Respectful Insolence

If there’s one thing that gets my blood boiling almost above all else when it comes to quackery, it’s when parents subject children to it. The result has been copious blogging about cases, such as that of Daniel Hauser, Katie Wernecke, and Abraham Cherrix, all of whom refused chemotherapy for treatable cancers. I’ve also discussed Madeline Neumann, a 12-year-old girl whose parents, based on their religion, allowed her to die of diabetic ketoacidosis rather than save her life by allowing physicians to administer insulin and fluids. They thought prayer would save her. It didn’t.

The following story is like these, but, I must admit, although it follows the template of the stories above, it is in a situation where I’ve never seen parents refuse science-based medicine before. The story takes place in Philadelphia, at Thomas Jefferson University Hospital, and it involves a most unfortunate 16-year-old wrestler named Mazeratti Mitchell, who suffered a spinal cord injury while wrestling:

Clearly, Mazeratti’s mother loves him. She comes across as a caring, committed mother. Unfortunately, she is (mostly) wrong. In fact, she’s so wrong that she’s risking her son’s recovery. The situation is described in a recent news story:

Lying stock-still in a bed Friday at Thomas Jefferson University Hospital, his neck and chin gripped in a rigid plastic collar, 16-year-old Mazeratti Mitchell could barely move his jaw.

But the Boothwyn teenager, whose spine was severely injured in a high school wrestling accident Tuesday, smiled faintly as he spoke of the escalating battle between his mother, an herbal healer, and mainstream medicine over his care.

“One of the doctors said I needed surgery because I’d be paralyzed the rest of my life if I moved my head just a millimeter,” he murmured, then lifted his left arm about three inches and wiggled his fingers. “I’m OK.”

He was taken to Jefferson after butting heads at practice with another wrestler at Chichester High School in Delaware County. He had fallen to the floor, unable to move for several minutes.

The hospital has wanted to secure his bruised spine with pins and plates while it mends. Vermell Mitchell, a naturopath who goes by the title “Dr. Mitchell,” is fighting to have her son released so she can heal him with herbal remedies, such as liquid chlorophyll and a compound she calls “Super Trio.”

Mitchell is also resisting giving her son steroids. In all fairness, I’ll give that one to her, because, quite frankly, the evidence supporting the routine use of steroids in spinal trauma is, at best, weak to nonexistent. I don’t know whether there is a specific clinical indication for proposing the use of steroids for Mazeratti other than the fact that he has a spinal cord injury, but I’d actually oppose using steroids in him if he were my son unless there were a specific indication for their use. On the other hand, using plates and pins to stabilize his spine to prevent reinjury, with the potential for permanent quadriplegia as a result, is a science-based modality. As long as the boy’s spine is not stabilized, there is the potential for disaster. What’s even worse, Vermell Mitchell is interfering with her son’s recovery for the simple reason that he can’t be mobilized properly until his spine is stabilized.

By way of background, Vermell Mitchell’s degree in naturopathy was obtained from the Trinity School of Natural Healing in Warsaw, IN. If you want to get an idea of the woo that is taught there, just peruse the school’s website. Trinity offers courses leading to a the M.I. degree (Master of Iridology, but the woo would probably give me an M.I. if I were forced to take these classes), a doctor of naturopathy (the “discipline” for which no quackery is too bizarre), a certified health specialist (sort of a “naturopath lite”), and, of course, an associate degree in Bible studies. What the last of these has to do with health, I have no idea, but it’s a degree offered by Trinity. Perusing the curriculum for naturopathy, I’m amazed at the amount of sheer quackery packed into so little time, including homeopathy, reflexology, applied kinesiology, live blood cell analysis, “enzyme health,” and aromatherapy. In particular, I like the course on medical-legal issues:

Course: SNH389 Medical Jurisprudence

Description: This course outlines the legal responsibilities and restrictions the student must be aware of to protect himself/herself and act legally in the natural health field. The student will learn how to use proper terminology in communicating and interacting with others and how to educate others in the natural health field

Yep, when you’re practicing quackery, you do need to know the law.

So what does Vermell Mitchell propose to use on her son instead of accepted science-based surgery for spinal cord injury? This:

If Delaware County Court orders the teen turned over to his parents’ care, Vermell Mitchell said, she will use an herbal remedy known as “I.F. Relief” that “draws out inflammation.”

She also plans to use another compound she calls “P” because “its name is so long I can’t remember it.” It will, she said, help her son’s spine to “fuse.”

Hmmmm. I wonder what a patient of mine would say if I proposed using a medicine and said I call it “P” because its name is so long that I can’t remember it. It wouldn’t exactly inspire confidence in me. Yet somehow Mitchell gets people to let her give them whatever herbal woo she wants to give them even though she can’t be bothered to remember the name of the herbs. Nice work if you can get it. In any case, here’s I.F. Relief, and here’s what’s in it:

IF Relief contains a combination of herbal extracts that may support the body’s natural process for muscle pain and inflammation relief following exercise and massage. IF Relief contains compounds that may help the body achieve homeostasis. This formula has a very high ORAC value.

Noooooooo! Don’t abuse the Orac! Or ORAC! Or whatever. In any case, this Plexiglass box of blinking multicolored lights doesn’t want to be associated with woo like I.F. Relief. Orac does not like it. No, precioussssss, he does not!

Sorry about that. It’s the influence of the Dark Lords of Pharma.

These cases are always difficult, particularly when the child is a teenager approaching adulthood. When the child is young, it’s easy. Although a competent adult has the right to do with his or her body what he or she wishes. That means choosing one’s own therapies and even refusing potentially life-saving interventions. However, when the child is clearly too young to be able to understand the ramifications of his decisions, he relies on his parents to look out for his best interests. However, that does not mean that the parents have carte blanche to choose therapies that endanger his life, even if the child agrees–or even enthusiastically wants such therapies. The problem, as I’ve pointed out before, comes in when the child is a teenager who is within a couple of years of being legally an adult. Such people are no longer truly children, but they aren’t quite adults, either. As such, they have opinions, and those opinions are not as easily dismissed as those of younger children.

That’s why, although I’m happy to see this decision handed down yesterday, as was true in the case of Abraham Cherrix, I’m ambivalent about it:

Delaware County child welfare officials will keep temporary custody of a 16-year-old Chichester High School student who suffered a spinal injury during wrestling practice last week, a county official said.

Treatment for the injured teenager, Mazeratti Mitchell, could be delayed until Thursday while the boy’s parents seek additional medical advice, said county solicitor John McBlain. Doctors testified at a closed hearing in Delaware County court Monday that they believed the teen would remain stable through Thursday, McBlain said.

But Judge Mary Alice Brennan could also decide to rule on the boy’s treatment at any time, McBlain said.

Delaware County’s office of Children and Youth Services placed Mazeratti Mitchell in protective custody last week after his parents refused treatment suggested by doctors at Thomas Jefferson University Hospital.

These decisions are never easy. No one, least of all a judge, wants to abrogate a parent’s rights. We’ve seen this time and time again, even to the point of children suffering. In this case, the judge appears to have done the right thing. There is no good scientific evidence that herbs can heal a damaged spinal cord as Vermell Mitchell claims that they can, while there is evidence that stabilizing the spine surgically can prevent a damaged spinal cord from being reinjured by normal movement and thus allow the spinal cord an opportunity to heal. By denying Mazeratti the surgery that will stabilize his spine, as much as Vermell might love her son, she is risking grave harm to him.

Such is the price of belief in quackery.

Comments

  1. #1 skybluskyblue
    February 8, 2011

    Outrageous! What is wrong with surgery for
    “doctors of naturopathy ” ? If a person had an arrow tip in them, didn’t the ancient “healers” pry it out? I thought that it was “big pharma”[artificial chemicals!] who were the evil ones. Yikes.

  2. #2 jens
    February 8, 2011

    In Norway, child welfare would take custody of this kid, treat him and than give custody back to the caregivers.

  3. #3 Noadi
    February 8, 2011

    Really awful case. I think the judge made the right call. 16 is old enough for his wishes to be considered in treatment but not when it’s clear he doesn’t fully understand the consequences.

    For that matter, I’d question an adult’s competency if they refused to have a spinal injury stabilized in favor of herbal remedies. This isn’t an ambiguous case, its equivalent to having a broken arm and refusing to have the bone set and a cast put on.

  4. #4 Endless_Psych
    February 8, 2011

    A 16 year old is most certainly able to make their own decisions! In the UK they can work, get married and legally procreate at such age (and on the Isle of Man can vote).

    Below 16 we also have Gillick Competence: http://www.nspcc.org.uk/inform/research/questions/gillick_wda61289.html

    “…whether or not a child is capable of giving the necessary consent will depend on the child’s maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment proposed, so the consent, if given, can be properly and fairly described as true consent.”

    Which might be a double edged sword (there have been cases where Jehovahs witnesses (IIRC) have refused blood transfusions) but better than the situation above.

    A 16 year old is not a child.

  5. #5 sharon
    February 8, 2011

    Parents in Australia were recently jailed for treating their child Gloria Sam, 9 months old, homeopathically for a skin disease which eventually killed her.

  6. #6 Christophe Thill
    February 8, 2011

    I don’t know if she already was a naturopath when she named her kid Mazeratti. But clearly, something was already not quite right.

  7. #7 KittyB
    February 8, 2011

    she can love her child all she likes, but love and a belief in naturopathy isn’t going to stop her kid from becoming paralysed.
    Seriously, some people need a smack upside their head.

  8. #8 Cerise
    February 8, 2011

    A 16 year old though near adulthood probably doesn’t understand the concept of paralysed forever. It’s not ruling in favour of the doctors or the parents but what is best for the child. I was relieved the parents Sharon mentioned were jailed just as it was heartening to read another judge had overruled a mothers decision not to vaccinate her daughter (the father wanted her vaccinated). If these parents can’t see how they’re potentially placing their children in danger then let others decide for them.

  9. #9 Astrid
    February 8, 2011

    In the Netherlands, 16 is old enough to make your own medical decisions without parental consent. The nature of the decision cannot get you declared incompetent, just your inability to understand the information given, consequences of your decision, etc. I think here Ms. Mitchell and her son would’ve been able to go ahead with their quak treatment.

  10. #10 DLC
    February 8, 2011

    Somehow, I just want to take that mother by the shoulders and shake some damn sense into her. Ignorance is becoming the way of life in America, a nation which is rapidly descending toward Idiocracy.

  11. #11 Caudoviral
    February 8, 2011

    Ugh…I had no idea that the natural health movement was also trying to step into the orthopedic and surgical realm. Their ideas concerning pharmacology…they’re wrong, but at least “eat this herb” and “take this pill” sound a little similar. But “eat this herb and it fixes broken bones” is something more fit for a D&D game than you or your child’s health.

  12. #12 Beamup
    February 8, 2011

    I’m not sure I like saying this, but who will pay for his long-term care if he does become a quadriplegic? If the answer is Medicaid (as I somehow suspect, since it seems unlikely that a naturopath has real health insurance), then I’d conclude that there’s enough of a public interest in the outcome to override their wishes.

  13. #13 Pablo
    February 8, 2011

    1). Who cares how old tge child is? This quack has no business treating anyone for anything! How can this loon claim to be a health care provider? How can they claim to treat something with n nothingness? The court cannot take that claim seriously at all.

    2). What are the ethics of a doctor treating their own. Child? Let’s assume it is not quackery: if a doctor refused to have their child treated at a hospital because they “wanted to treat him themself” whow would that be treated?

  14. #14 Sam C
    February 8, 2011

    It’s always tricky when people need to be protected from themselves. It’s possible that the lad at this stage might respect his mother’s opinion enough to follow it, believing her lies about its efficacy. But I can imagine him feeling very, very annoyed at the age of 25 (say) when he’s stuck in a wheelchair, shouting angrily at the (real) doctors and judges “you knew this was nonsense, why didn’t you help me and stop my insane mother? Why did you just walk away and let me get into this mess?”.

    So when does a duty of care trump a right/freedom?

    I think there’s a difference between shrugging shoulders and saying “ok, take that silly pill if you want to, it probably won’t do much harm” and “ok, if you’re stupid enough to wreck your entire life, so be it”.

    If a person is walking blindly towards a cliff edge, I don’t think it’s naughty to rugby tackle them to stop them walking over, even if that would lead to an assault charge in most other circumstances. (Not a good example, but the best I could do!)

    It ain’t easy. Just to be clear, I certainly don’t advocate any procedures on the lad without his informed consent. But his mother should be under the same strictures as real doctors if she is acting as if she were one.

  15. #15 Sandir
    February 8, 2011

    Judge not lest thou be judged.

    Let he amongst you who has not sinned, cast the first stone.

    I wonder who will cast the next?

    Life Lives. Mothers care for their children in the best way they know how. Go take a look in the mirror and see your own soul and your own righteousness before you condemn any one else.

    Peace to the people. Bless them and may the Light of Love & Good blessings shine upon them.

    Send them love ~ and love yourself first.

    Please forgive and try to understand; all people are made differently. Even you. There are some that would condemn you for the words or actions you may feel to be correct. Send love only, never judge.

    Peace, Sandir.

  16. #16 plutosdad
    February 8, 2011

    I don’t get it, even if her compound could reduce inflammation, what does that have to do with preventing a more serious injury? It’s the same as taking vitamin D and calcium for a broken bone, some people think it helps, but it doesn’t mean you don’t set the bone!

    You’d think that, because this is a “physical” problem, i.e. the spinal cord could be severed unless they immobilize the vertebrae, it would be easy to understand. This is not “herd immunity” or germs that you can’t see, this is something people without any science training at all should be able to understand.

  17. #17 Vicki
    February 8, 2011

    Sandir–

    Nobody is casting stones. There is no suggestion that the patient’s mother is trying to harm him, or that she should be punished. The desire not to judge in that sense–to censure or punish–doesn’t mean we don’t judge in the sense of evaluating. I can look at someone and say “you’re drunk, please give me your car keys. Would you like to sleep on the couch, or should I call a cab?” without thinking they are evil or destructive.

    The fact is, with the best will in the world, the mother’s approach could do her son real, lasting damage. Standing back and saying “judge not”: what do you say if that 16-year-old comes to you later and says “why didn’t you at least try to protect me?” Would you find it sufficient to tell him that he cannot judge you because he is not without sin?

  18. #18 Anglachel the Common Sense Pagan
    February 8, 2011

    The stupid doesn’t just burn here!! It stinks to high heaven!!! Do none of these people have common sense?!?! Even at that age, at the beginnings of my decision to become pagan I knew better than expect the magic herbs to heal BROKEN BONES!!! I think requirements should be tightened for people to be able to call themselves a doctor, and we need to filter out such folks!! This boy could end up paralyzed for the rest of his life and for what?!

    Reminds me of the old faith healers. When you didn’t get better it was of course, your fault. You didn’t believe enough, pray hard enough, were sinful, etc. What happens when the herbs don’t work, and it becomes to late? I think the court did the right thing here. The kid is still a minor, and obviously doesn’t not know what is best for him. As for the mother, somebody smack her, shake her, SOMETHING!!! Make that woman see COMMON SENSE!!!!

    My mom, who is Christian use to tell me something. She said that people who pray for cures while neglecting medical advice and treatment are contrary to God. For He is up there, ringing his hands, saying “I gave you DOCTORS!!!! What else do you want!!”

  19. #19 Agent Smith
    February 8, 2011

    Are you part of some sort of cult, Sandir?

    Also, you might be interested to know that Christ never muttered that “cast the first stone” John 8:7 line, it is a interpolation that has origins in the 4th/5th century.

  20. #20 Beamup
    February 8, 2011

    You all look alike to me.

  21. #21 Beamup
    February 8, 2011

    Urgh, quote fail. Should have been “you all look the same to me.”

  22. #22 WLU
    February 8, 2011

    Hey Sandir:

    Neither God nor love heals people, doctors and the activity of their own bodies do. If believing in magic and wishing really hard worked as medical treatments, we wouldn’t need modern medicine. I can only hope that as time goes by, all the people who think superstition is better than evidence eventually die out through natural selection. I only wish heaven existed so I could gloat from it…

    And this news story is what happens when you treat self-limiting injuries with worthless nostroms and think the result is due to your own actions. Lady, a broken spine is not a cold.

  23. #23 Calli Arcale
    February 8, 2011

    Wow; this is the first I’ve heard of an alt med practitioner refusing surgery for trauma. I mean, even the Christian Scientists will tolerate bonesetting, and they’re among the wackiest of the faith healing set.

    Herbs to cure a broken spine? Jeez! There has got to be a significant element of denial involved. I feel for this family; this is a potentially life-altering injury, even in the best of circumstances.

    plutosdad:

    I don’t get it, even if her compound could reduce inflammation, what does that have to do with preventing a more serious injury? It’s the same as taking vitamin D and calcium for a broken bone, some people think it helps, but it doesn’t mean you don’t set the bone!

    Pretty much. She must not grasp the severity of the injury. My mom’s taking vitamin D and calcium for a broken bone, but she’s *also* got it in a cast (and is crossing her fingers that when the orthopedist looks at it again in a couple of weeks, it has healed enough that she can avoid getting a plate).

    Sad story, all in all.

  24. #24 Mary
    February 8, 2011

    OMG, It’s Homeopathic A&E. But for real. Sigh.

  25. #25 Scott Cunningham
    February 8, 2011

    Boy, Sandir, you couldn’t have chosen a worse place to say gibberish. Reminds me of that Far Side joke about a chiken tied to a red baloon drifting into a samauri bar.

    Mothers care for their children in the best way they know how.

    Yup. That’s why in my neighbourhood, moms start their kids on boozing and stealing clothes from the laundromat from an early age. Its the best they know how. Granted, community standards stink, but hey, let’s not judge. They teach ‘em to lie, too. That deserves a big A+ for effort.

    I’m glad the courts are trying to save Mazeratti from life long paralysis. The Trinity School of Natural Healing website wasn’t even funny with the thought of paralysed kids running in the background. It’s an outrage that gets called education, never mind medical training.

  26. #26 Denice Walter
    February 8, 2011

    Totally, totally OT but may be of interest to our esteemed host and those who battle anti-vax ( Todd, Chris, Dawn, Pablo, Science Mom, Kim, Liz, David, Prometheus,& others)

    A NJ state legislator, Herb Conaway (who is also a doctor) relates that in Summer 2010, the state “quietly” made it easier for parents to obtain a religious exemption from vaccination. The new measure maintains that authorities can’t question parents who reject vaccination if they merely say the word “religion” or “religious”. Conaway says that parents should be required to explain “how” vaccination conflicts with their religious beliefs because parents can now use the law for “other reasons”. The rate of vaccination has dropped : formerly NJ was once in the top 10 states complying, now it is in the bottom 10. Rates of MMR and HepB are especially affected.

    Although the article contains decent info about law, vaccination, and rising rates of illnesses, its author uses Deirde Imus as a source ( using the unbalanced for balance?) who discusses how experts are “picking and choosing epidemiological studies to prove there’s no causal link between children’s vaccination and autism or other neurodevelopmental disorders”. Additionally, Washburn says that advocates of parental choice (e.g. NJ Coalition for vaccination Choice)are requesting a philosophiocal exemption like those that exist in 20 other states ( sounds to me like they already have it).

    source: The Record, 2/7/2011. Lindy Washburn.

  27. #27 Lycanthrope
    February 8, 2011

    How does one summon the balls to look another human in the eye and say, “I intend to treat you/my son/any other human person with this substance here. Don’t ask me what it’s called, because I don’t remember.” That’s gotta be one of the biggest red flags for incompetence I could possibly imagine.

  28. #28 Giliell
    February 8, 2011

    Sadly I can make an educated guess to the outcome: The boy will have the surgery and go through a long and painful and hard rehabilitation. Things will never quite be as they were before. And his mother will blame on the surgery. If she’d had her way, everything would be perfect now.
    I hope the boy grows up to understand one day what’s happening here.

    @Sandir
    Ever heard that well meant is well done?

  29. #29 Giliell
    February 8, 2011

    Sorry, fatal writing error.
    The last sentence should read
    “well meant is the opposite of well done”

  30. #30 peicurmudgeon
    February 8, 2011

    In order for anyone to have ‘informed consent’ on any treatment, it would be important for them to understand the potential outcomes of each treatment option.

    I think that having those outlined for the boy would help him make a reasonable decision.

    Modern medicine = x% chance of recovery
    Naturopathy = 0% chance of recovery.

  31. “What are the ethics of a doctor treating their own Child?”

    It’s an inherent conflict of interest. As both guardian and practitioner, the person cannot remain objective when making decisions regarding treatment.

    Even if the son were over the age of 21, it would still be a serious conflict of interest to treat one’s own son for such a serious condition.

  32. #32 LovleAnjel
    February 8, 2011

    Probably because he can move and talk, she thinks his spine is not physically injured. Does she think they are exaggerating the dangers, or is she in denial? Either way, he does need someone to step in and make sure he gets adequate treatment. The consequences are way too high.

  33. #33 jenny
    February 8, 2011

    It is very sad that a story like this gives a bad rep to the Naturopathic Medicine. It should be noted here that there are only 4 accredited Naturopathic Schools of Medicine in US: Bastyr in Washington State, one in Portland, Oregon, one in Tempe, Arizona, and the last one in Bridgeport University, in Bridgeport, Connecticut. Naturopathic Medicine education is a 4 year doctorate program, post undergratuate. The programs involve extensive science-based basic sciences and clinical studies. Seeing many patients and performing procedures under supervision. Almost 15 states license the profession, which means two stage rigorous licensing exams, like the MD’s do, background checks, character committee evaluations, interships, preceptorships, and contunued medical education (CME) annual requirements. Naturopaths go through post doctoral training. In many states, Naturopaths are an integral part of the residency programs in hospitals. Moreover, in the states that license the profession the insurance companies cover naturopathic care. Naturopaths are primary care providers in many of the licensing states. Including Medicaid. It should be known that quacks are quacks, and it is sad that actions of some such quacks bear on the licensed medical practitioners.

  34. #34 Beamup
    February 8, 2011

    @ jenny:

    Care to present any justification for naturopaths to exist, or any evidence that a single one is NOT a pure quack?

  35. #35 Pablo
    February 8, 2011

    It’s an inherent conflict of interest. As both guardian and practitioner, the person cannot remain objective when making decisions regarding treatment.

    Even if the son were over the age of 21, it would still be a serious conflict of interest to treat one’s own son for such a serious condition.

    But who regulates that? If it is an actual doctor, it is a violation of the AMA practices, right?

    So it comes back to my question: if a real doctor were to go to the court and ask to take their child from a hospital and care for them at home or in their own office, would they be allowed to do it?

    I think my point is, this case actually goes well-beyond the fact that she is a quack. It is actually a breach of medical ethics, and she should have no case on those grounds alone.

    This case is pretty trivial. Assuming the judge gets the input from an expert witness at all, there are two clear problems:

    1) the aforementioned breach of ethics. Bring in a doctor and ask them, “Is it an acceptable practice?” Every doctor will say, no, there are ethical restrictions against treating your own family.

    2) Then there is the proposed treatment. Have the claims that substance P can be used to fuse bones been approved by the FDA? From a legal standpoint, if the stuff is not approved by the FDA for that procedure, then the judge cannot consider it to be an alternative medical treatment (it cannot be considered a medical treatment at all). The judge does not have the authority to determine whether her claim that it can be used to fuse bones together or not is correct, regardless of how many expert witnesses could be called – that authority rests with the FDA.

    As far as the judge is concerned, saying that she is going to treat her son with substance P is as meaningless as saying she is going to treat him by giving him Skittles. Skittles work to bribe the Offspring into going peepee in the potty, but they aren’t going to fuse his spine, no matter how much someone claims they will.

  36. #36 jenny
    February 8, 2011

    @Beamup

    No. Do not care. Have you ever been under care of a licensed naturopathic practitioner? Sounds like you may need to find out more about naturopathic practitioners from states that license the profession. It is in those states that the people and the legislators found justification and evidence for the profession to exist. It is also in those states that major, and minor, insurance providers found justification and evidence to recognize naturopathic treatment and pay for such treatment. The number of states licensing this profession is growing. Whatch out – naturopathic medicine is coming to your state!

  37. #37 Dangerous Bacon
    February 8, 2011

    jenny: “The (naturopathic) programs involve extensive science-based basic sciences”

    No matter how many times the word “science” is tossed in, when the end product of training is notoriously unscientific, the basic education does not matter (see “chiropractic” for another example).

    “In many states, Naturopaths* are an integral part of the residency programs in hospitals.”

    I’d like to see documentation for this claim. I’ve trained/worked in hospitals in five states and never seen a naturopathic resident. And wherever they might exist, I have grave doubts that they’re an “integral” part of patient care.

    “Well, we’re all agreed on the treatment plan, then?”
    “Wait…we haven’t gotten input from the naturopathic resident!!!”

    *are we supposed to capitalize Naturopath, as with Realtors?

  38. #38 Beamup
    February 8, 2011

    @ jenny:

    The fact that legislators have been deluded by con men is not a recommendation. Nice argumentum ad populum, though.

    And no, I wouldn’t care to waste my money on a quack. Which all of the scientific evidence demonstrates is exactly what all naturopaths are.

  39. #39 David N. Brown
    February 8, 2011

    @1:
    In case of a stab or puncture wound, it can actually be better to leave the penetrating action in, as removing it can accelerate bleeding and even add to the tissue damage. Medieval physicians seem to have appreciated this. I’ve read that the Mongols came up with a solution to the problem by wearing silk shirts, and twisting the fabric to remove arrows.

    Overall, I have qualms about official intervention in this case, and I could respect this family’s decision, if they were realistic about their options: definitely intrusive surgery, or permanently limited movement. But the idea that herbal medicine is an option is flat-out denial.

  40. #40 Rorschach
    February 8, 2011

    Jenny, as a lifelong Connecticut resident, thanks for giving me one more reason to regard Bridgeport at the 9th circle of hell.

  41. Jenny:
    “Sounds like you may need to find out more about naturopathic practitioners from states that license the profession. ”

    It sounds like you need to educate yourself as to what naturopathy really is.

    Naturopathy is inseparable and largely indistinguishable from woo.

    http://scienceblogs.com/insolence/2011/01/you_cant_have_naturopathy_without_homeop.php

    -Karl Withakay

  42. #42 Rorschach
    February 8, 2011

    A few other things worth noting: the article contains a classic example of naturopathic reasoning. To whit, the mother had a previous child who was born with bowed legs. They put the kid in braces and later applied some mystical naturopathic cream, and lo and behold when the braces came off, the kid’s legs were normal. So of course, it was the cream that did it.

    Secondly, since when is is necessarily an ethics violation for a physician to treat a family member? I appreciate why it might not be a good idea, and in some cases it could create a conflict of interest that WOULD be ethically inappropriate, but is it always wrong for a physician to administer care to a family member?

  43. #43 jenny
    February 8, 2011

    @Beamup & @Dangerous Bacon

    Sounds like some have missed the boat and remain in the dark. Naturopathic medicine (you would capitalize it in the beginning of a sentence or if you would like to name a program, title, practice – usual grammar applies here) is here and if you are fighting it, don’t. Save your money, don’t go to a naturopath, a chiropractor, a dentist, or a realtor. It is a free country, after all. I completely agree that the word “science” gets tossed around, notice how it is noticed in the naturopathic context…

    Here is a link for a taste of what naturopaths are doing in a hospital and other clinical settings. Having said that, please note that with proper care most persons should not end up in a hospital, barring some trauma or other serious conditions. It is this shift to the hospital based medicine that is alarming, and if anyone has spent some time inside a hospital, they will tell you that it is probably the worst place to heal. Doctors themselves will tell you that they want the patient out as soon as possible.

    Here is a link to naturopathic residencies, especially note the ones with NDs and MDs rotations. Most notably, Yale’s Griffin Hospital. Note also, that Yale has intergrated naturopaths into their cancer center and outreach clinics.

    http://www.aanmc.org/education/naturopathic-residencies.php

  44. @Rorschach, Orac is better qualified to comment on it, but the reason for the ethics violation is due to the conflict of interest. The person giving informed consent should not be the practitioner. There should always be informed consent independent of the physician. It’s an ethical violation for the physician to give consent to their own choices in treatment of a patient.

    The ethical and conflict of interest angles are really a side effect of the real problem, the practice of naturopathy. If it’s a legitimate form of medical practice, the only issues are the ethical conflicts. If it’s not scientifically valid medicine, that’s the real problem here.

  45. #45 MarciaC
    February 8, 2011

    “Almost 15 states license the profession”

    What is that, then? 14? 14 1/2?
    Chiropractors are “licensed” in many states and receive some insurance reimbursement. That doesn’t make them legitimate.
    Also, who cares how long or “rigorous” the programs are. I could study astrology for 20 years, get a doctorate in it, take an exam and recieve a license as “Certified Astrologer” and it wouldn’t make my profession real!
    I met a woman once who bragged that she was studying toward her Doctorate in Bach Flower Essences. Oooh! I was so impressed!!

  46. jenny,

    Caveat emptor.

    Nigerian scams, fraud, false advertising, theft by deception, and Madoff pyramid schemes are here and if you are fighting them, don’t. Save your money, don’t go to them. It is a free country, after all.

  47. #47 WLU
    February 8, 2011

    It is very sad that a story like this gives a bad rep to the Naturopathic Medicine.

    This story gives a bad rep to one parent, Naturopathic Medicine is both an oxymoron and an absurdity.

    It should be noted here that there are only 4 accredited Naturopathic Schools of Medicine in US…Naturopathic Medicine education is a 4 year doctorate program, post undergratuate. The programs involve extensive science-based basic sciences and clinical studies.

    But accreditation and education in what? If the program is so science-based, why does it need to exist since medicine is already science based? Why haven’t the schools abandoned homeopathy and reiki when they have been found to fail scientific tests? Why is traditional Chinese medicine taught when it hasn’t been subjected to scientific testing?

    Seeing many patients and performing procedures under supervision.

    But what kind of supervision? If a trainee witch doctor, under the supervision of an experienced witchdoctor, recommends sacrificing a chicken, bloodletting, sex with a virgin to cure AIDS – is that better because it is supervised nonsense?

    Almost 15 states license the profession, which means two stage rigorous licensing exams, like the MD’s do, background checks, character committee evaluations, interships, preceptorships, and contunued medical education (CME) annual requirements.

    Rigorous licensing in what? Knowing how to use homeopathy? Unlike MDs, the standard of care is not evidence-based and is often the opposite of evidence-based. Why does a background check matter? What on earth is a character committee evaluation? Do those CME courses note the latest and best studies that reject the idea that homeopathy has any specific effects? Medicine changes, slowly and painfully, as new evidence rolls in. Does naturopathy?

    Naturopaths go through post doctoral training.

    Except they aren’t doctors.

    In many states, Naturopaths are an integral part of the residency programs in hospitals. Moreover, in the states that license the profession the insurance companies cover naturopathic care. Naturopaths are primary care providers in many of the licensing states. Including Medicaid. It should be known that quacks are quacks, and it is sad that actions of some such quacks bear on the licensed medical practitioners.

    How is naturopathy anything but quackery and unlicensed psychotherapy? Homeopathic nostroms are worthless, detoxification is unfounded, herbs can be downright dangerous, acupuncture has only two very limited uses, and we’re supposed to be happy that these people are being integrated into actual medicine? It’s either a waste of money, or there will be an accumulation of bodies as this “practice” gets extended. Jenny, have you ever heard of Tooth Fairy Science? You’ve got tooth fairy credentialing, tooth fairy supervision, tooth fairy internship, tooth fairy continuing education, tooth fairy post-docs, tooth fairy licensing and the insurance companies are apparently the ones leaving the money under the naturopath’s pillows.

  48. #48 jenny
    February 8, 2011

    @Beamup & @Dangerous Bacon

    Sounds like some have missed the boat and remain in the dark. Naturopathic medicine (you would capitalize it in the beginning of a sentence or if you would like to name a program, title, practice – usual grammar applies here) is here and if you are fighting it, don’t. Save your money, don’t go to a naturopath, a chiropractor, a dentist, or a realtor. It is a free country, after all. I completely agree that the word “science” gets tossed around, notice how it is noticed in the naturopathic context…

    Here is a link for a taste of what naturopaths are doing in a hospital and other clinical settings. Having said that, please note that with proper care most persons should not end up in a hospital, barring some trauma or other serious conditions. It is this shift to the hospital based medicine that is alarming, and if anyone has spent some time inside a hospital, they will tell you that it is probably the worst place to heal. Doctors themselves will tell you that they want the patient out as soon as possible.

    Here is a link to naturopathic residencies, especially note the ones with NDs and MDs rotations. Most notably, Yale’s Griffin Hospital. Note also, that Yale has intergrated naturopaths into their cancer center and outreach clinics.

    http://www.aanmc.org/education/naturopathic-residencies.php

  49. #49 jenny
    February 8, 2011

    @MarciaC

    I’m sorry to hear that you cannot learn certain subjects. I respect those who spend many years of their lives studyinig a subject and becoming most knowledgeable in it. It is silly to boast about your inability to learn something. It maybe hard to believe, but some people are that dedicated to learn, study, and still have a desire for more.

    Currently, 15 states, five Canadian provinces, the District of Columbia, and the US territories of Puerto Rico and the US Virgin Islands all have laws regulating naturopathic doctors (NDs). In these states and provinces, naturopathic doctors are required to graduate from a four-year, residential naturopathic medical school and pass an extensive postdoctoral board examination (NPLEX) in order to receive a license.

    Licensed naturopathic physicians must fulfill state- or province-mandated continuing education requirements annually, and have a specific scope of practice defined by the law in their state or province.

  50. #50 WLU
    February 8, 2011

    Jenny, I would go to a realtor or dentist because they have genuine, useful certification in recognized, evidence-based professions (the legalities of transferring home ownership and taking care of the teeth and gums). Naturopathy isn’t even a discipline, it’s integrative medicine without the medicine – it’t nothing more than a grab-bag of unconnected methodologies and feel-good slogans. I don’t mind idiots spending money on naturopaths, but I do object to tax and insurance dollars being used because that forces me to subsidize interventions that do no good.

    Regards your comment on science – science has empirical evidence as its touchstone. You don’t get to keep believing when the evidence is against you, and still claim to do science. You don’t get to say “it’s popular so it is science” and still claim to do science. Science means testing and rejection of hypotheses that fail. Naturopathy has about as much to do with science as astrology does with launching a satellite.

  51. #51 Pablo
    February 8, 2011

    The ethical and conflict of interest angles are really a side effect of the real problem

    I disagree. The ethical and CoI angles are part and parcel of this case, and are irrespective of the quackery.

    I ask again, if a real doctor went to the court and tried to get their son taken out of the care of the hospital so that they could treat him in their office, would that be allowed?

    I don’t think it would, for the reason mentioned: a doctor cannot give informed consent on behalf their own patient, which is exactly what would be happening. Given the conflict of interest between the doctor as a parent, the way it is handled is to separate their roles.

    If this were just a case of, “I don’t want my son to be treated by an allopathic doctor, and want to take him to this quack over here,” which is more typical of these types of cases, it would be about the extent of quackitude. But this case goes well-beyond that into the realm of professional medical ethics. That it happens to be a quack is just the tip of the problem.

  52. #52 Chris
    February 8, 2011

    jenny:

    Have you ever been under care of a licensed naturopathic practitioner?

    Not after I saw what they did to a relative of mine! She is now dead, first one put her on a super restrictive diet years ago (which didn’t help), and the most recent ND (stands for Not a Doctor) told her to stop taking the real meds and take her special homeopathic remedies.

    I know it is an anecdote, but it still makes us very unhappy.

  53. #53 WLU
    February 8, 2011

    Jenny, why would you respect someone studying long and hard for a worthless topic? If someone studied hard to practice law based on the Hammurabic code would you respect them? I’m not talking studying the code of Hammurabi for historical reasons, I’m talking in order to practice it. I don’t mind learning new things but it is a waste of time to learn about worthless treatments in order to practice them. I might learn about homeopathy to criticize it, but I would never learn about it to treat anyone.

    The licensing and practice laws that exist regarding naturopathy are not, and have never been evidence for their efficacy – normally they are the result of intense lobbying by practitioners and often the politicians they can convince. And again, they are getting a license for tooth fairy medicine, not dentistry. Science and medicine advance by demonstrating an approach works, then practicing it. Naturopathy assumes their interventions work and never bother testing them. Seriously, research is just careful counting, so who would rationally support implementing a treatment before it is known if it has any merit?

    In this case, probably people who are already making money from it.

  54. #54 jenny
    February 8, 2011

    @WLU

    I wish I had more time to point out and educate. However, since you also took a stab at homeopathy, check this out:

    http://www.huffingtonpost.com/dana-ullman/luc-montagnier-homeopathy-taken-seriously_b_814619.html

    You’re absolutely right, science changes everyday, read the latest breakthroughs and try to keep up. You may need to eat your words.

    There is a time and place for different medical approaches. There are also individuals who require various treatments. To be so uninformed and make such unfounded statements, really shows how much more needs to be done to educate the public. I want to thank you for exhibiting just how deep the ignorance runs. It is true, our children need to be much more educated to keep up in the world.

  55. #55 T. Bruce McNeely
    February 8, 2011

    jenny:

    Interesting list of “residencies”. Not one appears to be associated with a non-naturopathic academic center or a general hospital.

    Interesting stuff the “residents” get exposed to, as well:
    detoxification
    hyperbaric oxygen therapy
    infrared sauna
    lymphatic drainage
    nutritional and IV chelation
    homeopathy
    botanical medicine
    hydrotherapy
    lifestyle counseling
    Specific areas of focus include: chronic fatigue, mental Health, allergies and chemical sensitivities
    blood cell analysis
    colonic therapy
    microcurrent
    acupuncture

    It’s mostly stuff that you could get at your neighborhood spa, and that has never been shown to be effective by any credible means.

    I completely agree that the word “science” gets tossed around, notice how it is noticed in the naturopathic context…

    You keep using that word. I do not think it means what you think it means.

  56. #56 Todd W.
    February 8, 2011

    @jenny

    Do you have an open mind, one that is not closed to the possibility that maybe, just maybe, you might be wrong? If so, then I recommend reading some of Orac’s other posts about naturopathy, homeopathy and other alternative practices. I also highly recommend the book Trick or Treatment by science journalist Simon Singh and the world’s first professor of complementary and alternative medicine, Edzard Ernst. You may also find some of the articles over at the Science-Based Medicine blog an interesting read.

    Believe it or not, but many of the folks that comment here have done a lot of looking into alternative medical practices like naturopathy, homeopathy and the like. They’ve just come to a different conclusion than you after looking at the scientific evidence.

    And I’d advise you to go somewhere other than the HuffPo for your health news. Their contributors are not exactly known to be grounded in reality.

  57. #57 Lawrence
    February 8, 2011

    Jenny – science may change, but the laws of physics don’t.

    Homeopathy is the worst kind of junk-woo – I won’t even call it science, because the very fundamentals of it are so completely ridiculous. Oh, and use the search function here, because Orac already did a takedown of Luc Montagnier and his decent into the art of woo.

  58. #58 T. Bruce McNeely
    February 8, 2011

    Oh yes, another thing.
    Naturopaths are in the forefront of the anti-vaccination movement. I have no respect for them for this reason alone.

  59. #59 Jason
    February 8, 2011

    I say let the parents take their idiot son out of competent care and end up paralyzed as a result of the administrations of a quack. If they do, his DNA, and as a result theirs, will not be passed down to the next generation as the contagion it so clearly is.

    Educating people is a good thing to do, but if mentally deficient people are determined to destroy their ability to reproduce, well that’s just the shoddy stock getting weeded out. We wouldn’t have decent beef cattle if we’d insisted that every steer have his chance to procreate. We only breed the good ones. These folks are VOLUNTEERING to remove themselves from the gene pool.

  60. #60 mikerattlesnake
    February 8, 2011

    Oh what an unfortunate coincidence, Jenny ran out of time (she’s so busy) right when the questions got pointed and difficult to answer and people started actually showing her evidence. Then a “you just need to open your minds!” as she wafts out the door. Jenny is a pathetic cretin whose dishonesty is apparent to all but the most gullible. i wonder if she thought her pap might actually convince someone here.

  61. #61 Poodle Stomper
    February 8, 2011

    @Jenny,
    I wish I had more time to point out and educate. However, since you also took a stab at homeopathy, check this out: http://www.huffingtonpost.com/dana-ullman/luc-montagnier-homeopathy-taken-seriously_b_814619.html You’re absolutely right, science changes everyday, read the latest breakthroughs and try to keep up. You may need to eat your words.

    Dr. Montagnier has been heading downstream in his woo-canoe for a while now but before you point that particular atricle out remember three things; 1) his “research” on this hasn’t been published, 2) it would have to be replicated (personally I’m inclined to think it is nothing more than ill-performed PCR with contamination and poor controls), and 3) there are many intelligent individuals that subscribed to crazy ideas. Just because Luc shared the Nobel Prize for the discovery of HIV doesn’t mean that his ideas on homeopathy are correct. Isaac Newton believed in alchemy and tried to create the philosopher’s stone. Should we accept that as evidence it is a valid science?

  62. #62 jenny
    February 8, 2011

    @Chris, I am truly sorry to hear about that. That is how I felt when we almost lost our son in MD care.

  63. #63 MI Dawn
    February 8, 2011

    @T. Bruce McNeely: Yeah, I was noticing that probably 99% of the “hospitals” on jenny’s list are not true, JCAHO-certified hospitals. I looked for a few, but had no success and wasn’t going to look at them all.

    I didn’t know anything about “Yale’s Griffin Hospital Integrated Medical Center” so I googled it. Gee, Griffin Hospital has a Integrated Medicine clinic. The hospital may be affiliated with Yale for medical rotations, but I love the way Yale’s name has been co-opted to make the website look good. “See? See? YALE believes in us. Nah, Nah, Nah.”

    I’m not impressed.

    @jenny: few of us run to the doctor for every little thing. But very few of us on this site are going to use quackery.

    Herbal medicines, because they have measureable ingredients, are not quackery (depending on the item and what it is being used for). Many, many “true” medicines have been found by looking at the effects of herbs. Classically, of course, you have digitalis, quinine, aspirin all originally derived from herbal medicines. Modern medicine simply made the dosage more uniform, buffered them for fewer side effects, and made them work more reliably.

    I’ll drink herbal teas for a cold. Not because I think they will cure me, but because ANY hot liquid makes me feel better and the herbs just add flavor. I don’t believe they will shorten/cure the cold, “strengthen my immune system”, or anything else.

    This young man risks lifetime paralysis if his mother is allowed to use her nostroms instead of tried and tested surgery. Is that a chance you would take yourself?

  64. #64 mikerattlesnake
    February 8, 2011

    @59

    Firstly when the issue of consent is involved, including cases of age, coersion (which parents are well capable of), and being improperly informed, it is an issue of compassion to intervene.

    Secondly, your ideas about genetics and intelligence/reason are pretty simplistic. To pick an example I was reading today, only about 30% of southern baptist children stay in the flock. This is despite coersion and brainwashing. To assume that a child would maintain all the beliefs of his mother into adulthood is downright moronic.

    Overall you come off as a faux-rational, libertarian type. It’s not a worldview that survives scrutiny all that well, but I suggest you try it out anyhow. It might stop you from getting culled when your simple-minded impulses would otherwise put you on the evolutionary chopping block.

  65. #65 Beamup
    February 8, 2011

    Naturopathic medicine (you would capitalize it in the beginning of a sentence or if you would like to name a program, title, practice – usual grammar applies here) is here and if you are fighting it, don’t. Save your money, don’t go to a naturopath, a chiropractor, a dentist, or a realtor.

    So we’re supposed to give these quacks carte blanche to defraud and kill their ‘patients’ instead?

    Also, as for Montagnier, his recent work in these fields has been (charitably) grossly incompetent. If the ‘papers’ in question had been handed in as junior-level lab reports, they would have received Fs. Just one example should serve. In one recent paper:
    – The cessation of the ‘signal’ when Faraday-shielded was baldly asserted to demonstrate that it was an induced effect. Not a single attempt was made to demonstrate that it was not external noise.
    – Signal-to-noise ratio was not even mentioned, much less calculated.
    – The apparatus and procedure were described in only the most general terms.
    – No meaningful data was presented.

    The entire thing amounted to “I say so, therefore this is conclusively proven.”

  66. #66 jenny
    February 8, 2011

    @MI Dawn

    “This young man risks lifetime paralysis if his mother is allowed to use her nostroms instead of tried and tested surgery. Is that a chance you would take yourself?”

    I don’t want to pretend to know the specifics of this medical case. Personally, I have experience opting for invesive surgery and supplementing recovery with complementary treatment.

    @others, I respectfully disagree with most of the comments. Firmly believe that there is a place for both. Knowing what goes into MD and ND training, I have full confidence that there is a place and time for each. Good talk guys!

  67. #67 jenny
    February 8, 2011

    @MI Dawn

    “This young man risks lifetime paralysis if his mother is allowed to use her nostroms instead of tried and tested surgery. Is that a chance you would take yourself?”

    I don’t want to pretend to know the specifics of this medical case. Personally, I have experience opting for invesive surgery and supplementing recovery with complementary treatment.

    @others, I respectfully disagree with most of the comments. Firmly believe that there is a place for both. Knowing what goes into MD and ND training, I have full confidence that there is a place and time for each. Good talk guys!

  68. #68 madder
    February 8, 2011

    Jenny–

    It should matter that there appears to be no standard for naturopathic practice. See, especially, my exchange with Michael Thomsen in this thread.

    If naturopaths are unwilling to eject worthless treatments and false teachings, why should anyone ever listen to one?

  69. Jenny is apparently of the opinion that’s there’s a place and a time for both Tooth Fairy Science and real science.

    I’m sure there’s some objective criteria to use in order to know when it’s appropriate to discard science and critical thinking.

  70. #70 WLU
    February 8, 2011

    Jenny, you aren’t educating me with a Huffington Post article. However lauditory it may be for left-wing perspectives on politics, HP is notorious for it’s promotion of nonsense and shoddy science reporting. Who cares if a Nobel laureate believes something? The question is, does the evidence support them? And if homeopathy is ever vindicated, how about I print out and eat this blog post? I’m guessing my fiber will come from fruits and vegetables. Your assertions that we need to “educate” people still runs ahead of the actual evidence. Most of the people here probably know a lot about alternative medicine, primarily in terms of its weaknesses, failure to align with scientific knowledge of medicine, biology, physics and chemistry, and have utter, utter contempt for anyone who attempts to “educate” beyond the current knowledge base. Creationists similarly attempt to “educate” students about the (nonexistent) failings of evolution and their attempts fail for similar reasons.

    You don’t get to proclaim a “revolution in medicine” or whatever until the “revolution” has been replicated, extended, and demonstrated to work irrespective of who does the studies or where they are done.

  71. #71 jenny
    February 8, 2011

    Guy, even Hippocrates said, that medicine is something between science (here I go using this word again!) and art. Please do not confuse your “physics is physics”, medicine is not strictly science, there is a huge component of art. ;) Also, as most of you hopefully know, every MD carries malpractice insurance.. hmm, I guess that is to cover their mistakes. Yes, everyone makes mistakes. Also, statistics show that every third American seeks alternative care, maybe these people are not satisfied with the care they are receiving.

  72. #72 Pablo
    February 8, 2011

    I respectfully disagree with most of the comments. Firmly believe that there is a place for both. Knowing what goes into MD and ND training, I have full confidence that there is a place and time for each.

    Who cares what “confidence” you have? No offense, but all this comment does is beg the question of your intellect. If you are fully away of what goes into MD and ND training, then why not explain why there is a place for both, instead of just asserting it?

    I am also well aware of what goes into both MD and ND training, and I have full confidence ND to be an idiotic concept that has no business any where near being part of the health field.

    There, I just matched YOUR confidence with my confidence (similarly, I have equally begged the question of MY intellect).

    One of us is wrong, Jenny, regardless of how “confident” we are.

    Now, can we get back to actually discussing the legitimacy of naturopathy in a meaningful sense, without resorting to some special insight?

  73. #73 Scott Cunningham
    February 8, 2011

    Wow. This post exploded with comments while I was in class.

    Currently, 15 states, five Canadian provinces… all have laws regulating naturopathic doctors (NDs)…It is in those states that the people and the legislators found justification and evidence for the profession to exist.

    Jenny, since when have politicians been great defenders of truth and reason? I thought they were mostly liars, ignorant curmudgeons and trendy fluffy airhead celebrities, personally. And they care most about financially well-heeled special interest groups that can bring in advertising dollars and easy votes from wedge issues that let them cry persecution. Naturopathy has all that.

    Whatch out – naturopathic medicine is coming to your state!

    It’s already here. That’s why my old neighbourhood is home to two centers offering exorcism of evil spirits, hypnosis, past life regression, healing stones, chakra re-alignment, ayurvedic medicine, tarot reading, Angel therapy, TCM, and enemas of every concievable kind.

    There’s only one problem. None of it works.

    You’re absolutely right, science changes everyday, read the latest breakthroughs and try to keep up. You may need to eat your words.

    Oh yes. I’ve heard science recently discovered the existence of Santa Claus. Turns out he and Bigfoot were riding the Loch Ness monster when they were suddenly abducted by aliens. That’s why your parents bought the presents all those years. But Santa’s back now. Hooray.

    Long story short: if a study comes out tomorrow saying magic that contradicts well-established knowledge of chemistry, physics or human anatomy and physiology is suddenly vindicated, it’s gonna need a lot of corroborating evidence to prove it. And so far, that evidence isn’t there.

    Have you ever been under care of a licensed naturopathic practitioner?

    Not presently, but I have been under the care of a chiropractor, I have taken hormone and herbal remedies that had undocumented adverse side effects while insisting that natural = safe or which did nothing, I have family who swear by accupuncture while not improving whatsoever, or juicing with no benefit and some harm, or ear candling, and some family friends are deeply anti-vaccine. (And into Angel therapy. And veganism. Veganism with vitalism woo. I could go on all day.)

    It’s all bullshit. Bullshit. Bullshit. Bullshit. Some skeptics are not born but made. Don’t assume we’re all ignorant, closed minded people who started in science and know nothing else. I became a science student because everything else I’d ever done turned out to be complete crap. And yes, I’m bitter.

  74. #74 Beamup
    February 8, 2011

    Firmly believe that there is a place for both.

    Belief has no relevance to the question. Evidence matters.

    Guy, even Hippocrates said, that medicine is something between science (here I go using this word again!) and art.

    Fortunately, we’ve moved rather beyond that. Unlike naturopathy, which assumes that people thousands of years ago are ultimate authorities on anything simply due to antiquity. (Often false antiquity; see acupuncture which was actually invented by Mao.)

    Also, statistics show that every third American seeks alternative care, maybe these people are not satisfied with the care they are receiving.

    Another argumentum ad populum, and a false one at that. The commonly-cited statistics along those lines include such things as praying for someone who’s ill, or getting a massage for relaxation.

  75. #75 Pablo
    February 8, 2011

    Please do not confuse your “physics is physics”, medicine is not strictly science, there is a huge component of art.

    Wait a minute, I thought you were claiming that naturopathy was based on scientific principles?

    What does that have to do with the “art” aspect of practicing medicine?

    (although I personally have a quibble with those who call it “art” – it is more of an application of population statistics, which is not art at all,and is absolutely scientific; the trick is to recognize which population to use as a basis for your probability assessment; unfortunately, sometimes the population base is too small to interpret accurately. People call it “art” because there isn’t always a single answer, but that doesn’t mean that all answers are equal. An infliction that will respond to treatment X 70% of the time, treatment Y 40% of the time (with overlap between the two), and treatment Z 30% of the time might require trying X, Y, and Z before the solution is found (although there could be 5% that is untreatable by any of the three), but that doesn’t mean there is an art to it. Now, if you could find an indicator that the infliction will specifically respond to Y, then you can skip X, but that is all an issue of probability)

  76. #76 Todd W.
    February 8, 2011

    @jenny

    medicine is something between science (here I go using this word again!) and art.

    The art of medicine is in deciding how to apply the science of medicine. It is not simply throwing nonsense treatments at a patient and saying, “Hey, man! Isn’t that just a groovy work of art!”

    Not all treatments are created equal. There are those supported by science. We call those “medicine”. Everything else we call either “unproven and therefore unreliable/possibly unsafe” or “utter bollocks”.

  77. #77 Beamup
    February 8, 2011

    Not all treatments are created equal. There are those supported by science. We call those “medicine”. Everything else we call either “unproven and therefore unreliable/possibly unsafe” or “utter bollocks”.

    And their purveyors can get in the effing sack.

  78. #78 JohnV
    February 8, 2011

    Good lord its like most every play in the “alt-medicine” playbook has been tried out by Jenny in a short period of time. Extra credit for eschewing the typical Galileo reference for a Hippocrates blast instead.

  79. #79 Travis
    February 8, 2011

    Jenny, as you can see people here generally do not care about how confident, or how sincere people are when they present their ideas. Evidence is needed (and as pointed out, not some article on a news site, especially not one that has been ripped apart as much as that one).

    I think Jenny’s responses about naturopathic practioners readily show that it is a cargo cult style of medicine. We have all the trappings of medicine presented. She can point to naturopaths being licensed in some places, hospitals that have nautropaths, even a few papers. Then they can shout to the world “Look at us, we look like medicine!” without having to have the rigour demanded of science. Setting the structures up is not enough, you actually need to be scientifically literate, to be honest about the evidence you have, and to be critical. This is always missing.

  80. #80 Heliantus
    February 8, 2011

    @jenny

    every MD carries malpractice insurance

    And every car built following regulations carries safety belts. Your point?
    If your point is that medicine is not perfect, YES. We got it. We know it. MDs do mistakes, like every other living being ever born on this floating piece of rock we call Earth. So what? In what is this validating naturopaths’ position?

    BTW, do Naturopaths have malpractice insurance? Or do they never do mistakes?

    maybe these people are not satisfied with the care they are receiving.

    Again, what does this prove? Because medicine doesn’t have all the answers, the first idiot should be free to claim what he does, and sell as panacea whatever he happens to be carrying in his back pocket?
    If you think you can do better, prove it.

    Back on topic, what does this have to do with the current case? We are talking about someone whose spine has been injured enough to let the physicians advice to install pins and plate around his bones. It’s not as if fractured bones were a mysterious, half-understood illness.
    Medicine does have answers for this sort of things. Millennia-old answers, actually, bone injuries having been documented since ancient Egypt physicians. Fortunately, along its way to modern times, humankind did some progress in treating trauma and pain.
    More could be done, to be sure. If you have something coming with good evidence, we are buying.

  81. #81 Scott Cunningham
    February 8, 2011

    Jenny said:

    Knowing what goes into MD and ND training, I have full confidence that there is a place and time for each.

    What goes into an MD? Mostly science. Chemistry, human anatomy and physiology, histology, pharmacology, pathology, surgical practice etc. Mostly founded in reproducible experiments and evidence.

    What goes into an ND? Appeals to the ancientness or exoticness of the practice. Celebrity endorsement. Grandiose back stories. Elder Gurus on mountaintops. Arguments from popularity. Sympathetic magic. The allure of the natural. Vague spiritual talk. Vitalistic forces. Mysterious things unknown and unseen and un-reproducible. And lots and lots of enemas.

    Well then, Jenny, let’s play a familiar game. Remember Sessamee Street?

    One of these things is not like the others
    One of these things just doesn’t belong
    Can you tell me which thing is not like the others
    Before I finish this song?

  82. #82 jenny
    February 8, 2011

    @80, yes, naturopaths have malpractice insuranse, don’t worry.

    @Travis, the big pharma and present state of allopathic medicine is more like “cargo cult style of medicine”.

  83. #83 jenny
    February 8, 2011

    @81, dude, NDs study the same basic sciences as MDs. In fact, the first part of both board examinations is the same.

  84. #84 madder
    February 8, 2011

    @83 Jenny:

    And the second part is a test of your range for chucking all that knowledge in the toilet.

  85. #85 Todd W.
    February 8, 2011

    @jenny

    Are you willing to read Trick or Treatment (should be available at your local library) and other posts by Orac or at Science-Based Medicine?

  86. #86 Science Mom
    February 8, 2011

    @81, dude, NDs study the same basic sciences as MDs. In fact, the first part of both board examinations is the same.

    No they don’t and there is also tremendous variability with programmes and state requirements. Do you wish to argue that the mother of the spinal-injured boy has received a comparable education to even the most poorly rated U.S. medical school?

  87. #87 jenny
    February 8, 2011

    Hey, does anybody work around here?

  88. #88 jenny
    February 8, 2011

    @Science Mom, this is exactly what I was trying to show, that mom, in the story, did not graduate from an accredited naturopathic medical school. That is the problem when people use defined words loosely or out of context. Again, check out the science course requirements at the accredited schools.

  89. #89 Peapoh
    February 8, 2011

    If I recall correctly yes, Naturopaths (depending on the “scientific” authority the chosen school wants to assume) do have the basics of chemistry, biology, etc. as a requirement. Whether or not they utilize this knowledge is what matters.

    Hell, an acquaintance of mine obtained a bachelor’s in biochem at ASU and is pissing it away at Hogwarts somewhere in Oregon. He believes in homepathy, reiki, and just about every other woo du jour. So yea…go science.

  90. #90 Bob O'H
    February 8, 2011

    This formula has a very high ORAC value.

    Damn, it’s on Wikipedia. I was starting to imagine it was an American version of the Quackometer.

  91. #91 MI Dawn
    February 8, 2011

    @jenny: “cargo cult style of medicine”.
    I don’t think so. I don’t think that phrase means what you think it means.

    I don’t think you will get an argument from anyone here that the human body is capable of a lot of amazing things.

    Broken bones heal. Wounds heal.

    Except when they don’t heal properly.

    Have you ever seen a broken bone that hasn’t healed properly? I have. It isn’t pretty. Yes, the body grew more bone to “heal” the break. Unfortunately, the bone wasn’t straight. The doctor ended up having to re-break the bone and put the child through a lot of pain that would have been avoided if it had been set properly in the first place. The parents were strict Christian Scientists who ate/fed their family a very healthy diet (and, weirdly, consulted a naturopath. Never did figure out how that worked with CS). They only took the child to the doctor after weeks of the child refusing to put any weight on the leg.

    Another child had a huge scar because the parents used a ND who advised topical treatments on the wound and tight wrapping rather than stitches. Yes, the wound eventually healed, but the child had a very big, ugly scar where most would not want one to show.

    No, I don’t like NDs. They are quacks, just like the ones who try to argue how good they are. The examples above were 2 different NDs in 2 different states. I haven’t met a ND yet who isn’t a quack. Not to say they may not be nice people, but they are quacks in their practice of care.

    Oh, and you never defended your “residency” list. Where is the list of REAL, JCAHO hospitals that have ND residency programs? Not quack clinics.

  92. #92 Travis
    February 8, 2011

    Jenny, in what way do you feel modern medicine is a cargo cult?

  93. #93 Heliantus
    February 8, 2011

    @jenny

    Hey, does anybody work around here?

    Touché, I’m procrastinating.

    @80, yes, naturopaths have malpractice insuranse, don’t worry.

    Then why did you ask if MDs had insurance?

    That is the problem when people use defined words loosely or out of context.

    If I call myself a physician and go and treat people, the board of physician (or whatever name goes for the official physicians’ guild in my country) will drop on me like a ton of bricks. Or they should if they were half-decent human beings.
    If I call myself a naturopath… Nothing happens. Don’t you see a problem here?
    And if you see it, don’t you think that naturopaths should do something about it?

  94. #94 mrmisconception
    February 8, 2011

    Jenny,

    Have you ever heard of the bacteria H. pylori?

    Back in the 80s Dr. Barry Marshall and Dr. Robin Warren in Australia came up with the hypothesis that a bacterium called Helicobacter pylori caused at least some stomach ulcers. The scientific thinking at the time was that no bacteria couldn’t survive in the stomach so their idea was roundly dismissed. When they later PROVED their hypothesis to be true, by ingesting the bacteria and giving themselves ulcers before curing them with antibiotics, were they dismissed as cranks?

    The answer is no, they were giving a Nobel Prize because science has this funny way of accepting when it is wrong. If you would care to PROVE any of your naturopathic modalities actually work, using studies rather than anecdote, science would be happy to start using them.

    They would no longer be called naturopathic or alternative though, just simply MEDICINE.

  95. #95 Science Mom
    February 8, 2011

    @Science Mom, this is exactly what I was trying to show, that mom, in the story, did not graduate from an accredited naturopathic medical school. That is the problem when people use defined words loosely or out of context. Again, check out the science course requirements at the accredited schools.

    I have looked at curricula and faculty at so-called accredited schools and they are not as rigorous as medical schools. The faculty are mostly NDs themselves which leads to a rather incestuous, watered-down education. There is no standardisation of licensing, nor qualifications so your argument of “but but but, the boy’s mum is a bad ND” when many or even most NDs subscribe to the same nonsense as she doesn’t exactly hold much weight.

  96. #96 madder
    February 8, 2011

    @Heliantus:
    That’s exactly the point. To protect the naturopathy label, they’d have to show (among other things) how quacks from schools that don’t get the Jenny Stamp of Approval fail to meet the standard of practice set by the quacks from those schools. But as we all know, there is no standard of practice in naturopathy. They can’t defend it because there’s nothing to defend.

  97. #97 Peebs
    February 8, 2011

    I’ve just clicked on the link which Jenny provided in comment 48.

    The link Didn’t work but I was offered three free tarot readings!

  98. #98 jenny
    February 8, 2011

    @93, great example! the Helicobacter Pilaris was discovered when allopathic medical community laughed the scientists out of a conference hall. Maybe similarly to what is being said here today. The scientist went back home and infected himself, then cured himself with an antibiotic – proving his theory which was laughed at before. May I remind you that invasive surgery used to be the treatment for uscers before this discovery.

    Maybe it is woth a pause and reevaluation, that some treatments may have merit. What is alarming is when MDs claim to know “alternative” treatments, subjects which are not taught in allopathic medical schools.

    @90, you probably heard that the same also happens with casting.

  99. #99 the bug guy
    February 8, 2011

    @97. While the infection stunt got attention, what changed minds about H. pylori was the solid, published science that was replicated by other researchers.

    While it keeps getting trotted out as “they were laughed at by science”, the true story is that it is an excellent example of how well science works for novel and groundbreaking ideas.

  100. #100 Heliantus
    February 8, 2011

    @jenny

    The scientist went back home and infected himself, then cured himself with an antibiotic – proving his theory

    Then go back home, break yourself a bone, and heal it using naturopathy.

  101. #101 Travis
    February 8, 2011

    jenny, your reading of that case is a myth. It did not happen that way.

    Of course, it definitely took a while for the result to be accepted and put into practice as this this article discusses. But that is usually how it should be. Doctors do not, and should not, jump on every single result that gets published and decide it must be correct and that they will change how they treat patients. Changing requires evidence.

  102. #102 Travis
    February 8, 2011

    And often one paper is not enough, you need multiple papers, people trying to replicate the results, to build a consensus as to what is going on.

  103. #103 Beamup
    February 8, 2011

    Indeed, H. pylori is a beautiful example of what’s wrong with naturopathy. Warren and Marshall were met with skepticism. Their response was not to ignore it and claim that because some schmuck 2000 years ago said it, it’s true. No, they went and did the careful science, and other scientists attempted to replicate their results and succeeded, and their hypothesis was accepted.

    If naturopaths did the same, and actually produced good science to back up their claims, said claims would likewise be accepted. But they don’t.

  104. #104 mrmisconception
    February 8, 2011

    @101 That was my point, Jenny seems to have ignored the second half of my post.

    The point, Jenny, was not that they were laughed at therefore all that are laughed at are right; my point was thay PROVED themselves to be right therefore science accepted them.

    Nice try though.

  105. #105 Giliell
    February 8, 2011

    Ahhh, naturopaths.
    FYI, it is also licensed and regulated in Germany. People get a pretty certificate and a lot of health insurance companies also cover it.
    Well, just last week I got into a discussion about vaccination with people who were not so much “anti-vax” as they were “concerned citizens wanting to make informed choices and against the stigmatisation of people who decide otherwise and really do we need to vaccinate a bay against XY?”.
    One of them was a naturopath. When she was still in training I was kind of impressed about the amount of scientific and medical knowledge she had to gain, it almost made me think that there might be something to naturopathy.
    Well, this discussion showed me that she knows shit about anything. She didn’t know what a placental barrier is and why it lets some things through and not others and why that means that the risk of mother-child infections is greatest during birth.
    If I now imagine that this woman is “treating” pregnant women, it makes me fear for lives.

  106. #106 liladly
    February 8, 2011

    Some very interesting points raised in Orac’s blog about stabilizing the spine and the use of steroids. I viewed a recent report (2010) about the use of steroids which contained some very interesting studies about the use of steroids within eight hours of the injury. (Medscape Emergency Medicine). According to this report, many neurology specialists are reviewing the former practice of always prescribing IV steroids to reduce the inflammatory response at the site of the spinal trauma. It, apparently has become a hot issue in hospitals, which is on the front burner in Neurology Departments. Going through the various recent studies, the take away argument is, when steroids are used, depending on the injury, the window is now down to one-two hours post trauma, for maximum effectiveness. Well that window doesn’t apply here, because the parent refused the treatment recommended by the neurosurgeon. I suspect that the “doctor” mother did not base her decision on any scientific knowledge, but on her own training as a naturopathic doctor.

    “Doctor” Mitchell states her sixteen year old doesn’t want surgery to stabilize his spine. Of course he doesn’t, when his “doctor” mother fills him with all the gibberish about the mysterious (“starts with a P”) medication and other nostrums.

    Mother (“doctor”) Mitchell disparages any medical doctors and any traditional science based treatments (“all the doctors lied to me”). She wants to use (“a starts with a P”) medication to reduce the inflammation and other herbs to stabilize her son’s spine. She is not just a caring parent who got herself involved with some woo meisters, she is the woo meister who has set herself up in a practice “Get Well Stay Well Center” in her small community.

    An article in today’s Philadelphia Inquirer “Judge Says Parents Can’t Treat Wrestler at Home”, provides some background on the “doctor” and her husband. “Doctor” Vermell Mitchell a/k/a “Apostle Vermell Mitchell has a number of businesses with her husband under the banner of Mitchell Enterprises in a storefront. According to the Inquirer Mitchell Enterprises does tax preparation, document printing, classes in conflict resolution, vegetarian cooking and sells handbags, electronics and jewelry.

    Slick businesswoman, maybe; “doctor”, no.

  107. #107 iamnothouse.com
    February 8, 2011

    Geez, I wish I could use that answer on my exams:

    “What medicine is first line treatment for acute renal failure”
    “Um…..it starts with an F? Or an L? I dunno, it’s too long to remember”

  108. #108 Todd W.
    February 8, 2011

    On a side note (well, related to the original post), did anyone else get a chuckle out of I.F. Relief? IF Relief? Does that mean that IF the patient finds relief, it worked?

  109. #109 Jarred C
    February 8, 2011

    @Jenny #54

    However, since you also took a stab at homeopathy, check this out:

    http://www.huffingtonpost.com/dana-ullman/luc-montagnier-homeopathy-taken-seriously_b_814619.html

    You’re absolutely right, science changes everyday, read the latest breakthroughs and try to keep up. You may need to eat your words.

    I see your Luc Montagnier article from Huffington Post and raise you a debunking of the same article by PZ Meyers:

    http://scienceblogs.com/pharyngula/2011/01/it_almost_makes_me_disbelieve.php

  110. #110 Sastra
    February 8, 2011

    And another side note related to the original post: did anyone else appreciate the way the mother kept talking about her “viewpoint” vs. the doctors’ “viewpoint?” This is a common tactic of the woo-sters: reduce science down to a lot of different opinions, like opinions on music or lifestyle. Then play victim being persecuted by bullies who won’t respect your personal “viewpoint.” There should be room for everyone’s personal “viewpoint.”

  111. #111 Tsu Dho Nimh
    February 8, 2011

    @71 – Jenny said: Guy, even Hippocrates said, that medicine is something between science (here I go using this word again!) and art.

    He said a lot of things that we now know are not good medicine. Hippocrates also said that burning the fat of baby seals mixed with herbs, and letting the smoke enter a woman’s vagina would cure her of uterine cancer.

    Naturopathy is not medicine, it is not science, and if it is “art”, it’s “performance art” like the Wizard of Oz.

  112. Pablo @51, what I meant by that comment isn’t that the ethical conflict isn’t serious, but that all the mother needs to do is go out and find another naturopath who recommends/prescribes the same treatment, and the ethical conflict of interest goes away, and we we would still be left with the unscientific practice of naturopathy being chosen by the mother as the core issue.

  113. …and the deeper core issue is that the practice of naturopathy is given any serious consideration or licensing and considered a valid form of medicine anywhere.

  114. #114 Dangerous Bacon
    February 8, 2011

    jenny: “Here is a link for a taste of what naturopaths are doing in a hospital and other clinical settings. Having said that, please note that with proper care most persons should not end up in a hospital, barring some trauma or other serious conditions.”

    Hmmm, with “proper care” by naturopaths one can avoid hospitalization, except for “serious conditions”. Does that mean that naturopaths avoid using their compendium of woo in such cases or have they fantastic powers to treat them such that hospitalization is avoided?

    Here’s a fairly typical naturopathic clinic citing its staff’s capabilities:

    “Nearly all chronic and most acute conditions can be treated by Naturopaths*.”

    • Fatigue and insomnia
    • Skin conditions
    • Headaches
    • Digestive complaints
    • Arthritis
    • Heart disease and diabetes
    • Cancer
    • Menopausal concerns
    • Menstrual disorders and other women’s conditions
    • Weight Management
    • Depression, anxiety and stress
    • Men’s health
    • Cold’s, flu’s** and infections
    • Allergies
    • ADD, ADHD

    Impressive. It probably pays for naturopaths to be aware of what hospital-based care entails, so that the physicians there can clean up their messes.

    *see, they’re also into that weird Realtor-style shtick of “they’ll take us more seriously if we Capitalize our name”. :)
    **won’t someone take pity on the grammarians?

  115. #115 Dangerous Bacon
    February 8, 2011

    Hmmm, with “proper care” by naturopaths one can avoid hospitalization, except for “serious conditions”. Does that mean that naturopaths avoid using their compendium of woo in such cases or have they fantastic powers to treat them such that hospitalization is avoided?

    Here’s one naturopathic clinic citing its staff’s capabilities:

    “Nearly all chronic and most acute conditions can be treated by Naturopaths*.”

    • Fatigue and insomnia
    • Skin conditions
    • Headaches
    • Digestive complaints
    • Arthritis
    • Heart disease and diabetes
    • Cancer
    • Menopausal concerns
    • Menstrual disorders and other women’s conditions
    • Weight Management
    • Depression, anxiety and stress
    • Men’s health
    • Cold’s, flu’s** and infections
    • Allergies
    • ADD, ADHD

    Impressive. It probably pays for naturopaths to be aware of what hospital-based care entails, so that the physicians there can clean up their messes.

    *see, they’re also into that weird Realtor-style shtick of “they’ll take us more seriously if we Capitalize our name”. :)
    **won’t someone take pity on the grammarians?

  116. #116 Chris
    February 8, 2011

    Jenny, what kind of science to NDs learn when one told my relative to get off her meds and use homeopathy (which apparently were specially made and expensive), plus to stop consuming foods that had allergens, but eat soy again. Um, soy is one of the top dozen foods that people can be allergic to.

    Oh, yeah… some “science.” It made my relative lose all the gains she had made, and did not relieve her chronic pain.

    You will have to do much more to convince me that naturapaths know basic chemistry.

  117. #117 Dangerous Bacon
    February 8, 2011

    Hmmm, with “proper care” by naturopaths one can avoid hospitalization, except for “serious conditions”. Does that mean that naturopaths avoid using their compendium of woo in such cases or have they fantastic powers to treat them such that hospitalization is avoided?

    Here’s one naturopathic clinic (Greenwood, in Canada, which boasts of having “unique testing equipment” like a darkfield microscope, oo, how 1940s) citing its staff’s capabilities:

    “Nearly all chronic and most acute conditions can be treated by Naturopaths*.”

    • Fatigue and insomnia
    • Skin conditions
    • Headaches
    • Digestive complaints
    • Arthritis
    • Heart disease and diabetes
    • Cancer
    • Menopausal concerns
    • Menstrual disorders and other women’s conditions
    • Weight Management
    • Depression, anxiety and stress
    • Men’s health
    • Cold’s, flu’s** and infections
    • Allergies
    • ADD, ADHD

    Impressive. It probably pays for naturopaths to be aware of what hospital-based care entails, so that the physicians there can clean up their messes.

    *see, they’re also into that weird Realtor-style shtick of “they’ll take us more seriously if we Capitalize our name”. :)
    **won’t someone take pity on the grammarians?

  118. #118 feralboy12
    February 8, 2011

    Mothers care for their children in the best way they know how.

    And if they don’t know how?

    I love my mother, but spinal injuries were not her field
    If a caregiver can’t pronounce the name of the remedy, that is somewhat worrisome, but worse would be a caregiver that has never treated my injury before.

  119. #119 nybgrus
    February 8, 2011

    This thread got onerous FAST!

    Jenny has been schooled a NUMBER of times on the concepts of naturopathy and tooth fairy science. Even Orac himself has given her references, links, and citations to refute each and every specific claim she has ever made. First she claimed homeopathy was basically bogus but that NDs don’t practice it – and was schooled on that. Then she claimed that therapeutic touch was legit because “kangaroo care” worked and was schooled on that (kangaroo care has NOTHING to do with TT). I hate to say this fellas, but she has become the (albiet less rank and crass) Th1, Sid Offit, and Auggie troll for naturopathy. As Chris has said before – don’t feed the trolls, it is a waste of time. For me, it also makes it difficult to catch up with the comments made by actually intelligent, informed, and critical people here – something I learn from. I know – we all like to a feed a troll from time to time, but at least if we recognize her as one we can keep it to a minimum.

    On a more serious note, in regards to the concept of Gillick competence – that is a very true statement (@4). 16 year olds CAN be considered to be adult and make independent healthcare decisions. In the case of reproductive health there is precedent that allows for privacy and independent decision making. However, there is also the necessity to differentiate “dispositional” and “occurrent” levels of autonomy when applying the Gillick rules of competence to an otherwise minor individual. This allows for cases in which an independent health decision is needed for the best health of the minor patient to be allowed and kept private (to grant them the autonomy reflected by their more mature but not quite fully mature status) but do step in and remove such autonomy when it is clear that the ramifications are not fully understood by the minor in question. Dispositional autonomy is generally attained first – i.e. the ability to understand the complexity of a medical procedure. Occurrent autonomy is then attained later – i.e. the ability to understand the relative importance and life long impact of a complex medical procedure. Precedent for that is also available – the case of a minor patient in need of a heart transplant that would require taking pills for the rest of her life. She claimed she would rather die than endure lifelong health management like that. The court ruled that she clearly lacked the occurrent autonomy to understand the magnitude of her decision to die and in her still immature perspective on life taking pills was more onerous than death. This also tends to fall in line with determining the competence of an adult – it is generally recognized that a desire to die when life saving intervention is available is a sign that a person may not be fully competent. In the case of an adult, when taken alone, this is not enough to declare them incompetent – other corroborating factors must be present as well. However, in the case of a minor (such as the case here) if he is willing to risk such great further injury or death that could be taken as a sign that he has not reached a sufficient level of occurrent autonomy and thus strip him of Gillick competence. Granted, that by default then only allows for his parent(s) to override his medical decision which in this case is not the best course of action either. However, in Australia, there is precedent for that as well – the minor children of Jehovah’s witnesses can still be administered blood against their and their parents’ wishes in critical cases since the state considers the welfare of the child to be of highest importance and can thus rescind parental authority in such extreme cases and then justify removing the minor’s decision making capacity based on the judged lack of occurrent autonomy and Gillick competence.

    I would then conclude that (at least here in Australia) Mazeratti would be treated surgically despite his own AND his mother’s objections. But this is happening in America so who knows….

  120. #120 nybgrus
    February 8, 2011

    This thread got onerous FAST!

    Jenny has been schooled a NUMBER of times on the concepts of naturopathy and tooth fairy science. Even Orac himself has given her references, links, and citations to refute each and every specific claim she has ever made. First she claimed homeopathy was basically bogus but that NDs don’t practice it – and was schooled on that. Then she claimed that therapeutic touch was legit because “kangaroo care” worked and was schooled on that (kangaroo care has NOTHING to do with TT). I hate to say this fellas, but she has become the (albiet less rank and crass) Th1, Sid Offit, and Auggie troll for naturopathy. As Chris has said before – don’t feed the trolls, it is a waste of time. For me, it also makes it difficult to catch up with the comments made by actually intelligent, informed, and critical people here – something I learn from. I know – we all like to a feed a troll from time to time, but at least if we recognize her as one we can keep it to a minimum.

    On a more serious note, in regards to the concept of Gillick competence – that is a very true statement (@4). 16 year olds CAN be considered to be adult and make independent healthcare decisions. In the case of reproductive health there is precedent that allows for privacy and independent decision making. However, there is also the necessity to differentiate “dispositional” and “occurrent” levels of autonomy when applying the Gillick rules of competence to an otherwise minor individual. This allows for cases in which an independent health decision is needed for the best health of the minor patient to be allowed and kept private (to grant them the autonomy reflected by their more mature but not quite fully mature status) but do step in and remove such autonomy when it is clear that the ramifications are not fully understood by the minor in question. Dispositional autonomy is generally attained first – i.e. the ability to understand the complexity of a medical procedure. Occurrent autonomy is then attained later – i.e. the ability to understand the relative importance and life long impact of a complex medical procedure. Precedent for that is also available – the case of a minor patient in need of a heart transplant that would require taking pills for the rest of her life. She claimed she would rather die than endure lifelong health management like that. The court ruled that she clearly lacked the occurrent autonomy to understand the magnitude of her decision to die and in her still immature perspective on life taking pills was more onerous than death. This also tends to fall in line with determining the competence of an adult – it is generally recognized that a desire to die when life saving intervention is available is a sign that a person may not be fully competent. In the case of an adult, when taken alone, this is not enough to declare them incompetent – other corroborating factors must be present as well. However, in the case of a minor (such as the case here) if he is willing to risk such great further injury or death that could be taken as a sign that he has not reached a sufficient level of occurrent autonomy and thus strip him of Gillick competence. Granted, that by default then only allows for his parent(s) to override his medical decision which in this case is not the best course of action either. However, in Australia, there is precedent for that as well – the minor children of Jehovah’s witnesses can still be administered blood against their and their parents’ wishes in critical cases since the state considers the welfare of the child to be of highest importance and can thus rescind parental authority in such extreme cases and then justify removing the minor’s decision making capacity based on the judged lack of occurrent autonomy and Gillick competence.

    I would then conclude that (at least here in Australia) Mazeratti would be treated surgically despite his own AND his mother’s objections. But this is happening in America so who knows….

  121. #121 skybluskyblue
    February 8, 2011

    “Moreover, in the states that license the profession the insurance companies cover naturopathic care.”

    Yeah, i am among the unlucky in a state that has state licensed NDs.When i moved here i had to pick a primary care Dr. off of a list. I was so angry when 99% of my choices were NDs. Maybe no one else wanted them so they were not “not taking new patients”.

    “Personally, I have experience opting for invesive surgery and supplementing recovery with complementary treatment.”
    Yeah i knew a client who did not want invasive surgery. They ended up with a cat with a non-union fracture mid shaft femur. It nearly felt like another joint on the cat. The doctor who gave into their wishes was sued by those same people. I wonder if this would have happened in this case if the kid and mother got their way.
    So, yeah, naturopathy does not work for pets either.

  122. #122 DMG
    February 8, 2011

    First I love this blog. It gives me hope that the internet hasn’t completely gone to hell.

    I’m assuming the the steroid issue is moot, since the 8 hour window has long been passed, and the utility in acute spinal cord injury is controversial anyway. The article suggests he was having issues with hypotension. The parents refusing meds to maintain adequate blood pressure and spinal perfusion is just mind boggling, and shows they really don’t understand what’s going on. Woo seems to be winning (and thereby driving MY blood pressure up).

    I’m actually torn as to what I would do in this situation (other than annoy my wife with a long winded rant about stupid parents). I don’t mean that I believe that the mothers quackery has any merit, but I really cannot imagine wheeling a patient to the OR who has voiced his disagreement with surgical intervention. Although he’s legally a minor, he is probably as capable of understanding the risks, benefits and alternatives as he would be at 18. Anyway, he’s still firmly in his mothers sphere of influence.

    Sending him home with his misinformed parents is, in my opinion, akin to wishing potential permanent injury on a 16 year old kid. But if he has the procedure, and a complication occurs no matter how small, you’ll never hear the end of it. I hate to say it, I might call off the dogs and let him go home and roll the dice, documenting every conversation and making sure the parents understand the consequences in graphic detail.

  123. #123 WLU
    February 8, 2011

    I always find it amusing when alt med types bring up the bacteria-ulcers issue as if it vindicated their arguments. Because after they discovered ulcers were caused by bacteria what was the treatment again? Was it acupuncture? Homeopathy? Reiki? Herbal medicine?

    Nope. Antibiotics. Evil, Big Pharma antibiotics.

    So even if medicine is wrong, it still a) corrects itself and b) solves health problems with evidence-based pharmaceuticals. Not magic and wishful thinking.

  124. #124 jenny
    February 8, 2011

    Hey guys,

    38% of US adults use CAM, according to NIH: http://nccam.nih.gov/news/2008/121008.htm

    Note that these people seek help from practitioners, ie NDs, who do not use prescription drugs. Take surgery away, it is a different discipline, as you will see in doctorate descriptions there are doctors of medicine and those of surgery. Then, if you take allopathic and naturopathic doctors, take away allopath’s prescription drug privileges, what is left… basically, allopath will be almost useless, without the ability to prescribe drugs, they will not be able to treat much. Allopaths are not trained in the treatments that naturopaths are trained in. Naturopaths have been using and are perfecting the use of natural remedies.

    As to surgery, they’re wizards with their hands. I remember my pre-med college recruiters who put is most delicately: if you want to be a surgeon, you are going to have to be a good plumber.

    @125: did you know that antibiotics come from fungus? which is quiet natural, hmm, not really pharma, or even big pharma…

  125. #125 Peapoh
    February 8, 2011

    Yay! *marks appeal to nature square off*

  126. #126 Chris
    February 8, 2011

    Argument from popularity is just lame.

    So what if a bit over a third seek CAM? Look at it more closely, some of the “CAM”s are meditation, supplements and yoga. The use of Not Doctors is not even on the list, but chiropractors are included.

    So do tell us what kind of science is taught to the None Doctors that tell them that soy is not allergenic and homeopathy actually works. Do list those studies. Also tell us how Ms. Mitchell’s proposals will do anything to help her son.

  127. #127 Poodle Stomper
    February 8, 2011

    Then, if you take allopathic and naturopathic doctors, take away allopath’s prescription drug privileges, what is left… basically, allopath will be almost useless, without the ability to prescribe drugs, they will not be able to treat much.

    As opposed to naturopaths who are pretty much useless and unable to treat anything even with their repertoire intact?
    Yes if you take all doctors’ tools away they won’t be able to do much but that doesn’t mean that naturopathy is valid or in any way effective. The burden of proof is on naturopaths to show the science (if there were any) behind their practice.

    did you know that antibiotics come from fungus? which is quiet natural, hmm, not really pharma, or even big pharma.

    Not all of them.

  128. #128 Todd W.
    February 8, 2011

    @jenny

    Naturopaths have been using and are perfecting the use of natural remedies.

    Okay, what are the natural remedies for the following. Please include citations to support your answer:

    * Type 1 diabetes
    * Leukemia
    * Multiple Sclerosis
    * Rabies
    * Tetanus

  129. #129 jenny
    February 8, 2011

    @130

    Threonine may reduce signs of spasticity in multiple sclerosis. – GreenMedInfo Summary

    Abstract Title:
    An antispasticity effect of threonine in multiple sclerosis.

    Abstract Source:
    1: Arch Neurol. 1992 Sep;49(9):923-6. PMID: 1520082

    Abstract:
    To determine whether the naturally occurring amino acid threonine, a potential precursor for glycine biosynthesis in the spinal cord, has an effect on spasticity in multiple sclerosis, 26 ambulatory patients were entered into a randomized crossover trial. Threonine administered at a total daily dose of 7.5 g reduced signs of spasticity on clinical examination, although no symptomatic improvement could be detected by the examining physician or the patient. In contrast to the side effects of sedation and increased motor weakness associated with antispasticity drugs commonly used for the treatment of multiple sclerosis, no side effects or toxic effects of threonine were identified. Levels of threonine were elevated in serum and cerebrospinal fluid during treatment, but glycine levels did not change. Enhancement by threonine of glycinergic postsynaptic inhibition of the motor reflex arc in the spinal cord may represent a non-sedating, nontoxic approach to the management of spasticity in multiple sclerosis.

    Study Type : Human Study
    Additional Links:
    Substances : Threonine
    Diseases : Multiple Sclerosis
    Pharmacological Actions : Antispasmodic

  130. #130 jenny
    February 8, 2011

    @130

    Gymnena sylvestre has therapeutic effects in type 1 diabetes. – GreenMedInfo Summary

    Abstract Title:
    Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients.

    Abstract Source:
    1: J Ethnopharmacol. 1990 Oct;30(3):295-300.PMID: 2259217

    Abstract:
    Full Citation: “GS4, a water-soluble extract of the leaves of Gymnema sylvestre, was administered (400 mg/day) to 27 patients with insulin-dependent diabetes mellitus (IDDM) on insulin therapy. Insulin requirements came down together with fasting blood glucose and glycosylated haemoglobin (HbA1c) and glycosylated plasma protein levels. While serum lipids returned to near normal levels with GS4 therapy, glycosylated haemoglobin and glycosylated plasma protein levels remained higher than controls. IDDM patients on insulin therapy only showed no significant reduction in serum lipids, HbA1c or glycosylated plasma proteins when followed up after 10-12 months. GS4 therapy appears to enhance endogenous insulin, possibly by regeneration/revitalisation of the residual beta cells in insulin-dependent diabetes mellitus.”

    Additional Links:
    Diseases : Diabetes Mellitus: Type 1

  131. #131 jenny
    February 8, 2011

    @130

    Black hellebore (Helleborus niger) induces programmed cell death in the Actue lymphoblastic leukemia (ALL) cells and Acute myeloid leukemia (AML). – GreenMedInfo Summary

    Abstract Title:
    Apoptosis-inducing activity of Helleborus niger in ALL and AML.

    Abstract Source:
    1: Pediatr Blood Cancer. 2009 Apr;52(4):464-9. PMID: 19090543

    Abstract:
    BACKGROUND: Helleborus niger is used in the adjuvant treatment of different tumors in anthroposophical medicine. Indications include various types of brain tumors in children, as well as prostate cancer, leukemia and lymphoma. Our aim was to investigate the therapeutic effects of these extracts apart from the traditional use. PROCEDURES: : We used an aqueous whole plant extract of H. niger in different cancer and leukemia cell lines and primary cells of patients with childhood ALL and AML and identified the main mechanisms of action. RESULTS: A strong inhibition of proliferation is caused by specific apoptosis induction, which is executed via the mitochondrial pathway and caspase-3 processing. Apoptosis could be detected in lymphoma (BJAB), leukemia (Reh, Nalm6, Sup-B15) and melanoma (Mel-HO) cells and overcomes a Bcl-2-mediated block of apoptosis. In primary cells of patients with childhood ALL and AML, which were partly poor responding to doxorubicin and daunorubicin, a strong apoptosis induction was determined. In combination with the vinca alkaloid vincristine, strong synergistic effects were detected in BJAB cells. CONCLUSION: We demonstrate in vitro efficacy of H. niger extract in cells of hematological malignancies; these studies should encourage in vivo experiments. Copyright 2008 Wiley-Liss, Inc.

    Study Type : In Vitro Study
    Additional Links:
    Substances : Black hellebore
    Diseases : Acute lymphoblastic leukemia (ALL), Acute Myeloid Leukemia, Leukemia: Acute myelogenous leukemia (AML)
    Pharmacological Actions : Apoptotic

  132. #132 jenny
    February 8, 2011

    @130

    for emergency cases, such as scare of rabies or tetanus, a good naturopath will recommend to go to the ER immediately.

  133. #133 Heliantus
    February 8, 2011

    @ jenny

    without the ability to prescribe drugs, [allopaths] will not be able to treat much.

    Well, yes, if you take away your plumber’s monkey wrench, he won’t be able to do much to fix your bathroom. Big surprise.

    Allopaths are not trained in the treatments that naturopaths are trained in.

    One last time: and the evidence that naturopath’s treatments are good for anything is?

    did you know that antibiotics come from fungus? which is quiet natural, hmm, not really pharma, or even big pharma..

    And atropine, aspirin, taxol, morphine are from plants; and botox is from a bacterium. Should I talk about insulin, epinephrine, or steroids, all from animals?
    All blockbusters of big pharma. We didn’t wait for the naturopaths to get interested in natural substances. Galen’s pharmacy is a big chunk of the foundation of today “allopathic” medicine.
    And most of these naturally occurring molecules have been heavily modified by pharmaceutical companies to improve one or another of their properties. It could be to reduce side-effects (aspirin, codeine), or to race against bacterial resistance (penicillins). To say that the antibiotics we are using are all-natural is disingenuous.

    In a typical fashion for CAMs proponents, you are hijacking successes of mainstream science or medicine and are claiming credit where you deserve none.

  134. #134 jenny
    February 8, 2011

    @130

    Black hellebore (Helleborus niger) induces programmed cell death in the Actue lymphoblastic leukemia (ALL) cells and Acute myeloid leukemia (AML). – GreenMedInfo Summary

    Abstract Title:
    Apoptosis-inducing activity of Helleborus niger in ALL and AML.

    Abstract Source:
    1: Pediatr Blood Cancer. 2009 Apr;52(4):464-9. PMID: 19090543

    Abstract:
    BACKGROUND: Helleborus niger is used in the adjuvant treatment of different tumors in anthroposophical medicine. Indications include various types of brain tumors in children, as well as prostate cancer, leukemia and lymphoma. Our aim was to investigate the therapeutic effects of these extracts apart from the traditional use. PROCEDURES: : We used an aqueous whole plant extract of H. niger in different cancer and leukemia cell lines and primary cells of patients with childhood ALL and AML and identified the main mechanisms of action. RESULTS: A strong inhibition of proliferation is caused by specific apoptosis induction, which is executed via the mitochondrial pathway and caspase-3 processing. Apoptosis could be detected in lymphoma (BJAB), leukemia (Reh, Nalm6, Sup-B15) and melanoma (Mel-HO) cells and overcomes a Bcl-2-mediated block of apoptosis. In primary cells of patients with childhood ALL and AML, which were partly poor responding to doxorubicin and daunorubicin, a strong apoptosis induction was determined. In combination with the vinca alkaloid vincristine, strong synergistic effects were detected in BJAB cells. CONCLUSION: We demonstrate in vitro efficacy of H. niger extract in cells of hematological malignancies; these studies should encourage in vivo experiments. Copyright 2008 Wiley-Liss, Inc.

  135. #135 jenny
    February 8, 2011

    @130

    Black hellebore (Helleborus niger) induces programmed cell death in the Actue lymphoblastic leukemia (ALL) cells and Acute myeloid leukemia (AML). – GreenMedInfo Summary

    Abstract Title:
    Apoptosis-inducing activity of Helleborus niger in ALL and AML.

    Abstract Source:
    1: Pediatr Blood Cancer. 2009 Apr;52(4):464-9. PMID: 19090543

    Abstract:
    BACKGROUND: Helleborus niger is used in the adjuvant treatment of different tumors in anthroposophical medicine. Indications include various types of brain tumors in children, as well as prostate cancer, leukemia and lymphoma. Our aim was to investigate the therapeutic effects of these extracts apart from the traditional use. PROCEDURES: : We used an aqueous whole plant extract of H. niger in different cancer and leukemia cell lines and primary cells of patients with childhood ALL and AML and identified the main mechanisms of action. RESULTS: A strong inhibition of proliferation is caused by specific apoptosis induction, which is executed via the mitochondrial pathway and caspase-3 processing. Apoptosis could be detected in lymphoma (BJAB), leukemia (Reh, Nalm6, Sup-B15) and melanoma (Mel-HO) cells and overcomes a Bcl-2-mediated block of apoptosis. In primary cells of patients with childhood ALL and AML, which were partly poor responding to doxorubicin and daunorubicin, a strong apoptosis induction was determined. In combination with the vinca alkaloid vincristine, strong synergistic effects were detected in BJAB cells. CONCLUSION: We demonstrate in vitro efficacy of H. niger extract in cells of hematological malignancies; these studies should encourage in vivo experiments. Copyright 2008 Wiley-Liss, Inc.

  136. #136 Karl Withakay
    February 8, 2011

    Jenny keeps hitting on all the popular CAM gambits, it’s quite impressive.

    Apparently she is unaware the 1/3 of all people using CAM figure has been debunked numerous times. When you include massage, relaxation/meditation, light exercise, nutrition and lifestyle (things already accounted for in scientific medicine) as CAM, that inflates the numbers to 30-40%. When you only include actual CAM like acupuncture, homeopathy, naturopathy, etc, the numbers are much lower.

    She is also, apparently unaware of the fact that naturopaths in numerous states are fighting for the right to prescribe those evil, “allopathic” drugs.

    Yes, penicillin was derived from moldy bread. And though its discovery was semi-serendipitous, it was discovered and validated as safe and effective through science. Arsenic, formaldehyde, and botulism are also natural, by the way.

  137. #137 Chris
    February 9, 2011

    I find it interesting that jenny has never addressed any of my comments. Is it because our family has personal experience with the results of naturapathy, which we can visit at the cemetery not far from where we live? Surely she knows about this.

    So tell us, jenny, what “science” do naturapaths (also known as Non-Doctors) learn about allergens and homeopathy? Do tell us how soy is not an allergen, and that homeopathic remedies are better than real medication. Show us the scientific literature (give journal, title, date and authors, must be available in a medical school library) that shows naturapaths have a better record with chronic pain that results in mental illness. I really want to see what wisdom you can impart.

  138. #138 Travis
    February 9, 2011

    Perhaps someone here will know more about this issue that has been bugging me as of late. Why is it that anyone would think that medicines derived from “natural” products, or herbs/mold and whatnot would actually be better for us, as a general principal? It is not as though these compounds are made for our use in nature, they are not tailored to us. We just happen to find out that certain things in them are useful (or harmful and poisonous other times). I suppose if these plants had evolved in some sort of symbiotic relationship they might be extremely helpful but this is not the case in most instances.

  139. #139 jenny
    February 9, 2011

    Heliantus,

    “to reduce side-effects (aspirin, codeine), or to race against bacterial resistance (penicillins).”

    Reduce one side-effect and cause another two. Race against bac. resistence cause of MRSA.

  140. #140 Travis
    February 9, 2011

    Chris, I too have unanswered questions. I am still wondering in what way modern medicine is a cargo cult.

  141. #141 jenny
    February 9, 2011

    it seems that maybe someone here is blocking my posts… I tried to educate everyone here with abstracts from articles, with titles, and authors, and all you’ll need to located it on the shelf in the medical school near you, favorite medical journals on the use of naturopathic substances for treatment of conditions addressed in post 130. sorry, I will try next time.

  142. #142 Heliantus
    February 9, 2011

    @ jenny

    You have no idea, do you?

    “Reduce one side-effect and cause another two.”

    Example?

    “Race against bac. resistence cause of MRSA.”

    More likely overuse of antibiotics. And bacteria are naturally resistant to antibiotics, this is not a race we can choose not to go into.

    Still waiting evidence that naturopaths have anything to propose.

  143. #143 Poodle Stomper
    February 9, 2011

    Travis,
    Perhaps someone here will know more about this issue that has been bugging me as of late. Why is it that anyone would think that medicines derived from “natural” products, or herbs/mold and whatnot would actually be better for us, as a general principal?

    Mainly because they fail to understand basic chemistry or biology. That’s just my guess. There are a ton of “natural” things that can kill us just fine (unless of course you dilute them to the point that there is nothing left =P)

  144. #144 Chris
    February 9, 2011

    jenny, you are limited to two URLs per comment. Sometimes a key word will put a comment into moderation. Be patient, Orac is a kind overlord and approves most comments.

    Now that you know the rules, just post the journal, title, date and authors of the studies that support you position. Show us exactly how homeopathy is supported by science, and that naturapaths actually understand Avogadro’s Number. Because if they did, a Bastyr graduate would not be running the idiotic “Children’s Homeopathic Clinic.” (and yes it does exist!) Also that they have the definite cure for this list from Todd

  145. #145 David N. Brown
    February 9, 2011

    As I pointed out previously, this boy has two realistic options: One is what could easily be regarded as an invasive surgery, that presumably has some risk of complications or failure. The other is limited mobility for the rest of his life. I might sympathize if he frankly asked to be allowed to choose the latter over the former. But thinking that herbal remedies can somehow accomplish what conventional medicine needs major hardware to do is just delusional.

  146. #146 Giliell
    February 9, 2011

    for emergency cases, such as scare of rabies or tetanus, a good naturopath will recommend to go to the ER immediately.

    Or, in other words: As soon as something happens that will probably not heal all by itself we send you to somebody who actually has something that works.

    Yep, most antibiotics are a by-product of fungi. Only I can eat all the mushrooms I want and it still won’t help me a bit (with the exception of their nutritional value).
    Yes, over-use of antibiotics has led to things like MRSA. But it is funny to hear people complain about this who, if they had their way, would never have saved anybody in the first case on account of being clueless. Sure, if you never discover antibiotics (but wait, if they’re all natural they surely can’t be bad for you. Isn’t that the ND claim? I’m confused) you can never discover that bacteria actually become resistant. You can just die all naturally.

  147. #147 Andreas Johansson
    February 9, 2011

    Karl Withakay wrote:

    Apparently she is unaware the 1/3 of all people using CAM figure has been debunked numerous times. When you include massage, relaxation/meditation, light exercise, nutrition and lifestyle (things already accounted for in scientific medicine) as CAM, that inflates the numbers to 30-40%. When you only include actual CAM like acupuncture, homeopathy, naturopathy, etc, the numbers are much lower.

    Some of those seem questionable to describe as “medicine” at all. That I bike to work (which surely counts as “light exercise”) can only be considered medication if shitty public transportation is considered a disease.

  148. #148 LW
    February 9, 2011

    jenny, you cited several studies by real scientists investigating the use of certain natural substances against diseases. If these studies pan out, there will be new drugs to use in real medicine.

    Naturopaths may have stumbled across these substances and found them to be useful, but — and this is the important point — naturopaths didn’t do the real science to determine whether they really worked (not a placebo effect or other confounder), what side-effects they had, what the proper dosage is, how they work, what the active ingredient is so that perhaps it can be isolated and used with fewer side-effects, and so on. That is the work that real scientists do and it gives rise to real medicine.

    All you have succeeded in showing is that real scientists will look for cures wherever they might seem to be found, and that there is no prejudice against natural sources if they seem effective.

  149. #149 Asper
    February 9, 2011

    I am sorry to say, but this discussion in the comments is a perfect example of wasted time both for reasonable people and the believers in naturopathy. I do not know if this flowchart….

    http://atheismresource.com/wp-content/uploads/Debate-Flow-Chart1.jpg

    …. was presented here on this blog (I am currently catching up on some older posts, but Orac has produced huge amounts of content and my english skills have lots and lots of room for upgrades), but it is a nice gimmick to bear if a discussion is usefull and or a waste of time.

    Nice day, Asper

  150. #150 MI Dawn
    February 9, 2011

    @jenny: nice articles. Interestingly, 2 of them (Threonine and Gymnema sylvestre) are nearly 20 years old. Any more recent studies on them? If the first studies panned out, you would think there are more recent, larger studies. The Helleborus niger, a more recent 2009 study, appears to have some use in cells in petri dishes and the authors are recommending in vivo (human) trials.

    So….any current, double-blinded, large number human studies that show that these items really work? Believe it or not, doctors DO like finding new treatments that work for their patients.

    Oh, and if you are in the US: doctors are given diplomas of medicine and surgery, not one or the other. It is the individual’s choice as to what they specialize in, not based on their diploma. An internist (medical doctor) could legally perform surgery. A surgeon could legally treat a heart attack (medical treatment). Their licenses do not restrict what they do. Doctors, and to some extent the hospitals in which they practice, are what restricts what each kind of doctor does. Not their licensure or their degree. (Not referring to certification, which are different).

  151. #151 Science Mom
    February 9, 2011

    “Then, if you take allopathic and naturopathic doctors, take away allopath’s prescription drug privileges, what is left… basically, allopath will be almost useless, without the ability to prescribe drugs, they will not be able to treat much.”

    They would still be able to treat far more than a naturopath for the nostrums naturopaths use are mostly useless now. Also jenny, could you tell me why naturopaths lobby so hard to expand their scope of practise and for prescriptive authority if they are so anti-medicine?

  152. #152 Dianne
    February 9, 2011

    I wonder what a patient of mine would say if I proposed using a medicine and said I call it “P” because its name is so long that I can’t remember it.

    To be fair, I often refer to ipilimumab as “ipi” because I stumble all over the middle syllables if I try to say “ipilimumab” too many times in a row.

  153. #153 Todd W.
    February 9, 2011

    @jenny

    Thank you for providing actual studies. Taking a look at them, as others have already noted, they are hardly the basis for standard use of threonine for MS, Gymnena sylvestre for type 1 diabetes or black hellebore for leukemia. The first two are quite old, and I had trouble finding any recent follow-up/replication in PubMed. They also used rather small sample sizes, so at best, we can say that their findings are interesting and should be studied further, but they cannot be used to justify their use in everyday treatment.

    The black hellebore study was much more recent, which is good. But again, there’s a problem. It is in vitro, a bench study, not examining its use in a living system. The results, again, are interesting and bear looking into, but they cannot be used to justify its standard use in the treatment of leukemia subjects, particularly when other drugs with proven track records already exist.

    In short, you have not provided evidence of natural remedies (the implication being something that doctors do not use) for the conditions I listed. Interestingly, there are medicines derived from natural resources for those conditions: insulin is an animal product (typically from horses), a variety of steroids (also animal products) are used in the treatment of MS, Indirubin derived from Indigofera tinctoria (a plant) may be used in the treatment of leukemia, rabies and tetanus antitoxins and vaccines (derived from the virus and bacterium respectively) are also natural sources. I find it interesting that a naturopath (or one of its supporters) wouldn’t mention these common drugs for treatment.

  154. #154 han
    February 9, 2011

    When I was a teenager, I knew a kid named Yolan (a friend’s little brother) who got really, really sick. His mother, with the best of intentions, repeatedly took him to an acupuncturist instead of a real doctor. He continued to waste away until the family finally broke down and took him to the hospital. He was diagnosed with leukemia and died within 24 hours.

    As I get older (it’s been about 10 years), his death hits me in new and unexpected ways. My friend lost his little brother and his parents lost a son, but Yolan lost his chance to grow up. The rest of us have gone on to get married, have children, and begin our adult lives. Yolan never got that chance, not because his mom didn’t love him enough to get him medical help, but because she thought she was getting him medical help.

    When people ask, “What’s the harm?” I will always see Yolan’s smiling face, forever frozen at age 14, a needless death at the hands of an alt-med practitioner.

    Jenny, naturopaths can’t cure leukemia. Maybe Yolan would have died anyway, but thank to the misinformation and far sown by people like you, he never had a chance to recover. Shame on you.

  155. #155 Pablo
    February 9, 2011

    In short, you have not provided evidence of natural remedies (the implication being something that doctors do not use) for the conditions I listed

    and the further implication being something that naturopaths DO use to treat (actually and heal) the problems listed.

    So Black Hellabor shows promise in the lab against leukemia. Do naturopaths actually use black hellabor against leukemia with any success? Note that success has to be determined objectively, and not just resorting to anecdotes (funny, we didn’t even get that).

  156. #156 Vicki
    February 9, 2011

    @131:

    So, the “natural treatment” for MS symptoms is a drug that produced no relief of symptoms detectable by either the patient or the doctor.

    The goal is not to “reduce signs of spasticity on clinical examination,” it is to reduce the actual effects on the patient.

    We’re also looking at a single 26-patient study from the 1990s. The lack of anything more recent suggests that professionals had the same reaction I did: that there is nothing to suggest that threonine would benefit people with MS.

    And, since you brought up H. pylori, what was the naturopathic theory of stomach ulcers before the conventional doctors demonstrated that many of them are caused by bacterial infection? And has the naturopathic approach changed since those doctors won the Nobel Prize?

  157. #157 Beamup
    February 9, 2011

    38% of US adults use CAM, according to NIH: http://nccam.nih.gov/news/2008/121008.htm

    Let’s look at that list. Deep breathing is not CAM. Meditation is not CAM. Massage is not CAM. Yoga is not CAM. In other words, the claim is completely false.

  158. #158 madder
    February 9, 2011

    I find it amusing that when Jenny is asked to provide evidence for a naturopathic treatment for Type 1 diabetes, her “evidence” is an old and pitiful study on treating non-insulin-dependent diabetes.

    Apologies for engaging her; I hadn’t realized (as nybgrus points out above at #120) that she’s the same person who’s been schooled so thoroughly and so often. Given that, and her self-contradictory statements (e.g. doctors can’t be trusted because they need malpractice insurance, but then of course naturopaths are responsible enough to carry malpractice insurance), citation of an article about Montagnier in the HuffPo, and other inanities, I am convinced that she’s a troll. I wash my hands of her.

  159. #159 mikerattlesnake
    February 9, 2011

    “Then, if you take allopathic and naturopathic doctors, take away allopath’s prescription drug privileges, what is left… basically, allopath will be almost useless, without the ability to prescribe drugs, they will not be able to treat much.”

    “did you know that antibiotics come from fungus? which is quiet natural, hmm, not really pharma, or even big pharma…”

    After reading that second quote, I immediately see a problem with your first scenario. Do you? Or are you capable of contradicting yourself within the span of two sentences and not noticing it?

  160. #160 jenny
    February 9, 2011

    Coriander seed may stimulate insulin release from pancreatic beta cells in a type 1 diabetic rat model. – GreenMedInfo Summary

    Abstract Title:
    Effect of coriander seed (Coriandrum sativum L.) ethanol extract on insulin release from pancreatic beta cells in streptozotocin-induced diabetic rats.

    Abstract Source:
    Phytother Res. 2009 Mar ;23(3):404-6. PMID: 19003941

    Abstract Author(s):
    Akram Eidi, Ali Saeidi, Alireza Sadeghipour, Kamal Bahar, Maryam Eidi, Massih Bahar, Saadat Molanaei

    Article Affiliation:
    Department of Biology, Varamin Branch, Islamic Azad University, Varamin, Iran. maryameidi@gmail.com

    Abstract:
    Coriander (Coriandrum sativum L.) is grown as a spice crop all over the world. The seeds have been used to treat indigestion, diabetes, rheumatism and pain in the joints. In the present study, an ethanol extract of the seeds was investigated for effects on insulin release from the pancreatic beta cells in streptozotocin-induced diabetic rats.

  161. #161 jenny
    February 9, 2011

    Resveratrol may improve Multiple Sclerosis by causing apoptosis in activated T cells. – GreenMedInfo Summary

    Abstract Title:
    Resveratrol (trans-3,5,4′-trihydroxystilbene) ameliorates experimental allergic encephalomyelitis, primarily via induction of apoptosis in T cells involving activation of aryl hydrocarbon receptor and estrogen receptor.

    Abstract Source:
    1: Mol Pharmacol. 2007 Dec;72(6):1508-21. Epub 2007 Sep 14. PMID: 17872969

    Abstract:
    Resveratrol (trans-3,5,4′-trihydroxystilbene), a polyphenolic compound found in plant products, including red grapes, exhibits anticancer, antioxidant, and anti-inflammatory properties. Using an animal model of multiple sclerosis (MS)

  162. #162 Todd W.
    February 9, 2011

    @jenny

    Re: coriander for diabetes. Again, an interesting study, but still preliminary. Results in animals cannot be extrapolated to what will happen in humans. This is not evidence to support the standard use of coriander seed extract in the treatment of type 1 diabetes (unless, of course, you’re treating diabetic mice).

    Same thing for the resveratrol for MS study. It was done in animals, not humans.

  163. #163 Pablo
    February 9, 2011

    And to ask again, are naturopaths actually using these things for the treatment of anything? Jeezus, resveratrol, if it pans out, is a friggin drug! trans-3,5,4′-trihydroxystilbene is as reductionist allopathic as it can get!!!!!!!

  164. #164 Kevin
    February 9, 2011

    Jenny:

    I think Dara O’Briain said it best… “Yes, they’ve tested herbs and the things that worked became — MEDICINE. The rest is just a nice cup of soup and some potpourri.”

    The FDA has regulations about what gets to be called medicine.
    1. The compound in question has to be shown effective in preclinical studies. It also has to be shown to produce those beneficial effects in animal models without undue toxicity. The product also needs to be shown to be as pure as possible, with no potential confounding compounds that might increase toxicity.
    2. The product needs to be shown to be safe when given to healthy volunteers. The pharmacokinetics and pharmacodynamics of the product are measured carefully, to determine how the drug is metabolized, its half-life, the maximum and minimum concentrations, and on and on.
    3. The product then is tested in a small series of patients with the disease in question. Much of this testing is designed to find the right dose that has an impact (if any) on the disease in question without causing toxicity. If the drug has no effect and/or demonstrates toxicity, it’s jettisoned.
    4. The product then must be tested in TWO rigorously controlled clinical trials in a large number of patients powered to provide statistically significant and clinically valuable results. One test is not enough. A small trial in rats is not enough. TWO trials. Safety MUST outweigh efficacy.
    5. Only then will the FDA consider approving a drug as medicine. And even then, approval is not automatic. At any point in the proceedings, the FDA can decide (and has) that the potential benefits do not outweigh the risks.

    You’re proposing treating diabetics with coriander because some rats ate it and didn’t die? Ummm….I think you have a problem of disequivalence. Get the purified compound through the ENTIRE process, and we’ll talk. Otherwise, what you’re offering is taco seasoning as a therapy for a potentially deadly disease.

    Again, as Dara O’Briain would say “get in the fookin’ sack.”

  165. #165 JohnV
    February 9, 2011

    @jenny

    “an ethanol extract of the seeds was investigated”

    Do you even realize how idiotic it is for you to use this as an example? THAT’S HOW EVIL SCIENTISTS AND PHARMACEUTICAL COMPANIES DISCOVER DRUGS IN THE FIRST PLACE. (some times).

    Since you previous noted that antibiotics are microbial secondary metabolites (well, not to that level of detail), how do you think it gets into pill form? Or if someone had a bacterial infection would you suggest they just eat random bits of moldy food until they happen across a fungal species that makes enough of the right metabolite to help clear the infection.

    Having read the abstract and judging by the dosage (200 mg extract / kg body weight) and mode of injection, I would to ask how a naturopath would get the same effects by eating the seeds?

    Of course, that’s the whole damn point. Actual scientists can work on isolating the compound and working out a way to synthesize it, if necessary, and formulating it so that a realistic dosage can be achieved.

  166. #166 Calli Arcale
    February 9, 2011

    Or, to put it more bluntly, the fact that naturopaths occasionally manage to accidentally use an effective treatment doesn’t legitimize the practice of naturopathy. (Assuming, that is, that anyone can even tell what naturopathy is. To call it an ill-defined field would be to lie by understatement.)

    It is not important that some treatments have been shown to have some effect. Nor is it important that some mainstream treatments have been shown to be ineffective. What *is* important is what treatments naturopaths actually use, whether or not those treatments are effective, and whether or not their overall practice is any better than that of MDs or DOs. Most of jenny’s arguments strike me as irrelevant to those questions.

  167. #167 Dianne
    February 9, 2011

    insulin is an animal product (typically from horses)

    Used to be. It’s now mostly recombinant. No horses need be harmed in the production of insulin. Which brings me to another point about “naturopathy” versus “allopathy”: naturopathic remedies, besides not working, can devastate the environment. Got erectile dysfunction? You can go to a naturopath, get white rhino horn, and continue to have erectile dysfunction (while contributing to the death of a species) or go to an MD or DO, get certain drugs which will remain unnamed lest I set off the filter, have no more ED and do no major harm to the environment. (Check for contraindications before using, though: a drug or substance that has efficacy can have unwanted side effects.)

  168. #168 Todd W.
    February 9, 2011

    @Dianne

    You bring up a very good point. Related to that, I get periodic e-mail updates from FDA on recalls and such. One of the most common non-food problems that I see are for “herbal” ED products that are, in reality, adulterated with actual drugs used in the treatment of ED. So, there’s a product safety issue, as well, related solely to the manufacture of the product.

  169. #169 lilady
    February 9, 2011

    @Todd W. Spot on about “herbal” ED products being adulterated with actual drugs used in the treatment of E.D. I suppose when a physician explains to the patient that they are not a candidate for Viagra…because of existing co-morbidities, that the patients resorts to the natural “herbal” method for “cures”. The FDA and General Accounting Office have conducted hearings with testimony from scientists and laboratories about adulterated herbal products.

    Other unexpected…and not listed on the labels of these Herbal products… are the heavy metals (mercury, cadmium and arsenic) present in herbal products. (New York Times article-May 25, 2010-titled “Study Finds Supplements Contain Contaminents”) This article available on the web, refers readers back to the hearings conducted by the FDA and the GAO and the rather long testimony about bogus claims my herbal manufacturers about cancer cures and garlic supplements in lieu of medication for control of hypertension.

  170. #171 Narad
    February 9, 2011

    BWAHAHAHAHAHAHA [wipes eyes] BWAHAHAHAHAHAHAHAHA

  171. #172 Todd W.
    February 9, 2011

    @jenny

    I’m not even going to click on that link. Take a look around this site for reasons to not even bother with Natural News.

    Now, do you have any actual, relevant evidence that naturopathy offers something valid that medicine does not? For example, remedies (i.e., effective, safe treatments) for any of the diseases I listed.

  172. #173 JohnV
    February 9, 2011

    or for that matter, Jenny, do you have anything you can add that doesn’t just dig a deeper hole?

  173. #174 Beamup
    February 9, 2011

    The short reason Natural News is not credible, by the way, is that Mike Adams has repeatedly proven himself either delusional or a pathological liar. If he said that 1+1=2, I’d have to seriously reconsider whether mathematics actually works…

  174. #175 Dangerous Bacon
    February 9, 2011

    MI Dawn: “@jenny: nice articles. Interestingly, 2 of them (Threonine and Gymnema sylvestre) are nearly 20 years old. Any more recent studies on them? If the first studies panned out, you would think there are more recent, larger studies.”

    Why do there need to be more studies? Obviously no one took them any further because you can’t patent natural medicines (well obviously they have been patented but let’s ignore that), or they were suppressed by Big Pharma, which could make fabulous amounts of money curing disease but chooses not to because it’s greedy. And research is so corrupted and self-serving that you can’t rely on it anyway, which begs the question of why one would approvingly cite the initial studies on threonine, Gymnema etc. if one dismissed research, but why be such a bug about consistency anyway? if you don’t like those cites there are more. Besides, we all know what the real story is.

    Sorry, I was projecting there. I’ll try not to do that again.

  175. #176 Enkidu
    February 9, 2011

    The mom was just interviewed on the local talk radio station (KYW 1060 in Philly, the Michael Smerconish Show). What a nutjob! She claims that she is nothing like people who refuse medical care based on religious beliefs, because her herbs and homeopathic “medicines” are actively doing something, not passive like prayer. So basically, because she is giving her son water, sugar pills, and some herbs this is totally different than doing nothing aka praying. Hello, IT IS EXACTLY LIKE DOING NOTHING! Ugh I wanted to reach through the radio and shake some sense into her.

    Then she goes on to say that she will NOT allow the rods and pins to stabilize her son’s spine because they are artifical and nothing should go into the body that God didn’t already put there. Wait, but she said she wasn’t anything like religious zealots I thought…?

    Oh, and she came out and stated she was anti-vaccine too. Smerconish let her talk uninterupted, but then went off on her about that right before he went to break.

  176. #177 skybluskyblue
    February 9, 2011

    From Wakefield in that video:”Half of what I am telling you is right half is wrong. I do not know what half is right…” (That is a paraphrase.)
    Good to be humble but, the whole video seems to be filled with long disproved ideas and scientific inaccuracies. The whole video is laughable, if only everyone knew it was facetious.
    I guess that is why citing Natural News is considered a joke for real scientists around here.

  177. #178 Enkidu
    February 9, 2011

    Oops, the radio station I cited above should be 1210, not KYW 1060… that’s the news/ traffic. :)

  178. #179 skybluskyblue
    February 9, 2011

    Oops, instead of “The whole video is laughable, if only everyone knew it was facetious.”
    More correct is, “…knew it SHOULD BE facetious.”

  179. #180 adelady
    February 9, 2011

    This woman is both crazy and evil. Her son is in dire trouble.

    I remember the feeling watching my daughter going for an MRI to rule out a brain cancer/ other problem. We were lucky, it was something else. But I’ll never forget that pit of the stomach sinking feeling.

    Does she really understand just how awful her son’s problem is? I find myself almost wishing that the son’s accident had required surgery instantly on admission so that the necessary process had already started before she got a chance to derail it.

  180. #181 adelady
    February 9, 2011

    In fact, I have another problem with this woman.

    If I were researching health treatment options for a child in deep trouble, I would make absolutely sure that I knew every single thing I needed to to pursue the various options.

    Maybe she *normally* refers to this preparation as ‘P’. But this is not normal. Surely she should have been reading and tracking down references on this substance so that she had memorised every minutest detail – including its name. (She should also know all the related, beneficial, negative, nutritional and biological interactions with every other known preparation, herb, soap, floor polish and toothpaste. Including the common, botanical and chemical names of every possible ingredient.)

    In her position, I’d be able to name this thing forwards, backwards, and upside-down ….. in my sleep.

  181. #182 Pablo
    February 9, 2011

    Does she really understand just how awful her son’s problem is?

    It’s not an issue of being unaware, it is denial.

    It’s just an example of the Dunning-Kruger effect. This dingbat is under the delusion that she has medical training and knowledge just as good as that of those evil doctors. The problem is that her “training” is so poor that she doesn’t realize how clueless she is. Whether she realizes what the injury is or not doesn’t matter, because she denies, based on her idiotic “education,” that it is serious.

    Moreover, like the typical Dunning-Kruger case, her ignorance is accompanied by greater insistence that she is right. In fact, I think she is a perfect example of the DK effect that, the lower the level of knowledge on the topic, the more likely one is to insist that they are right. Actually, I think she might able to prove my theorem that in the limit of where cluelessness approaches infinity, the belief that one could possibly be wrong goes to zero.

    She’s pretty darn close to that limit.

  182. #183 Matthew Cline
    February 9, 2011

    From Wakefield in that video:”Half of what I am telling you is right half is wrong. I do not know what half is right…” (That is a paraphrase.)

    What, seriously?

  183. #184 Leah DiPlacido
    February 10, 2011

    I don’t think the woman is evil, though she is severely misguided. What makes it worse for people who think like this is the abundance of websites touting homeopathy (or treatments like Super Trio) while saying the FDA is conspiring to suppress natural remedies that work! What the FDA is doing is trying to prevent people from killing themselves with “treatments” that don’t do anything (and thus they die from underlying disease that wasn’t treated) or adversely affect their health by taking megadoses of whatever vitamin or mineral the website is touting. As a a medical writer that writes a considerable amount of health-interest articles, I only use solid .gov or .edu references. It’s scary the misinformation out there.

  184. #185 herr doktor bimler
    February 10, 2011

    nothing should go into the body that God didn’t already put there.

    Evidently she felt differently 17 years ago.

  185. #186 Andreas Johansson
    February 10, 2011

    Evidently she felt differently 17 years ago.

    Alternatively, the spawn is the Messiah Mk 2.

  186. #187 Jarred C
    February 10, 2011

    nothing should go into the body that God didn’t already put there.

    So she doesn’t believe in consuming essential vitamins?

  187. #188 Shasta
    February 10, 2011

    “No one, least of all a judge, wants to abrogate a parent’s rights. We’ve seen this time and time again, even to the point of children suffering.”

    Yes. Thank you.

  188. #189 Enkidu
    February 10, 2011

    @ 187, herr doktor bimler: D’oh! That’s a good one. :)

  189. #190 daveprime
    February 10, 2011

    Parents should be limited to refusing treatment only for those same diseases/ailments which their “beliefs” have been [i]PROVEN[/i] to cure.

    Unfortunately the teen in this situation may have a [i]vague[/i] idea of the consequences, but can society as a whole afford to pay his way should those consequences come to fruition? I think not.

    I suppose we could get around this by having the parents post some sort of surety bond that will cover all future medical fees which may result in their having refused treatment.

  190. #191 Turning Winds
    February 16, 2011

    It’s sad to know that some parents do believe in the effectiveness of alternative medicines than that of the more proven success of the scientific way. Personally, we can’t blame them for choosing something they traditionally believe in as well as the lack of financial support for their ill teen. But parents, but our children’s health aren’t something we should just consider a trial and error situation. We should do the proven and most effective way to help bring back our kid’s good health.
    Alternative ways may be an option if the all doctors would already give up on their child’s health.

  191. #192 Gail Holst
    July 15, 2011

    well I guess It also depends on the parents to save their child’s lives , having to get to bring them on fake quack doctors are very rubbish. .

  192. #193 Wow
    July 15, 2011

    “nothing should go into the body that God didn’t already put there.”

    1) So no sex, then?

    2) God’s a man. Eeew! Butsecks… from on high!

  193. #194 charzi
    May 11, 2012

    …
    “Hi,

    This is exactly what I ever searched for on such Informative topic , I read it and also enjoyed thoroughly, it is very informative post for me as I always look in for unique and original content which can help me and my knowledge grow better.

    Great. Keep it up!!!!
    I am keen to read every post that is very informative, like yours.”