What does the National Institutes of Health Office of Alternative Medicine (OAM)/National Center for Complementary and Alternative Medicine (NCCAM) have to show after providing grants and awards of close to $110 million to individuals and centers from 1993 to 2000? An independent review says published reports on funded projects indicate that "no ['complementary' or 'alternative'] method has been determined to be either useful or ineffective on the basis of OAM or NCCAM grants." [Green S. Scientific Review of Alternative Medicine and Aberrant Medical Practices 5:205-207, 2001.]
Last year's crackdown by Baja California regulators on clinics in Tijuana offering expensive, useless treatments promoted as "alternative" medicine has stalled, reported Penni Crabtree and Sandra Dibble as part of a series of articles on the clinics and "alternative" medicine published in the San-Diego Union-Tribune in February. They say that an estimated 30 to 70 clinics continue to operate because of an inspector shortage, patients who won't -- or don't know how to -- file complaints, clinics that disguise their illegal treatments, and clinic operators who exploit in court flaws in state and federal laws.
The clinics bilk U.S. insurance companies by falsely billing for providing emergency care. They submit claims to the insurers through third-party billers they hire or set up to fraudulently claim that approved treatments are offered. They usually get away with such practices, but, Crabtree and Dibble reported, Scott Norby, president of Hospital Meridien, was convicted in San Diego federal court of 24 counts of mail fraud and was sentenced in August to 57 months in prison. He is free on bail while his case is appealed. Investigators gathered evidence that Norby's companies allegedly filed 273 fraudulent claims seeking $3.8 million of which insurers paid $626,000
The Tijuana clinics are a significant source of advertising revenue for Alternative Medicine magazine (which champions nonsensical methods of healthcare). Patients from the United States are also drawn to the clinics by attending "alternative" medicine conventions in the United States and by visiting Web sites on the Internet. Crabtree and Dibble told the stories of several victims drawn to the clinics:
Jim and Rhonda Luciano brought their 6-year old Silas, who suffered from a rare and deadly cancer, to the American Metabolic Institute (AMI) in Tijuana for cancer "vaccine" treatments derived from animal tissue. Weeks into the treatment AMI medical director Geronimo Rubio presented CAT scans that purportedly showed the cancer to have disappeared. Nevertheless the Luciano's spent $90,000 and three months at the clinic. Silas's condition deteriorated; tests at another hospital confirmed that his body was riddled with cancer. Rubio assured the couple that Silas was fine, and promised a new, stronger course of experimental treatments. But Silas died two days later at the clinic on February 21, 2001. AMI continues to offer dubious treatments for cancer.
Bill and Kristine Smith's daughter Courtney was unable to crawl or walk. She was diagnosed with spinal muscular atrophy, a rare, deadly genetic disorder. Hope provided by the book The Cure for All Diseases led the Iowa couple to write to the author, Hulda Regehr Clark, for help. Clark convinced the Smiths to take Courtney, then 2, to her Century Nutrition clinic in Tijuana. The Smiths told Crabtree and Dibble that they sold their home in order to raise money to do so. According to Kristine, Clark used a "Syncrometer"-a phony diagnostic device-to determine that "Courtney's body was ravaged by heavy metals, pollutants, and parasites," and said the child was allergic to most foods. Clark put her on a diet consisting largely of potatoes, pickled beets, sardines, and bananas. She ordered eight hours of daily treatment with her Zapper, a device that produces a mild electric current and which is not approved for any medical purpose. The couple said that Clark kept saying that she was close to curing the child and that it would be dangerous to stop treatment. The Smiths said they spent $30,000 over 10 months; Courtney's condition remained unchanged.
Eugenia Serebryakova, 76, was terrified when her San Diego doctors recommended surgery to remove early-stage colon cancer. The treatment would have given her at least an 80% chance of a cure. But she was drawn instead to convicted tax evader and illegal nostrum smuggler Kurt Donsbach's clinic, Hospital Santa Monica in Tijuana by its upbeat Web site that her daughters showed her. The clinic offers a variety of bogus treatments including hyperbaric oxygen and hydrogen peroxide infusions. She checked into Donsbach's clinic on May 11, 2001. Her medical records from the weeks before she came to the clinic indicated she was in relatively good health. Her daughters said Donsbach advised her to stop taking her three blood-pressure medications a few days later. On May 19, her older daughter found her bedridden and moaning in pain, and transferred her to Scripps Memorial Hospital in La Jolla. "She died three weeks later," Crabtree and Dibble wrote. "Scripps doctors said the blood supply to her bowel had been cut off and the bowel had 'died,' an unusual occurrence that appeared unrelated to her cancer." The daughters demanded from Donsbach a refund of the $8,000 they spent on her treatment. He gave it to them after they agreed to waive any future financial claims.
Beverly Collins, 58, a registered nurse from Arizona who feared chemotherapy learned in April that her colon cancer spread to her liver. She went to Providence Pacific Hospital, a Tijuana clinic run by Gary Tarasov. Known as "Dr. Gary," he is not licensed to practice in Mexico or in the United States, where he resides in San Diego County. Collins received Tarasov's treatment of "polyatomic oxygen therapy" and "[s]he had five teeth and several fillings removed after she was told that her mercury fillings were draining her body's capacity to combat disease," Crabtree and Dibble wrote. "Despite spending a month and more than $30,000 in Tarasov's care, Collins' cancer was not halted or cured. She died Oct. 5." Her husband said she had no regrets about going to Tijuana for treatment.
Neil Mortimer, 43, had multiple myeloma. He found the Web site of BioPulse International that falsely claimed that "insulin-induced hypoglycemic therapy," which puts patients into daily low-blood-sugar comas to supposedly starve cancer cells, had been tested and found to reduce or eliminate tumors in many cancer patients. Mortimer declined the radiation therapy recommended by his specialists. Instead he spent $70,000 for four months of BioPulse's treatment and $26,000 for its stock. Mortimer bled internally for five days at BioPulse, but, Crabtree and Dibble explained, "the clinic's physicians didn't give him a transfusion for three days because they couldn't find blood to match his type." He was transferred to the Scripps Memorial Hospital in Chula Vista. He died a few days later on January 15, 2001.
[Source articles from San Diego Union-Tribune by Crabtree & Dibble: Borderline medicine (2/24/02), No insurance against fraud (2/24/02), The 95 percent promise? (2/24/02), High hopes, false promises (2/25/02).]
The adoptive mother of Candace Newmaker, the 10-year old victim of a fatal session of the "attachment therapy" called "rebirthing," pled guilty on October 12th to criminally negligent child abuse resulting in death. Jeane Newmaker, a pediatric nurse practitioner from Durham, NC, did not attempt to intervene as she witnessed "therapists" torturing her daughter to death. In a deal struck with the district attorney's office, Newmaker received a 4-year deferred sentence. After those four years, if she stays out of trouble and completes 400 hours of community service, her record will be wiped clean.
Attachment therapy is a bogus mental health treatment for "attachment disorder," which is not recognized in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). "Rebirthing" is supposed to enable patients to re-experience and confront the physical distress of birth so that they can then trust and love others. [See NCAHF Newsletter, March/April 2001.]
"Therapists" Connell Watkins and Julie Ponder were previously convicted of reckless child abuse in suffocating Candace, and received the minimum 16-year prison sentence from a Colorado judge. On October 4th Brita St. Clair and Jack McDaniel, their assistants in the fatal session, were sentenced to 10 years probation and 1,000 hours of community service.
Newmaker has worked in a non-clinical position since she was charged. Prosecutors Steve Jensen and Laura Dunbar attempted to convince the court to prohibit her from working with children during her deferred judgment period. Jensen argued that there were "serious questions about [Newmaker's] ability to recognize and intervene" when the welfare of children was at stake. Jensen cited the signs of Candace's distress-the sounds of vomiting even audible on videotape of her "rebirthing," the complaints of nausea, Candace's statement that she had vomited, her complaints of not being able to breathe, etc. Jensen spoke of a lecture Newmaker gave in 1994 on recognizing the subtle signs and symptoms of nausea, dehydration, etc. Despite Newmaker's prior claims to expertise in such matters, she "lacked a willingness to intervene when other authority figures were around," said Jensen.
Newmaker's lawyer countered that the prosecution's request was unrelated to the case and was unreasonable. Newmaker, she said, was at the time of the "bizarre and tragic events" a mother and a patient, not a nurse. Newmaker had gone to Connell Watkins for attachment therapy for her daughter because it was the "only possible therapy." Newmaker's lawyer said she had a "stellar nursing career" and excelled at research and teaching.
Judge Jane Tidball agreed that Newmaker had "exhausted all other forms of therapy," had conducted "significant research" on attachment therapy-which "...include[d] talking to parents who know about attachment therapy"-and "reasonably
trusted" Watkins and Ponder. Tidball cited a mental health evaluation of Newmaker for the court that recommended only grief counseling and found "[n]o evidence that Ms. Newmaker poses a threat to any child or person anywhere under any circumstances."
I submitted a 13,000-word complaint to the North Carolina Board of Nursing (NCBON). I argued that NCBON should revoke Jeane Newmaker's nursing license because she: (1) put a child in harm's way, (2) did nothing to aid the child when the child was in severe and obvious distress, (3) was unwilling to question the judgment of others, (4) showed poor judgment in turning to a bizarre, unvalidated therapy, (5) was accepting of sadistic treatment of a child, and (6) ignored basic nurse training, notably on the proper use of restraint and basic life support.
NCBON spokesperson Donna Mooney responded that the Board could not launch an investigation because: (1) the crime occurred in Colorado, not in North Carolina, (2) Newmaker received a deferred sentence, (3) Newmaker's guilty plea does not mean she was guilty; and (4) Newmaker was acting as a mother, not a nurse. Mooney conceded that these reasons have no basis in law. NCBON will not consider revoking Newmaker's license.
"Attachment therapy has many characteristics associated with warning signals of an unvalidated treatment," writes Jean Mercer, PhD, professor of psychology at Richard Stockton College in Pomona, New Jersey in a review of the treatment published in the July-September 2001 issue of the Journal of Child and Adolescent Psychiatric Nursing. These warning signals-which are also associated with bogus mental health treatments such as craniosacral therapy, patterning, and facilitated communication-include: (1) harmful side effects, (2) broad claims of effectiveness, (3) information not usually found in peer-reviewed sources of information, (4) proponents promote other inappropriate therapies, (5) absence of empirical support, (6) lack of a basis in generally accepted theory, and (7) lack of adherence to accepted therapeutic practices [e.g., codes of ethics regarding physical contact during therapy]. Mercer notes that commonly accepted treatments may be linked to one or two of these warning signals, but unvalidated treatments are associated with many of these signals. She calls for mental health professionals to discuss with patients and families warning signals of unvalidated therapies, and educating the community including legislators.
Mercer describes three basic procedures used by so-called attachment therapists. "Rebirthing" is a procedure in which the child is heavily restrained with blankets and pillows as adults push to simulate uterine contractions. The child is instructed to escape from the restraint to be "reborn." Rebirthing, as practiced by attachment therapists, involves restraint unlike the "New Age" Yogic breath control technique of the same name. "Holding therapy" involves restraint that is less severe, but sufficient to frighten and enrage the child. "Therapeutic parenting" techniques do not appear to involve direct restraint, but include physical and psychological seclusion of the child through various coercive means applied either by parents or by specially trained foster parents.
It is unknown how many children and adolescents have been treated with attachment therapy practices. It is alarming that national and state organizations connected with adoption have been supportive of attachment therapy.
[Mercer J. Attachment therapy using deliberate restraint: An object lesson on the identification of unvalidated treatments. JCAPN 14(3):105-114.]
Clustered WaterTM earned the first annual Silver Fleece Award for Anti-Aging Quackery from S. Jay Olshansky, professor of epidemiology at the University of Illinois at Chicago School of Public Health on February 12th as part of a seminar sponsored by the International Longevity Center-USA. The award-a bottle of vegetable oil labeled "Snake Oil"-was given, said Olshansky, to "the product (and its producer) with the most ridiculous, outrageous, scientifically unsupported or exaggerated assertions about aging or age-related diseases." The recipient was selected based on an evaluation of purported health and longevity benefits, claims about scientific evidence supporting the product, the degree to which legitimate scientific research is exaggerated, and the profit potential of those selling it. The producers of Clustered WaterTM claim on their Web site that the product "truly assists our body's natural processes in counteracting the cellular malfunctions that many health practitioners and researchers believe are responsible for degenerative health." A four-ounce bottle of concentrated Clustered WaterTM currently sells for $39.95, and, as suggested by the manufacturer, yields four gallons of Clustered WaterTM when mixed with regular water.
The recipient of the Silver Fleece Award for an Anti-Aging Organization was the Academy of Anti-Aging Medicine, which describes itself as a "nonprofit medical society of 10,000 physicians, health practitioners, and scientists from 65 countries worldwide who pursue life-enhancing and life-extending medical care." The Award goes to the organization that contributes the most to disseminating misinformation and/or products associated with the claim that human aging can now be stopped or reversed.
"More than any other organization in the world, the American Academy of Anti-Aging Medicine is responsible for leading the lay public and some in the medical and scientific community to the mistaken belief that technologies already exist that stop or reverse human aging," said Olshansky. "It has created an alleged medical subspecialty and accreditation in anti-aging medicine, even though there are no proven anti-aging medicines in existence."
The awardees were selected by a committee of three scientists in the field of aging: Olshansky; Leonard Hayflick of the University of California at San Francisco; and Bruce Carnes, National Opinion Research Center at the University of Chicago. Olshansky and Carnes are authors of The Quest for Immortality: Science at the Frontiers of Aging (Norton, 2001). Hayflick is author of How and Why We Age.
Olshansky and Carnes state in their book: "The life extension industry begins with a grain of truth but quickly gets mixed with a tablespoon of bad science, a cup of greed, a pint of exaggeration and a gallon of human desire for a longer, healthier life-a recipe for false hope, broken promises, and unfulfilled dreams."
A new comprehensive review of the multi-billion dollar U.S. "anti-aging" medicine industry by a blue-ribbon panel of twelve experts in gerontology and medicine organized by the International Longevity Center-USA describes the industry as a movement linked to a "long chain of quacks, snake-oil salesmen and charlatans." In its report "Is There an 'Anti-Aging' Medicine?" the panel describes the movement as: "under the control of non-scientists who use terms like 'virtual immortality' and 'an ageless society' to attract customers to untested remedies that have not withstood the rigors of serious clinical trials." It states:
There is as yet no convincing evidence that administration of any specific compound, natural or artificial can globally slow aging in people, or even in mice or rats. Claims to the contrary (e.g., that a specific hormonal or vitamin preparation can slow down aging), are not based on evidence. Such claims are thus misleading to the public, and these substances should not be administered or used. These claims also obstruct the search for greater understanding of the biology of aging, and the eventual development of authentic longevity-promoting interventions of documented safety and efficacy.
The panel objects to the concept of "anti-aging" medicine, which it says "places a negative connotation on the very concept of aging." It says the "anti-aging" movement threatens to discredit serious longevity research that can yield important health-related benefits and cost-savings. It uses the term "longevity medicine" to express efforts to extend healthy life by such means as diet, exercise, cessation of tobacco, and advanced medical care.
The report was developed at a workshop held at the Canyon Ranch Health Resort, a co-sponsor of the report. Other co-sponsors were the Kronos Longevity Research Institute and the Columbia University College of Physicians and Surgeons Center for the Study of Science and Medicine. The full report can be downloaded at http://www.ilcusa.org.
The U.S. Preventive Services Task Force (USPSTF) reviewed the widely publicized Nordic Cochrane Collaboration critique of randomized controlled trials of screening mammography (discussed in NCAHF Newsletter Jan/Feb 2002) and concluded that flaws in the trials identified in the critique gave insufficient reason for rejecting the results of the trials.
In its report on "Screening for Breast Cancer" released on February 21, the USPTF "recommends screening with or without clinical breast examination, every 1-2 years for women aged 40 or older." The USPTF characterized as "fair" the evidence that mammography screening every 12 to 33 months significantly reduces mortality from breast cancer. According to the Task Force, the evidence is strongest for women aged 50-69.
The report noted potential harms of screening such as anxiety, inconvenience, discomfort, and additional medical expenses for women who receive false-positive mammograms. Between 80% and 90% of abnormal screening mammograms are false-positives.
The USPSTF, the leading, independent panel of private-sector experts in prevention and primary care, is sponsored by the federal Agency for Healthcare Research and Quality to conduct rigorous, impartial assessments of scientific evidence for a broad range of preventive services.
Additional independent analyses of clinical trial data on screening mammography were recently published in The Lancet, one in the February 2nd issue, the other in the March 16th issue. Both papers suggested that screening mammography reduces mortality from breast cancer.
NCAHF reviewed draft recommendations of the White House Commission on Complementary and Alternative Medicine Policy and issued a statement strongly suggesting that the recommendations "be viewed as unsupported and considered accordingly." See www.ncahf.org/pp/whcpp.html.