Archive for July, 2009

The Spinal Trap

Posted: July 29, 2009 by Tim Barclay in Science
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free debateIn April 2008, Simon Singh, author of the excellent Big Bang and Trick or Treatment: Alternative Medicine on Trial, wrote an article in the Guardian demonstrating the lack of evidence for the claims made by chiropractors. He pointed out that true chiropractic did not limit itself to helping back pain, but was in fact originally created as something of a panacea that could supposedly cure all manner of diseases and disorders through spinal manipulations. He demonstrated that, despite chiropractic’s success in hiding some of its pseudo-scientific past, many practitioners still do claim, without evidence, to be able to treat conditions such as asthma and colic.

The British Chiropractic Society disliked all this talk of lacking evidence and dubious claims and promptly sued Singh for libel. Note that they did not try to disprove his claims or present the evidence for their position as any proponent of a scientific position would, but instead used the conveniently prohibitive expense of the flawed English libel laws to silence the perceived threat.

Rather unluckily for the BCA, Singh happened to be in a position that allowed him to fight the suit rather than be chilled by it, and by doing so has vastly raised the public awareness of the complaints the BCA was trying to suppress. A classic case of the Steisand effect.

Much has been written about this case around the internet, so for the full story, I would direct you here, here or here.

Sense About Science have started a campaign to have the libel laws changes so that they can’t be used to silence important scientific concerns and stifle debate. You can sign your name to show your support.

Anyway, in a show of solidarity to Simon, many blogs and magazines are today, 29th July, reprinting a version of his original Guardian piece (slightly edited to remove the specific bit that the law suit is about). So I reprint it below:

 Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

God Hates Us All

Posted: July 23, 2009 by Tim Barclay in Religion
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One of the most contraversial and widely hated groups in America is the Westboro Baptist Church. Following wide-spread media attention, and features by journalists such as Louis Theroux, their methods of picketing the funerals of victims of anti-gay hate crime, as well as service men, with slogans such as “God hates fags” and “Thank God for 9/11” have become well known and widely despised.

Westboro Baptist Church

Their behaviour has earned them myriad lawsuits and numerous arrests. For example, in 1995, Benjamin Phelps, the grandson of the church’s founder, was convicted of assault for spitting in the face of a passer-by during one of their regular pickets. In 2007, the father of a marine whose funeral was picketed successfully sued them for damages amounting to $5m.

Most people’s reaction to hearing or reading about this group’s actions tends to be disbelief and disgust. How could anyone be this callous? How could anyone show so little respect for their fellow humans? The answer, of course, is that they believe they are doing God’s work.

Homosexuality, they assert, “pose[s] a clear and present danger to the survival of America, exposing our nation to the wrath of God as in 1898 B.C. at Sodom and Gomorrah”. They interpret the Bible in such a way that they believe it is the job of anyone who truly believes in God’s greatness to war against “workers of iniquity”, and this includes gay people, and those who accept them and enable them to lead their lives. They picket the funerals of soldiers and service men because “they voluntarily joined a fag-infested army to fight for a fag-run country now utterly and finally forsaken by God who Himself is fighting against that country.”

Quite rightly, the WBC has drawn criticism from Christian religious groups just as it has from non-religious and other-religious groups. Perhaps Christians find their rhetoric more offensive because they claim to be speaking for God and on behalf of those who truly follow him. Perhaps they are also worried that actions like this from one Christian group will bring disrepute upon the whole church and be a shot in the foot for the whole mission of the glorification of God. Perhaps they particularly dislike the way they twist the words of the Bible to justify their hateful position.

To despise this group on humanistic grounds, for their hideous disrespect of humanity is reasonable and, in my opinion, absolutely correct. However to criticise them on religious scriptural grounds is not. The reason is that the WBC does not twist the words of the Bible to justify their position – they don’t need to – those hateful words are there already.

The WBC point to Psalms 5:5, “The foolish shall not stand in thy sight: thou hatest all workers of iniquity”; Proverbs 6:16-19, “These six things doth the Lord hate:… he that soweth discord among brethren”; Psalms 11:5, “The Lord trieth the righteous: but the wicked and him that loveth violence his soul hateth”; and Malachi 1:3, “And I hated Esau, and laid his mountains and his heritage waste for the dragons of the wilderness.”

The argument that the they are misrepresenting the Bible’s meaning, because really God loves everyone starts to look a little thin when you start to read a bit more of the Bible and come across these examples of God being unashamedly hateful towards, not just people’s actions, but people themselves. Indeed, as Skeptics’ Annotated Bible points out, one can hardly fault the group’s logic: God hates “workers of iniquity” (Psalms 5:5); homosexuality is “abomination” (Leviticus 18:22); therefore God hates fags.

I will reiterate quickly that I do not think this group deserves anything but the deepest contempt and condemnation, but for the religious to dispute them on scriptural grounds is hypocritical. What are they doing but validly, albeit selectively, quoting parts of the Bible? And this is exactly what every moderate sermon does aswell. For every John 3:16 quoted, there is a Psalms 5:5 being ignored, because to give equal weight to both would lead to so much contradiction and cognitive dissonance that no believer would know what to do with themselves.

In order for Christianity to function as a religion, the Bible needs to be read selectively, or at least certain passages need to be interpreted liberally. So it should be no surprise that there is one group that pays attention to those bits that everyone else leaves out, and who saves their liberal interpretations for those sections that others might prefer to take literally. This is the problem with the claim that the Bible offers any sort of revealed moral teaching – without engaging the evolved humanist moral sense to overlook the contradictions and to only pay attention to the positive messages, the Bible can be used to justify violence and hate just as well as it can love and compassion.

The Westboro Baptist Church are a disgusting group, but theirs are the same tools that are used in every pulpit every Sunday. A long, ambiguous book of myths can be used to justify any moral position, for real goodness, we must look to the evolved sense to protect ourselves, our families and our species that we all have without having to take any book’s word for it.

Pseudo Scientists Podcast

Posted: July 23, 2009 by newhavenlse in Groups and organisations, Science
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For those of you looking for something to listen to whilst on your commute, you may be interested in this podcast:

http://www.youngausskeptics.com/category/podcast/

Called the Pseudo Scientists it’s run by the Young Australian Skeptics and covers topical subject with plenty of mirth.

Complementary and Alternative Regulation

Posted: July 17, 2009 by Tim Barclay in Science
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The University of Central Lancashire, one of the numerous universities in David Colquhoun’sfiring line for their disregard of science in offering BScs in homeopathy and traditional Chinese medicine, has held a review of issues associated with teaching alternative medicine subjects. The report from this review has been published online here (pdf).

The review came to a pleasing conclusion, that

“the University refrains from offering any CAM courses until such disciplines have achieved statutory regulation status.”

Since homeopathy, acupuncture and Chinese herbal medicine are not subject to statutory regulation, and are unlikely to become so, this means that the teaching of these subjects, and the conferring of BScs for them, should cease.

However, despite the encouraging conclusion reached, some of the arguments that got them there were, for an academic review board, bafflingly nonsensical.

In section 4.1 on efficacy, the report states:

“The debate on the efficacy and benefits of the various CAM disciplines and what constitutes an “acceptable” evidence base for CAM treatments can be viewed as a dichotomy between two differing ways of “knowing”, linked to the principles of supposed “holism” and “reductionism” in medicine…”

A dichotomy between different ways of “knowing”? This is the sort of thing I could imagine Deepak Chopra spouting at a critic. The issue here is whether it’s worth teaching acupuncture as a science degree and therefore whether it works. How many different ways of “knowing” whether something cures patients or not can there be? Well, of course according to alternative medicine proponents, there is the reductive, simplistic and possibly evil western way (or ‘randomised controlled trial’ for short) and then there is the wholly undefined, but undoubtedly better alternative/traditional/intuitive way.

This is an oft-quoted problem with the assessment of evidence for CAM modalities – that their methods of healing are beyond the reach of science – but is there any basis for it?

Well, no. Science, and specifically the RCT, is designed to test specific, predicted effects of interventions. If homeopathy claims to make people better, then it can be tested by science.

At its most basic, the method of an RCT involves giving one load of people a particular intervention (say, a homeopathic headache pill), giving another load of people a placebo, and then counting up the number of people who still have a headache a bit later on. The group with the fewer headaches wins. Once you get beyond the potentially confusing technical language, and the definitely confusing anti-science propaganda, the controlled trial is the simplest, most intuitive and most evidently effective way of testing the efficacy of a medicine there is.

It can also be altered to take into account any details of the modality being measured. For example, homeopaths often complain that their trade isn’t amenable to this method of testing because they offer personalised treatments. The prescription of homeopathic remedies, the say, isn’t just based on the symptoms presented, but on many more diverse and esoteric personal details gleaned from a lengthy consultation. However, this element of homeopathy can easily be factored into the clinical method. Imagine a study where 100 people with mild conditions all go to the same homeopathic practitioner for a consultation exactly as they would normally. The practitioner then chooses the correct remedy for them based on whatever details they normally would, and then tells the patient to collect their personalised treatment from a desk on their way out. At the desk, 50 people are given their personal prescribed treatment and the other 50 are given identical looking sugar pills. The personalisation and consultation parts of the treatment are maintained without compromising the blinding or the randomised elements necessary for it to be a fair scientific trial.

In short, scientific testing is perfectly able to test the claims of alternative medicine, and any discussion of different ways of “knowing” is pure smoke.

Nevertheless, the UCLAN review decided that:

“conclusions from research into the efficacy of the various CAMs are outside the remit of this report.”

This is simply baffling? When deciding whether acupuncture should be taught to people who may go on to tend to patients with real illnesses, surely the first and most important question to be answered is that of efficacy. However, this accomodationist stance that we shouldn’t rock the boat by demanding of alternative practitioners the same standard of evidence for efficacy expected in real medicine is very common. Recently HolfordWatchspeculated about what would happen if nutritionists were allowed a place in the NHS alongside Registered Dietitians. While RDs could be held accountable for any unevidenced or dangerous advice, as has happened recently in the case of Katie Peck who gave dubious advice to diabetic patients, nutritionists (astrologers to dieticians’ astronomers), would be unlikely to fall under the same scrutiny.

In the end, it is good that this report concluded that unregulated modalities should not be taught, but many of the finer details of the review are, I think, a cause for concern. Not least because in tip-toeing around the difficult and important questions of evidence and efficacy, it shows that even universities are being taken in by CAM’s anti-science hand waving. Real scientists in real universities should know better. Alternative medicine is just as testable as any other medicine and therefore there is no excuse for the by-passing of questions of evidence.

Unborn in the USA and freedom of speech?

Posted: July 16, 2009 by newhavenlse in Free Speech
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Abortion is a topic in the US that can not only lead to a polarization of opinion, but also a polarization of action. One only need look at the recent killing of controversial abortion doctor George Tiller to see the lengths some people will go to support their cause.

Yesterday evening on returning from work I noticed the documentary on Netflix titled “Unborn in the USA”. The programme details the often controversial and at points criminal behaviour of  groups associated with the pro-life movement. As interesting as this was; one scene in particular got me thinking. This takes place close to the end of the film and shows from a cinema vertie perspective, the argument between a Christian woman (who hasn’t had an abortion) and the anti-abortionist picketers.

The pro-life group have set up camp alongside a busy road and erected large banners and boards plastered with images of aborted babies. These pictures are presented to passing motorists, and those who slow down to take in a better view, often find children at their windows presenting them with pro-life leaflets.

The woman in question takes no time to lay into the pro-lifers for their choice of imagery, and the fact that they are forcing those walking down the street or driving past to view it. The pro-lifers of course launch into counter arguments, and the conversation quickly descends into accusations of being associated with Satan followed by it all “kicking off”.

A nearby police officer intervenes and arrests the angry woman for punching the mouth piece of the pro-lifers.

This moment in the film raises a somewhat controversial question regarding freedom of speech.

In the US like the UK, films of a graphic nature are labeled with a ratings system designed to protect children from viewing the material. However no such system seems to exist to vet the images displayed in public places, these are of course protected by first amendment rights… in most cases.

The controversy enters the debate when one asks, do I have the right to choose not to see these images? If we take the recent Scientology exhibition in Cambridge MA. titled “Psychiatry an Industry of Death” as an example we can see in this case all images and material was located within a building, where people could chose to enter and view the content. However the photos of aborted fetuses in the documentary are placed in public areas, where people have to pass through, thus having little choice but to avert their eyes if they are lucky enough to have been forewarned.

An interesting experiment would have been to ask the pro-life protesters a number of questions. Would they for example be happy with a poster depicting two consenting homosexual males indulging in anal sex being displayed outside their church?

Would they be happy with members of the public asking their children if they knew the meaning of sexually explicit words?

We could also ask if they would mind protesters with sandwich boards, following their carol singers around at Christmas, depicting photos of dismembered children killed by bombing raids in Iraq.

I think the chances are the first of the above questions would see the groups burst into an apoplectic rage and freedom of speech would be out of the window.

I am of the opinion freedom of speech means exactly that, however when photos of a graphic nature are involved then we can reasonably ask;  should people be presented with the opportunity to not view the images? This is a question that of course would be an interesting debate point.

In conclusion, this documentary has not just highlighted the on going debate between the pro-life and pro-choice groups, but also how rank hypocrisy exists within the Christian right in America. They want free speech when it suites them and to legislate against what they don’t like.

As freedom of speech is challenged in the west by the Christian fundamentalists, as well as any other religious fundamentalist group, I think it is important to remind these groups of the immortal phrase; You can’t have your cake and eat it!

You can read more about the documentary here:

http://www.firstrunfeatures.com/unborn_synopsis.html

And can see how the name has been bagged by the Christian right here:

http://www.unbornintheusa.org/

Welcome

Posted: July 15, 2009 by Tim Barclay in Uncategorized
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Welcome to Tycho’s Elk, a new blog about politics, science, scepticism, rationalism and anything else that interests us.

My areas of interest include religion, pseudoscience and superstition – the types of thinking that encourage them and the injustices done in their names. I also work in the media and am therefore interested in how related ideas are portrayed on television and in print.

My co-blogger, The English Radical shares some of my interests and opinions, but his views also diverge from mine in a number of areas. We hope this blog will foster discussion and constructive argument as much as it also shows solidarity in its broad rationalist position. To this end, we heartily invite the reader to add their opinions, views and ideas to any matter being discussed via the comment link attached to each post.