NCAHF has received word from the Coordinator of its Victim Redress Task Force that a litigation group has been formed to file a class-action lawsuit against the manufacturers and promoters of L-tryptophan. Interested parties are advised to contact the Association of Trial Lawyers, 1050 31st Street, N.W., Washington, DC 20007 for further information.
An antitrust lawsuit brought by Medical Services Center, a cytotoxic testing company, against the American Academy of Allergy and Immunology, California Medical Association, The California Society of Allergy and Clinical Immunology, Central California Allergy Society, and several individual physicians was dismissed on November 7, 1989. The defendants were awarded costs. This case was significant because it represented an attempt by a company, whose business interests had been badly hurt, suing groups and individuals who had publicly exposed cytotoxic testing for food allergies as a scientifically invalid health service. (United States District Court, Central District, Case No. SA CV 88-644 AHS.)
Early findings from the "Lifetime rat carcinogenicity study with sodium fluoride," commissioned by Procter & Gamble and performed at Hazelton Laboratories of Madison, Wisc., found no bone or oral tumors in about 700 rats tested on levels of fluoride that were double those of the National Toxicology Program that have been recently publicized as showing fluoride to be carcinogenic. Neither study has been finalized, and both sets of results should be considered preliminary. However, the above study should provide incentive for overzealous reporters to wait for the scientific analysis. The Hazelton Laboratories report appeared in the American Dental Association News, March 5, 1990.
The FDA has to bear a major portion of the blame for the outbreak of EMS related to L-tryptophan supplements. Promotional literature making drug claims (ie, "Article intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease" FD&C Act, Section 201[G]) was widespread which gave the agency reason for legal action against it. However, consistent with its practice of ignoring illegal claims involving no apparent health threat, appearing to only cost consumers money, FDA took no regulatory action. NCAHF has long been critical of FDA for this practice, characterizing it as tantamount to permitting robberies as long as no one is shot. In 1984, the late Paul J. Sage, an FDA Consumer Safety Officer stated almost prophetically: "L-tryptophan is but one more in a long list of nutritional products that expose the public to serious harm. The marketing of such unapproved drug products must be attributed in part to FDA's lax enforcement policy. How many more people must be exposed to harm, what level of confusion, deception and chaos must appear in the marketplace before FDA will announce that it expects the [supplement] industry to comply with the law? A lax enforcement policy serves to license crime." (Nutrition Forum, 1:1-2, 1984). [This quote is taken from Nutrition Forum 7:7,1990.] Last issue, we noted that the problem could be laid to the ill-conceived 1976 Proxmire Law. We still believe that this is true. Individuals within regulatory agencies have stated in private that a reason for lax enforcement is the perception that dietary supplements enjoy a special privilege. To prosecute their promoters too vigorously will bring political repercussions, therefore, they "look the other way." Clearly, the ill-conceived Proxmire Law helped create the atmosphere in which lax enforcement existed. Repealing the Proxmire Law would send a strong message to the health food hucksters that no category of items in the marketplace can make unsupported health claims without penalty.
The Federal Trade Commission has charged Nature's Way Products with making unsubstantiated claims in advertising that "Cantrol" capsules fight yeast infections. Under a consent agreement announced for public comment, the company agreed not to make unsubstantiated claims about certain nutritional supplements in the future and agreed to pay $30,000 to the National Institutes of Health to support research on candidiasis or the effects of yeast upon health. (FTC News Notes, 1/29/90.)
Comment: NCAHF has commented on this FTC action. One suggestion was that fines levied for false advertising should be given to agencies that would publicize the misinformation disseminated by false advertising campaigns. Misinformation is the fuel that keeps the engines of health fraud and quackery running. Misinformation about "nutritional approaches" to alleged yeast infection has been promoted for so long that it has become a part of the modern, urban folklore. As such, no one need advertise the "yeast-connection" any longer. Thousands of health food store clerks, mail-order degree "nutritionists," chiropractors, naturopaths, maverick doctors, psychologists, nurses, and so forth are out there reinforcing the notion. Products need only be available on the shelves; those who practice pseudomedicine will do the rest. The money collected by the FTC would be more appropriately applied if used to undo the misinformation they disseminated in the first place.
An excellent critique of what's wrong with the well-intended HeartGuide logo program of the American Heart Association is expressed by Kristen McNutt, PhD, JD, in the Jan-Feb, 1990 issue of Nutrition Today. In addition to her well-thought criticisms, Dr. McNutt offers some constructive ideas about how the program might be salvaged with some revisions.
Comment: We are much in agreement with Dr. McNutt's critique. It would be nice to see some aspects of the HeartGuide program retained. Its method of labeling the amounts of "total fat, cholesterol, saturated fat and sodium" is the most readable we have seen. We hope those who are trying to improve labeling information format will take notice.
Ever since Thomas J. Moore wrote Heart Failure, (which NCAHF lauded), there has been a lot of confusion about where the rational ground upon which one can stand scientifically lies. The article "Forget About Cholesterol?" in the March (1990) issue of Consumer Reports states the case in the most lucid, scientifically credible terms we have seen. Anyone puzzled about where NCAHF stands on this issue can pretty much take the CU article as representative of its position.
NCAHF board member Victor Herbert, MD, JD has filed a lawsuit against the National Academy of Sciences alleging plagiarism of the work of the 1985 panel of scientists that developed the Recommended Dietary Allowances (RDA). The NAS rejected the panel's draft and canceled publication because it had insisted upon lowering the RDA for vitamins A and C which went against the popular vitamin theory that more is better. Dr. Herbert copyrighted the rejected 1985 report. In 1989, the NAS published the RDA, which turned out to be a bowdlerized version of the 1985 report its leaders had rejected. Dr. Herbert's lawsuit is more about scientific integrity than other factors. He claims to have evidence of special interests influencing decision-makers in the NAS affair. These facts will be brought out in court. A more complete description of the background of this lawsuit appeared in Science, March 2, 1990, p.1022.
Deception is an art. It involves the study of human nature. Among those who practice deception for gain are charlatans, con men (bunco artists), phony psychics (pardon the redundancy), spirit mediums (ie, "channelers"), and magicians. Of these, only the latter admit to using deception (they say "conjuring"). Employing the old adage "it takes one to know one," magician Robert Steiner has written Don't Get Taken, a book about how to protect yourself from bunco and bunkum. The book is divided into five parts (29 short chapters) and an epilogue. Part one informs readers that they can be taken and reveals the quintessential factor of instilling confidence by con artists. Part two deals with alleged psychics, astrologers, blood readers, and others. Part three exposes cons, swindles, scams and other diversions. Part four is entitled "The Cruelest Cons" and includes quackeries such as faith healing, pseudomedicine, mental health frauds (cults, channelers & mystics). Part five is on how to protect yourself from the above. This is a simple, easy-to-read book. It is entertaining as well as useful. Bob Steiner is the immediate past president of the American Society of Magicians (founded by the late, great Harry Houdini), and a member of the NCAHF Board of Directors. Bob pays tribute to NCAHF and some of its activists for improving his insight into quackery. The main reason he was nominated for the NCAHF Board was because of his interest in and study of quackery, and his participation in anti-quackery seminars. Bob Steiner makes his living as a Certified Public Accountant. Order from Wide-Awake Books, Box 659, El Cerrito, CA 94530. $14.95.
Pat Kehoe, director of the Mental Health Clinic in Whitehorse, Yukon lists 13 hazards of New Age thinking in the British Columbia Skeptics Newsletter (1989). The list reveals how "thinking" (ie, basic beliefs about the nature of reality and our place in it as individuals) is at the root of the problems of health fraud, quackery and misinformation. Faulty beliefs provide fertile soil for misinformation. Health fraud and quackery exploit misinformation and misbelief, although it must be acknowledged that the perpetrators are often themselves victims of the same faulty thinking processes. Available for $.50 (US postage stamps accepted) & SSAE.
A total of 32 cancer patients, 13 women and 19 men, were interviewed to determine their use of vitamin-mineral supplements. Ninety-two percent of the women and 63% of the men reported using supplements. In addition, 46% of the women and 32% of the men reported using some type of herbal supplement, and 38% of women and 21% of men used "other" supplements (eg, acidophilus, brewer's yeast, lecithin, pangamic acid, protein powder, tryptophan). The data are consistent with usual findings that women supplement more than men, but the level of use is significantly above national norms. (J Am Dietetic Assoc, 90:278-9, 1990).
The practice methods of Twin Falls, Idaho naturopath James Solomon is being criticized even by other naturopaths. In addition to an undisclosed type of blood test and hair analysis, Solomon swung a pendulum over charts and other items. Burley, Idaho naturopath H.G. Vodicka stated that pendulums "have no place in naturopathy. It's something you just don't use. It's fakery." Solomon is in legal trouble with the FDA for selling dubious "immunization kits" through the mail in at least 7 states. Analysis of the kits found that they contained alcohol-and-water solutions and sugar pills. Idaho Falls naturopath Lee Richards says that immunizations such as Solomon's are legitimate, but FDA laboratory analysis cannot detect the active ingredient because it's highly diluted with sugar. Naturopath Jared Zeff, academic dean of the National College of Naturopathic Medicine in Portland, Oregon said that some naturopaths administer conventional childhood vaccines and others give homeopathic formulas that "stimulate the immune system." (Times-News, 12/10/89).
Comment: The above report shows just how confounded naturopathy is. How come, we ask, homeopathy is regarded as a legitimate form of immunization, but pendulum divining is not. Scientifically, neither have demonstrated value. It seems like each naturopath simply selects what strikes his or her fancy as being appropriate. Personal preference alone may be an acceptable standard for art and fashion, but is irresponsible in health care. Naturopathic reformers cannot be expected to be taken seriously as long as they endorse less than a scientific standard.
Regular readers may recall NCAHF's report of the expose of the offer to pay consumers $1,000, in the form of a government treasury bond, by Board of Medical Advisors of Henderson, NV (NCAHF Newsletter, Nov-Dec, 1988). It turned out that the $1,000 bond was only a share in a unit trust worth $17.50! Charged with misrepresentation, the company has agreed to settle the charges and pay $60,000 in refunds. Contact: Jeffery Klurfeld, 415/995-5220.
The January 24, 1990 issue of Nursing Times, a weekly London, England publication that dubs itself "the independent voice of nursing," features "complementary therapies" used in nursing. Included are massage, aromatherapy, reflexology, shiatsu, therapeutic touch, visualization, herbalism and dietary practices. The article claims that the use of these modalities is "part of a general move away from the high technology, reductionist medicine of today..." Three articles describe the way these "therapies" are employed and focuses upon how to get one's hospital staff to accept these practices. The series provides insight into the thinking of RN's who engage in the rampant empiricism of "holistic" medicine. One cannot help but to celebrate the willingness to provide the close personal attention, care and comfort that is an inseparable part of these modalities. On the other hand, it is appalling to read nonsense statements about "balancing the body's energy" and uncritical acceptance of alleged reflex points on the feet supposedly corresponding to specific organs made by health care professionals. Most of the time, these nurse authors seem to recognize the reality that they are providing a much-needed, and highly laudable, personal touch to their nursing practices. It is unfortunate that they undermine their credibility by promoting vitalistic explanations for easy to understand patient responses. They address the very real economic problem of having RN's apply these modalities. They believe that this problem may be partially resolved by savings on medications now used.
On February 21, the California Department of Health Services ordered Virginia Livingston-Wheeler, MD, to stop administering a urine-derived vaccine to cancer patients because there is no evidence that the therapy is safe or effective. Dr. Livingston-Wheeler has advanced her pet theory that cancer is caused by a bacterium, that only she recognizes as existing, which she has named Progenitor cryptocides. Livingston-Wheeler therapy has long been listed on the American Cancer Society's Unproven Methods of Cancer Management list. The most recent ACS evaluation of the therapy was published in 1989. Dr. Livingston-Wheeler lost her Medicare reimbursement privileges for a period of ten years in 1986 for providing inappropriate therapies. The state of California issued a corresponding ruling excluding her from Medicaid (Medi-Cal) for the same time period. Livingston-Wheeler is not the only person to believe that microorganisms may be the cause of some cancers, but in spite of diligent research, none has been clearly linked to a cancer in humans. The notion that a single bacterium is responsible for a wide variety of cancers stretches the imagination beyond belief. Other aspects of her therapies such as cancer being due to a defective immune system, that a whole foods diet restores immune deficiencies, that abscisic slows tumor growth, or that cancer is transmitted to humans by chickens are also faulty according to the ACS statement.
She claimed to be Dr. Trudy R. Bricker, MD(MA), RDN, RNC, MH, a "Registered Nutritional Consultant." She turned out to be plain old Trudy Bricker, RDN (Registered Dental Nurse). Bricker's MD(MA) stands for Doctor of Medicine (Medicina Alternativa) from the Open International University for Complementary Medicines of Sri Lanka (not recognized in Canada). It was awarded following a 3-day on-site visit by Jan de Vries, an alternative health practitioner. MH stands for "Master of Herbology" and was issued by the Rio Grande Center for Herbal Studies, Albuquerque, NM (also unrecognized in Canada). Bricker's RNC is a certificate awarded by the Canadian Nutrition Institute founded by David Rowland, "PhD" (Donsbach University!), "NMD" (John F. Kennedy College of Nutrimedical Sciences!). These revelations came out as the result of an investigation by the Hamilton Spectator newspaper. Bricker has been a regular guest on CHML radio for about three years. Her faddist health and nutrition advice made people like reporter Paul Benedetti suspicious. Bricker fancies herself to be an expert on food allergies, but Allergy specialist Dr. Jerry Dolovich of Chedoke-McMasters Hospital called her allergy advice "laughable." After disclosure that Bricker's credentials were bogus, a presentation she was to give on food and allergies was canceled by Woman's World (Bricker was sponsored by the Natural State Health Foods store of Hamilton). Bricker has operated a holistic health clinic in Kitchener, Ontario for the past 8 years, referring to herself as "Dr. Bricker." She now is in legal difficulty with the Ontario College of Physicians and Surgeons because it is illegal to use the title "Doctor" without holding a medical license. Bricker continued being aired by radio station CHML until recently. John Hardy, the talk show host, said that he had checked her out with the Consumer Health Organization of Canada (CHOC) and had been assured of her credentials. Hardy was unaware that CHOC was a private interest group representing alternative health practitioners. A tape of Bricker's November 22 talk show was criticized by local physicians as "riddled with errors, falsehoods, and misinformation." Apparently, she has been discontinued on radio, but her clinic is reported to be doing well. (The Spectator 10/21/89, 11/22/89, 12/13/89).
According to a report in C&EN (2/12/90) the late Elena Ceausescu engaged in an elaborate deception involving fraudulent science. Ms. Ceausescu received credit for published material she never researched and technical degrees granted but never earned. The article details how Ceausescu finagled her degrees to feed her ego. Most shocking was the revelation that her charade was widely known by scientists in both the Eastern bloc and the West. The complicity of many governments in maintaining the deception was called "shameful" by Zavran Margureanu, an electronics engineer at Polytechnic Institute at Bucharest. He stated that "many good scientists were forced to publish their papers under the name of party members or to take them as coauthors."
A visit to the "Hubbard Dianetics Foundation (Scientology) located in the United Kingdom is detailed in a first-person experience in The Cult Observer (Jan-Feb, 1990). The reporter responded to a posted sign offering "Free Personality Tests." The story reveals how an experience begins with a personality test and proceeds through psychological manipulation designed to sell Scientology. A frontal attack is made upon the person's self-concept, and she is made to think that she really has serious problems that require immediate attention. Terrible things are predicted if she doesn't buy the service. This article can be useful in educating consumers about defending themselves against pseudopsychology.
A 1984 survey to determine the methods and procedures used by chiropractors in Oklahoma provides insight for anyone interested in chiropractic practices. The study was conducted by Oklahoma State University doctoral student, Hugh Gemmel, DC and Bert Jacobson, EdD, who is with the OSU Department of Health, Physical Education and Recreation. The project was a cooperative effort by the Chiropractic Association of Oklahoma and OSU. The survey, which utilized a questionnaire, was sent out on OSU stationery which may have biased responses (ie, the tendency to put your best foot forward when viewed by outsiders); 273 of 532 DCs responded. Although most DCs use Diversified technique (an eclectic approach) a number of sectarian practices were reported. DCs utilize numerous physical therapy procedures, and 27% report having referred patients to PTs. Most interesting was that 74% of DCs, who purport to be "drugless healers," report having prescribed non-prescription drugs to their patients (10.6% often, 34.6% sometimes, 28.9% seldom, 26.9% never). The investigators believe that state law should be reevaluated to allow DCs to prescribe drugs appropriate for chiropractic practice. 90% indicated that they treat internal conditions as well as structural problems. The majority felt that correction of structural problems will affect internal conditions. The researchers state that there is a lack of scientific documentation to warrant this belief, and recommend further investigation. This report appeared in the Oklahoma Chiropractic Journal, 1:(2):6-7 (Spring) 1989. Reprints may be obtained from Hugh Gemmel, 4146 S. Harvard, F6, Tulsa, OK 74135.
The steady influx into school libraries of books that promote unsound health practices is an on-going problem. NCAHF has recently been party to a dispute between the health science faculty and their college librarian over the presence of a substantial number of books promoting cancer quackery. Some useful ideas emerged, which we share below:
The Librarian's viewpoint:
The Health Science faculty viewpoint:
Toward a solution:
A distressing amount of quackery seems to have found its way onto the campuses of the nation's schools. For instance, in Oregon, the vice-principal of an elementary school is also a distributor for a popular, multilevel vitamin sales company. Parents report that he strongly urges the parents of children experiencing academic or social problems to put the child on a vitamin regimen he sells to improve their performance.
In California, a 6th grade teacher in a private school is a distributor for a multilevel herbal products company. Her school schedules periodic parent-teacher conferences for all children. Parents report that she spends more time trying to convince them of the exceptional benefits of herbs than she spends discussing the performance of their children. An athletic coach at a California college is a distributor for a potassium and herbal concoction that purports to enhance performance. Not only does he sell the nostrum, he also urges students and athletes to join his sales team as downline distributors in which he receives a share of their profits.
A health educator and coach at a Utah university permits his name and university affiliation to be used by a multilevel herbal products company that openly misrepresents a "study" done in the school's physical education department. He appears on a company video tape and says that the body can tell a man-made chemical from one which is natural which he privately acknowledges to be false. The athletic director of the same school also appears in the video and falsely claims that the company's herbal products provide the same short term benefits as steroids without the long term problems. These individuals permit their names and school affiliations to be used in spite of revelations in the local media of substantial misrepresentation by the company and its leaders.
A Colorado college permitted a course in "Herbal Science and Acupuncture" to be taught as a part of its community extension curriculum. Uncritical presentations generated enthusiasm for herbal self-treatment as "safe" because herbs are "natural," and "effective" because of "long-term use by primitive people." Pennyroyal oil, touted as a natural abortifacient, was used by a young woman who feared that she had become pregnant. Ingestion of approximately one-quarter ounce caused the woman to be hospitalized. She was lucky, others have died of liver toxicity from pennyroyal oil.
A junior high school principal invited a person representing an international organization that promotes transcendental meditation to talk about the benefits of meditation in stress management. An impressionable 14-year-old girl became enamored with the wonderful claims for the technique. She made contact with the organization the speaker represented and soon found herself swept up in the program. She was trained by the organization, travelled to several foreign countries and eventually was a representative. Nearly twenty years passed before she realized that she was going nowhere. After reading a book on cults, she awakened to the fact that she was the victim of cult exploitation. She now is taking cult-exit therapy and trying to build a new life for herself after having given away twenty important years during which she should have been building a career or establishing a family life. We can only wonder whether the junior high school principal was merely naive or a meditation enthusiast himself. In any case, it seems clear that he exposed immature young people to cultic persuasion techniques they were unprepared to deal with. (This case was deleted from the original publication due to lack of space--it has been restored for the Internet version.)
Comment: These cases are only a small sample of the reports NCAHF receives about quackery on campuses across the nation. They prompt three questions: First, we wonder how well prepared teachers are to serve as thought leaders for their students in health matters. What kind of health education, if any, are they receiving in their preparatory courses? We can also wonder if any standards exist for determining the kinds of courses that a school will offer in community education programs. Educators are supposed to lead humanity out of the darkness and superstition of the past, not encourage students to wallow in the ignorance of prescientific herbalism and acupuncture.
Second, we wonder if educators have a sense of ethics. Teachers enjoy a superior relationship with students and parents. As authorities in their fields with special information on the needs of budding youth, is it proper for an educator to use his or her privileged position as a sales forum for anything, let alone dubious health products? Even if the products were useful, what about the inescapable conflict of interest inherent in selling items one recommends or prescribes. Physicians aren't even permitted such privilege.
Third, we wonder if a basic flaw exists in higher education itself. Several authorities have noted that susceptibility to quackery seems to increase with education. The 1986 study done for FDA by Louis Harris stated in its Executive Summary: "Academic education is no protection against questionable product use, indeed, college graduates seem more likely than those without a degree to use treatments that are questionable." Do we teach skepticism or cynicism in higher education. Skepticism teaches one to be "thoughtful," "look," and "consider" Webster's Dictionary). This includes skill in asking the right questions, methods for objectively testing propositions and evaluating results obtained. Cynicism merely teaches negative attitudes of distrust and captious faultfinding. The difference between these is essential. This question is worthy of further study.
On February 7, 1990 the 7th Circuit U.S. Court of Appeals upheld the 1987 decision by Judge Susan Getzendanner that the AMA's former (1957-1980) ethical restriction against its members collaborating with chiropractors, because they were unscientific, was an attempt to eliminate chiropractic and violated the Sherman Antitrust Act. Although NCAHF agrees that no universal proscription against physicians associating with chiropractors should now exist, this is only because circumstances have changed. Many chiropractors, including the National Association for Chiropractic Medicine organized in 1984, now openly reject chiropractic cultism. Chiropractic public relations promoters are confusing the issues in the public's mind by distorting the fact that declaring the AMA boycott to be illegal is not the same as determining that it was unjustified from a scientific or consumer protection perspective. The lack of scientific validity of chiropractic and the duty of medical doctors to protect their patients by guarding the scientific aspects of health care is at the heart of the matter. Under the conditions which prevailed during the boycott, NCAHF believes that the AMA was right in restricting collaboration and had a duty to try to eliminate chiropractic pseudomedicine.
These legal opinions are consistent with a free-market ideology that flowered under the Reagan Administration that strips away regulation without differentiating between ordinary business and scientific affairs. Free-market devotees believe competition to be a panacea for lowering health costs and determining the value of products and services. Unfortunately, they seem not to realize that health care is more than a business. It is also a clinical enterprise employing art and empiricism to achieve subjective outcomes not unlike pseudomedicine. Most importantly, it is also a scientific endeavor which enables constant improvement of its methods. Whatever faults it has as an imperfect human system are justified by its scientific basis. The court wrongly singled out its business aspects and imposed business law into a situation where greater issues involving science and consumer protection should predominate.
The failure to appreciate the preeminence that must be afforded the scientific aspects of this case is obvious when the court said: "It is not enough to carry the day that competition (chiropractic) should be eliminated in the name of public safety" (p.14). Citing a precedent involving a professional engineers society the court ignored the important differences between medicine and engineering. Interestingly, not a single case cited by the court involved scientific health care versus a pseudomedical system. The court's disregard for the scientific issues was clear in the statement: "Like the district court, we do not see our task as deciding whether or not chiropractic is scientific" (p.22). In its rationale for rejecting the defendant's assertion that the plaintiffs were "unscientific" practitioners, the court acknowledged that: "there was some evidence that the plaintiffs did not use common methods in treating common symptoms, and that treatment of patients appeared to be undertaken on an ad hoc rather than on a scientific basis (emphasis ours)... Regardless, neither the district court, nor this court is equipped to determine whether chiropractic is 'scientific' or not. So the AMA's argument must fail in any event" (pp.21-2). In other words, the court's inability to evaluate the scientific validity of chiropractic stripped the defendants of their defense that the scientific aspects of patient care justified their actions against chiropractic.
If this court's thinking were to be applied to Food & Drug law, where the inseparable rules of science and consumer protection are best established in law, safety and efficacy, truthfulness in labeling and advertising, and the fundamental that the burden of proof rests upon proponents, would be set aside in favor of a right to sell in the open marketplace. The American Chiropractic Association prays for such a "buyer beware" situation. In its press release it eagerly quotes chiropractor's Attorney Paul Slater who says: "Free enterprise, not a private group, must govern the medical marketplace." If this decision stands, any scientifically-founded professional private group that takes an ethical stand against a nonscientific health care guild will be vulnerable to antitrust action. Consumers are the main losers when the court interferes with the ability of medical professionals to take a united stand against pseudomedicine. With the experts ethically throttled any effort to warn the public about pseudomedicine will appear trivial. Consumer education can be effective only when firmly backed by recognized experts.