Evidence Based Policy: Corrections

by endlesspsych

By Keir Liddle

In response to the comments left by Peter Maxwell on this week’s evidence based policy.

1.Since when did herbal medicine not have efficacy beyond placebo? Given there is actually a large cross-over between modern drugs and herbal medicine, your assertion does not display a great understanding of the subject matter you are talking on.

I accept that this is an example of sloppy writing. The paragraph is reproduced in corrected form below:

Far asides from efficacy beyond placebo (of which there is little high quality evidence for any of the above treatments), there have been genuine safety concerns in the past.

This is true, and still applies to many herbal medicines that exist today. However, a paragraph such as the following should probably have been added to the original article:

The issue with all herbal medicine is not necessarily efficacy but more safety, labelling and proper investigation of interaction effects. A large problem that concerns Indian and Chinese imported herbal remedies and the like is contamination with other substances that aren’t reported and can lead to dangerous side effects up to and including death.

2. I posit however, if we started to look at the numbers then modern medicine will come out worse on a case-for-case or treatment-for-treatment basis. Do you *really* want to start pulling that that thread?

Well, given the limited or non-existent efficacy of alternative and complementary medicines, if we looked at it on a case-for-case or treatment by treatment basis, I would posit that ‘modern medicine’ has far more successes than failures. For instace: eradicating smallpox, the germ theory of disease, transplant surgery, vaccinating against many fatal diseases and increasing life expectancy around the globe. In short some, and I stress, some alternative or complementary practices will have a better safety record than ‘modern medicine’. However, their ratio of kill/cure will be pretty unimpressive compared to medicines.

3. Any chance of writing this in an evidence based manner? You’ve just attributed an opinion to a whole group of people without any evidence. If you are willing to be critical of others for not working from evidence/sources then I fully expect you to substantiate your own opinion.

Perhaps often is a touch unfair, although one doesn’t have to look all that hard to find evidence of proponents of CAM intimating there is, or overtly decrying, a pharmaceutical industry conspiracy or medical campaign against complementary and alternative “medicine”.

Whale.to is perhaps one of the best examples of this containing such gems as:

The main pharma shills are the Allopaths (most medical industry workers are completely oblivious as to the true reality which is why it works so well) who just market the products of the drug industry. Nutritional Medicine is what should have replaced Pharma medicine (Allopathy), as numerous medical doctors are demonstrating. The next main shill is government, not just the health departments all run by Allopaths (WHO, CDC, FDA), but the whole political system which is also a monopoly. The medical cartel is the main source of bandit income for the Elite, and the main organ of control, like the Church used to be in times past. It is the new covert state religion.

Another example is Natural News – Mike “Health Ranger” Adams’ site:

The cancer industry is losing its propaganda battle as more and more people discover the truth about the toxic side effects of chemotherapy as well as the cancer preventive powers of nutrients like vitamin D and selenium. With the science now clearly showing thatchemotherapy fails most patientsand that conventional approaches tocancercause more harm than good, thecancer industryhas resorted to celebrity-influenced emotional theater to try to lure more people into keeping its “someday we’ll find a chemical cure” scam going.

Here is a post from the main alt-med newsgroup (Courtesy of ORAC):

Please be aware that many comments and responses posted to this forum are not those of casual posters interested in an honest exchange. A number of individuals with ties to industry are engaging an effort to shape public sentiment about the risks of mainstream medicine while denigrating the benefits and validity of natural medicine. I refer to these individuals broadly as “Pharma Bloggers”(*). Pharma Bloggers on usenet don’t promote a specific company or product, as might be the case with standard “blogging” on a weblog. Most of these people are likely to have an association with a PR campaign whose “blogging” efforts are underwritten by the media and marketing groups of industry.

Also, it can be enlightening to check out the one star reviews of books like “Trick or Treatment” or “Bad Science” on Amazon and the like, as the shill gambit appears quite a lot:

The drugs industry is morally corrupt and its loyalties lie with satisfying its shareholders. Indeed the only thing good about the drugs industry is the massive profits through contractual and monopolistic tie-ins with health-care organizations. It’s funded by venture capital and hedge funds that are only interested in short term profits.

These are just a few examples of the pharma shill/pharma conspiracy gambit, which most certainly exists and is sometimes used on the internet. However, it was remiss of me to give the impression of over-generalising, so I suggest the paragraph in question could be amended to:

Some practitioners of alternative therapies often deride “allopathy” or “Western traditional medicine” as being disease-centric, or the product of a greedy pharmaceutical industry bent on keeping people ill to peddle drugs.

I hope this addresses some of your concerns about the previous article.

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