Respectful Insolence

About six months back, I wrote about Katie Wernecke, a 13-year-old girl diagnosed with Hodgkin’s lymphoma last year, whose parents fought with Texas courts to let them take her to Kansas to receive high dose vitamin C therapy rather than the chemotherapy and radiation therapy that she needed to have a chance of beating her cancer. Events have suggested to me that an update is in order. It turns out that Katie is still alive, although it is unclear how she is doing. Her family has apparently taken her to an undisclosed cancer treatment center out of state, where she is getting more altie “cures” other than the high dose vitamin C that she got late last year. One witness, her school’s assistant principal, reports that before her departure to this “undisclosed location,” she seemed “weaker, more tired and wasn’t acting herself.” Her father has been quoted as saying, “I really can’t say anything because it could jeopardize her treatment.” In addition, his further elaboration on her family’s blog sounds to me as though he’s whistling past the graveyard:

On a condition of receiving treatments there can be no publicity at all. That is why there has been no communication on this website for months. We cannot tell you what we are doing or where we are at simply because the doctors and hospital would refuse to continue treatments. Katie’s tumor grew in March but now is receding with the new treatments.

I have to wonder: What kind of “treatments” require the family to remain silent or risk the doctors’ refusing to continue? Are the treatments illegal? Why on earth would the doctors and hospital demand the family’s silence? After all, the Werneckes already won their court battle and can essentially have Katie treated any way they want without much fear of her being taken away from them again–even if they end up bankrupting themselves (as I fear they are doing) paying for unproven “treatments” and are forced to hawk various books on alternative medicine and ask for donations to cover medical treatment.

It’s all so sad and could have been prevented.

This update brings me to the event that led me to look into what has happened to Katie Wernecke since November, namely my learning that she now has company. In Virginia, a 15-year-old has taken the first steps down the same path as Katie:

NORFOLK - Fifteen-year-old Abraham Starchild Cherrix never intended to challenge the medical establishment when he refused chemotherapy earlier this year.

He simply believed the treatment was poisoning him, rather than saving him from Hodgkin’s disease. What he wanted was a more natural approach, which he sought through an alternative treatment clinic in Tijuana, Mexico.

That decision has led to a courtroom battle, accusations of parental neglect and the possibility of being removed from his Chincoteague home.

A judge earlier this week ordered Abraham to receive diagnostic tests to determine the status of his disease. On Friday, though, the tall, lanky boy refused to abide by the order. After showing up at Children’s Hospital of The King’s Daughters in a crisp white shirt and blue tie, he rejected the test.

“I think my body has taken enough, and it shouldn’t have to take any more,” he said.

Abraham’s case has brought into public view some difficult questions: What are parents’ – and more expressly, children’s – rights in choosing medical treatment? When is alternative medicine helpful or harmful? And who has the right to intervene when the answers to such questions are in dispute?

It all began in February, when, after an initial round of chemotherapy for Hodgkins’ Disease, tests showed that there was still residual cancer, and oncologists recommended another round of chemotherapy, followed by radiation:

Doctors said the boy needed more chemo, and radiation therapy to attack tumors in his chest and neck.

That’s when Abraham dug in his heels. He and his father did some research and decided to try a treatment in Tijuana that includes an organic diet and herbal supplements. Soon after, his case was reported to a child-abuse investigator at the Accomack County Department of Social Services, who asked a judge to order that the teen continue conventional treatment.

At a Tuesday hearing, Judge Jesse E. Demps ordered tests to see whether Abraham’s cancer had worsened. He also filed a temporary order saying the parents had “neglected or refused to provide necessary treatment” for the boy. He ordered that joint custody be shared between the parents and Social Services to ensure proper care.

The therapy that the Cherrixes have chosen for Abraham is a doozy. They’ve decided to go to The Association for Research and Enlightenment. This Association was founded by a psychic healer named Edgar Cayce, who was known for falling into trances and giving readings on topics as varied as Hitler, astrology, the existence of Atlantis, ESP, ancient Egypt, and others. Through Cayce’s Association, Abraham and his father have settled upon a dubious treatment known as the Hoxsey treatment.

Basically, the Hoxsey treatment involves herbal concoctions popularized by Harry Hoxsey. Different varieties exist, including an “internal” treatment and external treatments with various pastes made up of some of the components of his treatment (usually used for skin cancers or tumors that can be palpated through the skin). Hoxsey claimed that the formula had been passed down from his grandfather John Hoxsey to his father to him, after his grandfather had mixed together grasses and flowering wild plants growing in a pasture where one of John Hoxsey’s horses grazed daily. The horse supposedly had a cancerous growth that went away, and Hoxsey thought that it was due to the plants upon which the horse grazed. He took plants from the pasture, mixed them together, added some ingredients for home remedies for cancer at the time, and–voilà!–he had what he thought was a cure for cancer. Many decades later, Hoxsey’s grandson described how this remedy supposedly worked thusly:

“It follows that if the constitution of body fluids can be normalized and the original chemical balance in the body restored, the environment again will become unfavorable for the survival and reproduction of these cells, they will cease to multiply and eventually they will die. Then if vital organs have not been too seriously damaged by the malignancy (or by surgery or irradiation) the entire organism will recover normal health.”

He [Hoxsey] also did not claim to know how or why his herbal cancer treatment worked, but he maintained that it “corrects the abnormal blood chemistry and normalizes cell metabolism” by “stimulat[ing] the elimination of toxins which are poisoning the system.”

There’s only one problem. There’s no good evidence that the Hoxsey treatment has any antitumor activity. Although some of the components have been reported to have mild antitumor activity in cell culture and animal systems, others have been reported to promote tumorigenesis. In any case, there is no evidence that the Hoxsey treatment as given has efficacy against any cancer. Indeed, the NCI investigated Hoxsey’s case series, and, as is frequently the case with such altie reports, concluded that there was inadequate information recorded to make any conclusions at all. The FDA investigated 400 cases whom Hoxsey claimed to cured and found not a single case of a bona fide cancer cure (Semin Oncol 1979;6(4):526-535). Indeed, in 1956, the FDA Commissioner ordered the posting of a “Public Beware!” warning against the Hoxsey treatment in U.S. Post Offices all over the country. And, as quacks frequently do, Hoxsey went to his grave claiming he was being “persecuted” by the “establishment.”

Until her death in 1999, Hoxsey’s longtime chief nurse Mildred Nelson continued Hoxsey’s legacy and administered his “treatment” in Tijuana, claiming an 80% success rate (as mentioned in the original article above). Of note, Nelson believed that a “bad attitude” was usually responsible for her “20 percent failure rate” she reported for the Hoxsey treatment, with a patient’s strong belief that the treatment is going to lead to recovery being the best predictor of success. Convenient, isn’t it? Those pesky patients who have the temerity to die in spite of the Hoxsey treatment? Well, it was obviously their own fault! They didn’t believe enough!

After Nelson’s death, her sister took over running the Bio-Medical Center in Tijuana, which continues to give the Hoxsey treatment, sometimes in combination with dietary supplements, chelation therapy, or laetrile. The really sad thing is what alties themselves say about the Bio-Medical Clinic:

An unpublished pilot study of treatment results at the Bio-Medical Center (and the Livingston Clinic in San Diego, CA, an alternative treatment center founded by the late Virginia Livingston-Wheeler, MD), conducted by the University of Texas at Houston’s Center for Alternative Medicine Research, is currently being circulated for review. The study examined a series of Bio-Medical patient records from 1992. It was funded by a grant from the National Institutes of Health (NIH) through the National Center for Complementary Alternative Medicine (NCCAM) and the National Cancer Institute (NCI).

According to the study, at a point five years after a new group of Bio-Medical Center cancer patients began their treatment in 1992, 11.4 percent of them were alive, 34.9 percent were deceased, and 42.9 percent were lost to follow-up. These results are conservative, but, in contrast to the outcomes of most standard forms of cancer therapy, seem promising. The inability to evaluate a greater number of patients and to contact more of them after five years in order to assess outcomes prevented any definitive conclusions about the Hoxsey Therapy’s ultimate viability from being reached.

No kidding.

Only 11.4% of the patients could be confirmed to be alive and 43% were lost to followup (which, in cancer studies, all too often means that most of them are probably dead)? And that’s a good result? In comparison to what? It’s impossible to know whether this result is good, bad, or indifferent without breaking patients and results down by types and stages of cancer, as well as the Karnofsky or ECOG performance status of the patients when presenting, and whether they were being treated for new or recurrent cancer. Absent that information, the results reported are utterly meaningless.

What really infuriates me about cases like Katie Wernecke and Abraham Cherrix is that in teens Hodgkin’s disease is an eminently curable cancer. Indeed, both Katie and Abraham could have expected around an 85% chance of surviving their cancers with appropriate chemotherapy and radiation. The siren call of quackery (in the form of more “natural” treatments) is luring these young patients away from known effective treatments with a high probability of saving their lives. Indeed, in Katie’s case, delays in therapy because of her parents’ doubts about conventional treatment arguably drastically decreased her chances of a cure even with the best conventional treatment medicine has to offer. Adults, of course, are perfectly free to choose snake oil over proven therapy if they so desire. They are presumed to be mature and responsible enough to weigh the options and pay the price for their bad choices. However, we as a society have decided that children should not have that same freedom, because they are not yet capable of making such decisions or taking the consequences. We can certainly argue over exactly what age is the appropriate cutoff–is 18 too high or low, for instance?–but there is no disagreement that, below a certain age children must rely on their parents or guardians to decide such matter for them. The question then becomes: What do we as a society do when the parents choose a course for their children that is so obviously not in their best interest? Despite my libertarian leanings, I see situations such as these, where the parents have made choices so obviously harmful to their children, as one of the few types of situations where it is appropriate for the state to step in and overrule the parents’ wishes–and, if necessary, the child’s wishes as well. These cases are no different to me than cases in which Jehovah’s Witnesses refuse to allow their injured children to receive life-saving transfusions. (Yes, in many cases the situation is not nearly so clear-cut that the parents are doing their children harm, but neither of these is one of those cases.) In Katie’s case, the state lost, I suspect because her odds had become so poor that the court thought that she would be better off spending her last months happy with her parents, even if they chose ineffective “alternative” medicine for her. However, it’s not yet too late for Abraham.

Sadly, so desperate are the parents to believe in the quackery that they have chosen that they delude themselves that the treatment is working. In Katie’s case, such self-delusion manifests itself as her father’s glossing over the fact that her tumors grew in March and that the assistant principal at her school is concerned that she isn’t looking so good. In Abraham’s case, it’s very similar:

In the time between the end of chemotherapy in December and April, the lump on Abraham’s neck did get bigger, but the family thinks that’s because the new treatment has not yet taken effect. His parents said the growth hasn’t gotten bigger in the past two weeks.

“Abraham said that God has told him this is his test,” Jay Cherrix said. “I think that, too.”

If Abraham dies from his enlarging tumors (as he will if he does not receive the additional therapy he needs–and soon), does that mean he will have failed God’s test? Or does it mean that he will have succeeded because he was faithful enough to follow the Hoxsey treatment, even though doing so eliminated his chance of long term survival?

I hope we don’t find out, but, sadly, I probably hope in vain.

Comments

  1. #1 Alex
    June 1, 2006

    After Nelson’s death, her sister took over running the Bio-Medical Center in Tijuana, which continues to give the Hoxsey treatment, sometimes in combination with dietary supplements, chelation therapy, or laetrile.

    It’s weird how these people stack up delusion on delusion. I mean, the chelation bullshit is meant to treat autism, but this is clearly no barrier to prescribing it for cancer. As Hemingway had one of his characters remark, a doctor who cannot remove your appendix with success will refer you to one who can’t diagnose your gall stones (I may be misquoting).

  2. #2 Noodle
    June 1, 2006

    There’s a saying that, “if you have to get cancer, Hodgkins is the one you want to get”. It’s emminently curable. I was diagnosed with Stage III B HL in Dec. 2000. 9 months later I had had 12 rounds of chemo (ABVD) and it was gone. I’m 5 years out with no evidence of disease. My hair thinned and I was often tired and nauseous but I gladly traded that for getting rid of the cancer. I never even considered not getting chemo. I hope these kids get the treatment they need. To allow them to die from HL is nearly homicide. It’s completely unnecessary. My $0.02.

  3. #3 palinal
    June 1, 2006

    I am getting very cynical in my old age, my thoughts tend to be, “There are too many people in the world, now, so if we let the stupid ones kill themselves, so much the better!”

  4. #4 richard kearns
    June 1, 2006

    am new to this blog and am enjoying exploring it.

    my name is richard kearns. i am a gay man living with aids in los angeles.

    the issues of quackery you raise also have an impact on the aids pandemic. look, for instance, at the actions of president mbeke in south africa.

    i am also aware of “alternative medicines” that help manage hiv disease. actually, i’ve read studies that demonstrate taking vitamins helps people survive in better shape. not a cure. a step.

    i also work with traditional chinese medicine, acupuncture and qigong, and it helps to manage side affects from the meds as well as the effects of the disease.

    i will be thinking about this post and writing about it on aids-write.org. however there is an additional resource–an essay i would like to refer you to. it’s called “hunger in america” written by richard mitchell, the underground grammarian.

    http://www.radiofreemike.com/hunger.html

    –rk

  5. #5 figmo
    June 1, 2006

    I’m with palina. I too am tired of the idiots. Let them die off without getting a chance to breed.

  6. #6 Dan R.
    June 1, 2006

    I’m going to be very cynical and say that Katie Wernecke is receiving standard medical treatment at an out of state hospital — and the parents face significant incentives to not reveal it both in terms of financial, pressure from others, and embarrassment.

  7. #7 Greco
    June 1, 2006

    “if you have to get cancer, Hodgkins is the one you want to get”

    Never heard that saying, but I agree. I was diagnosed with stage IIA in November 1994, and treated with six cycles of MOPP chemotherapy and radiotherapy. It has been now 10.5 years since the end of therapy, with no signs of Hodgkin or a second malignancy.

  8. #8 Orac
    June 1, 2006

    I’m going to be very cynical and say that Katie Wernecke is receiving standard medical treatment at an out of state hospital — and the parents face significant incentives to not reveal it both in terms of financial, pressure from others, and embarrassment.

    You know, I had considered that possibility (and perhaps I should have mentioned it in my piece), but I don’t think that’s the case. The family seemed too committed to the alternative therapy. On the other hand, I hope you’re right; Katie might actually have a chance if your speculation is correct.

  9. #9 Paul
    June 1, 2006

    In general, I would agree that when alties die from their improperly treated conditions, the net result is an increase in the average intelligence of the human race. However, what we are talking about here is not stupid people killing themselves, rather stupid people killing their children, and it is horrifying.

  10. #10 figmo
    June 1, 2006

    Paul, while I agree that killing your children is horrifying, these parents are bound and determined to kill them. I learned a long time ago that I can’t save the world. I pick and choose my battles. As the parent of a childhood cancer survivor, I have nothing but empathy for anyone fighting this battle. That said, without conventional treatment, these two children are going to die before their time. Maybe the good will be that other people will realize that these children weren’t saved by altie treatment. My now 16 year old daughter is alive and well thanks to science and the wonder of chemo/radiation and a bone marrow transplant. When I want to talk to her, I go to her room not to a cemetery. Although I sounded flip, I have a real dog in this fight and have grown weary of the altie group. They hinder science and ultimately put other children at risk. The less of them the better.

  11. #11 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  12. #12 tavella
    June 1, 2006

    While I do mostly agree with you, I also think a 15 year old is old enough to make the decision to refuse treatment. I think it’s sad, especially with a treatable cancer like Hodgkin’s, but I’m also extremely reluctant to say someone has to endure the ravages of chemotherapy and radiation; my grandmother made the same choice, and she was a doctor herself. Of course, she made it at 88, and with a much less treatable form of cancer.

    Where the lunacy comes in is in the belief in the quack treatments.

  13. #13 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  14. #14 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  15. #15 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  16. #16 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  17. #17 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  18. #18 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  19. #19 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  20. #20 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  21. #21 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  22. #22 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  23. #23 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  24. #24 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  25. #25 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  26. #26 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  27. #27 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  28. #28 Sun&Sea
    June 1, 2006

    A close friend of mine recently bit the dust from kidney cancer just four months after diagnosis, leaving behind a very distraught wife and four kids under ten, including a newborn (at least he got to see her before he went). The kids also happen to be my godchildren and trying to help them (and their mother) pick up the pieces is proving one of the toughest experiences of my life. And I have a beloved aunty currently fighting bowel (colon?) cancer, but it was picked up early and treated aggressively at an excellent centre, and she is doing extremely well with a better than 90% chance of a normal life span. So cancer mortality is kind of freshly personal for me too.

    I find myself in the horrible position of agreeing with both Paul and figmo. The pointless death of a kid is about as bad as it gets, and there is no question that the best chance Kate and Abraham have (or had?) is with modern mainstream medicine, whatever its flaws. But maybe the publicity about this will also bring twenty other, umm, misguided parents of kids with still treatable malignancies to their senses. So a net gain, maybe, in a tragically weird kind of way.

  29. #29 Not My Second Opinion
    June 1, 2006

    It is sad to hear the statistics at the Bio-Medical clinic in Tijuana. Hopefully the transparency of the altie study will convince even whackjob alties with a slight knowledge of math NOT to go to a facility where a third are dead and almost half of their patients are MIA after 5 years.

    It is through sheer will and faith in the Miraculous Thingie that can never be proven that these people think that this is “promising.”

  30. #30 TheProbe
    June 1, 2006

    There is no way any 15 year old can make a truly informed and rational decision without their parents also being truly informed and rational. When a kid makes a decision to refuse treatment, I conclude, absent evidence to the contrary, that they are repeating their parents teachings.

    Fortunately, the Alties such as these will succomb to Darwin’s survival of the smartest.

  31. #31 llewelly
    June 1, 2006

    Fortunately, the Alties such as these will succomb to Darwin’s survival of the smartest.

    There are two interesting assumptions here:
    (a) Being an ‘Altie’ is related to an heritable trait natural selection can act upon.
    (b) ‘smart’ is a survival trait.

    Since I’m not an ‘Altie’, I find (a) emotionally appealing because it implies that I am fitter.
    Because I have tested above average on IQ tests, ACT, SAT, etc, and am often told I am rather smart, I also find (b) quite appealing.

    However:
    (a) I don’t know of evidence linking genes to being an ‘Altie’.
    (b) There are a good many creatures – plankton, beetles, bacteria – which are quite numerous, and have been on this earth a long time, but are not very ‘smart’.

    So… can anyone provide evidence supporting either of these two assumptions?

  32. #32 David Harmon
    June 1, 2006

    Parents killing their kids is still evolution in action — it’s still their genes, reassorted. But yeah it’s rough on the kids….

  33. #33 llewelly
    June 1, 2006

    Parents killing their kids is still evolution in action — it’s still their genes, reassorted.

    You miss the point. No-one has offered evidence the behavior – killing the children via ‘Altie’ idiocy – is the result of heritable characteristics. If it isn’t in the genes, the fact that ‘it’s still their genes, reassorted’ is irrelevant.

  34. #34 Abel PharmBoy
    June 1, 2006

    So here’s a different take from a natural products cancer pharmacologist: I’m trying to work with some psych, MD, botany, and MSW colleagues to get patients to feel better about their chemo, particularly those who refuse it because it doesn’t seem natural. Most folks are surprised to learn that more than 60% of so-called chemo drugs come from nature (not that it should matter, but bear with me a bit.).

    If I understand correctly, NCCN guidelines generally recommend the ABVD regimen for most stages of Hodgkin lymphoma. What I would have loved to educate this young woman about, and her parents, is that 3 of the 4 drugs (doxorubicin (Adriamycin), bleomycin, vincristine) in the ABVD regimen ARE natural (and even synthetic dacarbazine/DTIC is an alkylating analog of a naturally-occurring purine nucleotide, i.e., DNA building block). And Orac is right on about the 85% survival rate.

    These drugs are the result of decades of research efforts literally scouring the globe for any plant, bacteria, or fungus that produces a chemical to kill something else. In essence, the ABVD regimen has harvested the best of the natural worlds’ tools to fight cancer. Docs and nurses can then be viewed as bringing nature into the treatment room, albeit with the unpleasant connotations of “chemotherapy.”

    The surprise for many patients and even some physicians and scientists is that so much of chemotherapy is actually the alternative medicine of decades past, first tested for effectiveness then incorporated into conventional medicine.

    Does anyone think that some patients would have a less negative emotional response to chemotherapy if they were educated about this issue?

  35. #35 anjou
    June 1, 2006

    Hi Abel–
    Does anyone think that some patients would have a less negative emotional response to chemotherapy if they were educated about this issue?

    No…(big bad pharma and not a supplement co is marketing it)- Ive been trying to for years on the cancer support boards… BUT it would still be an interesting article for you to present as folks are VERY interested in this stuff on the cancer support boards

    anjou

  36. #36 Gelf
    June 1, 2006

    llewelly: (a) Being an ‘Altie’ is related to an heritable trait natural selection can act upon.

    You seem to be speaking under a false presumption that natural selection acts only upon genetically heritable traits. To be brief and unnecessarily flippant, they don’t call them the “Darwin Awards” for nothing, and it’s not because there’s something wrong with the recipients genetically.

    Incidentally, your criticism of the claim that “smart is a survival trait” contains a logical conversion fallacy. The teeth and claws of a tiger are without a doubt a survival trait — a sine qua non of tigers, if you will — but it does not follow from this that bacteria, plankton and beetles ought to have the teeth and claws of a tiger, or that their survival would be enhanced by such. Survival traits are not universal, but relative to an organism and its environment.

  37. #37 llewelly
    June 2, 2006

    You seem to be speaking under a false presumption that natural selection acts only upon genetically heritable traits.

    The children inherited the genes (from their respective parents). I cannot tell from the articles whether they inherited the Altie ideas through cultural mechanisms. (If you are thinking of a mechanism which is not cultural or genetic, please explain.)
    My presumption was – and is – that genetics are the only quantity that I can be certain the children inherited. I ruled out cultural mechanisms primarily because I know of many cases where people have adopted beliefs substantially different from their parents, and done so at an age older than 13 or 15. I do not know how common such a change in belief is. I only know that it is possible, in principle, that if these children survive, they will discard the Altie beliefs that nearly killed them.

    To be brief and unnecessarily flippant, they don’t call them the “Darwin Awards” for nothing, and it’s not because there’s something wrong with the recipients genetically.

    They are called ‘Darwin Awards’ because it is humorous to do so. Said humor is founded in the pleasing assumption that smart is a survival trait. I would be delighted if this is true, but I believe in being extra-cautious of accepting assumptions that are egotistically pleasing.

    Incidentally, your criticism of the claim that “smart is a survival trait” contains a logical conversion fallacy.

    Thank you. This is encouraging. Can you do better? For example, can you show that better problem solving ability in humans is correlated with more offspring?

  38. #38 impatientpatient
    June 2, 2006

    I am glad you wrote about this- I saw it somewhere in the last day and contemplated sending it in, but figured you would already know about this. This is why I am so pissed off about alternative treatments being offered at real medical centres- it gives an edge of credulity to something dubious. I hate being an angry bitch all the time, but these people infuriate me. Screw prayer, screw natural- God certainly did not make tvs and fridges but you alties use them. Why the hell is medical technology and science any different???? People are so truly idiotic and it infuriates me.

  39. #39 Hyperion
    June 2, 2006

    It’s still an act of natural selection, regardless of whether a given trait is hereditary. It is not important what traits the children may have inherited, but rather that the parents are the ones causing their children’s deaths. In other words, the parents themselves lack the competence necessary to successfully raise children to adulthood, thus preventing their genes from propagating (since human procreation is more dependent upon reaching adulthood than reaching childearing age, for cultural reasons).

    As outraged as I am at what can only be called negligent homicide on the part of the parents, I don’t really know if it’s worth forcing the issue. If the kids hadn’t gotten cancer, something else would have happened: the parents refuse to use sunscreen, resulting in skin cancer; they refuse to use antibiotics to cure bronchitis or strep; the kid gets mono and they do something stupid like throw him in a sauna to “sweat it out.” There are any number of different ways in which these parents would eventually cause their children’s deaths. Maybe I’ve just spent too much time looking at the bigger-picture policy analysis side, but I can’t help feel that trying to stop these parents might simply be wasting resources that could be better spent getting quality information on early screening or other practices to people who would actually help themselves.

    Meh. I agree with doing everything possible to let people know the dangers of altie treatments, to explain the benefits of evidence-based medicine, of trying to do the best job possible of educating the population at large…but if a few ignoramuses are really willing to sacrifice their children to maintain their delusions, I don’t know if it’s really worth trying to stop them after a certain point.

  40. #40 Andrew Dodds
    June 2, 2006

    Orac – I suspect that the reason why the treatment is being kept secret by the ‘doctors’ at this clinic is because they don’t want to be associated with a high profile case in which the patient dies (which this unfortunately the probable outcome in this case). Of course, they still want the cash..

    llewelly – If I recall correctly, studies do show that women are attracted to men who appear competent in general; and certainly humans rely on intellegence to get food, etc. Unfortunately, these things are not really related to number of offspring any more. A genetic propensity for reliegous fundamentalism could well exist and would nowadays be correlated with more offspring, which is a worrying thought.

  41. #41 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  42. #42 Valhar2000
    June 2, 2006

    Children are able to inherit knowledge and behavior form their parents by learning it, and, as Llewelly said, they can inherit those things form anyone else the same way, although they are very unlikely to learn things from people or institutions far removed form their own environment.

    Any trait that can be inherited in any way can be subjected to natural selection, although in the case of learned behavior it would be acting to select the knowledge learned and the individuals ability to learn, rather than specific physical adaptations.

    Hence, it is reasonable to suppose that children do inherit Altieness from their parents and environment, and that Natural Selection may act to reduce the ability of these ideas to spread by reducing the population of the ones who spread (the parents who kill themselves by being stupid) and the population that is in a position to acquire these ideas (the children who are killed by their stupid parents).

    These arguments are however open to much criticism. It is likely that “stupidity” is a set of characteristics rather than a single one, and that therefore a person who is for many reasons considered smart may act stupidly in the sense of believing in Altie medicine, and may therefore overcome the disadvantage this gives them by their success in general.

    It is also possible that Altie medicine is really not that big a deal, that it does not kill very many people, are therefore has only a mild effect on the population in general, so there is no selection taking place.

    It is even possible that these people are actually breeding healthier humans by letting the members of their own population that are more prone to disease die (since most Altie treatments are essentially the same as no treatment at all, i.e., letting the immune system deal with it on it’s own). If that were the case, we might notice in coming decades that the people who are more likely to use Altie treatments are actually less likely to be sick.

    That would make us look silly…

  43. #43 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  44. #44 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  45. #45 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  46. #46 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  47. #47 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  48. #48 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  49. #49 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  50. #50 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  51. #51 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  52. #52 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  53. #53 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  54. #54 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  55. #55 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  56. #56 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  57. #57 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  58. #58 Sun&Sea
    June 2, 2006

    “A genetic propensity for religious fundamentalism could well exist…”

    Not my area of expertise, but IIRC twin studies show that religious belief is strongly heritable.

  59. #59 Samantha Vimes
    June 2, 2006

    I like Abel Pharmboy’s approach.

    When I needed dental surgery, I was scared of the idea of general anasthetic, and wanted to know if it could be done without it. The surgeon said he refused to work that way– too traumatic to the patients, and asked what bothered me about it. I explained I’d read of people unable to signal when anathestic wasn’t working on them.

    He explained that was with other types of surgery when a paralytic is given as well, which wouldn’t be the case. I also mentioned I tend to over-respond to some drugs. He told me there wasn’t enough in his entire supply to reach the LD50. (lethal dose in 50% of cases)

    Just plain good communication was all it took to quell my fears, and I think a lot of people are *terrified* when it comes to cancer, and chemotherapy, and need to be talked into believing 1) they have a decent chance of survival and 2) it’s going to be worth the discomfort.

    I would also point out that contrary to the usual assumption that teens think they are immortal, many teens are under a delusion they will be dead before they are 30. With a sort of myth/romance built around the youthful death, teens are not prepared to make huge decisions regarding their medical treatment.

  60. #60 Ruth
    June 2, 2006

    I used to work at a cancer center, I was always amazed at how well most kids delt with treatment. I still remember 2 boys racing down the hallway, using their infusion pumps on stands as scooters. Whatever the ultimate outcome, there was joy and life in that place.

  61. #61 Flex
    June 2, 2006

    Valhar2000 wrote,

    ‘we might notice in coming decades that the people who are more likely to use Altie treatments are actually less likely to be sick.’

    There are a few points in discussion here that should be looked at a little more closely.

    First, it is pretty clear that a great deal of the knowledge a person learns happens after birth. This is a pretty good indicator that whereas the sections of the brain may be genetically determined, the knowledge that fills that brain is not. This does not mean that genetics has no impact on the ability of someone to think, but that the influence is likely smaller than the influence of the enviroment. Stupidity, barring gross genetic and developmental defects, is probably at best weakly heritable.

    However, what the child experiances is heavily influenced by the parents, so ill-considered ideas that the parents have can be transmitted to children. The idea of socialization includes exposing the child to points of view which are not in agreement with the parent’s point of view. This, ideally, leads to the developing human considering these alternate points of view. At some point, which varies among cultures, the developing human is considered an adult and is allowed to direct their own lives.

    The immune system, so far as I recall from my reading, does not seem to have it’s responses coded into genes. Instead, it is an adaptive system with a very clever feedback system. You do not inherit immunities from your parents (or their ancestors).

    Finally, decades would not be enough to see any selection response in a human population through natural selection. As we are all aware, natural selection normally operates over dozens of generations. Considering the average human generation to be about 20 years, it has only been 100 generations since the time of Christ. It is not likely that any natural selection has operated on the human race within that time. (Other selection pressures, particularly sexual selection, can operate at a faster rate.)

    I like to think that since the discovery of alcohol the human race may, just may, have evolved slightly due to the introduction of wine and beer, about 500 generations. There has been little time to adapt to distillation, about 50 generations. And no time to adapt to soda pop, about 5 generations. So drink your beer!

    Cheers,

    -Flex

  62. #62 Greco
    June 2, 2006

    I’ll be a bit nitpicky here: vincristine is used in the MOPP regimen – it’s the “O” in the acronym after the commercial name Oncovin. ABVD uses vinblastin. Both are extracted from an African plant, the Madagascar periwinkle.

    As for MOPP – Mechlorethamine comes from mustard. Prednisone is a corticosteroid. And vincristine comes from another plant. It’s hard to be more “natural” than that.

  63. #63 SoCalGal
    June 2, 2006

    I was directed to this blog by a member of a health discussion board wherein I’m perceived by some as the resident “Altie basher.” But I’m not. I’m a staunch proponent of alternative medicine PROVIDED THAT it meets or exceeds minimum standards of rigorous scientific inquiry via randomized, double-blind, placebo-controlled studies for safety and efficacy of non-Official Medicine treatment modalities.

    There are a number of issues, however; one is that Big Pharma, by virtue of its size and power, rules the roost. Quite naturally, anything that cannot be synthesized and patented will not be pursued. Thus, there may very well be treatments, such as Gerson Therapy or Hoxsey Therapy (off the top of my head) that will be dismissed and/or ridiculed by Official Medicine and its handmaidens, the FDA, NIH, etc., because to recognize them would be anathema to Official Medicine’s interests.

    [quote] I think that the real question here, which Orac and others seem somewhat disingenuous in sidestepping, is whether regulatory agencies appointed by the government sometimes give preference to the interests of business over those of the public. In a society that assumes, as a guiding principle, that self-interest is the mainspring of human action, we must anticipate such a preference and acknowledge its existence.

    Does B17 (for example) cure cancer? Perhaps not, but if it did, the pharmaceutical industry would surely prefer to keep selling its products instead of buying natural products at the grocery store. Moreover, they have the resources to actualize their preferences. Is any fuel other than petroleum viable for powering vehicles? If there is, billions of dollars are invested against making such a thing public. These are the consequences of capitalism, and the result of popular belief in the premises of capitalism.

    Autonomy or altruism cannot be expected from the FDA, the WTO, the DOD, or any other agency whose decisions can make or lose billions of dollars. Furthermore, referring to such an idea as a “conspiracy theory” is naive and misleading; it’s not called a “conspiracy,” it’s called “corruption,” and it’s not a new thing. We know that military, government, and popular leaders in the past have sacrificed countless lives to maintain their power: is it reasonable to think that a corporation would choose not to use its economic influence to sway the decisions of the FDA, even if it meant that cancer patients kept dying? Would it be a logical inference to conclude that people in the FDA, who previously served in the pharmaceutical industry and still own shares, would prefer to see those companies thrive?

    The Sarbanes-Oxley Act only came about after dozens of high profile examples of corruption were made public. But, much of the corruption that the Act addressed was already known to exist. It was no secret that audit bureaus were making money from the companies they were supposed to be independently auditing; it was no secret that supposedly disinterested chairpersons held large amounts of stock in the companies they chaired for.

    Corruption exists, and it influences public policy. If something seems like a conflict of interest, it very well may be. Apparently, some people still believe that Dick Cheney has nothing to do with Halliburton’s no-bid contracts, and Orac is showing us why. The mendacious posturing undertaken by free market apologists is painful to watch, because it always ends up this way. “Oh, that’s just conspiracy talk”. Regardless of whether B17 cures cancer, our society would be well served by a little more critical thinking about the nature of those whose putative role is to serve us. [end quote]

    Let me state it a different way through a familiar fable.

    [quote] It seems there was this Emperor who wanted a magnificent new suit of clothes for a parade he was going to lead through town. The suit was to be constructed by the Royal Tailor and it had to be the best and most magnificent suit ever sewn. You can imagine the stress this placed on the poor tailor. If the suit was not the best ever constructed, the tailor would be blamed. The tailor knew that no matter how fine the garment, someone in the Emperor’s entourage would criticize the suit as not worthy of the Emperor. What was he to do? The plan he developed was risky but ingenious.

    The tailor decided to make no suit at all. Nothing. But he would tell everyone that the suit, invisible to all, was the most magnificent suit ever sewn. It contained all the finest linens, silk, and jewels befitting of an Emperor. The suit, truly, was magnificent. There was only one caveat. Only the chosen people could actually see the suit. The unworthy would see nothing. Since no member of the Emperor’s entourage wanted to appear unworthy, the tailor felt they would say nothing. He was right. The people in the street would say nothing because they feared the Emperor. If he said he was wearing the most magnificent suit ever sewn, so be it.

    On the day of the parade, the Emperor walked regally down the middle of the street in the town square. All his subjects ooooed and awwwed over his magnificent new suit. Such a suit, they said, was truly worthy of the Emperor. Well, almost everyone said this. As the Emperor passed one small child, the child pointed to the Emperor and yelled loudly, “The Emperor is walking down the street in his underwear!” The illusion of the magnificent suit quickly evaporated as all the people saw the truth: the Emperor was actually walking down the street in his boxer shorts. Only a small child, unencumbered by bias or a fear of the Emperor, could see the truth.

    Rumor has it, the tailor is still missing.

    What does this parable have to do with anything? Well, as far as high tech in general is concerned, it says a great deal. High tech companies in general, and Big Pharma and Biotech in particular, are very high on touting the sophisticated nature of their technologies and products. High tech is best and all that. There is only one problem. If you are in the telecommunications industry, it is certainly true that new technologies make our lives better and more convenient. Certainly, no one wants to go back to actually dialing telephones or depending on snail mail for all our communication needs. But medicines are different–very different. In truth, many of the modern medicines in development are either not necessary or they are vastly over-hyped as far as their effectiveness is concerned.

    Here are a number of examples. A large biotech company recently purchased another biotech company because the latter had a high tech anti-arthritis product on the market and the former company wanted to expand its product portfolio. This happens all the time. This was a multi-billion dollar transaction. Biotech people are highly impressed with themselves, their technologies and the big bucks they get for these prescription drugs. Arthritis drugs are highly desirable because they have to be taken forever. The drugs never really treat the disease–only the symptoms. This particular arthritis drug neutralizes an immune hormone called tumor necrosis factor alpha (TNF-alpha). This is a big word for a very important, yet highly inflammatory immune hormone that is directly involved in the pathogenesis of arthritis. Neutralizing TNF-alpha with a prescription drug sounds like a good idea, but it isn’t. It is better than a poke in the eye with a sharp stick, but doesn’t really deal with the factors that are actually causing the excessive release of TNF-alpha in the joints. If you could block the release of TNF-alpha, which this drug does NOT do, the treatment would be more effective and long term. Unfortunately, the term “long term effectiveness” is not part of the vocabulary of Big Pharma and their Biotech brethren. Short-term effectiveness is much more profitable. Another problem with this drug is that it has to be injected. Ouch! Do we have a more effective, less expensive alternative? Oh, yes.

    There is nothing mystical about inflammation of the joints. There is also nothing mystical about how to treat the inflammation. Aspirin, ibuprofen, acetaminophen and naproxen, all over the counter anti-inflammatory drugs, will reduce the symptoms of arthritis. In the form of a skin lotion, they will accomplish more than symptom relief. They will actually shut down the inflammatory stimuli that are response for releasing excessive amounts of inflammatory hormones, such as TNF-alpha, into the synovial tissues of the joints. These anti-inflammatory agents are not available in lotion form for only one reason. They are 10 to 100 times more potent than oral drugs when administered through the skin. There is also no stomach discomfort associated with a skin or topical delivery system, because these drugs never see the stomach. When 600 mg ibuprofen (Motrin, Advil) is taken orally, it is completely removed from the body in 24 hours. If a gel is made containing the same amount of ibuprofen, 99.5% of the drug is still found in the tissues after 24 hours. If you really want to get something into the body, and keep it there for a prolonged period of time, you introduce it through the skin. If ibuprofen, an important anti-arthritis drug, was available as a lotion with prescription, it would destroy not only the market for TNF-alpha inhibitors, but COX-2 inhibitors, such as Celebrex and Vioxx, as well. These are billion dollar drugs for Big Pharma. These people are not in business for love. They are not going to sell something just because it is effective and cheap, especially if it destroys, and we do mean destroys, the market for their high ticket (expensive) drugs. [Post-script: Ibuprofen has recently been implicated in a two-fold increase in risk of heart attack.]

    If you believe any of the ads on TV about the wonders of the drug of the moment, take it with a grain of salt. One more point. Natural, plant derived products more potent than aspirin and ibuprofen combined have been identified in the scientific literature for years.

    Here is another example. A recent report found 409 cancer drugs were in development in the US. Most of these drugs will fail. They will fail not because they don’t work. Some of them might work fine. This isn’t the point. They are expensive and in most cases unnecessary. Three of the most important anti-cancer compounds ever discovered are found in soy, green tea and chili peppers. Do you think this is a joke? It isn’t. Thousands of scientific papers have been published that investigated the anti-cancer properties of an almost endless array of natural products. Turning these natural anti-cancer compounds into prescription drugs is a problem. One of the problems is patentability. They aren’t patentable because the information has been in the public domain for a long time. It doesn’t make any difference if they work. The only consideration is control. Natural products, taken orally, might act to prevent cancer, but they are unlikely to shrink a tumor. If delivered by a route other than oral, their anti-cancer potency is enhanced. Since most of the world cannot afford health care, more and more of these natural products, formulated differently, are going to appear on the market. They are cheap and effective, especially when combined with other natural compounds. Wait and see.

    Since we are on a roll, consider the market for anti-HIV drugs. Protease inhibitors are the big drugs these days. The idea behind these drugs is simple. If a drug inhibits the protease or enzyme associated with processing viral proteins as soon as they are synthesized in the infected cell, the viral particles released by the treated cells will be not be infectious. Simple logic and totally wrong. Under normal conditions, only one viral particle out of 60,000 is actually infectious. So inhibiting the HIV protease with drugs makes no sense. On the other hand, HIV protease inhibitors actually do decrease the amount of viral RNA in the blood. How can this be? If protease inhibitors behaved as advertised, viral particles would still be released from infected cells but they would NOT be infectious. Each viral particle would still contain the HIV RNA, so the level of viral RNA in the blood should not go down. It really shouldn’t change at all. But it does. These protease inhibitors can decrease the level of HIV RNA in the blood to almost undetectable levels. What is going on? It turns out that these anti-HIV enzyme inhibitors are also inhibiting cellular enzymes that have nothing to do with the HIV virus. One such enzyme is the chymotrypsin associated with the proteasome complex in infected cells. This complex of enzymes is responsible for breaking down highly unstable signal proteins involved in cell cycle control and the activation of numerous genes. When the proteasome is inhibited, infected cells die by apoptosis or programmed cell death. This is good. If programmed cell death does not occur, the infected cells might remain intact but they will not produce virus. The HIV gene is turned off. This sounds like a winning combination of effects, but it is dangerous if pursued long term. These drugs turn off the proteasome in all tissues–not just HIV infected cells. This can be deadly. So, the HIV virus may be turned off, but the patient will die of something else. There is one more problem with these drugs. The drugs are expensive and difficult to take orally. Natural polyphenols in green tea are more effective proteasome inhibitors and they don’t cost anything. These polyphenols also have many other beneficial effects in the body beside inhibiting the chymotrypsin enzyme associate with the proteasome. If we recall correctly, green tea is still in plentiful supply, and it has no known toxicity of any kind. Why doesn’t HIV infected people know about this? For the same reason arthritis suffers don’t know about topical aspirin. Money.

    Our favorite biotech company was called Shaman Pharmaceuticals. It is now known as Shaman Botanicals. They had an interesting business model. They raised and wasted over a $100 million searching for anti-HIV and other drug candidates in the rain forest. This isn’t necessarily a bad idea, especially if you ever saw the movie “Medicine Man.” Here is the problem. There have been thousands of scientific studies conducted on the medicinal properties of natural products. One recent review article listed over 25 different natural plant products that could suppress the synthesis of the HIV virus in a laboratory cell culture. This doesn’t mean these compounds would do the same in the body, especially if they, the plant extracts, had to be orally consumed. Shaman found a product that helped curb the diarrhea associated with AIDS. The FDA turned it down as a prescription drug. Shaman was looking for something they could patent, something unique that they could turn into a prescription drug. This was a mistake. Thousands of important anti-disease botanicals have already been identified, but they cannot be patented because the research was conducted by non-profit organizations that did not file patents. Biotech and pharmaceuticals are ONLY interested in products they can patent and control. Their business models do not contain a section entitled “Acting in the public interest.” These are commercial companies that have to make money for their investors. The FDA review process for drugs is an expensive, time consuming nightmare. Shaman should have formulated these products into proprietary blends and marketed them as herbal health products, which, we might add, is exactly what they are doing now. One hundred million dollars down the toilet for nothing. Live and learn. We wish them the best. They are now on the right track.

    What has all this got to do with a naked Emperor? It is all about perception. Big Pharma is selling itself to the consumer and to its investors as “keepers of the flame of health” and this simply isn’t true. Many of their products will fail because consumers will find something better, and less expensive. There is nothing written in the stars that says only expensive, prescription drugs are effective. Remember, 30% of the drugs on the market today evolved from natural products. Virtually all the prescription cholesterol lowering drugs on the market are synthetic copies of compounds first isolated from certain strains of fungi. The public does not understand that there is a wealth of information published in scientific studies on the power of these natural products. Scientists publish their studies for review by their colleagues around the world. They do not attempt to convey this information to the public. This isn’t their job. If a natural medicinal product is effective against a particular disease, this is great news, but it doesn’t mean the natural product is ever going to be turned into a real medicine. So, what is the alternative? Educate the public about these products and their health benefits. The Internet is the great leveler in this respect.

    So the next time you see some pharmaceutical company “strutting their stuff” about some great new product they just invented, keep in mind that God and/or Mother Nature was probably already there first. If you look carefully, Big Pharma doesn’t have any pants on. They just think they do. So sad. [end quote]

  64. #64 Orac
    June 3, 2006

    Thus, there may very well be treatments, such as Gerson Therapy or Hoxsey Therapy (off the top of my head) that will be dismissed and/or ridiculed by Official Medicine and its handmaidens, the FDA, NIH, etc., because to recognize them would be anathema to Official Medicine’s interests.

    No, the Hoxsey and Gerson therapies are not taken seriously because the evidence does not support their efficacy and because they are biologically implausible based on what we know about cancer. It has little or nothing to do with “official medicine’s interests” (whatever they are) or the nefarious machinations of big pharma.

    ]I think that the real question here, which Orac and others seem somewhat disingenuous in sidestepping, is whether regulatory agencies appointed by the government sometimes give preference to the interests of business over those of the public. In a society that assumes, as a guiding principle, that self-interest is the mainspring of human action, we must anticipate such a preference and acknowledge its existence.

    What you quote is made up of such a massive straw man argument that I hardly feel inclined to address each and every little point. Nowhere have I assumed or stated that pharmaceutical companies are altruistic or that the government is always right. Nowhere have I argued that business or government do not act in their own self-interest. Indeed, I’m deeply suspicious of government power. However, in the cases I discuss, because they are so clear-cut, I’m reluctantly coming down on the side of the government.

    The rest of the quoted rant is nothing more than one big red herring. Let’s put it this way: OK, fine, big pharma is in it for profit and can’t always be trusted to do the right thing or act in the public interest. Yada yada yada. You win. Big pharma is self-interested and out for money. Ranting on and on about that is certainly easy and certainly gets the old populist juices flowing, particularly the cleverly played mention of Dick Cheney and Haliburton. Ditto going on about how many of today’s drugs were derived from natural products (something I’ve actually pointed out many times in the past).

    It also entirely misses my point about Katie and Abraham. It’s clearly nothing more than a distraction from the real question.

    No, the real question in these particular cases that I wrote about is, the question that such ranting conveniently sidesteps is: Which does better curing Hodgkins’ disease? The evidence-based answer is unequivocably “conventional medicine.” Not the Hoxsey treatment. Not the Gerson treatment. Not any alternative medical treatment that I am aware of. None of them can come close to the 85+% cure rate in childhood Hodgkins disease that conventional medicine can. In fact, none of them that I’m aware of can cure or slow down the course of Hodgkin’s disease at all. Given that stark fact, refusing to provide conventional care to these children and choosing instead treatments that are not capable of doing even close to as well as conventional treatments is no different in my mind than a Jehovah’s Witness refusing to let doctors transfuse his child as he is bleeding to death from trauma. It’s child abuse. Even if every point in the above rant were absolutely true and justified, even if, as the rant says, big pharma “has no clothes,” the machinations of big pharma and the government would still be entirely irrelevant to my simple point that there is no good evidence for the Hoxsey treatment in treating Hodgkins’ Disease and that the promises of alternative medicine are luring two young and eminently savable patients away from treatments that have been proven to be very efficacious in curing their disease.

    Really, if you’re considered an “altie-basher” on the discussion group to which you refer, I’d really hate to see what the alties there look like. Or maybe I have seen what they look like there. You wouldn’t happen to be referring to misc.health.alternative, would you? I haven’t checked in there in several weeks. Perhaps it’s time I paid a visit to my old stomping grounds.

  65. #65 Laura
    June 3, 2006

    Orac,
    Great responce.

    In doing some searches regarding the topical NSAID’s for arthritis as well as green tea as a proteasome inhibitor I came across what appears to be SoCalGal’s source. If you want to check it out it is the Grouppe Kurosawa Society. Written by Stephen Martin, PHD in the essays section. I believe it is where the quotes came from as well as the story of the Emperor’s New Suit. Check it out if you are interested.

  66. #66 Laura
    June 3, 2006

    SoCalGal,

    I did some research into topical NSAID creams and they do not demonstrate superior effectiveness compared to oral NSAIDS. Initially they subjects reported improvement but after two weeks it was determined to be due to massaging the area, and expectation of improvement (placebo effect). It was also determined that mentholated gels outperformed unmentholated products which could also play a role.

    You also mention that using a cream is superior because it eliminates som the side effects. However people who are sensitive to NSAID’s still cannot use it safely because even transdermally it does reach the bloodstream. In fact a patient suffered renal failure after being treated once with an Ibuprophen cream proving the drug still has systemic effects.

    You seem to put a lot of weight on TNFs role in arthritis but it is not the cause of ALL arthritis. I did not see any evidence to support your belief that an NSAID cream would stop TNF in RA not to mention many people who are on TNF blockers still use NSAID’s for additional symptom relief. I know quite a few people with RA who would pay anything to stop their pain I do not see why it would not be in Big Pharma’s best interest to not investigate this further. I think it is because they have not found an effective formulation to transmit the medication into the joints that can withstand double blind trials.

  67. #67 Abel PharmBoy
    June 3, 2006

    anjou: I think I will wait until the move to be with my colleague, Orac, at ScienceBlogs before I do my diatribe on natural sources of medicine – whether it’s synthetic, semi-synthetic, or completely natural should not matter scientifically, but I have learned that it does matter to some emotionally.

    Samantha Vimes: Great anecdote; communication is key. Unfortunately, docs, nurses, mid-levels aren’t allowed enough time with patients to do so properly. That’s why I, even as a basic scientist, am trying to work on being more concise.

    Greco: Yes, MOPP is still used, but ABVD is the regiment of choice according to NCCN. I also have to note a discrepancy in the crediting of mechlorethamine: it is not natural, being derived instead from mustard gas, an internationally banned chemical weapon. It had been observed that the lymphatic tissues were obliterated in soldiers exposed to mustard gas. Replacement of the sulfur atom with the less reactive (less electron-withdrawing) made a more stable agent called nitrogen mustard that crosslinks DNA. You can read more in the Wikipedia entry. No big deal that it’s not natural, I just worry about my “natural” argument being overinterpreted.

  68. #68 Orac
    June 4, 2006

    Abel,

    Of course one famous example of a chemotherapy agent that is from a natural source is Taxol. It comes from the bark of the Pacific Yew tree, if I recall correctly. (Yes, it’s relevant to my specialty, which is why I like to bring it up.)

  69. #69 anjou
    June 4, 2006

    Hi Abel–Im certain you can get the point across better than I can since Im not a scientist!! Ive brought up the sources of vincristine many times, even had B calculate out how much yew bark someone would have to eat to treat… I’ll accept that maybe it helps some of the more rational folks emotionally, but….there are those who will forever see this as a black white split…

  70. #70 anjou
    June 4, 2006

    addendum: not that eating the bark would really treat–it was a very hypothetical example that did get a point across that some were quite struck by…

  71. #71 Abel PharmBoy
    June 4, 2006

    Brother ‘Rac and anjou: Yes, I love the Taxol example as well. In fact, I use the “why don’t we just chew on yew bark?” question as a teaching tool for the public about issues of bioavailability (Taxol would lack oral bioavailability), lack of potency of most herbal medicines (you couldn’t eat enough bark to get a systemic dose of Taxol even if it was orally bioavailable), and reproducibility of dosing (how would you know how much bark to use next time since content varies depending on location and time of harvest).

    Serendipitously, I can also comment on Laura’s comment above after seeing a seminar this week from Orac’s scientific hero, Judah Folkman. Among the many things I learned is that we have high levels of the angiogenesis inhibitor, endostatin, in our synovial fluid that minimizes vascularization of cartilage. It is when endostatin levels drop (reason unknown) that blood vessels start to sprout into cartilage, carrying cytokine-releasing cells that cause inflammation and degradation. Folkman has several examples where angiogenesis/anti-angiogenesis may play a role in about a dozen diseases besides cancer.

  72. #72 Andrew Dodds
    June 5, 2006

    Flex – IIRC, there are significant differences between caucasian populations and chinese populations in regards to (genetic) alcohol sensitivity. This appears to be because whilst the Chinese developed tea as a way of producing sterilised and safe drinking water, the Caucasians developed fermentation for the same purpose. Unsafe drinking water being a HUGE problem as soon as you start to develop civilisation.

    SoCalGal-

    Looks like you forgot to provide sources.

    http://www.ephilosopher.com/bb-print-87-15.html
    (search for ‘ILoveToSkiFast’ on the page)

    I think we have a new entry for ‘what-is-an-altie’ – If you think that making a large number of bad arguments makes a stronger case than a small number of good arguments, you might just be an altie.

    It isn’t very surprising that plants contain anti-cancer chemicals; they have being fighting a biochemical war against the world’s animals for approximately 300 million years (land plants, anyway..) and have hence evolved chemicals that probably interfere with virtually every biochemical pathway that exists. Hence it is very likely that there are chemicals out there that interfere with those chemical pathways crucial to the survival and proliferation of cancer cells.

    However, this does NOT mean that ‘natural is best’. First, the compound in question will only fight cancer as a secondary effect to it’s primary purpose (killing an insect that feeds on the plant, for instance). Hence a synthetic derivitive may be far more effective. Second, the compound may be too unstable in vivo, so again a synthetic derivitive will be more successful. Thirdly, useful dose ranges (between ‘ no effect’ and ‘killing the patient’) may be quite narrow, making direct consumption of leaves/bark/etc either ineffective or highly dangerous or both.

    In short, the ‘big pharma’ versions of these ‘natural’ drugs are going to be more effective. That does not mean that all information from these companies should be taken uncritically at face value – you should always look closely and critically at the real data supporting the claims made. However, at least this is possible. With alternative ‘cures’, all you get is the marketing.

  73. #73 Spike
    June 5, 2006

    I’m with Abel PharmBoy in educating everyone, the so-called “Alties” and you “Allos” as well, about the origins of most medicines. To paraphrase, today’s medicines were yesterdays alternative cures. And, to be sure, they came to be so through testing and peer review (in spite of the efforts of the FDA).

    Andrew Dodd makes a good point, but forgets that there are many small companies that perform rigorous tests and seek peer review. What keeps their product off the market is not that it’s ineffective, but that the companies often don’t have the capital to finance the complete battery of tests the FDA would call for (and big pharma can cover easily). The patients who were part of our clinical studies were helped by our product. They were helped better than the currently marketed drugs. But the treatment would be considered “alternative” because it’s not widely known.

    I’m talking about the PROSORBA(R) Column, developed by Cypress Bioscience and currently manufactured by Fresenious HemoCare. It is an “alternative” to drug therapy for the treatment of Rheumatoid Arthritis. It is an “alternative” treatment, because rather than altering the patient’s chemistry, Immunoglobulin G is removed from the blood by a kind of filtering process.

    In many ways, this therapy has all the hallmarks of “quack” medicine: The blood is taken out and treated in a column filled with “dirt” (actually diatomaceous earth) and the excretions of special bacteria (Staph. aureous). Then the blood is put back into the patient’s body. The patient has to forgo their regular treatment for some time before they can start the PROSORBA treatment, and they have to go through six sessions before they see any results.

    The best evidence I have for how this treatment helps improve patients’ lives is anecdotal: One of our patients was taking DMARDs, but because of the side effects was told she should not have children. She quit the DMARDs and used our treatment instead. Because her symptons were in abeyance long enough, she was able to have a perfectly healthy baby.

    Why is this not the preferred method for treating RA? Why does Enbrel(R) get all the glory? Two important reasons: 1)Drugs are easier to take than sitting through six apheresis sessions. 2) Amgen has more marketing money.

    My point? Not everything that’s out of the mainstream is “altie.” Each treatment should be judged on its own merits.

  74. #74 epador
    June 6, 2006

    I believe the Prosorba treatment unpopularity has nothing to do with Amgen – its been around for a LONG time, well before the explosion of “ibibs” hit about a decade ago. It is difficult, expensive, has significant risks of its own (some rare, some common), and the mechanism of action may not be from the “removal” of immunoglobin or immunoglobin complexes, but by other effects of the treatment on the immune modulating system.

    But it does work for this and other situations for some patients. If it were as simple to perform as DMARDs, it might be more popular. But its not. So it stands as an alternative but acceptable treatment. Nothing remarkable about that.

    It has also been tried in cancer treatments, with less success.

  75. #75 Andrew Dodds
    June 6, 2006

    Spike –

    Actually, your description shows exactly why mainstream treatments are better.

    Diatomaceous earth will by its nature absorb a lot of things from the blood; indeed, it’s not something I’d go near for that reason. So there is no way of knowing if it works for the reason given, or because of some other mechanism. If this mechanism were actually discovered through rigorous research, it is quite possible that a safer and less invasive way could be found to reproduce it, quite possibley in conjunction with existing treatment, therefore benefitting all patients.

  76. #76 David Harmon
    June 6, 2006

    [ Parents killing their kids is still evolution in action -- it's still their genes, reassorted. ]

    llewelly: You miss the point. No-one has offered evidence the behavior – killing the children via ‘Altie’ idiocy – is the result of heritable characteristics. If it isn’t in the genes, the fact that ‘it’s still their genes, reassorted’ is irrelevant.

    Not really. The thing is, we talk about selection being “for” this or that trait, but that’s usually an after-the-fact interpretation of observed trends. In practice, evolution is a matter of constant “sliding” toward an “ultimate bottom line” — which is long-term survival for the lineage rather than the individual. Anything in the short-term, such as means or ends, has relevance only insofar as it affects the long-term. To tweak an old line, “whatever gets you through the fight, that’s alright…”

    Now, this is even weirder than it sounds, and has some non-obvious consequences. One of those is that any heritable factor which is found in the event to be correlated with “survival”, will gain or lose by selection, exactly according to that correlation.

    And yes, sometimes that means arbitrary traits get fixed into a population by “chance”, because their bearers happened to be the survivors. (q.v. “founder effect”) But it also means that if there is some heritable factor making parents kill off their kids, evolution will eventually find it, “by experiment”. It also means that evolution, as an “automatic” process, is unconcerned with how or why they’re doing so. BUT: If the parents in question gain “secondary benefits” by their action, that’s another issue entirely. The classic case here is an animal that resorbs its pregnancy because of poor food prospects. It may miss the current breeding cycle, but next cycle, it’ll be in better shape than peers who pushed the odds.

  77. #77 Orac
    July 22, 2006

    Because of how old this post is, comments are now closed. If you wish to comment on the Starchild Abraham Cherrix case, please go to my latest post on the story.

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