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Edzard Ernst demonstrates he is No Scientist

thoughts & comment — 23 Aug 2011

New ScientistTHIS WEEK'S NEW SCIENTIST MAGAZINE (20 August) has a short "One minute" interview with Edzard Ernst, a physician who has just retired from his post as the UK’s first professor of complementary medicine at the University of Exeter. Ernst started his medical career at a German homeopathic hospital.>

Edzard Ernst, according to his interviewer David Cohen, is the "scourge of alternative medicine" and he has been described as a "quack-buster", a description he rejects in favour of thinking of himself as a scientist. Ernst likes to test complementary and alternative medicine (CAM) scientifically. The only problem is that his opinions on alternative medicine are actually unscientific — like many physicians he does not seem to have the capacity to understand his own bias, nor what science actually is.

For him, his opinions are not bias but fact, because he knows the Truth. So he speaks in misleading half-truths such as stating that the attraction of people to alternative medicine such as reflexology or colonic irrigation as "a sign of affluence". But these treatments are only one tiny facet of alternative medicine, and those who cannot afford such treatments choose other types of alternative therapy such as dietary changes and hands-on-healing, and many alternative healers donate time for free to those with no money.

And he speaks about "the criminal end of alternative medicine" where dying people he claims are sold lies, and yet makes no mention of how many people orthodox medicine kill with medications such as chemotherapy which are tested. The problem with chemotherapy is that doctors are not honest to their patients with respect to its overall effectiveness, and it is a fact that if patients were told actual survival rates many would not opt for this treatment. (Chemo is valuable in some instances, but the general public is generally sold this drug because physicians do not know what else to recommend.

Ernst also dismisses integrative medicine as "a cover for quackery being smuggled into conventional use," which seems a very distortive blanket point of view.

These are not the sort of statements that would come from a bone fide scientist, but from a man with strong unscientific opinions. Once again, we have a doctor pretending to be a scientist. (So many doctors are epistemologically naive, which is why many of them turn to quack-busting.)

An example of Edzard Ernst being naive is when he states the following:

I worked in a homeopathic hospital and was open to the idea that there were laws of nature that we didn't understand. I still think homeopath works… [but] after years of research, I think the answer now is conclusive. It works because of a very long empathic consultation. It’s a powerful placebo effect.

So this "scientist" is effectively claiming that he knows the difference between the effects of placebo and the workings of a new law of nature. But this makes no sense, as nobody actually fully understands the placebo effect. So he cannot scientifically use the term "conclusive" and he cannot categorically state that homeopathy is "a powerful placebo effect". But he does because he is not a scientist — he is just dressing up his opinions in scientific terminology, which misleads the public into dismissing homeopathy.

Having committed himself, he then probably realizes that he comes across as a closed-minded bigot and backtracks with a contradictory get-out statement that dismisses the conclusiveness of his previous statement:

If homeopathy - by discovery of a new law of nature - one day becomes possible and clinical evidence shows that my present conclusions are wrong then I will change my mind. I think it is a sign of intelligence to change your mind when the evidence changes.

So he is effectively saying that he thinks it is a placebo effect because he has no evidence for any other mechanism - a very standard closed minded response from closed-minded doctors. But so you don't think he is foolishly closed-minded, he states that he will change his mind if the "evidence changes" and that this is a sign of his intelligence. However, real intelligence in this situation would be not jumping to conclusions in the first place, and not dismissing anything as "placebo" when in fact we do not even understand placebo in the first place.

A proper scientific position for him to have taken would be to state that homeopathy seems to work but that he has not yet identified a mechanism by which it can work, and so has resorted to categorizing its effectiveness as a placebo effect. It is very important to understand, however, that dismissing something as the placebo effect is not the same as a scientist having a working model or hypothesis because the placebo effect is so elusive that it has no "working" function other than as a label to dismiss anything that is not understood or anything messily mixed with consciousness.

Edzard Ernst falls into the very trap of confusing the placebo effect with a working scientific model because, once again, he is not a scientist but rather a closed-minded doctor (for whatever reason) who masquerades unfounded opinion and sloppy thinking as science.


Update: Also check out Robert Verkerk's 2007 review of Edzard Ernst here.