evidence based medicine

On Taking Health Advice from Gandhi… World Homeopathy Awareness Week 2015

World Homeopathy Awareness Week (WHAW) is approaching once again, to take place from the 10th to the 16th of April 2015.

Last year’s WHAW took place just as the NHMRC’s draft information paper examining evidence on the effectiveness of homeopathy in treating health conditions had been made public, which led to a substantial amount of awareness raising via the media that homeopathy is not an effective modality. Similarly, this year WHAW is taking place the month following the release of the NHMRC’s completed review on homeopathy. This review has lead to headlines stating the findings that homeopathy is no more effective than a placebo, which makes for some fine public awareness of homeopathy from an evidence based perspective.

World Homeopathy Awareness Week’s theme for 2015 is, “Homeopathy For Infectious Diseases’.

There is no evidence for, nor plausible mechanism by which, homeopathy can be of any use in treating infectious disease; and I feel that it is highly unethical and very dangerous to mislead people by claiming such, particularly in the midst of the US’ current measles outbreak, and the ongoing ebola epidemic in West Africa.

The belief that ‘homeoprophylaxis’ (also referred to as ‘homeopathic vaccination’) provides any protection from diseases which ought to be prevented with immunisation leads to parents falsely assuming that they have adequately addressed preventative healthcare. This false sense of safety is both incredibly dangerous and cruel – ‘homeoprophylaxis’ (and homeopathy in general) cheats consumers into believing that they are looking after their own and their childrens’ health.

Speaking of unreliable and non-credible health advice, the organisers of WHAW have uploaded the image below as their cover photo on the Facebook page for World Homeopathy Awareness Week 2015, featuring a pro-homeopathy quote attributed to Mahatma Gandhi.

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Source: WHAW Facebook

Mahatma Gandhi is a widely influential and highly esteemed man; a peace activist, civil rights pioneer and the preeminent leader of Indian independence movement in British-ruled India. His philosophies regarding human rights, non-violent civil disobedience and the nature of humanity are valued by many people worldwide.

Did this qualify him to speak on matters of medicine and health with any authority though? He had no medical training or expertise (he was educated in law), but nonetheless penned a treatise on health matters, in which he noted, “I have arrived at certain definite conclusions from that experience, and I now set them down for the benefit of my readers.”

“A Guide to Health” by Mahatman Gandhi is available as a free ebook, courtesy of Project Gutenberg. It contains some quite fantastic claims and philosophies about the human body and the nature of disease, which I will gently describe as “ill informed”. For example,

The world is compounded of the five elements,—earth, water, air, fire, and ether. So too is our body. It is a sort of miniature world. Hence the body stands in need of all the elements in due proportion,—pure earth, pure water, pure fire or sunlight, pure air, and open space. When any one of these falls short of its due proportion, illness is caused in the body. – p12

On the cause of fever:

As most fevers are caused by disorders of the bowels, the very first thing to do is to starve the patient. It is a mere superstition that a weak man will get weaker by starving. As we have already seen, only that portion of our food is really useful which is assimilated into the blood, and the remainder only clogs the bowels. In fever the digestive organs are very weak, the tongue gets coated, and the lips are hard and dry. If any food is given to the patient in this condition, it will remain undigested and aid the fever. Starving the patient gives his digestive organs time to perform their work; hence the need to starve him for a day or two. – p100

On smallpox:

In fact it is caused, just like other diseases, by the blood getting impure owing to some disorder of the bowels; and the poison that accumulates in the system is expelled in the form of small-pox. If this view is correct, then there is absolutely no need to be afraid of small-pox. If it were really a contagious disease, everyone should catch it by merely touching the patient; but this is not always the case. – p105

Incidentally, Gandhi is highly quotable by anti-vaccination campaigners:

Vaccination is a barbarous practice, and it is one of the most fatal of all the delusions current in our time, not to be found even among the so-called savage races of the world. – p107

On first aid for burns:

If the skin has simply got red by the burn, there is no more effective remedy than the application of a mud poultice. If the fingers have been burnt, care should be taken, when the poultice is applied, that they do not touch against one another. This same treatment may be applied in cases of acid-burns, and scalds of every description. -p132

(Incidentally, for evidence-based guidelines on treating burns and some unfortunate quackery regarding burns, here is an excellent report by another of the Skeptic Zone reporters, Heidi Robertson.)

Gandhi himself ruminated on whether indeed he was qualified or correct in writing on health matters:

One question which I have asked myself again and again, in the course of writing this book, is why I of all persons should write it. Is there any justification at all for one like me, who am no doctor, and whose knowledge of the matters dealt with in these pages must be necessarily imperfect, attempting to write a book of this kind?

My defence is this. The “science” of medicine is itself based upon imperfect knowledge, most of it being mere quackery. But this book, at any rate, has been prompted by the purest of motives. The attempt is here made not so much to show how to cure diseases as to point out the means of preventing them. And a little reflection will show that the prevention of disease is a comparatively simple matter, not requiring much specialist knowledge, although it is by no means an easy thing to put these principles into practice. Our object has been to show the unity of origin and treatment of all diseases, so that all people may learn to treat their diseases themselves when they do arise, as they often do, in spite of great care in the observance of the laws of health. -p143

Unfortunately, pure motives are not enough when it comes to dispensing health advice, nor was Gandhi’s necessarily qualified to pass judgement that most science based medicine is ‘mere quackery’. It is also pertinent to remember that Gandhi wrote this treatise in 1921 – our body of knowledge in the field of medicine has grown immensely over the past century.

I invite you to have a fossick around “A Guide to Health” (his thoughts on chastity and childbirth were too long to include in this post, but they’re quite amazing) and come to your own conclusions as to whether you think he is a reputable source of health advice.

I ask you to then consider whether the endorsement of homeopathy cited by WHAW holds much gravitas when you’re aware of Gandhi’s ideas on health and medicine in general.

Finally, please take into account what is possibly the icing on the cake here… I have not been able to find any evidence that the quote used by WHAW can reasonably be attributed to Gandhi. Neither have these skeptics on stackexchange, or commenters on this post of Orac’s. Likewise, @zeno001 has been searching for an original source for the quote, to no avail (but he has listed some examples of Gandhi mentioning homeopathy, seemingly not in a favourable light)*.

The only place I’ve found the Gandhi quote “Homeopathy… cures a larger percentage of cases than any other method of treatment and is beyond doubt a safe, economical and a most complete medical science” (or any variations thereof), has been on pro-homeopathy sites – not in any independent archives of Gandhi’s writings or speeches. As such, I think that it’s a fair call to label the quote as unverified.

So to summarise, the WHAW organisers have used an unverified quote from a source whose health advice is highly questionable, to promote awareness of a modality for which there is no evidence of efficacy in treating disease greater than that of a placebo.

World Homeopathy Awareness Week 2015. Once again helping to raise public awareness that homeopathy is bulldust.

* Updated 24/03/2015, thanks to zeno001 for the additional information.

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Adult Pertussis Boosters – Please Help Protect Babies from Whooping Cough

There has been some incredibly sad news this week.

Four week old Riley John Hughes from Perth, Australia, has died as a result of contracting whooping cough (pertussis).

Baby Riley John Hughes (Source: Facebook)

Baby Riley John Hughes (Source: Facebook)

I cannot fathom what Riley’s family have gone through over the past weeks, caring for their son as he was ill, then holding him as he passed away. The loss of a newborn is a tragedy I have no words for, especially to a cause that we as a society have the capacity to minimise risk for. As with other families who have lost a baby to whooping cough, my heart and all of my support are with the Hughes family, now and in the future.

The capacity that humans have to get through unimaginably awful circumstances is something which I am in awe of. In an unfathomable show of strength and caring, I have witnessed people who have undergone the most terrible losses make the decision to campaign publicly in the hope of affecting change.

Two such people, the parents of Dana McCaffery, who have campaigned extensively for the prevention of whooping cough since losing their beautiful four week old daughter in 2009, brought my attention to the profound importance of vaccination, and inspired me to join others in the fight to prevent the lives of children being placed at risk by this disease.

The parents of Riley John Hughes have also made the decision to go public with their tragic story, in the hope that Riley’s passing will promote public awareness of the danger of whooping cough.

From a post on the Light for Riley Facebook Page, set up by Riley’s family as a contact point with the public and media, Riley’s father Greg has written,

“We’re desperate to ensure the passing of our child has not been in vain and to try and assist other families who may be potentially suffering from similar circumstances,”

“Long term we’d ideally like to be the drivers of change within this country surrounding the treatment, management and long term eradication of this horrific disease.”

Riley’s family have also set up a fundraising page in conjunction with Princess Margaret Hospital, to honour their son’s memory and raise money to be used by PMH to help fight whooping cough, respiratory illness and other preventable diseases.

Following the news of Riley’s death, the NSW Minister for Health, Jillian Skinner, announced that free pertussis vaccines will be made available to pregnant women in their third trimester. Shortly after, WA Health Minister Kim Hames announced to in Parliament that a no cost pertussis vaccine program for pregnant women was being fast-tracked and will be available in two weeks’ time. This will bring New South Wales and Western Australia in line with Queensland and Victoria, who have already implemented free maternal vaccination for women in their third trimester – a strategy which provides both protection to the mother, so that the risk of her contracting whooping cough and passing it on to her newborn is greatly minimised, and protection to the newborn child through passive antibody transfer in-utero.

This is very welcome news, and I hope that the remaining Australian states and territories will follow suit (the Northern Territory offers free pertussis vaccines to parents and close family members of children under seven months old, but no maternal third trimester immunisation). Still, I believe that we need to do more to prevent the spread of whooping cough.

When my son Oscar was born in 2009, New South Wales provided free pertussis vaccines not only to parents of newborn children, but to family members who were likely to come into contact with the child during those most vulnerable few weeks. All of my son’s grandparents and his aunt took this opportunity to access the whooping cough vaccination, which provided us with protection known as the cocooning effect – surrounded by immunised people, he was less likely to be exposed to pertussis.

Sadly, this strategy was unable to completely reduce the risk of my children being exposed to whooping cough. My daughter Daphne arrived in 2011, meaning that both of my children were born during the 2009-2012 whooping cough outbreak, and I was concerned when my children were out in public – particularly as I live in an area with one of the lowest vaccination rates in Australia. Several local playgroups are attended by families who openly don’t vaccinate, and I wasn’t willing to risk my children being exposed to whooping cough; particularly before they turned six months old and had completed their course of three vaccinations (the acellular pertussis vaccine is given at two, four and six months of age, as per the Australian National Immunisation Program Schedule).

I wasn’t only concerned about unvaccinated children and low herd immunity in my local area though; many adults in Australia do not have immunity to whooping cough – be it through not knowing that pertussis vaccines are available, not being aware that adult immunity wanes after 5-10 years and that boosters are required, or not realising the potential outcomes of contracting pertussis… sustained serious illness and the risk of passing it on to others.

Indeed, Riley Hughes’ family members had been vaccinated against pertussis. This minimised his risk of exposure, but was not enough to protect him.

According to the 2009 Adult Vaccination Survey, carried out by the Australian Institute of Health and Welfare, only 11.5% of adults in Australia have received a pertussis booster.

The people at Tiny Hearts Paediatric First Aid have launched a petition to increase the availability of pertussis booster vaccination at low or no cost for all adults in Australia, and have suggested that people who are concerned about low adult pertussis vaccination rates contact their state health ministers – a call to action which I am firmly behind.

While I acknowledge the difficult job that those creating and implementing public health policy have, performing cost-benefit analysis to determine where limited public health money shall be spent, I strongly conclude that resources are urgently required to increase public awareness of the importance of adult pertussis boosters, and that they need to be accessible to all. Neither cost, nor lack of awareness should be barriers to preventing the unnecessary tragedy of infant death due to whooping cough.

As the importance of adult pertussis booster vaccines is not widely understood, nor are vaccines currently freely available, I would like to ask that you help spread the word – by sharing this post, the graphic above compiled by Northern Rivers Vaccination Supporters, or the videos below (the first a segment from The Project, the second an interview with Toni McCaffery on Today Tonight) which outline Riley’s story and the importance of pertussis boosters for adults.

Additionally, if you have not had a pertussis booster within the last five years and are able, I hope that you will consider speaking with your GP about a booster vaccination. Not only will it provide you with protection from a nasty illness which can persist for several months, with greater numbers of adults in our society immunised against whooping cough, transmission rates will fall. Please help minimise the risk of another baby being lost to this horrible disease.

The #StopTenpenny Campaign against anti-vaccination seminars in Australia – Podcast Report

On The Skeptic Zone Podcast #325 {Permalink}, Evidence, Please has a report on the #StopTenpenny campaign against anti-vaccination seminars in Australia by US anti-vaccine campaigner Sherri Tenpenny.

Below are the links I’ve mentioned on the report, plus a transcript below the jump.

Social Media:

#StopTenpenny on Twitter
Stop Sherri Tenpenny from entering Australia Facebook Page

Blog Posts and Facebook Statements:

Reasonable Hank, “2015 anti-vaccine tour of Australia – the Tenpenny caravan of hurt
Diluted Thinking, “Anti-vaccination Seminars in 2015 by Stephanie Messenger
Diluted Thinking, “Healthy Lifestyles Naturally (HLN) – Seminars
Reasonable Hank, “Getting to know Sherri Tenpenny – a guide
Reasonable Hank, “Venues confirm being misled by anti-vaccine Messenger – Tenpenny tour
Stop the Australian (Anti)Vaccination Network, Statement regarding SAVN views and intentions are regarding Tenpenny’s visit

Media Reports:

4th January 2015
The Daily Telegraph, Jane Hansen, “Pro-vaccine lobby fight to stop US anti-vaccination campaigner Sherri Tenpenny lecturing in Australia

5th January 2015
Mamamia, Amy Stockwell, “This woman is a danger to children. And she’s coming to Australia.
The Daily Mail, Louise Cheer, “Should this woman be allowed to preach her anti-vaccine warnings in Australia? Parents’ outrage over American doctor’s child health seminars
news.com.au, Jane Hansen, “Uproar as US anti-vaccination campaigner Sherri Tenpenny announces trip to Australia
The Guardian, Michael Safi, “US anti-vaccine activist Dr Sherri Tenpenny plans Australian tour in March
The 7:30 Report, Jane Cowan, “Anti-vaccination lobby to blame for US return of preventable diseases say doctors” (video)

6th January 2015
3AW Radio, “Victorian Health Minister slams anti-vaccine movement
SBS, Shanthi Benjamin, “Calls for government to deny visa to US anti-vaccine activist
The Age, “Vaccine row about to boil over
Sunshine Coast Daily, Adam Davies, “Push to ban anti-vaccination campaigner from Aussie tour
ABC PM Radio, Bridget Brennan, “Controversial anti-vaccination campaigner to visit Australia
The Project TV, “Ms Information – the campaign against an anti-vaccination campaigner who plans a speaking tour in Australia

Times Live, Katharine Child, “No vaccine for Mandela-itis
The Age, Julia Medew, “Doctors want to bar anti-vaccination campaigner
ABC, Bridget Brennan, “Calls to deny visa to American anti-vaccination campaigner Sherri Tenpenny to speak in Australia
Junkee, Meg Watson, “Why You Should Join The Campaign To Stop Anti-Vaxxer Sherri Tenpenny Coming To Australia
Health of Ukraine, “Scandal in Australia : the inhabitants of the country are outraged at lectures about the dangers of vaccines” (in Russian)
Herald Sun, Phillipa Butt, “Health Minister urges organisers to cancel event featuring anti-vaccination activist Sherry Tenpenny
The Age, Nick Galvin, “ABC’s 7.30 under fire over anti-vaccination campaigner James Maskell

7th January 2015

New Zealand Herald, Daily Mail, “‘Deny her a visa’ – Australian outrage over anti-vaccination activist’s speaking tour
Queensland Health, Dr Sonya Bennett, “Queensland Health’s response to anti-vaccination discussions
The Guardian, Weekly Beast, “7:30 falls into vax wars
ABC News, “Sherri Tenpenny: Who is the controversial anti-vaccination campaigner planning to visit Australia?

ABC News, “Sherri Tenpenny: Sydney venue cancels seminar of US anti-vaccination campaigner” (Republished on Mamamia)
SBS News, “A controversial American anti-vaccination campaigner may be prevented from entering Australia.
ABC News , “Sydney venue cancels seminar of US anti-vaccination campaigner

8th January 2015

The Age, Eryk Bagshaw, “Sherri Tenpenny: US anti-vaccination campaigner’s Sydney and Melbourne shows cancelled
Sydney Morning Herald, Julia Medew, “Venues cancel events featuring US anti-vaccination campaigner Sherri Tenpenny
Medical Observer, “Doctors protest anti-vax speaking tour” (Login required)
3AW Radio, “Talking Health –  Sally Cockburn interviews Meryl Dorey and John Cunningham” (audio only)

9th January 2014

The Daily Mail, “More venues cancel anti-vax seminars
The Today Show, “Prof Peter McIntyre refutes Dr Tenpenny anti-vaccination beliefs” (video)

The Today Show, ‘The Grill’, “Misinformation tour by anti-vaccination activist” (video)
The Guardian, Oliver Milman, “Anti-vaccination campaigner compares critics to Charlie Hebdo attackers

11th January 2015

Sydney Morning Herald, “Anti-vaccination views are misguided – but not illegal
Daily Life, Jacqueline Maley, “Anti-vaccination advocate’s tour in tatters after most venues cancel
Sunrise TV, “Health experts urge parents to vaccinate kids” (video)

Skeptical Coverage:

Doubtful News, “Tenpenny’s anti-vaccination tour hits a snag in Australia (Update)
Society for Science Based Medicine, “They Do Not Shrug Down Under

Petitions:

change.org, “Petition to Refuse Sherri Tenpenny’s Visa into Australia
The Parenthood, “Petition to STOP anti-vax. campaigner Sherri Tenpenny #StopTenpenny

Event Links:

EventBrite Event Listing and Ticket Sales
GanKinMan Foundation
GanKinMan Foundation FB Page
Birth, Baby and Beyond FB Event

 

Report transcript:

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Queensland to Provide Whooping Cough Vaccines for Pregnant Women – Campaign for all Australian States To Follow

On July the 9th, Queensland Premier Campbell Newman and Health Minister Lawrence Springborg made a long hoped for announcement – Queensland will be providing free Whooping Cough (Pertussis) vaccinations for women in their third trimester of pregnancy, following dedicated campaigning by doctors, parent groups and concerned citizens.

Read more: Free whooping cough vaccine for all pregnant women in Queensland Courier Mail, 10th July 2014.

Premier Campbell Newman and Health Minister Lawrence Springborg announce free whooping cough vaccinations for pregnant women in Queensland.

Premier Campbell Newman and Health Minister Lawrence Springborg announce free whooping cough vaccinations for pregnant women in Queensland.

 

This is wonderful news for newborns and their families in Queensland. Maternal immunisation during the third trimester of pregnancy and the resulting passive antibody transfer to the infant has been shown to provide substantial protection to newborns during the first two months of life, before they are able to begin receiving whooping cough vaccinations (a three dose schedule, which is completed at six months). Maternal immunisation can also prevent the mother from contracting whooping cough herself, risking passing it on to her vulnerable infant.

Hopefully Queensland’s new policy will pave the way for other Australian states and territories to institute similar schemes, allowing families better access to a measure which can protect newborns from illness, disability and death.

If you are so inclined, please consider writing to and/or tweeting your state or territory leaders, health ministers and shadow health ministers to let them know that there is high community support for the provision of free whooping cough vaccines for pregnant women. I have listed contact details and Twitter accounts for them at the end of this post, and have been tweeting myself, using the hashtag #freewhoopingcoughvax.

 

 

I would like to share with you this letter written to the Premier of New South Wales, Mike Baird, and the New South Wales Minister for Health, Jillian Skinner. It was composed by Heidi Robertson and Alison Gaylard on behalf of the Northern Rivers Vaccination Supporters, a community group of concerned citizens who support vaccination and live in an area of New South Wales with alarmingly low vaccination rates.

 

Wednesday, 9th July, 2014

Dear Premier Baird and Ms. Skinner,

We write with regards the initiative announced by Queensland Premier Campbell Newman this morning (9th July 2014). Premier Newman revealed that Queensland Health will be funding a free Pertussis (whooping cough) vaccine for women in their 3rd trimester of pregnancy.

We sincerely hope that NSW will follow suit with this initiative. It is of course based on the latest research and evidence which states that the Pertussis vaccine given in the third trimester is very effective at protecting the newborn baby during those crucial first two months before they can receive their first Pertussis vaccine. Mothers-to-be are also protected from Pertussis with this initiative which of course reduces the chances of transmission to the baby. Mothers, often being the primary caregiver of the baby, are in close physical proximity on a 24- hour basis and are often inadvertently responsible for passing this potentially deadly infection on to their babies.

Losing a baby to Pertussis, a Vaccine Preventable Disease, is of course devastating; the economic cost to government will also be greatly reduced if less infants need to be hospitalised in Paediatric Intensive Care Units (over 9 out of 10 babies under three months of age need to be hospitalised as a result of contracting pertussis).

Please consider following Queensland in this important endeavour.

Regards,

Heidi Robertson and Alison Gaylard – acting on behalf of Northern Rivers Vaccination Supporters.

 

Again, if this issue is important to you, please consider writing or tweeting to your state or territory health MPs. Thank you.

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World Homeopathy Awareness Week – Raising Awareness that Homeopathy is Bulldust!

Well, this week is rather special – it’s World Homeopathy Awareness Week!

First, a very brief primer on homeopathy. Homeopathy was founded in 1796 by Samuel Hahnemann, based on his postulation that “like cures like” – for example, a small amount of a stimulant, such as caffeine, is purported to help with sleep troubles. Homeopathic preparations are produced by “dynamisation” or “potentisation”, in which active ingredients are diluted with alcohol or distilled water, then “succussed” (a form of ritualistic vigorous shaking). The dilution process is repeated until the likelihood of a single molecule of the original ingredient being present in a bottle of homeopathic “remedy” is as close as can be to zero.

Homeopathic remedies are sold as liquids or sugar pills and can be found in health food stores, online shops and to my great disappointment, in pharmacies in Australia. Homeopathy is at times confused with herbalism, as it is included within the scope of “natural medicine”, thus it is worth noting that while herbal remedies contain active ingredients, homeopathic remedies contain no detectable trace of such. For more information, visit the 10:23 Campaign’s page, “What is Homeopathy?” 

 

Beginning on the 10th of April each year,coinciding with the birthday of Hahnemann, World Homeopathy Awareness Week (WHAW) has been established by the World Homeopathy Awareness Organization to coordinate global promotion of homeopathy by those who practice and advocate it. Simultaneously, WHAW has been embraced by critics of homeopathy as a fine time to raise awareness of the lack of plausibility behind the mechanisms used to create homeopathic “remedies”, and the lack of evidence that homeopathy has any physiological effect beyond that of a placebo.

This year, WHAW related discussion kicked off a couple of days early, as Australia’s National Health and Medical Research Council released a draft of their information paper, “Evidence on the effectiveness of homeopathy for treating health conditions“. The NHMRC is accepting feedback on this paper until May 26th, so if you wish to provide them with any feedback for consideration, details on doing so are available via the above link.

Admittedly, when I first heard that the NHMRC were conducting a review on homeopathy studies, I was flummoxed – I was familiar with the findings on homeopathy already, and it seemed akin to reviewing findings on whether the sky was blue, or whether water was… wet. However, more public awareness on homeopathy – and the findings that no credible evidence supports its efficacy – has been a great prompt for the media to get on board and for public discussion of homeopathy to increase.

In short, people are still investing their money and hope in products and treatments which have no plausible mechanism of action beyond a placebo. Pharmacies are still selling homeopathic products, in what I consider to be a terribly unethical case of lending false credibility. A small but important minority of general practitioners are referring their patients to homeopaths and naturopaths (some of whom include homeopathy in their practice). There are people who, heart-breakingly, eschew evidence based medicine in favour of homeopathy – as was seen in the tragic case of Penelope Dingle. As such, I believe that it is worth getting the word out, loud and clear, that homeopathy is a sham.

 

I’ve spotted a few fantastic reads during WHAW this year. First up, Ken Harvey has written a piece on The Drum titled “Homeopathy – We Can’t Have it Both Ways“, in which he discusses the fact that, while the NHMRC paper condemns homeopathy, other authorities still give it legitimacy, by accrediting the study of homeopathy, including it in health insurance plans and allowing it to be sold in pharmacies.

From the Good Thinking Society, here is a wonderful page on Homeopathy Awareness Week, with a list of twelve quick facts on homeopathy. The project director, Michael Marshall, explains the importance of the site and of awareness of homeopathy in his Guardian piece, “Homeopathy Awareness Can Make The World A Happier and Healthier Place“.

This week’s episode of The Skeptic Zone Podcast (permalink) has more information on homeopathy than molecules of active ingredients in a homeopathic dilution, and includes my first attempt at a podcast report (replete with awful jokes, such as the one I’ve just made), in which I cover a minor skeptical activism success on the Better Health Channel’s promotion of WHAW. After an impromptu letter writing and social media campaign last week, and in light of the NHMRC draft report on homeopathy, the Better Health Channel made the commendable decision to remove WHAW from their events calendar. If you’re not already a regular Skeptic Zone listener, I encourage you to give it a go this week – despite my cheesy lines, the show is great.

Speaking of humour, I’d like to provide two more links on which to end this post. They’re not to be taken seriously, but sometimes laughter is… the best medicine. (Sorry – I’ll see myself out).

How Does Homeopathy Work? (from the 10:23 Campaign)

List of scientifically controlled double blind studies which have conclusively demonstrated the efficacy of homeopathy (from RationalWiki)

10:23 Campaign Against Homeopathy – Antarctic 2011 (a short video via The Skeptic Zone, in which Dr Paul Willis puts himself on the line and takes a homeopathic overdose!)

2009-11-02-homeoComic by Luke Surl, shared under Creative Commons Licence

Anti-Vaccination Advocates on the Front Line of Public Health

I have a confession to make, people. Sometimes I read the comments. And sometimes I even join in.

Earlier today, ABC News posted a news article on their Facebook page regarding Federal Health Minister Peter Dutton’s meeting with his state counterparts to discuss a possible decision to withhold Family Tax Benefit payments from parents who refuse to vaccinate their children, for non-medical reasons. It’s a complicated issue and one that Dr Julie Leask has addressed in the news article itself.

ABC News’ Facebook moderator invited comments from Facebook users on the topic, prompting much discussion, both advocating and opposing vaccination itself, and agreeing with or criticising the proposal to withhold benefits from families who choose not to vaccinate their children. Having a little free time on my hands, I had a look over the comments and made a few myself; predominantly providing rebuttals to anti-vaccination rhetoric and suggesting that people discuss any concerns that they may have about immunisation with a qualified health professional.

Here’s a fairly typical example of the sort of comment that those who oppose vaccination make on such threads:

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Usually I’ll respond to this sort of statement with an explanation of herd immunity, that unimmunised children increase the risk of vaccine preventable diseases entering our community, the importance of protecting children for whom vaccines are medically contraindicated (be it due to medically diagnosed allergy, an immunocompromised state due to cancer therapy or organ transplant, or being too young to yet be immunised), that vaccines aren’t one hundred percent effective (often noting that seatbelts aren’t either, but it’s sensible to take the high level of protection that we can get over none at all).

We’ve got a couple more fallacies here. “Straight up poisons” sounds fairly terrifying, but doesn’t take into account the rigorous testing vaccines go through, nor the doses at which vaccine ingredients are administered. Break down our foodstuffs and you’ll find scary sounding chemicals in many fruits and vegetables in minute amounts; some of which also occur naturally in our own systems.

To suggest that anybody is proposing that parents will be “forced” to immunise children is also disingenuous. The current proposal is to withhold a payment as an incentive, the option to refuse to vaccinate would still be available.

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Earlier, I mentioned that I often suggest to people that if they have concerns about immunisation, they should discuss them with a qualified health professional. Here, Deb has informed us that she is indeed speaking as a health professional.

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In fact, she is a nurse. The sort of person we should reasonably be able to trust for sound advice and information on vaccines. A practitioner of evidence based medicine.

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Here are some odd generalisations regarding lifestyle choices! Thankfully, many parents who ensure that their kids get outside and play and give them… food stuff that is actually food stuff… also choose to vaccinate.

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Which epidemics? Were vaccinations around during these epidemics also?

Sanitation is a marvel for public health, but it is not responsible for the significant lowering of vaccine preventable diseases. More information on this frequently repeated myth from WHO.

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A healthcare practitioner who buys into the “Big Pharma” business?

It troubles me. Out of curiosity, and using publicly available data, I found Deb’s LinkedIn profile. Her name (she uses a pseudonym on Facebook, but her Facebook URL contained her surname), photo and job description matched, so I am quite confident that I’ve identified her correctly. She works as a clinical nurse in what she describes as a “large, busy, Metro ED Department”.

Her refusal to have the influenza vaccine leaves her prone to contracting it… and working in an emergency department, she is likely to have a high risk of exposure to the virus. If she is at work while contagious, there’s potential for her to pass it on to some very ill and vulnerable patients under her care.

What is also deeply disturbing to me though, is that somebody on the front line of public health – in a position of authority on healthcare – would hold views that so strongly reject many tenets of evidence based medicine. We should be able to trust clinical nurses to know better.

 

 

19:20 – 12/04/2014 Edited to add: Two more of Deb’s posts on the ABC News thread, presented without comment.

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Although the discussion on ABC News’ Facebook page is a public one and Deb uses a pseudonym, I have chosen to pixelate her photograph and surname for this post, as I am noting her as an example of a health professional who espouses anti-vaccination views, rather than an individual to be exposed.

Anti-Abortion Protesters and Breast Cancer Lies in Melbourne.

I am currently staying in Melbourne to attend laboratory classes and have been catching the tram in to the city morning and afternoon to get to university. A couple of mornings ago as I was looking out the window, I noticed some anti-abortion picketers with banners and signs standing at either side of the gates to the Fertility Control Clinic in East Melbourne. They were displaying signs decorated with the pink ribbon symbol and slogans claiming that abortion increases women’s risk of developing breast cancer. On my way home, I was prepared to disembark from my tram so that I could take a photograph of the banners that the picketers had set up and ask them a few questions on where they were obtaining data to support their claim, but when I passed the fertility clinic, I saw that they had gone. They were not present when I went past the next day either.

I wish to note that as disagreeable as I find the distressing messages voiced by anti-abortion picketers, I am an advocate for freedom of speech and I do not want to take away their ability to peacefully state their views; though I do appreciate the argument for exclusion zones around abortion clinic gates and would proudly volunteer to be an escort for women who use the clinic’s services, given the appropriate training.

What I do very much object to though, is when they – or anyone, for that matter – tell lies about health risks in order to scare people in to doing as they wish.

There is no credible evidence to support the claim that having an abortion or experiencing miscarriage increases the risk that a woman will develop breast cancer. When I first saw the protesters this morning and tweeted about their appropriation of the pink ribbon symbol, @danientifically (who I recommend you follow if you enjoy tweets from reasoned, compassionate people with a fine sense of humour) asked the Cancer Council Australia how they felt about it. They kindly responded with this link, which contains a brief run down of credible information regarding the myth of a link between abortion and increased risk of breast cancer.

Having had time to look into it since, I’ve found that anti-abortion protesters have been using this myth for quite some time – and as such, there is much literature citing evidence which refutes their claim. From the American Cancer Society:

In February 2003, the US National Cancer Institute (NCI) held a workshop of more than 100 of the world’s leading experts who study pregnancy and breast cancer risk. The experts reviewed human and animal studies that looked at the link between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. Some of their findings were:

  • Breast cancer risk is increased for a short time after a full-term pregnancy (that is, a pregnancy that results in the birth of a living child).
  • Induced abortion is not linked to an increase in breast cancer risk.
  • Spontaneous abortion is not linked to an increase in breast cancer risk.

The level of scientific evidence for these findings was considered to be “well established” (the highest level).

The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice also reviewed the available evidence in 2003 and again in 2009. ACOG published its most recent findings in June 2009. At that time, the Committee said, “Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.”

In 2004, the Collaborative Group on Hormonal Factors in Breast Cancer, based out of Oxford University in England, put together the results from 53 separate studies done in 16 different countries. These studies included about 83,000 women with breast cancer. After combining and reviewing the results from these studies, the researchers concluded that “the totality of worldwide epidemiological evidence indicates that pregnancies ending as either spontaneous or induced abortions do not have adverse effects on women’s subsequent risk of developing breast cancer.” These experts did not find that abortions (either induced or spontaneous) cause a higher breast cancer risk.

The picketers’ stance against abortion is presumably a moral one, at times supported by religious belief, and I’m sure that they have moral arguments that they feel they can back up their position with. Certainly, moral positions can (and in my frank opinion, should) be backed up with fact – but when the fact being used is a blatant falsehood, I am very much compelled to call that out. Especially when those falsehoods are being used to distress people who may be feeling vulnerable.

pink_ribbon

As a person who is strongly pro-choice and an advocate for bodily autonomy, it can be very easy to demonise anti-abortion picketers – especially given the outcomes of their protests; both the harm they cause individuals and the political influence that they hold. The use of graphic images disgusts me, harassment and attacks on both women seeking abortion and abortion providers should be dealt with strongly via the legal system. Something I try to keep in mind when I see them however, is that they genuinely do believe that their view is right – that they are fighting to save the lives of vulnerable beings. Alongside anti-vaccination campaigners who truly believe that vaccines are harming children, and religious prosthelytisers who honestly hope to save our souls from eternal damnation, the majority of anti-abortionists do believe that they are trying to stop a terrible and unjust harm that occurs within our society. It is rare that a passionate campaigner for a cause does so to do evil.

As such, I suspect that it is entirely possible that some anti-abortionists may know that the abortion/breast cancer myth is a falsehood. When I discussed my thoughts on the matter with Felix (who lacks a Twitter account for me to link to), he relayed to me an experience he had years ago, when a friend was trying to convert him to Christianity. Felix went and had a discussion with his friend’s minister and questioned the minister’s claims that homosexuality presented dangers to people’s health. When confronted with somebody willing to question the credibility of his claims, the minister actually outright admitted that they were false, but he felt that telling a lie was an acceptable and minor wrong when looking at the bigger picture; the fate of a person’s eternal soul. Likewise, perhaps some anti-abortionists realise that their claim regarding breast cancer is less than credible, but feel that it is justifiable to use it as a scare tactic in the hope of preventing women from having abortions.

It is a complex situation and I do not believe that I have the requisite knowledge or skills to have a productive conversation with anti-abortion protesters and be able to convince them that their claims regarding breast cancer are scientifically unsound and can not be ethically employed as a part of their argument. However, what I am capable of to a degree is publicly stating that their claim regarding abortion and increased breast cancer risk is incorrect – and in publicising that they are perpetrating a falsehood, I hope that anybody who has been misled by anti-abortion propaganda on this topic can be assured that it is an outright lie.

NB: I have chosen to use the term “anti-abortion” to describe what is also referred to as the “pro-life” movement, as I consider it to be a more accurate descriptor. 

Further reading:

Breast Cancer Risk Factors – A Review of the Evidence Cancer Australia

Is Abortion Linked to Breast Cancer?American Cancer Society

Abortion – Breast Cancer Hypothesis – Wikipedia

The Truth About Abortions and Breast Cancer – Cosmopolitan Magazine