HOMEOPATHYHOMEOPATHY AND THE AND THE

NEW NEW FUNDAMENTALISMFUNDAMENTALISM

Lionel MilgromLionel Milgrom

Rx

Pr Px

The New Fundamentalism: what The New Fundamentalism: what is it?is it?

It is based on an extremely narrow interpretation of It is based on an extremely narrow interpretation of science and evidence-based medicine (EBM). science and evidence-based medicine (EBM).

It denies efficacy for any therapeutic modality that It denies efficacy for any therapeutic modality that cannot be ‘proven’ in RCTs. cannot be ‘proven’ in RCTs.

It ridicules, ignores, or misunderstands any explanation It ridicules, ignores, or misunderstands any explanation of homeopathy’s efficacy, and current research data of homeopathy’s efficacy, and current research data supporting such explanations, especially from outside supporting such explanations, especially from outside biomedicine. biomedicine.

It uses experimental bias, hear-say, even innuendo in It uses experimental bias, hear-say, even innuendo in order to discredit homeopathy order to discredit homeopathy (e.g., Ernst’s recent claim that (e.g., Ernst’s recent claim that negative trial data supposedly obtained by the Nazis has been deliberately negative trial data supposedly obtained by the Nazis has been deliberately covered up for over 60 years. See Ernst E, The truth about homeopathy. covered up for over 60 years. See Ernst E, The truth about homeopathy. Br J Clin PharmacolBr J Clin Pharmacol 2008; 2008;6565(2):163-4; and (2):163-4; and Milgrom LR and Moebius S. Is Using Nazi Research to Condemn Homeopathy Ethical or Scientific? Bri J Clin Pharm 2008;66(1):156-7))

It is itself, therefore, unscientific; indeed, it is anti-It is itself, therefore, unscientific; indeed, it is anti-scientific. scientific.

The New Fundamentalists: the most The New Fundamentalists: the most volublevoluble

In the UK: In the UK:

• Edzard ErnstEdzard Ernst , , Professor of CAM at the University of Exeter; Professor of CAM at the University of Exeter;

• Richard Dawkins,Richard Dawkins, Oxford professor, academic/author; Oxford professor, academic/author;

• David Colquhoun,David Colquhoun, UCL professor of pharmacology, UCL professor of pharmacology,

• Michael BaumMichael Baum , Emeritus , Emeritus professor of oncology, and his co-professor of oncology, and his co-signatories of the Times letter (23/05/2007) urging health signatories of the Times letter (23/05/2007) urging health authorities to cut funding for homeopathy/CAMs.authorities to cut funding for homeopathy/CAMs.

• Sense About ScienceSense About Science , which includes science writer and , which includes science writer and broadcaster broadcaster Simon SinghSimon Singh, and Labour peer , and Labour peer Dick TaverneDick Taverne; ;

• Ben Goldacre,Ben Goldacre, Guardian journalist; Guardian journalist;

From the US, From the US,

• Magician, Magician, James RandiJames Randi

• Physicist, Physicist, Robert L ParkRobert L Park

The New Fundamentalists: what to they The New Fundamentalists: what to they want?want?

They see themselves as ‘defenders of reason’ against a tide of They see themselves as ‘defenders of reason’ against a tide of irrational belief in, among other things, ‘quack’ medicine.irrational belief in, among other things, ‘quack’ medicine.

After all, how can homeopathic medicines work After all, how can homeopathic medicines work if there are no molecules of the original drug if there are no molecules of the original drug substance present?substance present?

So, New Fundamentalists want to tell us how to think, e.g., the So, New Fundamentalists want to tell us how to think, e.g., the latest from Ernst and Baum latest from Ernst and Baum ““All serious thinkers should have All serious thinkers should have a closed mind on the subject of homeopathy: it is anti-a closed mind on the subject of homeopathy: it is anti-scientific and simply does not work.scientific and simply does not work.”” (The Worst Medicine, 07/05/2008: (The Worst Medicine, 07/05/2008: Wellcome CollectionWellcome Collection http://www.spiked-online.com/index.php?/wellcome/bestandworst/C142/))

In the UK, they want:-In the UK, they want:- Total exclusion of all ‘quack’ therapies from the NHSTotal exclusion of all ‘quack’ therapies from the NHS: : Closure of state-funded homeopathic hospitals; regardless of the Closure of state-funded homeopathic hospitals; regardless of the

many who benefit from themmany who benefit from them..

Their activities have lead to reductions in NHS referrals to the Their activities have lead to reductions in NHS referrals to the RLHH, which is threatened with closure.RLHH, which is threatened with closure.

But 206 MPs signed an EDM to debate the fate of the RLHH.But 206 MPs signed an EDM to debate the fate of the RLHH.

Guardian journalist Tom Whipple, sent an email asking them why Guardian journalist Tom Whipple, sent an email asking them why and on what evidence they had decided to sign the EDM.and on what evidence they had decided to sign the EDM.

The New Fundamentalists: what did they The New Fundamentalists: what did they get?get?

Some typical responses:Some typical responses: Andrew GeorgeAndrew George::

“ “The primary purpose behind adding my name to this EDM The primary purpose behind adding my name to this EDM is to offer an alternative treatment where conventional is to offer an alternative treatment where conventional medicine has failed, providing that it can be clinically medicine has failed, providing that it can be clinically proven that the homeopathic option will not cause harm.” proven that the homeopathic option will not cause harm.” (‘First; do no harm.’ – Hippocratic Oath)(‘First; do no harm.’ – Hippocratic Oath)

“ “If the treatment helps some patients then within If the treatment helps some patients then within reasonable financial constraints and ensuring that decisions reasonable financial constraints and ensuring that decisions are fully informed then patients with the support of their GP are fully informed then patients with the support of their GP could be prescribed the homeopathic option.”could be prescribed the homeopathic option.”

Frank FieldFrank Field “ “I support the EDM because I have been a beneficiary of I support the EDM because I have been a beneficiary of

homeopathy medicine. Sometimes the drugs don’t work. homeopathy medicine. Sometimes the drugs don’t work. The NHS has been treating me for eczema for more years The NHS has been treating me for eczema for more years than I can remember without total success.than I can remember without total success.

“ “I do believe one aspect of getting well is that people I do believe one aspect of getting well is that people believe that they will get well. It is not the only aspect and believe that they will get well. It is not the only aspect and as the health budget has almost doubled in real terms I as the health budget has almost doubled in real terms I believe there is a place for homeopathic medicines for those believe there is a place for homeopathic medicines for those who wish to use them.”who wish to use them.”

The New Fundamentalism: propagating The New Fundamentalism: propagating porkiesporkies

In the history of science, paradigm shifts In the history of science, paradigm shifts are nothing new, but…are nothing new, but…

What’s different is that we live in an age What’s different is that we live in an age of easily accessible mass of easily accessible mass communication. communication.

The New Fundamentalism’s ‘quack-The New Fundamentalism’s ‘quack-busting’ message is propagated by busting’ message is propagated by some (but by no means all) in the media some (but by no means all) in the media who share their (mainly biomedical) who share their (mainly biomedical) scientific backgrounds and beliefs, e.g., scientific backgrounds and beliefs, e.g., Ben Goldacre.Ben Goldacre.

And they are a tad economical with the And they are a tad economical with the truth….truth….

The New Fundamentalism propagates The New Fundamentalism propagates porkiesporkies

From Nick Cohen: “The cranks who swear by From Nick Cohen: “The cranks who swear by citronella oil”. Observer; Sunday, 28/10/2007.citronella oil”. Observer; Sunday, 28/10/2007.

http://www.guardian.co.uk/commentisfree/story/http://www.guardian.co.uk/commentisfree/story/0,,2200815,00.html0,,2200815,00.html. .

“…“…..Yet dismissing homeopathy as quackery given by Yet dismissing homeopathy as quackery given by and for the feeble-minded is surprisingly hard. Anti-and for the feeble-minded is surprisingly hard. Anti-elitism dominates our society and many feel elitism dominates our society and many feel uncomfortable saying that the six million people who uncomfortable saying that the six million people who take alternative medicines are foolish - to put the case take alternative medicines are foolish - to put the case against them at its kindest. They sincerely believe in against them at its kindest. They sincerely believe in phoney remedies and sincerity trumps sense in modern phoney remedies and sincerity trumps sense in modern culture.culture.””

And, And, “(homeopathy’s)“(homeopathy’s) effects can be positively deadly. effects can be positively deadly.””

The New Fundamentalism propagates The New Fundamentalism propagates porkiesporkies

The lie of homeopathy’s ‘deadliness’ has been repeated The lie of homeopathy’s ‘deadliness’ has been repeated in in The LancetThe Lancet.. Ben Goldacre. Benefits and risks of homeopathy. Ben Goldacre. Benefits and risks of homeopathy. The Lancet 2007;370 (issue no. 9600): 1671-2: Udani The Lancet 2007;370 (issue no. 9600): 1671-2: Udani Samararasekara. Pressure grows against homeopathy in the UK. Samararasekara. Pressure grows against homeopathy in the UK. ibid. 1677-8.ibid. 1677-8.

…….Homeopathic malaria prophylaxis, attacked as .Homeopathic malaria prophylaxis, attacked as deadly by Simon Singh on Newsnight ….deadly by Simon Singh on Newsnight ….

…….And the Government’s Chief Scientist, Sir David King .And the Government’s Chief Scientist, Sir David King has also got in on the acthas also got in on the act (evidence to the Select Committee (evidence to the Select Committee on Innovation, Universities, and Skills, 06/12/07).on Innovation, Universities, and Skills, 06/12/07).

Presumably, fear over homeopathy/CAMs Presumably, fear over homeopathy/CAMs ‘deadliness’ arises from their replacing ‘deadliness’ arises from their replacing conventional treatments….?conventional treatments….?

…….But aren’t they all forgetting something…?.But aren’t they all forgetting something…?

The benefits of modern The benefits of modern medicinemedicine

In 2006 in the UK there were:-In 2006 in the UK there were:- 940,000940,000 recorded accidents by doctors and hospitals (government thinks recorded accidents by doctors and hospitals (government thinks

this an underestimate: more likethis an underestimate: more like 1,190,0001,190,000)) 300,000300,000 hospital-acquired infectionshospital-acquired infections 250,000250,000 serious adverse drug reactions (again an underestimate, closer toserious adverse drug reactions (again an underestimate, closer to

1,200,0001,200,000).). That’sThat’s 2.68 million Britons2.68 million Britons harmed by conventional medicine (4.5% of harmed by conventional medicine (4.5% of

the population). the population). Chair of the Commons Public Accounts Committee, Edward Leigh, said:-Chair of the Commons Public Accounts Committee, Edward Leigh, said:-

““These figures would be terrifying enough without our learning that These figures would be terrifying enough without our learning that there is undoubtedly substantial under-reporting of serious incidents there is undoubtedly substantial under-reporting of serious incidents and deaths….” and deaths….” (See,(See, Leigh E. A safer place for patients: learning to improve patient Leigh E. A safer place for patients: learning to improve patient safety: 51st report of session 2005-06 report, together with formal minutes, oral, and safety: 51st report of session 2005-06 report, together with formal minutes, oral, and written evidence. House of Commons papers 831; 2005-06, TSO (The Stationery Office). written evidence. House of Commons papers 831; 2005-06, TSO (The Stationery Office).

6th July 2006).6th July 2006). Why? Drs don’t want to face legal action from Pxs or disciplinary Why? Drs don’t want to face legal action from Pxs or disciplinary

action from the GMC.action from the GMC. In the US, conventional medicine is the third biggest killer after heart In the US, conventional medicine is the third biggest killer after heart

disease and cancer.disease and cancer. More people die by conventional medicine in the US than by firearms.More people die by conventional medicine in the US than by firearms.

(See(See http://www.health-care-reform.net/causedeath.htm)http://www.health-care-reform.net/causedeath.htm)

The benefits of modern The benefits of modern medicinemedicine

Malaria: second biggest killer in the world – Malaria: second biggest killer in the world – ~~1,000,000 new 1,000,000 new cases/year – a child dies every 30 seconds….cases/year – a child dies every 30 seconds….

• Big Pharma’s response: New anti-malarial drugs are not profitable so tend not to Big Pharma’s response: New anti-malarial drugs are not profitable so tend not to get involved in researching them – leaves it to charity, e.g., Bill Gates.get involved in researching them – leaves it to charity, e.g., Bill Gates.

• Current anti-malaria drugs can cause schizophrenia.Current anti-malaria drugs can cause schizophrenia. (See World Health (See World Health Organisation: Organisation: Review of central nervous system adverse events to the antimalarial drug mefloquine (1985–1990). Geneva: WHO, 1991. Report no: WHO/mal 91.1063Geneva: WHO, 1991. Report no: WHO/mal 91.1063)). . Up to 22% Up to 22% of Lariam takers have reported serious adverse psychological eventsof Lariam takers have reported serious adverse psychological events (see Mathew Parris, ‘I THINK I’D RATHER HAVE MALARIA’, The Times 04/04/1998)(see Mathew Parris, ‘I THINK I’D RATHER HAVE MALARIA’, The Times 04/04/1998)

….Prozac ‘no better than placebo’….Statin side-effects….Prozac ‘no better than placebo’….Statin side-effects….

….Withdrawal of Vioxx, Paxil, Bextra, Baycol…. Northwick Park .Withdrawal of Vioxx, Paxil, Bextra, Baycol…. Northwick Park antibody trial….only 15% of CM products tested by antibody trial….only 15% of CM products tested by RCTs….‘skewing’ of drug trials results in order to protect share RCTs….‘skewing’ of drug trials results in order to protect share price and investorsprice and investors (See, for example, http://www.google.co.uk/search?hl=en&q=Zoloft%3B+trials+questioned&btnG=Search&meta=)

…….Not to mention antibiotic abuse and the rise of MRSA…..Not to mention antibiotic abuse and the rise of MRSA….

…….MMR and the attempts to discredit Dr Andrew Wakefield.MMR and the attempts to discredit Dr Andrew Wakefield (See (See Martin Walker; ‘The Guardian, the Science Lobby, and the rise of Scientific Corporatism’, Martin Walker; ‘The Guardian, the Science Lobby, and the rise of Scientific Corporatism’, 22/01/200822/01/2008 http://www.whale.to/vaccine/walker13.html) http://www.whale.to/vaccine/walker13.html)

…….The invention of ‘new diseases’ to sell more drugs.The invention of ‘new diseases’ to sell more drugs (known as disease (known as disease mongering; see, Moynihan Rmongering; see, Moynihan R, , Heath I, Henry D. Selling sickness: the pharmaceutical industry Heath I, Henry D. Selling sickness: the pharmaceutical industry and disease mongering. and disease mongering. British Medical Journal 2002;324:886-891). 2002;324:886-891).

…….And then there’s vaccination…..And then there’s vaccination….

The benefits of modern medicineThe benefits of modern medicineThe vaccination myth?The vaccination myth?

http://www.vaccinationdebate.com/

“Scientific medicine has taken credit it does not deserve for some advances in health. Most people believe that victory over the infectious diseases of the last century came with the invention of immunisations. In fact, cholera, typhoid, tetanus, diphtheria and whooping cough, etc, were in decline before vaccines for them became available - the result of better methods of sanitation, sewage disposal, and distribution of food and water." Taken from 'Health and Healing' by Dr Andrew Weil

AND THEY CALL AND THEY CALL HOMEOPATHY/CAMSHOMEOPATHY/CAMS

!!!DEADLY!!!!!!DEADLY!!!

The New Fundamentalists: what they The New Fundamentalists: what they forgetforget

New Fundamentalists claim there is no New Fundamentalists claim there is no proof or evidence that homeopathy/CAMs proof or evidence that homeopathy/CAMs have efficacy (possibly beyond a placebo have efficacy (possibly beyond a placebo response). response).

But even if that were true (which it isn’t)….But even if that were true (which it isn’t)…. “…“…. . absence of proof is not proof absence of proof is not proof

of absence. In fact, from a of absence. In fact, from a methodological and statistical methodological and statistical standpoint, absence of proof is standpoint, absence of proof is very difficult to prove….very difficult to prove….””

Dean R Hess, Editorial; Respiratory Care, July 2002, Dean R Hess, Editorial; Respiratory Care, July 2002, Volume 47(7), p757.Volume 47(7), p757.

BAD SCIENCE?BAD SCIENCE? 2005: Shang et al. ‘Are the clinical effects of homoeopathy 2005: Shang et al. ‘Are the clinical effects of homoeopathy

placebo effects? Comparative study of placebo-controlled placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy’.trials of homoeopathy and allopathy’. Lancet. Lancet. 2005;366(9487):726-32.2005;366(9487):726-32.

Lancet editorial (by Horton) proclaims ‘the end of homeopathy’.Lancet editorial (by Horton) proclaims ‘the end of homeopathy’. Appeared during August when news is sparse – the media Appeared during August when news is sparse – the media

pounced.pounced. Actually, this research was outright scientific bias and was roundly Actually, this research was outright scientific bias and was roundly

criticised by many scientists working in the field (none of which criticised by many scientists working in the field (none of which was reported by the media). See JACM 2005; 11(5): 779-785:was reported by the media). See JACM 2005; 11(5): 779-785:• Horton Deplores Breach; As Do We HisHorton Deplores Breach; As Do We His.. George T. Lewith, Harald Walach, George T. Lewith, Harald Walach,

Wayne B. Jonas: Wayne B. Jonas:

• Shang et al. Carelessness, Collusion, or Conspiracy?Shang et al. Carelessness, Collusion, or Conspiracy? David Peters: David Peters:

• Bias in the Trial and Reporting of Trials of Homeopathy: A Fundamental Bias in the Trial and Reporting of Trials of Homeopathy: A Fundamental Breakdown in Peer Review and Standards?Breakdown in Peer Review and Standards? Michael Frass, E. Schuster, Michael Frass, E. Schuster, Ilse Muchitsch, Jeff Duncan, Walter Gei, Gloria Kozel, Christa Kastinger-Mayr, Ilse Muchitsch, Jeff Duncan, Walter Gei, Gloria Kozel, Christa Kastinger-Mayr, Anton E. Felleitner, Christian Reiter, Christian Endler, Menachem Oberbaum: Anton E. Felleitner, Christian Reiter, Christian Endler, Menachem Oberbaum:

• Failure to Exclude False Negative Bias: A Fundamental Flaw in the Trial Failure to Exclude False Negative Bias: A Fundamental Flaw in the Trial of Shang et al.of Shang et al. Helmut Kiene, Gunver S. Kienle, Tido von Schön-Angerer:Helmut Kiene, Gunver S. Kienle, Tido von Schön-Angerer:

• Understanding Placebo Effects in Homeopathic Clinical Trials.Understanding Placebo Effects in Homeopathic Clinical Trials. Trevor Thompson, Marjorie Weiss: Trevor Thompson, Marjorie Weiss:

• Sir: Is That Bias?Sir: Is That Bias? David Reilly.David Reilly.

BAD SCIENCE?BAD SCIENCE? Deconstructing Shang et al. Deconstructing Shang et al. From Dr Peter Fisher in From Dr Peter Fisher in

PubMed:PubMed:

• "The final analysis which concluded that ‘the clinical effects of "The final analysis which concluded that ‘the clinical effects of homoeopathy are placebo effects’ was based on homoeopathy are placebo effects’ was based on just eightjust eight clinical trials of homeopathy. clinical trials of homeopathy. The Lancet’s press release did The Lancet’s press release did not mention this, instead giving the impression that the not mention this, instead giving the impression that the conclusions were based on all 110 trials.conclusions were based on all 110 trials."  " 

• "One of the most serious criticisms is the complete lack of "One of the most serious criticisms is the complete lack of transparency transparency (which incidentally goes against the Lancet’s own (which incidentally goes against the Lancet’s own guidelines for conducting such meta-analyses)guidelines for conducting such meta-analyses): : we have no we have no idea which eight trials were included in the final, idea which eight trials were included in the final, damning, analysisdamning, analysis."  ." 

• "The literature references are not given, nor any information on "The literature references are not given, nor any information on the diagnoses, numbers of patients, etc., the diagnoses, numbers of patients, etc., nor can these be nor can these be deduced from the articlededuced from the article.” .” 

• ““Prof. Egger has refused several requests to disclose the Prof. Egger has refused several requests to disclose the identity of the eight trials. identity of the eight trials. This is not even a matter of This is not even a matter of scientific method, but of natural justice: the accused has scientific method, but of natural justice: the accused has the right to know the evidence against himthe right to know the evidence against him."."

Memory of water Memory of water

280 water molecules/icosahedronhttp:/www.lsbu.ac.uk/water/homeop.htm

Roy R, Tiller WA, Bell I, Hoover MR. Mat Res Innovat 2005;9(4):559-576 (On-line; www.matrice-technology.com)

The Memory of Water hypothesis is based on conventional physics and chemistry concepts of supra-molecularity arising from hydrogen bonding and other well-known weak interactions between water molecules. But MoW has been dismissed out of hand as a ‘belief in undetected sub-atomic fields’ (See Sagar SM. Homeopathy: does a teaspoon of honey help the medicine go down? Curr Oncol 2007;14(4):126-7, and Milgrom LR. Homeopathy, fundamentalism, and the memory of water. Milgrom LR. Homeopathy, fundamentalism, and the memory of water. Curr Curr OncolOncol 2007; 2007;1414:221-2):221-2)

Memory of water Memory of water Evidence from the physical sciencesEvidence from the physical sciences

A. Chaplin M. Water Structure and Behaviour. Online document at: www.lsbu.ac.uk/water/. Excellent section on homeopathy. Exhaustive and regularly updated

B. Thermo-luminscence: 1. Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride. Physica A 2003;323:67–74. 2. van Wijk R, Bosman S, van Wijk EP. Thermoluminescence in ultra-high dilution research. J Altern Complement Med 2006; 12(5): 437–443.

C. Thermo-chemistry and Electrochemistry: 1. Elia V., Niccoli M. Ann New York Acad Sci, 1999; 879: 241. 2. Elia V., Niccoli M. J Thermal Analysis and Calorimetry, 2000; 61: 527. 3. Elia V., Niccoli M. J Thermal Analysis and Calorimetry, 2004; 75: 815. 4. Elia V., Baiano S., Duro I., Napoli E., Niccoli M., Nonatelli L. Homeopathy, 2004; 93: 144–150. 5. V. Elia, E. Napoli, M. Niccoli, L. Nonatelli, Ramaglia A., Ventimiglia E. J Thermal Analysis and Calorimetry, 2004; 78: 331. 6. Elia V., Marchese M., Montanino M., Napoli E., Niccoli M., Nonatelli L., Ramaglia A. J Sol Chem, 2005; 34: 947.

Memory of water: composition vs Memory of water: composition vs structurestructure

D. Materials science - epitaxy Sceptics claim that since there is no difference in composition between a remedy and the pure water used, there can be no differences at all between them. Materials science shows “…. that it is structure (not composition) that (largely) controls properties, and structures can be changed in inorganic phases without any change of composition.” (e.g., diamond and graphite) “The burden of proof on critics of homeopathy is to establish that the structure of the processed remedy is not different from the original

solvent.” Roy R, Tiller WA, Bell I, Hoover MR. Mat Res Innovat 2005;9(4):559-576 (On-line; www.matrice-technology.com) Using Raman and Ultra-Violet–Visible (UV–VIS) spectroscopy Roy et al distinguished two different homeopathic medicines (Nux vom and Nat

Mur) and differentiated their 6c, 12c, and 30c potencies. “Materials science concepts and experimental tools offer a new approach to contemporary science, for making significant advances in basic science studies of homeopathic medicines.” Rao ML, Roy R, Bell IR, and Hoover R. Homeopathy (2007) 96, 175–182.

MoW and biology?MoW and biology?

Pressure changes in the membranes of the myelin sheath of long axons cause tightly-packed cholesterol-lecithin complexes to coil and stretch which, via lined-up water molecules, causes protein pores to open and close, allowing transmission of ions across the membrane. Such a mechanism is vitally important for the transmission of neural impulses.

There is a long way to go, but think of the chemistry inside cells as like watching a play at the theatre. The molecules of life – DNA, proteins, enzymes, lipids, vitamins, etc – are the principle ‘actors’ and they transfix our attention. But the ‘stage’, scenery, direction, even the theatre itself is made up of coordinated water molecules which allow these principle actors to perform.

Why ‘believe’ in science?Why ‘believe’ in science? Which means it might be possible to eventually Which means it might be possible to eventually

explain homeopathy in scientific terms.explain homeopathy in scientific terms. So why can’t the New Fundamentalists ‘get’ So why can’t the New Fundamentalists ‘get’

this?this? ____________________________________________________________________________________________________ Science is ‘special’: it is based on ‘facts’;Science is ‘special’: it is based on ‘facts’; These are claims about the world established These are claims about the world established

by careful unprejudiced use of the senses;by careful unprejudiced use of the senses; These ‘facts’ are used to ‘prove’ theory.These ‘facts’ are used to ‘prove’ theory. But isn’t science also based on assumptions But isn’t science also based on assumptions

about the world? about the world? And don’t these assumptions somehow ‘And don’t these assumptions somehow ‘ccoolloouurr’’

the facts?the facts? Need to go deeper and ask, Need to go deeper and ask, • What is science? What is science? • What is evidence? What is evidence? • How do we get there?”How do we get there?”

Why ‘believe’ in science?Why ‘believe’ in science?

DeductiveDeductive vs vs inductiveinductive logic…. logic….• All humans are mortal; John Smith is human; ergo, he is mortal.All humans are mortal; John Smith is human; ergo, he is mortal.

• In the farmyard, the turkeys are fed every day; the farmyard operates in a In the farmyard, the turkeys are fed every day; the farmyard operates in a uniform manner; ergo, the turkeys will be fed tomorrow.uniform manner; ergo, the turkeys will be fed tomorrow.

When we reason with When we reason with deductivedeductive logic we can be sure that the logic we can be sure that the conclusion will be true if the premises are true.conclusion will be true if the premises are true.

When we reason with When we reason with inductiveinductive logic we can end up drawing false logic we can end up drawing false conclusions from true premises (conclusions from true premises (what happens to turkeys on Dec what happens to turkeys on Dec 2424thth??!!??!!).).

Induction leads us to believe that the future will resemble the past.Induction leads us to believe that the future will resemble the past.

What has this got to do with science? Science relies on induction!What has this got to do with science? Science relies on induction!

• It is widely assumed that science starts with observation which provides a It is widely assumed that science starts with observation which provides a secure basis from which knowledge can be derived via secure basis from which knowledge can be derived via inductioninduction..

• But David Hume (18But David Hume (18thth C) argued it is all a matter of C) argued it is all a matter of CUSTOM or HABIT CUSTOM or HABIT and and that the use of induction cannot be rationally justified at all! that the use of induction cannot be rationally justified at all!

Science doesn’t ‘prove’ or ‘disprove’ anything: the word ‘proof’ Science doesn’t ‘prove’ or ‘disprove’ anything: the word ‘proof’ should only be used when describing should only be used when describing deductivedeductive logical operations, logical operations, like maths.like maths.

Offering a ‘reward’ to ‘prove’ homeopathy/CAMs work is a Offering a ‘reward’ to ‘prove’ homeopathy/CAMs work is a just a stunt and not a cheap one at that.just a stunt and not a cheap one at that.

Simple or Simple or Naïve Naïve InductionInduction A large proportion of our beliefs are obtained by projecting from observed A large proportion of our beliefs are obtained by projecting from observed

(past or present) events to cases that are either unknown, unobserved, or (past or present) events to cases that are either unknown, unobserved, or in the future. For example:in the future. For example: • Every swan I have ever seen has been white.

• Ergo; the next swan I see will be white. But what if the next swan I see is black? But what if the next swan I see is black? ALARM!ALARM! Is it a swan? Easier to say it isn’t! Or: maybe it was a trick of the Is it a swan? Easier to say it isn’t! Or: maybe it was a trick of the

light and I never saw it!light and I never saw it! This arises from what is called ‘This arises from what is called ‘Naïve InductivismNaïve Inductivism’, which asserts that:’, which asserts that:

• Purely objective observations can be made which lead to irrefutable facts:

• That generalisations can be induced from these facts: • That scientific laws and theories result from these inductions

Karl Popper attempted to address the limitations of Karl Popper attempted to address the limitations of Naïve InductivismNaïve Inductivism with his Principle of Falsification.with his Principle of Falsification.

He argued that if a scientific theory cannot be tested by falsification, then He argued that if a scientific theory cannot be tested by falsification, then it is pseudo-science (e.g., Freud, Marx), and should be rejected.it is pseudo-science (e.g., Freud, Marx), and should be rejected.

But scientists don’t work like that and there have been some notable But scientists don’t work like that and there have been some notable successes by NOT rejecting theories when falsification apparently has successes by NOT rejecting theories when falsification apparently has happened (e.g., Newton’s theory of gravitation and the orbit of Uranus).happened (e.g., Newton’s theory of gravitation and the orbit of Uranus).

Evidence-based Evidence-based assumptionsassumptions

Evidence is scientific – the result of research: ““I don’t believe in anything I can’t prove. I don’t believe in anything I can’t prove.

My only true belief is in science and its My only true belief is in science and its ability to sort out belief from fact…My job ability to sort out belief from fact…My job is to establish whether or not they (CAMs) is to establish whether or not they (CAMs) are evidence-based. There is no aspect of are evidence-based. There is no aspect of belief in this at all.belief in this at all.”” (Edzard Ernst; The Times, (Edzard Ernst; The Times, 24/12/2005)24/12/2005)

Ernst is being a Ernst is being a scientistic logical positivistscientistic logical positivist, , i.e., adopting the view that natural science has i.e., adopting the view that natural science has authority over all other interpretations of life, authority over all other interpretations of life, e.g., philosophical, religious, mythical, spiritual, e.g., philosophical, religious, mythical, spiritual, or humanistic explanations, and over other or humanistic explanations, and over other fields of inquiry, e.g., the social sciences.fields of inquiry, e.g., the social sciences.

EBM and the philosophy of EBM and the philosophy of sciencescience The current notion of Evidence-Based Medicine (EBM) The current notion of Evidence-Based Medicine (EBM)

assumes that:-assumes that:- Scientific evidence provides objective ‘facts’ about the Scientific evidence provides objective ‘facts’ about the

world.world.

Scientific beliefs stand or fall in the light of this evidenceScientific beliefs stand or fall in the light of this evidence..

But this is a view based explicitly in the early 20But this is a view based explicitly in the early 20thth C C philosophy of logical positivism.philosophy of logical positivism.

Developments in the philosophy of science since the Developments in the philosophy of science since the 1920s have posed serious challenges to logical 1920s have posed serious challenges to logical positivism (Popper, Quine, Ayer, Kuhn, and particularly positivism (Popper, Quine, Ayer, Kuhn, and particularly from Post-Modernists – Foucault, Derrida, Feyerabend, from Post-Modernists – Foucault, Derrida, Feyerabend, Lakatoé, etc), and therefore to the concepts of EBM Lakatoé, etc), and therefore to the concepts of EBM which are based on it.which are based on it.

Thus, a recent Post-Modernist deconstruction of EBM Thus, a recent Post-Modernist deconstruction of EBM discourse compares it to a ‘fascist’ structure for its discourse compares it to a ‘fascist’ structure for its intolerance of pluralism in healthcare systems intolerance of pluralism in healthcare systems (See, Holmes (See, Holmes D et al. Deconstructing the evidence-based discourse in health sciences: D et al. Deconstructing the evidence-based discourse in health sciences: truth, power, and fascism. truth, power, and fascism. Evidence-Based HealthcareEvidence-Based Healthcare 2006;4:180-186. 2006;4:180-186.

Observation is not objectiveObservation is not objective Observation is dependent upon and coloured by our Observation is dependent upon and coloured by our

individual senses and our background beliefs and individual senses and our background beliefs and assumptions (Columbus….!)assumptions (Columbus….!)

What we see is never what ‘really is’ (goes right back to What we see is never what ‘really is’ (goes right back to Kant in the 18Kant in the 18thth C, and further to some ancient Greek C, and further to some ancient Greek philosophers), even under the most highly controlled philosophers), even under the most highly controlled experimental settings.experimental settings.

Kant said we can’t know anything about the ‘Kant said we can’t know anything about the ‘things-in- things-in- themselvesthemselves’ (ontology) from which sensory data ’ (ontology) from which sensory data emanates.emanates.

A modern interpretation of quantum theory goes even A modern interpretation of quantum theory goes even further, and says there are no further, and says there are no ‘things in themselves’‘things in themselves’. . All there is, is what we can All there is, is what we can knowknow (epistemology) about (epistemology) about the world (Zeilinger).the world (Zeilinger).

Does a tree crashing in a forest make a sound if nobody Does a tree crashing in a forest make a sound if nobody hears?hears?

Observation is not objectiveObservation is not objective Past experience is involved implicitly in what constitutes Past experience is involved implicitly in what constitutes

evidence, bevidence, but this also includes the knowledge and standards ut this also includes the knowledge and standards constructed and adopted by ‘epistemological communities’: constructed and adopted by ‘epistemological communities’:

In other words, decisions about what constitutes evidence are also In other words, decisions about what constitutes evidence are also inherently SOCIAL; for we all experience the world through a inherently SOCIAL; for we all experience the world through a certain lens (paradigm – Kuhn):certain lens (paradigm – Kuhn):

What constitutes knowledge also depends upon cultural and social What constitutes knowledge also depends upon cultural and social values: these are just as subject to critique as the knowledge itself.values: these are just as subject to critique as the knowledge itself.

Thus, our acceptance or rejection of evidence can also lack Thus, our acceptance or rejection of evidence can also lack objectivity, for our natural tendency is to reject evidence which objectivity, for our natural tendency is to reject evidence which does not fit with currently held theory.does not fit with currently held theory.

Hence positive results from even the highest standard Hence positive results from even the highest standard RCTs in homeopathy will be rejected by those who do RCTs in homeopathy will be rejected by those who do not ‘believe’ in the possibility that ultra high dilutions not ‘believe’ in the possibility that ultra high dilutions can have an effect. Catch 22!can have an effect. Catch 22!

So don’t expect to collect on Ernst and Singh’s So don’t expect to collect on Ernst and Singh’s Thousands or Randi’s Millions!Thousands or Randi’s Millions!

So What is Science?So What is Science? It may be described as a conformist society which It may be described as a conformist society which

represents only the currently accepted paradigm.represents only the currently accepted paradigm. Consequently the ‘society’ of science defines Consequently the ‘society’ of science defines

‘reality’ relative to the accepted paradigm (e.g., ‘reality’ relative to the accepted paradigm (e.g., the size of the universe pre- and post- Edwin the size of the universe pre- and post- Edwin Hubble in the 1930’s-40’s).Hubble in the 1930’s-40’s).

Students are educated in the accepted paradigm: Students are educated in the accepted paradigm: alternative paradigms tend to be ignored.alternative paradigms tend to be ignored.

So, the ‘society’ of science plays a part in So, the ‘society’ of science plays a part in determining what scientists observe – and how determining what scientists observe – and how science is funded.science is funded.

And as with all things social, there are ‘fashions.’And as with all things social, there are ‘fashions.’ From that perspective, New Fundamentalism is From that perspective, New Fundamentalism is

decidedly retro….decidedly retro….

So What is Science?So What is Science? But the ‘society’ of science now feels itself misunderstood, and But the ‘society’ of science now feels itself misunderstood, and

under threat from ‘irrational’ belief systems (creationism; under threat from ‘irrational’ belief systems (creationism; religion, etc), and a climate of politically-correct anti-elitism.religion, etc), and a climate of politically-correct anti-elitism.

A symptom? In the developed world, between the ages of 9-16 A symptom? In the developed world, between the ages of 9-16 kids are being turned off science (Japan, the worst). kids are being turned off science (Japan, the worst). Schreiner C and Schreiner C and Sjøberg S. Science education and youth’s identity construction – two incompatible Sjøberg S. Science education and youth’s identity construction – two incompatible projects? In, Corrigan D, Dillon J, and Gunstone R (eds). projects? In, Corrigan D, Dillon J, and Gunstone R (eds). The re-emergence of values in the The re-emergence of values in the science curriculumscience curriculum. Sense Publishers, Rotterdam, 2007. . Sense Publishers, Rotterdam, 2007.

There has been a ‘dumbing down’ of science education: decline There has been a ‘dumbing down’ of science education: decline in real ‘hands-on’ experience via health & safety legislation.in real ‘hands-on’ experience via health & safety legislation.

Very little teaching of the history or philosophy of science.Very little teaching of the history or philosophy of science. The ‘society’ of science feels that its ‘message’ is not getting The ‘society’ of science feels that its ‘message’ is not getting

across to the public. So, over the last 10 years there has been a across to the public. So, over the last 10 years there has been a big ‘push’ on the Public Understanding of Science (PUS?!).big ‘push’ on the Public Understanding of Science (PUS?!).

Media courses being offered at universities and more people with Media courses being offered at universities and more people with science training (many from the biomedical sciences; to science training (many from the biomedical sciences; to graduate and post-graduate levels) joining the media.graduate and post-graduate levels) joining the media.

So What is Science?So What is Science? In a ‘media age’, however, the sound-bite rules.In a ‘media age’, however, the sound-bite rules. Science has to compete for time and space in a Science has to compete for time and space in a

crowded and commercialised media market. crowded and commercialised media market. Inevitably, this leads to over-simplification of Inevitably, this leads to over-simplification of

complex scientific issues. complex scientific issues. So, naïve inductivism is making a come-back!So, naïve inductivism is making a come-back! Combine this with a certain crusading zeal to Combine this with a certain crusading zeal to

inform and educate the public, and we have….inform and educate the public, and we have…. The New Fundamentalists’ attempting ‘to rid The New Fundamentalists’ attempting ‘to rid

the world’ of unreason, thoughtless belief, and the world’ of unreason, thoughtless belief, and anything that cannot readily be ‘proved’ and anything that cannot readily be ‘proved’ and explained by ‘black and white’ deterministic explained by ‘black and white’ deterministic science, e.g., homeopathy/CAMs.science, e.g., homeopathy/CAMs.

CONCLUSIONSCONCLUSIONS If ‘in science’s house there are many rooms….’ then New If ‘in science’s house there are many rooms….’ then New

Fundamentalists are straight out of the basement: they are Fundamentalists are straight out of the basement: they are ‘old school’ naïve inductivists.‘old school’ naïve inductivists.

They attack homeopathy as un- or even anti-scientific but:-They attack homeopathy as un- or even anti-scientific but:-• The New Fundamentalism is itself deeply flawed:The New Fundamentalism is itself deeply flawed:• It is challenged by Popper’s ideas on falsification, Kuhn’s It is challenged by Popper’s ideas on falsification, Kuhn’s

notions on paradigms, and Post Modern deconstruction of notions on paradigms, and Post Modern deconstruction of logical positivism and EBM:logical positivism and EBM:

• New Fundamentalists ignore, ridicule, or have no New Fundamentalists ignore, ridicule, or have no comprehension of evidence that supports homeopathy (e.g., comprehension of evidence that supports homeopathy (e.g., claiming that the Memory of Water hypothesis constitutes ‘claiming that the Memory of Water hypothesis constitutes ‘a a belief in undetected sub-atomic fieldsbelief in undetected sub-atomic fields’):’):

• They use misinformation, misdirection, bias, hear-say They use misinformation, misdirection, bias, hear-say masquerading as evidence (e.g., appeal to Nazi research) to masquerading as evidence (e.g., appeal to Nazi research) to ensure their views prevail:ensure their views prevail:

As such, New Fundamentalists are not only themselves As such, New Fundamentalists are not only themselves unscientific, they demean science.unscientific, they demean science.

CONCLUSIONSCONCLUSIONS THIS IS A BATTLE FOR HEARTS AND MINDS….THIS IS A BATTLE FOR HEARTS AND MINDS….

• Against skilful, crusading, implacable opponents who want neither Against skilful, crusading, implacable opponents who want neither peace nor rapprochement;peace nor rapprochement;

• Who see themselves as ‘defenders of Enlightenment values against a Who see themselves as ‘defenders of Enlightenment values against a rising tide of irrational beliefs’ rising tide of irrational beliefs’ (Richard Dawkins);(Richard Dawkins);

• And are hell bent on ridding the NHS of homeopathy/CAMs provision.And are hell bent on ridding the NHS of homeopathy/CAMs provision.

THIS IS UTTER HUBRIS AND MISDIRECTIONTHIS IS UTTER HUBRIS AND MISDIRECTION.. • They proselytise a narrow one-size-fits-all interpretation of evidence, They proselytise a narrow one-size-fits-all interpretation of evidence,

medicine, and science which is medicine, and science which is NOTNOT the epitome of Western the epitome of Western Enlightenment. Enlightenment.

• A pluralistic, humanitarian outlook on life which respects individual A pluralistic, humanitarian outlook on life which respects individual human rights, is. human rights, is.

• The New Fundamentalism threatens the rights of patients to own their The New Fundamentalism threatens the rights of patients to own their own health and healthcare, and to express their freedom of informed own health and healthcare, and to express their freedom of informed therapeutic choice within the NHS.therapeutic choice within the NHS.

• In this respect, it is doubly dangerous, so….In this respect, it is doubly dangerous, so….

TIME TO ‘LOCK AND LOAD’.TIME TO ‘LOCK AND LOAD’. • Time to getTime to get ANGRY; ANGRY; to getto get UNIFIED;UNIFIED; to getto get BUSY BUSY

DEFENDINGDEFENDING homeopathy/CAM.homeopathy/CAM.

FAMOUS LAST WORDS….FAMOUS LAST WORDS…. ““There are more things in heaven and earth, There are more things in heaven and earth,

Horatio, than are dreamt of in your Horatio, than are dreamt of in your philosophy.”philosophy.” From Hamlet by W. Shakespeare

““Science appears as what in truth she is; not Science appears as what in truth she is; not as our glory and absolute boast, but as a as our glory and absolute boast, but as a succedaneum, and a prop to our infirmity.”succedaneum, and a prop to our infirmity.” William Wordsworth

““Science is a broad church full of narrow Science is a broad church full of narrow minds, trained to know even more about even minds, trained to know even more about even less.”less.” Prof Steve Jones (geneticist and science populariser)

““I tell you; we are here on earth to fart around; I tell you; we are here on earth to fart around; and don’t let anybody tell you different.” and don’t let anybody tell you different.” Kurt Vonnegut (writer)