Scepticism is one of the most important values in advanced societies. I’m glad Loretta Marron has it in spades. But like just about everything, you can have too much of a good thing, and Ms Marron proves this point with her burst of hypercynical colour-writing in last week’s item Quacks, charlatans and witch doctors: medical practitioners promoting alternative cancer cures.
I don’t doubt Ms Marron’s expertise or background as a scientist, or her award-winning cynicism. Nor do I take lightly her personal experience with cancer, which I wouldn’t wish on anyone. It’s obviously influenced her strident views, and I wish her well with her future health.
I too have seen the hokey lures of snake-oil merchants spruiking cancer cures. Our son was treated last year. We followed the conventional path, trusted the expertise of our doctors and had no regrets. But this same boy also has autism, and our experience with mainstream vs alternative medicine has been entirely different.
The medical establishment’s line is that the autism question is settled: it is a “brain disorder” or “developmental” abnormality with mainly genetic causes. It is accordingly a lifelong condition best “managed” with a range of behavioural therapies and social supports or aids.
But there is a growing movement — backed by numerous respected organisations, foundations, treatment centres, doctors and scientists — that question this so-called consensus. They argue that autism is in part a biochemical imbalance that is quite treatable. While genetic vulnerabilities play a part, environmental exposures are also major culprits, in particular vaccines and food allergies or intolerances.
We followed the second path and have seen some tremendous results. One of the main treatments we tried was “toxins removed by chelation”, so breathlessly mocked by Ms Marron in the context of cancer. We had our son’s hair tested by a US laboratory which had found an enormous excess of certain heavy metals, some of which are found in particular vaccines. The subsequent treatment involved taking supplements designed to gradually extract these toxins from his system.
Ms Marron claims that “hair, urine and blood analysis (sic) are ineffective for heavy metal and nutritional diagnostics”. These tests are scientific tests ordered by doctors and conducted in independent laboratories. Hair analysis is regularly used to determine if someone has a history of drug use, giving a timeline to toxin exposure much like age shows in tree rings. Doctors do blood analysis to see if a patient has anaemia or vitamin deficiencies (which can be life-threatening in severe cases).
While many disagree with the “alternative” position on autism, one cannot deny that it is supported by people with qualifications and is more than pure quackery. Not that some sceptics would believe it, or even tolerate the freedom of people to choose their own course. Many have launched themselves into this debate with a passion not seen at football matches. We have seen the “pffts” and disdain in doctors’ rooms, and (worse) the raving on the internet. Sadly, what should have been a purely medical issue has degenerated into the kind of politically-charged scrap that would make climate change cage-matchers blush.
It happens on both sides. Some in the mainstream medical community have reported receiving abusive phone calls and even death threats, simply for piping up in support of the orthodox studies. On either side, it’s a disgrace plain and simple. In the heat of the fight, kids are forgotten. There is only one important thing: to each find our own path to health rather than a right or wrong for everyone. Because there often isn’t one.
It’s all very well to have scepticism — it is our main line of defence against phonies. But you can take scepticism so far that you end up choking off any lines of inquiry that could lead to progress. People can use language to debunk anything, even if it means finding nothing. In the “mainstream” camp, many studies appear robust, but if they are framed around narrow terms of reference, if they set the burden of proof so high, if they look at 100 pieces of evidence but ignore another 1000, or simply ask the wrong questions, what use are the answers?
I think what’s missing from Ms Marron’s article is a distinction between doctors who practice the best alternative therapies because they recognise the shortfalls of mainstream medicine and someone opening a “crystal healing clinic” in their back room.
A medical “canon” is essential. But canons evolve and are challenged. Many advances in our society, including medical breakthroughs, are often only possible when a renegade dares to buck orthodoxy. For how long did Big Tobacco wield medical and scientific expertise to bolster its credibility? For how long were various mental illnesses treated as “madness” before common medical treatments demystified them?
If Ms Marron wished to study the autism wars, she could turn that same brilliant, white-hot blowtorch of scepticism onto the well-resourced, PR-buttressed medical establishment, and its close cousin Big Pharma. Of all the hundreds of studies disproving a link between autism and vaccines, few are independent of these two industries. While this doesn’t always undermine the integrity of the studies, isn’t it worth a glimpse of the sceptic’s probing eye?
Autism rates have gone from 1 in 10,000 to 1 in 150 in about 30 years. Countries with different vaccine schedules, eg Sweden, Italy and Denmark, have much lower rates of autism. Surely we must ask why?
It seems scepticism, even in its strongest and most elemental form, can be selective.
“For how long were various mental illnesses treated as “madness” before common medical treatments demystified them?”
Autism, for example. Perhaps improved diagnosis is the cause of the apparent increase in prevalence?
“Of all the hundreds of studies disproving a link between autism and vaccines, few are independent of these two industries.”
Okay, so who if not medical researchers and pharmacologists would you have conduct the studies? Lyndon Larouche?
Half the supposed “conflicts of interest” provided (on the link from this article) by ‘fourteen studies’ are groups such as the Centre for Disease Control and Prevention.
If we cant trust the national government bodies that are staffed by reputable scientists to fund large, peer reviewed studies in some of the most rigorous journals in the world then by that standard we should not believe – or seek the recommended treatment for – AIDS, cancer, heart disease etc.
The author accuses people who react to the unfounded claims about the links between vaccines and autism with anger as degenerating into a politcally charged scrap yet he is clearly basing his argument on his political beliefs not on a consistent, rational position about science and medicine.
He is free to think whatever he wants, but should understand that if he is going to push an unproven, dangerous line in the public sphere it is little wonder that people will be angered by it.
While debate is healthy and Loretta Marron also made some suspect claims, several of Julian’s comments shouldn’t go unchallenged.
“While many disagree with the “alternative” position on autism, one cannot deny that it is supported by people with qualifications and is more than pure quackery.”
What if the qualification is in quackery? For nearly 1500 years doctors believed what they were taught about the four humours and denied the existence of germs. They were, by modern definitions “quacks” exactly because they believed and propagated what they were taught rather than seeking proof. Contemporary homeopaths (as an example) are in the same boat – they are well trained, but trained in something that is proven not to work. Similarly one can be a qualified journalist and end up reporting garbage.
“Autism rates have gone from 1 in 10,000 to 1 in 150 in about 30 years. Countries with different vaccine schedules, eg Sweden, Italy and Denmark, have much lower rates of autism. Surely we must ask why?”
Incidence rates of disease represent the frequency of diagnosis, not just frequency of occurrence. There are lots of reasons for variations between countries. The reason for changes in autism rates are almost entirely due to the fact that it’s a difficult disease to diagnose and there is still substantial debate about what the disease is. When strict definitions are used there is actually very little variation in incidence and certianly not one that supports the hypothesis that vaccine schedule has any influence. For example, asthma rates and melanoma rates have also increased in the last 30 years. How about the rates of HIV – they’ve been increasing too. There are reasons for these changes in incidence but the vaccine schedule is not one of them.
“Ms Marron claims that “hair, urine and blood analysis (sic) are ineffective for heavy metal and nutritional diagnostics”. These tests are scientific tests ordered by doctors and conducted in independent laboratories. Hair analysis is regularly used to determine if someone has a history of drug use, giving a timeline to toxin exposure much like age shows in tree rings. Doctors do blood analysis to see if a patient has anaemia or vitamin deficiencies (which can be life-threatening in severe cases).”
I believe her criticism was of pseudo analysis, (such as those performed by scientologists on your average street corner, or “body energy field” analysis to search for “allergies”). When tests are performed (as you menion) in accredited labs and when the test is interpreted by someone who knows how to do it, in the context of evidence to prove that their interpretation has some meaning (for example testing the iron binding proteins in the blood to look for causes of anaemia) then that’s a useful test. If however the test involves holding two metal probes, watching a needle move and then getting a declaration of “liver toxins” followed by advice to take some unproven supplements for a few weeks. The probelm is that how does the customer know what they are getting? Unfortunately (as previously discussed on Crikey) often some pharmacists and doctors buy into this unproven trickery to make a quick buck themselves. So it’s important to separate the two kinds of tests – proven and unproven, meaningful and meaningless.
Your personal experience has also shaped the way you see this problem:
“One of the main treatments we tried was “toxins removed by chelation”, so breathlessly mocked by Ms Marron in the context of cancer. We had our son’s hair tested by a US laboratory which had found an enormous excess of certain heavy metals, some of which are found in particular vaccines. The subsequent treatment involved taking supplements designed to gradually extract these toxins from his system.”
Did it work? If so, how quickly? What other treatments did you try at the same time and how do you know one of them didn’t do the trick? How about for the other autistic kids you know – did this treatment work for them? What did subsequent tests show? How did the hair travel to the US? Which “heavy metals?”. How do you know the “supplements” (which are also drugs by the way – supplements just sounds nicer) worked the way they were “designed” to?
The problem with this kind of example is that it is an anecdote. Just one experience. It doesn’t prove anything. I have experience with autistic kids (classical and spectrum), many of whom have been severely limited early in life and have shown dramatic improvement with a variety of (non-drug) treatment. Others treated in exactly the same way have shown none. We don’t know why. So we need to keep looking for the answer.
The role of medicine is not just to find answers, but to reveal when one potential explaination is wrong. It’s fine to say scepticism can limit your options, but having dozens of options isn’t helpful if they’re all wrong! The autism-vaccine theory was an interesting idea, but not one which is backed up by the vast majority of the evidence (which is not all supported by Big Pharma!). It’s our responsibility to listen to possible explanations and to dismiss them if they do not fit the evidence. My problem with this article is not its intent (which as far as I can see is to encourage an open minded approach to problems that do not have a definitive solution) but the fact that it uses specious arguments and claims:
“There is only one important thing: to each find our own path to health rather than a right or wrong for everyone. Because there often isn’t one.”
The truth is that there are lots of wrong paths, and both conventional and alternative medicine may put you onto them. But science (and when done properly, scientific medicine) is about looking for these answers. Much of alternative medicine denies evidence and even worse refuses to search for it. I believe there are answers to these problems and I’ll put my faith in the evidence, which means doing the research properly and being prepared to criticise people who make dodgy claims.
DECLARATION: I am a medical practitioner who is neither well-resourced nor PR buttressed and has no links with Big Pharma.
It is not possible to make a “distinction between doctors who practice the best alternative therapies because they recognise the shortfalls of mainstream medicine and someone opening a “crystal healing clinic” in their back room.”
Therapies are either “proven” (i.e. based on solid evidence) or “non-proven”. The only time “non-proven” therapies should be used is as part of a properly established and controlled clinical trial. Then, if they are proven to work, they become part of the mainstream treatment (even if they were once considered to be alternative). And if they are shown not to work, they remain “unproven”.
If doctors hypothesise that something alternative might work, they should conduct a trial, not offer unproven therapies to the gullible public.
The primary difference between so-called “complementary medicine” and mainstream medicine is that mainstream medicine is backed by scientific evidence.
There is no link between vaccines and autism. Period. It’s been studied to death and nothing has ever been found by any large, reputable study.
Thiomersal (aka thimerosal in the US), an organic molecule containing a mercury ion, and the common bogeyman of the anti-vaccine campaigners, has not appeared in childhood vaccines for many years. It was used as a preservative. Apart from the fact that the mercury present in this molecule had no chance of being biologically active, the dose was so tiny that it would’ve been irrelevant even as freely available mercury. Some of the vaccine studies even showed a small, statistically significant but almost certainly entirely spurious, PROTECTIVE effect of thiomersal against autism.
Foolishness such as the misuse of chelation therapy on the basis of analysis of a hair sample by a dodgy US lab should be grounds for children to be removed from parents.