The Health Report (ABC RN) of Monday 10th May had a story on a “unique centre in Western Australia combining high tech cancer care with complementary medicine.”
For the curious, the MP3 can be downloaded here: http://www.abc.net.au/rn/healthreport/, go to Monday 10/5/2010, Cancer Care.
Dr Stephen Basser responds:
I listened to the Health Report piece this morning, and offer the following thoughts:
– The report perpetuates the myth that there are two ‘strands’ or ‘streams’ of medicine, and offers implied support for those who push the idea that the alternative stream is a valid one that we should be using more, but cannot do so because it is being suppressed or not fully acknowledged by the mainstream. We are meant to believe that alternative medicine is being rejected because we don’t understand it, or it’s financially challenging us, or we’re brainwashed by drug companies, or some other conspiracy related charge. All of this is, of course, rubbish.
– To have selected some therapies means they rejected others. What was the basis of the rejection? How did they decide what was reasonable and what was not? If it was science please share with us the positive and the negative results that led to these decisions being made.
– How did they decide there was a difference in benefit between a general no health claims attached massage and ‘therapeutic massage? How did they decide there was a difference between aromatherapy and just being in a relaxing room with gentle music and lighting, and the scent of fresh flowers? Do they believe the benefit reported by people undergoing Reiki is a general relaxation benefit, or do they believe the practitioner is actually ‘directing energy’? If it’s the former then why not have non-specific relaxation therapy rather than a branded therapist. If it’s the latter then please supply some evidence regarding the type and source of the energy being manipulated.
– I believe the benefit reported is derived from the social connection provided and from patients achieving a high level of relaxation. I believe this is a significant factor in their well-being and fully support the program in assisting people in this regard. I do not believe, though, that the benefit is related to the postulated mechanism behind specific therapies such as Reiki or Reflexology. If you don’t accept the premise of the therapy why are you using it as a specific therapy?
– Are practitioners using their involvement in this program as a way of validating their belief system and therapy to clients they see in private? Are they using this as a scientific imprimatur in other settings?
– If they are serious about doing research they need to compare the specific techniques they have chosen to use with non-specific ways of inducing a similar relaxation response. Comparing Reiki to nothing does not prove Reiki works. ‘Healing’ is a good outcome, but it appears so far that no attempt has been made, or is going to be made to determine if specific therapies lead to specific benefit(s). It is exactly the mistake scientific medicine is designed to avoid – my patient tried x and reports they feel better, therefore I conclude x works.
– The comment about being a bent spoon nominee* was made in such a way that it conveyed to me little or no interest in finding out what’s right and what’s not. This is not only disappointing, but also a bit hypocritical.
– Does anyone else see the extreme irony in patients receiving scientifically established therapy for their cancer, and then being given Reiki and reflexology? Funny, isn’t it, that self-reporting of feeling better is considered an insufficient basis to establish which chemotherapy regime is needed, and that the difference between real and not real matters so much for patient welfare at this stage of their treatment but it’s fine for their energy to be manipulated by the Reiki therapist after their chemo! What a strange world we live in!
Dr Basser is a GP with a practice in suburban Melbourne. He is also Vic Skeptics media spokesperson on Health issues, and Editorial Consultant (Medicine) for “The Skeptic”magazine.
* Made by Dr David Joske – Contemporary therapies leader. A history of Australian Skeptics Bent Spoon Award can be found here: http://www.skeptics.com.au/features/bent-spoon/.
It should be noted that Joske never won the much coveted Bent Spoon, though ths program makes me think he might be deserving.
Bent Spoon nominations are open, so the fact that someone nominated Joske says nothing at all about Australian Skepics.
And finally, the nomination must have really struck a cord with Joske if he still remembers it, considering that it was in 2003 and that a Google search for “joske spoon” does not return anything meaningful. The page with Joske’s name hasn’t been up for a long time.
Perth is nuttier than I ever knew when I lived there. Last week it was an Anglican priest and ex-police chaplain performing exorcisms. A while ago it was a “counsellor” who tells people they’ve been abducted by aliens. And then there’s the ever-present “media whore” associate professor who tells the public not to use sunscreen, among other things, because it’s part of a toxic conspiracy (and whose wife just happens to run a “wellness centre”).
The fact that a therapy may be based on a whacky theory doesn’t mean it won’t work. It might actually work for other reasons; they might even be unknown or not well understood.
If people report that they feel better after Reiki, if their blood counts improve, etc, it doesn’t prove that Universal Reiki Energy exists, it just shows that they might be doing something useful.
It maybe an epistemological problem, but it appears that while skeptics are engaged in other things the people who believe in reiki are willing to spend a couple of hours a week actually providing a benefit to these unfortunate people. One day they may be replaced with $100 an hour touch and chat therapists on Medicare item numbers but that isn’t available at present.
It’s pretty well established that “grooming” provides physiological benefits to mammals.
Jim,
It is true that a therapy based on a wacky theory might work.
The problem with therapies like Reiki is not that they’re based on a wacky theory. The problem is that they *don’t* work!
Or, to be more precise, when tested under scientific conditions, these therapies prove to have no benefit beyond that of a placebo.
Placebo effects are real, and are an interesting object of study in their own right. In fact, it’s well understood that placebo effects are the reason that therapies like Reiki are still around.
But placebos should not be considered a substitute for real medicine or genuine help.
I get the feeling that this must be a sore point with Dr Basser, having 2 modes of assessment juxtaposed and used apparently randomly. As he says, why not choose chemotherapy based on the patient reporting feeling better? To my mind, the point is that the role of chemotherapy in treating a patient with cancer is completely different from the role of oncology massage. The link to other belief systems, such as reiki belongs to yet another aspect of people’s well being. While chemotherapy tries to destroy cancer cells and works at a biological level, massage gives some human contact and tactile, psychological support. Reiki can be seen to sit alongside other spiritual beliefs, for those uncomfortable with established religions.
Thank you for the comments.
I gladly acknowledge that our well-being can be enhanced via a number of tactile and non-tactile means, and I fully support using a variety of these as an adjunct to a range of medical treatments.
It’s when the claim goes beyond enhancement of well-being that my skepticism bubbles to the surface. Claims of a more specific therapeutic benefit require supporting evidence, particularly when the supposed benefit is said to be mediated by mysterious forms of ‘energy’ that are perceivable only by the therapist.
The religious/spiritual analogy is a useful way to illustrate this principal of skepticism.
If you hold a personal religious/spiritual belief, and report that this enhances your well-being I have no reason, as a skeptic, to become involved.
If, though, you start claiming you can heal the sick, or that a statue is weeping blood, or that the Earth is only 6000 years old then I cannot and will not ‘turn the other cheek’!
Once a testable claim is made then lets test it and see. That’s the way of science, and it’s the reason we no longer live in caves, and no longer have a life expectancy of only 30 years.
I wouldn’t have it any other way.