Archive for March, 2010

Rational Thoughts

It has been a nearly a decade since the first claims that there was a link between MMR and autism hit the news, yet despite a mountain of evidence against the link there is still talk as if the debate is ongoing. The evidence is clear – there never was and isn’t a link between the two, but why do such ideas persist? The answer is that we are all terrible at rational thought due to what is called ‘confirmation bias’, a tendency for us to prefer information that confirms our preconceptions regardless of whether they are true. We’re all guilty of it – go in to any science lab and even there I’m sure you’ll find some ritual or voodoo for using a piece of old machinery which no-one dares question in fear that it might stop working.
Campaigning for rational thought appears to be a growing pastime, slowly breaking into the mainstream with advocates like Ben Goldacre and his ‘Bad Science’ column in the Guardian. In a growing number of cities one can find a ‘Skeptics in the Pub’ group for rational debate on topics ranging from easily dismissed UFO and paranormal stories to the more emotive issue of holocaust denial. Times are changing and scientific method is growing up and leaving the classroom. Of course you may wonder what this has to do with you – you’ve never tried claiming you’ve been abducted by a UFO, well except maybe that one time you were embarrassingly late to a party and even then you didn’t think it would hold up against the inebriated crowd.
One may think that the average member of the public can continue to go uninformed with little risk, but the truth is far more sinister. In 2007 Russell Jenkins, who ran a centre which offered complementary medicine, died from a minor injury.[1] The reason was that on suffering the injury he shunned conventional medicine, and when it became infected with gangrene he instead treated it with honey and magnesium sulphate. While Mr Jenkins’ death is tragic and probably avoidable with a simple course of antibiotics, he died at age 52 as an adult making his own choice based on his beliefs – a freedom I’d have trouble denying and something on some level we should all be able to respect, though not without some remorse. The story of Gloria Thomas in Australia on the other hand is far more disturbing. Gloria died at the age of just nine months from eczema after her parents treated her with homeopathic remedies instead of conventional medicine. The parents were both charged with manslaughter by gross criminal negligence.[2] In light of these events can anyone really say that this pseudo-science is harmless? It’s hard to look at such an event without feeling that everyone has lost due to the lack of understanding of the dangers and risks of letting these myths persist. The list goes on – in 2006 a Newsnight investigation showed homeopaths advising customers to take their ineffective alternatives to anti-malaria drugs[3] and there are even some homeopaths who claim to treat AIDS.[4]
For those who are unaware, homeopathy was invented in 1796 by Samuel Hahnemann and is based on his idea that ‘like cures like’. For example, if I have a problem getting to sleep I would take a dilute solution of something that keeps me awake or if I was ill I would take a dilute solution of a substance that causes the same symptoms. An important bit to the homeopath is the dilution which is carried out in successive steps with vigorous shaking, termed ‘succussion’. Homeopaths call this ‘potentization’. Hahnemann advocated the use of 30C dilutions, where C is his own centesimal scale, representing the number of times the solution has been diluted by one part in a hundred. I would hope at this point homeopathic remedies have lost all credibility with the reader, as a 30C dilution represents a dilution to 0.000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 1 % of the original concentration. This dilution is less concentrated than adding a single molecule of water to the entire mass of our sun! Or if you prefer probabilities, the chance of finding one molecule in the final dose is less likely than winning the national lottery jackpot five weeks in a row. The pseudo-scientific counter to this is that the water ‘remembers’ the material added to it, an idea first proposed in 1988 by Jacques Benveniste, nearly two hundred years after the method was originally put forward. In 2005 a Nature paper showed that all ‘memory’ of structure in water was lost in fifty millionths of a second.[5] From this we can say that unless the remedy is created by and administered to the comic book character ‘The Flash’ (and that his super-powers extend to his rate of metabolism) that any such memory will be lost before it passes the user’s lips. Even more importantly homeopathy has been tested in randomised controlled trials far beyond what is needed to conclusively show that it does not work beyond the placebo effect. This research is all to appease those who argue that science cannot explain everything (a totally null point I might add, as all researchers know science can’t currently explain everything, otherwise they would soon be unemployed). Often advocates will claim a few select examples of trials where it has appeared effective, but these are either not properly conducted or too small to be statistically significant. Depressingly, they cling to this evidence, displaying a perfect example of the aforementioned confirmation bias. Despite all this you can still get homeopathic treatment on the NHS, which spends around £4 million every year on it, and the government also supports four NHS Homeopathic Hospitals. It is even possible to walk into any Boots store and buy a 30C remedy, with no clear indication that the product you are buying is completely ineffective and only a placebo. Many homeopaths would argue this is about patient choice. I would argue that an uninformed choice is not choice at all.
The dilute nature of homeopathy makes it an easy target, sometimes to the detriment of the highlighting of dangers of other alternative medicines. For reasons that will become clear why I feel it should be highlighted, one example is chiropractic. You may think modern chiropractors no longer believe that they can treat anything by manipulating the flow of energy though the body as their founder did (chiropractic first being used to treat deafness), but rather, as I thought, that they concentrated on back pain. In reality, many offer a wide range of treatments. In an article in the Guardian, science author Simon Singh commented that the British Chiropractic Association (BCA) promotes ‘bogus’ treatment to help with childhood issues such as asthma and colic, despite no evidence that they are effective.[6] The result was that, instead of being engaged in a scientific discourse, he was sued for libel by the BCA. You may hope that this kind of use of the libel law in the UK is limited to just alternative medicine but two years ago Henrik Thomsen, one of Europe’s leading radiologists, presented his evidence relating to the possible dangers of the drug Omniscan, with the result that he is being sued by GE Healthcare for libel in the UK. It would seem that at the very same time that people are starting to finally give call for rational thought, the UK libel law is being used to squash scientific debate.
[5] Cowan ML, Bruner BD, Huse N, et al. (2005) “Ultrafast memory loss and energy redistribution in the hydrogen bond network of liquid H2O”. Nature.
[6] This article originally appeared in the Guardian on Saturday April 19 2008 on p26 of the Comment & debate section, it has now been removed due to legal action.