Court forcing 16 yr old with cancer into chemo

[Alex]

Originally Posted by tracilicious

It seems to be a combination. But what do you mean?

It can't be a combination. Either your stuff has something in it, or it doesn't.

Homeopathy is the theory that if something causes a symptom then consuming a very small quantity of that item will cure that symptom, even if that isn't what is causing the symptom in the specific case. So, if you're exposed to toxin that causes your eyes to water excessively, a minute quantity of onion (perhaps, this is a made up example of a treatment) would cure you of that toxin exposure. The second half of the theoryis that the smaller the dose, the more powerful the medicine.

Now, when talking about minute quantities, I mean truly infinitesimal quantities. Start with 1 ml of the substance and dilute it to 100 ml. Take 1 ml of the diluted mixture and dilute that to 100 ml (one such dilution is called 1C).

When Hahneman first put forward his theory of homeopathy he recommened a dosage of 30C (doing the dilution described 30 times). This means that for every molecule of the original substance you have 10^60 molecules of water.

To put it another way. If you wanted enough of this homeopathic solution to guarantee that you were getting at least one molecule of the "curing chemical" you would need 10^34 gallons of water. That is if you had a glass that could hold 10,000,000,000,000,000,000,000,000,000,000,000 gallons of water you would likely on be drinking one molecule of "onion." So, when you take a single capsule or eyedrop or whatever of a homeopathic solution your chances of actually consuming the substance that will supposedly cure you is essentially zero.

To put it yet another way: if you took that one "onion" molecule and dropped it into the Pacific Ocean (and assumed that all water on earth was connected), it would still be too concentrated by a factor of 10^16.

And this is just Hahnemann's original theory. Modern homeopathy frequently uses dilutions of 50,000C (called LM). This means that if you had a swimming pool the size of our galaxy, it likely would still not contain even a single molecule of curative substance.

To counter the obvious bunkness of all this, many homeopathy proponents posit that molecules of water somehow remember the "vibration" of the curative substance. This ignores the fact that most of the water in the dilution was never anywhere near a molecule of the curative and that all water on Earth has been in contact with billions of non-water molecules since the Earth first cooled and how exactly is it supposed to remember the onion molecule but not the time it was in Caesar's bladder?

The great advantage for homeopathists is that since all they are selling is water, their materials overhead is minimal and margins are very high.

[tracilicious]

Originally Posted by Alex Stroup

It can't be a combination. Either your stuff has something in it, or it doesn't.

I meant a combination of herbs and flower essences. I've never heard of what you are saying, but I've also never researched homeopathy. Perhaps it includes more than that? Anecdotally, the friends I have that swear by it are never sick.

I had a sports medicine doctor give me arnica tablets for a knee problem, and those are in the scope of homeopathy, are they not? It is a flower.

With the disease acupuncture thing, I simply meant that no one I know that goes to acupuncture does so to cure disease. Although, I suppose arthritis is a disease, and they do cure that.

[Motorboat Cruiser]

Originally Posted by tracilicious

Anecdotally, the friends I have that swear by it are never sick.

I never get sick either. I suspect it is my strict regimen of coffee and cigarettes.

[Alex]

Originally Posted by tracilicious

I meant a combination of herbs and flower essences. I've never heard of what you are saying, but I've also never researched homeopathy. Perhaps it includes more than that?

No, the essential element of homeopathy is the extreme dilution and like curing like. If you're medicine includes herbs in measurable quantities then it isn't truly homeopathic.

In recent years various other alternative remedies have begun slapping the word homeopathic on things simply because it is a term with cachet.

If homeopathy works, then we should all be perfectly healthy since drinking a glass of tap water is essentially the same thing as taking a megadose of every homeopathic elixir.

Anecdotally, my mom is a big believer in homeopathy and other altnerative supplements and she is constantly sick. I don't take even "Western" medicines and I'm very rarely sick.

Also anecdotally I have a friend in high school who raced the train at a nearby crossing every day after school. He's still alive so I guess that's safe too. He also has seven kids now so it maybe train racing is good for fertility.

What I am curious about is you have problems with Western medicine because sometimes it seems like they don't know so well what they are doing. But you are ok with homeopathy though you haven't looked into it enough to know what it is. You also said you are skeptical on most things.

What methods do you use to to decide which altnernative methods you are ok with? Obviously you exclude brocolli necklaces. But on what basis is that obvious quackery but blowing ozone up your ass isn't? Acupuncture is ok without any real validation but presumably you'd cast an eye askance at paper remedies, a modern variation on homeopathy, where they simply write your problem on a piece of paper, along with the homeopathic cure and you carry it in a pocket on the left side of your body with writing towards the body (this is real).

When it comes to medical claims, I have a certain toolkit of bull**** detectors:

1) Claims that there are no side effects. That there can be no negative impacts. Or that dosage is not important. Honestly, if it is impossible for a treatment to do damage then it probably doesn't do anything at all.

2) Does the claimed affect appear to violate the known physics of our universe? Such appearance is not, ipso facto, evidence of falsity but it should creates a pretty large burden of evidence. Homeopathy does this because its theories of dosage violates everything we understand about biology and chemistry while its theory of vibrational memory violates what we know about chemistry and physics. It is the pharmaceutical version of a perpetual motion machine.

3) Do its proponents rely on conspiracy theories for why their ideas aren't widely accepted in the mainstream. Yes, conspiracies happen and scientists can be just as dogmatically rigid as anybody else but most scientists really do want to find the closest answer to the truth and it almost always wins out in the end. The skeptical version of Godwin is "They laughed at Galileo." Well, they also laughed at Lysenko.

4) Do you have to "believe strongly enough" for it to work? Tylenol will get rid of my headache whether or not I believe in it. Lipitor will reduce my cholestorol. Applying electricity to water produces hydrogen and oxygen gasses whether I believe in the atomic structure of minerals. When I asked a friend who just graduated some Chinese medicine school (and is a licensed acupuncturist) he said that there isn't really anything he could do for me if I wasn't inclined to believe that it could work.

5) Can evidence of efficacy be argued without resort to simple anecdote?

None of these things is an absolute indicator of fraud, deception, or inefficacy. But they are all signs that scientific examination is being resisted for some reason.

As I've said, what I marvel at is that so many people toss aside "Western" medicine when it fails to live up to there expectations only to grasp at things that don't even try to meet those expectations.

[wendybeth]

But how do you really feel about it, Alex?

Actually, I agree. I'm too much of a realist not to. Show me as many facts as you can, and I'm a happy consumer, but don't tell me that your best friend's brother's MIL ate nothing but brown rice and tofu for a year and is now cured of her uterine cancer. I'm real happy for her, but not quite convinced that it's enough proof for me should I land in the same boat. I'm also very skeptical of meds that have been subjected to studies, in that studies are like statistics- any company with enough motivation can warp them to show whatever the hell they want. (Some experience in that area).

Let's face it- I trust no one....

[tracilicious]

Originally Posted by Alex Stroup

What methods do you use to to decide which altnernative methods you are ok with? Obviously you exclude brocolli necklaces. But on what basis is that obvious quackery but blowing ozone up your ass isn't? Acupuncture is ok without any real validation but presumably you'd cast an eye askance at paper remedies, a modern variation on homeopathy, where they simply write your problem on a piece of paper, along with the homeopathic cure and you carry it in a pocket on the left side of your body with writing towards the body (this is real).

I find it extremely amusing that the only time I can recall you showing any emotion is over homeopathy.

I'm ok with most any alternative treatment. I don't believe in a lot of them, but if others want to then that's ok. At worst they do nothing in most cases.

I really like acupuncture. To the point that I've considered becoming an acupuncturist (which takes six years, so it may not happen). It's been around for over a thousand years, so I think if there were nothing to it, it would have faded away. Plus the bruise thing. I think it works. I believe in chi/meridians, but I have no proof. I'm going to assume that there is some factual/logical basis in there somewhere. Someday I'll do the actual research to confirm it.

As for homeopathy, I think I've been using the term wrong, as I commonly see it used in conjunction with any remedy that comes from flowers. But google defines it as you did. So I think you are correct in assuming it's becoming catchwordish.

As far as anecdotes go, what isn't an anecdote? Don't many studies consist of giving a medicine and asking patients how they feel? Thus, a great deal of science is based in anecdote. I don't feel that anecdotes automatically disqualify anything.

I think some things work and I can't explain why. We know little about thee body, even less about energy of any sort, and almost nothing about the mind. If you compare what we don't know to what we do, we're practically in the dark ages.

Honestly, I don't practice any kind of medicine. If I get a cold or the flu, I simply ride it out and wait for my body to heal tself. I've done the same with walking pneumonia and strep. I'd love to see a naturopath, as I feel it's the best of both world's, but they're painfully expensive. I find all kinds of medicine interesting, natural or otherwise.

[Alex]

Originally Posted by tracilicious

I'm ok with most any alternative treatment. I don't believe in a lot of them, but if others want to then that's ok. At worst they do nothing in most cases.

And, for many things (such as cancer), nothing is a pretty horrible result. Which is why courts have long interceded (to address the original topic) when treatments that have been shown to be at least minimally effective are disregarded in favor of nothing or things that have no scientific support.

At least when it is a minor. The question is a very tricky one in deciding what parents are not allowed to decide for their children, but this recent decision is hardly precedent setting.

I believe in chi/meridians, but I have no proof. I'm going to assume that there is some factual/logical basis in there somewhere. Someday I'll do the actual research to confirm it.

I'm honestly ok with people (adults) deciding to follow faith-based approaches to life and health. Just call it that. It is when claims of scientific support are made for faith-based decisions that my back gets up a bit.

If you believe in forms of energy that can not be detected or tested then who am I to argue otherwise, but this is essentially the same view as Christian Scientists praying for God's intervention. Now, I am of the view that if those faith-based approaches actually do any good then the results will show up pretty clearly in standard evidence-based analysis. If people would prefer such analysis not be done, or not believe the results when they are done, then what can be done.

As far as anecdotes go, what isn't an anecdote? Don't many studies consist of giving a medicine and asking patients how they feel? Thus, a great deal of science is based in anecdote. I don't feel that anecdotes automatically disqualify anything.

Of course anecdote isn't automatically disqualifying and frequently it is indicative of something real. But it is also frequently indicative of misperception, false positives, selection bias, etc.

There are procedures for creating studies that remove those biases. In a properly double-blinded study, neither giver nor receiver of care knows what type of care was given. Therefore, biases of perception can't easily influence results. Particularly in the area of pain and discomfort it is important to remove these because perception of pain is so subjective. What is intolerable to one person is hardly noted by another and there is no way to measure it other than self-evaluation.

There are also statistical models for evaluating results that are truly significant. And the one things missing from evidence labelled "anecdotal" are control groups. An important element of non-anecdotal evidence is looking for a differential between two courses of action. Let's say I feed each of my 11-year-old triplets a pesto of oak leaves every morning for a year. After that year they are all about 2.5 inches taller.

Anecdotally, oak pesto promotes growth. (and a tendency to hide acorns in bedding). Obviously, that probably isn't the case. The kids were very likely to get taller in that year regardless of what you did with them. Did they get taller than they otherwise would have? Maybe they actually grew less than they already would have and the actual impact of oak pesto is the opposite of the observation.

So, if you were trying to do a non-anecdotal study of the impact of oak pesto on growth in pre-adolescent children, ideally you would take something approaching these steps:

1) You would only give oak pesto to some of the children. You'd have a control group that receives no oak pesto so you have something to compare to.

2) You'd try to otherwise make the pesto-receiving group and the non-pesto receiving group as identical as possible. If you, for example, split the group based on gender this would likely introduce confounding factors since girls that age are more likely to see a large growth spurt than boys.

3) You'd blind the children as to whether they were eating oak pesto or not. So, all the children would consume something that looked like oak pesto and tasted like oak pesto but only half of it would actually be oak pesto. This prevents the children from behaving differently in ways that might affect growth (perhaps, kniwng that they are receiving what may be a growth proponent and being focused on the idea of growing taller they subconsciously start drinking more milk).

4) You'd blind the researcher so that they wouldn't know which children were receiving oak pesto and which were receiving the faux-pesto. So a different person would prepare the dishes than gives it to the kids. The real pesto always goes in Bowl A, but the person who puts it in Bowl A doesn't know which kid eats Bowl A. The person who gives Bowl A to the kid doesn't know whether it has real pesto in it or not. This prevents the researchers from treating differently the kids receiving what they hope is a growth proponent (researchers always want their theory to be right, or they probably wouldn't persue it; so perhaps they'd subconsciously give the pesto-kids larger portions of their other food items).

5) You'd pre-determine what is a significant result. This isn't actually done anew with each experiment but there are standard statistical models. If, after a year of this study the pesto group, on average, saw an additional 0.73 inches of growth? Is this significant? You can't say based on just that number (but many pseudoscientists do; they don't care a whit for confidence intervals). Sample size and measurement method is important here. If there were only 10 kids in the study that difference could be generated by a single child experiencing a very large growth spurt that had nothing to do with pesto. If there were 500 kids in the sample than random distribution of natural growth has less impact. Also, what is the method used to measure height and how accurate and precise is it? With growth it is easy to be very precide, but on a different topic, such as perception of pain, measurement is accurate only for the moment (the exact same pain might feel like an 8 today but tomorrow when you learned you just became an aunt it may only feel like a 5) and precision is impossible (nobody is going to say, today the pain is a 7.352). These factors introduce the margin of error to the result. So, a 0.73 inch differential with only ten participants probably isn't significant and a 0.73 inch differential when the margin of error is plus or minus 0.75 inches also isn't significant. But it is important to predetermine what measure of significance is going to be used because the natural humna instinct is to grasp any indication of significance to support the year (or frequently in large scale medical studies many years) of work you put into the examination.

To summarize more bluntly: No, proper scientific research is not essentially anecdotal in nature.

Yes, there is a lot of anecdote in our scientific understanding because proper double-blinding and other techniques for removing the anecdotal element are frequently impossible or unethical. This particularly can make it difficult to create properly homogenous cohort groups.

However, when done properly, these confounding factors are reported up front, everybody does their best to minimize them, and the results are understood to be fuzzy. This is why sometimes it feels like you get contradictory health information every week. Study A find a minor heart health benefit to Vitamin Whatever and the media is all over it, not properly passing along the hedges that are likely in the paper about to be published. And then Study B finds that Vitamin Whatever increases the chances of cancer, and the media is all over it, not properly passing along the hedges that are likely in the paper about to be published. And certainly they won't attempt to do any kind of analysis of relative risk. Is a 2% reduction in heart disease risk outweighed by a 4.5% increase in the risk of melanoma?

I think some things work and I can't explain why. We know little about thee body, even less about energy of any sort, and almost nothing about the mind. If you compare what we don't know to what we do, we're practically in the dark ages.

This is what I don't get. We know so incredibly much more than we used to, but because we don't know everything all things are essentially equally believable.

To think our current knowledge is essentially the same as in the dark ages is to not show a proper understanding of just how little we knew about the body back then (when people weren't exactly sure of what role the heart played, it was believed that each sperm contained a full miniature person just waiting to grow, and the shape of your bowel movement indicated your future).

I am just baffled that one can look at the last 100 years of medical advancement and doubt that it has been vastly more effective than all the ancient alternative methods combined.

Yes, we've gone too far in depersonalizing medicine and that turns a lot of people off. But I'll without hesitation take the quality of life offered by modern Western medicine over the quality of life that has been historically provided by alternative medicines.

[scaeagles]

Originally Posted by Alex Stroup

But I'll without hesitation take the quality of life offered by modern Western medicine over the quality of life that has been historically provided by alternative medicines.

All one has to do is look at the increases in average life expectancy and it is relatively easy to attribute it to medical advances.

However, I have performed no double blind studies, so what do I know? (since this is in reply to Alex I'll refrain from posting a smilie.)

[SacTown Chronic]

Yeah, spare us the anecdotal evidence of your life expectancy until after you have died, Leo. <smilie

[Alex]

Originally Posted by scaeagles

All one has to do is look at the increases in average life expectancy and it is relatively easy to attribute it to medical advances.

However, I have performed no double blind studies, so what do I know? (since this is in reply to Alex I'll refrain from posting a smilie.)

For the record, I don't attribute increased life expectancy purely to medical advances. I do attribute specific reductions in mortality to specific medical advances. There are many non-medical causes for our increased life expectancy.

Also to be clear, I am not claiming that all research on all topics needs to be double-blinded. That is obviously not the case. But most pharmaceutical and medical procedure research benefits greatly from it because perception biases so easily impact results and independent confirmation is generally not easily achieved.

(And I know your kidding around, but it is kidding around that parralels common failures in understanding of good methodology.)