Homeopaths Respond to CBC Marketplace

Marketplace

On Friday, 28 November 2014, CBC Marketplace aired an episode (which I recommend watching before reading this) in which they sent parents and their babies to homeopaths for vaccine advice. They were exploring whether homeopaths were one of the sources of misinformation scaring concerned parents away from vaccines.

(Note: This article is not about the effectiveness or safety of vaccines and I ask the reader to consult Canadian regulations, summaries of the scientific evidence on vaccination, and the current recommended schedules for vaccination. This article is also not about whether homeopathic remedies are effective and I ask the reader to consult this evidence summary for a very detailed analysis of available evidence.)

Homeopaths are certainly not the only source of vaccine misinformation, or even the primary source, but as purported alternative health care providers, they have earned additional scrutiny. Within the context of the provision of health advice, their statements were shocking and deeply troubling, especially considering gaps in regulation of their remedies and the profession as a whole. Also disturbing was the use of autism — a supposedly vaccine-linked condition (it is not) — as a scare factor, contributing to stigma against people with autism, and the confidence and authority with which they made statements that are factually incorrect.

We are not entitled to our own facts; an aside on ethics…

This is the context in which I object to the current practice of homeopathy. The problem is more than the vaccine claims. The problem is that, despite those that have good intentions, the practice of homeopathy is far below the quality of service that Canadians should expect to receive from health practitioners and there are insufficient protections in place to ensure accountability and safety.

A patient/client has a right to informed consent, which means that any information or recommendations provided to them must be accurate (i.e., based on the highest quality evidence currently available), objective, non-judgemental, and appropriate/relevant. The client (or a substitute decision-maker) must also demonstrate reasonable understanding of the information and must unambiguously agree to recommendations, otherwise the treatment cannot ethically proceed. The practitioner must be accountable for their recommendations and maintain appropriate documentation. This is the basis of all health care interactions.

The erroneous statements made by the homeopaths in the Marketplace piece demonstrate that at least some homeopaths, regardless of their good intentions, are not ready for even this basic level of practitioner responsibility. The subsequent public responses on social media and the alleged deletion of information from websites without public acknowledgement also demonstrates a concerning lack of accountability. Finally, the accusations of conspiracy are beyond the pale for a health practitioner.

Homeopaths are not ready to be health care practitioners — a demonstration:

Homeopaths, and people who use homeopathy services, were apparently incensed and angrily took to Twitter and Facebook during and after the program aired. The vast majority of the response focused on having been secretly taped and conspiracy theories that Erica Johnson, Marketplace, CBC, and Health Canada are Big Pharma shills who target homeopaths. Many respondents retweeted each other and shared the same articles.

Keep the following in mind when considering the responses of homeopaths to CBC Marketplace:

  • Homeopaths and their respective organizations have failed to provide an adequate response to Marketplace that demonstrates appropriate professional accountability. Since the program aired, there has been no reassurance from the schools or organizations promising education to their members to ensure that future client interactions will be in line with public health recommendations. Many homeopaths still continue to claim that nosodes are as effective as vaccines, despite this statement from the Canadian Homeopathic Pharmaceutical Association (CHPA): “Our association and its members cannot recommend the use of any homeopathic medication, in lieu of conventional medical vaccinations. To our knowledge there have been no homeopathic substances thoroughly tested as consistently effective replacement therapeutics for conventional medical vaccinations.”
  • Health Canada does not recommend nosodes being used as vaccine alternatives (manufactured nosodes now require a warning label saying as much), but they lack authority over what homeopaths do/say. Lack of authority to act does not mean that they counter-intuitively approve of compounded nosodes (which are nosodes that the homeopaths prepared themselves).

I will highlight a few responses:

Beth Landau-Halpern wrote a blog post called “A Shot of Deceit” in which she took issue with Marketplace’s clandestine methods of data collection and stated that she is not sure which lawful circumstance(s) she met to be secretly taped (hint, they are in Beth’s article: “abuse of trust” and “no other way to get the information”). She likened her interaction with the patient as “bully” tactics, because the patient asked for a remedy for measles before leaving and Beth obliged. The implication is that she was pressured into giving the remedy, which made her look bad.

But a healthcare practitioner operates within their scope of practice and code of ethics at all times. If Beth thought it wouldn’t be appropriate to provide the remedy to “Emma” at that time, she shouldn’t have done so. So either Beth thought it was appropriate, or she allowed a patient to “bully” her into providing an inappropriate treatment. Neither circumstance is a demonstration of competence on Beth’s part, so I fail to see how this is a criticism of Marketplace or a defense of her actions.

She also threatened CBC with libel before the show aired and, as Scott Gavura discusses here, she gloated about the response from Health Canada regarding her paternalistic lack of warning to the patient and Marketplace’s subsequent complaint. The implication is that the Marketplace complaint was dismissed because it was spurious, and Beth takes the dismissal as “clearance” (i.e., that Health Canada agrees with her), when in fact it was routine bureaucracy.

 

Laurie J. Willberg has shared many links on Facebook and Twitter — before and after Marketplace aired — claiming vaccines are deadly, toxic, and ineffective while also claiming that homeopathy can treat or cure deadly diseases (such as whooping cough, dengue fever, meningococcal, chikungunya, cholera, ebola, etc). She has linked to known anti-vaccination organizations such as NVIC and VRAN and known anti-vaccine proponents such as Joe Mercola and the Health Ranger. Following the Marketplace piece, she tweeted prolifically about homeopathy “skeptics” (always in scare quotes, often with links to Skeptical About Skeptics), exposing an interpretive framework of persecution and battle. She directly responded to the Marketplace piece thusly:

She has so far not provided any justification for her stance on nosodes and vaccines being contrary to the CHPA, Health Canada, and the government of Ontario. I also fail to see how recording statements during a clinical interaction is “entrapment”, as no homeopaths were incited by Marketplace to commit a criminal offense.

 

Sonya McLeod, judging from her tweets and Facebook page, has apparently also decided that anyone who disagrees with her is part of a conspiracy that spans everyone working in public health, CBC, WHO, the Canadian government, and anyone else who supports vaccines. She tweeted a blog post by Karen Wehrstein listing some studies to demonstrate that homeopathy is effective, yet concluding in the final paragraph that “It’s not scientific per se, but the popularity of homeopathy around the world is testament to its effectiveness.” 

So even the Canadian Consumers Centre for Homeopathy concluded that there is no compelling evidence. If I were to base my professional conduct on popularity rather than actual evidence, I’d never prescribe exercise again.

Before and after Marketplace aired, Sonya shared and composed pro-nosode and anti-vaccine tweets. She has also since bragged about blocking “homeopathy skeptics”, indicating an unwillingness to consider evidence contrary to her beliefs. Sonya responded directly to Marketplace thusly:

This is an inadequate response to the significant professional and public health issues exposed by CBC and an inadequate defense of recommending nosodes, despite the stance of the CHPA. Health practitioners are obliged by professional ethics to change their practice, if necessary, based on evidence to ensure best practice for the client. Sonya blocks out any disagreement, demonstrating an inappropriate and unethical relationship with evidence with respect to client care.

 

Access Natural Healing Holistic Health Centre set up a Facebook page several years ago with the apparent intent of allowing homeopaths to warn each other of CBC investigations (e.g., past posts to the page show shares/posts of CBC ombudsman complaints) in addition to general information about homeopathy. The comments and a link to a blog post from 29 September 2014 seem to indicate that homeopaths felt burned by another Marketplace special on homeopathy from 2011 (Cure or Con) and were distrustful of them the second time around.

A post from 25 August 2014 indicates that a producer from CBC Marketplace contacted a homeopath named Elena Cecchetto of Access Natural Healing via email following a visit and follow-up phone call. The post alleges that CBC never contacted them before the email and that “Erica Johnson of Marketplace is at it again”. The email states that CBC visited the clinic and documented their interaction with Elena, during which it was claimed that nosodes were “over 90% effective”. CBC then invited her to speak to them on camera about their findings. In the comments, Elena indicated that the same letter was sent to Sonya McLeod and Beth Landau-Halpern indicated she got the letter as well.

This indicates that at least 3 months passed between Marketplace’s initial investigations and airing their show, but during that time none the homeopaths that were contacted agreed to speak to them about their evidence. Now, if I believed I was being set up, I probably wouldn’t want to be on CBC Marketplace either. But 3 months is plenty of time to organize an independent rebuttal demonstrating conclusively that there is sufficient evidence to support their clinical recommendations and claims about vaccines. They have not done so.

 

Susan Drury responded to Marketplace in an email bulletin, accusing them of cherry-picking and again taking issue with being secretly filmed. She does not provide supportive clinical evidence or specifically address how she was cherry-picked.

Conclusion

I believe that most homeopaths truly do want to help people. But without proper oversight and guidance, they are putting their much-admired desire to help people to disappointing use and are exceeding Health Canada’s ability (or willingness) to reign in their potentially damaging clinical recommendations.

Homeopaths’ main complaints with CBC Marketplace seem to be:

  1. They were secretly taped, which is deceit, entrapment, etc. (as contextualized by the overwhelming focus of their responses).
  2. They were misrepresented or taken out of context.
  3. The show did not provide false balance about vaccine shortcomings (and they don’t mean known shortcomings like vaccines not being 100% effective or the risk to people with egg allergies, etc.; they mean the unproven “shortcomings” of having killed children or caused autism — as contextualized by their social media links and claims).
  4. CBC Marketplace are Big Pharma shills and their show was propaganda.

Here is my response to each of these complaints:

  1. A health professional should be able to stand by their recommendations, because they should be clinically justified. The same client interaction should take place with or without a camera.
  2. The Marketplace footage shows full, naturally-occurring statements that are factually incorrect and contrary to public health recommendations. Homeopaths have not adequately addressed the factual inaccuracy of their statements. Rather, many have continued to make pro-nosode and anti-vaccination statements on their personal social media accounts, while at the same time claiming the Marketplace piece was biased and deceitful.
  3. I have yet to see a single adequate response that directly and clearly justifies their clinical reasoning in providing advice that is contrary to public health recommendations and their own pharmaceutical association regarding nosodes and vaccines.
  4. If Marketplace are shills for Big Pharma, then who is CHPA shilling for? Homeopaths have a conflict of interest, in that they stand to gain financially by vilifying mainstream medicine and selling their own remedies in addition to the cost of a consultation (for example), yet they have accused CBC Marketplace (and anyone else who accepts public health recommendations that run counter to homeopathic advice) of being government and Big Pharma shills spreading propaganda. It is not propaganda to carefully consider evidence and present an appropriate conclusion.

If homeopaths want to act as health professionals, they must also accept the responsibilities of health professionals including obtaining informed consent, having professional accountability, minimizing and disclosing relevant conflicts of interest, providing robust supporting evidence for clinical decisions, and changing their clinical practice as evidence dictates. The responses of homeopaths so far have not sufficiently met any of these criteria.

Advertisements

Shoulder Subluxation

As a student Occupational Therapist, I had a patient with a subluxation of the shoulder. This is a relatively common side effect for people who have had a stroke, as this person had, because essentially the weight of the arm is hanging without muscular support. When the shoulder muscles lack tone, the arm is held by flaccid tissue that has the ability to stretch out, allowing the shoulder to displace downward from the socket.

In my treatment of this patient, I did some research on shoulder subluxation, as you do when you are an evidence-based practitioner. A Google search of “treatment shoulder subluxation” found me this as the first entry. Continue reading Shoulder Subluxation

CPSO Extends Public Commentary Regarding Bizarre Health Policy Proposal

As was reported by David Gorski (surgical oncologist), Scott Gavura (pharmacist), the CFI Committee for the Advancement of Scientific Skepticism, Larry Moran (biochemistry professor), and others a bit more colorfully, the College of Physicians and Surgeons of Ontario (CPSO) has drafted an appalling (and at times simply confusing) policy regarding alternative medicine as it relates to general medical practice. Originally, the policy had been open for public commentary until 1 September, but after an overwhelming response the CPSO has extended the deadline to 16 September. Continue reading CPSO Extends Public Commentary Regarding Bizarre Health Policy Proposal

CBS Fail

The skepticism website Skepchick has alerted the masses that CBS is airing a joint venture by Joe Mercola and NVIC (two hefty sources of anti-vaccination nonsense) alerting people to the “risks” of vaccines and their “choice” of whether or not to get them. Though by highlighting risk, it’s clear what choice they want people to make.

There’s a petition to sign. I’m not really partial to those, however there is also information on how to contact CBS directly and through Twitter with the hashtag #VaxCBS.

Are Psychics the New Therapists?

Short answer: No.

Longer answer:

Psychics/mediums are people who claim to predict the future and/or talk to the dead using paranormal powers. There is no evidence (despite years of investigation) that people have these abilities. There is evidence that psychics/mediums use a technique called “cold reading” – even when they aren’t aware of it – which is a technique that allows psychics to gather information from their client/mark using body language, other cues, and a clever tongue. This allows the psychic to appear very accurate in their information, requiring no supernatural ability. Anyone can learn to do this.

People’s self-ignorance of using a trick may seem odd, but most people haven’t tested their “abilities” under controlled conditions. This allows them to legitimately believe that they have supernatural powers through thinking errors, like one called confirmation bias (remembering hits more than misses). Unfortunately, as with most things, there are also people who are downright frauds, using cold reading with intentionally-practiced skill. They may even go so far as to use “hot reading”, where the psychic cheats by surreptitiously gathering information about their mark before their reading. Examples of psychics and their techniques can be seen in Penn and Teller’s Bullshit! episode about psychics here.

Psychics operate on a scale from small local shops to vast phone networks to a much grander scale: national TV. One example of the latter is John Edward (previously busted using both cold and hot reading techniques on his former show Crossing Over), who was recently featured on the Dr. Oz show in a segment entitled “Are Psychics the New Therapists?“, hence this topic coming to the attention of a  health blog.

Edwards and Oz essentially present the argument that grief is like a cancer that, if left “untreated”, will metastasize, and psychics/mediums are helpful in this regard. But even this one claim contains several assumptions:

  • First, as discussed above, there is no respectable evidence that psychics can talk to the dead.
  • Second, even if we assume that psychics abilities are real (or at least non-harmful), there is no evidence that they are helpful.
  • Third, in relation to the segment title, can psychics be so helpful as to replace professionally-trained therapists with evidence-based skills in grief counseling?
  • Fourth, even if psychics are real, can John Edwards – specifically – really talk to the dead? Does he deserve to be featured on this show given his history using (intentionally or not) known reading tricks?

Their “yes” arguments are less than compelling, with Dr. Oz stating:

“as a heart surgeon I have seen things about life and death that I just cannot explain and that science can’t study.”

And later:

“I can’t make up an explanation for what John Edward does. And, again, what was most eerie was his level of detail, the concreteness of it all.”

In other words, “I’ve never heard of cold reading and I assume science can’t study some things, therefore I assume psychics are real/helpful.” Dr. Oz’s ignorance about the topic and his allowance that psychics abilities “can’t be studied” (they have – psychics just don’t like the results) allows him to imply to his trusting audience that psychics are a valid form of grief treatment.

So put down your psychology textbooks and peer-reviewed clinical research, young health students, the “new therapists” are helpful because we can’t explain how it might work. ???

Forget your degree, learn cold/hot reading.

The position of critical thinkers, as with anything, is that evidence comes first. There’s no evidence that John Edward or any other psychic/medium has the capability to provide consistent therapeutic benefit for grief, let alone as much benefit as a trained professional.

Psychics/mediums are not a health profession, they have no standards of practice or code of ethics (which are required of any legitimate health provider to protect people), and they have no oversight to ensure their customers that they are legitimate (which is impossible, due to lack of supporting evidence) or that they are effective in providing their services. They likely have no training in psychology and therefore no appreciation for the harm that may be done by (intentionally or not) implanting false memories or altering existing memories of dead loved ones with their claims.

It’s unfortunate that a doctor, particularly one with such a large reach, would devalue therapeutic professions and lend authoritative “legitimacy” to the claims of unproven psychics/mediums, particularly when actual people’s lives, emotions, and personal well-being are on the line. It just goes to show how easily anyone can buy into unproven claims, no matter what their degree, if they do not practice critical thinking.

CBC Marketplace Investigates Homeopathy: A Review

Benefiting from the Atlantic Time Zone, I got to be one of the first to watch CBC Marketplace on Friday night (darn you, Newfoundland!) where they covered the topic of homeopathy. Here are my impressions.

First, I want to praise Marketplace for not offering false balance on the issue. Homeopathy is not something about which there is any serious scientific debate. The evidence is clear that homeopathy is not physiologically/chemically/physically possible, has no defined mechanism of action, and does not work beyond a placebo effect. It would be wonderful if it did work, but it doesn’t. More…

After Wakefield: Undoing a decade of damaging debate

From flickr user debsilver
It's said that you can't unring a bell

This article was co-written by Scott Gavura, Pharmacist. Cross-posted at his blog, Science-Based Pharmacy.

Immunization has transformed our lives. This single invention has prevented more Canadian deaths in the past 50 years than any other health intervention. Our parents and grandparents accepted illness and death from diseases like smallpox, diptheria, and polio as a fact of life. Mass vaccination completely eradicated smallpox, which had been killing one in seven children. Public health campaigns have also eliminated diptheria, and reduced the incidence of pertussis, tetanus, measles, rubella and mumps to near zero. More…

“Good” vs. “Less Bad”

People are more aware of healthy eating these days (whether they’re successful at putting awareness into practice is another story) and marketers have gained another angle from which to sell products.

Enter the “less bad = good” ad/product label.

This is where companies frame their product as better than other products, or better than a previous version of their own product because, for example, the new/improved product might have less fat, sugar, or calories, and more nutrients. The trouble is, often the food is still appallingly unhealthy. Don’t even get me started on fruit juice.

Mayo

I saw a TV ad for Hellmann’s, made with “real ingredients like whole eggs and oil”, now with half the fat. Their slogan is “It’s time for real.” and they boast that their product, Hellmann’s Real Mayonnaise, is:

Made with high quality ingredients, including whole eggs, […] low in saturated fat, contains no trans fat, and is low in cholesterol.

Mayo is not healthy no matter how it’s packaged, yet they try to convince us otherwise by virtue of it being less bad than regular mayo. But a one-tablespoon serving of this product has 100 calories. Put in perspective, an equal amount of mustard has almost no calories; cream cheese — about 30 calories. Though Hellman’s tries to sell us on the benefits of “healthy fats”, that doesn’t change the fact that mayo is basically processed eggs and oil whipped into submission. Consumers concerned with healthy choices shouldn’t have mayo anywhere on the radar.

Here are some other examples I noticed during a recent trip to the grocery store:

Chips

First, Multigrain Doritos. Now to be fair, the bag doesn’t boast any health claims, but they are certainly banking on the multigrain moniker to sell products. People might be surprised to learn that these chips have 12 grams of fat and 260 calories per 50 gram serving. Multigrain fibre is a tad less healthy when it’s covered in salt and fat…

Another guilty party is baked chips, such as Baked Lays, which have 120 calories and 2 grams of saturated fat per 1 ounce serving — by the way, who eats one ounce of chips (28 grams)? Chips are bad for you, baked or not. Yet the “low in fat” marketing of baked chips seems to comfort people into thinking they are healthier than regular chips. Are they, though? Baked chips do have less fat than regular chips, but they have as much salt (note the serving size when comparing) and about the same amount of calories.

Bread

Another trendy grocery store item are those flattened hamburger buns that are supposedly healthier because… um… they’re flat, I guess. The idea is that they are supposed to have fewer carbs. But they actually have more fat, more calories, and more sugar than regular hamburger buns, despite the “healthy choice” label on the in-store brand. I guess I should point out that if the regular hamburger bun brands bothered to boast about their “nutritional content”, they’d win the fake healthy choice contest hands down.

Cereal

The worst product that I noticed though, is the new Kellogg’s Fruit Loops and Corn Pops. Now with fibre! Super, so they added fibre to their 24 grams of sugar and over 200 calories per cup, boldly stating that “Kellogg’s makes fibre fun” in an ad campaign that is clearly geared toward children (adults generally don’t care if fibre is made fun for them).

If adults are having such a hard time making appropriate food decisions against the onslaught of misleading advertising, what chance do children have? Rather than decreasing the absurd amounts of sugar in their children-aimed breakfast cereal, they’ve added fibre as if this nutrient is a magic shield against diabetes.

Conclusion

I don’t believe there’s anything inherently wrong with the concept of cooking pre-made or packaged food, nor is there anything inherently wrong with having a treat every now and then. But we can’t fool ourselves into thinking that sugar, salt, and fat is healthy or invisible as long as one other unhealthy ingredient has been reduced or some arbitrary nutrient is promoted on the package.

Until companies change the way these foods are produced and packaged, we’re all better off with fresh food. Nutrients don’t necessarily mean healthy, especially when they are foremost a marketing tool.

Objective and equitable care through good science.