In the current edition (June) of the American Journal of Medicine, decease there is an exchange in the letters section between myself and Profs. Baum and Ernst about a misleading reference to me in the journal.
The origin of the exchange is their attack on homeopathy published in the journal in which their first reference appears to imply that I am an individual ‘claiming that those wanting to carry out the trials are in the pocket of the pharmaceutical industry and are part of a conspiracy to deny their patients tried and tested palliatives.’
It’s interesting how they go on to deny funding by Big Pharma or conflict of interest when I have earnestly pointed out that I have never accused them of this.
Anyway my reason for blogging on this is to clarify – at least for readers of this blog – my exact position on homeopathy, prostate EBM, Ernst and Baum, ‘nannies’ and NHS homeopathy.
1. In general I support Evidence Based Medicine (EBM) as a useful but stern test of medical efficacy. Much of both orthodox and CAM fail to pass it as I’ve pointed out many times and employed a Pie Man to deliver the message that most medical interventions are far from fully evidence based.
2. I have indeed used the word ‘hypocrisy’ in relation to those who use EBM as a blunt instrument to attack homeopath exclusively (note how Ernst and Baum cunningly leave out that word in their reply to my letter) If EBM is to be used as a referee on a level playing field, much of both conventional medicine and CAM are going to have to receive red cards – not just homeopathy. I don’t support this approach but consider it hypocritical to use it only against homeopathy and CAM.
3. With regard to ‘nannies’ , the nanny state and people thinking for themselves: This has nothing to do with EBM but everything to do with the NHS, democracy and liberty. You can only get NHS homeopathy if your GP sends you to another NHS doctor who uses homeopathy and takes responsibility for his/her interventions. Ernst and Baum want to stop this process from happening. In other words they seek to thwart (rather than attempt to dissuade) qualified doctors on the NHS from sending patients to other doctors (who happen to practise homeopathy in addition to conventional medicine) on the NHS . I think that’s playing the role of ‘nanny’.
4. As for ‘conflict of interest’ I have always warned that it is grossly unethical for anybody to criticise anybody else of this without producing a smoking gun. My philosophy and attitude to medicine and health is very different to that of Baum and Ernst but I have never accused them of conflict of interest. In their reply they say: Some might think that Kaplan might have a conflict of interest himself in so fiercely defending homeopathy, but we don’t, as we are sure he practices in good faith and that his very success is reflected in the support he enjoys from his clients.
How kind and reconciliatory of the professors. This is a remark almost subtle enough to be classified as Provocative Therapy! Actually I refer to the people who consult me as ‘patients’ and my ‘fierce defence’ has always been of NHS homeopathy as provided for at present by a by-law of the United Kingdom. How ‘some might think’ defending existing legislation in this country to be a conflict of interest is beyond me. Baum and Ernst then kindly point out that they personally don’t think this. Thanks guys, some of my best friends are professors who use EBM as a blunt instrument, not to use on the whole of medicine, but to attack homeopathy more or less exclusively.
Anyway I find myself ranting a bit like Lenny Bruce when he was going through all those ridiculous obscenity trials in America. Even he ceased to be funny after a while but if you read the transcripts of those trials now, we see how right he was at the time.
Actually I am very grateful to The American Journal of Medicine. Instead of printing fawning and concurring missives in relation to the article by Ernst and Baum, they unexpectedly chose only to publish my letter.