I didn’t realise how much crap-based medicine has infiltrated New Zealand until I came back from a working holiday. It seems almost every stretch of road in Auckland has some converted house promoting nonsense as legitimate therapy. Acupuncture is one such investation on the pseudoscientific front. Any increase in acupuncture and Chinese herbal medicine is probably due in part to greater Chinese immigration in the past decade. Acceptance of acupuncture as a conventional, evidence-based modality among the lay public and even GP’s is quite remarkable. So why are acupuncturists scrambling for cover when the word “science” is mentioned or “controlled test”?
Proponents of all pseudosciences wish to have their particular modality or hypothesis to be regarded as legitimate but in most cases avoid the one activity that will grant them that legitimacy: the controlled test. Claims to actual, umambiguous cause and effect is the domain of science so why then do peddlers of acupuncture and the like balk at the mere mention of testing their claims?
In 1995 Carl Sagan, American astronomer and astrobiologist wrote:
“Pseudoscience ripples with gullibility. Superstition and pseudoscience keep getting in the way of understanding nature, providing easy answers, dodging skeptical scrutiny, casually pressing our awe buttons and cheapening the experience, making us routine and comfortable practitioners as well as victims of credulity.
“Those who have something to sell, those who wish to influence public opinion, those in power, a skeptic might suggest, have a vested interest in discouraging skepticism.”
Because pseudoscientists can’t argue with the scientific evidence on their side, they turn to the tried and true tactics of ideological argument that cunningly avoids the most important topic – what does the scientific method reveal about the proponent’s claims?
Since this article is specifically about acupuncture, specifically in New Zealand, I shall address how and what acupuncturists argue, given the facts do not support their claims.
Pseudoscientific arguments by nature rely on logical fallacies and misguided criticism of the evidence. Case in point, probably my favorite humourous quote of 2008 comes from the mouth of Paddy McBride, president of the NZ Register of Acupuncturists. In the August 24, 2008 edition of the Sunday Star Times, McBride was asked what her thoughts were of a book by Simon Singh Ernst entitled Trick or Treat – The Undeniable Facts about Alternative Medicine – a book that specifically looked at the scientific evidence for a number of alternative medicine modalities. Singh and Edzard Ernst are critical of acupuncture claims and say that most are without scientific foundation and that the Qi or ‘life energy’ mechanism that underpins acupuncture is completely unsupported by science.
McBride said acupuncture is particularly effective for chronic conditions, where conventional medicine sometimes falls short. She strongly disagrees with the arguments of Singh and Ernst, saying acupuncturists have no “huge need to prove ourselves to western medical science”. She says acupuncture is difficult to study in the tight frames of clinical trials, such as being double-blind. The clearest results are in patients returning and referring others.
Let’s have hold that comment up again and examine what McBride is really saying:
…acupuncturists have no “huge need to prove ourselves to western medical science”
The critical mind could spend hours ripping that comment to shred so I will just focus on the main points that show how McBride’s comment is utterly ridiculous.
First off the bat, western medical science implies a false dichotomy. Science is science, it is simply a method for investgating nature and causal relationships within nature. There is no western science and there is no eastern science. The best way to investigate the truth value of any claim is to test it in a controlled manner so that all variables that could possibly effect the outcome of the test are accounted for. Science is only a method and so cannot be claimed to be ‘eastern’, ‘western’ or anything other such label. “Western science” is a cynical attempt to frame science as somehow cultural which it is not.
Secondly, this framing of science is a subtle way of dodging the responsibility of proving the claims that acupuncturists make. If their claims were true then the evidence derived from the scientific method would be embraced by acupuncturists with open arms.
Thirdly, dodging the responsibility of proving claims is a way of creating a double standard where one group of medical practitioners must adhere strictly to the evidence and facts and the other escapes this scrutiny. For what reason does the latter group of practitioners feel that they are somehow immune from scientific scrutiny? What if we accept that one group can escape scientific scruitiny and not have to prove that their practises actually work and don’t adversely affect patients? People and groups could then claim anything and there is no standard that we could apply to check validity of the claims. Is this an acceptable way of supporting medical claims given the importance of facts when dealing with a person’s health?
It is also clear that McBride has a very loose standard for evidence. She says patients returning and the number of referrals is a better standard to measure acupuncture by. Anecdotal evidence is a poor indicator of whether something works or not. If anecdotes is all that is used to validate a claim then we’re in the realm of belief and belief is subject to so many cognitive and perceptual flaws that it is practically useless. Again, this is dodging the real issue: does acupuncture work and what does it work for? Little wonder McBride does not like controlled, double-blind studies of acupuncture – the thousands of years old Chinese practise hasn’t survived decades of scientific inquiry. The evidence simply shows it does not work, unless… you’re talking about vague claims such as stress and associtaed symptoms. There is some evidence acupuncture works to relieve pain but the studies are unclear as to why. The scientific study findings of acupuncture will be discussed in forthcoming posts but I will say at this point that the pain relieving effects of acupuncture can be achieved with heat and electricity applied to acupuncture points and other parts of the body. This does not validate the magical claims that are amde by acupuncturists and does suggest that the use of needles is completely unnecessary.
Aside from the points I raise above in response to the notion that acupuncturists have no “huge need to prove ourselves to western medical science”, I will also point out that most pseudoscientific modalities originate from pre-scientific times and cultural forces rather than evidence. In this respect, acupuncture is a superb example and this issue will be the subject of my next acupuncture post.