sciences took thousands of years of trial and error and development to reach their present state. There was a time when the practice of medicine was based on flawed knowledge and, as a result, caused more harm than good. That being said, medicine has already evolved past this point. Thanks to things like the germ theory of disease, medicine is no longer a guessing game. That being the case, it’s hard for me to see why anybody would think it appealing to ignore this progress and practice medicine based on outmoded and flawed ways of thinking. We already have a system that works; so I don’t see the need to go back and re-iterate past mistakes.

I also think that it’s incredibly telling that the more chiropractic progresses and enters the mainstream, the more it begins to resemble modern physical therapy techniques. The fact that chiropractic seems to be honing in on real medicine as it matures seems to indicate not that it is a new way of treating disease; but merely that it is slowly converging on what medical science already knows.

As revealed in a previous post, we’ve recently implemented some fairly large additions to Lintbox and its direction.  Many may have noticed the newly-added Special Features section, wherein we will occasionally bring you a variety of special content.  Among these is the Panel Discussion, a biweekly compendium where the Lintbox staff and contributors alike may have their say on a singular topic of note.  This week’s topic is NHPs, or “Natural Health Products,” and the nature of the basic human freedom to consume what one chooses to.

March 2008 in Canada was met with controversy when an amendment entitled Bill C-51 was introduced by Canadian Parliament in an effort to improve the efficacy of the long-obsolete Food and Drugs Act.  The bill, though more of a compliment to the act than a modification, was met with a strong public outcry orchestrated by the website Stop C-51, a purported grassroots organization that claimed C-51 would implement draconian restrictions on natural health products and result in a proverbial police state.  The website was revealed to have been a front for Truehope Nutritional Support Ltd., an NHP company sued by the government for selling multi-vitamins as a treatment for bipolar disorder without a license. Read the rest of this entry »

Is it ethical to prescribe a placebo?

Glucosamine is a drug that is sometimes prescribed, and often recommended, to treat joint pain and arthritis. Extracted from the shells of shellfish, it isn’t toxic, and it’s relatively cheap to purchase. People who use it often notice a substantial decrease in their joint pain while they are on the medication. Unfortunately, glucosamine probably doesn’t work. Clinical evidence of its efficacy has been contradictory, at best (it’s a bit telling that the product is sold as a supplement, rather than a drug). However, in a randomized, double-blind, placebo-controlled trial, it was found to be no more effective than a placebo ¹. This would seem to indicate that any reduction in pain brought about by the drug is a result of the placebo effect, and not a medical effect.

In many ways, glucosamine is a lot like most other types of non-evidence based medical treatments. It has no proven biological effect, and any change experienced by the patient is identical to the placebo effect. However, glucosamine doesn’t exhibit most of the harms present in other quack medicine. It’s not toxic, and is relatively inexpensive; additionally, the illness that it’s meant to treat (arthritis/other joint pain) is both a) non-lethal, and b) incurable (meaning there is no harm from delaying seeking proper treatment). Treating the condition properly, one could only hope to reduce the pain — and this is already being accomplished by the placebo effect.

This creates a tough situation for the skeptically minded when we see somebody else using, or prescribing, glucosamine. On the one hand, belief in the efficacy of glucosamine is utter nonsense, and though it might not necessarily be the case, lack of skeptical thinking about one form of treatment could lead to a lack of skepticism concerning other treatments in the future. On the other hand, the harms in this case are relatively non-existent, and scientific skepticism not being too popular, skeptics are often forced to pick their battles.

What do you think?

I am a big fan of Consumer Reports magazine. For those of you who don’t know, it’s a consumer information and advocacy magazine. In each issue, it selects groups of products (e.g. computers, televisions, lawn mowers, refrigerators), and makes recommendations based on a battery of tests, surveys, and investigation of the product. It tests all of the products that it recommends, and usually has a very scientifically-minded approach to studying consumer goods.

However, the magazine is not limited to the analysis and recommendation of products, but also contains other supplementary material. Some of these things, like recall and safety notices, are often valuable in supplementing the content of the magazine. However, they can sometimes get into trouble in their supplementary sections, leading to problems like those in their latest issue. I took exception to two articles in particular: When to Buy Organic and How Did You Sleep Last Night?.

Read the rest of this entry »

Hearing Jenny McCarthy’s stance on vaccinations sickened me. This was no longer the innocent pseudo-science of UFO sightings and Free Energy, but rather a movement that has resulted in thousands of deaths world-wide, and outbreaks of previously-eradicated diseases in one of the most scientifically advanced countries in the world. Enraged, I decided to do something. I didn’t go out and hold a protest, or write an angry email. Rather, I decided to scour her Wikipedia article and see if I could find and fix any misconceptions. When I did, I found the following paragraph:

On April 2, 2008, she went on the Larry King Live special dedicated to autism, and engaged in a fierce, on-camera spat debating whether premature vaccines have contributed to the incidence of autism in previously unaffected babies. However, this opinion is in stark contrast to the scientific community opinion that no causal association exists between autism and childhood vaccines, such as the MMR vaccine,[15][16] although the US government has recently compensated a family whose child developed autism after receiving vaccines.

I took exception to the last part of that paragraph, and feeling that it was unnecessarily biased towards anti-vaccination sentiments, I modified it to read:

On April 2, 2008, she went on the Larry King Live special dedicated to autism, and engaged in a fierce, on-camera spat debating whether premature vaccines have contributed to the incidence of autism in previously unaffected babies. However, this opinion is in stark contrast to the scientific community opinion that no causal association exists between autism and childhood vaccines, such as the MMR vaccine,[15] although the US government has recently compensated a family whose child developed complications from a previously-existent disease, resulting in autism-like symptoms, after receiving a vaccination.[16] However, this is the only such case where a link has been established between autism and vaccination, and was most likely due to a pre-existing condition.¹

My addition was eventually removed due to the autism debate being deemed tangential to the rest of the article. That being said, I managed to start a process that would culminate in having the offended text removed. The current article now reads:

On April 2, 2008, she went on the Larry King Live special dedicated to autism, arguing that premature vaccines have contributed to the incidence of autism in previously unaffected babies. Her opinion contradicts the scientific consensus that no causal association exists between autism and childhood vaccines, such as the MMR vaccine.[15]

I feel satisfied knowing that I made a small difference. A minor victory, to be sure, but every little bit helps in the fight against medical hysteria — especially on a site like Wikipedia, which has become the go-to site for those unfamiliar with the topics they are researching.

Recently, I’ve been thinking as to the criteria that would cause me to accept the existence of an intelligent god that interacted with humans.

So here’s my challenge to God: start answering prayers. More specifically, start answering the prayers of sick people. If everybody¹ with some sort of disease, who prays to God to be healed, is instantaneously healed of that disease (without medical intervention, of course), I would take this as pretty conclusive proof that there is some sort of really powerful, if not omnipotent, God (if not some other powerful intelligence watching us).

The ball is in your court, God.

The BBC posted an article a while back, announcing, “Trust drug may cure social phobia.” Arguably, this article may be jumping the gun a little in terms of efficacy of the product, but the BBC does tend to be pretty good with this type of stuff, and the headline does include the important word may. However, I’m not interested in discussing the efficacy or plausibility of this product; rather, I want to talk about the underlying message behind products such as these.

The thing I love about science is the same thing many people hate about it. Not only do we try to find the solutions to problems, but we also solve things that we didn’t know used to be problems. Up until now, many people would become shy and nervous in social settings and that would be dismissed as just the way things were. Now, along comes a group of scientists who they tell us that we can change the way we interact with each other by taking a drug. I find this brilliant, and while it may not be as amazing a discovery as a cure for a disease, or a more efficient way of producing crops to feed the world population, these types of discovery – ones that change the perceived status quo – are still pretty amazing in their own right.

Read the rest of this entry »

Complimentary and Alternative Medicine (CAM) is sold as an alternative to conventional (i.e. science/evidence based) medicine. The rallying cry of CAM supporters is usually that of choice. They feel that the supporters of conventional medicine have backed them into a corner, and conspire alongside “Big Pharma” to ensure that their choices for treatment are limited. They demand to be able to choose how they treat their own bodies. Naturally, in a place like Canada where we have a universal public health care system, we fund these “treatments”, because we don’t want to deprive people of their ability to choose. Even if we take into account the fact that these “treatments” don’t work, they still make people feel better and get rid of symptoms, so why shouldn’t we fund them? Granted, some forms of CAM can be dangerous, but as long as people are properly informed as to the safety and proven efficacy of CAM techniques, why shouldn’t they be able to take that risk? Some forms of CAM, like homeopathy, are truly harmless — especially if taken in conjunction with conventional medicines.

Taken together, this sounds like a compelling case for public support and funding of CAM, and this is often seen as a compelling reason by legislators. If the people want it, and it makes them happy, then why shouldn’t we support it? Aside from the fact that this lends credence to ineffective methods of treatment (which arguably is also a rather large problem), the main reason for why this is a bad idea lies in the intended purpose of universal public health care.

Read the rest of this entry »

There seems to be a rather large problem with Bill C-51 that has been overlooked by our policy makers and health officials alike: nobody seems to understand the bill. The premise is simple enough: treat all medications the same way. If you want to sell something that claims to cure cancer, then prove that it cures cancer. That’s it. Simple.

Unfortunately, there seems to be a rather large opposition to this bill, and the basis of this opposition seems to stem from a gross misunderstanding of it. The C-51 Opposition Party is a big tent, ranging from FDA paranoia to the belief that this bill aims to ban all herbal remedies.

To clarify, this bill will not ban herbal remedies. It will require that all drugs marketed as cures or treatments will be subjected to the same standards. This would not prevent people from selling, purchasing or consuming non-harmful (and legal) substances. This is about health claims and fraud… that’s all.

I can’t help but think how much smaller the opposition to this bill would be if people only understood what it was about. The conspiracy theorists would probably still rant about how this is another scheme by Big Pharma to steal our money, make us sick, and extract our surplus value… but those people are already a lost cause. Hell, if you really wanted to, you could still sell Orgone crystals!

Here’s my challenge to you: If you are not in favour of Bill C-51, go and read it. Make sure you understand the terminology, and what each section means. Afterwards, if you still think it’s a bad idea, come back and chat.

Two weeks ago, I wrote about Bill C-51, Canada’s answer to the currently obsolete system of food and drug regulation. As is expected by the non-science crowd, they weren’t happy.

Clearly, a lot has happened since. Namely:

Our friends at Ottawa Skeptics have written several articles on the issue-

1. Bill C-51 – Jackboot Inspections, Big Pharma Intrigue, or Good Government
2. Natural Health Product (NHP) Regulation in Canada
3. A Letter to Denise Savoie, MP, about Bill C-51

Health Canada, furthermore, responded to the hysteria related to Bill C-51 here.

Dr. Steven Novella, president of the NESS and host of our favorite podcast, The Skeptics’ Guide to the Universe, has also responded to the controversy on his blog Science-based Medicine.

One intrepid commenter on Dr. Novella’s post made a very significant discovery concerning the people behind the Stop C-51 campaign (Surprise! There’s a conflict of interest!)

To those who have yet to do so, be sure to check out the Support Bill C-51 Facebook group and continue to show your support for reason, science, and common-sense!