Who is responsible for bad medical advice on TV?

I am not sure whether you have missed the storm in a teapot caused by an ongoing hearing of a US Senate Committee. The committee is investigating bogus claims by producers of dietary supplements. Dr Oz of The Dr Oz Show was castigated by Senator Claire McCaskill for ‘melding medical advice, news, and entertainment in a way that harms consumers.’ Dr Oz is an interesting character. Like the unfortunate Dr Phil he is also a product of Oprah, that masterful purveyor of everything pseudo-science. He is known to support faith healing, and homeopathy among other goodies. Dr Oz actually is a medical doctor with impeccable specialist credentials. He holds a professorship at Columbia University’s department of surgery. I have no reason to doubt that Dr Oz is anything but a superb cardiovascular surgeon. The problem with him – essentially – is that he uses his medical credentials during his show to peddle quackery. The lay audience that his show targets (courtesy of CTV in our neck of the woods) has every reason to assume that his advice has been vetted as far as the supporting evidence is concerned. That does not appear to be the case. McCaskill confronted Oz during the hearing I mentioned with the following three examples of miracle drugs promoted by him on his show: ‘(Green coffee extract) — “You may think magic is make-believe, but this little bean has scientists saying they found the magic weight-loss for every body type.”(Raspberry ketone) — “I’ve got the number one miracle in a bottle to burn your fat.” (Garcinia cambogia) — “It may be the simple solution you’ve been looking for to bust your body fat for good.” All of these supposed miracle drugs are at best placebos. Oz proceeds to calling his ‘magic’ and ’miracular’ weight-loss placebos during the hearing ‘crutches’. He claims that they help people jump-start their weight-loss programs. There is zero evidence for that claim.Oz also promoted an anti-aging substance for the efficacy of which existed no evidence at the time or today. This kind of stuff made the man a household name and pretty rich. I do think that medical professionals presenting such shows should stick to medical mainstream evidence as opposed to abusing their credentials and the trust they engender among us audience members to peddle nonsense. Ultimately, Dr Oz professional oath obliges him to ‘first do no harm’. Encouraging his audience members to purchase unproven – or worse, known not to work – concoctions is professionally unacceptable, and yes, it does cause harm.

Oprah meanwhile, who discovered and ‘made’ Dr Oz, promoted during two specials of her, at that time, top-ranking talk show a book called The Secret, a bunch of new age self-help nonsense. It sold the reading audience such remarkable insights as this: ‘You cannot ‘catch’ anything unless you think you can, and thinking you can is inviting it to you with your thought.’ So everyone, the flu you picked up, HIV you acquired, it was all a matter of inviting it with your thoughts. Oprah presented on one of her shows a woman who had developed breast cancer, proudly pronouncing that she would eschew all mainstream medicine in favour of thinking good thoughts. I don’t know how that one went for her. Oprah, whenever there was an opportunity to promote quacks on her show, went right for it. She busily promoted notorious actress Jennifer McCarthy’s conspiracy theories about vaccines and autism. On Oprah’s website under the header ‘Inspiration’ she has this to say about McCarthy: ‘ Since her son, Evan, was diagnosed with autism in 2004, Jenny has been an outspoken advocate for parents fighting the same battle.’ McCarthy actually campaigned against childhood vaccination, resulting in untold suffering among children who were not protected by their parents. McCarthy’s theories were known to be false at the time Oprah decided to promote her as much as they are known to be false today. The number of autism cases scientifically linked to vaccines is zero at the time of writing.

David T. Tayloe, a past president of the American Academy of Pediatricians expressed his concerns about the high media profile quacks can receive all too easily these days for their views this way: "I think show business crosses the line when they give contracts to people like Jenny McCarthy. If you give her a bully pulpit, McCarthy is going to make people hesitate to vaccinate their children. She has no medical or scientific credentials. It disturbs us that she's given all these opportunities to make her pitch about vaccines on Oprah or Larry King or U.S. News or whatever. We have to scramble to get equal time—and who wants to see a gray-haired pediatrician talking about a serious topic like childhood vaccines when she's out there blasting the academy and blasting the federal government?"

Now, you’d say, let the buyer beware, and there is some truth in that. But, in the case of Dr Oz there are the necessary medical credentials to assume the man is not selling me snake oil. Sadly he does so frequently. In Oprah’s case we all knew that she had funny ideas about self-empowerment and strong thoughts and whatnot, and we also knew that she was clueless about medicine. At the same time, she managed to pick titles for her book club that outsold Stephen King. People, in very large numbers, listened to Oprah. That’s why what these sorts of people sell to us in matters of health and medicine should be held to higher standards. I wonder what obligations TV companies and cable companies have with regard to the information they transmit, too. After all, having folks like Dr Oz on your line-up and knowing that they frequently transmit health related bogus advice to your lay audience makes you to some extent responsible for bad choices audience members will make based on the advice of your medical doctor.

Udo Schuklenk teaches bioethics at Queen’s, he tweets @schuklenk

MD'ed crackpotism

Apologies all for the hiatus since the last posting. I am currently on the road again and it's difficult to catch up with work as well as the blog when one's office is far away. Anyhow, I was in Montreal a few days ago and discovered on rue St Denis a lovely buffet style vegetarian place called Restaurant le Commensal. Delightful food. As is often the case with such places, they don't 'just' serve food, but they also serve a bunch of varying ideologies, frequently simply hippie'ish, but not always. I recall in Melbourne a place that served very basic (and very cheap) vegetarian food that was owned by the religious sect that was in the habit of buying Rolls Royces for its guru. So, I wasn't too surprised when I found a book called 'Soul Wisdom', written by Dr Zhi Gang Sha. The good doctor claims to be trained in both Western as well as Chinese traditional medicine. The book claims that he is also 'an expert in the most advanced cellular healing sciences now occurring in China'. You might have guessed already that the good doctor's cutting edge research is so recent that it has not made it yet into peer reviewed journals. Guess he's a good candidate for Oprah Winfrey's show. I'm sure, by now you know about her habit of promoting health related charlatans of the 'wish your cancer away' variety in her TV show.

Well, our Soul Wisdom doctor fits that bill. His book, to my great horror, made it to #1 of the New York Times bestseller list, if the book's cover can be trusted. It begins with a chapter on how the Divine chats to him, enters him and others and has chosen him to help others. Simple as that, most likely on a cellular cutting edge level. But then, the divine isn't cellular or is it, pardon me, or is he (it's a 'he' according to the good doctor). Anyhow, the book offers a healing method called 'divine downloads'. Sounds initially like a server from which people who purchased the book could download healing blurbs. Ha, that at least would have required the doctor to produce however inane content to be downloaded, and that would have meant work. So, instead, his divine downloads are hidden in paragraphs of the book. You can download em at any time by closing your eyes and hitting the invisible, imaginary divine download button. Say you're suffering from terminal liver cancer, all you got to do is chant a lot, go to the relevant page and download the invisible divine download ... or something like that. If you don't feel anything, that simply means you're not ready for it. If you feel your liver cancer has disappeared, the divine download worked obviously, if it hasn't, you chant a bit and you're sorted.

Here's a quote from the intro, just to give you a flavour of the book:

'The Divine continued, "... I offer my healing and blessing by transmitting my permanent healing and blessing treasures." I [ie the good doctor]asked, "How do you do this?" The Divine answered, "Select a person and I will give you a demonstration."I asked for a volunteer with serious health challenges. A man named Walter raised his hand. He stood up and explained that he had liver cancer, with a two-by-three centimeter malignant tumor that had just been diagnosed from a biopsy. I then asked the Divine, "Please bless Walter. Please show me how you transmit your permanent treasures." I saw the Divine send a beam of light from the Divine's heart to Walter's liver. The beam shot into his liver, where it turned into a golden light ball that instantly started spinning. Walter's entire liver shone with beautiful golden light. [The divine reportedly said...] "I have just transmitted or downloaded my Soulsoftware for Liver to Walter. It is one of my permanent healing and blessing treasures."

It goes without saying, and possibly to avoid law suits, the divine explained that the download alone isn't going to heal Walter's liver cancer. Walter has to work on it. He needs to chant for at least two hours per day: 'Divine Liver Soul Software heals me.' If he didn't do that, he might just have died from his liver cancer. However, Walter chanted 'Divine Liver Soul Software heals me' for very many hours. And, there's the good news, his liver cancer just disappeared. Amazing stuff, completely unclear why we bother with modern medicine, when all that's needed are invisible divine software downloads!

Can you imagine, a 300 pp book, filled with crap like that, aimed at people suffering serious ailments? I'm surprised that people are able not only to get away with this, but also that there's a reading audience out there that catapults such bollocks to the #1 spot of the New York Times bestseller list. Scary scary.

Madonna's children

I'm fascinated by the rich and famous' child buying sprees in developing countries. Here's what fascinates me: The kids that they tend to take out of - usually lousy - orphanages are beyond reasonable doubt better off by being raised by a very wealthy person such as Madonna (or more to the point, likely by the people she pays to bring up her biological as well as adopted children). I would not be so certain when it comes to less well adapted stars - say, like Michael Jackson. So, in a way all the drama and bickering surrounding Madonna's adoption plans seems completely out of place. The net effect of these folks' adoptions is positive. The children in question will be better off, and, in Madonna's case, her biological children might also benefit from being brought up in a mixed-ethnicity environment. Seems good news all round.

And yet, I have some nagging doubt along these lines: If Madonna and folks like her really cared that much about impoverished kids in developing countries, instead of wasting a lot of their money to bring up just one or two (and adjust them to their own decadent lives), why can't they do something slightly more useful. Slightly more useful? As in: like Oprah has done with her South African girls' school. The same resources Madonna deploys to buy herself another third world child could arguably help many more kids in that same part of the world if they were deployed differently.

It seems, in other words, as if Madonna's motives are a tad bit more selfish than just wanting to help an impoverished kid live a good life. However, it's also true that we usually don't bicker too much about rich people spending their resources in a less than perfect manner (Oprah cruising in her private jet to South Africa to check out her school is a case in point - I have not heard anyone crying 'wasteful'). We accept that they're entitled to spend their money as they see fit, especially if it goes to good causes.

What's fair to say though, it seems to me, is that Madonna could indeed have done better. It's also fair to say that her intentions are probably not as selfless as she would like them to appear. And still: it is unfortunate that the Malawian court did not permit her to adopt the child she planned to purchase. That child would have been better off as a result of her actions, and nobody would have been any worse off.

On a personal note, I trust regular readers of this blog will be pleased to know that I seem to have at least a superficial knowledge of popular culture.