Complementary and alternative medicine Medicine Quackery Skepticism/critical thinking

Woo infiltrates the U.K. undergraduate curriculum…

I’ve lamented time and time again how woo has been infiltrating American medical schools, even going so far as to find its way into being totally integrated into mandatory curriculum from the very first term of the first year of medical school at Georgetown. I realize I’m a bit late on this one, but sadly it’s not just the U.S. where pseudoscience, anti-science, and woo are infiltrating universities. In the U.K., it’s starting too:

Over the past decade, several British universities have started offering bachelor of science (BSc) degrees in alternative medicine, including six that offer BSc degrees in homeopathy, a therapy in which the active ingredient is diluted so much that the dose given to the patient often does not contain even a single molecule of it. Some scientists are increasingly concerned that such courses give homeopathy and homeopaths undeserved scientific credibility, and they are campaigning to get the label removed (see Commentary, ‘Science degrees without the science’).

Many scientists and advocates of evidence-based medicine feel that giving homeopathy scientific status is unjustified. Aside from the fact that there is no known mechanism by which this treatment could work, they argue that the evidence against it is conclusive. Of the many rigorous systematic reviews conducted in the past decade, only a handful have produced evidence, marginal at best, in favour of homeopathy, with the authors in each case stating that the data were weak. Several reviewers found no effect, and a prominent study suggesting that homeopathy does work (L. Linde et al. Lancet 350, 834-843; 1997), and which is frequently cited by homeopaths, has had its methodology extensively criticized since publication.

But homeopaths involved in the university courses — those that were willing to speak to Nature, at least — argue that they teach students scientific principles, including the critical analysis of evidence.

Homeopaths, teaching “scientific principles”? Homeopaths, teaching “critical analysis of the evidence”? When I read that, I laughed so hard that I almost hurt myself.

Then I thought about it. It’s as much of a laughing matter if you take the time to think a little more about it. For one thing, as Ben Goldacre found out, it’s not at all easy to find out exactly what these courses are teaching, without, I guess, taking one of them yourself:

Finding out exactly what is taught in the courses is not straightforward. Ben Goldacre, a London-based medical doctor, journalist and frequent critic of homeopathy, says that several universities have refused to let him see their course materials. “I can’t imagine what they’re teaching,” he says. “I can only imagine that they teach that it’s OK to cherry-pick evidence. That’s totally unacceptable.”

I can only imagine they teach it’s OK to cherry-pick evidence. That’s totally unacceptable.

Pharmacologist David Colquhoun of University College London has had the same problem, and is now using freedom-of-information legislation to get access to course materials after having numerous requests refused. The University of Central Lancashire and the University of Salford both declined requests to talk to Nature or share details of their homeopathy degrees.

I can only ask, as a commenter over at Bad Science asked: If you’re studying for a homeopathy degree do you get a better and better grade the less work you do?

This wouldn’t be such a big deal if these were being taught as history or culture, but they’re being taught as science. David Colquhoun gets it right in his Nature editorial when he says:

Other CAM courses are in aromatherapy, acupuncture, traditional Chinese medicine, herbal medicine, reflexology, osteopathy, therapeutic bodywork, naturopathy, Ayurveda, shiatsu and qigong. None of these is, by any stretch of the imagination, science, yet they form part of BSc degrees. They are not being taught as part of cultural history, or as odd sociological phenomena, but as science. The University of Westminster also offers a ‘BSc’ in nutritional therapy. Proponents of ‘nutritional therapy’ have been known to claim that changes in diet can cure anything from cancer to AIDS. For example, the British nutritionist Patrick Holford infamously recommends vitamin C as a remedy for HIV and AIDS.

He also gets it right when he points out that what is in essence happening is that U.K. universities are giving degrees in science for subjects that are anti-science. Naturally, homeopaths and purveyors of woo are very unhappy about such commentary, and they’re trotting out the same old excuses:

When a patient visits a homeopath, the practitioner asks questions that go beyond the symptoms and probe other aspects of the patient’s life, such as whether they are feeling stressed or unhappy. The result is an individualized treatment that takes longer than the ten or so minutes that the patient would get with a government-funded family doctor. This personal interaction is critical to homeopathy, both in tailoring the medicine and in gaining the patient’s confidence. Homeopaths say that if there is a chance that the patient might receive a placebo at the end of it, the necessary trust can break down.

“Trying to do what I do in that context didn’t work very well,” says Clare Relton, a practising homeopath who is conducting research into homeopathy at the University of Sheffield and has taken part in a clinical trial designed to assess homeopathic treatments for chronic fatigue syndrome. “I found it difficult to build a therapeutic relationship,” she says. Relton argues that homeopathy is scientific, but that the problem of trust means that double-blind trials aren’t the best way to measure its effectiveness. Instead, she and other homeopaths prefer to rely on more qualitative methods, such as case studies and non-blinded comparisons of treatment options. These, they say, provide ample evidence that homeopathy works.

Wrong. I’ve deconstructed this tired old excuse in excruciating detail before, not just for homeopaths, but when it’s trotted out to make similar claims for many other alternative medicine modalities. It’s nothing more than a lame excuse not to have to do the science, an admission that homeopathy is nothing more than a placebo effect from an attentive homeopath. But, then, I guess I’m one of those “microfascists” who insists on actual, oh, scientific evidence and evidence from well-designed clinical trials before accepting a treatment.

I’m funny that way.

Perhaps our American medical schools should team up with these British universities. They could make beautiful woo together.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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