PROF. EDZARD ERNST: Who's confused about alternative medicine?/UK Anti-Comp Med Campaign given another stab by Prof Ernst


Read and forward this - the press won't publish it!

We have exhausted the national press in an attempt to rebutt the Daily Mail article of 14th Dec which, with the help of Prof Ernst, again slammed complementary medicine (Zeus note: see second press release at end re. 'Complementary medicines are useless and dangerous, says Britain's foremost expert')

We were told that the national press won't publish an article that opposes a purported leading expert, such as Professor Ernst.

Please help us to get the word out! The article can be downloaded in full, complete with one of Emma Holister's cartoons, at the following link:

Please email this link to anyone you think might be interested!

 Who’s confused about alternative medicine?

By Robert Verkerk MSc DIC PhD, executive & scientific director, Alliance for Natural Health (
PROFESSOR EDZARD ERNST, the UK’s first professor of complementary medicine, gets lots of exposure for his often overtly negative views on complementary medicine. He’s become the media’s favourite resource for a view on this controversial subject. Yesterday’s report by Barbara Rowlands in the Daily Mail (Complementary medicines are useless and dangerous, says Britain’s foremost expert, 12 December 2006) is par for the course.

The interesting thing about Prof Ernst is that he seems to have come a long way from his humble beginnings as a recipient of the therapies that he now seems so critical of.  Profiled by Geoff Watts in the British Medical Journal, the Prof tells us: ‘Our family doctor in the little village outside Munich where I grew up was a homoeopath. My mother swore by it. As a kid I was treated homoeopathically. So this kind of medicine just came naturally.
Even during my studies I pursued other things like massage therapy and acupuncture….As a young doctor I had an appointment in a homoeopathic hospital, and I was very impressed with its success rate. My boss told me that much of this success came from discontinuing mainstream medication. This made a big impression on me.’ (BMJ Career Focus 2003; 327:166; doi:10.1136/bmj.327.7425.s166).

Here we see Ernst responding as a clinician working in the field of alternative medicine – and also as a consumer, like the millions of Daily Mail readers who have remained passionate about this form of healthcare. The question is: why is there so much controversy over these non-pharmaceutical therapies? Why is it that users keep coming back to food supplements, herbal remedies, homoeopathy and all the therapies medics refer to as “complementary”, while a relatively small group of doctors attack such therapies as if they were some form of illicit witchcraft?
The answer may lie in the cloudy world of the scientific method, which is perhaps not as objective as many of the alternative medicine sceptics might claim. Being a skeptic (let us not forget that Ernst gave the keynote address to the 11th European Skeptics Congress on September 5–7, 2003) might suggest less than an open mind.  The divergence in views might also have something to do with the variable and often positive experiences of users of these therapies.

After his early support for homoeopathy, Professor Ernst has now become, de facto, one of its main opponents. Robin McKie, science editor for The Observer (December 18, 2005) reported Ernst as saying, ‘Homeopathic remedies don't work. Study after study has shown it is simply the purest form of placebo. You may as well take a glass of water than a homeopathic medicine.'
Ernst, having done the proverbial 180 degree turn, has decided to stand firmly shoulder to shoulder with a number of other leading assailants of non-pharmaceutical therapies, such as Professors Michael Baum and Jonathan Waxman. On 22 May 2006, Baum and twelve other mainly retired surgeons, including Ernst himself, bandied together and co-signed an open letter, published in The Times, which condemned the NHS decision to include increasing numbers of complementary therapies.

Six months on, Professor Waxman, in an article in the British Medical Journal (BMJ), said on 24 November 2006 that he wanted peddlers of food supplements consigned to “the cobra filled dustbin of oblivion”. I have to say, I’m not sure that such an attitude towards human life is particularly compliant with the Hippocratic Oath, but Professor Waxman has made it clear he feels very strongly about this issue. In the BMJ’s Rapid Responses to the same article, my colleague Dr Damien Downing and my responses reminded Waxman that orthodox medicine was not well known for its spectacular curative properties. We cited, by example, a recent study of the effectiveness of chemotherapy in Australia and the USA which showed it contributed less than 5% to the 5-year survival rate (Clin Oncol (R Coll Radiol) 2004; 16(8): 549-60).

As high profile as the Ernsts, Baums and Waxmans of this world might be – their views are not unanimous across the orthodox medical profession. Some of these contrary views were expressed just last Sunday in The Sunday Times (Lost in the cancer maze, 10 December 2006). The author of the article, Robert Randall, is a cancer sufferer himself. He claims to be a consumer of services offered by both sides of the divide and it is interesting that from this consumer’s perspective, we receive a much more balanced debate.
The concept of orthodox medicine relying on the evidence-based gold standard of the randomized controlled trial (RCT) is now wearing thin when it comes to understanding the relevance of this methodology to many forms of alternative medicine. Let's take nutrition, for example. Is it really scientifically valid to condemn the potential role of supplementary nutrients like vitamin E and carotenoids (from carrots, peppers and other brightly coloured fruits and vegetables) because, when delivered in their synthetic, pharmaceutical forms, they have failed to generate strong beneficial effects in RCTs aiming to investigate their role in reducing chronic diseases like cancer and heart disease? Is it fair to do this when copious evidence from epidemiological and observational studies – which are often less prejudiced by bias and confounding factors – have consistently demonstrated strong associations for the natural, dietary forms of these nutrients? I think not – and, as a scientist, I am far from alone.

Natural products work within the human body in a different manner to pharmacologically-active drugs. They often work as complex mixtures in which the components interact with each other synergistically, or they interact with factors in the diet or the body. These sorts of variables are omitted from the pharma-friendly gold standard that Ernst and his colleagues seem to worship. I have no issue with using the evidence base – but I have a big problem with how selective you are being when you view the available evidence.

The real loser in open battles between warring factions in healthcare could be the consumer. Imagine how schizophrenic you could become after reading any one of the many newspapers that contains both pro-natural therapy articles and stinging attacks like that found in this week’s Daily Mail.

But then again, we may misjudge the consumer who is well known for his or her ability to vote with the feet – regardless. The consumer, just like Robert Sandall, and the millions around the world who continue to indulge in complementary therapies, will ultimately make choices that work for them. ‘Survival of the fittest’ could provide an explanation for why hostile attacks from the orthodox medical community, the media and over-zealous regulators have not dented the steady increase in the popularity of alternative medicine.

Although we live in a technocratic age where we’ve handed so much decision making to the specialists, perhaps this is one area where the might of the individual will reign. Maybe the disillusionment many feel for pharmaceutically-biased healthcare is beginning to kick in…. Perhaps the dictates from the white coats will be overruled by the ever-powerful survival instinct and our need to stay in touch with nature, from which we’ve evolved.

Dr Robert Verkerk, Alliance for Natural Health,

Acknowledgment – We’d like to thank Emma Holister for providing the cartoon for this article.



Date: 14-Dec-06




UK anti-comp med campaign given another stab by Prof Ernst

It beggars belief that the UK's "first professor in complementary medicine" can be so opposed to this form of healthcare...

For the full article from the Dail Mail (UK), click here.

If you want to make a comment direct to the Daily Mail - please click here.

The Daily Mail article reads as follows:

Complementary medicines are useless and dangerous, says Britain's foremost expert


Useless. Dangerous. Even crooked. The brutal verdict on our most popular complementary cures - by Britain's foremost expert:


A lot of complementary medicine is ineffective, and some positively dangerous. Meanwhile, alternative treatments that promise to cure cancer 'are downright irresponsible, if not criminal'.


These are the views not of an old-school doctor dismissive of alternative therapies, but of Professor Edzard Ernst, Britain's first professor of complementary medicine and, you would have assumed, its greatest champion.


There is a booming market for complementary medicine, and it's not only the public who are turning to alternative remedies. Last week it was revealed that 60 per cent of Scottish doctors prescribe their patients homeopathic or herbal remedies.


Professor Ernst is not yet convinced by homeopathy, either. Its effectiveness has neither been proved, nor ruled out, he says.


'Miracle' cures and 'anecdotal' evidence mean nothing to him. But if a therapy passes scientific muster - which usually means it has been shown to be effective in a double-blind placebo-controlled study - he gives it the thumbs up.


Acupuncture gets the thumbs up. It's good for pain, particularly back pain, though it has nothing to do with mysterious energy flows, as many therapists claim. 'Acupuncture works in a physical way: it's nothing to do with yin and yang,' he says.


Massage, too, gets the Ernst thumbs up. It has 'considerable potential' for treating conditions such as constipation, back pain, anxiety, depression and stress.


Herbal medicines - though not all of them - also pass muster because their success in treating a number of specific conditions has been demonstrated.


But most therapies don't come up to scientific scratch. In a series of articles for the trade publication Independent Nurse, reprinted on the publishers' website, he gives most the thumbs down.


These include spinal manipulation, particularly chiropractic. He says there is little evidence that spinal manipulation, practised by osteopaths and chiropractors, is any more effective than other remedies, such as exercise, and indeed it carries the risk of dangerous side-effects, including strokes.


Nor is there any reliable evidence that flower remedies (which are made from extracts of plants and flowers) generate clinical effects that differ from placebo - or a dummy remedy - says Ernst. And the same goes for reflexology, which he says shouldn't be used to diagnose illness.


Hardly surprising, then, to discover that Professor Ernst is the most vilified player in the complementary world. Mention his name in a room full of practitioners


Nand you can feel the mercury plummet. Ron Bishop, chair of the British Acupuncture Council, concedes that Ernst is unpopular with his members because he produces results with which they don't agree.


'He did a trial and found that acupuncture didn't help people stop smoking. If you're an acupuncturist working with people trying to stop smoking, every day you get good results and help people stop smoking. We think that's a bit unfair on what our members do.'


Nor do they like the professor's view that complementary medicine could be dangerous. He was the first to draw attention to Chinese herbs mixed with dangerous substances, the potential danger of 'high velocity' thrusting in spinal manipulation and ill-placed acupuncture needles.


'A lot of interest groups were very puzzled because, surely, complementary medicine was, by and large, very safe, and mainstream medicine was where you had side-effects,' says Ernst, who is professor of complementary medicine at the Peninsula Medical School at the universities of Exeter and Plymouth.


'But when we did our research we found a lot of surprises - and since we started our work 13 years ago, various things have been banned from the market because they are so unsafe.'


Practitioners argue his time could be better spent campaigning for regulation in complementary medicine to drive out the charlatans.


On paper, Professor Ernst, now 58, looked the perfect candidate for the first professorial post in complementary medicine.


He previously held the chair of physical and rehabilitation medicine at the Medical Faculty of Vienna - a high-status position with 120 people under him and a salary to match - and as well as his medical qualifications, he is a trained homeopath, acupuncturist, massage therapist and spinal manipulator.


But in 1993 Ernst turned his back on status and cash to take up the Exeter post. It has, he says, taken him over 'body and soul'.


Since then, his department has published well over 1,000 research papers and tested a hugely diverse number of therapies, making it the most productive research unit in the world in this field.


Professor Ernst and his colleagues have produced the weighty Desktop Guide To Complementary And Alternative Medicine: An Evidence Based Approach - the second edition was published in June.


'Putting science into complementary medicine is like mixing fire and water,' he acknowledges.


'But it is the only way ahead. Complementary medicine has always come and gone in waves, so historically, you need science to establish an evidence base, because if you have that, it won't go away.


'If you don't have that base, it may flourish under Prince Charles, but it will be short-lived. So in a way, I think I am the biggest champion of complementary medicine.'


Others might argue that the Prince of Wales deserves that mantle. But, says Prof Ernst, Prince Charles is 'amazingly resistant to the scientific approach - and if he keeps rejecting the scientific testing of complementary medicine, then the therapies he has spent much of his life championing could disappear under his reign'.


Practitioners accuse Professor Ernst of trying to shoehorn therapies which are individually tailored to the patient into the straitjacket of a double-blind randomised placebo-controlled trial - the gold standard for conventional medicine.


In such a trial, a drug and a placebo pill are distributed at random to selected patients. Neither patient nor scientist knows who gets what. The code is broken only at the end and the results analysed.


Practitioners question how a treatment such as homeopathy or acupuncture, which treats the 'whole' person not just the symptom, can be subjected to such a study.


Ernst concedes that the 'bog-standard' randomised clinical trial is sometimes not completely suited to a number of treatments, but says he and his team work hard to find new ways of testing different therapies.


'There are ways of doing clinical trials,' he says, 'where you can have the full spectrum of individualisation, holism and so on. You need to think a bit more - it's a challenge.'


ANH Comment
What can we say? This is at the same time almost unbelievable - yet also typical form for Prof Ernst. The most staggering thing about these sorts of attacks is that they lack scientific objectivity. They fail to address the inherent weaknesses of the scientific methodologies that these narrow-minded scientists hold in such high esteem. 
The concept of orthodox medicine relying on the evidence-based gold standard of the randomized controlled trial (RCT) is now wearing thin when it comes to understanding the relevance of this methodology to many forms of alternative medicine.
Let's take nutrition - is it really scientifically valid to condemn the potential role of supplementary nutrients like vitamin E and carotenoids which have failed to generate strong beneficial effects in RCTs aiming to investigate their role in reducing chronic diseases like cancer and heart disease? Is it fair when copious evidence shows that epidemiological and observational studies - which are less free from bias and confounding factors - have consistently demonstrated very strong associations. We think not - and so do many other scientists.
Natural products work within the human body in a different manner to pharmacologically active drugs. They often work in complex mixtures and interact with each other synergistically or they interact with factors in the diet. All these sorts of variables are ommitted from the pharma-friendly gold standard that Ernst and his cronies seem to worship as if it were the holy grail.
We have no issue with using the evidence base - but we have a big problem with how selective you are being when you view the available evidence.
Wake up, Prof Ernst...can you smell the coffee? Oh...and are you really as independent as you and some of the other scientists you are increasingly associating yourself with like to think you are - such Prof Michael Baum and Jonathan Waxman?
Date: 12-Dec-06


About the Alliance for Natural Health

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