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.’
Their original article can be read here, store my letter here and their reply here.
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.
I admire your restraint. It is always interesting when people who are acedemic say they have no conflict of interest. As this speech shows the whole system is deeply entwined and mutually dependent.
Best wishes
http://webarchive.nationalarchives.gov.uk/+/http://www.bis.gov.uk/News/Speeches/biotechnology-conference
Dear Brian,
I feel that the root of disagreement lies in the polarisation existing between
in one camp:
certain people’s belief and reliance on EBM at a time where such a belief, albeit intellectually stimulating and supported by a strong ethic, has not achieved large enough a body of knowledge to justify the reliance to the scale required by the public
and in the other camp:
certain people’s belief and reliance on their experiences in light of theories formed from experiences which are wide enough to appear to agree with reality but too complex or muddied with historical concepts and behaviours so as to not encapsulate it conclusively and stand upto scientific scrutiny.
The polarisation seems to translate in a view that the latter, in the eyes of the former, are misguided in their beliefs and the former in the eyes of the latter are misguided in their reliances.
It’s just another version of academic vs clinical, a battle that has been ongoing for many centuries between primarily male egos trying to be proven right. Point is that it is not actually really about who is right but how the two can be brought in to line with eachother as much as possible. The resultant arena being “best clinical practice”.
The difference this time round is that as both parties are accessing the available media, the battle is becoming increasingly public, equally accessible to the ill-informed and either party is loosing the dignity once represented by the elite.
I suppose that the mask slipping off either faces is a “draw-back” of democratising…
I do believe though that the eventual benefit of this is progress. A progress which can be achieved in a civil manner as long as all parties know that neither should do too much shouting. All that is happening now is that some people are actually shouting a bit more than they truly deserve and all that will happen is that the ones who were being shouted at will be getting ready to shout a little louder next time round. Maybe we should focus our energies on making sure that doesn’t happen as we would only be perpetuating the cycle…
Kind regards,
Stefaan
WITHOUT PREJUDICE”
An open letter to Professor Michael Baum
a personal view
Your contribution to cancer, and in particular, breast cancer, is an impressive achievement, as listed in the entry in WikiSurgery. As you state in your “Open letter to the Prince of Wales” quote “The power of my authority comes with a knowledge built
on 40 years of study and 25 years of active involvement in cancer research”. However, in all that time, the treatments that you offer are, surgery, chemotherapy, radiotherapy,
hormone therapy. These treatments have only been modified…the advantage of one chemotherapy drug over another, a novel technique for delivering radiotherapy, for instance. Treatments which only exist in the realm of evidence based medicine (EBM) and have the disadvantage of short and long term side effects. The patient is given no other choice of treatment.
Therefore when you wrote your letter (“Use of “alternative medicine” in the NHS”) to all the NHS Primary Care Trusts (PCT) advising them to withdraw funding, did you realise that there would be those patients who were relying on Homeopathic treatment to stay alive, and would be denied medication? Was there any attempt to assess their “quality of life” without medication?. Did it not occur to you that some of these patients would have made interesting test cases to complement your “active involvement in cancer research”? Human beings are individuals and not everybody can be treated under the “herd” principle of EBM and its medicine side effects. In any case, the amount of money spent by the NHS on Homeopathy, pales into insignificance when compared to the waste of financial resources in the NHS. It is surprising that your energies and influence were not channelled in that direction.
In a book entitled “Tell me why?” published in1966 at the end of the explanation of cancer is the following “No drug has been found that cures cancer completely and is useful for all kinds of cancer. One of medicine’s greatest goals is to understand the nature and cause of cancer, and to find a way to prevent and cure it” However, 44 years on, with millions and millions of pounds and dollars donated to research, the last sentence still applies. It would seem that EBM does not venture outside its comfort zone”. WHY?
Has EBM and cancer research taken a look at Epigenetics? It is interesting to note that epigenetic modifications can play a fundamental biological role in the initiation and progression of cancer. Environmentally induced epigenetic changes that, after development, can potentially be passed on from generation to generation. The memory of an event could be passed through generations and this event could switch genes on and off and thus change could be inherited.
In 1828, Samuel Hahnemann, the founder of Homeopathy, in his book “The Chronic Disease” proposed that a “miasm” is a predisposition towards chronic disease underlying the acute manifestation of an illness which is transmissible from generation to generation.
Thus Homeopathy cannot be dismissed as hocus pocus, as miasms predated epigenetics by over a hundred years.
As a matter of interest, even Hahnemann was preceded in his theory by a higher authority.
Exodus 20 I, the Lord thy G-d am a jealous G-d visiting the iniquity of the fathers upon the children unto the third and fourth generation
The Dalai Lama in his book “The Art of Happiness” said the following:-
“I met with some doctors who were talking about the brain and stated that thoughts and feelings were the result of different chemical reactions and changes in the brain. So, I raised the question: Is it possible to conceive the reverse sequence, where the thought gives rise to the sequence of chemical effects in the brain? The answer that the scientist gave was “We start from the premise that all thoughts are products or functions of chemical reactions in the brain”. So it is simply a kind of rigidity, a decision not to challenge their own way of thinking”
My point is that scientific healing has been dehumanised by the belief that human beings could be known and controlled if they were conceived as machines, broken down into components to be studied. The mind and body are conceived as having no relationship to each other.
In the same way as the Church in the 15th century could not integrate the Copernican heliocentric theory of the solar system into their rigid dogma and resorted to torture and imprisonment to those who opposed them, so EBM has refused to acknowledge any other system of healing that might just have the answer, and has resorted to propaganda, vilification and humiliation, through the media and the Internet to discredit these systems.
We now know that Copernicus’s theory was the truth, and was verified by Galileo
Is this why you have spent so much time and energy in your opposition of other healing systems, especially Homeopathy, rather than “challenging your own way of thinking”.? “Active involvement in research” would seem to be research into all avenues of healing to alleviate human suffering.
I am, therefore, disappointed and intrigued that a man of your stature in medicine, with other Professors and scientists should resort to describing 200year old Homeopathy as witchcraft, hocus-pocus, mumbo jumbo, crackpot medicine, and irrational superstition, and the homeopaths as charlatans, heretics and snake oil salesmen. Welcome back 15th century Inquisition.
Have you and your colleagues fully studied Homeopathic literature, met and talked to a suitable teacher, followed Hahnemann’s extensive testing principles? Without this, your refutation of Homeopathy is without foundation, for under true open-minded scientific thinking, you have not studied the subject, and thus are in no position to judge.
So, the question has to be asked……what is the reason for this medicine war that you and your colleagues, Colquhoun, Ernst, Dawson, Goldstone and Singh as champions of the Goliath EBM, are waging against the David Homeopathy? Can it be that you and your colleagues are a microcosm of the EU legislation macrocosm?
As an example, I refer to the European Directive on Traditional Herbal Medicinal Products.
Legally, the Directive requires that the same pharmaceutical standards applied to conventional synthetic drugs, are applied to herbal products and has not taken into account the complex nature of very long standing non-European medical systems. As a result, it discriminates against the traditional medical systems of both China and the Indian subcontinent which are integral to over one third of the world’s population.
Although Homeopathy is only 200 years old, the parallels are obvious.
Finally, the philosopher, Arthur Schopenhauer once said,
All truth goes through three stages
First……………….it is ridiculed
Then………………it is violently opposed
Finally……………..it is accepted as self evident