Saturday, August 15, 2009

Consultation

A hallmark of the UK NuLabour government is the sham public "consultation". Over recent months, Universities have been "consulted" on new procedures for self investigation (and effective cover-up) of research fraud (see consultation). The General Medical Council is "consulting" about their (already reasonable) guidance for doctors who fake research - while they fail to deal with actual doctors who have brought shame on the clinical research enterprise. The GMC is also "consulting" on how it could "improve its procedures for handling Fitness to Practice cases".

Much of what passes for "consultation" is theater designed to create an illusion that serious problems with these organisations are being addressed. I have yet to see actual examples of regulatory integrity lapses, cover-up and cock-up included within any consultation document.

Funniest of all is the current consultation on government regulation of "Practitioners of Acupuncture, Herbal Medicine, Traditional Chinese Medicine and Other Traditional Medicine Systems Practised in the UK". David Colquhoun is lucid on the problem of what we are regulating. He discusses in some detail examination papers and teaching material from degree courses on acupuncture and Chinese medicine at the University of Salford and the University of Westminster.

I am hardly a defender of the current state of medicine. Scientific medicine, medical leadership, and genuine evidence-based medicine are in a shambles right now. This is in part because of government interference, and because regulators have assisted in the "normalisation" of scientific fraud. It seems to me that there are a few things to address before "consulting" on the mechanics of regulation for these practitioners. Yet again, the clear message from government is that honest science and evidence are not on their agenda. Regulation and yet more guidance are not the solution to our problems - they are the problem.

I differ slightly from David in that I don't care that ill folk choose to get all sorts of advice. Nor do I care that such wares are sold, so long as they describe exactly what they do (see this company), and I don't foot the bill.

In any event, why regulate only these specific practitioners and techniques? Given my African origins I responded to the consultation with the helpful suggestion that we consider the regulatory normalisation of other therapeutic techniques such as scarification or FGM, drugs such as muti (human or otherwise), and diagnostic technologies such as bone throwing.

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3 comments:

Radagast said...

Don't forget the MHRA's public consultation, as to how it might better communicate with the public, whilst stoically ignoring all criticism that it had no answers for!

These various entities are defending a position (the position of their lords and masters, most probably, whoever they are), which is always a dubious approach to problem-solving, in my view. Such intransigence generally prevents one from moving towards a genuine solution, I've noted (ie, a solution that actually addresses the stated problem), the reason being that the problem actually serves as a benefit to somebody or other.

Matt

InformaticsMD said...

Regarding "alternative medicine": When the going gets bad enough, even the foolish can wise up:

http://news.bbc.co.uk/2/hi/health/8211925.stm

Homeopathy not a cure, says WHO

People with conditions such as HIV, TB and malaria should not rely on homeopathic treatments, the World Health Organization has warned.

It was responding to calls from young researchers who fear the promotion of homeopathy in the developing world could put people's lives at risk.

The group Voice of Young Science Network has written to health ministers to set out the WHO view.
However practitioners said there were areas where homeopathy could help.

In a letter to the WHO in June, the medics from the UK and Africa said: "We are calling on the WHO to condemn the promotion of homeopathy for treating TB, infant diarrhoea, influenza, malaria and HIV.

"Homeopathy does not protect people from, or treat, these diseases.

"Those of us working with the most rural and impoverished people of the world already struggle to deliver the medical help that is needed.

"When homeopathy stands in place of effective treatment, lives are lost."

Dr Robert Hagan is a researcher in biomolecular science at the University of St Andrews and a member of Voice of Young Science Network, which is part of the charity Sense About Science campaigning for "evidence-based" care.

He said: "We need governments around the world to recognise the dangers of promoting homeopathy for life-threatening illnesses.

"We hope that by raising awareness of the WHO's position on homeopathy we will be supporting those people who are taking a stand against these potentially disastrous practices."

'No evidence'

Dr Mario Raviglione, director of the Stop TB department at the WHO, said: "Our evidence-based WHO TB treatment/management guidelines, as well as the International Standards of Tuberculosis Care do not recommend use of homeopathy."

hat homeopathy was being promoted as a treatment for diarrhoea in children.

But a spokesman for the WHO department of child and adolescent health and development said: "We have found no evidence to date that homeopathy would bring any benefit.

"Homeopathy does not focus on the treatment and prevention of dehydration - in total contradiction with the scientific basis and our recommendations for the management of diarrhoea."

Dr Nick Beeching, a specialist in infectious diseases at the Royal Liverpool University Hospital, said: "Infections such as malaria, HIV and tuberculosis all have a high mortality rate but can usually be controlled or cured by a variety of proven treatments, for which there is ample experience and scientific trial data.

"There is no objective evidence that homeopathy has any effect on these infections, and I think it is irresponsible for a healthcare worker to promote the use of homeopathy in place of proven treatment for any life-threatening illness."

Homework

However Paula Ross, chief executive of the Society of Homeopaths, said it was right to raise concerns about promotion of homeopathy as a cure for TB, malaria or HIV and Aids.

But she added: "This is just another poorly wrapped attempt to discredit homeopathy by Sense About Science.

"The irony is that in their efforts to promote evidence in medicine, they have failed to do their own homework.

"There is a strong and growing evidence base for homeopathy and most notably, this also includes childhood diarrhoea."

The UK's Faculty of Homeopathy added that there was also evidence homeopathy could help people with seasonal flu.

Dr Sara Eames, president of the faculty, said people should not be deprived of effective conventional medicines for serious disease.

But she added: "Millions die each year as those affected have no access to these drugs.

"It therefore seems reasonable to consider what beneficial role homeopathy could play. What is needed is further research and investment into homeopathy."

D Bunker said...

"What is needed is further research and investment into homeopathy."

There's the meat of it:

Redistribution of Wealth to promote the well being of those on the receiving end.