How do you regulate Wu?

February 20th, 2010 by Ben Goldacre in bad science, herbal remedies, regulating nonsense | 81 Comments »

Ben Goldacre, The Guardian, Saturday 20 February 2010

You might have read the case of Ying Wu this week: a fully qualified traditional chinese medicine doctor operating out of a shop in Chelmsford who for several years prescribed high doses of a dangerous banned substance to treat the acne of senior civil servant Patricia Booth, 58, reassuring her that the pills were as safe as Coca-Cola. Following this her patient has lost both kidneys, developed urinary tract cancer, had a heart attack, and is now on dialysis three times a week. Judge Jeremy Roberts gave Wu a two-year conditional discharge, saying she did not know the pills were dangerous and could not be blamed, because the practise of traditional Chinese medicine is totally unregulated in Britain, a situation which he suggests should be remedied.

This sounds attractive, and has been loudly welcomed by alternative therapists, who see regulation as the path to legitimacy. It’s worth noting, in passing, that we do already have systems in place for dealing with dangerous substances (these pills are banned), false claims on the high street (like the regional Offices of Fair Trading, who chose not to use their powers here), and people prescribing treatments which have both powerful effects and dangerous side effects (like doctors, who make bad calls with sufficient frequency already that it seems a bit wishful to want shortcuts around that training).

But special regulation for alternative therapists raises one very simple problem: it’s very hard to regulate practitioners who make claims based on faith more than evidence. In such a situation, what is your yardstick for whether a clinical decision was reasonable?

Current attempts at regulation have exposed these contradictions. The Complementary and Natural Healthcare Council (or OfQuack, as they are affectionately known) has a Code of Conduct which forbids alternative therapists making claims without evidence. Blogger Simon Perry complained about every single reflexologist on the register, on the day they joined, if they were claiming to treat things like arthritis, infertility, babies with colic, and so on. All were told off, but the CNHC decided that fitness to practice was not impaired, because their reflexology expert said that the practitioners would have honestly believed their claims to be reasonable, since they would have been trained to believe that they could treat these diseases.

So is the training the problem? The government’s review into regulation of alternative therapists has recommended that it should be compulsory to have a university degree in alternative therapies, and that universities should run such courses. And what is taught on these courses? You cannot know, because the universities have gone to shameful lengths over many years, to the point of multiple appeals at the highest level with the Information Commissioner, to keep the contents of these science degrees a closely guarded secret.

Myself and Professor David Colquhoun of UCL have obtained occasional course materials from students themselves, who thought they were going to be taught the scientific evidence base for alternative medicine, and have been dismayed by what they found. You can see why the universities wanted to hide them. Handouts from the Bachelor of Science degree in Chinese Medicine at Westminster University, for example, show students being taught – on a science degree – that the spleen is “the root of post-heaven essence”, “Houses Thought (and is affected by pensiveness/over thinking) ” and is responsible for the “transformation of qi energy”, “keeping the muscles warm and firm”.

“Marrow helps fill the brain”. “Sin Jiao assists the Lungs ‘dispersing function’, spreading fluids to skin in form of fine mist or vapour (so it helps regulate fluid production…)”. We also see the traditional anti-vaccine spiel, as students are taught that vaccination is a significant cause of cancer.

One lecture by Niki Lawrence on “Herbal approaches for patients with cancer”, meanwhile, discusses the difficulties of the Cancer Act, which was specifically designed to protect patients from the more dangerous extremes of alternative therapists’ self-belief. “Legally you cannot claim to cure cancer” it begins, on a slide headed “Cancer treatment and the law”. “This is not a problem because: ‘we treat patients not diseases’.” Niki then romps on to explain that Poke root is “especially valuable in the treatment of breast, throat and uterus cancer”, Thuja occidentalis is “indicated for cancers of possible viral origin, eg colon/rectal, uterine, breast, lung” and Centella asiatica “inhibits the recurrence of cancer”.

It is a tragedy that someone has contracted a fatal condition and is on dialysis. What worries me is that when you try to slot the square peg of fanciful over-claiming and faith-based medicine into the round hole of serious regulation and university teaching, you create more problems and confusion than you started with.


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81 Responses



  1. Groinhammer said,

    February 22, 2010 at 11:09 am

    @biscuit
    Are you also taught all of the ‘mumbo jumbo’ of Acupuncture as well?

  2. B.Serious said,

    February 22, 2010 at 11:34 am

    The main point to understand in this case is that it would not have happened had Statutory Regulation been in place for herbalists, as the herbal profession has been calling for for 15 years and which the govt promised way back in 2001 and reiterated only recently:

    “Herbalists to face strict regulations
    a government report says there is an urgent need to protect the public. It recommends that anyone offering the treatments should be required to register with a regulator, who will require new practitioners to take a degree in their subject. Those who fail to keep the regulator’s code could be struck off, while those operating without a licence would be prosecuted.”
    Daily Telegraph 14 Jun 2008

    The DoH has just conducted the THIRD public consultation regarding this, with all three having been massively in favour (circa 98%) of regulation, and with the most recent receiving 6000 responses, the most ever received for a public consultation.

    It is highly doubtful that Ms Ying Wu is a doctor or a herbalist, but it is impossible to say with accuracy as she was not a member of the professional association which provide voluntary regulation for herbalists in the UK (the best thing we have in place until Statutory Regulation comes about).

    If she had been a member of a professional association, or if Statutory Regulation had been in place:
    Her medical qualifications would have been checked
    She would have had professional medical insurance
    There would have been an appropriate complaints procedure
    She would have know that the herb in question was banned over 10 years ago
    She would have been obtaining herbs from an authenticated supplier with appropriate Quality Assurance in place

    It is the governments failure to follow through with its promise of regulation that is at fault and to blame in this case. The judge is absolutely correct to highlight the need for regulation to protect public safety.

    Regulation has nothing to do with efficacy or status (there are other measures for that which form no part of this argument), it is purely a means of protection for the public by creating teeth for legal process.

  3. AC said,

    February 22, 2010 at 11:51 am

    This person was charged under the Offences Against the Person Act, which is a Victorian law – the same one that gives us “grievous bodily harm with intent to wound” aka GBH and other snappy offences.

    On that basis the judge appears to think that this law, which was designed for people poisoning their husbands, mainly could be stretched to cover this offence. It’s not really about the judge, but about the choice of the CPS to choose this offence. If you kill someone by doing something stupid or reckless, that’s gross negligence manslaughter. Since this victim didn’t die, presumably that wasn’t open to the CPS and they couldn’t find a criminal offence that dealt with reckless poisoning.

    As others have said, civil law remedies in contract and tort might well be available.

  4. AC said,

    February 22, 2010 at 11:53 am

    > On that basis the judge appears to think that this law,
    > which was designed for people poisoning their husbands,
    > mainly could be stretched to cover this offence

    EDIT: Ont that basis the judge appears to think that this law, which was mainly designed for people poisoning their husbands, couldn’t be stretched to cover this offence

    sorry…

  5. Ben Goldacre said,

    February 22, 2010 at 12:14 pm

    the herbal medicine fans who say that i have misrepresented or cherry picked the contents of BSc courses in alternative medicine should take their arguments to the obsessively secretive UCLan, Westminster and the rest. they refuse to be open about the contents of their courses. what i have seen in leaks has been damning. if they wish to be taken seriously they must stop acting like MI5 over an undergraduate course.

  6. biscuit said,

    February 22, 2010 at 1:19 pm

    Ben, How about finding out the bases of TCM from another source; I recommend ‘The Web that has no Weaver’ as a good readable introduction into the basic concepts. As well as a chapter on the difficulties between the integration of bio-med and TCM.

    I fully admit taken out of context it sounds absurd, I am anatural sceptic, and struggled not to dismiss it all off hand but as I learnt more I understood that the as a whole paradgim it makes sense. We are they clearly taught that these ideas are not accurate as fact but serve a purpose to explain the empirical responses to treatment.

    Out of interest have you contact Salford and Leeds?

    The institutes shouldnt be so closed as it only adds to suspicion but perhaps, theya re worried that you will take snippets of the course totally out of context as you did in the above article. Hence my request that you endeavour to gain a better understanding. And try and read the book fully rather than ‘cherry picking’ before ripping it to shreds in your affable manner!

  7. Happy Camper said,

    February 22, 2010 at 1:43 pm

    “DevonDozer said,
    I have no sympathy for her.”
    That’s outrageously harsh. She lost her kidneys because someone who she thought was a medical professional gave her pills and said they would make her better. My cousin lost both his kidneys and died at the age of 23. She’s on dialysis 3 times a week. Have a heart. It’s not like she was train dodging for fun.

    “Here we have a ’senior civil servant’ – presumably a person paid a lot of money by tax payers to shuffle bits of paper around”

    You don’t know that. She could have been a hard-working and industrious credit to the public sector. Supposing for a moment that she was the very worst and most lazy employee of all time, she still surely wouldn’t deserve to suffer a heart attack and develop cancer. The punishment wouldn’t fit the crime.

    It would be nice if people knew better than to take quack medicine, but they don’t – look at how popular horoscopes are. Most people have neither the time nor inclination to research every little thing. I propose that anyone selling anythig that makes definite claims, like ‘cures colic’, must submit it to a randomised controlled trial, double blind, etc etc, and if it passes they can claim it, if it fails they can’t.

  8. Actuary said,

    February 22, 2010 at 2:50 pm

    biscuit –

    I’m an Asian and have read some of the Chinese philosophy behind the traditional medicine. All very interesting stuff but Chinese philosophy is just that, philosophy. It’s not empirical science and if the “qualified” Chinese medicine practitioner had no idea how toxic the pills she was giving to the patient, that surely means that she was not qualified to prescribe any medicine.

    To those people who would say “Western medicine does harm too”, the problem is that it was KNOWN to be HARMFUL. While ignorance may be a legal defence, it’s not a defence for the so called medicine she practised.

    The problem with the Eastern traditional medicine is that it has not advanced since the middle ages, because it does not open itself to the empirical science. Same with all the alternative medicine. On one hand you have continuously developing Western medicine, and the other hand dead tradition which has not done any research other than 2000 years ago when someone ate some berries (which is not true, but I’m being flippant).

    My grandmother goes to her relative who is a traditional medicine practitioner for a spot of acupuncture for her chronic condition, frankly for a spot of TLC. When she gets cold she goes to a proper doctor. My grandfather was an acupuncturist but again, he goes to Western medicine doctor. Asians I find do not sprout the nonsense about “toxic western medicine” – traditional medicine is taken when there is no hope or for general well being like vitamin tablets.

    Spare me the wisdom of the East rubbish. The answer does not lie in history. We wouldn’t have improving longevity if that’s the case.

  9. the rim groper said,

    February 22, 2010 at 4:46 pm

    per lowercase:

    “your point seems to be that real medicine is flawed, yes it is, that’s why we have scientific method to improve it.”

    Cholesterol apparently causes heart disease and dietary cholesterol raises your ‘bad’ cholesterol fraction according to conventional scientific method – 50 years worth of utter nonsense… feel free to explain this to me, while my fingers tap out a mindless rhythm, waiting for your enthusiastic explanation as how your much vaunted scientific method has improved upon this catastrophic failure to admit the wrong-headedness inherent in isolating a molecule that is vital to life and trying to expunge it while caring not at all for the consequence of other substances within the mevalonate metabolic pathway…

    per skyesteve: The inception of NICE was supposed to provide a national repository of the best evidence-based medical knowledge and clinical practice that was available to clinicians and I supported that move back then. TA094 was the technical appraisal that arose out of consultation and became the background to the guidelines for prescribing statins to the nation. The pharmaceutical companies that produce statins were also invited to make their comments in the discussions (presumably because some idiot thought they should be included as stakeholders!) concerning statin prescriptions.

    I think it is clear to all that this should never have been permitted. Drug companies having an input into national prescribing policies for the products they want to be prescribed? Corruption at the highest level, would be the polite way to express such avaricious drug peddling.

    Bolam is a convoluted and complex piece of tort law which is unlikely to provide a defence to the clinician who does not follow the crowd or the dicta that is handed down by NICE.

    per jweirmccall:

    glad you like the name. ^_^

    “Experimentation on live patients is what should outlawed.”
    I feel you need to clarify this slightly. Do you mean anything which does not have incontrovertible evidence should not be carried out on anyone? If so how do you propose gaining that knowledge in the first place?”

    I am sorry for not being clear. What is wrong with the science is that much of it is worthless. Junior clinicians finding meaningless research projects to complete so that their CV looks better. The pharmaceutical company sponsored advertorials which pass for peer-reviewed clinical research and are little more than exercise in data manipulation to secure a marketing advantage of competing products.

    My disdain for NICE derives form them taking the advice from drug companies as to what the national prescribing policies for the said drug ought to be. If the drug was any good and if it had been independently assessed in RCTs which had not been tainted by drug company sponsorship, then I might adopt a different viewpoint. The medical profession are currently in thrall to big pharma and it is detrimental. Drug company provided date does not go any distance along the pathway to counting as evidenced-based medicine, in my book.

  10. biscuit said,

    February 22, 2010 at 8:25 pm

    Actuary

    A few points on your response:
    1. I wholeheartedly agree with you that to handout any form of medicine a practitioner should be fully qualified and legislated against. I think the ruling made by the Judge was wrong because in my opinion a person that hands out medicine be it herbal or other should be pharmacetagoly and medically trained. For her to fail to recognise that they may have been a link between her patients failing health and her pills is abhorent.

    2. TCM has been formed almost purely on empirical evidence, and is still evolving on empirical evidence.
    It is rooted in Daoism and to some point confucionist idealolgy, but so too has biomedicine been rooted in Positivist theory (and further back Christianity and paganism) which has held it back with it’s ridgidity. This is lessening with a wider understanding of the use of Qualitive research but still can result in some of the poor treatment received by patients especially in the field of mental health.

    3.I think your sweeping generalisation about ‘Asians’ is surely based on terrible research…to make such statments on the back of knowing some Asian people is hardly going to pass muster on this site!

  11. jwm said,

    February 22, 2010 at 8:30 pm

    Rim groper:

    Thanks for the info about NICE. Im dissappointed, although not surprised that pharma have infiltrated every aspect of medical existence. However your puritanical approach to evidence based medicine, while providing for a level to which to aspire, is impractical, and discounting all evidence will cause more harm than good.

    “Cholesterol apparently causes heart disease and dietary cholesterol raises your ‘bad’ cholesterol fraction according to conventional scientific method”

    Since this statement is based on evidence, what really happened was that a hypothesis was created that fitted the results of an original study, whih was then further analysed with larger studies with more statistical power and disproved – Surely the very process of scientific method, no? As stated earlier, you’ll stuggle to find modern medical textbooks advising low fat diets. A quick look in Kumar and Clark (the medical bible for medical students everywhere) reveals the only dietry advice to be to avoid excessive salt intake.

    “feel free to explain this to me, while my fingers tap out a mindless rhythm, waiting for your enthusiastic explanation as how your much vaunted scientific method has improved upon this catastrophic failure to admit the wrong-headedness inherent in isolating a molecule that is vital to life and trying to expunge it while caring not at all for the consequence of other substances within the mevalonate metabolic pathway…”

    Ah, I’d best let the diabetics know that their being misled in the advice they’ve been given regarding lowering their levels of a crucial component in the kreb cycle.

  12. ICanDoScienceMe said,

    February 23, 2010 at 1:03 am

    @biscuit

    I find it hard to believe that you are a “natural skeptic” when you clearly believe in the “paradigm of TCM”. It is quite simply total rubbish. Any passing success is due to an accidental stumbling upon a potent natural active ingredient NOT a validation of the “paradigm”. To assert anything else is to make a mockery of modern medicine.

    When TCM has a huge literature of “Daoist” – drug halflife, metabolic pathway interaction, gene expression effects, quantitative genomics, etc to prop up the mysticism then perhaps serious scientists will sit up and take real notice. Until then the people who can’t do real science will divert attention from the real work by playing “doctor” and sticking needles in energy flow lines… /sigh

  13. Martin said,

    February 23, 2010 at 3:32 am

    “…reassuring her that the pills were as safe as Coca-Cola. Following this her patient has lost both kidneys, developed urinary tract cancer, had a heart attack, and is now on dialysis three times a week.”

    So is Coca-Cola going to sue? :)

    I’m very open to the idea that anyone who wants to provide any form of ‘medicine’ has to have a medical degree from a certified body (and not one bought off the internet like Ben’s dead cat). Once they have this they can go off and learn their speciality. Don’t medical specialists (eg, dentists, surgeons, etc) have to do this? Why should homeopaths, nutritionists, etc get special treatment?

    Conventional medicine doctors also have insurance, so Symball’s idea of requiring alternative therapists to hold liability insurance is reasonable. If they want to be judged by conventional medical standards (which they do, despite what they say, why else are they pointing to the ‘trials’ they perform) then they have to meet conventional medical standards.

    And to those above who dislike extra regulation, I quite agree. I’d prefer that we didn’t have to introduce regulation to prevent venal, greedy parasites from preying on the weak and vunerable, but if you took that to it’s logical conclusion then we wouldn’t have to outlaw burglary because no-one would do it.

  14. B.Serious said,

    February 23, 2010 at 9:54 am

    Ben Goldacre said:
    the herbal medicine fans who say that i have misrepresented or cherry picked the contents of BSc courses in alternative medicine should take their arguments to the obsessively secretive UCLan, Westminster and the rest. they refuse to be open about the contents of their courses. what i have seen in leaks has been damning. if they wish to be taken seriously they must stop acting like MI5 over an undergraduate course.

    Thats just not true though is it Ben?

    Please show a modicum of journalistic integrity. As you know full well, the Westminster documents that have been much cited were obtained under the Freedom of Information act and despite that fact that they were taken out of context and ridiculed, Westminster have made available the rest of their curriculum. The UClan course is no longer running.

  15. elvisionary said,

    February 23, 2010 at 12:39 pm

    @BGray

    I’m not a lawyer, but I believe under English criminal law the mens rea test for most forms of GBH, ABH or assault is “intentionally or recklessly”. So you don’t need to prove intent if you can show recklessness.

    If someone is prescribing a substance without bothering to find out that it’s banned and highly dangerous, that sounds pretty reckless to me.

  16. Ennui said,

    February 23, 2010 at 1:20 pm

    I remember taking chinese medicine for acne when I was 15. It didn’t do anything. I only took one bottle, but now I’m worried about my health :-(

  17. AC said,

    February 23, 2010 at 1:38 pm

    @elvisionary

    You’re right that “reckless” is relevant to ABH, GBH and the like, but that wasn’t (I understand) the offence charged. In any event, even if it had been and the ‘reckless’ point was made for those offences, they would also have to have shown assault and/or battery (i.e. physical violence or the threat of it). In this case there was no such threat – indeed there was an assurance of no harm.

    The offence charged was, I believe, one of the admistering offences. The Offences Against the Person Act 1861 contains two “administration” offences.
    Section 23: “Whosoever shall unlawfully and maliciously administer to or cause to be administered to be taken by any person any poison or other destructive or noxious thing, so as thereby to endanger the life of such person, or as thereby to inflict upon such person any grievous bodily harm, shall be guilty of an offence.”

    And Section 24: “Whosoever shall unlawfully and maliciously administer or cause to be administered to or be taken by any other person any poison or other destructive or noxious thing, with intent to injure, aggrieve, or annoy any such person, shall be guilty of [an offence].”

    But here the test isn’t recklessness, its whether it was “unlawful” and “malicious”. In this case it appears that it wasn’t malicious as there appears to have been no deliberate evil intent. Recklessness can come into “malicious” but the caselaw generally relates to cases where something untoward was planned but a different and more serious effect occurred. Here nothing untoward was intented, apparently.

    An improvement to the law in this respect was suggested in the late 1990’s – presumably it came to nothing or we wouldn’t be having this discussion.

  18. MedsVsTherapy said,

    February 23, 2010 at 2:17 pm

    “I urge you to read The Web that has no Weaver as an accessible starting point. At the moment you sound very ignorant.”

    Yes, Ben quite ignorant. You must read these amazing works. Also recommended: “The symptom that has no pathophysiology.” “The cure to which no patient is seeking.” “The healer who receives psychosurgery from the patient’s brain waves.” “The vital sign that does not indicate some parameter of vitality.” “The influence of the remote stars upon your personality.” “How I received the donated liver of a chocolate lover, and darned if I don’t like chocolate now.” “Lower-class people have skulls with more pronounced areas of Acquisitiveness, and that is why they steal.” “All is actually nothing, and nothing is actually all, so why is the government trying to redistribute nothingness?.” “We are all one, so give me our money right now.” “What is the sound of one girl shopping?” “Don’t but this book.” And, “How the Elephant Man’s Mother Was Scared By an Elephant When She was Pregnant With Him, Causing His Elephantitis.”

    All classics, Dr. Ben. You must read. You sound quite ignorant unless you have read my favorites, and also believe them.

  19. elvisionary said,

    February 23, 2010 at 4:06 pm

    @AC – thanks for that. Sounds like the law needs updating…

  20. Gunga said,

    February 23, 2010 at 9:35 pm

    Educate a Canadian….
    Do you not have legislation that prevents prescribing?
    The Regulated Health Professionals Act (RHPA) in Ontario lists the medical professionals who can prescribe ANYTHING…..I, for example, as a registered reflexologist, am legally prevented from prescribing something as simple as increasing water intake to “flush the system after a treatment”. Even prescribing further treatment or a particular frequency of treatment is forbidden by the RHPA. I will admit, there are a number of my colleagues who don’t even know of the existence of the RHPA and they often (whether in ignorance or in blatant defiance of the Act) prescribe, treat specific conditions, and diagnose. All are forbidden by the RHPA unless you are one of the specific health professionals listed in the RHPA.
    I agree that there is a great deal of charlatanism out there but please, keep in mind that not all of us are crackpots. I, and other practitioners like me, see our services as an adjunct to mainstream medicine not as a replacement. There are some of us who even dedicate our own time and funds to develop and participate in evidence based research in the true spirit of the scientific method and will denounce elements of our practice even in the face of being rejected by our colleagues. We don’t claim to cure cancer. We do, however, see the benefit of any treatment that limits the devastating effects of chemo so the patient can complete a pharmacological treatment that has been proven to cure that cancer. We recognize the dangers of treating patients with thromboses….and we don’t treat them. We wont claim and have yet to prove we cure chronic pain, but we can help some patients deal with the constipation caused by pain meds without the need for pharmaceuticals.
    In short, laws need changing and practitioners of every description and discipline should be accountable. Patients should be encouraged to contact legislating bodies to make complaint and should be encouraged to use the colleges to search for practitioners with good credentials and no limitations on their licenses. When non-regulated practitioners, like myself, are educating their patients, I see it as part of my best and ethical practice to encourage the patient to contact my professional association for any information about the profession and background on me.

    An excellent discussion. One in which I am sure many holistic practitioners would not engage. Too bad.

  21. heavens said,

    February 24, 2010 at 12:48 am

    Do I have this straight in my mind?

    The British taxpayer forks over an enormous sum of money to these universities to run ‘alternative medicine’ programs.

    The British taxpayer then says, “By the way, what is it that you’re actually teaching in these classes?” and the university says, “It’s a secret,” or maybe “We just pay the instructors; we never bothered to figure out what they’re teaching.”

    To which the British taxpayer replies, “Oh, well, that’s fine, then” instead of the more rational response, which I suggest would sound a lot more like:

    “So — for all I know — you could be telling them to sacrifice chickens during a full moon, and you expect ME to keep PAYING for that? Fat chance, guys. I’m canceling those checks.”

  22. Colonel_Mad said,

    February 24, 2010 at 11:30 am

    Hey traditional Chinese medicine can cure AIDS didn’t you know….
    www.i-sis.org.uk/unravelingAIDS.php

    I love this site. Its full of loony’s coming up with all sorts of pseudoscience with an intensity only seen emenating from those with psychological disorders. Treat yourself to a peruse!

    I don’t know if its funny or worrying that the founder is apparently an Open University lecturer.

    Jonathan

  23. Colonel_Mad said,

    February 24, 2010 at 11:36 am

    PS apologies for my grocers’ apostrophe in that last post. Must be the ground up tiger claw I had for breakfast.

  24. Dr Spouse said,

    February 24, 2010 at 2:58 pm

    heavens: “The British taxpayer forks over an enormous sum of money to these universities to run ‘alternative medicine’ programs.

    The British taxpayer then says, “By the way, what is it that you’re actually teaching in these classes?” and the university says, “It’s a secret,” or maybe “We just pay the instructors; we never bothered to figure out what they’re teaching.””

    There is a slight problem with this tack: if alternative medicine teaching materials are going to be subject to FoI then so are all teaching materials at university level.

    These teaching materials are produced by academics – while universities would love to make academics produce easy-to-deliver teaching materials as part of their contract of employment, and then hand over those materials to contracted non-academic teaching staff, to save academic salaries, teaching materials are the IP of the academic staff that produce them. In general it’s not standard practice in academia to make teaching materials freely available.

    Academic staff are the teachers of the students on their courses who have themselves, or their sponsors, paid their course fees – they are not teachers of students at other institutions nor of the general public. If all academics are required to give their teaching materials to anyone who asks, they won’t be able to work those materials up into a book or prevent the university from making them redundant once they’ve created a course.

    Rather, since all degree level courses are accredited by a university and (should be) subject to external review and external examination, it’s the degree awarding bodies that should be scrutinised – degrees that are not rigorously taught and examined should be removed from the books of the university – where it’s not possible to teach something at degree level (or not possible yet, or the material should properly be part of another degree – so the herbs in Chinese medicine do have active ingredients, clearly, and when more is understood they’ll be part of a pharmacology or toxicology course) then that degree should be removed from the books.

  25. pv said,

    February 25, 2010 at 11:04 am

    biscuit, firstly your assertion that “TCM has been formed almost purely on empirical evidence, and is still evolving on empirical evidence”, is unsupportable tosh.
    www.quackometer.net/blog/labels/Traditional%20Chinese%20Medicine.html

    You also wrote:
    “I think your sweeping generalisation about ‘Asians’ is surely based on terrible research…to make such statments on the back of knowing some Asian people is hardly going to pass muster on this site!”

    You are addressing you comment to someone who has stated that they are Asian (not someone who might have met someone who knows someone’s mother’s father-in-law!) and that their grandfather was an acupuncturist who used “toxic” western medicine. There seems to be so much of Actuary’s excellent post that you haven’t bothered to read, or simply don’t understand.

    If I may say so it’s your own ramblings that don’t pass muster…

  26. outeast said,

    February 26, 2010 at 12:09 pm

    @ WestEast, Biscuit

    Claims such as ‘you can’t literally interpret the teaching of Chinese Medical Tradition’ and ‘the two traditions stem from a fundamentally different logic base’ are all well and good; hell, they may even be true. It may well be that [the translation of] ‘spleen’, say, does not in fact mean ‘the spleen’. Many disciplines have their own language, their own terminology and so on.

    But… at heart, and setting aside the psychosomatic aspects to illness (which any established and trusted medical tradition can alleviate through a meaning effect)alternative medical practices still deal with the corporeal body. When you treat an injury, or a viral disease, or a bacterial infection you are dealing with a physical problem. When you prescribe a medicine, you are providing the patient with chemical compounds they might not otherwise be exposed to. And so on. I see no reason that these physical interventions cannot be described in terms comprehensible to someone utterly ignorant of the ‘alternative’ tradition involved.

    You can say that an apparent claim such as “Sin Jiao assists the Lungs ‘dispersing function’, spreading fluids to skin in form of fine mist or vapour (so it helps regulate fluid production…)” is not as silly as it sounds because ”you can’t literally interpret the teaching of Chinese Medical Tradition’. Fair enough. But what does such a claim actually mean then – in terms a Western-educated person can understand? How can this be rephrased as a testable claim about the body? We’re may be dealing with a different ‘logic base’, but it’s the same human body with the same organs!

  27. Michael Grayer said,

    March 8, 2010 at 3:59 pm

    Having read “Foundations of Chinese Medicine” by Maciocia (well, part of it anyway, it’s a giant 1236-page tome), I’m unimpressed. My description of it is based on recall. It’s not available in many university libraries (in the Inform25.ac.uk consortium anyway), though curiously it is available at UCL and the Wellcome library, as well as a few ex-polys.

    It begins by introducing Western medicine as though it has remained completely unchanged since Aristotle, and continues by assigning a whole host of unmerited “philosophical” meanings to various permutations of Yin and Yang – essentially telling us nothing more than 2^3=8 and (2^3)^2 = 64. It has several references for its philosophical underpinnings, though alarmingly little in the way of evidential citations.

    Overall, it is what Douglas Adams might call “mostly harmless”, with no references to life-threatening diseases such as malaria, HIV or cancer (though that also means no explicit instruction to refer the patient immediately to a GP either). A couple of features did stand out as alarming though. Firstly, the only part of the text referring to vaccines suggests (with no evidence) a whole load of spurious links of vaccination with diseases such as autism (and the other usual candidates). Secondly, the section on diagnosis advises the reader to actively disregard the process of “cause and effect” and instead look for “patterns” – in other words, to rely on correlation rather than causation and to completely disregard confounding factors. This is where the book ceases to be a harmless, if boring, work of fiction and the implications of its advice begin to get more serious, especially given its de facto place as a standard “Chinese Medicine 101 and handy reference” book.

  28. Delster said,

    March 8, 2010 at 9:51 pm

    @Ian

    Re Homeopatist being safe
    “As long a they don’t prescribe too many sugar pills to a diabetic patient they should be pretty safe!”

    They can never give too many as the sugar contained is not diluted, ie 100% pure, and therefore would have no effect on a diabetic unless they actually failed to take one that was proscribed….

  29. Veronica said,

    March 14, 2010 at 5:31 pm

    Some of you commenting here have mixed up the function of NICE with the fnction of the MHRA.

    MHRA pronounces on the safety and efficacy of medicines, i.e. the risk:benefit ratio of taking them. NICE decides whether they represent value for money and therefore whether, however good they are, you and I should be allowed to have them on the NHS.

    I think this case stinks. Imagine the makers of thalidomide or Vioxx being able to get a conditional discharge on the basis that they have poisoned somebody but didn’t know what they were doing.

    It’s one rule for scientifically researched medical treatment, and another rule for woo.

  30. Ben Vail said,

    August 6, 2010 at 1:31 am

    @Veronica

    Intent is very important to our justice system, as it should be… It’s right that judges take this into account in deciding what’s the best outcome for those involved and society; Locking people up for honest mistakes is rarely going to help anyone, as those mistakes are not going to be made again. Ignorance of the law is not the same as strongly believing the consequences of your actions would be beneficial and not detrimental, :)

    A tragedy certainly, and regulation is needed, even if it’s just the improved application of regulation that already exists in regards to health claims and dangerous substances, but in my opinion, revenge is not the answer…

  31. john smiley said,

    January 3, 2016 at 5:54 pm

    ’tis a puzzlement.

    I am a cancer sufferer, I’ll likely be dead in a few years, say 5, but at present I’m asymptomatic, and hence refusing to have my life made unliveable with the recommended drugs. Am I to be denied access to people like this who offer in most cases nothing worse than a placebo? Ok, we have one case of someone being hurt. Out of how many?
    To put this in perspective, BOTH of my parents ( and many of my acquaintances) died as or when they did because of the acts of incompetent idiots with MD’s. regulation didn’t make them any less incompetent, arrogant know-alls. I remain unconvinced by most of the arguments. Leave the quacks alone and stick to truth in advertising laws: ie. they can’t claim to cure, only that there is some evidence that in some cases this might help.