Complementary and alternative medicine Medicine Surgery

The quack Miranda warning metastasizes

Today is the third day of the three day weekend cobbled together from happenstance that the Fourth of July fell on the weekend this year. In any case, I’m still in a bit of vacation mode; so this post won’t be as voluminous as you are used to. (Some of you are probably rejoicing at the lack of logorrhea.) I’m also working on my talk for the Science-Based Medicine workshops at TAM8. In fact, while working on my talk, I came across a little tidbit that forms the basis of this post.

Blog bud PalMD once coined a truly apt term to describe a certain form of disclaimer that’s found on quack websites, namely the Quack Miranda Warning. Indeed, the quack Miranda warning has even wormed its way into the Rational Wiki. Here are a few examples.

First, from Healing Water Works, which sells “alkaline ionized” water:

These statements have not been evaluated by the FDA and as such shall not be construed as medical advice implied or otherwise. No claims are made with respect to treatment of any physically diseased condition and no attempt is ever made to dissuade individuals from seeking medical treatment for any condition. In addition, this equipment, technology and products have not been evaluated by the FDA, nor are they intended to treat, cure, mitigate, diagnose or prevent any illness or disease.

And from Byron J. Richards Wellness Resources:

*These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease. Note: the asterisk mark following a paragraph and linking to the above FDA disclaimer applies to any or all statements in that paragraph.

You get the idea. Although various websites selling non-science-based nostrums, “treatments,” and dietary supplements may use somewhat different wording, at the core of every quack Miranda warning is a statement something like this:

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease.

Clearly, these statements are meant to immunize the seller of dubious treatments against the charge that it’s making any promises whatsoever about their efficacy with respect to any diseases or conditions, and quack websites always have some variant or other of this statement phrased with different levels of emphasis and detail listed somewhere on the website. Indeed, the presence of a quack Miranda warning is something that is about as reliable indicator that a website is selling rank quackery as I can find.

As much as I’ve railed against what has been termed “quackademic medicine,” there’s one thing that distinguishes quackademic medicine websites from full-on quack websites is the distinct lack of a quack Miranda warning. At least that’s what I thought until I started doing research for my talk. That’s when I came across a pamphlet published by the University of Colorado Hospital Center for Integrative Medicine at the Anschutz Medical Campus in Aurora, CO. The pamphlet is entitled Acupuncture & TCM, and it’s full of stuff like this:

Traditional Chinese Medicine is based on the management of a life force or energy called Qi (pronounced “chee”). According to TCM theory, Qi flows freely through channels in the body called meridians. Each meridian connects to a specific organ that governs a particular function of the body. When healthy, Qi maintains a balance between two opposing energies: the yin (negative, dark, feminine) and the yang (positive, light, masculine). Illness occurs when Qi becomes blocked or unbalanced. Acupuncture and other TCM treatments restore the balance and flow of the Qi. For certain conditions, TCM may work well as a stand-alone treatment, but for many conditions TCM therapy works most effectively when combined with Western care.

Nowhere in the entire pamphlet is a mention of any science whatsoever. It’s full of the same sort of acupuncture woo-speak full of references to qi and life energy you could find on any acupuncturist’s website. If that’s all that was in this pamphlet, I probably would not have bothered to blog about it. Unfortunately, this is what I found at the very end:

By making this information available, the University of Colorado Hospital and The Center for Integrative Medicine do not promise or guarantee the effectiveness of this integrative therapy. For any serious conditions, we recommend that you contact your physician before trying any new therapy.

That’s about as close to a quack Miranda warning as I’ve ever seen in a publication in an academic medical center’s website. I have a suggestion for the University of Colorado: Do what academic medical centers do and stand behind the therapies that you offer as science-based. If you’re offering something that you can’t fully stand behind, something that makes you feel that you have to offer a disclaimer for it, and it’s not part of a well-designed clinical trial, then it’s not science-based.

And if it’s not science-based, an academic medical center shouldn’t be offering it, much less charging for it.

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]

15 replies on “The quack Miranda warning metastasizes”

Sounds like marketing. Designed to attract the widest range of marks patients. It is even possible that the medical director is/was unaware of this crap. More likely, the marketing director was promoted above the medical director and has full control of treatment options offered.

Traditional Chinese Medicine is based on the management of a life force or energy called Qi (pronounced “chee”).

I always thought accupuncture was rather Qizy (pronounced “cheesy”). Now we have confirmation.

@2: In the words of Dr. Crislip (here mangled beyond repair by yours truly): Pronounced “ki” or “chee”, it still spells crap.

“You have the right to remain ignorant. Any woo you buy can and will deplete your wallet.”

Luc Montagnier has gone a little crazy, he has also come pretty close to AIDS denial despite discovering HIV and has some crazy opinions on antioxidants. Sometimes even good scientists go senile and I think that’s what’s happening.

thanks Chris.

reading that increased my sanity levels again.

still, something is up with Montagnier.

senility, Tortorific says.

maybe. Not sure though. Reminds me a lot of what happened to Lynn Margulis, and that wasn’t senility.

OTOH, others suggested he was taking money to say really stupid shit.

whatever the reason, it’s quite sad to see.

Remember, Montagnier is the not only respected researcher to go over the bend. Peter Duesberg was once a respected biologist who had legitimate virus research. Boyd Haley was a tenured chemistry professor before selling a chemical used in mining to chelate children. And don’t forget what happened to Nicola Tesla and the visits he had with a special pigeon.

The page makes three structure/function claims for its iodine product. By law all dietary supplements making structure/function claims must include the FDA’s disclaimer. From the FDA’s website:

“If a dietary supplement label includes such a structure/function claim, it must state in a “disclaimer” that FDA has not evaluated the claim. The disclaimer must also state that the dietary supplement product is not intended to “diagnose, treat, cure or prevent any disease,” because only a drug can legally make such a claim.”

Within 30 days of marketing a supplement, the FDA must be notified of the exact wording of any structure/function claim. The FDA has three options:
1) The agency can approve the claim. 2) It can request scientific evidence to validate the claim. 3) If the evidence is insufficient, the FDA can disalow the claim.

The FDA and FTC can, and will, take action against those companies making unapproved, or unsubstantiated structure/function claims. Here’s one example from Quackwatch.

“The proposed consent agreement with Quigley would also prohibit that company from making any claim that any food, drug or dietary supplement can or will cure, treat, or prevent disease, or will have any effect on the structure or function of the human body, unless it has competent and reliable scientific evidence to substantiate the claim.”

At least in the case of supplement companies like Wellness Resources, posting the FDA’s disclaimer is meant to avoid any trouble from the FDA itself.

@ 5,6,7,8,9:
While it may not be frontal lobe dementia (the symptoms would be too alarming) it could be part of normal age-realted effects on judgement. Consider Dick Cheney and his endorsal of increasingly bad policy choices, if you want an example from politics.

When analysing Cheney’s policies, it is often helpful to remember the difference between good or bad policy choices for America and good or bad policy choices for Dick Cheney and his cronies.

– Jake

When healthy, Qi maintains a balance between two opposing energies: the yin (negative, dark, feminine) and the yang (positive, light, masculine).

That’s remarkably misogynistic. I’m surprised they didn’t leave out the female/male distinction.

I think the hard thing about some of the sites using that claim is that well… it works, at least in some cases like accupuncture- it’s awesome wonderful for pain relief, for example, and I know a lot of people who have successfully used it for such. But ancedotes =/ data and all the wootalk in the world doesn’t make an explanation for why a thing works any less wooey.

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