State-Sponsored Quackery Feng Shui and Snake Oil for California Nurses
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State-Sponsored Quackery Feng Shui and Snake Oil for California Nurses The Independent Investigations Group investigates pseudoscience—particularly therapeutic touch— in professional nursing. Just how well regulated is nursing in California? OWEN HAMMER and JAMES UNDERDOWN he California Board of Registered Nursing (CBRN) oversees and licenses more than 350,000 registered Tnurses in the Golden State.1 Nurses in California must complete thirty hours of continuing education units (CEUs) every two years to remain licensed. These units must be issued by certified CEU providers and “must be relevant to the practice of nursing.”2 The courses may, however, be related to topics as varied as “social and behavioral sciences . therapeutic interpersonal relationship skills. .and nurs- ing administration.”3 There is no ongoing reporting mechanism to keep track of each individual’s CEUs. Nurses comply based on the honor system but are expected to submit proof of coursework if SKEPTICAL INQUIRER November / December 2009 53 Jim Underdown reaches into an anatomically correct rubber corpse and flings an armful of bloody latex entrails onto a stage to divine the future. re quested. Correspondence courses can qualify for credit, and ment agency led us to inquire about Clearsight’s application. the board requires little substantiation that anything has been Had Clearsight defrauded the CBRN in order to cash in on learned.4 the CEU market? A Tectonic-sized Crack in the System Sacramento, We Have a Problem The Independent Investigations Group (IIG) at the Center for After some prodding to remind the CBRN that Clearsight’s Inquiry/Los Angeles has been an active skeptics group since provider application was public record, the IIG received a January 2000. When we at the IIG learned that a nursing copy of the application and discovered that it was blank in CEU provider called Clearsight was offering credits for a class some places and that the instructor’s educational credentials in “energetic medicine,” we investigated. “Energetic medicine” consisted of a BA in comparative religion and a ministerial cer- is Clearsight’s name for therapeutic touch (TT), the manipula- tificate from the Church of Divine Man—a psychic institute tion of alleged energy fields such as chakras and auras over the that offers healings, psychic readings, and other such activi- body. (The practitioner’s hands make no actual contact with ties.6 The application also made the unsubstantiated claim that the patient.) Clearsight advertised that they were licensed by the “medical science has recognized and quantified the existence state of California to teach the following to registered nurses: of a human energy field which, when blocked, may result in a 7 The skills of “seeing energy” to see and diagnose body organs; broad range of physical and psychological ailments.” to scan the physical and energetic bodies for dis-harmonies or From January to May 2006, IIG investigators had a frus- illness; and to heal the aura and chakras, the energetic systems trating series of exchanges with the nursing board. Initially, of the body. we asked that they withdraw Clearsight’s certification to teach Clearsight introduces you to the skills of Free Will, the energetic medicine based on the omissions in the application art of energy diagnosis, how to make Separations from your Healee so you do not take another person’s energy or dis-ease and the lack of supporting medical value for the practices home and how to release old patterns and stuck energy in your being taught. We naively thought that after we pointed out body and auric field. When you use Clearsight healing skills Owen Hammer is an investigator with the IIG and a writer and you clear and clean the entire energy field (chakras, channels visual effects artist in Hollywood. James Underdown is the exec- and aura) and grow and evolve evenly at the rate of growth you are ready to access.5 utive director of the Center for Inquiry/Los Angeles and the chair and founder of the Independent Investigations Group. He can be Our shock at discovering that such a pseudoscientific reached by e-mail at [email protected]. course had been sanctioned by an ostensibly scientific govern- 54 Volume 33, Issue 6 Skeptical Inquirer these (what we thought were stunning) revelations, the board The board promised to consider our suggested changes to would recognize their oversight and withdraw Clearsight’s the regulations, but we never heard from them or saw any sign certification to teach New Age malarkey. We had no idea our that the item was listed on any subsequent board agenda or odyssey was just beginning. In a February 2006 letter, then CBRN Executive Officer Ruth Ann Terry wrote to IIG investigator Owen Hammer that “nurses . need to be informed about these techniques in order to understand the patient’s/client’s perspective and learn what is involved in each technique.”8 IIG Chair James Underdown addressed the board person- ally in May and June of 2006 and argued that Clearsight’s course was not a class about energetic healing; it was a course teaching (i.e., endorsing) energetic healing, an unscientific concept. The IIG submitted a proposed rewrite of the current rules that would help prevent future lapses in science standards. The current rules say (in effect) that content must be relevant to the practice of nursing, related to scientific knowledge, or related to client care.9 Our proposed change was that content must be relevant, scientific, and related to client care. We also submitted a clause clarifying the definition of scientific and a change providing for automatic withdrawal of certification from CEU providers who give false information on an application. The IIG then contacted the California Department of Con- sumer Affairs, which oversees nursing regulations, and received a reply in July 2006 that defended the granting of Clearsight’s certification. In August 2006, Underdown addressed the board’s Education/Licensing Committee in Sacramento. There, the IIG was informed10 that the board will “award a CE Provider number to the applicant if the alternative or comple- mentary medicine modality is discussed in the publication Best Practices in Alternative and Complementary Medicine.”11 addressed at any meeting. We were stonewalled. Best Practices, which would be key to our investigation, is a hard-to-find publication that is regarded by the board as You Want Crazy? You Got It! its guidepost to educational policy. It contains sections on We then decided to see for ourselves just how lax California’s TT, magnet therapy, Reiki, aromatherapy, homeopathy, and CEU provider application process really is. We created a CEU qigong. The material on these topics is highly credulous12 provider called the California Foundation for Institutional despite poor scientific support and wide criticism in the Care—or CFI-Care (www.cficare.org)—and sent an applica- SKEPTICAL INQUIRER and other journals. The board neverthe- tion with the $200 fee to the CBRN. We called our course less defended the licensure of energetic medicine classes and “Feng Shui for Home Care Providers” and listed IIG inves- other alternative medical practices by citing Best Practices as tigator Karen Kensek as the instructor because she teaches an acceptable standard. architecture at the University of Southern California and thus After an exhaustive search, we found Best Practices in a meets the qualifications of a certified instructor. But we didn’t library and carefully read the sections that dealt with TT. We stop there. then crafted a comprehensive, well-documented refutation of The following sections appear on our application for this Best Practices’s TT claims and sent copies of this refutation to course aimed at professional nurses: each board member. This was in addition to literature we had already given the board, including material from Robert Park’s 1. Möbel Kinesiology (Möbel is the German word for furni- SI piece “Alternative Medicine and the Laws of Physics”13; “A ture, so möbel kinesiology is, essentially, furniture moving.) Close Look at Therapeutic Touch”14 by Linda Rosa, Emily 2. Feng Shui (a practice in which a structure or site is chosen Rosa, Larry Sarner, and Stephen Barrett (in The Journal of the or configured so as to harmonize with its qi, or life energy) American Medical Association); and Kevin Courcey’s “Further 3. Chinese Shéyóu (translation: snake oil) Notes on Therapeutic Touch,” which is available online at www. 4. Vapor and Reflective Surfaces (another way to say smoke Quackwatch.org. and mirrors) Oddly enough, Rosa et al’s JAMA paper was cited in the 5. Apophenia (the experience of seeing patterns or connec- Best Practices literature despite the fact that it elegantly refutes tions in random or meaningless data) claims that TT works! 6. Anthropomancy (divination through human entrails) SKEPTICAL INQUIRER November / December 2009 55 7. Canupiary Flexibility (The word canupiary exists in no lan- that it took the CBRN eight months to discover this (as yet guage we could find. We made it up.) unnamed) error and only after our extensive publicity cam- paign spotlighting the folly of their approval. When the unfamiliar content on our application was ini- We taught the class anyway, with no promise of CEUs, to tially questioned, we simply pointed out that the sections we an amazed and incredulous crowd. The handful of nurses who proposed were consistent with material found in Best Practices, attended the class with around seventy-five others were appalled the board’s own gold standard for educational content. They that the class’s ludicrous content had been approved by the would either have to certify CFI-Care or reject Best Practices. board. Jim Underdown reaching into an anatomically correct CFI-Care was certified as Continuing Education Provider rubber corpse and flinging an armful of bloody latex entrails #15166 on August 28, 2008.