Tues 29/4/09

Motion: ‘This house believes that complementary and alternative therapies do more harm than good.’

Before the debate              After the debate
FOR:                       27                           36

AGAINST:                116                        109

ABSTENTIONS:        18                           11

The debate was lively but unruly and poorly moderated. Failure of technology (mechanistic science has its limitations) meant that speakers couldn’t show slides. This was no bad thing as a) words should be enough at university debates and b) it spared the audience what sounded like a Michael Baum-made horror show of fungating breast carcinomas..

The votes before and after the debate were pretty meaningless. The packed lecture theatre was filled with supporters of CAM (‘probably packed with homeopaths’ as Baum put it though how he diagnoses homeopaths on sight will remain his secret). Unbalanced audiences don’t enhance debates but if it is CAM supporters that bother to show up at open debates – then so be it.

The speakers for the motion resorted to the usual boilerplate stuff: lack of evidence (easy to refute using the Pie Man), see implausible (matter of opinion) bad for the third world (sic) – unlike  Big Pharma which always prioritises the health of third world countries as the main issue to be discussed at all board meetings!

Prof. Baum added his recurrent but utterly irrational argument against homeopathy eating up NHS funds that could be better used elsewhere. I really think I’ve refuted this rather tired argument here.

Simon Singh went on about CAM’s lack of evidence and made the points that he wasn’t a doctor but ‘wanted to help patients’ and that he had nothing against systems such as Alexander Technique, there Yoga and massage presumably because he personally does not consider them ‘biologically implausible’.

I was sad to hear the team proposing the motion resort to insinuating that CAM practitioners ‘deceive’ and ‘lie’ to their patients. Straightjacketed by their exclusively mechanistic view of medicine, ambulance it may look to them as if  CAM practitioners are deceiving or lying to their patients but I am sure that the great majority of CAM practitioners genuinely believe that the tools they use work independent of a placebo effect. Thus I believe that it is unacceptably insulting for these learned men to attack them (and even fellow doctors using CAM) in this way. I’ll give my view on why they feel obliged to continue to make this vulgar accusation another time.

The arguments of the professors opposing the motion were sound with David Peters making a good case for the integration of CAM and conventional medicine. He also made the point that RCTs are much better at assessing drugs than CAM. George Lewith reminded us of the side effects of conventional drugs (eg. 2000 deaths annually in the UK due to NSAIDs) and convincingly answered Baum’s attack on CAM websites by saying that it was dissatisfaction with ‘right wing oncologists’ rather than websites that drove cancer patients towards CAM practitioners.

The debate was well attended but poorly organised and moderated. Members of the audience were not invited to challenge ‘statements of fact’ and without rebuke, were allowed to heckle and interrupt the speakers to the extent that an unprotected Simon Singh had to appeal (in vain) for “manners” midway through his speech. Prof. Baum was also rudely interrupted and subjected to completely unsubstantiated ad hominem attacks by members of the audience. I found this rather embarrassing and unacceptable though I was glad that one member of the audience chose to remind everyone that Baum was a co-signatory of those infamous letters to the PCTs one of which at least was inappropriately written on paper with an NHS logo.

Although I can empathise with an audience that has seen our belief systems attacked, jeered at and unfairly claimed to lack evidence, (The Pie Man is available at any time to show that most of commonly used conventional interventions also ‘lack evidence.’) by Singh and Baum over the past few years, there should be no room at civilised debates for shrill invective, unauthorised interruptions and ad hominem attacks on speakers. We simply do not need these to refute the case of the likes of Baum, Singh, Ernst, Colquhoun and others, however disingenuous and against the interests of the public we may think their arguments are and however hurt we feel. With the moral philosophers, the BMJ’s handbook of Clinical Evidence, what is left of democracy – and even the future monarch and the angels on our side, we should be able to fight our corner without having to resort to low blows.