Trick or Treatment (33 page)

1. ‘Natural’ fallacy
   Just because something is natural it does not mean that it is good, and just because something is unnatural it does not mean that it is bad. Arsenic, cobra poison, nuclear radiation, earthquakes and the ebola virus can all be found in nature, whereas vaccines, spectacles and artificial hips are all man-made. Or, as the
   Medical Monitor
   put it, ‘Nature has no bias and can be seen at work as clearly, and as inexorably, in the spread of an epidemic as in the birth of a healthy baby.’
   
 

2. ‘Traditional’ fallacy
   The notion that traditional is a good quality helps many alternative therapists because it means that the placebo effect is reinforced by a dose of nostalgia. However, it would be wrong to assume that traditional therapies are inherently good. Bloodletting was traditional for centuries, and throughout this time it harmed many more people than it healed. Our job in the twenty-first century is to test what our ancestors have bequeathed us. In this way, we can continue with the good traditions, adapt the traditions with potential and abandon those traditions that are mad, bad or dangerous.
   
 

3. ‘Holistic’ fallacy
   Alternative therapists use the term holistic to imply that their approach is superior to conventional medicine, but this ‘more holistic than thou’ attitude is unjustified. Holistic merely means taking a whole-person approach to medicine, and conventional doctors will also treat their patients holistically. GPs consider a patient’s lifestyle, diet, age, family history, medical background, genetic information and the results from a variety of tests. If anything, conventional medicine takes a more holistic approach than alternative medicine. This was demonstrated in Chapter 3 when we compared conventional against homeopathic health-care in the case of a student looking for advice about malaria prevention. The conventional clinic offered a long consultation, covering not just the drug options, but also the use of insect repellent, appropriate clothing and the student’s medical history. By contrast, the majority of homeopaths offered a very short consultation and gave no advice on basics such as bite prevention.
   
 

In addition to promoting their own fallacious, yet superficially attractive, core principles, the alternative-health industry also tries to recruit patients by condemning mainstream scientists. Alternative therapists are, of course, aware that scientists are largely critical of alternative treatments, so they attempt to undermine the scientific criticisms by questioning the credibility of science itself. The attacks on science cover three areas, but again we can see that the alternative therapists are basing their propaganda on fallacies:

1. ‘Science cannot test alternative medicine’
   fallacy As we have shown throughout this book, science is more than capable of testing alternative medicine. Indeed, that is exactly why scientists are sceptical about its many and varied claims. All these alternative therapies boast that they offer real and significant physiological impacts, ranging from pain relief to curing cancer, and medical science has developed techniques for measuring all these medical outcomes. If science cannot detect the alleged benefits of alternative medicine, then it is either because they do not exist or because they are too small to be worth bothering about.
   
 

2. ‘Science does not understand alternative medicine’ fallacy
   This is true, but irrelevant. Failing to understand how a therapy works has never been a barrier to accepting that it does work. Indeed, the history of medicine is littered with breakthrough treatments that were clearly effective and yet not initially understood. For example, when James Lind discovered that lemons could prevent scurvy in the eighteenth century, he did not understand how the lemons actually worked. Nevertheless, his treatment spread across the world. It was only in around 1930 that scientists isolated vitamin C and understood why lemons safeguard against scurvy. If a particular alternative treatment were proved to be effective tomorrow, then scientists would accept it and immediately attempt both to apply it and to understand its underlying mechanism.
   
 

3. ‘Science is biased against alternative ideas’ fallacy
   This is even more absurd than the first two fallacies. People who have alternative ideas are mavericks, and the whole of modern science has been built by mavericks, from Galileo right through to the latest crop of Nobel Laureates. In fact, it could easily be argued that all great scientists are mavericks in some way. Unfortunately, the converse is not true – all mavericks are not necessarily great scientists. Having come up with a radical idea, the challenge for any maverick is to prove to the rest of the world that the idea is correct, but this is where the majority of pioneers of alternative medicine come unstuck.
   
 

The last fallacy is worth exploring further, as science is often portrayed as a closed shop, when in fact the scientific community lovingly embraces those mavericks who can find evidence to support their claims. For example, in the 1980s, Australian researchers Barry Marshall and Robin Warren suggested that most peptic ulcers are caused by bacteria. The conventional view was that excess acid, the wrong diet and too much stress were the major factors in causing ulcers, which is why initially nobody took Marshall and Warren’s revolutionary idea seriously. However, in a famous and courageous experiment, Marshall successfully identified the rogue bacteria, cultured it, swallowed it and developed ulcers, thereby proving that ulcers had a bacterial origin. Obviously, other medical scientists were now convinced by the new theory and rewarded Marshall and Warren with a Nobel Prize in 2005. Even more importantly, a combination drug therapy has been developed to ward off the bacteria and cure those plagued by ulcers – this drug therapy is more effective, cheaper and quicker than previous treatments, so millions of people around the world have benefited from this once maverick idea.

It does not matter who the mavericks are, or how, when and where they come by their discovery. Even lucky discoveries are readily recognized by the establishment if they can be validated. Viagra, one of the most successful drug discoveries in recent years, was originally developed to treat angina, but a pilot study showed that it did little to alleviate this condition. However, when researchers decided to stop the trial early and recall any unused pills, they were perplexed by the reluctance of the trial volunteers to return them. Subsequent interviews revealed that Viagra had an unexpected and desirable side-effect. Further trials and safety tests have resulted in Viagra’s current widespread availability for the treatment of impotence. No homeopathic, chiropractic, herbal or acupuncture therapy has been able to show such a dramatic impact on the treatment of erectile dysfunction.

Curiously, while alternative medicine is often quick to criticize science on the one hand, it is equally keen to use science to its own advantage whenever it is convenient. But, yet again, alternative therapists are relying on flawed arguments and faulty notions to promote themselves. These fallacies fall into three broad categories:

1. ‘Scientific explanation’ fallacy
   Some alternative therapists employ scientific explanations to give credence to their treatment, but just because an explanation sounds convincing, it does not mean that it is true. For example, magnet therapists sometimes argue that magnets act on the iron component in our blood to restore the body’s electromagnetic balance, but this makes no scientific sense. The haemoglobin in our blood does indeed contain iron, but it is not in a form that responds to magnetism – this can be crudely tested by placing a strong magnet next to a drop of blood. Sometimes the explanations in alternative medicine contain pseudo-scientific jargon, such as a London-based healing clinic which uses phrases such as ‘the client’s electromagnetic circuitry’ and ‘defragmentate the body’. This jargon may be impressive to a non-specialist, but it is scientifically meaningless. We, the authors of this book, have a medical doctorate and two PhDs (particle physics and blood rheology) between us, yet we are baffled by these words.
   
 

2. ‘Scientific gadget’ fallacy
   Just because some alternative therapists employ gadgets that look impressive, it does not mean that they actually work. The Aqua Detox, for instance, is an electrical footbath that claims to draw toxins out of the body. The water actually turns brown during this process, which seems like evidence that the body is being cleansed. A UK-based alternative clinic claims that this treatment ‘has helped people of all ages, from babies (via a unit that fits in the bath) to the elderly, and has eased things like digestive dis orders, skin conditions, chronic tiredness and migraine to name but a few…it’s been used by cancer patients to draw radio activity from their bodies after chemotherapy.’ Unfortunately, the water in an Aqua Detox unit only turns brown because of a simple electro-chemical reaction which rusts the iron contacts on the side of the footbath. In other words, the water is not becoming saturated with toxins, it is merely awash with rust. Medical journalist Ben Goldacre analysed some water before and after an Aqua Detox session. Sure enough, the iron content in the water increased by a factor of fifty, yet there were no signs of the most obvious toxins. In one further test, Goldacre placed a Barbie doll into the footbath, and once again the water turned brown, which only reinforces the view that the discoloration was related solely to the machine’s own functioning.
   
 

3. ‘Scientific clinical trial’ fallacy
   We have stressed the vital role of clinical trials in determining the truth about a treatment, but just because an alternative therapist cites a trial in support of a particular treatment, it does not mean that it is effective. The problem here is that a single trial is not enough to demonstrate that a particular therapy works, because that particular trial might have been prone to error, the vagaries of chance or even fraud. That is why we have not based the conclusions in this book on individual pieces of research, but instead we have examined the broad consensus drawn from the totality of the reliable evidence. In particular, we have relied on meta-analyses and systematic reviews, in which a team of scientists has set itself the task of examining all the research in order to come to an over-arching conclusion.
   
 

The importance of the third fallacy can be illustrated by looking at research into whether or not prayer can help patients. Scientists already accept that patients who know that their relatives are praying for them may have a slightly better chance of recovery. This can be explained by obvious psychological effects, such as the likelihood that prayers give the patient a sense of love, hope and support at a time of crisis. Therefore, there is no need to resort to a paranormal explanation for the benefit given to patients who are aware of family prayers. However, scientists have wondered what would happen to patients who are being prayed for, but who are unaware of this spiritual intervention. Any resulting benefit could not be attributed to psychological factors, because the patient is blind to the prayers. Hence, if these patients were to benefit from secret prayers, then it would indicate some level of divine intervention.

One of the most famous studies into the power of prayer was published in 2001 by three authors, including one scientist based at the prestigious Columbia University in New York. It looked into whether prayer could help patients receiving fertility treatment. The trial involved 199 women in South Korea, 100 of whom received IVF treatment and had their photographs sent to prayer groups in Canada and Australia, and 99 of whom received just IVF. Crucially, the women did not know whether or not they were among the group being prayed for, yet the women being prayed for had twice the pregnancy rate of the control group – a remarkably significant result.

The research was published in the respected
Journal of Reproductive Medicine
, and it was then reported around the world with headlines declaring that scientists had proved that prayers can help patients. Meanwhile, other researchers thought that it was premature to jump to any such conclusion. Although this was certainly an interesting piece of research, it was just a one-off trial and the scientific community is reluctant to accept the conclusion from a single piece of research, particularly when its conclusion is so extraordinary. The only way that the results from this research would be taken seriously would be if follow-up clinical trials pointed to the same conclusion. Alternatively, if subsequent studies showed no effect, then it would be safe to assume that the initial study was flawed in some way and it could then be reasonably disregarded.

In fact, there was already a similar prayer study under way in 2001. This one involved 799 patients in an American coronary care unit. Half of them unknowingly received ‘intercessory prayer’ from groups of healers for twenty-six weeks, and the other half received no such prayers. The number of deaths, heart attacks and other serious complications were similar in both groups, which implied that prayers were having no effect.

In another study, which took place in 2005, 329 patients undergoing angiograms or other cardiac procedures received no prayers, while 371 patients received prayers from Christian, Muslim, Jewish and Buddhist prayer groups. Unfortunately, the prayers had no measurable effect on serious cardiovascular events, hospital re-admission or death. And, in 2006, the results of a ten-year study costing $2.5 million were published by researchers studying the effect of prayer on over 1,000 cardiac bypass surgery patients at six American medical centres, including Harvard and the Mayo Clinic. Christian groups prayed for half the patients for several years, while the other half received no such prayers. Again, the average outcome was the same for both groups, implying that the prayers were ineffective.