A 66-page booklet which traces the development of children's legal rights to medical care when parents have religious objections to it is now available. It is The Law's Response When Religious Beliefs Against Medical Care Impact on Children by Rita Swan, PhD, founder and President of Children's Health Is a Legal Duty (CHILD). Dr. Swan reviews the history of how the wealthy and powerful Christian Science church won the right to practice religious healing. Also covered are the legal aspects of religious exemptions from immunization, Jehovah's Witnesses and the law, custody decisions, religious exemptions from child abuse, and what is needed to improve the situation. NCAHF provided a grant to help support the research for this book in 1986. We are pleased to see it published and hope that it will help save the lives of children who are easy victims of parental zealotry at this time. The book may be purchased from CHILD, Inc, Box 2604, Sioux City, IA 51106; $7.95.
The Aetna, Metropolitan Life and Employers Health insurance companies were awarded $18 million in a civil suit against the Russian emigre brothers, the Smushkeviches, who billed $100 million through their diagnostics labs and clinics scam. The award was the first ever for health insurance fraud under the Racketeer-Influenced Corrupt Organizations Act (RICO). This may set a precedent for future well-organized health fraud scams. Physicians Financial News, 4/15/90).
The clamor for relaxed consumer protection standards by AIDS activists is seen by some as proof that FDA law sets unreasonably high demands for new therapies for an incurable disorder. Organized quackery, which is always looking for a way to undermine consumer protection law, is attempting to capitalize on this issue.
The reality is that safety and effectiveness are not absolutes but part of a benefit-risk equation. On the risk side, no one wishes to see the misery of AIDS patients increased by toxic unproved remedies. Safety demands that therapies not be more harmful than the disease itself, and this can only be known by testing. On the benefit side, cure is not the only measure of effectiveness. Such things as prolonged life, extended functional independence, improved quality of life, or reduced suffering are measurable benefits of therapies. NCAHF believes that anyone offering remedies for AIDS or ARC should be required by law to only administer these only as part of a peer-reviewed, experimental protocol that will guarantee that worthwhile information regarding their safety and effectiveness will be obtained. Requirements as to what is permitted as an experimental remedy may be reduced to only reasonable proof of safety. The only other requirement NCAHF would insist upon is that consumers be fully informed on the nature and status of the remedy.
NCAHF believes that these represent the minimum level of consumer protection in a responsible society. To do less would be to abandon desperate AIDS and ARC sufferers to unjustifiable exploitation by quackery. It is essential that states pass and enforce such laws due to the fact that the Federal government is concerned only with drugs and devices in interstate commerce and does not regulate health care practitioners.
A comprehensive article examining the idea that personality plays a causal role in the development of various diseases appeared in the American Psychologist (June, 1987). Linkages between personality and disease have been proposed for asthma, headache, peptic ulcer, rheumatoid arthritis, heart disease, and cancer. The article summarizes the research on these and points out some of the problems with proving the existence of such connections. With the increasing popularity of psychoneuroimmunology, and other behavioral medical theories, this article is very useful in trying to sort out sound approaches to this complex concept.
Human Nutrition was designed to be a supplemental workbook for college nutrition classes. It turned out to be an excellent information source for anyone who wants a practical, interesting guide to good nutrition practices. The 186-page, full-sized, wire-bound workbook is packed with facts about foods and dietary practices followed by today's kids, teenagers, young adults, athletes, fast food users, dietary abusers (eating disorders), and so forth. Author is Anne Caprio Shovic, PhD, RD; publisher Kendall/Hunt Publ. Co., P.O. Box 539, Dubuque, IA 52004-0539. Price: $18.95.
In 1989 the California legislature passed a reform bill that would help eliminate easy degrees from "authorized" schools (not "approved" or "accredited"). Now one of those unaccredited colleges is pushing bills that would undo the stricter standards. Three California Senators helping in the effort reportedly are John Seymour (R-Anahiem), Cecil Green (D-Norwalk), and Ralph Dills (D-Gardena). The three have received more than $20,000 in campaign contributions from California Coast University, the correspondence school behind the effort. CCU recruits about 1,000 students annually mostly through magazine ads. Students can earn bachelor's master's and doctoral degrees in less than a year. The three legislators authored a bill that would allow unaccredited schools to say that they are comparable to state universities. Bruce D. Hamett of the State's Postsecondary Education Commission says that the bill "provides a legal sanction for misleading advertising." (Santa Ana Register, 5/22/90).
Comment: California has never been known for the integrity, courage or intelligence of its state legislators.
John R. Butcher, PhD, Head of General Toxicology at the Experimental Toxicology Branch of the National Toxicology Program says that the results of the sodium fluoride studies that caused such a furor this Spring will not receive mention in the NTP Sixth Annual Report on Carcinogens because listing in that document typically requires a positive response in carcinogenicity studies with two species of animals. The results of the studies they conducted were that there was no evidence of cancer in male or female mice, or in female rats, and the evidence in male rats was equivocal. (6/6/90 Letter to John Small, National Institutes for Dental Research.)
A survey to assess the perceived knowledge and usefulness, referrals and utilization of "alternative" health approaches (AHA's) of U.S. and British pharmacists was conducted by Nelson, Bailie and Areny of the Wayne State University College of Pharmacy (Detroit, Mich.). More than 50% of the pharmacists in both countries had 'never heard of' or 'only heard of' about half of the 21 AHA's listed. Acupuncture was felt to be the most useful AHA (U.S. 83.8%; UK 91%). Osteopathy and chiropractic were most often referrals by U.S. pharmacists (38.6% and 33.5% respectively), whereas, homeopathy (14.7%) and osteopathy (14.5%) were most often referrals by British pharmacists. The most utilized AHA's were osteopathy (21.8%) and chiropractic (19.3%) by U.S. pharmacists, and homeopathy (10.1%) and herbal medicine (6%) by the British. The authors conclude that it is essential that pharmacists become knowledgeable about AHA's because of their prominent role as dispensers of reliable health information to the public. (J Clin Pharm & Therapeutics, 15:141-146, 1990).
A prospective study of 300 patients with chronic fatigue found that only six percent met the criteria for chronic fatigue syndrome (CFS). The most common diagnosis (61%) was major depression. Panic disorder (14%) and somatization (11%) were more common than CFS, and dysthymia was as common (also 6%). The cause of chronic fatigue was identified in 84% of the patients, and psychological diagnoses were by far the most common. The researchers concluded that psychiatric testing is the most useful diagnostic tool for patients with chronic fatigue. (Manu P, Lane TJ, Matthews DA. "Chronic fatigue: a prospective diagnostic study of 300 patients," Clinical Research, 38:(2):1990 [Abstract]).
The September-October, 1989, issue of this newsletter described a deceptive marketing tactic being employed by the promoters of Berry Trim, a dubious weight-loss product. The trick uses what appears to be a full-page newspaper ad that has been ripped out and sent by an anonymous friend. The ad arrives in an unmarked envelope. Either written in the margin or attached is a hand-written message using the recipient's first name (eg, "Joe, try it, it works!") signed with a single initial (eg, "K"). Recently, two other promotions are employing similar tactics. One is a pill called Cholestrolite that claims to "... insure weight-loss without conventional calorie counting dieting. ." The other is the discredited "anti-aging formula" Gerovital H3. The trick seems to work quite well. Many people who ask NCAHF about the product are unaware that the note is not actually from someone they know. They are often quite surprised when we explain how the deception is accomplished.
The Sunrider Corporation has paid a fine of $175,000 to the State of California for false advertising and unfair competition. Among the misrepresentations listed in the complaint were the claims that its product "Nutrien" contained "Vitamin B-8" a substance that doesn't exist; that Nutrien and other products have an effect upon heart disease and pneumonia; and the assertion that Sunrider products have an effect upon high blood pressure. The unfair competition charges listed the foregoing misrepresentations plus offering for sale adulterated food products (salmonella), mislabeling--including claims of more protein and less carbohydrates than products actually contained, and containing less Vitamin A than claimed. (Superior Court of the State of California, County of Los Angeles, Case No. C747506, Dec. 26, 1989.)
In the mid-1970's foot reflexology was a popular fad among hippies and fringe physical therapists. In 1980, NCAHF organized a study at Loma Linda University to test the claim that existing maladies could be confirmed by sensitive spots on the feet. A reflexologist certified by a leading proponent organization examined 70 subjects who had filled out a questionnaire asking about problems experienced within the past two years in 43 different organ locations. The results failed to support reflexology's claim of an association between sensitive spots on the feet and organ pathology. John Renner, MD, covered reflexology's lack of validity in his Health Bulletin column in The Kansas City Star (10/22/89). NCAHF has prepared a single page reprint along with a schematic drawing of reflexology (also known as "Zone Therapy") theory. Send $1 and a SSAE.
According to a report in The Sacramento Bee, organically grown produce is failing in the marketplace. The main reason seems to be high prices. Raley's, one of the first supermarkets to offer organic produce is calling the experiment a failure and is cutting back on its offering. The firm is losing money from waste. Raley's president, Charles Collings, says that the company apparently overestimated the public's real interest in such products. "We can't afford to keep throwing it away" said Collings. Bel Air Markets also found that despite good showings on some varieties, organic produce sales were not sustained. The alar scare was apparently responsible for the temporary successes experienced by marketers. It seems, however, that the reality of higher prices has turned many consumers off. The stores still intend to carry some organic produce, but only what demand dictates.
Promoters are pushing hard to establish "ayurveda" as a marketing term for health food products and unorthodox health services. The main promoter of Ayurvedic Medicine is Deepak Chopra, MD, a follower of the East Indian guru, the Maharishi Mahesh Yogi who is the founder of the Transcendental Meditation movement. Chopra is profiled in "The Maharishi's Medicine Man" (In Health [formerly Hippocrates] May-June, 1990). Ayurvedic medicine is ancient East Indian folk medicine inseparable from Hinduism. Like all ancient approaches to treatment, it relies heavily upon psychology (ie, magic) and subjective empiricism. Chopra is aggressive and becoming better known. This article will help readers become familiar with his views and style. Readers of this newsletter should know that Dr. Stephen Barrett has denied making the critical statement about Chopra attributed to him in the article; he only criticizes Ayurvedic philosophy.
The April meeting of the Arizona Board of Medical Examiners focused upon the problem of off-beat medicine. Arizona licenses a wide variety of nonscientific health care providers (eg, acupuncturists, chiropractors, homeopaths, naturopaths), and seems to have more than its fair share of fringe MDs and osteopaths. According to the report, "Letters of Concern" (the Board's least-serious form of rebuke) were issued to several physicians.
Other MDs were censured for promoting dubious remedies for hemorrhoids and smoking cessation. Still others were cited for malpractice abuses unrelated to quackery. (The Arizona Republic, 4/8/90.)
NCAHF is in contact with naturopaths who are leaders in a reform movement. They understand that NCAHF's objection to the recognition of naturopathy is based upon its traditional antiscience orientation. Reformers say that they hope to remove this objection and make naturopathy into an acceptable health care system. Their view of an ideal naturopathic physician (ND) is a practitioner sufficiently trained in diagnosis and screening to serve as a primary entry health care provider practicing general medicine with an emphasis upon teaching healthful lifestyles, managing minor illnesses, natural childbirth, personal counseling, and so forth. Rather than automatically opposing drugs and surgery, they say, naturopathy would simply have a different emphasis. NDs would teach appropriate lifestyle changes that are safe and effective alternatives to drugs. For instance, weight-loss and exercise would be used as an alternative to medication for high blood pressure. If it were found not to be working for an individual patient, he or she would be referred to a regular physician. ND's believe that there is a selective patient population of people willing to make the extra effort required who would utilize naturopathic services. ND training would emphasize patient screening and practitioners would work in cooperation with MDs to whom more serious problems would be referred.
Counter to their tradition as "drugless practitioners," reformers say that the idealized ND might even prescribe some medications. NDs say that they prefer to use herbal remedies, but acknowledge that these would have to meet scientific standards of safety and effectiveness. NDs would apply contemporary medical standards to validate their practices and would open themselves to peer review by MDs. NDs would rely upon the standard scientific medical literature for its knowledge base. NDs would abandon homeopathy, iridology, reflexology, and other sectarian or pseudomedical practices. Recognizing the propensity for naturopathy to attract sociopaths, the profession would work to set a higher standard for self-discipline than is presently done with conventional medicine.
ND reformers see the present dearth of family practitioners, its appeal to a growing health promotion-minded public willing to work at lifestyle changes, the high cost of high tech health care, and the high cost of medical education as favorable to their marketing strategy. Reformed NDs would encourage immunization, pasteurization, fluoridation, and other proven public health measures. What the reformers have in mind sounds something like nurse practitioners, midwifery, barefoot doctor, and physician assistants, all rolled into a single role. This vision presents naturopathy, not as an "alternative" form of health care, but as filling a gap that has been left by the evolution of highly specialized, high-tech medicine. It would provide a low cost, low-technology brand of health care.
Is this a pipe-dream or could such a profession emerge from the ranks of present-day naturopathy with its unorthodox traditions? If so, could and would AMA-approved medical schools also offer such a program? Several reform-minded NDs say that it can be done. NCAHF's President has advised these reformers to demonstrate by developing a model program in one or more of the states that presently license NDs and approve Naturopathic Medical Education. It may take a generation to accomplish, but once shown to be a responsible profession working within mainstream health care, naturopathy would have arrived and would grow rapidly. NCAHF has told ND reformers that just as it has done in the case of affiliating with a chiropractic reform organization, it would be willing to help build a bridge for NDs to enter mainstream health care if they approached their practices objectively and were open to careful scrutiny from the consumer protection perspective. As we have suggested to chiropractic reformers, reformer ND's may find it advantageous to change the name of their profession to make it easier to purge itself of incorrigible quackery. NCAHF would be interested in reader's comments as the dialogue continues.
Michael Botts has recently sent two letters of warning notifying agencies that actions they were about to undertake put the public at risk of serious injury and that ignorance of that fact could not be used as an excuse because they have been notified of the potential dangers of their actions.
On May 17 Botts wrote to Oregon Attorney General David Frohnmayer regarding a Rule pending before the Naturopathic Formulary Council (NFC) of the Oregon Naturopathic Board. The Rule would permit naturopaths to prescribe 104 potentially dangerous or poisonous drugs. Included, for instance, was digitalis which can cause cardiac toxicity, heart attacks and deaths. Botts notified the AG that "injury to the public from naturopaths prescribing under this Rule is not only probable, it is imminent." He strongly advised that the AG "take whatever steps are necessary to see that the public health is not endangered in this manner." Botts served notice that if the Rule is enacted and people are injured that he intends to publicize that prior notice had been given of expected dangers from the Rule.
For your information, the NFC was formed by an act of the Oregon Legislature in an apparent attempt to satisfy naturopaths who have been clamoring to become something other than "drugless practitioners." The NFC has been constituted in such a way that pro-naturopathic interests outnumber qualified pharmacologists likely to descent 3 to 2. From what NCAHF has learned the NFC appears to represent the worst kind of politicizing of a serious health care issue. The Oregon Board of Naturopathic Examiners objected to the list because it was too restrictive, but agreed to adopt it under strong protest rather than go to court. The naturopathic patient medication time-bomb is ticking in Oregon!
On June 6, Botts sent a letter of warning to the Governor of Alaska asking that he veto Alaska House Bill 146 because of Section 22 which states: "...the board may not base a finding of professional incompetence solely on the basis that a licensee's practice is unconventional or experimental in the absence of demonstrable physical harm to a patient;" (In plain language, the board cannot lock the barn unless a horse has been stolen!) Botts clearly pointed out that this law put Alaska's citizens in very real danger because the only time the State could act is "after someone is hurt or killed." Botts noted his own past experience as a former Iowa Assistant Attorney General citing the reality that people are regularly injured by quackery. He made it clear that he intended to publicize his letter in the event that the law was passed and someone was injured by a (deviant) Alaska practitioner. Copies of either of these letters are available upon request. Send $1 and a SSAE.
The Office of Technology Assessment (OTA), the agency which does research and investigation on matters involving science and technology for the U.S. Congress, initiated a study of unconventional cancer treatments in January, 1987. The study was requested by the House Committee on Energy and Commerce which oversees a wide range of health issues. The Committee had been heavily lobbied by proponents of so-called "Immuno-Augmentative Therapy" (IAT), a dubious cancer remedy being sold in the Bahamas by a maverick zoologist Lawrence Burton, PhD. Like laetrile promoters in the 1970's, the strategy involved picketing congressmen by allegedly cured cancer patients (many of whom are now dead), and people who operate the referral agencies posing as consumer advocates.
NCAHF has followed this study carefully, but limited its comments to a single item in the May-June, 1987 issue of this newsletter. We predicted at that time that OTA would "..simply go over the ground covered by all of the rest of us who study cancer quackery. Following a negative report, the quacks will predictably yell 'foul' and resurrect their standby arguments about conspiracies, cover-ups, inside fixes, and so forth." This statement sounds like a perfect prophecy in light of what has transpired. On March 9 the OTA held a public meeting at which many of the promoters of cancer quackery appeared to vent their anger over the report. The usual players were present to present the familiar distortions of reality that has become their creed.
Promoters are pushing for a double standard. They want to be able to sell cancer remedies on the basis of the marketplace demand they can create through publicity and advertising employing testimonials and unsubstantiated claims. The essence of the OTA's review of the unconventional remedies and arguments of proponents can be summed up by linking several outstanding sentences in the draft report: "One system of medicine is formally recognized in the United States--scientific medicine, dominated by medical doctors. The safety and efficacy requirements of the Food, Drug & Cosmetic Act for new drugs and medical devices codify scientific medicine as the national standard" (1-14). ". . .'unconventional cancer treatments'. . . are defined not by what they are, but what they are not: part of mainstream, orthodox medicine" (1-25). "Valid methods for determining the efficacy and safety of unconventional cancer treatments are the same as those that are valid for evaluating conventional treatments. There is no 'alternative evaluation' methodology that can give valid answers. . ." (1-43). No matter how much the promoters of unconventional therapies moan, there is no denying these facts. The obvious financial self-interest of those selling unconventional cancer remedies negates their arguments charging self-interest on the part of the establishment. What the promoters obviously seek is to escape the accountability that goes with offering responsible medical care.
[Citations used above are technically not quotable because they are taken from the unofficial, preliminary draft. They are presented to show what it is that promoters are complaining about.]
The quackery-related death of a 17-month-old girl has sent shock waves across Canada. No one aspect of the story is unusual. The scenario is a classic combination of cultural vulnerability, modern urban mythology and quackery.
Dead from malnutrition and pneumonia is Lorie Atikian. Eight months before her death on September 25, 1987, Lorie was a perfectly healthy baby. When she died she was nearly bald, covered with deep red rashes, and so emaciated that the paramedics thought they were being tricked by being given a doll to treat.
Lorie's parents Sonia, 38, and Khochadour, 54, are emigres from Lebanon and Syria. In addition to Lorie, the couple has two teenaged children. Like many people these days the Atikian's were concerned about modern food additives, pesticide residues, and drugs. Their cultural background may have made them a bit more vulnerable, but like most people they held positive attitudes toward "natural" food and medicine. Sonia became enamored with Gerhard Hanswille, an "herbologist."
Gerhard Hanswille, 55, says that he learned herbology in Germany through self-study and books (Germany has a tradition of folk medicine that includes a great deal of Medieval herbalism). In 1972, Hanswille obtained a mail order doctoral degree in naturopathy from "Bernadean University" (BU) located at that time in Las Vegas, Nevada. BU, which was never approved or accredited to offer any courses, was closed down by the Nevada Commission on Postsecondary Education in 1976. It then moved to California where it operated for several years before eventually becoming "authorized" under the State's liberal rules (Aronson, 1983). California has tried to close BU but has been blocked by its claim to being a religious school of the Church of Universology (Emshwiller, 1987).
Hanswille owns two "House of Herbs" stores, writes and gives seminars at which he expounds his theories, which include making wax and clay effigies sealed with drops of blood and sperm (notions founded in Monism and Vitalism which are the basis of most primitive folk medicine). Hanswille's book describes how to heal diabetes, epilepsy, TB, tumors and paralysis by "touchless massage." Hanswille likens the technique to dowsing for water, something that "not everyone can do." Sonia paid $450 to take Hanswille's course.
Hanswille's compelling vision of natural health made a convert of Sonia. When she became pregnant with Lorie in 1985 Hanswille convinced her to remain "pure" for the sake of the child. She testified that Hanswille promised to make Lorie a super baby. "That baby is going to be very different. Its going to develop without chemicals. Its going to be strong and pure...it going to be very special." Hanswille convinced Sonia that vaccinations would "poison" her child, and that ultrasound examination would damage an unborn baby's brain. He had Sonia tell her pediatrician that she would not be bringing Lorie in any more because the family was moving to California. Hanswille was described as ". . .like a doctor. . .surrounded by medicine and books. . . sure of what he was saying. He always had an answer."
Hanswille advocated an organic, vegetarian diet. He sold the Atikians a special juicer for $400 alleging that their own juicer "burned the nutrition" out of fruits. Among the special products the Atikians purchased from Hanswille were a bottle of baby oil that cost $16, a bar of soap costing $7.40, and a 3 kg box of laundry detergent that cost $35.99.
When Lorie became ill she was treated with royal jelly, "cell salts" (homeopathy), and an herbal concoction brewed by Hanswille. He also treated Lorie with an electromagnetic "vitalizing" machine that "stimulates the blood" and has attachments such as an electrified comb that "livens up the hair." Sonia Atikian testified that they became very concerned about Lorie's condition but that Hanswille assured them that it was normal for clumps of her baby's hair to fall out and not to worry if Lorie didn't gain weight. Hanswille told Sonia that taking Lorie to a hospital would be like "holding a loaded gun to Lorie's head and pulling the trigger."
The Atikians were charged with failing to provide the necessities of life for their baby daughter (child neglect). Up until now Hanswille has not been charged with anything. He has angrily complained that he feels like "the accused" but denies that he did anything wrong. He says that he "cannot tell people what to do," that it is up to the parents to make decisions for their children. The judge instructed the jury that it was all right for them to "vent your spleen" over the activities of Hanswille "and his ilk," but neither he nor herbalism were on trial in the death of little Lorie.
On June 12 the Atikians were found guilty of child neglect. Sentencing is scheduled for July 6.
The sad story of the death of little Lorie Atikian received national coverage in Canada by the Toronto Star (5/10-6/13) and The Globe and Mail. It is the kind of story that elicits harsh blame of the parents for their gullibility. "How could they have been so foolish?" is the usual response. The reality is that most of the public is sympathetic to the underlying assumptions that condemn modern food, commercial agriculture and extol "natural" medicine. The herbal industry is trying to distance itself from Hanswille by saying that the case is "not typical." However, we believe that what Hanswille told the Atikians is not only widely believed by health food and natural (herbal) medicine ilk; it largely represents the philosophy that is used to justify the existence of "alternative" medicine and herbalism. The faith the Atikians placed in Hanswille seems cult-like, but how different is it than the confidence a patient must put in a surgeon, anesthesiologist, radiologist, or physician who hold lives in their hands?
In 1962, a California chiropractor was convicted of second-degree murder by words alone in the death of 11-year-old cancer patient, Linda Epping. To get a conviction, the prosecutor had to prove that "his fraudulent representations ... caused Linda to die when she died" (Miner, 1964). We do not know enough about Ontario law to know if what Hanswille did constituted the unlawful practice of medicine, and if so, the resultant death of Lorie Atikian makes such a felony. We do know that Lorie's death is even more tragic than Linda Epping's because Linda had a form of cancer that is usually fatal while Lorie was a healthy baby with a normal future. People who presume to give health advice that can make the difference between life and death must be regulated by the government and held accountable for their misdeeds. Consumer protection law holds that practicing medicine is a privilege, not a right. Like driving a car or flying an airplane, only those who are qualified are granted such privilege by the state. It is clear that the state has a compelling responsibility to protect vulnerablepeople--and their children--from the glib purveyors of pseudomedicine. It matters not that such practitioners are sincere in their beliefs. Experience teaches that, when it comes to quackery, zealotry can be more dangerous than fraud.