Integrative medicine and the point of credulity
BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6979 (Published 08 December 2010) Cite this as: BMJ 2010;341:c6979
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McLachlan may be a serious scientist. By this article he proves he is
no less an arse than the immature students he has in his charge. The only
debate would be on how pert or patulous his diagram might be considered to
be. Having arrogantly stood by the scientific paradigm of medicine I was
suitably humbled by the evidence of clinical experience to understand how
scientific dogma lacked many answers regarding the human response to
illness and particularly ignored the placebo effect e.g.'the doctor is the
drug'. I truly hope the author remains in rude good health.
Competing interests: Member of the Faculty of HomeopathyMember of the British Medical AssociationMember of the Royal College of General Practice
Avraham Fried writes "Besides, I will add that if I would be a
researcher or an academic member of Durham University, I would be a bit
concerned by the fact that on my campus there is a researcher who writes
to international scientific committees about his research he never made
and about results he never found and that never existed, while he signs
his letter with the campus's official title.
Avraham Fried also writes "These issues have nothing to do with the
legitimate debate on the subject of integrative and complementary or
alternative medicine."
In the first statement, my response is that I would be concerned if I
had a colleague who was sufficiently gullible to accept such obvious
nonsense as offered by Prof. McLachlan. Furthermore, to the second point,
it 'is' an issue of "legitimate" debate when it is determined that those
"disciplines" have no filter for claptrap. What kind of 'debate' do you
have between science and nonsense? Hint: the scientific literature tells
us that acupuncture, cupping and reflexology are all nonsense.
How does one improve medicine by integrating bogus methods?
Competing interests: Preference for science-based medicine
This quote from Thomas Jefferson appropriately describes Professor
McLachlan's clever hoax:
"Ridicule is the only weapon that can be used against unintelligible
propositions. Ideas must be distinct before reason can act upon them."
Competing interests: No competing interests
I don't think this argument from the conference organisers stands up
to much scrutiny (much like most CAM). They basically say "because the
author was well-known in his field (embryology) we didn't scrutinise his
abstract at all." Can you see any other field of medicine doing that? If
the embryologist professor had tried to submit similar nonsense to a
conference on, say, hand surgery do you think the organisers would have
been so overawed by his record as to not apply some critical thought to
it?
They also make a big thing about Prof McLachlan's ability to tell the
'truth' and are willing to accuse him of fraud. He did tell the truth in
his article - that he made up the abstract to (successfully) highlight the
laxity of CAM regulation.
Competing interests: Preference for science-based medicine
If you look at the CVs for the committee, you can't help but be stuck
by how thin their credentials are; only one or two have significant
academic positions (assist in a physical diagnosis course and you can be
an 'instructor')or a significant publication list. When they're padding
their CVs with CME courses they took during their residency you know their
in trouble.
Competing interests: No competing interests
The bottom line is this is the christmas issue and we all look
forward to it with relish as a bit of light banter in the world of
academic writing that can sometimes be a creative-free earnest-heavy zone.
It might have sat more easily if the author had declared his playful role
in his application but some of the humour is seeing sensible people trying
to cope with what is obviously tosh - or should I say tush. Avaham Fried
delivered an excellent repost(erior) and I hope we can continue the
tradition of dialogue between our different perspectives.
Competing interests: No competing interests
@Kevin Chuang,
The ancient herbalists' research was pre-scientific. It is the same
type of research that brought us bleeding, violent purgatives, trepanning
and many more ineffective and outright harmful methods.
Consider ancient treatments for malaria, out of more than 100
recommended herbs (some say more than 200) only one, artemisia, was found
to be effective. That is not a very good record, you can read about it
here:
http://www.ncbi.nlm.nih.gov/pubmed/16722826?ordinalpos=21&itool=EntrezSy...
There was a practice in Europe of treating women after childbirth
with aristolochia. There are no records of how many women suffered kidney
failure subsequent to that, something that today we know is likely.
It was not until we realized that we could easily fool ourselves and
adopted science that we made real progress.
Competing interests: Preference for science-based medicine
I believe the Rapid Response of Avaham Fried, Director, the Jerusalem
International Convention on Integrative Medicine needs to be published in
the paper journal on the basis of the merits of his counter-arguments and
responses to McLachlan's piece. In light of what Fried is saying, the
original piece almost reads like slander.
I can understand what Brett L. Kinsler means when he says that "we
all feel a little bit sick for participating in the joke." I certainly do.
Prashant Sharma
Competing interests: No competing interests
Competing interests: Also have preference to EBM
I am totally confused by evidence-based medicine
After more than 30 years as a doctor I am more confused than ever
about what is scientific and what is not. Many articles I see about a
subject are followed by others with an opposing point of view in due
course, all very scientic it seems. I prescribe statins. They are full of
risks but still I prescibe them. Aspirin-after a hundred years I would
like to state categorically that those over a certain age in good health
should take a low doses or not. What is the proper treatment for
hypertension? I have looked at protocols from many counties and they have
very little in common. Should I prescribe antibiotics for an upper
respiratory infection or even otitis media? I read journals from all over
the world and I am getting more confused by the day. At a recent
psychiatric meeeting in Germany I learned that haloperidol is the
antipsychotic of choice in Italy for bipolar disorder. Other doctors
would blow a fuse at this point of view.
Personally I would never write a spoof article for a medical journal
as lives are at stake.
Competing interests: No competing interests