Alternative medicine: worth a try?
A Daily Dish reader who asked to remain anonymous recently wrote in about their experiences using psilocybin, also known as “magic mushrooms,” for medicinal purposes. Andrew Sullivan received so many emails about mainstream marijuana use that he and his writing team compiled them into a book — and something similar has been happening lately on the topic of psilocybin. At the Dish, it’s a sociopolitical conversation mostly about the legal status of drugs, but that’s not really what I want to talk about today.
This reader wrote:
I take small (no more than a pinch or two) quantities of psilocybin every day. Not to get high, not to unwind, but to try to heal my body. For 5+ years I’ve had an autoimmune problem that’s demyelinating my peripheral nerves – it’s called neuropathy. I do take a monthly treatment of gamma globulin to try to stabilize it, but the prognosis is for a long slow decline. Since “western medicine” doesn’t really have a clue and basically has the equivalent of sledgehammers to treat this thing, I’ve tried a host of non-Western modalities, including acupuncture and Chinese herbs, homeopathy, bio-energy balancing and strict diet. Not entirely no dice, but my condition is still declining. I suppose my fail-safe maneuver is to visit Lourdes or John of God in Brazil.
Anyway, fortunately I’ve also got contacts in the spiritual community of “medicine”, who have given me the idea of using what folks in Mexico call “the little healers”. I have a scientist friend who used it in small quantities daily to recover from bad asthma. It is reputed to help with the immune system (as well as anxiety and depression).
I am as yet too scared to undertake a full trip, which evidently can be like 6 months or a year’s worth of therapy in a few hours, but someday I will work up to it. I am befriending it right now, and I feel the mushrooms are helping my condition. You could call it merely a result of magic thinking, but what harm can it possibly cause? It’s natural, and I am determined to use whatever I can to heal.
Did you catch it? “Since ‘western medicine’ doesn’t really have a clue … I’ve tried a host of non-Western modalities.” “My fail-safe maneuver.” “The spiritual community of ‘medicine.’” “It is reputed to help.” Medicine wasn’t working out for this person, so they figured they might as well try alternative medicine as a backup. This is an attitude I’ve grown accustomed to hearing, but the frequency with which it’s repeated doesn’t make it any easier to comprehend or any more pleasant.
I think it was Tim Minchin who said it best: “Do you know what they call alternative medicine that’s been proved to work? Medicine.” These “non-Western modalities,” so appealing to our (misguided) sense of reverence toward any and all ancient wisdom, are all things that haven’t been proved to work, or have been proved not to work. Let’s take a look, shall we?
- Acupuncture: Sticking little needles all over the body at particular points, believed to heal a wide variety of ailments by manipulating “qi” or “energy flow” in some vague, magical way. It turns out that merely pretending to give someone acupuncture has equal, if not greater, healing power. Hmm.
- Chinese herbs: This is pretty nonspecific. Suffice it to say that there are plenty of herbs that do have curative effects, and many of the ones we know about have been used in actual medicines, but the simple fact that something is an herb doesn’t make it healthy by definition. The fetishization of eastern/Chinese wisdom doesn’t make an herb curative, either.
- Homeopathy: I, too, used to think that “homeopathy” was a synonym for “natural remedy.” But it turns out that it’s based such blatant magical thinking, it’s shocking that any generally sane person could buy into this scam. Homeopaths believe that the more dilute something is, the more powerful it is, so they dilute their “medicines” far beyond the point where a single molecule of the “active ingredient” would even be present in the solution. And about that active ingredient — they believe that “like cures like,” so to treat a symptom you should take something which would cause that symptom. Luckily (I guess), they dilute it into nonexistence first.
- Bio-energy balancing: What does this even mean? What is “bio-energy,” and how might an “imbalance” of it relate to peripheral neuropathy? This is just a nonsense phrase, an attempt to sound scientific and convince gullible people to open their wallets.
- Lourdes: I can only hope these last two were offered tongue-in-cheek. The shrine at Lourdes is about as credible a source of miracles as a burnt grilled cheese sandwich.
- John of God: This guy is a con artist. Perhaps he’s fooled himself too, but when you get right down to it he performs carnival tricks and scams people out of their money. Not a very good “fail-safe maneuver,” if your definition of “fail” is anything like mine.
Interestingly, the anonymous email-writer acknowledged the effectiveness of these alternative treatments: “Not entirely no dice, but my condition is still declining.” I’d chalk “not entirely no dice” up to the placebo effect, given the list that was offered and what we know about those “modalities” from scientific investigations.
I understand that people with long-lasting, painful medical conditions want some way to make themselves better. However, wanting something doesn’t make it so. The popular notion that “alternative medicine” is worth a try when you’re in dire straits can definitely be harmful. It distracts people from, and sometimes interferes with, proven science-based medical treatments. It wastes people’s time and money. In the rare cases where “alternative medicine” is not just a modern-day version of dancing around a bonfire or sacrificing a goat, where it has some actual direct physical effect, it can be very dangerous — because it isn’t regulated, hasn’t been adequately tested, and is not well-understood.
What about psilocybin? I admit I don’t have the scientific background to have an educated opinion. Perhaps it could be used for some valid treatments; our current legal framework might be constraining adequate research into these possibilities. What I can say with more certainty is that the attitude so perfectly encapsulated here — in which treatments which are “non-Western,” “spiritual,” or endorsed by “folks” in developing countries are given privileged status over evidence-based medicine — is what motivated this writer to try it. And that attitude is dangerous.
Older isn’t always better
The Washington Post has this really silly article about an on-again, off-again diet trend called the “Paleolithic diet.” It consists of eating “lots of lean meats, nuts, fresh fruits and vegetables; no grains, salt, sugar, legumes or dairy products.” Unsurprisingly, like most hip and fashionable diets, this is just an approximation of the tried-and-true but boring calorie-counting approach. They give the green light to fruits and veggies and lean meats, but cut out starches and added sugar — that sounds like a regular diet to me.
Of course, the “Paleolithic diet” has added appeal because it’s old. If traditional is good and ancient is better, why not go all the way to prehistoric?
[Fitness coach John] Main says at least half of his gym’s 80 or so members follow the diet pretty consistently, thanks to his convincing pitch that “this is how our human bodies have evolved to consume and process our nutrition” before the “onset of modern agriculture.” (“Modern agriculture” can sound like a disease in Paleo-speak.)
… [Colorado State professor Loren] Cordain writes that our Paleolithic ancestors were “lean, fit and free from heart disease and other ailments that plague Western countries.” Now, he adds: “Look at us. We’re a mess. We eat too much, we eat the wrong foods, and we’re fat.”
Any critical notions are constrained to one paragraph which begins, “Of course, there are skeptics.” Because you know how those skeptics are! Always being disagreeable, with their actual claims about human evolution and the human body’s ability to process various foods! As the reporter returns to Jennifer Jeremias, the star of the article, we read: “What’s important is that she’s never felt healthier.”
I’m not saying this is necessarily a bad diet. Like I said before, it sounds pretty much like normal calorie-counting with an added gimmick. However, it’s dangerous to endorse the idea that if humans did it a long time ago, it must be healthier than and generally superior to anything we do today. There are plenty of other so-called traditional or ancient health/medical practices that definitely result in harm, and even if this one is harmless, it teaches and normalizes an ideology that opens the door to danger.
What blows me away about the whole ancient=healthy idea is the fact that most of the people attracted to it have a great standard of living in the present, and they have no idea how bad things were long ago. Sure, people in the Paleolithic may have had a diet with the “proper balance of omega-3 and omega-6 fats,” but they didn’t have, for example, meat thermometers to make sure they never got sick from undercooking it. Pretty sure they also didn’t have refrigerators or freezers. We also have penicillin, vaccines, a deeper understanding of anatomy and genetics — heck, we have the germ theory of disease! I could go on and on. Modern life isn’t looking so unhealthy now, is it?
And let’s not get our facts muddled up, please. I agree that it’s unlikely that many people in the Paleolithic era died of type 2 diabetes or heart disease, but I’m pretty sure that has less to do with the precise details of their diet and more to do with the fact that the average life expectancy was 33.
The bottom line: there’s nothing wrong with a diet that’s high in valuable nutrients and low in calories, but there’s no reason to involve any pseudoscientific hype.
Michael Specter on the Charlie Rose Show
I’m watching Michael Specter, a science writer for the New Yorker, on the Charlie Rose Show right now. I’d never heard of this guy before but I adore him already. (I’m also admittedly not usually a fan of Charlie Rose, I suppose because I’ve fallen victim to the flashiness of modern media — I struggle to stay awake for his one-on-one interviews in front of a black screen for a full hour. The interviews are usually brilliant, though, and this is no exception.) The show’s bio of Specter says he’s just written a book called Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens our Lives. The interview and the book are about some of the same things he covers for the New Yorker: the current anti-vaccination chaos and its effects, misconceptions about organic food and genetically engineered crops, obsession with vitamins and supplements that don’t do any good … among other things. A few highlights that I managed to type before the moment passed by:
- Insightful line from Specter: “Science isn’t a company, it isn’t a country, it’s a method of doing something.” People often oppose scientific consensus and dispute the results of study after study because they claim that political and business interests shaped the results. To be sure, some funding-source bias may slip through occasionally, and a couple so-called “researchers” pop up from time to time who are outright sleazy. But to portray the entire institution of science as something so malleable, so easily lobbied and influenced, is to misunderstand deeply the concepts at the root of science.
- Explaining that eating locally grown, organic food is a nice goal but not a workable solution to the problems of starvation in the developing world, Specter emphasizes, “We’re not going to be serving everyone Swiss chard from the backyard. We’re just not.” The normally somber Charlie Rose starts giggling and says, “That’s true.”
You can watch the interview here once it goes online, probably later on Wednesday.
What’s the harm?
Like many, many others, I’m a big fan of the website F My Life (yes, the F stands for what you think it does, and no, it is not in general safe for work). In case you haven’t seen it: it’s a collection of short anecdotes describing humiliation, awkwardness, sadness, and other life unpleasantries. Sometimes, they’re hilarious, in a dark, “I’m glad that’s not me” sort of way. Sometimes, they help remind you that things in your life aren’t really so bad. Posts end with the letters “FML,” a kind of ritual exclamation, almost like an “Amen.”
Here’s one from today:
Today, my girlfriend of 3 years broke up with me because the love advice that she gets on her cellphone every week says that I’m cheating on her. I’ve never cheated on her and I was planning to propose next week. FML
A lot of the comments on that post express my basic sentiment to the poor guy: you’re better off without her, if she was dumb enough to believe those things. It doesn’t sound like it was generic love advice (like, “Communication is important!” kind of stuff) but instead that it claimed to be in some way tailored specifically to her. Maybe it was based on horoscopes, or it was from a psychic hotline type of service. Either way, the message is clear. What was seemingly an innocuous source of amusement for this woman drastically changed her life and the life of her boyfriend for the worse. He lost someone he loved, and she pushed away someone who genuinely loved her.
All too often, we see people using unproven, unscientific treatments or sources for life guidance and we think, “What’s the harm? If it makes them happy, isn’t that good enough?” As though consulting a psychic or getting acupuncture or taking homeopathic “medicine,” actions which are ineffective at achieving their stated goals, actually have no effect whatsoever. Of course that’s not true. Even sugar pills affect your health, even if it’s only by way of displacing the real medicine you should have been taking instead… to say nothing of the grave and direct consequences of many other “woo”-based practices.
Unconvinced? Take a look at What’s the Harm?, a website that catalogues the consequences of not exercising critical thinking skills. Sadly, but unsurprisingly, there are lots and lots of examples.
Time to talk
Orac’s post on the National Center for Complimentary and Alternative Medicine (NCCAM, part of the National Institutes of Health) reminded me of this card [PDF] made by them that I’ve been carrying around in my coat pocket for a while now. It says “Ask” and “Tell” in friendly orange speech bubbles, and it encourages me to speak to my health care provider about CAM treatments. I found it in my doctor’s office, and I wasn’t sure what to make of it.
On the one hand, this card tells me that NCCAM is “[my] source for reliable information about complimentary and alternative medicine.” Reliable is good. I checked out the website for the Time to Talk campaign, which these cards are a part of, and the point of it seems to be that patients should tell their doctors (and doctors should ask their patients) about any CAM treatments they may be pursuing on their own, so that doctors can advise patients about potential health concerns. The patient tip sheet says: “If you are considering a new CAM therapy, ask your health care providers about its safety, effectiveness, and possible interactions with medications (both prescription and nonprescription).”
On the other hand, CAM is still CAM. The best way I’ve ever heard to describe the crux of the issue: “You know what they call ‘alternative medicine’ that’s been proved to work? Medicine.” If NIH’s NCCAM is doing anything other than telling people to get as far away from CAM as possible, they’re doing a deplorable job of promoting public health. From the postcard and the Time to Talk site, it seems like they could be encouraging patients to find out about how pretend acupuncture has the same effects as real acupuncture, or about how homeopathy makes no sense whatsoever. However, as Orac’s breakdown of NCCAM grants makes clear, these are not their priorities. The vast majority of their grant funding is going either to things that shouldn’t be categorized as “alternative” (such as studies of the effects of particular diets on health) or — and this is the real issue — studies of therapies based on truly ridiculous ideas that shouldn’t be getting any credibility from a national research institute. For example: NCCAM funded a study to examine homeopathic succussion (vigorous shaking, claimed to make homeopathic treatments more effective; never mind that shaking doesn’t change the fact they are pure water) and to compare succussion to regular stirring, in order to “improve standardization of homeopathic remedy manufacturing and prescribing.” It’s terrifying to think that real money was spent on this so-called study, and others like it. Orac made the very apt comparison: “it’s like studying whether eye of newt or pixie dust is more efficacious in curing cancer.”
If NCCAM was there to provide an authoritative bank of data showing which supposedly alternative therapies were actually real medicine and which were “alternative” because they were pure garbage, that would be fine with me. I would be very excited about that, to be honest. Unfortunately, no matter how scientific the stated intentions of the center’s directors, they seem dead-set on promoting CAM rather than critically examining it.
Skeptics’ Circle #105: The Shakespeare Edition
Welcome to the 105th edition of the Skeptics’ Circle. It’s a privilege to be hosting such a fine carnival here at It’s the Thought that Counts. I hope you enjoy your stay at our humble blog.
In honor of the 105th edition, we’re going to take a look at William Shakespeare’s Sonnet 105. Although of course it’s actually about the beauty, gentleness, and loyalty of one’s beloved, I think we can give it a skeptical reading if we try hard enough. And with Valentine’s Day right around the corner, a love poem seemed appropriate. So let’s get right to it!
Let not my love be call’d idolatry,
Nor my beloved as an idol show,
What better way to open a meeting of skeptics? Several submissions focused on questioning facts assumed to be unchallengeable. One blogger unwilling to engage in such idolatry of assumptions was Karl Haro von Mogel at Biofortified, who can’t find a kernel of truth to anti-GMO groups’ claims that President Obama promised to mandate labeling of genetically modified foods. In other biology idolatry news, Jeremy at the Agricultural Biodiversity Weblog discussed the claim that 98% of the world’s seeds come from six companies. Is that a real fact, or is it a great example of Bellman’s Theorem?
Since all alike my songs and praises be
No problem — skepticism doesn’t have to be applied only to rare or outlandish things. Sometimes the everyday provides perfect opportunities to exercise one’s critical thinking skills. Marty, of Marty’s Place, wrote about the natural explanations for his apparent telekinetic and psychic powers over his refrigerator and car stereo. Meanwhile Matt, the Skeptical Teacher, explained how fortune cookies don’t know your fortune, even if they appear to help someone win the lottery on occasion — and how the same is true for psychics.
While we’re on the subject of psychics: Seth Manapio, of Whiskey Before Breakfast…The Blog reminded us that psychics are con artists, using false advertising to trick people into believing them. He argued that we shouldn’t blame a psychic’s customer for getting scammed, just as we shouldn’t blame a rape victim for getting raped.
To one, of one, still such, and ever so.
Some people think that if you hold a particular viewpoint, you’re never allowed to do anything that might reveal slight complicity in anything perceived by anyone as contradictory. TechSkeptic, of Effort Sisyphus, found an article on Fox News criticizing environmentalists for ever using electricity, using manufactured items, or doing anything with any environmental cost. TechSkeptic explained why, if we encouraged that attitude, we’d all be living without the convenience of indoor plumbing.
Kind is my love to-day, to-morrow kind,
Still constant in a wondrous excellence;
Love may be constant, but the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) is not. The Socratic Gadfly described how the definition revisions that took place between the DSM-III and DSM-IV may have contributed to the increase in autism diagnoses.
Therefore my verse to constancy confined,
One thing expressing, leaves out difference.
Yes, staying constant might be romantic, but it’s not always rational. Sometimes the difference is important, and shouldn’t be left out! It’s important to challenge our beliefs and see if a change is necessary. Barbara Drescher, at ICBS Everywhere, described her attempts to convince Frank Ferris to allow controlled tests to see if his dog Dave can really do math. Will she succeed? Stay tuned to her blog; there is some hope. TechSkeptic also gave us a great post on the challenge paradigm and its many manifestations. Check it out to see who’s doing it right, and who just doesn’t get it.
‘Fair, kind and true’ is all my argument,
‘Fair, kind, and true’ varying to other words;
Fairness, kindness, and truthfulness are certainly things we skeptics can get behind. (Heck, we’re even respectful while we’re insolent.) The emphasis is on that third one, though, so let’s take the time now to discuss evidence and how to examine it to find truth. Greta Christina, at her eponymous blog, asked if theists are really being intellectually honest when they say that the question of the existence of God(s) deserves “further exploration.” She argues that their version of exploration seems to involve a lot more omphaloskepsis than evidence-gathering. Over at Skeptimedia, Bob Carroll (of The Skeptic’s Dictionary fame) explained the importance of evaluating evidence. The class he used to teach on this topic sounds really interesting. Matt, the Skeptical Teacher, found some people who seem like they could use a lesson from Bob. He bravely delves into the strange and baseless claims made by conspiracy theorists worried about the Hudson River plane landing.
And in this change is my invention spent,
Okay, this is getting tricky, but I’m going to use the word “invention” to transition into publication of scientific research. Please imagine that that was graceful. Andrew of The Evolving Mind brought us the happy news of a paper published that gives a null result which may surprise you. Finding no relationship between variables is worth noting! I wrote about how papers posted on the freely available arXiv database do not necessarily contain reliable science, so they should be approached with caution. Blake Stacey, at Science after Sunclipse, shared a similar sentiment as well as a great example of some “alternative” genetic research he found there.
Three themes in one, which wondrous scope affords.
Skeptics know well that when you combine seemingly unrelated things into one new thing (think: quantum harpsichord bubble bath, sounds so curative!) you can make miracles… or at least a lot of money off the uninformed. Bing McGhandi, at Happy Jihad’s House of Pancakes, used this philosophy to bring us chapter 1 of his Feng Shui Diet book, all about preventative feng shui. So convincing, it’ll make you wonder why no one’s tried to sell this before. Over at Ionian Enchantment, Michael Meadon showed us a story that was all too real: a Reuters piece on what feng shui masters have to say about finances in the coming year.
‘Fair, kind, and true,’ have often lived alone,
Which three till now never kept seat in one.
As Shakespeare closes, so will we, with Kylie’s review of the show “Lie to Me,” at Podblack Cat. She wrote, “They don’t seem to be short-changing the science” of lie detection, and she says it’s also pretty interesting and entertaining. Three for one; I may start watching the show myself!
That’s it for this time around. Join us for the next Skeptics’ Circle on February 26th, to be hosted by Disillusioned Words.
Learning opportunities
I found myself in two frighteningly similar, yet significantly different situations while on winter break. One occurred at the home of a family member I was visiting. I found several books and pamphlets on homeopathy and other associated woo, and naturally became concerned about how deeply the woo had spread. The other happened at a party I was at with friends. I heard one person (a new friend who I don’t know all that well) tell another (a friend of mine for many years) that he had been having some mental and physical problems recently but that thankfully he’d found a “good homeopath.” I was sitting next to the conversation and could have easily jumped in, but I wasn’t being talked to directly.
My proper course of action in the first situation was obvious. Knowing this family member well, I couldn’t believe that they would honestly buy into homeopathy if they knew exactly what it meant. I sat them down and flipped through the books, explaining about dilution and succussion, using ipecac as a cure for nausea, and so on. It took less than two minutes to convince them to get rid of the books, though we talked a little longer about the details because of their curiosity. It turned out that the books were bought used and on sale very cheap, and seemed worth picking up because they looked like medical encyclopedias. We decided to throw the books away rather than donate them or bring them to a used book store, so that no one else would be fooled by them. Later, they asked me to look through a pile of books about medicine and to pull out the ones based on pseudoscience. It would have been nice to have taught them how to identify woo, rather than just how to run potential woo by me for evaluation, but overall I consider it a success.
I had quite the moral dilemma in the second situation, though. I didn’t know the person that well, wasn’t clearly a part of the conversation, and wasn’t sure whether it was actually a teachable moment. I heard him explain that he got worse before he got better — a classic hallmark of issues like a cold or a headache that appear, worsen, and heal on their own over time, and good evidence that homeopathic treatment is unrelated to the healing process. I squirmed in my seat and tried to make eye contact with a known-skeptic friend on the other side of the room. The real dilemma happened when he explained how the mind and body are so interconnected, and how so many ailments are psychosomatic. He used this as evidence for the necessity of “holistic” medicine, but I thought, good point! Maybe if you have a fake medical problem, it’s not so bad to treat it with fake medicine. This may even work for some real but not-too-serious problems — the placebo effect actually does help some people get better faster than they would have without it.
I decided not to say anything. I just complained about it later to that skeptic friend across the room, who never noticed my desperate stares. I think it was the right call because it would have made a scene and made people unhappy and upset (in a way I was safe from while visiting family). People don’t tend to learn from what you tell them, if telling them makes them very upset. Still, I know there is plenty of harm possible from this kind of stuff, and I feel bad about not even trying to intervene.
So, did I do the right thing? When do you step in to teach people about science and pseudoscience, and when should you just let it go?
Updates in scientific literacy
Several stories have been floating about lately, all generally on the topic of popular understanding of science. Here are the highlights.
A court has ruled that the University of California was well within its rights to deny admission to students they found unqualified as a result of their having attended Christian schools. The schools in question taught many classes that were extremely Bible-centric, to the exclusion of nearly all other content, making it impossible to meet the UC admissions requirements with their courses misleadingly called “biology” or “history.” I found this personally interesting in light of my earlier comments on how far it’s appropriate to extend religious tolerance. Even though it has upset some religious people, the courts have ruled that it’s okay to assess religious descriptions of the world and find them academically lacking.
Speaking of lack of academic background, I was happy for once to read USA Today, which reported that 76% of Americans believe that improving science education should be a priority issue for presidential candidates. In keeping with this, about 26% say that they themselves have an adequate understanding of science, but more ridiculously “44% couldn’t identify a single scientist, living or dead, whom they’d consider a role model for the nation’s young people.” My reaction is similar to Doug Natelson’s: Or dead? Really? We couldn’t name, oh I don’t know, Einstein? Perhaps he is not hip enough for the youth. (Check out Doug’s post for some more details on presidential candidates and their support for science research funding, as well.)
The USA Today article discussed science literacy in the context of voting ability. If Americans aren’t sufficiently “science-savvy,” how can we make the right choices about science issues? It’s not just about budgeting for research, it’s also about healthcare availability, education, stem cells, abortion… and it’s about every issue that invokes statistics. A bit more math than science, yes, but if we were more educated about science we’d be better at identifying large enough sample sizes and acknowledging deviations from the mean. That applies to almost every issue on which there is public debate involving presentation of evidence.
I certainly agree that science education should be a bigger priority than it currently is, and my opinions were only reinforced by this report on end of life care, which stated that 57% of the American public believes that “God’s intervention could save a family member if physicians declared treatment would be futile.” Almost 20% of medical professionals share this belief. While I don’t believe in miracles myself, I of course can’t offer positive falsification of their existence. What we should all be able to agree on, though, is that if all medical signs point to imminent or already-real death, a miracle recovery is not coming this time. There are many other interesting outcomes in the study, such as differing opinions about persistent vegetative state and how long it is acceptable to demand continuing treatment of a dying loved one. Orac of Respectful Insolence wrote a very thoughtful and thorough treatment of all this, cautioning against becoming too preoccupied with the religion aspect. I agree wholeheartedly with his bottom line:
Indeed, the focus on religion takes away the focus from the real issue: improving public understanding of scientific medicine and what it can and cannot accomplish. Lots of patients have unrealistic beliefs about health care based on all sorts of things, be they religion, faith in pseudoscientific quackery, or just fears based on misinformation that is rife in the media (i.e., the claim by antivaccinationists that vaccines cause autism). … Persuading families and patients that what evidence-based medicine recommends is the best for their injured or ill loved ones requires a far gentler touch.
Not evaluated by the FDA
Due to some scheduling freedom, I’ve lately become a bit nocturnal, and I’ve found myself watching a lot of late-night/early-morning TV. This has given me the opportunity to reflect on the ridiculous ads that companies save until we are maximally sleep-deprived and hopefully stupid enough to believe the crap that they are shoveling. Frankly, it is unbelievable.
I wanted to write something all about Dr. Frank’s No Pain Spray, because I’ve seen about nine zillion commercials for that. But once you get over the fact that it’s an oral spray that looks like a breath freshener but that’s supposed to provide all the way up to post-surgery level pain relief (no, I’ll take the Percocet, please), the fact that it claims not one but ten different homeopathic ingredients (slightly increasing the probability that a single non-water molecule might exist in the spray), and the fact that it’s only advertised at 3 AM (not a good sign for credibility), there’s really not a lot more to mock. Borrr-ing. Besides, someone else has done it more thoroughly than I would care to.
However, I think it’s important to say something about a more general problem I have with this class of advertisements. All these diet pills, “male enhancement” tablets, and so on make their claims of widespread success, then display the tiny text: “This product has not been evaluated by the FDA.” Is that enough to meet our legal standard for truth in advertising?
The Federal Trade Commission has this very clear FAQ about false advertising on their website. In particular I think it’s worth highlighting this one.
What makes an advertisement deceptive?
According to the FTC’s Deception Policy Statement, an ad is deceptive if it contains a statement – or omits information – that:— Is likely to mislead consumers acting reasonably under the circumstances; and
— Is “material” – that is, important to a consumer’s decision to buy or use the product.
It goes on to explain the process the FTC uses to investigate claims of false advertising, and uses the particular example of a mouthwash that claims to prevent colds. The FTC looks from the point of view of a “reasonable consumer” and evaluates both “express and implied claims,” checking to see if the advertiser has enough proof to back them up. In the particular example of medical or other scientific claims, the advertiser is expected to have “competent and reliable scientific evidence.”
I also found a page on the FTC’s website called Dietary Supplements: An Advertising Guide for Industry. It has a lot of important and relevant information, and in particular in section II.C.3 mentions the Dietary Supplement Health and Education Act (DSHEA) disclaimer, “that the statement has not been evaluated by FDA and that the product is not intended to ‘diagnose, treat, cure or prevent any disease.’” DSHEA doesn’t explicitly apply to advertisements, but this document does say that it’s a good idea to include the disclaimer “to prevent consumers from being misled about the nature of the product and the extent to which its efficacy and safety have been reviewed by regulatory authorities.” I was glad to see this example used to illustrate the issue:
Example 34: An advertisement for an herbal supplement includes strong, unqualified claims that the product will effectively treat or prevent diabetes, heart disease, and various circulatory ailments. The advertiser does not have adequate substantiation for this claim, but includes the DSHEA disclaimer prominently in the ad. In face of the strong contradictory message in the ad, the inclusion of the DSHEA disclaimer is not likely to negate the explicit disease claims made in the ad, and will not cure the fact that the claims are not substantiated.
This is a good standard to have. There are two prongs to the DSHEA disclaimer; I’ve usually only seen the first half used (in small and hard-to-read print, no less). The second half, that the product is not intended to provide any actual medical service, would seem ridiculous when compared to the explicit claims of medical service made over and over again in the ad. Of course it’s intended to diagnose, treat, prevent, or cure something! The first half of the disclaimer, though, is even less effective at offsetting the false advertising. The lies may not have been evaluated by a regulatory agency, but that doesn’t make it okay to lie. It’s the advertiser’s job to make sure what’s in the ads is true, and this feeble attempt to displace blame is laughable.
The problem, then, is not that we don’t have a good standard delineating what’s false advertising, bur rather that the standard is not being enforced. These advertisements aren’t just stupid, they’re nefarious — they’re lies told only when viewers are expected to be at their weakest emotionally and blurriest rationally.The FTC needs to step it up and get these cranks off the air.
How much for a psychic?
The last issue of Newsweek reports on Laura Day, a New York-based psychic business consultant. I was horrified to read the opening bit about the very technically competent hard drive company Seagate hiring her to run a management workshop. I guess motivational speakers at management workshops are always sort of nine parts fluff to one part content, but hiring a psychic seems like going a little too far. Interesting that they were impressed by her ability to intuit a disconnect between R&D and marketing. She must have gone to great lengths to divine that insight — like maybe reading a Dilbert comic strip before she arrived.
Perhaps Day does have some powers of intution — at least enough to realize that she’d get better business by avoiding that stigmatized term, “psychic.” From the Newsweek article:
Day is one of a small but expanding cadre of corporate psychic consultants—the professionalized face of an occupation better known for hokey headscarves and crystal balls. Rebranded as “intuitionists” or “mentalists”—terms more palatable to mainstream America—psychic advisers in recent years have been crossing over into the world of legitimate business, where they are used by decision makers in law, finance and entertainment looking for an edge in a down economy. “I specialize in nonbelievers,” says Day, referring to her roster of “red-meat-eating, Barneys-shopping, Type A personalities.”
Well, they’re not that hard to win over, because they’re willing to pay $10,000 a month for Day’s services. I don’t know if that’s really the mark of a nonbeliever.
“Intuition” is a real phenomenon, based upon almost subconscious detection of important cues that might be hard to consciously identify. You might notice that a person’s facial expressions, tone of voice, or way of moving are slightly different from what’s usual, which could clue you in to the idea that something is troubling them. Intuition is a valuable skill for management consultants, as they have to synthesize an accurate understanding of events from different people’s perspectives, watch individuals working together and analyze the dynamics, and give advice based on the trends they observe. People don’t usually come out and say to each other, “I hate taking orders from you” or “I disagree with your philosophy of how this office should be run;” it’s all much more subtle than that, so intuition about others’ feelings is essential.
After perusing Day’s website, though, I don’t think she really bills herself as not-a-psychic the way the Newsweek article suggests. The Experience Intuition section contains recordings on how to “send healing” to people or situations who need it and how to give your own “intuitive reading.” In describing the books she’s written, she says she “showed readers how to apply [intuitive] techniques in their professional and romantic lives while developing a variety of advanced intuitive skills such as telepathy and precognition.” In the first sentence it does sound like this might be just another take on relationship advice. (When your girlfriend says nothing’s wrong but then slams the door in your face, use your intuition….) But then she goes all Philip K. Dick on us! What is this, Minority Report?
“Remember when doing a reading that when you give to another, you give to yourself, because we are all really one energy in the circle,” Day says in the “Prologue to intuitive reading” recording. Um, right. Then she says you might get only glimmers of impressions that won’t make much sense to you, so you have to ask the person you’re doing a reading for to fill in the details for you — a classic psychic reading trick that makes the subject feel like they’re getting some information while really they’re explaining it all themselves. (Example: “I sense a man… the letter J is associated with him somehow.” “Oh yes, my uncle! His middle initial is J!” “Yes, I’m now getting a strong uncle sense….”) Thankfully she does tell people not to give medical advice using these techniques, though the natural question is, if these techniques really work, then why not?
Speaking of medical advice, I found this thread in a part of the forum dedicated to “Health and Healing,” which seems to be about half people asking for healing energies to be sent to their ailing loved ones, and half requests for help with specific medical problems — blatantly ignoring Day’s directions. I liked this thread in particular not only because it was for a really weird-sounding medical ailment that really ought to have a doctor’s attention (the topic is “Brown lower eyelids – dry & wrinkly”), but also because most people are giving really general and obvious advice. The most “intuitive” they get is having sensed the word “nutrition” while thinking about the problem, but (a) it’s not that mind-blowing to say “Are you eating a balanced diet?” when someone asks you for medical advice, and (b) I’m particularly unimpressed by the poster who mentions it after having read it already in the original question.
Like all alleged psychics, Laura Day and her followers do a decent job of making educated guesses while padding their readings with nonsense. There’s something to be gained by using a bit of intuition to supplement cold, hard intellect, to tell you when you can’t trust a new business partner who offers you a deal that looks lucrative on paper or to warn you that a close friend or relative might be hiding some important information from you… but intuitive skills like those aren’t worth $10,000 a month. My favorite part of the article was this:
(Though she admits her teenager can be psychically distracting as well: “I don’t want to see what he did with that girl until 2 a.m.,” she says. “But I can.”)
Are you kidding me? Is there any mother who doesn’t “see” what their teenage child is up to when they’re out until the wee hours with a significant other? It really doesn’t take psychic powers.
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