UK: Challenge to Prince Charles over Alternative Medicine Backfires

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Health

On Tuesday 23 May 2006, we were treated to news - here an article in The Times - of a letter from thirteen prominent but conservative doctors in the UK who challenge the wisdom of integrating alternative therapies in hospitals and doctors' practices. The slur was time coincident with a speech by Prince Charles to the World Health Assembly, urging that the alternatives be given more space.

But it seems the operation may be backfiring in unexpected ways. For one, Prince Charles insisted unperturbed that "orthodox medicine has much to learn" and he told the World Health Assembly: "The proper mix of proven complementary, traditional and modern remedies, which emphasises the active participation of the patient, can help to create a powerful healing force in the world."

Others are taking the UK doctors to task over their proposal to only allow "evidence based" therapies to be reimbursed by the health system's funds. Apparently they overlooked that most of today's medical practices are neither evidence based nor well researched, and that pharma-based "western" medicine is itself one of the leading causes of death in the western world.

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My feeling on this is that yes, we could make the evidence base a standard and perhaps we should really do so. But then let's have all the evidence at our fingertips. That would mean drug trials are not done only against placebo or against another, older drug, but also against an appropriate modality of nutritional, herbal or other alternative intervention. This way, evidence will clearly show what is better and perhaps medicine can gradually overcome the stigma of being the big killer of our times.

Public reaction seems to be with the Prince - a poll associated with the BBC's article shows a growing percentage of respondents are in favor of reimbursing complementary medicine.

The reactions to the "letter of thirteen" question the qualifications of our official western version of medicine to call itself evidence-based. Let's start with the reply by Neil Levin, a clinical nutritionist, to The Times, which gave ample space to the challenging letter:

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From: Neil Levin 
Sent: Tuesday, May 23, 2006 4:47 PM
Subject: My letter submitted to the Times of London today

Whose evidence?

Could someone please tell me which of the conventional medicine treatments meet the "evidence-based" standard that some prominent British physicians are demanding the National Health Service trusts apply to funding requests (NHS told to abandon alternative medicine, May 23)?

Certainly not even the concept of a 98.6 ° F healthy body temperature for everyone is strictly evidence-based, as it was first postulated many decades ago but accepted without independent verification through stringent collection of data from multiple centers. Nor is non-emergency bypass surgery, which was accepted as conventional reimbursable treatment for many years without a single trial to compare results with alternative methods, including diet and stress reduction. Modern science tells us that bypass surgery does not increase one-year survival rates without additional interventions.

Perhaps these physicians are referring to the safety evidence of the drug Vioxx, recently withdrawn from the market after previously undisclosed dangers? Or NSAIDs drugs (common painkillers, such as ibuprofen), which were recently associated with a 30% increased risk of first hospital admission for heart failure. Or acetaminophen, responsible for a majority of liver failures reported by hospitals.

Nor do cholesterol control measures meet their brave new evidence standard, especially the use of total cholesterol as a marker of cardiovascular risk. Science does not show a clear benefit in reducing total cholesterol, especially when half of all cardiovascular incidents affect people with total cholesterol levels below 200 showing no previous symptoms. Even the statin drug ads list a disclaimer in their fine print. However, oxidized cholesterol is a risk factor.

Perhaps cancer therapies come to mind as evidence-based. But 40% of all cancer patients die from malnutrition, while some oncologists reflexively warn against taking supplements that have been shown in published studies to prevent side effects and enhance their own conventional cancer therapies. And cancer rates have risen over the past few decades, while many billions of taxpayer and charity funding have been spent on devising new, patented, for-profit treatments.

Did they forget the 100,000 annual deaths from prescription drugs that were used as directed, under doctor’s supervision? Or did they simply forget to read their scientific journals that publish thousands of studies on vitamins, minerals, herbs and other alternative therapies?

I guess I am confused. These physicians seem to have one evidence standard for their own brand of medicine and another for everyone else’s. Have the followers of Hippocrates become hypocrites?

Neil E. Levin
Certified Clinical Nutritionist
Diplomat in Advanced Nutritional Laboratory Assessment
Bloomingdale, Illinois, USA

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Mike Abrahams, long time owner of a health store in Bristol and promoter of decent (organic) foods as well as natural therapies, echoes these sentiments with the following comment:

Date: Tue, 23 May 2006
From: Mike Abrahams
Subject: Complementary Medicine Unscientific - Copy of letter sent to the Times

Sir,

So our top brains pontificate that complementary medicine is unscientific, a waste of money and should be abandoned.

When less than 15% of orthodox medical intervention is supported by good science and less than 5% of all published research is "scientifically sound" (The BMJ's own findings - references follow), do I detect a case of pots, kettles and black here? These gentlemen are denigrating a set of tried and tested disciplines with that supreme confidence born only out of total ignorance (and possibly, fear) of the subject. (And I include the infamous Prof Ernst). How, when over 250,000 are known to die annually in the west as a direct result of properly applied medical treatment, can they pillory an approach that will have at least the same placebo performance as orthodox medicine without the inherent slaughter.

This is Prof Baum's second attempt to ridicule the Prince of Wales. His first attempt was shot down by the BMJ in Oct 2004, and he has done nothing to change his argument this time. Which raises the question - why has he (Baum) ignored the evidence and disinterred his discredited claims once more?

References supplied below.

regards
Mike Abrahams

1 http://bmj.bmjjournals.com/cgi/content/full/329/7470/858-b
2 Smith R. Where is the wisdom? BMJ.1991;303:798-799.
3 Journal American Medical Association 2000 Jul 26;284(4):483-5 
4 http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm

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Will The Times publish these comments? Perhaps not, but then - who cares. The press is steadily losing relevance, especially when it is seen to snuggle up to vested interests such as - in this case - big pharma, seen to be doing much damage to both our health and the environment.

The Alliance for Natural Health, a UK-based but pan-European campaign organisation working to protect and promote natural health care, weighed in on the issue as well. Dr Robert Verkerk, Executive and Scientific Director, said

"It is unfortunate that Professor Baum and colleagues fail to recognise the wide range of so-called complementary or alternative medicine - or CAM - practices which are clearly scientifically or clinically proven. Judicious adoption of particular therapies into mainstream medicine would help increase the efficiency and safety of medical practice, as well as reduce overall costs. These are inevitably important concerns for the NHS."

In a Times editorial titled Physician, heal thyself, Jerome Burne, author of a forthcoming book to be titled Food is Better Medicine than Drugs, chimes in to point out the wrongly targeted attack by Prof Michael Baum, promoter and principal signatory of the "letter of thirteen".

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Many thanks to Emma Holister, UK-born artist and health activist living in France, for sending along this follow-up comment in The Times and for contributing the cartoons.

Comment - The Times: Physician, heal thyself

by Jerome Burne

PROFESSOR Michael Baum, who laid into alternative medicine yesterday, is right to be concerned about wasting scarce NHS funds on “unproven or disproved” treatments. But he has the wrong target in his sights. If he wants to root out hype dressed up as science, he would do far better to focus on conventional drugs.

Far too many prescription drugs are marginally effective and carry risks out of proportion to the conditions they are designed to treat. Drug side- effects kill around 10,000 people a year in the UK — three times the number killed on the roads — and cost the NHS more than £4 billion. Patients are being perfectly rational in seeking alternatives and it is simply outdated medical arrogance to condemn them for it.

Only last week it emerged that one of the antidepressant SSRI drugs increased the risk of young adults committing suicide — a possibility that the companies had always strenuously denied even though in 2003 doctors had been advised not to give these drugs to anyone under 18 because of a suicide link. The evidence for that official ruling dated to 1996 but had never been published. During the intervening years British doctors were prescribing more SSRIs to children than any other country in Europe and yet there was no proper evidence base for this at all. Treating those children by changing their diet or with acupuncture seems sane by comparison.

The scandal surrounding the anti-inflammatory drug Vioxx — withdrawn from the market in 2004 because it doubled the risk of developing heart disease — is anot