Science Sells Out to Big Stupidity

Dave Gorski reports the very bad news that the journal Science, published by the American Association for the Advancement of Science, has sold out to Big Stupidity, aka the “traditional” and “alternative” medicine and supplement industry that profits by scamming the sick and the desperate.

I do, however, feel obligated to deal with one painfully inappropriate action by a major science journal left over from 2014. It happened in an issue that came out just before Christmas, and, with all the festivities, being on call last week, and having houseguests; so, unfortunately, I just didn’t get around to addressing it, either here or on my not-so-super-secret other blog (where I might crosspost this later in the week). The journal is Science, which, as most readers know, is one of the two most prominent general science journals out there, the other being Nature. Actually, it’s appropriate that I mention Nature in this discussion because Nature pulled exactly the same bone-headed move three years ago, almost to the day.

Yes, Nature shilled for traditional Chinese medicine (TCM) by publishing an advertising supplement promoting it sponsored by a Japanese supplement manufacturer. Now it’s Science‘s turn to do the same in the form of—you guessed it!—an advertising supplement entitled The Art and Science of Traditional Medicine Part 1: TCM Today — A Case for Integration. Worse, Science appears to be going Nature one better—two better, in fact. This is the first part of what is promised to be a three part series.

Looks like I have blog material for a while.

Indeed. And the World Health Organization is in on it as well, to make things far worse, whose director, Margaret Chan, is spouting bullshit like this:

TM [traditional medicine] is often seen as more accessible, more affordable, and more acceptable to people and can therefore also represent a tool to help achieve universal health coverage. It is commonly used in large parts of Africa, Asia, and Latin America. For many millions of people, often living in rural areas within developing countries, herbal medicines, traditional treatments, and traditional practitioners are the main—and sometimes the only—source of health care. The affordability of most traditional medicines makes them all the more attractive at a time of soaring health care costs and widespread austerity.

Gee, what’s missing from that paragraph? Oh yeah, does it actually work? I’m sure we could hire someone entirely unqualified to tell us how to build a bridge much cheaper than an actual engineer, but you’d be a fool to drive your car over it. If traditional medicine works, then do the science and show that it does. If you can’t, it doesn’t matter how cheap it is, does it?

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  • Sastra

    This is what happens when people confuse fact claims with cultural identities. Why not have spaghetti AND egg rolls? They both belong on the banquet table so there’s freedom to pick.

    This doesn’t just happen in medicine, of course. It happens every time someone wants to protect a particular belief from criticism and the parameters are or can be made ambiguous. Treat it like a value, a choice. a lifestyle. It works if it works for you.

  • caseloweraz

    Totally OT: I trust everyone here is aware of the story involving the late Neil Armstrong and a Mister Gorski. I won’t repeat it, but Google and Snopes are your friends. Great story! Too bad it’s only an urban legend.

  • Pierce R. Butler

    Some “traditional medicine” does work – e.g., willow-bark tea has the same active ingredient as aspirin.

    However, I doubt the purveyors of willow bark have bought advertising supplements in major scientific journals lately.

  • karmacat

    Hmm. Maybe “traditional medicine” is so cheap because IT DOESN’T WORK!

  • http://www.facebook.com/andrewasante andrewbrown not the one from the grauniad

    From memory, a lot of traditional Chinese medicine had fallen out of favour in China. When Mao moved millions out to work in the fields he needed a form of cheap medical care for them. To that end he promoted a revival of traditional Chinese medicine. It was cheap, the people would use it and they couldn’t object to the fact that it didn’t work. From there it spread to the west and Hollywood and the rest history.

  • scienceavenger

    There’s a word for traditional medicine that works:

    Medicine.

  • hunter

    Pierce R. Butler @3: Yes, some traditional medicine does work, and it’s worth remembering that a lot of our pharmaceutical drugs were derived from plants used in traditional medicine — people were drinking infusions of ma huang twigs for congestion long before scientists discovered epinephrine, the active ingredient.

    Some of those home remedies have been tested scientifically, most haven’t. More work could be done in that area.

    That’s one reason I have small patience with blanket condemnations of traditional medicine — it just smacks too much of knee-jerk bigotry founded in ignorance.

  • Reginald Selkirk

    Some “traditional medicine” does work – e.g., willow-bark tea has the same active ingredient as aspirin.

    STOP NOW, BEFORE YOU DIE A HORRIBLE DEATH

    Willow bark tea contains salicylic acid. This serves, among other things, as an anti-coagulant. Get too much if it and you may bleed out.

    Aspirin is acetylsalicylic acid. That tiny little acetyl group is your friend. Acetlysalicylic acid is much much safer than the unmodified natural version. Science FTW.

  • nrdo

    While a lot of modern medicinal compounds are derived from natural sources, it does not actually follow that “most” traditional treatments work. Pre-scientific societies had no reliable way of connecting drugs to specific diseases and so, not surprisingly, identified substances that had immediate, general and relatively obvious effects i.e. pain killers and (some) antibacterials.

    The notion that traditional medicine addresses the “root causes” of diseases more than science-based medicine is simply backwards.

  • Reginald Selkirk

    hunter #7: Some of those home remedies have been tested scientifically, most haven’t. More work could be done in that area.

    Some have been tested repeatedly and have failed repeatedly (e.g. echinacea), and yet the natural-organic crowd keeps on using them. These are simply not evidence-based people. So I suggest that directing your lack of patience in their direction would be a more appropriate response.

    Also, the NIH, under Congressional mandate, set up an office which was supposed to be carrying out exactly that sort of research. It has accomplished almost precisely zilch with all those taxpayer-funded dollars. Spend more time on the Respectful Insolence blog for many additional details.

  • moarscienceplz

    STOP NOW, BEFORE YOU DIE A HORRIBLE DEATH

    Willow bark tea contains salicylic acid. This serves, among other things, as an anti-coagulant. Get too much if it and you may bleed out.

    Aspirin is acetylsalicylic acid. That tiny little acetyl group is your friend. Acetlysalicylic acid is much much safer than the unmodified natural version. Science FTW.

    Ehhh, this is a bit hyperbolic. Both Aspirin and salicylic acid are anti-coagulants. Both can harm you if you overdose. The main problem with occasional ingestion of salicylic acid is that it is very irritating to the stomachs of most people. Aspirin is much less so.

    Taking willow bark tea is somewhat problematic because the dosage of active ingredients can be highly variable, but if you only drink one cupful a few times a year for occasional pain relief, I wouldn’t worry too much about it.

  • Kevin Kehres

    As to the OP, I wouldn’t get my knickers in a twist over it.

    It’s an advertising supplement. You know, money for the journal to use for its operations.

    I get lots of journals and a lot of them have advertising supplements. They’re clearly marked as such. And I’m quite sure that the vast majority of subscribers do exactly what I do when I receive one. Put it right in the recycle bin.

    I weep at the thought of all those dead trees being ignored. But that’s it. As the world’s problems go, this is definitely a “small p” problem.

  • http://www.pandasthumb.org Area Man

    There is quite a lot of literature showing that different ingredients in TMCs are effective. Not all of course, but some, and in some papers I’ve read the investigators have been able to isolate which ingredients are causing which actions. A few examples from a brief search:

    http://www.ncbi.nlm.nih.gov/pubmed/25246794

    http://www.ncbi.nlm.nih.gov/pubmed/23759835

    http://www.ncbi.nlm.nih.gov/pubmed/24447861

    http://www.ncbi.nlm.nih.gov/pubmed/22460422

    http://www.ncbi.nlm.nih.gov/pubmed/25552899

    Now, maybe all these studies (the above are just reviews, and I’m not endorsing them, just pointing out they exist) aren’t any good, maybe the researchers are hopelessly biased by their cultural background. And then again maybe not. But there’s nothing odd about the idea that herbs have pharmacological properties, and that people in cultures going back a long way may have been able to notice their effects. If you’re actually in favor of evidence-based medicine, and not just exercising prejudice, you want these things to be thoroughly studied, if for no other reason than to prove their uselessness. Attacking journals merely for taking an interest in the subject is absurd.

    There are of course serious concerns when it comes to the influence of advertisers and deep-pocketed business interests on the integrity of the big-name journals, but holy-hell, the mainstream pharma and device industries chased that horse out long ago.

  • http://www.jafafahots.com Jafafa Hots

    I read an article the other day listing several species expected to go extinct in the next year or so.

    Several of them are being killed off pretty much solely for “use” as “traditional medicine.”

    “Small p” problem?

  • Kevin Kehres

    You really think a Japanese supplement manufacturer is going to pay for a 2-issue supplement to Science to tout the benefits of rhino horn? C’mon man!

    You can read the entire supplement yourself. It’s about acupuncture and herbal products.

    Problem with a small p.

  • http://www.facebook.com/profile.php?id=1246980039 caseyboucher

    I’m going to play devil’s advocate here for a moment.

    From what I’ve read, the Chinese government does regulate the training and practice of traditional medicine to some level, and did historically rely on traditional healers to expand access to at least some level of care (effective or otherwise) in underserved areas. From what I understand (and this is based off of what I remember from a few articles I had to read for a class I took several years ago, so I might be wrong), their decision to do such seems to have been largely pragmatic–if there aren’t enough real doctors to go around, a quack is better than nothing for most minor complaints, which tend to resolve themselves anyway.

    Peru used a similar approach, with quite a bit of success, to expand healthcare access in remote areas too. They even fund research in traditional healing techniques to help make their traditional healers more effective. Heck, drugs aren’t always around; a remedy based on local plants that has some demonstrable effect is also better than nothing if it’s prepared and administered properly.

    If practitioners of alternative therapies are required to be trained to recognize the signs and symptoms of conditions serious enough to require a referral to a real doctor, some regulatory requirement exists that they must make appropriate referrals in such instances, and the therapies that they use are at least regulated based on safety, then it is quite possible that they could be useful in expanding access to primary care. Again, for most minor complaints, the placebo effect of even the strangest therapies still does provide enough relief to the patient that it shouldn’t be written off entirely.

    To paraphrase Hippocrates, most of medicine is simply a matter of distracting the patient while nature takes its course. For a large portion of complaints, such distraction does not require an MD or a prescription pad. As long as the patients who actually need somebody with an MD (or other appropriate qualification) and a prescription pad are sent to the right place and the training of the practitioners is at least somewhat standardized, then the argument that alternative medicine practitioners might help expand access to primary care is quite valid.

  • http://www.facebook.com/profile.php?id=153100784 Michael Brew

    I always have this issue with my wife. She’s from Taiwan, so as with a lot of people in that country she and her family rely on “traditional Chinese medicine” for most things. Now, I’m not saying none of it works (pretty sure drinking water with burned paper in it doesn’t, though), but I don’t really know if it works or not. I’ve tried telling her that I’d rather take a pill that has proven efficacy and controlled dosage of the active ingredient than something that is totally up in the air as to its usefulness. She still gets upset about it because I’m apparently insulting her culture by demanding science-based medicine, but as much as I’m willing to indulge her by keeping a magic talisman in my wallet and refraining from whistling at night while I’m around her, I feel like what I put in or on my body is a bit more of an issue.

  • Mobius

    You know what they call “alternative medicine”

    That’s been proved to work?

    Medicine.

    Tim Minchin — Storm

  • weatherwax

    #3 Pierce R. Butler: “Some “traditional medicine” does work – e.g., willow-bark tea has the same active ingredient as aspirin.

    However, I doubt the purveyors of willow bark have bought advertising supplements in major scientific journals lately.”

    A canard. Aspirin was created by determining the active agent in the willow bark, testing to determine the effective dose, finding the side effects, and encapsulating it in a known dose.

    Or you can drink willow bark tea and maybe get some salicylic acid, or maybe a lot more, or a lot less, or none at all.

    Hmmm, know let me think…