Thursday, May 29, 2008

More than a touch of bias

Just got wind of a 3-year Stanford University clinical trial that's underway to study the efficacy of Healing Touch (HT) [1]. What is HT? It's very much akin to Therapeutic Touch (TT). Duh! Ok, ok. It's basically a laying of hands on the sick. In TT the hands don't actually touch the person. In HT, the hands can be in physical contact. Both techniques are said to be based on the manipulation of some human "energy field." Here's how one of the researchers of the Stanford study describes the basis of HT.
"It's based on the belief that our bodies are surrounded by a field of energy and our bodies themselves are a denser form of energy," [Kathy] Turner said. "The belief there is that once the body's energy is cleared and balanced, our bodies have the innate capacity to heal themselves."

The underlying technique is age-old, advocates say, and intends to balance and align people's energy fields so they become "whole in body, mind, emotion and spirit" - although no one knows quite how it works.
And here's how HT is performed.
People remain fully clothed. A lot of it is actual touching, but if someone has just had surgery, the healer can work above the person's body. Healing Touch International Inc. runs a certification program across the country that many nurses take, but it's open to everyone.

[Anne] Broderick, a former corporate executive turned psychotherapist, provides Healing Touch to Lydia Li every week. Both survived breast cancer and took part in Healing Partners at Stanford.

Earlier this month, Li arrived at Broderick's Palo Alto office with shoulder pain and a headache. She lay on a massage table, and Broderick covered her fully clothed body with a white sheet. Broderick, 69, then silently told herself, "I set my intention for the highest good," and began methodically touching Li to the sounds of running water and quiet music, occasionally sweeping her hands above her. At times, she firmly held a foot, knee or wrist. At others, she seemed to play an imaginary piano on Li's back.

Often, Broderick begins sessions by holding a crystal (although she said a "lifesaver on a string" would work just as well) 4 inches above Li and watches it circle over the seven chakras - energy vortices - that run along the length of the body. Clockwise is a good sign. No movement or one that's counterclockwise means the person could use some help getting healthy energy flow, she says.

To most people, a scientific study is a scientific study. And once a study has shown that there is evidence therapy X is effective you'd think that's that; X does work. Well, as with cars, not all studies are of equal quality. You'd of course trust a Rolls and a Ferrari over the China-made Chery. So it should be with clinical trials. And guess what? The Stanford trial is a poorly designed study. It has two major flaws even at the outset. Participants are not randomly assigned to the experimental and control groups, i.e., there is either self-selection--the patients choose in which group they want to be in--or the researchers get to determine the group assignment [2]. Secondly it employs neither single nor double blinding (masking), i.e., the participants know whether they're receiving HT or not and the researchers know which patient is assigned to which group. What all this boils down to is massive propensity for bias and hence unreliability of the forthcoming results. Thus, even at this stage we already know that this clinical trial won't lead to any conclusive findings. In fact should the findings be positive it would be most suspect precisely because of the lack of blinding and randomization--two very crucial factors in any clinical trial that's able to guard against experimental biases.

Another potential problem lies in the control group. If a sham/faux HT procedure is possible then one group ought to be provided this "treatment," just as is in the case of tests of acupuncture where the control group is given sham needling. Therefore, a better designed trial would've involved actors who have no training in HT whatsoever perform the sham HT, with the participants blinded to this fact. If it turns out that patients in the sham HT group fare worse than those in the HT group then there would be good reason to say that there is favorable evidence for HT.

As we said both HT and TT claim the human body possesses an "energy field." Traditional Chinese Medicine likewise claims the body has an energy called qi (pronounced as chi). However, there is absolutely no evidence for this energy field or aura. And in a JAMA study conducted to evaluate TT, the practitioners (most if not all who practice TT are nurses) who claimed to be able to detect and exercise control over this energy field failed to even detect it. Given our knowledge of human anatomy, physiology, biochemistry, and given the experiments thus far conducted the plausibility of the theory of both TT and HT hovers around zero.

Be that as it may, the physical presence of someone who commiserates probably does have a psychological (and even detectable physiological) effect on patients. So does a loving touch--a friendly hand clasping the patient's for instance Or for that matter, embrace and companionship by the patient's loved ones. There's nothing controversial or implausible about these. In fact we would expect these behaviors and events to be helpful in some way, even if only to calm the patient and counteract the stressors s/he's experiencing. But let's dispense with all the energy field, chakra, and crystal poppycock.


1. Learned of this study via Now What, Cat? a site that I think is owned by Cathy. I left a short and rough version of this blog entry as a comment. Moderation is active. Wonder if she'll post what I wrote. If not does that mean I'm persona non grata whatever the content of my comment?

2. The SFGate article made a booboo, describing the Stanford trial as randomized when in fact it isn't.

Monday, May 26, 2008

He's baaack!

That deluded priest Fernando Suarez is back in the country. At the end of this month the Pied Piper is leading his flock to Montemaria, Batangas for more imaginary healings. If you're a believer then go ahead, pack up your gear, make a beeline for that mountain lair of his and have an endorphin-enkephalin-opioid rush. Your deity has imbued humans with an innate storehouse of these drugs to give you a high. Avail of it. Be faithful and have faith in faith healing. Be charmed by Suarez. Believe in his curative powers. And feel better. I swear!

Just don't expect your diabetes, cancer, cardiovascular disease, amputated limb, Down syndrome, spina bifida, hemophilia, et be a thing of the past when you come down from cloud nine. That placebo effect you just experienced? It'll wear off soon enough and has no therapeutic value vis-a-vis diseases, as is with the effects of heroin, opium, morphine, booze, and other narcotic substances your deity created but failed to make inherent in your physiology.

Guess I'm really dumb to be a skeptic. Now I'll never be able to enjoy the narcotic, pain-killing, feel-good benefits from delusions of magical supernatural healing and SCAM (Supplements, Complementary and Alternative Medicine). Drats! Somebody give me a delusion quick! Turn me back into a stupid, credulous, gullible ignoramus.

Sigh. Indeed, ignorance is bliss. And Jesus said, "Blessed are the poor in mind, for they shall reap the fruits of the placebo effect."

Thursday, May 22, 2008

God, I.D.

Last week Fr. Fernando Suarez celebrated a healing Mass in Los Angeles, California. Some 14,000 attended. Well you're in for a surprise (or for skeptics, a yawn). Apparently the Christian deity messed up and failed to lick one woman's cancer the first time around:
[Teresita] De la Cruz had been “healed” by Fr. Suarez in a healing Mass in San Pedro, California last year. She attended Saturday’s healing event because her cancer recurred, invading her brain this time.
"ID" used to mean to Inefficient Designer. Now it also stands for Incompetent Doctor.

I've just begun reading Rose Shapiro's Suckers: How Alternative Medicine Makes Fools of Us All. Replace "Alternative Medicine" with "Faith Healing" and the title would be just as spot on. Then again I regard FH as being part of alt med.

Richard Sloan in his Blind Faith: The Unholy Alliance of Religion and Medicine delves into the various studies and tells us that not only are there that not many studies on the subject of health and religion but that those which are scientifically sound don't lead to the conclusion that religion (including being religious and praying) has health benefits. However, the lack of any good evidence that supernatural beings or deluded and puffed-up blokes like Suarez or religious beliefs (faith) can cure or have any therapeutic effect (apart from placebo effects) isn't going to deter the thousands (or millions) from seeking and availing of free magical panaceas.

As it's been been said, there's only one type of medicine--one that actually works, one whose efficacy is grounded in good evidence.

Sunday, May 04, 2008

Jesus says, Mo says

As always the barmaid hits the nail on the head. She tells Jesus and Mo, "You cannot escape the fact that when you say 'God says X' what you are actually saying is 'I say God says X.'"

Believers of various religions tell us in so many words that "deity Y said/did X." As the barmaid explains, the statement is elliptic and leaves out important details: "My imam/rabbi/guru/priest/pastor says...", "Book B says...", "I say..." In short the statement "deity Y said/did X" is merely a claim. Without empirical substantiation it is irrational to believe in it not least because the existence of the claimed entity has not even been shown to be true.

Logically, epistemologically speaking, any statement in the form of "entity E said/did X" is presumptuous unless E is a phenomenon that is already known to be true/real. The antecedent and implicit premise is "E exists." So unless E is in fact known to exist and has been reasonably shown to exist, to be true and real, immediately telling the reader/audience "E said/did X" is misleading.

An example to illustrate: "E performed surgery on author Daniel Dennett." Now replace E with one of the following:

1. Michael Hopkins, M.D.
2. Ahura Mazda (god of the Zoroastrians)
3. Diktab, a doctor from the planet Woptwam located 3 billion light years from Earth.

Clearly #1 deserves the least skepticism. We know that humans exist. We know that humans who have medical degrees have in fact performed surgery. #2 and 3, however, deserve utmost skepticism, and should not be believed in. There is no evidence that Ahura Mazda exists. There is yet no evidence that any extraterrestrial lifeform exists. And of course there is no evidence that there exists the said planet at the specified location, and one that has a population of organisms that have the intelligence and technology for surgery.

#3 is instructive. The more specific the claim--the more details there are in it--the more premises are being offered, the lesser the probability of the claim being true, and the riskier it is for the one making the claim. Thus in #3 the claims include a planet, a given distance, a sentient being (and even perhaps a range of species and their evolutionary lineage), a nonhuman who has medical expertise and knowledge of human anatomy and physiology, as well as the implicit claim that this being was somehow able to travel the 3 billion light year distance (either physically or otherwise) to operate on Dan. That's a lot of claims packed into it.

Whenever an extraordinary claim comes up, we need to automatically ask, How do you know it's true? Just as well we need to ask ourselves what we haven't been told, what the implicit premises are. Many times once we expose these hidden premises the claim immediately falls flat on its face simply because these premises have yet to be shown to be true. Thus with any claim that deity Y commanded or did X, by merely revealing the fact that Y is not yet known to be true, the entire claim comes crashing to the ground.

Saturday, May 03, 2008

Ethical development

Imagine the following: There is in fact a god or gods. This deity or committee of supernatural beings in fact created the universe, is omnipotent or peri-omnipotent, and has decreed a set of rules for humans to follow. What are these commandments? Well, among the most important ones are: be caring toward others, be fair and just and compassionate, and treat other sentient species with respect. While you are here on Earth you are assured that you will not be punished for any transgression. Neither will you be rewarded in this life for following The Law to a tee.

And oh yes, one more thing. This god/committee has decided that after you die, that's it. You're dead and are no more. Forever. In other words, there is no afterlife. No paradise, no happy hunting grounds, no harem of six dozen virgins awaiting you on the other side. And no hell of any sort either. Once you've kicked the bucket and are six feet under, the gods make certain that bacteria and worms see to it you are irrevocably obliterated.

Now ask yourself, Given that you know with absolute certainty that there is no divinely-caused punishment (nor reward) in this life and that there is no hereafter, would you then go about leading a life of crime? If you're a young man, would you suddenly appoint yourself as the alpha male and ravage every teenage female you run into? Instead of queuing up in a bank to withdraw from your account, would you cut in front of the line and announce a heist? Would you carry around a sword and summarily hack every guy who gets your goat? Would you let your ego become the emperor and allow it rule absolutely?

In educating our children our goal is not teach them to be good only because there's a reward in the offing and to avoid evil only because punishment awaits them. While we employ the carrot and stick with the very young, we eventually want to impart to children the habit of doing good for goodness sake, and to avoid evil because it is bad. We also yearn and hope that in time they do good and avoid evil not because we've commanded them, not because rules, regulations, and laws tell them to do this and not do that, but again because it is good to do good and harmful to do bad. We want our descendants to begin by learning the letter of the law but graduate to understanding the spirit of the law, cherishing it, incorporating it into their very being, and becoming persons who have the ability for ethical thinking and judgment. We want them to be able to think and judge for themselves what is right and what is wrong, and take the appropriate action.

Now there are not many religions that foster such a formation. Buddhism is among the few that easily comes to mind. We need only remind ourselves what the Buddha advised his disciples: "Do not accept what you hear by report, do not accept tradition, do not accept a statement because it is found in our books, nor because it is in accord with your belief, nor because it is the saying of your teacher. Be lamps unto yourselves" [1]. You will also find it being fostered in strands of various religions including liberal Christianity. But you will be hard pressed to find it in most mainstream religions, not least because most religions and denominations guard the orthodoxy, are dogmatic and doctrinaire, and are authoritarian in nature. Such conditions necessarily lead to the polar opposite of maturation, independence and self-reliance. Indeed, the ability to unfetter oneself from authority and tradition and then think for oneself is frowned upon, discouraged, and at times even sanctioned.

Needless to say those who are unaffiliated with any religion (or are adherents of religions that have no ethical dimension, i.e., have no moral prescriptions/proscriptions or offer no criteria for ethical decision making) must perforce search for and choose their own ethical system and must actively use their minds in this endeavor. In being on one's own, there is no guarantee or implication that one will acquire excellent ethical judgment skills or that one will be ethical. Nevertheless, there is that freedom to be able to think for oneself and to be eclectic and learn from any and all sources.


Huston Smith, The World's Religions: Our Great Wisdom Traditions, Harper San Francisco, 1991, p. 94.