My Scibling, Orac, over at Respectful Insolence has a special thing about those he calls "alties." They make him crazy. For Orac alties represent a broad category of alternative medicine approaches. I more or less agree with him but I don't have the same passion about it he does. I'm also willing to believe some things now considered alternative approaches will become mainstream at some point and I know that many things we now consider conventional will be abandoned as without any scientific foundation. That's pretty much the way things work and I don't draw any larger lessons from it, except perhaps a slight tendency towards humility. Pretty slight.
Having said all that, this story from the UK is truly beyond the pale:
A doctor at a family planning clinic told a patient that she needed an exorcism because there was something sinister moving around inside her stomach, a medical tribunal was told yesterday.Joyce Pratt, 44, allegedly told the patient, who was seeking contraceptive advice, that she might be possessed by an evil spirit and needed religious rather than medical help.
She gave the woman crosses and trinkets to ward off black magic, allegedly told her that her mother was a witch, that she and her husband were trying to kill her, and suggested that she visit a Roman Catholic priest at Westminster Cathedral in London.
During the consultation at the Westside Contraceptive Clinic in Central London the doctor was said to have told the patient that she had black magic powers that could help to alleviate the problem.
The patient, identified only as Mrs K, was said to have left the clinic "very shaken and intimidated". (TimesOnline)
So Doctor Pratt is being investigated by the General Medical Council's fitness to practise committee. A good psychiatric consultation might also be in order.
This patient sought care at a free reproductive health clinic because of pain, bleeding and an increase in girth. She wanted a contraceptive injection. A good diagnostic workup was indicated first, but instead Dr. Pratt offered her magical powers and told her to take holy water and see some priests. Instead of a diagnostic workup the patient received crosses and stones to protect her because Dr. Pratt had already made a diagnosis: the patient's mother was a witch and she and her husband were conspiring to kill the poor girl.
As I said, beyond the pale. Way beyond the pale.
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If this is organized religion, I am going atheist like Revere. But they do have healthcare in the UK so what happened here?
Indeed!
44 is a little late for a first psychotic break, even for a female. Drugs, maybe? Delerium?
Very strange...
Maybe the doc needs a work up-she may have a mets to the brain, a primary tumor or other such thing that could cause new onset mental confusion.
increased girth? something sinister moving in her stomach? sounds like pregnancy.
My "take" on this is that it is most likely a cultural thing.Britain is very multi-cultured and struggling with the emergent reality of imported belief systems that are widely at odds with modernity.In NZ we have the situation where the native people(Maori) persist with Taonga,spiritual healers,who resist Western medical practice.It is very "correct" these days to proclaim that all cultures are equal;eg voodoo is culturally correct and valid.I follow this case,as with many other similar ones,with some interest.
Holy red herring, Batman! (multiple pun intended)
That's not alternative medicine, it's the substitution of a spiritual healing claim for any kind of medical advice. Part of the reason it's shocking is because it's a category violation.
Western medicine tends to be guilty of a "moat effect," where anything outside the paradigm is immediately condemned, but as soon as it is understood in scientific terms and accepted, the fact that it may have origins in folk medicine is conveniently forgotten and the original practitioners continue to be written off as savages. That's not science, it's politics, and turf-protection.
Consider the number of pharmaceuticals developed from native medicinal herbs, notably from Central America. Consider acupuncture, biofeedback, meditation, and visualization. Consider certain uses of nutritional supplements. Consider that in Western culture, the ancient Kosher rules and certain Biblical proscriptions map closely with sanitary precautions (pork, shellfish, etc...).
Here I am not arguing against scientific rigor, or arguing that outright nonsense be accepted, or arguing for some kind of insipid cultural relativism. I am simply making the case that a-priori ideology of any kind has no place in science, and that it's easier to see the mote in the other guy's eye than the board in one's own.
Well I just have to add this story even though it is only marginally related. Its too wild to pass up passing on.
http://www.advocate.com/news_detail_ektid36140.asp
Pastor who allegedly raped woman possessed by "lesbian demon" is indicted
A Texas pastor accused of raping a church member at his house last year after telling her she was possessed by a lesbian demon has been indicted. Leonard Ray Owens, 63, who is free on $25,000 bail, is now awaiting trial on a charge of sexual assault, a second-degree felony punishable by two to 20 years in prison. He was arrested in November.
Police began investigating Owens last year after a 22-year-old woman reported that Owens raped her twice at his Fort Worth home. The woman told police that in July, several months after she began attending the Prayer House of Faith, she went to Owens's home for counseling following a miscarriage.
Owens told her that a sex spirit and lesbian demon were inside her and needed to be cast out, police said. The pastor then asked her to lie on the floor and began yelling at her as if she were a demon, saying, "Loose her in the name of Jesus," according to an arrest warrant affidavit.
The woman told police that Owens pulled down her pants as he called for the demons to come out. When she tried to get up, he pushed her down, the affidavit said. The pastor then began to fight with her as if she were a demon before climbing on top of her, pinning her down, and raping her, police said.
Then Owens, a self-proclaimed prophet, ordered her to wash her face in the name of Jesus and to read Psalm 105:15, which says to do no harm to prophets, the woman told police. The woman told officers that Owens raped her again a month later, after he asked her to go to his house to pray for another woman.
Owens has denied having sexual contact with the woman, police said.
g510: I agree with you completely, which is why I qualified the introduction. I am thinking of writing a post on the inherent problem of what philosophers of science call the demarcation problem, separating the scientific from the pseudoscientific. Many examples show it is historically contingent but there must be more to say as well.
K.: Jeez.
In the above stories I think a DIS personality disorder can be the case and there are a lot of sektarian movements who actually induce personality disorders by traumatization. It's a very sick world and the members are very intelligent so they are never caught. Maybe some stimulus has triggered the disturbed behaviour of one of the 'alters', but it's guessing indeed.
Too bad the victim in the raped by the priest story was raped a second time. That's another question, how to deal with reality and not let it happen again.
Not nearly as much as you think. At the root of many alternative medicine claims and "therapies" are various forms of "energy healing" based on a supposed "life force" (i.e., qi). There is no evidence for the existence of qi or that "manipulating" qi does anything therapeutic. Qi is, more than anything else, a spiritual/religious belief. Yet, Reiki therapy, acupuncture, and qi gong are all firmly within the spectrum of treatments known as "alternative medicine."
That's the problem with so much of alternative medicine in an nutshell. Not only is the vast majority of it without good evidence for efficacy, but a disturbing proportion of it is based on religious and spiritual beliefs rather than empiric data. While almost everyone would look at this story and say that it was an example of a doctor trying to use religious dogma to diagnose and treat, why don't many of those same people say exactly the same thing about Reiki, acupuncture, qi gong, distance healing, and other such alternative medicine modalities?
Orac: You raise a couple of issues. In evidence based approaches the question is whether it works or not, not how it works. I have been told that there are RCTs of acupuncture that show efficacy (including one just presented at the ARA meetings I think), which is independent of how you think it works. You seem to be conflating the two in your comment. I'm afraid that surgery is not the best home base of well tested therapeuttic modalities, if you will excuse me saying so, although it has a well grounded rationale.
Here's an interesting exorcism story - a linked pair of exorcisms, actually. The players include a world class chemist and a couple well qualified pyschotherapists, one of whom was the landing pad for the "demon" removed from another woman during the first exorcism.
If you've ever struggled with your Shadow (the Jungian variety), you'll immediately grok this piece. Otherwise, you may find yourself in that other corner with Orac.
Tympanachus, thanx tres muchley for posting this working psychotherapy model utilizing psychoactives as the trigger for conscious entry into the unconscious matrix -- sounds a bit wanky, but that's how I read the story...
I disagree with your perception of the experience, seeing the "demon" move from one patient to another. To me, the story reads literally, as you say, "[a struggle] with your Shadow (the Jungian variety)". There does not appear to be a transference of "energy" from one person to another -- it's just a classic example of an adult dealing (via some fab imagery) with the parental crap dumped onto her during childhood...
I used to "vision quest" with the help of THC -- Jungian a go go... I dealt with a lot of "issues" during that late 1997-8 period -- timeframe during which WHO chief Margaret Chan was working to stop H5N1 from exploding into a human to human epidemic in Hong Kong! Several "vision quests" during late 97 actually induced dramatic emotional insight into the nature of H5N1 -- but obviously, being a "stoner" had its drawbacks... No one took me seriously!!!
Jon S: "I disagree with your perception of the experience, seeing the "demon" move from one patient to another."
That would be with the demon's new host that you disagree. To wit:
I agree with you that somehow the first exorcism awakened her to her own Shadow material. The dog's behavior is a bit more difficult to explain. I've noticed that dogs have a more diverse set of sensors for the electromagnetic spectrum. I see this collective experience as just more evidence that situations like this are a bit more complicated than we think they are.
Sasha Shulgin has fabricated and explored more psychoactive substances than anyone else professionally or avocationally dedicated to these ways of plumbing the domain of consciousness. He introduced MDMA to Leo Zeff, protagonist of the book, The Secret Chief. Shulgin's Epilogue to that book is a quick and insightful read (Zeff was called Jacob in the first edition of the book).
So, might your THC modulated "dramatic emotional insight into the nature of H5N1" be revealed here?
Sagan was a stoner. "Mr. X" in Lester Grinspoon's book, Marihuana Reconsidered (1971), was actually written by Sagan. He wrote the account in 1969 when he was in his mid-30s. He continued to use cannabis for the rest of his life.
Is it fiction passing itself off as science or does science ever attempt to pass itself as fiction? I'm having trouble with the probability of "Cloning Jesus", a recent publication by Authorhouse. Would it be in the DNA of such clones to perform such exorcisms?
There are RCTs that support lots of things. The question then becomes are they well designed and are the reproducible. Acupuncture, like chiropractic, has some great PR that has managed to fool some of the brightest people into the mindset of "I just assumed it was legitimate" or mentioning the wonderful study that proves an alt med therapy beyond doubt that is always just about to be published or that a link to it can't be recalled.
There may be a plausible mechanism for why acupuncture may have some effect on subjective complaints like pain and nausea, blocked meridians not being one of them of course. If it turns out that it can be effectively shown that, say, counter-irritation is the etiology of any perceived benefit, and acupuncture takes off in conventional medicine, does it matter that it was invented in a more primitive culture a couple hundred years ago. Medicine that works is medicine that works. g510 may have said he(or she) didn't mean to, but his or her comment reaked of supporting a different set of rules for alternative therapies.
Clark: I am not sure what you are saying here. As I said to Orac, there is a difference between efficacy and mechanism. You can have the right mechanism and it still doesn't work (surgeons should be familiar with this) and vice versa. When Nixon opened China one of the things that happened was that acupuncture anesthesia came to the US. There was a nurse at Boston's Beth Israel who had an appendectomy with acupuncture anesthesia (it was on the front page of the Boston Globe). She got up off the operating table and walked out of the OR. I don't know how this works. I'm pretty sure it isn't Qi, whatever that is. But I have some strong belief it does work to some extent.
The history of medicine is full of wrong ideas and wrong therapies that were a lot worse than almost anything today's alternative medicine does (think lobotomy, which is pretty recent). I'm not defending alternative techniques. I'm guessing most are bogus. But I've been a doc for almost 40 years and I know we've done a lot of bogus things, too, even though NEJM said they were OK. RCTs are not the only standard, either. I'm an epidemiologist and the fequency with which the medical profession misinterprets RCT is astounding. I doubt one in ten know what it means for a difference not to be statistically significant. Most think it means the difference is due to chance.
I am more than slightly annoyed at the pots calling the kettles black.
Acupuncture anesthesia stories are often passed around with many being pure fantasy. The rest are devoid of the little details that matter such as how a patient might have gotten a good administration of local anesthesia in addition to the acupunture. Or versed. Or ketamine. I've never seen evidence of a major surgery being done with acupuncture as the primary source of anesthesia.
I don't have a problem with studying acupuncture. Come up with a plausible mechanism of action and go for it. But the therapy is tightly adhered to an immense amount of magical thinking and historical inaccuracy as well as primarily anecdotal support of its effectiveness so I don't think it has a place in the practice of a rational physician. I'm not a big fan of the let's just try it and see if it works approach regardless of how many people may think that it does.
This comes up often when discussing alternative medicine. Conventional medicine isn't perfect and it used to believe in weird things so we should be open to weird alternative theories with no basis in reality. Does that make sense? It doesn't matter that we used to bleed people or give calomel until our patients hair and teeth fell out. That doesn't make it okay for acupuncture or any other therapy to play by a different set of rules. What do you propose should be the gold standard by which we investigate treatments?
Clark: There is a consistent conflation of two different ideas in your objections to Alternative Medicine (which I hold no brief for; it is just a convenient way for me to explore the underlying epistemology used to counter it). One is efficacy. The other is the underlying theory. You keep sliding from one to the other. To give you an example where you accept the efficacy angle and don't mind dispensing with underlying theory, take the placebo effect. You have no idea how it works except for a somewhat magical idea that the "mind" can interact with "the body." Yet you then have no problem invoking it as the answer to a lot of efficacy results in alternative therapies. To paraphrase you, I don't have a problem with the placebo effect. Come up with a plausible mechanism that isn't just handwaving. On the other hand, there are probably hundreds of conventional therapies that have never been tested, whatever their underlying theory, and when put to the test would fail. Thus these two criteria are independent, as you comment implies.
I don't know if acupuncture is "real" or not and frankly it isn't something I worry about a lot. Intellectual rigor is something I worry about a lot. Skeptics of alternative medicine (who are probably right about most of what they say) still need to be intellectually rigorous in their reasoning or they have no standing in the argument which depends upon rational thinking. With all due respect, I find "skeptics" to be some of the most gullible folks in science. They are willing to believe anyone who "debunks" a conventional view they find objectionable. Like a John Stossel, for example, one of the most intellectually dishonest journalists around (in the same league with the American Council on Science and Health).
Maybe you'd like to tell the rest of us what separates science from pseudoscience. Because if you can you have solved one of the most vexing problems in the philosophy of science, the Demarcation Problem. BTW, forget about "falsibiability" of Popper. Philosophers haven't bought that one for decades, the problem being, as Quine has pointed out, the underdeterminaiton of theory. Many scientists don't seem to know this is a dead issue and even confuse falsifiability with testability with confirmability, three different, and in the case of the first and the last, contradictory criteria.
As for the "gold standard," by convention we use one of Mills' Cannons (one of four), an idealization of The Experiment, the RCT. It may interest you to know that Popper's target in falsifiability was Mills and Humes Inductivism that underlies it, but we'll let that go. The idea of the RCT is that A causes B if, all things being equal, a change in A consistently produces a change in B. Unfortunately, as many have pointed out, all things are never equal. You may consider this a major or a minor point, but it is a crucial one for RCTs. I'm an epidemiologist and dealing with data like this is my stock in trade.