Key Source (Politely) Trashes loM's 'Medical Errors' Report! - P.3

David Zimmerman's newsletter on science, media, policy and health Vol. VIII, No. 5 (April) May 1, 2000, New York, NY $5 Bush Coddles Creationists Republican Presidential candidate George W. Bush an intelligent designer, i.e., God. But this fom1ulation has not supports Creationism, the fundamen talist Christian theory of been disallowed by the courts. how the earth, life, and hum ankind were forme d and deve loped. The Southern Bap tist Con vention (SBC) , a creat ionist fount , He does no t direct ly denigrate science, which is a major recently acknowledged that intelligent design theory is a enterprise in Texas, where Bush is governor. But the candidate "wedge" to get religion back into science and the schoo ls (SBC supports a two-theory , loca l-choic e educat ional policy that is Life, Feb./M arch, ' 98). prese ntly the spearh ead in religionists ' dr ive to replace This effort is gussied up with app eals to let the children make Darw inian science with bibl ical teachings on life 's origins. up their ow n minds, First Amendm ent Rights, free exp ressio n. Bush's views were reported in a Nov. 8, Re11ters dispatch and other pleas for tolera nce, di versity, and indi vidual choice. from Wilmington, Del. It says he thinks schoo ls should teac h The National Academ y of Sc iences has count ered this ros i­ "different forms of how the wo rld was forme d," with evolution tion, stating that "to rein troduce [Creationism] into the public taught alongs ide Creati onism. schoo ls . . . would be aki n to requ iring the teaching of Bush went on to say, according to Reuters, that he favored Ptolemaic astronomy." "morality-base d" educati on in public schools. The seco nd prong of the Creationists' approac h, favored by candidat e Bush, is loca l co ntrol: working from the bo110111up. Local Choice Lauded Says Mary Douglass Brown, a member of the Kansas Board of "I have absolutely no pro blem with children learning differ­ Education, which last yea r voted to delete evo lution from the ent forms of how the eai1h was formed," Bush declared. state's teachin g standard s: He added, significantly, that it was up to local schoo l board s cont inued on page 3 Lo decide on curricula. What Reuters did not report is that Bush's formul ation is identical to Crea tionists' strateg ic plan to beat back the scientific worldview, particularly on biology, but also on astrophysics and other disc iplines whose evide nce co ntradicts Creationis ts' belief that the world was created, recen tly, in six 24-hour days.

IQ Seen Up There The creat ionists' stra tegy has two prongs, acco rding to a newly released report - "Sa botaging Science: Creationist Strategy in the '9 0s" - by Peop le for the Amer ican Way (PFAW), in Washington, D.C.: Since the U.S. Supreme Court (in 1968) struck dow n state laws to prevent evo lution from being taught in public schoo ls, Creationists have regro uped to insist that "Cr eation sc ience" be taught side-by-side with ordinary science - a poss ibility sanctioned by the Court. To circumvent the sec ular objection that Creationism is a religious belief, the Creat ionists have now substituted an "intelligent design" for God in their Creationist myth. Obv iously, as PFAW po ints out, "intelligent design" implies

© 2000 The Probe News lette,; Inc. Follow-up the incidence of preventable patient harm which the IoM cites .... In fact, there is general agreement that these findings are, Our 'Errors' Critique if anything, likely to be an underestimate. Despite your florid suggestions to the contrary, there is Knocked by Panelist simply no empirical evidence that would support your claims that the IoM has misrepresented or misreported or misinter­ Editor's note: We sent copies of the March PROBE, con­ preted the evidence in support of the claim that there are taining our critique of the Institute of Medicine (loM) report 44,000-98,000 deaths due to preventable errors each year in the on medical e"ors, to loM officials. U.S. We also sent copies to the authors of the two studies whose As to the argument you raise about the appropriateness of findings are reflected in the loM's dire warning that up to using "medical errors" or "medical mistakes" interchangeable 100,000 Americans die each year as the result of medical with "adverse events" or "negligent adverse events," I respect­ e"ors. We invited their comment. None replied. fully suggest you re-read the IoM's definition of error and But one of them, internist Troyen A. Brennan, M.D., has adverse event which appears on page 23 of the soft-cover edi­ now written his own critique of the loM document, which was tion of the report. The report's use of "error" does not require published by the New England Journal of Medicine on April an adverse outcome. But the assumption is made that all 13. He covers many of the same problems that we reported in "errors" are potentially "preventable." Thus an error that causes PROBE (see story,facing page). harm is a "preventable adverse event" - the two terms are We also sent the issue to our friend Arthur Levin, MPH, the interchangeable. consumer health acnvist,who is Director of the Centerfor Medical Consumers, in Manhattan. He was a member of the loM Health Care Lags on Safety committee that wrote the report. uvin has replied as follows: Many of us working around issues of quality have long been aware of the amount of harm caused by medical mistakes - I frankly was surprised by the tone and content of but unlike other industries, health care has seen fit, and has your coverage of the IoM report "To Err Is Human." In your been allowed to bury its mistakes rather than work to solve the front page story, you charge that the IoM's estimate of deaths problem. There are exceptions of course, for example anesthe­ from medical error is based on "stale, veiled and skewed" data. siologists got serious about reducing human error over a decade ago, and the results have been impressive, saving many from Evidence Is Strong death and permanent disability. While it is true that the two studies you cite, the 1991 Harvard With regard to John Bailar's comments [that the problem's Medical Practice study and the more recently published dimensions are unclear] the loM report clearly states (also on Colorado and Utah study ( 1999), are based on observations that page 23) that "we do not yet have a complete picture of the epi­ took place some time ago, they are the most comprehensive demiology of errors." But, we do have the experience gained studies available today. But it is important for your readers to in other industries and sectors to help us understand both the know that the IoM report is based on an exhaustive review of all cause and cure for problems in safety. Do we allow preventable the available studies of medical errors, which are cataloged in deaths and injuries to continue while we wait for a more Appendix C-1 of the report. complete picture of the epidemiology of error? I hope not. These other studies strengthen, not weaken, the evidence of -Arthur A. Levin MPH Director, Center for Medical Consumers

A Note To Readers This issue closed on April 24, 2000 The editorial assistants who gather 'round - and some­ times climb atop - our desk have paws and claws, not hands and fingers. So they're not much help in writing PROBE PROBE! Editor and Publisher Writing is a solitary occupation. When we tire - as David R. Zimmerman we did late in the winter - deadlines are missed. All of Circulation Comptroller which is to say that we apologize here for missing our Tom Gilgut Veva H. Zimmerman April issue. PROBE is written and published independently, on a We're proud, on the other hand, that this is the first monthly schedule. Subscription: $65 per year (home), $95 issue we've missed in more than a year - a record for (office). Editorial office: 139 West 13th St., New York City, PROBE. NY 10011-78S6. Phone: 212-647-0200. For subscriptions, When we do miss, we always move all subscriptions Box 1321, Cathedral Station, New York, NY 1002S. forward one month into the future. So every reader will Opinions expressed are those of the Editor and Publisher, receive the full complement of issues for which he or she unless otherwise indicated. Contents of this newsletter may has subscribed. -D.R.Z. not be reproduced without permission. ISSN 1062-4lSS Internet address: PROBENEWSLETTER.COM

Page 2 Probe loM Report on 'Medical Errors' Is Erroneous, Key Source Says Well now. Who should come out against the recent cases there was no apparent blunder or slip-up by the surgeon." Institute of Medicine (IoM) report's findings on medical errors Adds Brennan, with a hint of sarcasm: ..The IoM report refers but the very researcher upon whose work the report is based! to these cases as medical errors, which to some observers may His name, which we have reported, is Troyen A. Brennan, seem inappropriate" - as it did to us. (But, also see letter, M.D.; he is an internist at the Brigham and Women's Hospital facing page.) in Boston. He lodged his complaint at the New England Brennan says: Journal of Medicine (NEJM), which published it on April 17, "[N]either study cited by the IoM as the source of data on the under the provocative heading: "The IoM Report on Medical incidence of injuries due to medical care involved judgments by Errors - Could It Do Hann?" the physicians reviewing medical records about whether the Yes it could, declares Brennen. He is a co-author of the injuries were caused by errors. Indeed, there is no evidence that Harvard studies in New York and Colorado and Utah from such judgments can be made reliably." which the loM extrapolated its charge that errors cause between Finally, Brennan protests, "The IoM calls for a 50% 44,000 and 98,000 deaths every year in American hospitals reduction in medical errors." The problem is that no one's ever (PROBE, March). figured a way to measure the incidence of errors. But without "[A] careful reader must have some reservations about the such a baseline, there's no way to know if you've succeeded in IoM report," Brennan declares. reducing it by half.

Malpractice Suits Foreseen ### He says the worst risk (which we didn't cover) is IoM's call In short, the IoM report, and the multi-billion dol­ for mandatory reporting of errors. Such a move, Brennan says, lar reforms trailing behind it, should be largely would only raise the burden of malpractice lawsuits. This in discounted. You read it first in PROBE! -D.R.Z. turn would drive the reporting of errors even further under­ ground than it already is, i.e., medical omerta. As the researchers' figures and our analysis showed, medical practice is in fact getting safer. Extrapolating from the New Coddles ... continued from page 1 York and Colorado-Utah data, Brennan says, it now is possible to say - as we indicated - that the number of deaths due to "We just handed the baton to the locals. I am very pro-local errors had fallen to 25,000 in 1992 - and may still be falling, control." as we projected. The scientist co-chairman of the Kansas science standards The IoM report and the scare headlines it generated drove committee, which had recommended that the board not endorse Brennan to look up the word error in a thesaurus. He found Creationism, has pointed out, according to PFAW, that the synonyms like blooper, boner, and blunder, and he says: Board has been anti-local control on most other educational "The combination of the strikingly large number of errors issues. cited by the report and the connotations of the word 'error' create an impression that is not warranted by the scientific work Board Does an About Face [his work, with colleagues] underlying the IoM report." "The Board has been very pro-active in creating state stan­ Brennan, in other words, rejects the conclusions that the IoM dards in all of the subject areas," John Staver said. "To single panel (which included his Harvard co-investigator Lucien L. out one theoretical framework, evolution, [for local control] Leape, M.D.) had drawn from their studies. (Brennan also represents a major inconsistency." acknowledges, as we reported, that the Colorado-Utah study While one local school board's incorporation of ..intelligent wasn't published until this year, after everyone, including design," may seem trivial, PFAW points out that it can affect President Clinton, had made up his mind, from IoM summaries, how science is or is not taught throughout the state. Textbook about what it meant!) publishers, for example, can't sell books to communities that demand Creationist content without watering down the Reports Were Error Free evolutionary material. What is more, in many states, including Brennan now takes up a point that we made: The word error Texas, textbooks are ordered on a statewide basis. scarcely appears in the two reports of which he is author. Its Candidate Bush thus supports the thrust of Creationists' use was the decision of the IoM panel that wrote the report. current strategy, which, as one of its leaders, John Morris, This use of it made no sense to us. It makes little sense says is "to see science return to its rightful God-glorifying to Brennan, either. He points out that IoM labelled many position ... removing roadblocks to the Gospel." operating room errors "as preventable ... even though in most If elected, Bush has pledged to help. ■

May2000 Page 3 National GeographicSows Hokum About 'Natural' Plant Remedies The National Geographic never tires of proclaiming woman in Georgia. She is happily munching a chunk of clay to its allegiance to science. But when it comes to medical science, relieve "morning sickness." The "doctors warn against it," the the Geographic appears all too willing to disregard facts, and Geographic acknowledges, "but some women crave it." This point its readers toward folly. suggests - as does much of the rest of the article - that users Case in point: the April issue. It carries a long and and practitioners of what the magazine calls "Nature's Rx" may disingenuous piece called "Medicine in Nature," which panders know more about what works and what doesn't than doctors. shamelessly to the public's current fascination with herbs and other It's folk wisdom! "natural" remedies. To do so, the mag's editors, including Joel L. The cause of this clay-eating urge, which is similar to the Swerdlow, who wrote the piece, blur the boundaries between urge that prompts many poorly nourished children to chew science and superstition. They do this in a dangerous way. lead-based wall paint - which can kill them - is not dis­ cussed; neither is the medical name for this disordered behav­ Clay Eater Depicted ior. It's called pica. The thrust of the piece is to use the story of unproven natural Our Stedman s Medical Dictionary (25th ed.) notes that pica remedies among people who have little or no access to safe and is named for a bird, the magpie, an indiscriminate feeder, and effective modem drugs, to validate the marketing and use of means: "A perverted appetite for substances not fit as food or of similarly unproven (although milder) natural remedies, such as no nutritional value, e.g., clay, starch, ice." herbs, by people who do have access to safe and effective drugs. Pica is caused by iron-deficiency anemia. The safe treatment The piece opens with a double-page photo of a grinning black is simple: iron supplements. The Geographic ignores this less colorful, but more reliable information.

Nature Is Non-prescriber 'Nhich Herbs¥fork? The whole premise of the piece - that Nature has Rx's - is faulty. Nature indeed has millions, perhaps billions of chemi­ Several herbal products have, in fact, been approved cal compounds. But it is not Nature, but local practitioners who as safe and effective by the Food and Drug Administration provide the Rx - instructions to use a plant, say, that might (FDA), based on scientific data, according to pharmacognocist work. Verro E. Tyler, Ph.D., of Purdue. He is the academic guru of Sometimes they're right, as with the Indian shrubs that yield the nature-as-medicine field. Tyler told a recent conference at rauwolfia, the antipsychotic substance that now is synthesized the University of North Carolina that all of these substances as thorazine. But all too often they're wrong, since their bases should be regulated as drugs, not as foods, as they presently for selecting a particular plant product may be thoroughly irra­ are under 1994 federal legislation, to ensure their safety and tional: For example, the plant is shaped like the human body efficacy. part it will be used to treat. Tyler says FDA has rated six classic botanicals as safe and Swerdlow starts his text with sentiment and with science: A effective. They're listed below, along with the FDA's approved Washington, D.C. teenager is celebrating her cure from indications for their use (as described in our Complete Guide to leukemia - thanks to a drug, vinblastine. It is derived from an Nonprescription Drugs, the last and only such reference work unprepossessing looking flower, rosy periwinkle, that comes on OTC drug products, which was published in 1993 - and so from Madagascar. On the facing page, a dramatic photo shows may now be a bit out-of-date). an herb gardener in Maine watering her crop of what the mag­ azine's caption writer calls "healing herbs - valerian. echi­ Name Approved Indications nacea, and hyssop." Capsicum [red pepper] counterirritant in liniments to relieve aches and pains Herbs' Value Unproven That, however, is not science. It's folklore. This is because Elm Bark soother in lozenges to relieve none of these herbs has been shown to be safe and effective sore throat according to scientific standards. Juxtaposing the periwinkle Juniper tar (oil of Cade) itch and pain relief for the picture and text with the herb gardener lends a false patina of skin, including hemorrhoids science to folk remedies - as does the clay-chewing photo. Karya gum laxative The text threads its way through the science vs. nonscience Psyllium seed and husk laxative conflict, quoting, approvingly, ex-New England Journal editor Arnold Reiman, M.D., who declares that plants contain potent Witch hazel astringent This coverage continues on following page ➔

Page4 Probe Minnesota Bill Promises New Life For Old Frauds; VenturaOK Seen Quackbuster Robert W. McCoy, in Minneapolis, has .... Minnesota will have lower standards than ... Uganda.'' assiduously collected fake and fraudulent medical devices for a The bill under consideration would cover unlicensed practi­ couple of decades now. As we have reported (PROBE, tioners, freeing them from any regulatory oversight or constraint. Jan. '99), he has assembled these quackery exemplars in his These practitioners include, but are not limited to, acupuncturists, Museum of Questionable Medical Devices. aromatherapists, ayurveda practitioners, herbologists, iridolo­ McCoy has just sent us an anguished communique: gists, Qi Gong practitioners and mind-body healers. He writes that a bill, already passed by the Minnesota They will be officially recognized and their practices will be Legislature, will legalize, legitimize, and protect, for the future, legalized. the devices and methods he has been collecting as artifacts of the bad old past! These are methods that science, medicine, Opposition Is Scant health reform, and state and federal health regulations have - Except for a few quackbusters like himself, McCoy told slowly, painfully - banned, outlawed, and turned into museum PROBE, there has been no opposition to this bill - which was pieces over the last century. introduced and is being promoted by alt/med practitioners and their shills. Law is Described The Minnesota Department of Health has not opposed the The regressive Minnesota legislation is called the bill, McCoy says. When he phoned to ask why the state would Complementary and Alternative Health Care Freedom of allow this, he recounts, an agency spokeswoman said of the Access Act. According to McCoy: alt/med practitioners: "Enactment of [it] would permit unlicensed alt/med practi­ "They do it anyway!" tioners to engage in many unproved and untested practices. If the bill passes, it will go to Gov. Jesse Ventura (Reform). And, it would permit modalities of treatments that have been He's not said yet if he'll sign it. But why shouldn't he. shown to be worthless in the treatment of serious diseases." Minnesota once was a leader among the states for consumer More colloquially, he and an associate, Shawne FitzGerald, protection. Now, it is tipping precipitously in the opposite charge: direction. "Minnesota is about to become the 'quackiest' state in the "If this becomes law," McCoy notes, "everything in the nation, with less consumer health care protection than any other museum will be legit!!!" •

medicine men use it against cancer. Hokum ... Visiting Madagascar, Swerdlow is ecstatic when he discovers continued from previous page a marketplace where hundreds, perhaps thousands of botanical chemicals, whose value must be demonstrated in research. But medicines are sold. Despite the severe deforestation that mars Swerdlow carefully backs away from Reiman 's rigor, to uphold this island, medicinal plants still are everywhere al hand, he vox populi: reports. One kills viruses. Another boosts the immune system, "Reiman insists on scientific testing before he'll believe in an an African ethnobiologist assures him. herbal remedy, but people use hundreds of plants, not all of Given this pharmacological cornucopia, it's hard to which have been tested by science, to combat ailments ranging understand why infant mortality in Madagascar is 91 per 1,000 from cancer to colds." births, compared to 8 per 1,000 in the U.S. Similarly, accord­ Of course it's "few of which," rather than "not all of which ing to UN statistics, life expectancy on the tropical island is 20 have been tested by science . . . " Beyond this misstatement, years lower than in the U.S., where (at least until recently) sick Swerdlow's view is rooted in the belief that, at least in poor people were treated with safe and effective medicines, not countries, the ethnobotanists and healers who make and sell unproven herbs. these plant concoctions have firm traditional and empirical The idea that wild nature can provide sources of important bases for what they are doing. new drugs is appealing, especially to conservationists. But recent reports in the science press indicate that ethnobotanic Some Plants Are Helpful companies that were started to pursue this path have mostly With some remedies, like white birch bark, which contains been stymied. Scientific interest is currently focused on efforts aspirin, they do. With many others, he reveals, they don't. to model new drugs based on the configuration of the human The rosy periwinkle, for example, is sold medicinally in and foreign molecules with which the drugs must interact. This Madagascar to relieve diabetes, not cancer. Swerdlow declines is indoor biology - not as colorful as bushwhacking for vines to say whether, in fact, it helps against diabetes, or whether the This coverage continues on following page ➔

May2000 Page5 Mythos Vs. Logos: Science's Foes Take the Offensive; Confession: As a newsman, we States, Iran, and Israel; that is to say in tices, starting in childhood. If, as secu­ like to cover stories once, when they're Christianity, Islam, and Judaism. larists aver, God doesn't exist, then the topical - or should be. Then, it's time Fundamentalists, .Armstrong says, are fundamentalists don't, either. They are to move on, to new news or deeper people who fight modernity. But con­ soul dead. Annstrong says fundamental­ views. Not for us, then, the repetitive temporary fundamentalism is a new, ists fear the secular world that excludes batting down of one, then another, and 20th century phenomenon: God with the same terror - and fervor still another unproven remedy or irra­ "It is a reaction against the scientific - that Jews and others fear the tional viewpoint. and secular culture that first appeared in Holocaust. So: the West, but has since taken root in the Conflict between secularists and fun­ We're growing bored with alt/med and rest of the world." damentalists has been a main thread of irrational anti-sciencism. We want now She elaborates: American history, Armstrong reminds to dig at - or out - their roots. What is Fundamentalists have no time us. While Jefferson and his supporters to be done (as Lenin once asked)? for democracy, pluralism, reli­ won the major battles with the gious toleration, peacekeeping, Constitution and Bill of Rights, the Scholar Looks at Religions free speech, or the separation of Salem elders, and Cotton Mather and his church and state. Christian Pondering this dilemma last month, fundamentalists reject the crowd won many of the succeeding skir­ we came across a new book that deals discoveries of biology and mishes. directly with the underlying problem: physics about the origins of life the religious, historical, and psychologi­ and Insist that the Book of Retreat Is Temporary Genesis Is scientifically sound in cal underpinnings of the fierce global They took a bad fall - to science, every detail. At a time when conflict between faith-based fundamen­ many are throwing off the shack­ ridicule, and common sense - at the talists and science-based modernists. les of the past, Jewish funda­ Scopes Monkey Trial, then withdrew, The book is by English historian Karen mentalists observe their nursing their wounds and their anger Armstrong, a fonner nun, who took a lit­ revealed Law more stringently through much of the midcentury. But as than ever before, and Muslim erary degree at Oxford, and now teaches scientific understanding continued to women, repudiating the free­ at a Jewish college. She keeps close tabs doms of Western women, shroud crowd them out of public discourse, they on all three major Western monotheistic themselves in veils and chadors. fought back, forcefully and cleverly, in religions in her role as a secular histori­ recent decades led by southern Protestant an. Her book, The Battle for God Why? preachers. (Knopf) examines the long and compara­ Mortal fear is the imperative, says The fact that the Creationist battle is ble warfare between what she calls Armstrong. Existential terror! still being fought in the schools, and that mythos and logos as it has been - and is Fundamentalists' beliefs are shaped to one presidential candidate in this millen­ now being - fought out in the United seek God by ritualistic religious prac- nial year supports them politically, is a

Hokum ... vis-a-vis the much more colorful folkloric uses that are depict­ continued from previous page ed in other pictures with the piece. So what is this all about, in the end? and herbs - but conceivably much more promising. It turns out that the article is a come-on for a book on herbs The selection and use of photos in the article is duplicitous: by article writer Swerdlow that the Geographic is publishing The folk-medicine photos are sharp, clear, and dramatic. But this month. It's commerce, not science! there also are a few photos from science, and they are dull and We'll get a copy of this book, and review it shortly. ■ unclear. One shows two unidentified National Cancer Institute researchers in a witchy-looking tableau with glass retorts that looks like a scene from Act I of Macbeth. Two pages are given ConsumeristsLower to a wholly blurred photo of a frog exuding antibiotic skin chemicals that contain an antibiotic. TheirStandards Photo Selection Is Biased Meanwhile, up at Consumers Union, in Yonkers, No big deal there: Dog saliva, and for that matter human spit, N.Y., similar pandering is in progress: Their magazine, contain antibiotic compounds. It's hardly news! But these pic­ Consumer Reports (May) surveyed readers, and found that a tures do reflect, unfavorably, on the scientific study of plants, continued on page 8

Page 6 Probe An Historian Foresees No Peace \ sign of the staying power these beliefs traces in The Battle for God also provide technology - particularly radio and TV have and the fear that drives them. (see a bridge through which religionists can - to reinvigorate their movement. But, story, p. I) accommodate their beliefs to the chang­ in co-opting these tools of Satan, Armstrong eschews eschatology. But . ing new social reality; in her view, it's a Armstrong says, they also arc being - like most of us - she's attracted to it. dialectical process. forced to realign their beliefs to accom­ She writes that fundamentalist beliefs As examples, she cites the Ayatollah modate modernity. and actions come to the forefront during Khomeini, in Iran, whom she says was periods of major social change, such as not a religious recidivist as he was No Peace Talks Foreseen the long "Axial Age" from 700 to 200 depicted in the West. Rather, his ideolo­ Nevertheless, the struggle continues. No BCE, when improved agricultural meth­ gy was populist and democratic, within a end is in sight. So the question remains: ods freed peoples' time and minds to religious matrix that may yet help lead Should scientists, secularists, and build the first great civilizations. The Iran from a feudal and colonial past to political liberals simply ignore the funda­ modern scientific era is a similar Axial religiously sanctioned participation in mentalist threat. as many are doing? Or Age, she declares, with scienti fie the modern world. Similarly, ultra­ fight them - which is what we favor? advances fostering new - and for reli­ Orthod ox Jews in Israel, who had Or try to find new syntheses of mythes gionists, threatening - belief systems. shunned Zionism and the political and logos - which we think is a fool's process, formed fundamentalist political mission that the fundamentalists and Modernizing Role Elucidated parties in the '60s and '70s. They have other true believers will endlessly manip­ Fundamentali sm, surprisingly, docs gained immense power in shaping the ulate for their own purposes? play a modernizing role, she says. While Israeli political and social agendas. U.S. "Each. the religious and the secularist. they fight modernity, the fundamentalists fundamentalists, similarly, have seized gazes at the other with horror," in the countr ies whose histories she the tools of modern commun ications Armstrong says. "Both recall the excess­ es, cruelties, and intolerance of the 'other side' and, wounded to the core, they can­ not make peace." Dispatches From the Front "Given the global dynamics of this Here are a few key observations from # # # impla cable struggle, Armstrong, Karen Armstrong's The Battle f or God: understandably, offers no easy solutions. "Fundamentalists feel that they are "Fundamentalism is not going to dis­ The fundamentalists must become more battling against forces that threaten appear. In America, religion has long tolerant, she says. And so must the their most sacred values. During a war shaped opposition to government. Its secularists - who might learn to treat it is very difficult for combatants to rise and fall has always been cyclical ... fundamentalists' fears as a sickness - appreciate one another's position .... and ... has occasionally become fright­ neurosis - rather than a reactionary [M]odernization has led to a polariza­ eningly explicit." - p. 362 political threat. Here's her last word: tion of society, but sometimes, to pre­ If fundamentalists must evolve a vent an escalation of the conflict, we more compassionate assess ­ must try to understand the pain and ment of their enemies in order to perceptions of the other side." - p. xvi be true to their religious tradi­ tions, secu larists must also be # # # more fait hful to the benevolence, to lerance, and respect for "Protestant fundamentalists and humanity which characterizes Christian conservatives ... seem to modern culture at its best, and have felt unmanned by the evil forces address themse lves more empa­ of secular humanism. They appeared thetica lly to the fears, anxieties, and needs which so many of deeply concerned about male impor ­ their fundamentalist neighbors tance." - p. 312 experience but which no society can safely ignore. # # # Armstrong's analysis is exce llent. "[Th]e desire for a militant virile We' re less enamored of her proposals. Christianity also explains [the] Moral But this much is sure: PROBE readers Majority's hostility to gun control leg­ will find much information and insight in islation." - p. 312 HistorianAnnso-ong counsels conciliation. The Battle fo r God . - D.R.Z.

May 2000 Page 7 ing to establish basic rules regarding herbal and nutritional supplements, to require appropriate label­ Standards. ing, to establish consistent manufacturing standards , •• and to require reasonable evidence of safety. continued from page 6 third of them used alte rnative med icine . Reade rs liked Sounds great! But what Karpatk.in doesn 't say is the prob­ "alternati ve manua l therapi es" such as chirop ractic and deep lem: She does 1101say that FDA should req uire eviden ce of massage. But they didn ' t think herbs and supplements were efficacy . Beca use, of co urse, if - by a miracle - Congre ss much help for their ailments; they didn ' t like over-the-counter changed its mind , and the law, to let FDA require proo f of (OTC) drug s very much, either. efficacy, the herb industry would wither on the vine. It ain 't likely to happe n! Soft Safeguards Asked But it's shockin g that Karpatkin and Consumer Repo rts, Based on these finding s, Co nsumers Union president Rhoda who insist that vac uum cleaners - as well as cars, H. Karpa tkin write s, thund erously, up front in the magaz ine, lawn mowe rs, and toilet clea nsers - must work , must that there is need for: "alt ern ative-medicine safeg uards" for be effec tive, to ea rn high ra tin gs, do not thin k it's co nsumers. She says: importan t to hold herbs and other alt/med stuff to simil ar We believe the FDA should have the authority and fund- standa rds. ■

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