Library:Trick or Treatment
| Trick or Treatment: Alternative Medicine on Trial | |
|---|---|
| Author | Simon Singh & Edzard Ernst |
| First published | 2008 |
| ISBN | 978-0-393-06661-6 |
| Role | Analysis |
| Domains | Health & Medicine |
| Tactics | Pseudoscience / Junk Science |
Trick or Treatment: Alternative Medicine on Trial is a 2008 book by Simon Singh & Edzard Ernst.
Summary
Simon Singh, a science writer, and Edzard Ernst, a physician who held Britain's first university chair in complementary medicine at the University of Exeter, published this book in 2008. It asks a simple question about the most popular alternative therapies — do they work? — and answers it by examining the evidence.
How we know what works
The book begins with a history of evidence-based medicine. It describes how the Scottish naval surgeon James Lind tested treatments for scurvy in 1747 by comparing groups of sailors given different remedies, and how Florence Nightingale used statistics to show that improving sanitation would save soldiers' lives. These stories establish the principle the book applies throughout: claims about treatments should be tested fairly, with controls, and judged on the results.
The therapies
The core of the book examines four major therapies. On acupuncture, the authors find that much of the apparent benefit can be explained by the placebo effect and by poorly designed trials, though they note some evidence for limited effects on certain kinds of pain and nausea. On homeopathy, they find no credible evidence that it works beyond placebo, and explain why its premise is scientifically implausible. On chiropractic, they find limited evidence of benefit for some back pain, no good evidence for its use in many other conditions and real risks, including rare but serious injuries from neck manipulation. On herbal medicine, they find that some herbal remedies have genuine effects, which also means they can cause harm and interact with other drugs.
The placebo problem
The authors discuss the ethics of placebos at length. Even if a treatment works only as a placebo, they argue, promoting it requires misleading patients, and that can lead people to delay or reject effective treatment.
The libel case
In 2008 Singh wrote a newspaper article criticizing the British Chiropractic Association's claims that chiropractic could treat certain childhood conditions. The association sued him for libel. Singh fought the case and the association dropped it in 2010 after he won an important appeal. The case became central to a campaign that led to reform of English libel law in the Defamation Act 2013.
Relevance to Bullshitopedia
The book is a model of how to evaluate health claims: fairly, with evidence and with acknowledgment of where some benefit exists. It anchors the Health & Medicine domain and the Pseudoscience / Junk Science tactic, and Singh's libel fight is a reminder that challenging false claims can carry legal risk.