COMMENT AND OPINION

patients feel ill-informed about this area (Joos et al. 2006, 6; Armitage et Unproven or al. 2007, 10). Reliable information is scarce, and the little that does exist is not easily accessible. Word of mouth Disproven is thus the most common source of information for people tempted to try “alternative” medicine (Robinson et al. Treatments—Why 2008, 14). Cur rently, about forty million Web sites exist on this subject. The vast majority provide information that is Would Anyone factually wrong or dangerously mis- leading. Print media play an important role in introducing “alternative” med- Want to Use Them? icine to consumers, and more often than not, they are equally misleading (Weeks, Verhoef, and Scott 2007, 14). EDZARD ERNST The House of Lords Select Committee al ready noted eight years ago that the media have “undue influence” in the realm of “alternative” medicine (Lords Report 2000). Providers of “alternative” medicine are likely to disagree and would point out that “people are not stupid.” True recent report (Channel 4 2008) unless, of course, he or she was unaware enough, consumers trying alternative suggests that the sales of that it does not work. Nobody buys a therapies tend to be well educated Ahomeopathic remedies in the car that is beyond repair, far less does (Stevinson and Ernst 2006) and often United Kingdom have increased by anyone knowingly employ bogus ther- perceive these treatments as effective 24 percent during the last five years. (Lords Report 2000). They certainly are Other unproven or disproven treat- not stupid. However, perception can dif- ments, such as Bach Flower Remedies, This is what makes fer from fact. The impression “it worked crystal therapy, and spiritual healing, for me” is often due to a wide range are equally popular. But why would misleading information of factors. For instance, symptoms may anyone want to use unproven or dis- have improved independent of any proven therapies? about alternative medicine intervention, or another treatment was According to numerous survey particularly pernicious. administered at the same time, or the data, people try “alternative” med- placebo effect could have done its share, icine be cause of a complex mix of Untruth can masquerade or the therapist was kind and caring. This factors, in cluding philosophical con- is what makes misleading information gruence, a de sire to take control over as truth with the apparent about alternative medicine particularly pernicious. Untruth can masquerade as one’s health, desperation, rejection of support of personal science, and dis appointment with con- truth with the apparent support of per- ventional health care (Stevinson and experience. sonal experience. Ernst 2006). This may well be the case, Many people are easily misled, but I fear the true reason is much more obvious than that. Table 1 Nobody, I would argue, would pay apies. This is only conceivable if one for an ineffective medical treatment— has been misled to believe that the Common themes of misinformation about “alternative” medicine Edzard Ernst, MD, PhD, is a professor treatments in question actually might in the Complementary Medicine unit, work. The vast majority of people using 1. It is natural and thus safe. Penin sula Medical School, Universities homeo pathy, for instance, believe it is 2. It has been used for hundreds of effective (MillwardBrown 2008). years. of Exeter and Plymouth. He is co-au - 3. It defies scientific scrutiny. th or, with Simon Singh, of Trick or Many experts have pointed out how 4. It is suppressed by the scientific Treat ment? Alternative Medicine on Trial much misleading information exists establishment. (Bren tam Press, UK, 2008). E-mail: Edzard. in the realm of “alternative medicine” 5. Anecdotal evidence is good [email protected]. (e.g., Schmidt and Ernst 2004, 15, Table enough. 1), and unsurprisingly, the majority of

SKEPTICAL INQUIRER November / December 2008 13 COMMENT AND OPINION

particularly if confused by clever mar- Armitage, G.D., E. Suter, M.J. Verhoef, and able online at www.millwardbrown.com/ keting techniques. B.J. Palmer, one M. Bockmuehl. 2007. Women’s needs (A(Zya2DQkT_BL2_kSe74B- of the founding fathers of the chiro- for CAM information to manage meno- z7vIhxcbqgs1tV41Iq9Q- practic movement, had a motto that pausal symptoms. Climacteric 10(3), zLqxIG8KeoEwwUH9rhl- Xe adorned his office: “The world is your 215–224. Channel 4. 2008. Alternative medicine now cow—but you must do the milking” mainstream. Available online at www. (Shapiro 2008). In his 1926 book Selling channel4.com/news/articles/society/health/ Yourself he suggested that “patients alternative+medicine+now+maistream/ should never be told that they are 630472 (last ac cessed June 3, 2008). well, only that they are getting better. Industry Canada. 2008. Project false hope If a patient asks if chiropractic treat- un veiled—competition bureau combats ments are to be continued for life, the cancer fraud through education and answer should be: No, only as long as enforcement. Available online at www. you want to stay healthy” (Shapiro ic.gc.ca (last accessed March 13, 2008). 2008). Joos, S., T. Rosemann, J. Szecsenyi, E.G. Hahn, S. N. Willich, and B. Brinkhaus. 2006. Misinformation is always regretta- Use of complementary and alternative ble—in the realm of health care it can medicine in Germany—a survey of patients cost lives. Action is therefore urgently with inflammatory bowel disease. BMC required. The UK Department of Complemen tary and Alternative Medi cine, Health (DoH) told the House of Lords 6, 1–7. inquiry: “We believe that it is very Lords Report. 2000. House of Lords, Science important that consumers have access and Technology Committee Sixth Report. to adequate and appropriate infor- Avail able online at www.publications. mation” (Lords Report 2000). Yet only parliament.uk/pa/ld199900/ldselect/ months later, the DoH sponsored a ldsctech/123/12301.htm. “patient guide” that is overtly promo- MillwardBrown. 2008. Homeopathy. Avail- tional, uninformative, and mislead- ing about many disproven alternative therapies (2005). Lip service is clearly not good enough. What we need are Is ‘Knol’ for actions like the recent initiative by the Canadian Competition Bureau. They launched a project that uncovered Knowledge or for dozens of Canadian Web sites offer- ing bogus “alternative cancer cures” (In dustry Canada 2008). Their deputy com missioner commented: “Swindling Pseudoknowledge? peo ple living with cancer is one of the most despicable forms of fraud” JAY M. PASACHOFF (Industry Canada 2008). The swindle, I hasten to add, is by no means confined to cancer. In the final analysis, it also damages the respectable aspects of alternative medicine, of which there are many (Singh and Ernst 2008). If dis- proven treatment options are allowed to masquerade as effective therapies, he runaway success of Wiki- and can be edited by anybody (with potentially valuable interventions will pedia, which comes up first the exception of a few controver- be tarnished by the brush of quackery. T in many Google searches for sial en tries, political and otherwise, in formation, has led to much criti- that are controlled by Wiki pedia cen- References cism. Wiki pedia entries are uncredited tral), so one never knows whether 2005. The Prince of Wales’s Foundation Jay Pasachoff, a new consulting editor the site’s information is accurate. Still, for In tegrated Health: Complementary of SKEPTICAL INQUIRER, is Field Memorial a comparison of accuracy between a health care: a guide for patients. Available Pro fessor of Astronomy at Williams selection of articles from Wikipedia on line at www.fih.org.uk/NR/rdonlyres/ College and, during 2008-2009, visiting and Encyclo paedia Britannica, widely 75C60D68-A115-42E5-A523C3DF7AC96D associate at the California Institute of reported in the popular press, shows 72/0/ComplementaryHealthcareaguide no major ad vantage to either. forpatients.pdf. Technology. E-mail: Jay.M.Pasachoff@ williams.edu. Google, a wildly successful commer-

14 Volume 32, Issue 6 SKEPTICAL INQUIRER