Friends of Science in Medicine

Last updated

Friends of Science in Medicine Association
Formation2011
Type professional association lobby group
Headquarters Morayfield, Queensland
Location
Membership
1000+ [1]
Official language
English
President
 Ken Harvey [2]
Key people
CEO Loretta Marron
Website http://www.scienceinmedicine.org.au/

The Friends of Science In Medicine (FSM) is an Australian association which supports evidence-based medicine and strongly opposes the promotion and practice of unsubstantiated therapies that lack a scientifically plausible rationale. They accomplish this by publicly raising their concerns either through direct correspondence (E.g. the Australian government, universities, etc.) or through media outlets. [3] FSM was established in December 2011 by Loretta Marron, John Dwyer, Alastair MacLennan, Rob Morrison and Marcello Costa, a group of Australian biomedical scientists and clinical academics. [4] [5]

Contents

Scope and operations

Friends of Science in Medicine advocate the cessation of those university complementary medicine courses that are not based on scientific principles nor supported by scientific evidence, although they do support research into alternative and complementary approaches where there is evidence for potential benefit. [6] [7] [8] By April 2012 they had widened their focus from university education to the clinical practice, use and legitimacy of complementary medicine within Australian society. [9] Entirely volunteer run, FSM was initially supported by a A$3,000 grant from the Australian Skeptics Science and Education Foundation(ASSEF). [10] [11]

Politics

Throughout its history, FSM has been actively involved in a variety of medical policy issues surrounding evidence-based medicine and complementary and alternative medicine. They continue to appeal to the Australian Health Practitioner Regulation Agency, Medicare (Australia) and Australian universities [12] [13] [14] to review current policies.

FSM entered into the Australian media and promoted their message through The Sydney Morning Herald , [15] The Courier-Mail [16] the Australian Broadcasting Corporation, [12] The Conversation , [17] The Medical Journal of Australia , [8] the Australian Doctor magazine and regional radio stations. By May 2012 thirteen separate FSM discursive events created the unified message that all alternative and complementary medicines should be banned unless proven by rigorous scientific inquiry. [18] [19]

In September 2012 FSM was involved in lobbying the Australian Health Minister, Tanya Plibersek, to expand the chief medical officer's study into complementary medicine to include chiropractic and acupuncture. The group further demanded that all alternative medicines be taken off private health insurance which the Australian Government subsidizes. [20] The Australian Government is currently examining the evidence of clinical efficacy, cost effectiveness, safety and quality of natural therapies. The result, expected in April 2015, will include a decision as to which natural therapies should continue to receive the rebate. [21] The therapies under review are those not provided by an accredited health professional, which are covered by private health insurance but not Medicare. In addition to homeopathy, they include iridology, aromatherapy, various kinds of massage, Buteyko, yoga and pilates. [22]

Criticisms

Critics complained in various opinion pieces that the group had "taken its tactics too far." [7] [23] The group underwent further criticism through editorials in The Medical Journal of Australia calling on the association to reverse its tactics. [24]

Kerryn Phelps, former President of the Australian Medical Association, wrote the group had "cast its net too wide" in its condemnations, particularly in attacking courses in chiropractic, traditional Chinese medicine and Western herbalism. She further stated, "there is evidence supporting CAM approaches. You also have to remember that a sizable part of what is done in mainstream medicine lacks robust evidence." [25]

Phelps, along with Stephen Myers, a Professor of Complementary Medicine and Director of the Natural Medicine Research Unit at Southern Cross University, in a 2012 editorial in The Medical Journal of Australia wrote, "there is great danger for the public if complementary medicine practice is allowed to develop outside mainstream education." They wrote it would undermine "safe practice and critical appraisal", and stated there is now an extensive evidence base for complementary therapies available. [26] [27]

In an open letter on their website which was triggered by FSM's position on the proposed partnership between nutraceutical company Swisse and La Trobe University, the Australasian Integrative Medicine Association (AIMA) [28] criticizes the FSM for not contacting AIMA or other complementary medicine organizations which, the AIMA states, would at least establish "a more effective dialogue ... to improve the basis of health care and research for academics, medical professionals and the general population alike." [29] They further state that "FSM appear to be purposefully limiting their use of scientific scrutiny."

Activities and impact

The following describes some of the initiatives and accomplishments of the Friends of Science in Medicine.

Acupuncture

WHO listed 160 diseases/problems thought to respond to acupuncture treatments, although no well performed studies prove that acupuncture can cure or alter the specified pathologies. FSM successfully approached WHO who retracted the recommendations adding instead plans for further study. [30] FSM also raised its concerns regarding what they consider to be unethical promotion of acupuncture with Australian Health Practitioner Regulation Agency (AHPRA) executives and the AHPRA Chinese Medicine board, but they were unsuccessful at achieving a change. [30]

Chiropractic

As a result of the efforts of John Dwyer and the Friends of Science in Medicine, in August 2013, the chairman of the Chiropractic Board of Australia said it had removed some courses from its approved training schedule and would be randomly auditing practitioners to ensure they were not making unsubstantiated claims about the benefits of chiropractic. It also announced all registered chiropractors would be required to remove anti-vaccination claims from their websites. [31]

In April 2013, Macquarie University began discussions with higher education providers to transfer its chiropractic degrees by 2015. [32] Executive Dean of Science, Professor Clive Baldock said the initiative was first and foremost an academic one, based on a need for the Faculty of Science to build upon the University's recent major strategic investments in research-intensive disciplines such as biomedical science and engineering. [32]

Earlier in 2013, FSM sent out a series of letters about inappropriate treatment of babies and children by chiropractors who claim that spinal manipulation helps health conditions such as Attention deficit hyperactivity disorder, Asthma, allergies, bedwetting, colic and ear infection and is a substitute for vaccination. This was prompted in part by the report that government funding of chiropractic care for children under 14 was reported to have risen by 185% in four years. FSM sent letters to the Chiropractic and Osteopathic College of Australasia (COCA), Chiropractors' Association of Australia (CAA), Chiropractic Board of Australia (CBA), the Australian Spinal Research Foundation (ASRF), Chiropractic Council of NSW and Council on Chiropractic Education Australasia (CCEA). A second letter sent to the four universities teaching chiropractic, asking them to justify the 'subluxation' theory that is the foundation of chiropractic. The response by the CEO of Chiropractors' Association of Australia, Andrew Macnamara claims that there is no evidence provided to back up the concerns that chiropractic subluxations are an unjustified hypothesis, [33] however there is evidence from a 2007 systematic review published in Pediatrics and a 2009 report by four chiropractors which would back up FSM concerns that subluxations are not causally related to disease and thus have no valid clinical applicability. [34] [35]

In March 2014, surgeon John Cunningham and FSM's Joanne Benhamu published an article in The Medical Journal of Australia calling for a national system for chiropractors to report adverse events in the wake of allegations that a four-month-old baby had a neck fracture following treatment for torticollis. The Chiropractors' Association of Australia responded by saying that it was in favor of a mandatory adverse reporting system but that it should apply to all health professions and be run through Australian Health Practitioners Regulation Agency (AHPRA). [36]

As of 2017, FSM has reported over 1200 chiropractors to APHRA for promoting treatments that FSM considers dangerous and not evidence based. [37] FSM has also called on the Australian Government to ban chiropractors from treating children younger than eight years old. [38]

Homeopathy

In systematic reviews of randomised controlled trials, Cochrane Researchers examine recent evidence for the safety and effectiveness of therapies. Edzard Ernst conducted a systematic review of reviews in The Cochrane Database of Systematic Reviews (generally considered to be the most reliable source of evidence) in January 2010. Ernst's review, published in The Medical Journal of Australia, concluded, "The findings of currently available Cochrane reviews of studies of homeopathy do not show that homeopathic medicines have effects beyond placebo." [39]

Commenting in an article in The Guardian on a National Health and Medical Research Council (NHMRC) study (draft) debunking homeopathy, FSM co-founder John Dwyer stressed an area that was not investigated; the use of homeopathy for protection. Dwyer told The Guardian, "the most serious issue was the spreading of the concept that homeopathic vaccinations were harmless and just as good as orthodox vaccinations. People who believe that are not protecting themselves and their children." [40] [41]

La Trobe University/Swisse Wellness partnership controversy

In January 2014, La Trobe University formed a A$15M partnership with vitamin manufacturer Swisse Wellness, causing a wave of controversy in the Australian medical community. One month later, Ken Harvey, Adjunct Associate Professor at the School of Public Health at La Trobe, resigned his position, stating "here were clear dangers in conducting research that was paid for by companies, and he could no longer be associated with the university given the 'fraught way' the research was being undertaken." [42]

In light of this controversy, FSM wrote to the Australian Government's NHMRC, urging them to "generate formal guidelines for research funding that would reflect the 'world's best practices,' as this is needed to protect the credibility and integrity of contracted research, particularly where the results could affect the pecuniary interests of the funder." As a result, the NHMRC is reviewing the evidence for the effectiveness of homeopathy and released a resource for clinicians entitled "Talking with your patients about Complementary Medicine – a Resource for Clinicians." [43] [44]

Nursing and midwifery

FSM expressed concern after the Australian College of Midwives (ACM) endorsed the training of nurses in a range of alternative therapies, such as moxibustion for turning breech babies, as part of nurses' professional development requirements. [30] [45] Alastair MacLennan of FSM argued that such therapies are "dark arts" that do not have a scientific basis. [45] In response, the ACM defended these courses, arguing that "it is essential that midwives have an understanding of practices that women are interested in, including complementary therapies", and that they believe "that all health professionals, including midwives, have the critical thinking skills to enable them to suitably analyse and assess any practice or research to determine whether it can be incorporated into their evidence-based practice". [46] However, Sue Ieraci, an executive member of FSM, noted that these courses do not review the evidence in favour of these therapies, but rather teach participants how to administer the therapy. [45]

Osteopathy

FSM raised concerns with AHPRA's Osteopathy Board regarding the advertisement of osteopathy of the cranial field (OCF) and visceral manipulation; techniques that they consider objectionable. [30] [47] Although the Osteopathy Board agreed to state in their advertising that that OCF is not backed up by scientific evidence, this did not occur. [30] [47]

Therapeutic goods

FSM has urged the Therapeutic Goods Administration (TGA) to improve its regulation of the advertising of therapeutic goods, arguing that the advertisement of unproven or disproven complementary medicines and medical devices is dangerous and could potentially harm consumers or delay their use of effective treatments. [48] FSM found that few product claims are actually audited by the TGA and that scientific evidence was absent for these claims in the majority of cases. [30] FSM have also expressed disappointment in what they consider to be a lack of transparency in the TGA's system of handling complaints. [49] FSM also lobbied the TGA regarding advertising relating to products such “bioresonance” devices, which were subsequently the target of a TGA crackdown due to a lack of scientific credibility of these devices. [50]

Awards

Loretta Marron, CEO of FSM, was awarded a 2014 Medal (OAM) in the General Division of the Order of Australia "for service to community health". [51] [52] Marron has also received the Skeptic of the Year award three times from the Australian Skeptics who wrote she "has made great contributions to public health and the exposure of dangerous and discredited treatments that profit through offering spurious cures to the vulnerable and ill." [53]

See also

Related Research Articles

Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of medical science and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.

<span class="mw-page-title-main">Chiropractic</span> Form of pseudoscientific alternative medicine

Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.

<span class="mw-page-title-main">Homeopathy</span> Pseudoscientific system of alternative medicine

Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product. Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent remember the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.

<span class="mw-page-title-main">Naturopathy</span> Form of alternative medicine

Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of pseudoscientific practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as naturopaths. Difficult to generalize, these treatments range from outright quackery, like homeopathy, to widely accepted practices like certain forms of psychotherapy. The ideology and methods of naturopathy are based on vitalism and folk medicine rather than evidence-based medicine, although practitioners may use techniques supported by evidence.

<span class="mw-page-title-main">History of alternative medicine</span>

The history of alternative medicine refers to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment. It includes the histories of complementary medicine and of integrative medicine. "Alternative medicine" is a loosely defined and very diverse set of products, practices, and theories that are perceived by its users to have the healing effects of medicine, but do not originate from evidence gathered using the scientific method, are not part of biomedicine, or are contradicted by scientific evidence or established science. "Biomedicine" is that part of medical science that applies principles of anatomy, physics, chemistry, biology, physiology, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice.

<span class="mw-page-title-main">Applied kinesiology</span> Alternative medicine technique

Applied kinesiology (AK) is a pseudoscience-based technique in alternative medicine claimed to be able to diagnose illness or choose treatment by testing muscles for strength and weakness.

<span class="mw-page-title-main">Edzard Ernst</span> German academic physician and researcher (born 1948)

Edzard Ernst is a retired British-German academic physician and researcher specializing in the study of complementary and alternative medicine. He was Professor of Complementary Medicine at the University of Exeter, the world's first such academic position in complementary and alternative medicine.

Alternative veterinary medicine is the use of alternative medicine in the treatment of animals. Types alternative therapies used for veterinary treatments may include, but are not limited to, acupuncture, herbal medicine, homeopathy, ethnomedicine and chiropractic. The term includes many treatments that do not have enough evidence to support them being a standard method within many veterinary practices.

Throughout its history, chiropractic has been the subject of internal and external controversy and criticism. According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all disease. A 2003 profession-wide survey found "most chiropractors still hold views of Innate Intelligence and of the cause and cure of disease consistent with those of the Palmers". A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today." Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license. D.D. Palmer considered establishing chiropractic as a religion to resolve this problem. For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as vertebral subluxation.

<span class="mw-page-title-main">Veterinary chiropractic</span>

Veterinary chiropractic, also known as animal chiropractic, is the practice of spinal manipulation or manual therapy for animals. Veterinary chiropractors typically treat horses, racing greyhounds, and pets. Veterinary chiropractic is a fast-developing field that is complementary to the conventional approach. Veterinary chiropractic is considered a controversial method due to limited evidence that exists on the efficacy of osteopathic or chiropractic methods in equine therapy. There is limited evidence supporting the effectiveness of spinal manipulation or mobilization for equine pain management, and the efficacy of specific equine manual therapy techniques is mostly anecdotal.

Osteomyology is a multi-disciplined form of alternative medicine found almost exclusively in the United Kingdom and is loosely based on aggregated ideas from other manipulation therapies, principally chiropractic and osteopathy. It is a results-based physical therapy tailored specifically to the needs of the individual patient. Osteomyologists have been trained in osteopathy and chiropractic, but do not require to be regulated by the General Osteopathic Council (GOsC) or the General Chiropractic Council (GCC).

<i>Trick or Treatment?</i> 2008 book by Singh and Ernst

Trick or Treatment? Alternative Medicine on Trial is a 2008 book by Simon Singh and Edzard Ernst. The book evaluates the scientific evidence for alternative medicines such as acupuncture, homeopathy, herbal medicine, and chiropractic, and briefly covers 36 other treatments. It finds that the scientific evidence for these alternative treatments is generally lacking. The authors concluded that homeopathy is merely a placebo.

Because of the uncertain nature of various alternative therapies and the wide variety of claims different practitioners make, alternative medicine has been a source of vigorous debate, even over the definition of "alternative medicine". Dietary supplements, their ingredients, safety, and claims, are a continual source of controversy. In some cases, political issues, mainstream medicine and alternative medicine all collide, such as in cases where synthetic drugs are legal but the herbal sources of the same active chemical are banned.

<span class="mw-page-title-main">Kimball Atwood</span> American medical doctor, researcher and alternative medicine critic

Kimball C. Atwood IV is an American medical doctor and researcher from Newton, Massachusetts. He is retired as an assistant clinical professor at Tufts University School of Medicine and anesthesiologist at Newton-Wellesley Hospital.

<span class="mw-page-title-main">Ken Harvey (professor)</span> Australian public health doctor

Kenneth John Harvey AM is an Australian public health doctor, currently Honorary Adjunct Associate Professor at the Institute for Evidence-Based Healthcare in Bond University. Described by The Age as an "anti-quackery crusader", Harvey is an advocate of evidence-based medicine and a critic of pharmaceutical marketing and unproven diet products. He is the president of Friends of Science in Medicine. In 2017, Harvey was awarded a Member of the Order of Australia (AM) for his "significant service to community health and the pharmaceutical industry”.

<span class="mw-page-title-main">Loretta Marron</span> Australian public health advocate (born 1951)

Loretta Josephine Marron, OAM is the Chief Executive Officer of the Australian Friends of Science in Medicine organization. Popularly known as the "Jelly Bean Lady", she has promoted an evidence-based approach to medicine since being diagnosed with cancer herself in 2003. In the media, she has presented exposés of unproven treatments, some of which have resulted in successful legal prosecutions. She was awarded the Medal of the Order of Australia for her service to health, and she has been "Skeptic of the Year" three times.

<span class="mw-page-title-main">Alastair MacLennan (obstetrician)</span> Scottish-Australian physician, researcher, and health advocate (born 1945)

Alastair Harvey MacLennan,, MB ChB, MD, FRCOG, FRANZCOG is a Scottish-Australian physician, professor of obstetrics and gynaecology, medical researcher, and a community health advocate. He studied and practised medicine in Glasgow, Chicago, and Oxford before moving to Australia in 1977 to take up a position at the University of Adelaide, where he went on to become the Professor and Head of the Discipline of Obstetrics and Gynaecology in 2006. He retired from his full-time academic position in 2013, and he is now Emeritus Professor of Medicine. He leads research projects at the Robinson Research Institute, and he is Head of the university's Cerebral Palsy Research Group.

<span class="mw-page-title-main">John Dwyer (medicine)</span> Australian doctor, professor of medicine, and public health advocate (born 1939).

John Michael Dwyer, is an Australian doctor, professor of medicine, and public health advocate. He was originally a Professor of Medicine and Paediatrics, then Head of the Department of Clinical Immunology at Yale University. Returning to Australia, he became Head of the Department of Medicine and the Clinical Dean at the University of New South Wales and Director of Medicine at Sydney's Prince of Wales Hospital, the University's major teaching hospital, for over twenty years. In retirement he is an Emeritus Professor of Medicine of the University. He founded the Australian Health Care Reform Alliance, and was the founding president of the Friends of Science in Medicine until 2019. He was appointed an Officer of the Order of Australia for his service to public health.

<span class="mw-page-title-main">Marcello Costa</span> Australian medical researcher, academic, and public health advocate (born 1940)

Marcello Costa is an Italian-born Australian medical researcher, academic, and public health advocate. He specializes in the structure and functions of the enteric nervous system. He taught in Turin, Melbourne, and Helsinki before moving to Adelaide in 1975 where he was a foundation lecturer at the Flinders Medical School, building the new discipline of neuroscience at the college. He was at Flinders University where he held the title of Matthew Flinders Distinguished Professor of Neurophysiology in the Department of Physiology. In 2021 Marcello retired from his position at Flinders University.

Alternative medicine describes any practice which aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested or untestable. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings of the same phenomenon.

References

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  51. ↑ "Governor presents Australian awards and honors Tuesday 9 September 2014" (PDF) (Press release). Government House, Queensland: Government of Australia . Retrieved 15 September 2014.
  52. ↑ "Search Australian Honours: Simple Search: Marron, Loretta Josephine". It's An Honour. Government of Australia. 26 January 2014. Retrieved 28 July 2014.
  53. ↑ "Loretta Marron wins Order of Australia". www.skeptics.com.au. Australian Skeptics. 25 January 2014. Retrieved 15 September 2014.
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