Just before heading off on holiday I gave notice of my intended reading matter. Pedalo-duty permitting, I hoped to get through all four books.
The wind and currents of the French Atlantic coast precluded any pedalo action so the kids had to settle for surfing lessons instead, and were placed in the capable hands of an instructor. And so I turned first of all to Singh’s and Edzard’s Trick or Treatment, an analysis of complementary or alternative medicine.
The book is clearly and meticulously written – I found it an easy read. The authors are at pains to explain the necessity for an evidence-based approach when evaluating any proposed treatment of human ailments. Acupuncture, homeopathy, chiropractic and herbal medicine are covered in the greatest depth, each getting a chapter to themselves. All the remaining known ‘alternative’ therapies are given much briefer treatment in the appendix.
Singh and Ernst lack the irreverent humour of Ben Goldacre, whose excellent Bad Science covers some of the same territory, and their tone may be a bit too didactic for some. But I appreciated the attention to detail. The authors drilled carefully into the core of alternative medicine and, almost invariably, came up with… snake oil. They found that none of the treatments has much to offer beyond the placebo effect or the benefits of more conventional therapies.
Ultimately what struck me most about the book was the sense that emerged of the intellectual poverty of alternative medics. They might tacitly admit the primacy of the scientific approach to the evaluation of treatment efficacy by trying to clothe themselves in science, but they’re like children who can’t dress themselves properly. Trick or Treatment (like Bad Science before it) is very good on explaining the inequalities of different types of evidence. A great recent example of this is the fabulous blogospheric dissection of the evidence that the British Chiropractic Association finally produced in response to the criticism of its libel case against Singh. Much of it, argued the bloggers, was irrelevant or cherry-picked.
The other, more depressing realisation I came away with, is that alternative medics aren’t about to disappear anytime soon. Alas, they’re usually quite happy to get into the ring with science and go a full 15 rounds. Lacking the skill to land much of a punch, their aim appears to be to duck and weave until the scientists are finally exhausted. So I’m afraid it’s up to us to keep trying to knock some scientific sense into the alternative medicine community.
We have to keep on questioning the evidence for alternative medicine. It not a matter of arrogant condescension but of quietly and firmly pointing out how the methodology of science and its resolutely critical culture are so essential for understanding how the world — and good health — works. I don’t want to get all po-faced about this but more of us need to stand up to counter the seepage of fanciful medical practices into modern life. With Trick or Treatment now in my back catalogue (and I reckon I’ll be returning to it frequently for points of reference) I’ll be able to do my little bit more confidently.
(Parenthetically, anyone looking for an opportunity to step up to the mark should head over to Improbable Science where David Colquhoun is calling for people to respond to the Department of Health’s consultation on the Pittilo Report. The report has recommended that practitioners of acupuncture, herbal medicine, traditional Chinese medicine should be subject to statutory regulation by the Health Professions Council. All very innoucuous sounding perhaps but, as David explains, it opens the way for untested treatments to acquire an official-looking seal of approval.)
Having finished Trick or Treatment I launched straight into astronaut Buzz Aldrin’s Magnificent Desolation. A confirmed moon-nut, I had been really looking forward to the book but, oh dear me, what a shambles…
(To be continued, soon.)