[Discussion] Medical Quackery

Pages

This is a follow up to the thread "Medical quackery in the US upsets me very, very much". The aim of this current thread is to take up the discussion on medical quackery (widening the scope since the US isn't the only country concerned), discuss news item pertaining to it and the potential responses to address it.
The definition of medical quackery is not up for debate and includes, among others, homeopathy, vaccine skepticism, naturopathy, crystal healing, psychic healing.

Kehama wrote:

I really wanted to ask her who she thinks spreading the flu would benefit but typically her answer in this is hospitals and doctors. She's made the argument a thousand times before that doctors only want to make people sick so they can keep making money treating them.

Does she know that doctors in countries other than the States also give flu shots? As do pharmacists (who I guarantee aren't making bank on administering them)?

For the record, I'm neither frustrated, nor angry. Just putting my foot down.

This, I'm sure, we can all agree is most excellent news:
Homéopathie: "Il faut dérembourser" (L'Express)
Translated by yours truly

131 members of the Academies of Science, Medicine et Pharmacy are denouncing the reimbursement of the small pills.
(...)
No, homeopathy is not an active substance, even though it received the authorization for commercialization from the High Authority on Health and is reimbursed. This current situation can in no way be justified, since homeopathy, contrary to other drugs, has not proved its efficacy in any objective, methodologically sound study acknowledged by the worldwide scientific community.

My translation skills are rusty and this is done on the fly, but you get the idea. As the High Authority on Health is currently taking the case of homeopathy under advisement, this is a big step. Here's hoping we stay the course.

You'll just get Big Water lobbying to make things go their way!

Eleima wrote:
LarryC wrote:

Really? The genetic code is exactly the same and you're not changing anything in your upbringing. Are you implying that an error in chromosomal splitting is an essential trait in a person's character and being? If we could correct the trisomy post pregnancy, is that better? Would you do that? I would. Why would you want me not to be able to correct something I don't want in myself?

It really feels like you're being deliberately obtuse. I'm giving you specific examples where people have spoken out against gene editing, because it would erase them. I'm talking about my experience as a MD on the spectrum and parent to boys on the spectrum. I've spoken about people coming forward to various documentaries, folks with dwarfism, with Down's. Once again (because I don't seem to be getting through), I'm not saying you shouldn't cure sickle cell. But when you're saying you wan't to "get rid of something you wouldn't want in yourself", that speaks to profound, deep, staggering ableism.
But fine, if you won't take my word for it, hear it from someone else:
Please Don't Edit Me Out (The Washington Post)

I am who I am because I have dwarfism. Dwarfs share a rich culture, as do most disability groups. We have traditions, common language and histories rich in charismatic ancestors. I can honestly say that I may not have been able to work in the White House doing diversity recruitment for President Barack Obama had I not been born a little person. It allowed me to understand discrimination, isolation and society’s lowered expectations.

While non-disabled people fear a prenatal diagnosis of disability, disabled people think of the possibilities. How rich would our society be if we all did this? What if that child with osteogenesis imperfecta becomes a world-changing architect because they think differently about how the world is set up due to their disability?

I am who I am because I'm on the spectrum. Make no mistake: this isn't about "feelings", it's about the right to exist.

I'm begging indulgence, but I'd like to clarify that I'm not getting angry, either. I'm being clear. It may sound like it's harsh, but believe me, guys, it gets way harsher in a mortality conference. Both Eleima and I are used to this. This is a little bit of how science is made - with battle and conflict.

Eleima says that what I'm saying is ableist. It is. Absolutely it is. It is not ableist, however, in the sense that I don't want to hire people who are different, or don't want them around, or don't want them to exist. Absolutely not. This also ties to my experiences personally, and as a doctor. For my part, I am ableist in the sense that I want to help people who want to be helped. That's the kind of ableism that invents spectacles, wheelchairs, prosthetics, and accessibility technology.

(For the record, I'm not actually justifying real ableism, just to be clear)

You may all know medicine as a practice that saves lives, but much of it also saves quality of life and mobility. It saves limbs. Most of the practice of orthopedic surgery is about improving mobility and quality of life for those who want and can afford it. Without orthopedic surgery, I would not have the use of my hands, fingers, or arms, and I'm right damned skippy happy I'm able to use them to post on these boards. I cannot emphasize enough how glad I am to live in the modern world.

I think, Eleima, that that piece and that many of the things around these fears wants to make it sound like it's anti-Semitic discrimination, but it isn't. Medicine as we practice it as always been opt-in, and that's how I'm approaching it. Obviously, forcing medical treatments on those who don't want it is horrible, and that's why it's criminal to do that right now in most of the world. I am convinced this practice will not change just because we uncover genetic editing techniques.

When they talk about fearing these things, it sounds reasonable and plaintive, but it is, in fact, terrible and horrific. Right now, osteogenesis imperfecta can't be cured, so the discussion is different, but if it CAN be cured, then wishing it on people just so they can understand suffering is precisely the kind of twisted morality practiced by Mother Teresa. No to that. No doctor should be able to stomach saying that.

As a doctor, I am oath-bound and voluntarily stand against intentionally causing people to suffer or break their bodies. The real fear there isn't that they will personally be erased. It is that, given a choice, no one will want to have the same challenges and join them.

For emphasis: the fear isn't that you will be erased from existence or that you will be killed. It is that no one will choose to be like you, given the choice.

That's an understandable fear because it is true. Few people will choose to have osteogenesis imperfecta, near-sightedness, muscular dystrophy, or a host of physical problems. And I have no problems with people not understanding how it is to have those things, just as I have absolutely no problems with people forgetting how bad it was to have smallpox. It is good that that scourge is dead. May it stay dead.

LarryC, I need clarification. Are you comparing autism to smallpox?

No. I haven't gone into autism at all. I am specifically talking about Down's Syndrome, osteogenesis imperfecta, achondroplasia, and similar conditions. If someone can choose not to have them, then that's a choice that should be offered and made available. Blocking research and treatment for the sake of the cultural advantages of human suffering is not an ethically sound decision, IMO.

There are many with autism who are severely affected and cannot live independently let alone pursue a career in medicine. There is much research money being spent to find a “cure” for autism or ways to prevent it.

So, if a simpler intervention were found that could prevent a newborn from being born autistic and a test were identified that could detect those who will develop it, do you think it would be ethical to offer it? I know most of my friends who are parents of autistic kids would pursue that treatment in a heartbeat. I love my son dearly but if I could treat his autism, take it away, I would. My wife still questions what she could have done differently as if she is at fault. I know she would do anything to prevent his autism and mourns the impact that his disorder has had on her life.

If this were available to a pregnant mom would it be ethical to take that option away? Or is termination of the pregnancy the only choice we think is ethical for a mother who would choose not to face the challenges of raising an autistic child?

If the answer is that it would be ethical to offer the treatment, why is it that a genetic intervention is more problematic than a non-genetic one?

LarryC wrote:

No. I haven't gone into autism at all. I am specifically talking about Down's Syndrome, osteogenesis imperfecta, achondroplasia, and similar conditions. If someone can choose not to have them, then that's a choice that should be offered and made available. Blocking research and treatment for the sake of the cultural advantages of human suffering is not an ethically sound decision, IMO.

You were responding to Eleima, were you not? She referenced her autumn multiple times.

DocJoe, I have no simple answer to that. I’m aware that autism is a spectrum, and affects people differently. I’m not sure where to draw the line.

She did that, but she also referenced specifically osteogenesis imperfecta and achondroplasia. So I talked about those specifically. I am quite specifically not talking about autism and medical opinion on it because I do not feel competent to do that, whether professionally or personally. She can say what she wants about it without contest from me.

I really wish you folks wouldn't use "cure" when talking about autism. It's not a disease.
As for your stance, DocJoe, I don't know that I can agree with that. Yes, it's hard, but take away your son's autism, and he's a different person altogether. It's not just a life experience that's different, it's your entire way of thinking, of being. Even "non verbal" autistic folks have very rich inner lives, some even go on to write books (see Carly's Voice and Why I Jump).

In any case, I wish we would move on from this topic. We've moved *very* far from the thread's purpose as I'd outlined it in the original post. This is not supposed to be about whether or not autistic folks should exist, but about homeopathy, healing crystals, and anti-vaxx nonsense. Speaking of which:
Measles cases spike globally due to gaps in vaccination coverage (WHO)

Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease.
Using updated disease modelling data, the report provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunizations. However, reported cases increased by more than 30 percent worldwide from 2016.

Also:
Italy’s vaccine-sceptic M5S sacks entire board of health experts

Italian health minister Giulia Grillo has unexpectedly sacked every member of the Higher Health Council, the committee of medical experts chosen to advise the government on health policy.

Grillo, from the populist Five Star Movement, wrote on Facebook that it was “time to give space to the new” after sacking the 30 board members unexpectedly with a formal letter yesterday.

“We are the #governmentofchange and, as I have already done with the appointments of the various organs and committees of the ministry, I have chosen to open the door to other deserving personalities,” she wrote.

Thanks for clarifying, Larry.

Now, back to the topic at hand:

Here's some recent autism-related quackery: BC Man first Canadian convicted of selling Miracle Mineral Solution

Well I did get lectured yesterday by a patient that CBD oil cures all cancer. They were fairly shocked that I didn’t know this fact. It’s all over the internet and being suppressed by big pharma because they don’t want the cure for cancer getting out.

I should check out this internet thing some time. I always thought curing cancer was really hard, who knew it was so easy!

I have an old high school friend who has bought big time into the CBD fad. Bought into a company marketing it (I suspect it is just a pyramid scheme) and everything.

While there is anecdotal evidence that marijuana is useful for some things (appetite in chemotherapy patients is the big one I have reliably seen) I look forward to universities and hospitals up here in Canada being able to finally test it, legally and ethically, in a controlled environment.

mudbunny wrote:

I have an old high school friend who has bought big time into the CBD fad. Bought into a company marketing it (I suspect it is just a pyramid scheme) and everything.

While there is anecdotal evidence that marijuana is useful for some things (appetite in chemotherapy patients is the big one I have reliably seen) I look forward to universities and hospitals up here in Canada being able to finally test it, legally and ethically, in a controlled environment.

My wife tried CBD for a while to manage anxiety. It helped. Until...it didn't. I'm not sure if it is a thing that a tolerance can be built up against, or if the anxiety became so severe that it overpowered the effectiveness of the chemical. She dropped it pretty easily and was glad of it because vaping it made her feel very stupid. I was pretty bummed out because for a good month or so she was feeling much better about things in general so I thought the CBD stuff was awesome. Oh well.

I am so happy we will finally get some actual human research started on cannabinoids. Yay Canada!

I prescribe medical cannabis literally every day in my practice. I have no idea if it is effective. Some patients tell me pain or appetite are a little better, some report no benefit and some have terrible side effects. All of it (the good and bad) could be placebo effect.

I will say, again anecdotally, that of the dozens of my patients that have tried treating their cancer with straight up CBD single agent, I have yet to see any kind of tumor shrinkage. But who knows what that are actually taking and what is actually in it.

Cannabis affects everyone differently in a myriad of ways, and that applies to recreational THC just as much as medicinal CBD.

Hell, it affects the same person differently when taken at different times or in through different methods - bake the same weed, vape it or smoke it and it will affect you radically differently.

*nods*

And that's one of the things that needs to be studied - Is there a way to get a controllable dose into a person that will be metabolized controllably?

Right, is it because the concentration of the active substances varies from plant to plant? Why does it trigger psychosis and schizophrenia in some teenagers? And why is it good for relieving nausea in some people but in others causes intractable nausea and vomiting? Happened to one of my patients on chemo, was hospitalized for uncontrolled vomiting and did not seem to correlate to his treatments. Took me 4 months to figure out it was all the weed he was smoking because I didn't know about cannabinoid hyperemesis syndrome. Completely went away once he quit hitting the bong.

I thought it was really rare but maybe not so rare:

https://www.ncbi.nlm.nih.gov/pubmed/...

The problem is that it's not just one drug, there's a vast array of cannabinoids that have different effects, and each one's effect on any given person will vary independently of the others.

Add to that that each strain of weed will have a different weighting between the cannabinoids, and in addition to that, there's variance between each plant in a given strain.

Docjoe wrote:

Right, is it because the concentration of the active substances varies from plant to plant? Why does it trigger psychosis and schizophrenia in some teenagers? And why is it good for relieving nausea in some people but in others causes intractable nausea and vomiting? Happened to one of my patients on chemo, was hospitalized for uncontrolled vomiting and did not seem to correlate to his treatments. Took me 4 months to figure out it was all the weed he was smoking because I didn't know about cannabinoid hyperemesis syndrome. Completely went away once he quit hitting the bong.

I thought it was really rare but maybe not so rare:

https://www.ncbi.nlm.nih.gov/pubmed/...

Huh! I did a bit of partaking in college, I am fine with just MJ, but if I mix it with the any alcohol, instant vomit city. Everyone told me I was nuts because "MJ is supposed to suppress nausea"

There clearly needs to be a lot more research done on how it affects different people and why. It's a serious problem how much research has been stiffed in the US and elsewhere

thrawn82 wrote:
Docjoe wrote:

Right, is it because the concentration of the active substances varies from plant to plant? Why does it trigger psychosis and schizophrenia in some teenagers? And why is it good for relieving nausea in some people but in others causes intractable nausea and vomiting? Happened to one of my patients on chemo, was hospitalized for uncontrolled vomiting and did not seem to correlate to his treatments. Took me 4 months to figure out it was all the weed he was smoking because I didn't know about cannabinoid hyperemesis syndrome. Completely went away once he quit hitting the bong.

I thought it was really rare but maybe not so rare:

https://www.ncbi.nlm.nih.gov/pubmed/...

Huh! I did a bit of partaking in college, I am fine with just MJ, but if I mix it with the any alcohol, instant vomit city. Everyone told me I was nuts because "MJ is supposed to suppress nausea"

There clearly needs to be a lot more research done on how it affects different people and why. It's a serious problem how much research has been stiffed in the US and elsewhere

Right? I had no idea.

When I was reading up about it, I found a study showing that the incidence of cyclic vomiting seen at ERs in Colorado doubled after the legalization of weed and they are trying to make the connection.

Oh, here I found the study.

https://www.ncbi.nlm.nih.gov/pubmed/...

It was the only thing that let my dad eat, during his chemo. He had been a frequent ‘smoker’ since the late ‘60s, too.

Pages