… and they know what they are doing (and they do it anyway)

Pseudoscience with Academics

A guest contribution by Dr. phil. Susanne Dietz

There are existing, unfortunately, the Jakeszs, Hubers, Broers, Burkarts, Dahlkes, etc. of this world, who spread esoterically and spiritually veiled beliefs (in addition to the occasionally available professional competence in their field) and earn money with them.

The photo shows an entry of an university buildingSince I myself have been active in the academic sector and know that there is a very special commitment to knowledge, for a long time it has been an absurdity for me to experience how some intellectually crashed “scientists” or physicians consciously inflict damage on their field and mislead other people – against better knowledge and thus assumingly with lack of conscience.

The attitude of integer scientists to such revelation oaths of scientific ethos still consists too frequently in declining and saying: “I have better things to do than to deal with something like this. It’s clearly obvious that xy is off track.”

Sorry, but no, it is not obvious, not clearly recognizable for many. The average citizen recognizes only that here someone “of the discipline” confirms his world of faith and cites this again and again as testimonial for the conservation of his view of a “spiritual/esoteric world”. But he does not recognize (or is not willing to recognize) that this is only a fact-negative interpretation of reality. A reality which – in light of a research which hat advanced far in the 21st century – has little or nothing to do with esotericism, but with rules and laws which we often do not suit and are partly difficult to understand because they run contrary to our everyday thought structures and processes.

Such an indifferent attitude on the part of scientists of integrity makes it possible for laypersons to engage in pseudo-scientific cherry-picking for more or less base motives, and thus to give themselves a scientific touch that is de facto none. And to improve oneself pecuniarily with it – not exactly seldom.

Our world, our existence, our finiteness is not easy to understand and also not easy to accept. It is understandable to me that many therefore gather a view of the world that gives them pseudo security and well-being. But I cannot agree with that.
Because it doesn’t change anything that faith and knowledge are two pairs of boots and at the end of the day that what we know is preferable to what we believe – simply because it is KNOWLEDGE. And the nature of secure knowledge – such as the ineffectiveness of homeopathy beyond placebo – is its non-negotiability.

If, then, the scientific community does not publicly clearly reject and clarifies postulates from doctors like R. Jakesz, or J. Huber (by the way: these are doctors and by no means scientists) or D. Broers (whose imaginative academic career is more than questionable) and other esoterically inclined “colleagues” or hypotheses from pre-scientific times like those of Samuel Hahnemann, they commit in my eyes a sin of omission that damages the status and reputation of science.

I would wish therefore more and more people and committees from the scientific / academic field to take a clearer stand against such currents, just as the Münsteraner Kreis (German transdisciplinary scientific network against pseudomedicine in medical and non-medical practice) does against homeopathy.

We have the opportunity to obtain specific information: There are Cochrane, Higgs (Swiss scientific portal), Information Network Homeopathy, GWUP (German skeptics association), MaiLab (very popular scientific video blog), MedWatch (investigative project of misleading medical advertisement and information), and bloggers like Dr. Natalie Grams, Dr. Florian Aigner, Dr. Norbert Aust and many, many more. So there would be offers for every social and intellectual group to protect themselves against esotericism and pseudomedicine, their false assertions and manipulations – and thus to protect their own purses and health.

However, getting this information is a commitment to themselves – and is not always lived, not even by academics. What does that tell us? That the personal feeling of well-being counts more for some people than the awareness of the limits of the possible that indeed goes hand in hand with knowledge implying some inconveniences and imponderables that have to be endured in the real world. Even some students prefer to believe and repress, although they know better. And that’s where the fun ends.

Because academics know one thing:

Conspiracy theories of all kinds are lived errors of thought, which are clearly recognizable as such and can be named – and must also be named, so that the manifold damages, which can emanate from esoteric influences of all kinds, are contained. The responsibility lies with the scientific community of the 21st century, simply because it has the ability to do – and knows better.

Ergo: If academics, some doctors and some scientists make use of esotericism, this has a clear proximity to wilful intent and has to do with self-interest and manipulation of others. Consequently, I cannot resist assuming that it is fraud. The sentence: “They don’t know what they’re doing” doesn’t work.

At this point it is no longer a matter of desire – I EXPECT from academics to differentiate, clear conclusions (i.e. not to base them on simplistic cause-effect thinking) and to position themselves clearly against esotericism. No academic can tell me that he doesn’t know better – or at least could know better – if he did what he learned: research cleanly.

And why did I write this? I did my doctorate and the title is not just an academic achievement to me. Above all, I associate it with a clear academic ethos: I feel committed to interdisciplinary, clean, development-oriented acquisition of knowledge, preservation of knowledge in line with reality, and a faithful transfer of knowledge.

Dr. phil. Susanne Dietz


The above article first appeared in the blog “Draufgeschaut” by Dr. Susanne Dietz and is published here with the kind permission of the author.
Original article at http://dietz-trainings.com/#4#blog#30


Picture credits: Pixabay Creative Commons CC0

Homeopathy as “refugee aid” – a medical and ethical problem!

Under the flag “Homeopathy for refugees in Germany” the “Homeopaths Without Borders” together with the initiative “Homeopathy in Action” advertise a nationwide network of homeopathy offers for the “treatment of refugees”. Again and again, related “offers” appear in refugee aid associations which – obviously in complete ignorance of the relevant connections – misinterpret and gladly accept such things as meaningful offers of help.

So one can read for example in an announcement of such an association:

… “Unfortunately, tablets are far too often desired and used to alleviate the symptoms. There are far too few therapy places for psychotherapeutic treatments. In the second part of the evening, we would like to present two free therapy offers from the field of natural medicine.
Dr. med. … and Mrs. …, alternative practitioner, will present the project “Homeopathy for refugees in Germany”.
Every Friday doctors and non-medical practitioners offer homeopathic treatments in the rooms of … as a holistic treatment method for physical and mental problems, if necessary also with the support of interpreters.
… The treatment leads to a reduction of stress and stress symptoms and has a balancing, relaxing effect, so that many people can cope better with stress and thoughts of trauma afterwards.

The activities of the “homoeopaths without borders” (a name trying to benefit from the good name of the “doctors without borders”) were not so long ago criticized in West Africa. There they were consistently rejected with their request to treat Ebola with homeopathy. Apparently, offers under the flag of humanitarian aid is part of the business model of the Homeopaths without Borders. The Süddeutsche Zeitung also reported on corresponding activities in the Munich area.

Quite apart from the therapeutic worthlessness of these “measures”, the question arises whether there is a particular ethical problem besides the medical one.

The fact is: People in need of help from a foreign culture, who as a rule cannot be regarded as “responsible and informed patients” in the sense of our health system, are literally recruited for homeopathic “methods”. People who have to deal with severe traumas – which is explicitly the “goal” of the actions of homeopaths without borders. There is no question about it: providing all these people with psychologically and psychotherapeutically professional care is an almost unsolvable task. But the offer of a sham therapy can’t be a solution! With traumatized people, often children?

Certainly one or the other superficial “success” will occur, precisely because of the psychologically occupied overall situation. But an improper treatment of mental disorders does not solve the problem. Neither is there a careful differential diagnosis (“trauma” is not a diagnosis), nor is anything lastingly done for the patient, nor does one gain knowledge about possible external or self-endangerment due to a psychological disorder. In the age group mainly affected here, one may have to reckon with borderline disorders, whose treatment with sham drugs is hair-raising. We do not like to remember the treatment of the assassin of Ansbach (German small city, where it came to a crime with causing death) with a completely inadequate “therapy” – here by a non-medical practitioner, with a devastating result.

In our opinion, the unspecific “treatment” of severe mental illnesses with homeopathic placebos instead of guideline-oriented drugs goes beyond any tolerable framework. Especially in cases of severe depression, the absence of a specific effective treatment can even be fatal in the worst case because of possible suicide risk. It is not unusual for a traumatised or severely depressed person to be able to undergo therapy at all only with the help of preliminary medication treatment individually adjusted by a specialist.

Even the aspect of the placebo effect must be viewed critically in this context. The language barrier and the origin from a different culture, also and especially in connection with psychological problems, make it seem largely unpredictable whether and how a placebo effect will occur. Since the patients, in this case, might even perceive the “treatment” as overly invasive or authoritarian, even a nocebo effect is conceivable.

Is it really so impossible to provide low-threshold help offers (skills) for those affected instead of idly watching how not only ineffective, but dangerous illusory therapies are offered here? And shouldn’t it be possible – as it happens also for German-speaking patients particularly in emergency situations or in “waiting position” – to publish information brochures in the appropriate languages and age-appropriately, which can help concerning first of all to understand one’s experience and to see that also other humans experience similar after comparable experiences?

Our opinion:

Here the consequence of the social reputation and political “ennobling” of homeopathy becomes visible in a devastating way. Under the guise of helpfulness and support for refugee initiatives, the “Homeopaths without Borders” spread their propaganda for ineffective treatment methods. In this particular case extremely irresponsible. The credulous refugee aid associations, which serve here as vehicles for the transport of the “message homeopathy”, cannot estimate the consequences of these “offers of help” at all and rely on the “good reputation” of homeopathy and the willingness to help shown. There is probably no legal means to prevent this. As always, this is rooted by the fact that homeopathy is anchored in the public health system.
Which indeed sets us apart from the states of West Africa.
Shouldn’t this finally be revised in view of such excesses?


Authors: Monika Kreusel, Udo Endruscheit


Picture: Fotolia_106344027_XS1

Dead child in Italy: Homeopathic doctors association sees “individual medical malpractice”

Malpractice or systemic risk?

In Italy, a child died recently because his parents and the doctor who treated him only relied on homeopathy. The German Central Association of Homeopathic Physicians sees here a “medical malpractice”, thus the “famous” regrettable individual case, but no responsibility of homeopathy as such.

What is a “malpractice” in the medical profession? The correct legal term is “medical error”. It means that a medical treatment is not carried out according to the existing, generally (i.e. according to scientific principles) recognized standards. That homoeopathy does not belong to these generally accepted medical standards is a fact that is testified by the worldwide scientific community. The reason why the Central Association refers to evidence-based medical guidelines in this context is confusing anyway. To whom or what does the homeopathic medical profession feel obliged? The guidelines – or a claim of homeopathy, as the chairwoman claims it on her own homepage? (1) Neither is possible at the same time.

It seems somewhat presumptuous that the Zentralverein speaks here of a “malpractice” – this is why, according to the standards explained above, any treatment carried out by a doctor on a homeopathic basis would be a “malpractice” because it deviates from the generally accepted standards. At least as long as he carries out an homeopathic treatment exclusively, as in the present case.

It should only be mentioned in passing that these considerations have no relevance for non-physician homeopathic practitioners anyway, who, however, in many cases also have no problem wanting to use homeopathy to cure illnesses in which the self-healing powers fail.

In principle, homoeopaths, including the Central Association and above all the chairwoman herself (e.g. on her homepage (1)), are fuelling the hope that homoeopathy can help precisely in such and many other cases. This does not fit in with the relativizing withdrawal in the Central Association’s statement on this case.

In the decision for a homeopathic treatment instead of scientific medicine, the damage potential is already inherent in the core. The potential risk of such incidents exists in principle and from the outset when deciding on homeopathic treatment. In other words, incidents such as the one in question are not unexpected in the sense of a “production fault” or a similar incident in everyday life. They are inherent in the method, systemic, they are manifestations of an unnecessarily high risk level from the outset, since homeopathy cannot offer any specific medicinal effect. When a (no longer) self-limiting disease coincides with the erroneous assumption that it can be combated or even cured with homeopathy, this risk potential is inevitably realized, of course not very frequently, even to the point of death (which, however, has definitely occurred).

It is not for nothing that the main criticism of homeopathy is that it can prevent or delay effective medical treatments. This warning has been given often enough. Even complementary (accompanying) treatment with pseudomedical means or methods impairs the treatment success of well-founded therapies, e.g. due to a lack of compliance (2). For this reason alone it is mistaken to speak of a “malpractice”, a human error in individual cases.

Here the Central Association fails to recognize the reality in which patients rely on an actual and medically equivalent medicinal effect of homeopathic remedies – not least because (not only) repeatedly propagating such an effect itself.

It is not unusual for homeopathy supporters to completely turn away from medicine, to regard it as “poison”, “chemistry” and “harmful” and to reject antibiotic therapy in particular. This effect alone, without reference to a specific treatment case, gives rise to a systemic risk for supporters of the method, which is why the question is once again raised: Is it responsible for the political actors in the health care system to continue exposing consumers or patients to this potential danger by de facto equating homeopathy with evidence-based medicine? And to let people believe and trust that homeopathy is – even legally legitimized – a specifically effective medication therapy?

The explanation as “malpractice” – in the sense of the infamous “regrettable individual case” – we therefore do not want left unchallenged. Rather, we believe that in this case the systemic risk potentially present in any ineffective “alternative” therapy has manifested itself in a particularly tragic way.

We see here rather the “tip of the iceberg” than a “single malpractice”. There’s certainly a dark figure that we all don’t know. And: This boy died in a “normal” clinic. How often will a homeopathic pretreatment with its consequences not become known when it leads to a case of scientific medicine and is recorded with all possible consequences up to death in its statistics?

The special thing about this case is that it has received publicity. The next “individual case” is already waiting. Hopefully it won’t be another death. Seeing the error here not systemically in homeopathy clearly points in the wrong direction.


Supplement, 09 June 2019

The parents of the deceased boy have now given a suspended sentence of three months on probation for culpable manslaughter, according to the Independent.

As always, it is very difficult to decide on individual guilt in such a case. The parents deserve great respect for the fact that they spontaneously decided to release an organ transplant. It is also reported that the parents were not at all against scientific medicine in principle, but were worried because their boy had already received “a lot” of antibiotics in the past. Now these are fundamentally legitimate and understandable concerns of medical laypersons. The basic error, however, was to rely on homeopathy in this initial situation instead of consulting a competent doctor. And this apparently once again due to the conditioning through earlier “healing successes”. Things we’re all too familiar with.

The matter is not made any easier by the fact that, according to the information that has become known so far (source: Corriere della sera), the “therapist” is said to be a man who was temporarily excluded from the Medical Association and during this time was engaged in a wide variety of activities. When the Pesaro Medical Association enquired about the start of his homeopathic activity, he was said to have replied that he had no interest in an answer. What weighs heavily is that he had probably actively advised the parents not to take the boy to a clinic – with horror stories about what he would be administered there. The trial against him is scheduled for September 24.

Once again we see one of the key points of our criticism confirmed: Despite all the lack of understanding for how one can entrust oneself to such a “therapist”: It is not justifiable to leave homeopathy in its positive public reputation or even to confirm that it is a proven, demonstrably effective method that is ultimately equivalent to scientific medicine. In Germany, this misperception is also massively promoted by the legal privilege of internal consensus and the reimbursement practice of health insurance funds. The fact that every “non-treatment” such as homeopathy has inherent risks, which cannot be compared with a risk-benefit evaluation of a scientifically based treatment, must force a rethink.

This is precisely what fundamentally promotes such individual mistakes as in this case. And we believe that this is no longer justifiable – more than that, it never has been. Politicians and health insurance companies are urgently called upon to do their bit here.

 


(1) Quote: “I have been working classically homeopathically in my own practice since 1997. This method not only allows acute diseases such as flu, cough, gastrointestinal infections, middle ear infections, etc… to be healed quickly and gently, but is also a way to treat severe chronic diseases such as asthma, rheumatism, neurodermatitis, hypertension, etc…. With the help of the homeopathic anamnesis, the symptoms of the disease are worked out and then the appropriate homeopathic medication is administered. It leads to a retuning therapy with benefit for the organism.” (Called on 1 June 2017)

(2) Skyler B. Johnson, MD; Henry S. Park, MD, MPH; Cary P. Gross, MD; et al; Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers; JAMA Oncol. Published online July 19, 2018. doi:10.1001/jamaoncol.2018.2487


More on antibiotics and homeopathy here.

More about this case at “Die Ausrufer” LMHI – Antibiotika und tote Kinder and at DAZonline (in German).


Authors: Dr. Natalie Grams, Dr. Norbert Aust, Udo Endruscheit

Picture credits: Fotolia 145924672_5

Offener Brief des INH und des Wissenschaftsrats der GWUP zur “Ringvorlesung Homöopathie” der LMU München

In einer aktuellen Veröffentlichung bewirbt die Ludwig-Maximilians-Universität München eine Veranstaltungsreihe (Ringvorlesung) im Wintersemester 2016/17 zum Thema “Homöopathie: Von der Theorie zur Praxis – Mit Praxisbeispielen und Patientenvorstellungen”. Dabei handelt es sich, wie ein Blick in die Ankündigung zeigt, um eine Reihe von Vorträgen, die den “homöopathischen Ansatz” bei unterschiedlichsten Krankheitsbildern vorstellen will.

Wir halten es für verfehlt, durch eine solche Veranstaltung der homöopathischen Methode zu akademischem Ansehen zu verhelfen, nachdem dies eigentlich längst als obsolet angesehen werden müsste:

  • 1939: Die von August Bier, einem seinerzeit führenden Homöopathen, durchgesetzte Einrichtung einer homöopathischen Fakultät an der Universität Berlin wird rückgängig gemacht – ausdrücklich wegen “Ergebnislosigkeit”.
  • 1958: Die gleiche Universität wehrt sich mit deutlichen Worten gegen den Versuch, diesen Lehrstuhl wieder aufleben zu lassen.
  • 1992: Die medizinische Fakultät der Universität Marburg weist in einer deutlichen Erklärung jede Relevanz der Homöopathie für den Wissenschaftsbetrieb zurück und verwahrt sich gegen ministerielle Bemühungen, Homöopathie in die Lehre einzubeziehen.

Vor diesem Hintergrund ist es mehr als befremdlich, dass die LMU den Lobbyisten vom Deutschen Zentralverein homöopathischer Ärzte eine Plattform bietet, zumal diese mit Lehre und Forschung, den Grundaufgaben jeder Universität, offenbar wenig bis nichts zu tun hat. Leider. Denn wir sind durchaus der Ansicht, dass richtig verstandene Lehre auch in Bezug auf die Homöopathie an einer Universität Platz finden könnte, ja sogar müsste.
Lehren! Das würde für die Homöopathie bedeuten, sie im medizinhistorischen Kontext zu vermitteln, ihre Widersprüchlichkeiten und Unverträglichkeiten mit naturgesetzlichen Gegebenheiten zu erörtern und den fehlenden Wirkungsnachweis und die sogenannte Grundlagenforschung zur Homöopathie vorzustellen und zu diskutieren. Das wäre im Hinblick darauf zu begrüßen, dass angehende Mediziner dann auch auf diesem Gebiet mit solidem Wissen und nicht mit einem Bündel von nicht hinterfragten Vorurteilen ins Berufsleben starten.

Davon ist in der Ankündigung der LMU allerdings nichts zu finden. Stattdessen besteht die Ringvorlesung aus einer Abfolge von Veranstaltungen, in denen die “homöopathischen Ansätze” bei unterschiedlichsten Krankheitsbildern präsentiert werden. Dabei reicht die Palette von einfachen selbstlimitierenden Erkrankungen wie Sinusitis bis hin zu schwersten Erkrankungen, sogar bis in den palliativmedizinischen Bereich. Die angekündigte Eingangsvorlesung “Geschichte und Philosophie der Medizin: Samuel Hahnemanns Begründung einer rationalen Heilkunde” wird wohl auch kaum zu einer methodenkritischen Einführung in die nachfolgenden Vorlesungen gedacht sein. So sind die angekündigten “Praxisbeispiele und Patientenvorstellungen” kein positives Merkmal, sondern bieten nur wieder die Möglichkeit, Homöopathie als “Erfahrungsmedizin” darzustellen.

Wir meinen:

  • Diese unkritische Behandlung der Homöopathie hat an einer wissenschaftlichen Fakultät nichts zu suchen.
  • Es ist mit dem Auftrag zu Forschung und Lehre unvereinbar, einer von der überwältigenden Mehrheit der weltweiten Forschungsgemeinde als spezifisch arzneilich unwirksam eingestuften Methode eine oberflächlich-werbende Darstellung zu geben.
  • Es wäre allenfalls geboten, die Homöopathie gut wissenschaftlich im Sinne einer Erörterung und Falsifikation ihrer Annahmen zu behandeln.
  • Das aktuelle Vorgehen entspricht nicht der Verantwortung der Hochschule gegenüber Studierenden und Patienten.

Unterzeichner:

Für das INH

Dr. Norbert Aust
Udo Endruscheit (Verfasser)
Prof. em. Dr. Edzard Ernst
Dr. Natalie Grams
Amardeo Sarma
Prof. Dr. Norbert Schmacke

Für den Wissenschaftsrat der GWUP

Prof. Dr. Michael Bach
Prof. Dr. Dr. Ulrich Berger
Lydia Benecke
Prof. Dr. Peter Brugger
Prof. em. Dr. Edzard Ernst
Prof. Dr. Dittmar Graf
Dr. Natalie Grams
Prof. Dr. Wolfgang Hell
Prof. Dr. Dieter B. Herrmann
Prof. Dr. Johannes Köbberling
Prof. Dr. Walter Krämer
Prof. Dr. Martin Lambeck
Dr. Rainer Rosenzweig
Prof. Dr. Dr. Gerhard Vollmer
Dr. Barbro Walker
Dr. Christian Weymayr
Dr. habil. Rainer Wolf


Weitere aktuelle Stellungnahmen:

Blogbeitrag bei Edzard Ernst (auf Englisch) hier

Kritischer Kommentar von Wissenschaftsjournalist Werner Bartens in der Südeutschen Zeitung hier

Interessanter älterer Beitrag zur Homöopathie an der LMU auch im Laborjournal hier


Bildnachweis: Fotolia_90994398_XS

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