Wednesday, 5 February 2014

In support of Integrated Medicine

(NOTE: the views and arguments presented in this critique are only my opinion. Whilst I believe these opinions provide a vital contribution to the debate emerging in medicine, nothing I say here should be construed as the objective 'truth' - but only an opinion based on evidence and reasoned argument). 

This is primarily a critique of the article by David Robert Grimes (DRG) entitled `six stubborn myths about cancer` (published in The Guardian on 30/08/2013 - see link below). It also explores articles and/or ideas promulgated by DRG in recent years and it takes a critical look at how pseudo-scepticism is being confused with scepticism in our society.  

Stephen Schneider (Professor of environmental biology and global change at Stanford University) once taught a course at Stanford titled 'Environmental Literacy'. One of the first questions he asked his students was - 'how can you discern the quality of an argument'?  In prompting discussion and critical dialogue on the question, he offered the advice - watch out for the myth busters and the truth tellers! 

[NOTE: if you would like to read my critique entitled 'Dogmatic Skeptics and Medicine' about the writings of David Robert Grimes and Ben Goldacre, this is the link:] 


  • Introduction
  • Myths 1-6
  • Part 2 -  a note on scepticism
  • Part 3 - David Robert Grimes' ideas on vegetarianism, organic food, GM / Monsanto, and water fluoridation


The article `six stubborn myths about cancer` exhibited inaccurate information, un-balanced scepticism, logical inconsistencies and deep errors in critical thinking. More importantly, this article promulgated ideas about cancer that are misleading, strengthening the polarisation that exists between conventional and `alternative ` medicine. Not only is this at odds with present scientific thinking; it is also highly irresponsible regarding topics as important as the public understanding of cancer. Current scientific understanding, as well as robust logical and objective thinking, leads to the emerging realisation that the future for health care is integrated medicine. Integrated medicine takes the best of both worlds – treatments (that have been scientifically validated) and ideas (that are logically robust) from conventional and un-conventional sectors of the medical community. The future for cancer care is in integrated medicine. 
I will discuss each of the six ‘myths’ in turn. Before I do, it is important to highlight that the article by DRG gets off to a bad start even before any of the science is discussed, for 2 reasons. Firstly, the use of the term `myth` in the title is deceptive, akin to semantic trickery, whether DRG is aware of it or not. What is the definition of a `myth`? The article doesn`t say, and no doubt the public understanding of this word varies widely. If `myth` is taken to mean something that only a small minority believe to be true (and it clearly isn`t), then this article will hold little relevance for improving the public understanding of cancer. Here, the `myth` becomes the perfect Straw Man – and it distracts us from more urgent questions. On the other hand – if `myth` is taken to mean a false idea or assumption that holds a prevalent sway in the public imagination; then this is different -  and I would argue that this is a misappropriation of the word `myth`. The point is that DRG has chosen a term that is undefined and unclear. Secondly, the article begins with an emotive reference to an individual cancer patient. This is emotionally coercive and very much at odds with scientific inquiry. This opening act sets the tone that conventional medicine is the only responsible approach, therefore burdening readers into feeling one way even before the arguments are presented. This suggests that DRG`s scepticism is un-balanced. He could just have easily presented the facts that 15,000 people die every year on average in the UK as a direct result of chemotherapy treatment ( or that, in the USA, 100,000 people die every year on average as a direct result of correctly prescribed pharmaceutical drugs (American Medical Association). This would be an example of un-balanced scepticism from the `other side` and is used here to illustrate the point that DRG`s anecdote at the start of the article does nothing more than cloud the objective eye. 
The Guardian can do better than this. It is important to red flag this article because it is absolutely vital that the promulgation of information on topics such as cancer is accurate, logically consistent and, above all, helpful. An un-biased analysis of the data, together with reason and logic, would arrive at the conclusion that cancer – a diverse and epidemiologically complex disease – needs an integrated approach in medicine. 
I am writing this article also to raise awareness about the need for true scepticism and critical thinking to be encouraged in our society. The article is a case study for the dangers of automatically believing in `authority`, especially when those `authorities` are self-proclaimed. The credentials of David Robert Grimes - `physicist`, `researcher`, `Oxford` - do not necessarily guarantee a reasonable and logically coherent argument. By writing his article – which is now in circulation on the web and available to hundreds of millions of people to read – DRG has the life-long responsibility to participate in the self-correcting process of science and update his article as and when valid suggestions and counter-arguments emerge. The onus is on David Robert Grimes to engage in honest scientific debate to self-correct the information he promulgates in the public domain. 
Sadly, instead of welcoming criticism like a scientist, some skeptics seems to channel their energy into developing more and more sophisticated but dishonest ways to thwart criticism, even when that criticism is intelligent and constructive, and therefore conducive to the dialectical process – the cornerstone of science. DRG often picks the `low hanging fruit`, and so, you wouldn´t know from his public reflections (on his blog and twitter site) that his articles actually receive some very intelligent – and valid – criticism. Sometimes, even peer reviewed evidence is presented in direct rebuttal to his articles, but it seems to be ignored. As an example, this was a rather brilliant public comment in response to the article `six stubborn myths about cancer`: 
As soon as I read this article and saw the first comment, I thought of this important article:
Husting, G. Orr, M. 'Dangerous Machinery: ‘Conspiracy Theorist’ as a Transpersonal Strategy of Exclusion' Symbolic Interaction Vol. 30, No. 2 (Spring 2007), pp. 127-150
"In a culture of fear, we should expect the rise of new mechanisms of social control to deflect distrust, anxiety, and threat. Relying on the analysis of popular and academic texts, we examine one such mechanism, the label conspiracy theory, and explore how it works in public discourse to “go meta” by sidestepping the examination of evidence. Our findings suggest that authors use the conspiracy theorist label as (1) a routinized strategy of exclusion; (2) a reframing mechanism that deflects questions or concerns about power, corruption, and motive; and (3) an attack upon the personhood and competence of the questioner. This label becomes dangerous machinery at the transpersonal levels of media and academic discourse, symbolically stripping the claimant of the status of reasonable interlocutor—often to avoid the need to account for one's own action or speech. We argue that this and similar mechanisms simultaneously control the flow of information and symbolically demobilize certain voices and issues in public discourse."
The paper also mentions the insult of the 'tin foil hat brigade' as a strategy of basically ad hominem. How can there be rational discussion when even the journalist concerned is using the above strategies to preclude such, let alone the commentators? :(
David Robert Grimes replied; 
I'm not sure how exactly I'm precluding discussion, as the journalist concerned - nor did I reference the paper you mentioned. Rational discussion does not mean that all assertions are treated equally - claims backed up by evidence should have far more clout than those devoid of any veracity, or wouldn't you agree?
The commentator retorted; 
You are precluding RATIONAL discussion by using such strategies. The paper I cited shows the problems in these - it's quite clear from the abstract. I'm rather dismayed that you've chosen to imply I don't agree with evidence based claims (itself constituting an ad hominem fallacy) rather than engage with the actual problem - your use of the term 'conspiracy' in order to discredit, in advance, anyone who might not agree with your views, or who would question some of the assertions you've made.
That was the end of the dialogue between this person and DRG. The point made by this member of the public was profound, nuanced and highly relevant to the broader question of how rational debate might actually be being thwarted by social mores in the academic and scientific community. This person clearly wants to see rational debate encouraged. DRG not only side-steps the comment by throwing in a red-herring (ironically re-enforcing the reader´s point); he doesn´t seem to understand its relevance. As I discuss later, the reliance on `scientific evidence` does not necessarily ensure that the inquiry into important questions is balanced, reasonable and objective - and free from powerful socio-cultural and economic forces. A complex social question calls for critical thinking that is deep and nuanced. It is at just this moment that the objectivity of `dyed-in-the-wool` sceptics and academics seems to abandon them, and they become simply unable to engage in intelligent debate. 
The article is symbolic for the rising tide of pseudo-scepticism in the intellectual and scientific community and the need for us to remain grounded and objective about what scepticism truly is (and isn`t) and what role it plays in getting to the truth. In a desperate dash to win recognition in the intellectual community, this author has shot himself in the foot and wasted a privileged and golden opportunity to champion critical thinking and promulgate helpful and nuanced information in The Guardian. 

The implication here - that the demographic factor of ageing population is the main driver for the proliferation in cancer rates - is incredibly misleadingAge standardised global cancer rates provided by the World Cancer Research Fund (WCRF) show that cancer rates vary significantly between nations (for example; Denmark´s cancer incidence is 30% higher than Austria). Age standardisation factors out the influence of age; to show how cancer rates vary between countries, regardless of variation in demographic structure. Japan, which has the longest lived people on earth, doesn´t even make it onto the top 50 list of nations with highest cancer rates. This could be partly due to a discrepancy in detection and diagnosis rates between Japan and other countries – but, overall, it can be seen that substantial differences in age standardised cancer rates exist across the world. 
Of course, age standardised rates do not tell us what the causes for the differences are – and it doesn`t even imply that age is not an important correlate with cancer incidence. It simply tells us that there are differences in cancer rates between countries and those differences are driven by factors other than age. DRG doesn´t provide cancer statistics for different age groups, and so when he says that age is the single biggest risk factor in getting cancer this is misleading, and about as helpful as saying that age is the biggest rick factor in dying! This is because we can confidently expect that, for health conditions such as cancer where degenerative processes play a role (such as problems with cell replication and DNA repair), incidence will naturally become higher with age, regardless of other factors. But by not highlighting changes in cancer rate and type within specific age brackets, David Robert Grimes confuses the point, and so therefore misinforms the public. There is plenty of evidence that cancer rates are becoming more prevalent in younger age categories – i.e. in the opposite direction that DRG draws our attention to.

For example, cancer is the leading cause of death among Americans aged 35-64. Here´s the source:

Essentially, DRG is able to justify his claim that cancer rates are NOT rising because he doesn't specify any time frame. For sure, cancer incidence 'over time' would not follow a 'hockey stick' shape - because there might have been cancer 'spikes' during other periods in history - such as the Medieval Ages when viruses were abundant or during the Industrial Revolution when pollution and poor working conditions were rife. But for all intents and purposes, when people believe that cancer rates are rising, the unspoken idea is that this is against a 'background level' when humans weren't subject to the unnatural conditions and forces that have arisen due to human cultural development. Simply, the logic statement I propose is: (a) cancer rate is driven largely by environmental factors (an accepted fact); (b) environmental factors have got much worse compared to background levels (fact); (c) therefore, cancer rates are rising.  

There is a danger that people reading DRG’s article will be distracted form the urgent need to confront the fact that cancer probability is significantly related to our lifestyle choices. Indeed, this is what the evidence is showing. In 2008 an article was published in the journal Pharmaceutical Research stating that `cancer is a preventable disease that requires major lifestyle changes`. Here`s the link: More recently, an article in the British Medical Journal links alcohol consumption with cancer. Here´s the link:

It is important to stress that – regarding a public health topic - it should not be the readers’ job to wade through the semantic gymnastics of an author in order to decipher what is really being said. At the end of the day, what the majority walk away thinking about cancer after reading DRG`s article is what the article is promulgating. This is why journalism on health topics carries a huge responsibility. I feel that David Robert Grimes makes the mistake here of treating the `dispelling of cancer myths` as an intellectual exercise. Cancer is not just an academic question; it is a complex socio-cultural question and information pertaining to it must be clear, honest and helpful. 
An important but simple truth that must be made clear to the public is that poor lifestyle choices increase your risk of getting most, if not all, types of cancer.

The Guardian recently published an article on the proliferation of cancer and the link to poor lifestyle. It says: ``These so-called "non-communicable diseases", which have all taken off as sedentary lifestyles, junk food, smoking and drinking have spread around the planet, are already a massive burden on rich countries and are steadily becoming one in poorer countries, too``. Here´s the link:
The World Health Organisation (WHO) mirrors this view. The WHO says:   
`Risk factors for cancers: Tobacco use, alcohol use, unhealthy diet and physical inactivity are the main cancer risk factors worldwide. Chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in low- and middle-income countries. Cervical cancer, which is caused by HPV, is a leading cause of cancer death among women in low-income countries`. 

And, `Cancer prevention is an essential component of all cancer control plans because about 40% of all cancer deaths can be prevented´. 
Here´s the link for the WHO cancer information website

For children in the US, cancer is the second biggest killer (after accidents) and cancer incidence in children younger than 15 is increasing at about 1% per year. Half of these are leukaemia and brain cancers – aggressive cancers and so statistics for these much less likely to compound detection biases. Breast cancer rates in Europe between 1990 and 2008 had also been rising at about 1% per year, with the greatest rise in woman under 35. Here, detection bias is a possible contributory explanation, but the ´mammography effect` (where rates increased by 3-4% due to widespread introduction of screening) occurred 1982-1987,before the study. Interestingly, a meta-analysis of studies shows a significant link between diet and risk of breast cancer. Here´s the study:
An article published in The Lancet which explores the incidence of childhood cancer in Europe since the 1970s concludes: `Our results are clear evidence of an increase of cancer incidence in childhood and adolescence during the past decades, and of an acceleration of this trend. Geographical and temporal patterns suggest areas for further study into causes of these neoplasms, as well as providing an indicator of progress of public-health policy in Europe`. 

Lastly, analysis of cancer rates between identical twins for a study published in the New England Journal of Medicine showed that `environment has the principal role in causing sporadic cancer`. Identical twin studies are the `gold standard` for analysing the relative influence of `nature` versus `nurture`. This study suggests that, overall, 65% of cancer risk is attributable to environmental factors. Some academics suggest an even higher influence of environmental factors: Dr. Mel Greaves, Director of Leukaemia Research at the Institute of Cancer Research, suggests that environmental factors could account for as much as 90% of cancers. Concurrently, studies on Diaspora groups - populations of migrants who settle in another country - suggest that environmental factors present, overall, the most important risk , as found by the study in the NEJM.  
Wikipedia says: `Cancers are primarily an environmental disease with 90–95% of cases attributed to environmental factors and 5–10% due to genetics.[2] Environmental, as used by cancer researchers, means any cause that is not inherited genetically, not merely pollution.[14] Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%),radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.`[2]

Furthermore, DRG makes the assumption that humans are living longer today than ever. That is highly questionable. Which epoch in human history is he comparing to? To ancient ancestral populations of humans, or Palaeolithic, or present day indigenous groups, or humans that lived during the industrial revolution in Britain? That people should be living longer today compared to the industrial revolution, for example, is hardly surprising. But the bombardment of pollution and general squalor characteristic of this time – and the concurrent proliferation of disease - is not representative of an environment that Homo sapiens are adapted to.  
In fact, most ancestral societies – from relatively recent industrial aggregations to Palaeolithic hunter-gatherers – present a rather artificial construct when trying to compare variation in life expectancy for human populations over time.  This is because the unique set of factors that kept life expectancy down - disease pandemics, work-related illness and death, war, malnutrition – is a peculiar aspect of human cultural development and is largely at odds with the natural factors shaping the demographic structure of all other species.  One factor that human societies do share with other species is high infant mortality, and it should be noted that infant mortality rates are usually included to produce life expectancy models. Thus, statistics given for life expectancy for any given epoch will be highly skewed if they include infant mortality in the average. Taking all this into account, figures on life expectancy in the past do not indicate how long a human could have been expected to live if they survived childhood and were not exposed to `human forces` - war, malnutrition, work, pollution and dieses pandemics.  
Basically, DRG does not point out the important difference between life span and life expectancy. This is a critical omission – because life span has NOT changed for humans, perhaps not even in the past 100,000 years. This is because there has been no fundamental change in human genetics and the rate of ageing in this period.
Why is this important? It`s important because, essentially, there is nothing ‘unusual’ about human beings living long today. The biological potential to live long depends on genetics and, in this sense; humans are fundamentally the same now as ever. An aspect of evolutionary biology called kin selection theory would suggest that there`s even an adaptive reason why we should live long – to contribute to the reproductive success of our children and grandchildren. Because they contain our genes, helping them survive actually contributes to the success of our genes. Kin selection theory is often relevant in highly social species such as Homo sapiens
Essentially - if cancer is mainly a factor of age in the genetic sense (i.e. DNA damage increases with age) and old age has an adaptive function - then we might expect DNA repair mechanisms to have co-evolved with adaptations for long life. Or conversely, DNA repair efficiency enables long life span, as noted in studies on mammals:
Furthermore, regular food scarcity would have been common for most of our human ancestors, and we know from scientific studies that periodic fasting is very beneficial for health, as long as nutritional requirements are met. Indeed, caloric restriction has been correlated with increase in life expectancy and with decrease in cancer probability. Wikipedia says: `Currently, the only (non-transgenic) method of increasing maximum life span that is recognized by biogerontologists is calorie restriction with adequate nutrition`. Source:

As much as I am appalled by the decimation of shark populations for `shark fin soup` and other shark products - (I`m a vegetarian, wildlife campaigner and I wholeheartedly support the banning of these abhorrent practices) - DRG here presents us with a Red Herring. The contention is whether sharks do – or do not – get cancer. Incidentally, scientists at the University of Aberdeen have found that there are, in fact, compounds unique to sharks that have anti-cancer properties. These can be produced synthetically. Here´s the link:
David Robert Grimes is right when he asserts that all multi-cellular organisms can get cancer. The problem here, from a logical perspective, is that DRG makes the implicit assumption that we have the paleo-cellular evidence to show that the animals he mentions – sharks, elephants and dogs (or wolves – the common ancestor of all dogs) – exhibited cancer pathologies and/or frequencies in their populations before human industrialisation. This is important because today, almost all species on earth are exposed to some type of man-made pollution. Sharks are a particularly bad control group to be presented as proof that animals in natural ecosystems get cancer. It is well known in biology that pollution and toxins are concentrated up the food chain by a process called bio-magnification, such that animals like sharks become laden with much higher concatenations of carcinogens than other animals. Dogs and elephants, for that matter, are also bad control groups to explore the natural phenomenon of cancer in other species. 

Straw Man argument presented here. This is analogous to contriving the myth that obesity is a modern disease. There is a prevalent, more nuanced - and altogether different notion in society - that the epidemic of cancer is a modern phenomenon. If DRG insists on contriving and debunking his own idea of a `myth`, let it be said that - the fewer the people his article educates, the less relevance his article holds in the first place for the promulgation of important health information. 

Firstly, spot the oxymoron when DRG writes: `Fact that cancer treatment without side effects is unlikely to be killing any cancer cells`. 
In my opinion, this is where the confusion and unhelpfulness promulgated by David Robert Grime`s article really begins to take shape. He says: `... one must also consider that each cancer is unique to that patient because it arises from mutations in their own cells`. This (true) assertion - that cancer is an intrinsic disease that arises due to mutations in one`s own DNA and unregulated cell division – is the basis upon which I build my subsequent arguments. 
Firstly, to clear up a possible misunderstanding – the intrinsic nature of cancer does not necessarily mean `genetic` in the sense that it is `destined`. This is because we know that lots of extrinsic environmental factors can damage DNA and lead to mutations and dysfunction in the cell division cycle, leading to cancer. However, the intrinsic genetically programmed ability to protect DNA from damage, and repair it when damaged – or to respond epi-genetically to environmental factors – does vary from person to person. In other words, if you could consider a hypothetical (age standardised) population of people all exposed to exactly the same environmental conditions (physical and psychological), some people would get cancer and others wouldn´t, simply as a factor of genetic variability. 
It is important to understand that the intrinsic nature of cancer suggests that all those factors which can affect DNA replication, DNA repair and epi-genetic expression, will influence the probability and incidence of cancer for any given person. These factors are both genetic and environmental. 

Here, DRG builds up another Straw Man argument to knock down. Regardless of whether this `myth` is true or not (and I strongly doubt it is true), the author distracts the readers from the seemingly similar - but much more nuanced – idea emerging in society that the actions of the pharmaceutical industry are highly questionable and need to be treated with scepticism. Given the known corruption that exists within the pharmaceutical industry – corruption which endangers lives and has no doubt cost lives – I invite DRG to provide a cogent reason why suppressing a `cure` for cancer would represent a fundamental ethical shift - a `step too far` - for the pharmaceutical industry. 
Read Ben Goldacre`s critically acclaimed book `Bad Pharma` for more information on the topic.  The Drug Industry clearly is motivated by money. As one psychiatrist succinctly summed up their Modus operandi: `The first disaster is that you kill them; the second disaster is that you cure them`. Only recently, GlaxoSmithKline was fined 3 billion dollars `after admitting bribing doctors and encouraging the prescription of unsuitable antidepressants to children´ ... and for `failing to report safety problems with the diabetes drug Avandia`. Here´s the article published in The Guardian: 
Personally, I do not believe that `Big Pharma` is suppressing a `cure`, but not because I think this would truly represent a `step too far` for the industry. To begin with, `cure` is an inappropriate and misleading word when it comes to an intrinsic disease such as cancer (as I explore in more detail later).  Furthermore – and related to this point – is that science is showing us that the prevention and treatment of cancer is best tackled using an integrated approach – an approach which cannot be patented
Furthermore, specific natural substances cannot be patented by the pharmaceutical company and they have no economic incentive to promulgate health information they won’t benefit from financially. 
Strong indications of this are when we consider 2 drugs sold and recommended by the industry: a drug for the regulation of blood sugar level and, recently, the suggestion that the drug aspirin could help treat aggression indirectly via the regulation of inflammation in the body. If the pharmaceutical industry truly had any humanitarian ambitions, they would make available the knowledge that various pyhto-chemicals (plant substances) have been clinically proven to be just as effective as synthetic drugs for the regulation of inflammation and blood sugar level. In this specific case, natural substances might be better because they not have dangerous side-effects. Also, they contribute to adjusting the cause rather than just treating the symptoms – an inherent problem with most, if not all, drugs. 
The author is scathing, even libellous, about the information site `Natural News` calling it a `bastion of misinformation`. I don`t know if this is true or not - but the evidence is clear that the pharmaceutical industry certainly is a bastion of misinformation. What´s worse, Big Pharma knows it´s misinforming the public but still does it anyway. Truly corrupt, truly criminal, and truly needs to stop. 
DRG says: `idea of a single magic bullet to treat all these forms (of cancer) with different causes, pathologies and responses is extremely far-fetched and should be treated with scepticism`. Yes, I agree. But isn´t that precisely what chemotherapy and radiotherapy essentially are – a magic bullet? He goes on to say: `Because cancer can arise from potentially any type of cell mutation, there is a huge range of malignancies – some respond well to surgery, others to radiotherapy, others to chemotherapy. ` Are these really the only options? No. Science is showing us that cancer treatment can be far more sophisticated and should embody aspects of `alternative medicine` - that have been scientifically validated - in an integrated approach. DRG seems to show a biased interest, and a poor knowledge and understanding of the scientific and medical literature. 

In one statement, David Robert Grimes expedites a common misunderstanding of the alternative medicine movement when he says (in a different article): `alternative medicines fall into two categories – treatments that have not been proved to work, and treatments that have been proved not to work. Treatments that have been proved to work are simply called medicine`. In one fell swoop, David Robert Grimes trips over his condescending lyrical witticism to exhibit not only his misunderstanding of the fundamental premise of alternative medicine, but also the founding ethos of modern medicine itself. Indeed, it was Hippocrates, the father of modern medicine, who said: ``Let food be thy medicine and medicine be thy food``.
Hippocrates also said: 
·         ``The natural healing force within each of us is the greatest force in getting well``
·         ``It´s more important to know what sort of person has a disease than to know what sort of disease a person has``
·         ``Wherever the art of medicine is loved, there is also a love of humanity``
·         ``Natural forces within us are the true healers of disease``
·         ``Whenever a doctor cannot do good, he must be kept from doing harm``
·         ``Cure sometimes, treat often, comfort always``
·         ``Nature itself is the best physician``  
·         ``If you are not your own doctor, you are a fool``  
The wisdom and insight of Hippocrates is embodied (as a fundamental way of thinking about health and disease) within the paradigm of `alternative` and integrated medicine. 
DRG fails to give a definition of `alternative medicine` and, indeed, fails to play fair and concede the distinctions and vast range of ideas and levels of critical thinking exhibited within the alternative medicine community. What is alternative medicine? Put simply, it is medicine alternative to that which is conventional – in this case, chemotherapy, radiotherapy, and surgery.  It is a knowledge base and method of addressing a health issue as a complex interplay of different factors; psychological, socio-cultural, mental-emotional and physical. 
Yoga and meditation are very much associated with alternative medicine. Even though these techniques have been clinically proved to be helpful and efficacious for a whole range of health conditions (including cancer) I very much doubt that the orthodoxy of medicine will be calling it `medicine` anytime soon. This goes for other types of alternative medicine – massage, sauna, nutritional therapies, emotional and psychological therapy, exercise, aspects of Chinese medicine, herbalist wisdom, aspects of indigenous or ethnic medicine – aspects of all of these have been scientifically validated as being efficacious for health and well-being. But they are not regarded as medicine
Would someone with a connection to the ethos of alternative medicine be against conventional treatment such as chemotherapy, radiotherapy or surgery? No, not necessarily. Would someone with an allegiance to conventional medicine be against alternative therapies? I don´t know, but David Robert Grimes seems to show his scepticism in only one direction. By clumping together all of alternative medicine as an incoherent paradigm, DRG polarises the health debate in a most unhelpful way and distracts us from the reality that unconventional or alternative medicine has some valuable insights to share. It is as untrue as clumping religion with spirituality, or simply, what`s false with what`s true. 
There is no rationale in assuming that people who support the ethos of alternative medicine are any less logical or objective in their thinking than those who swear by conventional medicine. This is highlighted by DRG`s erroneous use of Carl Sagan´s quote `extraordinary claims require extraordinary evidence` in the context of natural substances providing cures or magnetic therapy being efficacious for cancer. If chemotherapy drugs can treat cancer - then there is no fundamental reason why natural substances or compounds couldn´t do the same. This is precisely because natural and synthetic compounds abide by the same laws of physics and chemistry; it is the outcome of the interaction of a compound (natural or synthetic) with the cancer cells and/or biochemical environment of the cancer cells that is important. Only recently, a compound naturally found in Chamomile tea has been discovered to possess chemotherapeutic properties. Here is the link: Also, look at this clinical study on the anti-tumour potential of ginger for hematologic malignancies:   
Similarly, the knee-jerk dismissal of `magnetic wave therapy` is logically unsound – `magnetic waves` and the radiation from radiology treatment inhabit different spots on the electromagnetic spectrum. It is only a matter of magnitude. We would expect radiology to work because it is much more powerful. Conversely, `magnetic` waves might be too weak to exert a significant biological effect. The same goes for sunlight - UVA is more damaging than UVB because it´s more powerful. But the fundamental mechanism is the same – radiation to exert a biological effect. This is why the claim that magnetic therapy could be efficacious is actually so un-extraordinary. 
Even when debunking homeopathy - (quite rightly so, according to the conclusive evidence that homeopathy works no better than the placebo effect (I will discuss the placebo effect later)) – David Robert Grimes takes his assumptions a step too far. Consider the hypothetical situation that homeopathy did work – it wouldn´t necessarily be because the laws of physics had been broken. It could simply mean that we don`t yet know all the laws of physics. Ironically, DRG is inciting magic for that which we don`t know. Objective sceptics might urge caution about what we are able state we know for absolute. To think we know all the laws physics, surely, is magical thinking. (NOTE: I am NOT defending homeopathy). 
Ostensibly, homeopathy is a ‘cut and dried’ case – because we can be as sure as anything that it is 100% placebo. So when DRG says that ‘homeopathy is useless’, surely he’s right? Actually, no. Just because something works solely due to the placebo effect doesn’t make it useless. We know that the placebo effect is one of the most important aspects of healing, and therefore, of medicine. For relatively minor health conditions – and particularly those that are predominantly psychosomatic, placebo treatments have potential value. DRG’s un-nuanced and prejudiced position, mirrored by large swathes of the medical establishment, only serves to polarise opinion and preclude any honest and rational debate in this field. Their trump card is the ethical standpoint – i.e. it is simply wrong to ‘lie’ to patients by giving them homeopathy treatment. Well, research has shown that a whole host of conventional drugs work either partially, or substantially, due to the placebo effect. Should a doctor prescribing Prozac to a patient with mild to moderate depression tell him or her that the drug they are taking is at least 80% placebo? If not, why not? This is an ethical quagmire which needs to be addressed in the medical community, honestly and rationally. By throwing in their obvious biases, some sceptics muddle this process in a selfish and most unhelpful way. 
Suggesting the use of homeopathy for things like cancer could quite rightly be described as irresponsible and a ‘bad idea’. Having said that, cancer is a diverse and epidemiologically complex disease – and it is not beyond the realm of possibility that certain cases could response well to placebo treatments. Ultimately, the only honest approach to considering the role of placebo treatments in medicine is to use outcome based models. This means you consider a condition – let’s call it condition ‘x’- and you apply different treatments to it and look at the outcome. Drug ‘y’ might have a combined effect of 35% reduction in condition ‘x’. I say ‘combined’ because the placebo effect always plays a role, even for drugs with an established biological effect. So, let us say, in this example, that drug ‘y’ has a combined effect of 35% (10% placebo and 25% pure physical effect). Now, let us consider a homeopathy treatment ‘z’. Is it possible that homeopathy could result in a reduction in condition ‘x’ of, say, 45%, solely due to the placebo effect? Yes, it’s possible. For certain health conditions, it’s even likely. Homeopathy treatments are usually prescribed in nurturing and friendly settings, with kind and caring practitioners who spend a relatively long time with their patients and offer on-going support. These are all features of palliative care that exaggerate the placebo effect. In this regard, it is the outcome that is important. You might argue that the outcome could be maximised by giving the drug in a more caring and nurturing environment. In principle, yes, but in practice, no. Conventional doctors aren’t really even trained to nurture the emotional state of the patient, nor to encourage innate healing potential. Even if some doctors do realise the importance of this, they simply don’t have the time to do this effectively.

HYPOTHETICAL LOGIC ARGUMENT: In a randomised, double blind, placebo controlled trial, drug 'X' is found to work no better than the placebo control for curing condition 'Y'. However, for whatever reason, the placebo effect was so strong in this trial that all patients were cured of condition 'Y'. Now, imagine drug 'X' was actually a homeopathic remedy. It worked no better than the placebo effect but, in this example, the placebo effect was so powerful that all patients were cured. For this condition, should we use the placebo effect to help patients? If not, why not? Evidence Based Medicine (EBM) factors out the placebo effect such that this 'drug' would be deemed useless. Outcome Based Medicine is only interested in the outcome. In this specific example, a homeopathic remedy would be deemed useful and medicinal. 

Importantly, words like `cure` and `alterative` will increasingly become redundant as science provides more and more evidence for the benefits of integrated medicine. If you use the word `cure` and `cancer` in the same breath (without providing qualifiers), it is likely that you have a poor, or at least undeveloped, understanding of the principles underlying the science of cancer - given it´s intrinsic nature and epidemiological complexity. Something that is intrinsic can be `cured` only to return – unless the body is healed of underlying factors. `Healing` is a word much more symbolic for the truth of the situation, and integrated medicine is mostly interested in `healing` rather than `curing`. This is a fundamental difference of the Modus operandi of the two paradigms; conventional medicine is a disease care system, integrative medicine is essentially a health care (and health - promoting) system. 
An integrated approach in medicine for cancer would include the use of natural substances that have been proved to be efficacious by clinical trial. It would also include the whole range of aforementioned techniques to reduce the stress load of the patient and encourage the intrinsic healing mechanisms of the body. Stress has been shown to have a negative effect on immune function and the regulation of blood sugar level, and causes inflammation – all linked to cancer. In a very real sense, therapies that reduce stress are medicinal.  Recent research published in the journal Psychoneuroendocrinology suggests that meditation can induce beneficial epigenetic effects on our genome. Here´s the link: This article indicates that meditation can exert the same mechanism of action as proposed anti-inflammatory and analgesic drugs. Furthermore, evidence is emerging to suggest that even the psychological experiences of your ancestors could influence your genetics and therefore your experience in life. Here´s the link:
Integrative medicine would incorporate the best that wisdom traditions such as Chinese medicine and indigenous or ethnic healing traditions have to offer and, of course, it would include the best from conventional medicine. It would integrate the latest research on the science of caloric restriction and fasting, and it would also consider the science of supplementation and orthomolecular medicine. As an example, it would give honest consideration to topics such as vitamin D supplementation. 

'Vitamin` D is somewhat of a misnomer – since Vitamin D acts more like a hormone in the body – having estrogenic regulating properties and epi-genetic effects on up to 10,000 genes. Problems with Estrogenic regulation have been correlated to cancer prevalence ( Integrative medicine would not ignore these research findings – and it certainly wouldn´t ignore the potential value of procedures such as chemotherapy and radiotherapy. Vitamin D article:
Furthermore, it would not dismiss (in a knee-jerk fashion) substances and methods unproven in a clinical setting – as long as they aren´t harmful or don´t have contraindications with other drugs a patient might be taking. This is because scientific proof is not synonymous with truth. Science unveils the truth (e.g. gravity existed and the earth was round before these facts were discovered by the scientific process). Consider the myriad indigenous herbs and plant substances of folk medicine that have been used for millennia but only very recently verified by science as having therapeutic effects above and beyond the placebo effect. Some things that spring to mind are Chaga mushroom, Green Tea and Pomegranate extract. 
This is, in fact, a scientific process – an evidence-based system - that has been employed by indigenous groups in the past to produce a body of knowledge of folk medicine (the double-blind, randomised and placebo controlled trial is a recent addition in the evolution of the scientific method). How is it possible that ancient cultures could have `known` that foods and substances like this had therapeutic value? Through a process of cultural natural selection over thousands of years - truths gauged by paying attention to subjective experiences over the course of millennia, and by a process of trial and error. Also, by an intuitive connection with nature that modern medicine has all but lost.

An interesting critique of EBM - Evidence Based Medicine - was published in the British Medical Journal in 2003. It is an ingenious and brilliant satirical piece which questions the logic of structuring public health policy solely around that which has been proved by the randomised, double blind and placebo controlled trial. It is a call for common sense based on good science. Here it is:

As long as a product is safe, with no contraindications and does not result in a patient substituting it for something that has been proved to work by clinical trial; then there is no problem. However, evidence is always a top priority in integrative medicine, and the evidence is mounting at an astonishing rate on the therapeutic potential of natural substances. For example, see this recent study by Cambridge University Hospitals on the anti-cancer potential of broccoli, pomegranate and turmeric:
Facts are facts, as the saying goes. 
An excellent introduction to the shifting paradigm in cancer treatment is provided by this TED talk by Dr. William Li on the role that nutrition can play in cancer treatment - by encouraging a process called angiogenesis: This talk discusses the logical idea that cancer cells – like all cells – have specific biological needs. Mutant cells (i.e. cancer) have epi-genetic drivers, just like healthy cells. By altering the surrounding biochemical environment of cancer cells by changing our food choices, the voracity of cancer cells can be weakened. Here, as Hippocrates stated, food really is medicine. A useful analogy I heard for this therapeutic model is to consider mould growth in a house. You can either kill the mould or you can remove the conditions for its proliferation. This, in a nutshell, is another fundamental difference between the logic of conventional and integrative medicine.  Here´s the link for the talk on TED: 
Taking all this into account, an integrated approach to cancer treatment is actually far more logical, reasonable and sophisticated than the approach of conventional medicine at present. It is also cheaper – which is a strong incentive for governments at a time when the health care systems in the UK and the USA are at breaking point. 
Integrated medicine is a far more sophisticated, nuanced and scientifically honest method for the prevention and management of disease. Dr. Andrew Weil of the Arizona Centre for Integrated Medicine tells of the outrage he felt when his father was given a `pastrami sandwich and vanilla ice-cream` in hospital after heart bi-pass surgery. Orthodox medicine might see this as irrelevant. Integrated medicine would see this as ridiculous, even medically negligent. Given the established link between certain cancers and poor diet, giving junk food to any cancer patient is, in principle, not much better than giving cigarettes to a lung cancer patient. Really, it is incredible that the best food possible isn`t automatically given to cancer patients - to exercise the precautionary principle in the very least. Good food is not likely to have any more contraindications than bad food. Indeed, good food is likely to help protect the patient from the damaging effects of chemotherapy and radiotherapy and, as discussed, will improve the general health of the patient. Indeed, the fact that cancer patients aren`t automatically put on the best diet possible shows how cancer care is, at present, stuck in the Dark Ages. 
Doctors of Integrative medicine would also pay very close attention to the subjective experiences of the patient, something DRG snubs as `patient-experience`. 
The beneficial physiological effects of positive psychological states are well known to science. The potential healing effect of the mind-body connection (i.e. the placebo effect) is one of the most important phenomena that must be encouraged in any health condition.  Hippocrates knew this when he said `Natural forces within us are the true healers of disease `. Studies of people with split or multiple personality psychological disorders show that, in certain cases, acute allergic responses to specific foods can be present when the individual is in one personality state, but absent when he or she is in another personality state. Such is the power of the subconscious mind. I encourage people to listen to the discussion between Nicholas Humphrey and Richard Dawkins when they discuss the mind-body connection. The placebo effect is powerful - truly `Darwinian medicine`. Indeed, if it wasn´t for the placebo effect, the pharmaceutical industry would make far less profit – such is the profound irony inherent in any un-nuanced defence of Big Pharma. 
Here’s the interview between Dawkins and Humphrey:
David Robert Grimes says `cancer is scary, but it should not be forgotten that treatment options and outcomes have never been better and continue to improve`. Really? How many treatment options has he suggested and how could the number of possible outcomes possibly change?  Yes, cancer is scary but people will be even more scared after reading DRG´s article which tells people that the chance of getting cancer is mainly a function of age (catch-22!) and that side effects are nearly always a necessary part of cancer treatment. 

There´s no need to be scared by cancer. I encourage readers to (a) develop their ability to think critically, with nuance and objectivity; (b) to do their own research about cancer; and (c) to discover more about how the body works and what type of lifestyle is conducive to best health. There ARE plenty of reasonable organisations which provide a more integrated and holistic approach to cancer treatment. Two examples are:
1.       Arizona Centre for Integrated Medicine
2.       Hippocrates Health Institute

Lastly, David Robert Grimes references the FDA as a source of information on fake cancer treatments. Readers should be made aware that the FDA is definitely NOT an independent source! For more information on controversies surrounding the FDA, look at this link from Wikipedia (DRG is himself an advocate for the credibility of Wikipedia as a source of reliable information): 

PART 2 - a note on scepticism

DRG`s articles and public comments seem to attract public outrage – and not just from people who are illogical, reactionary or quite obviously quacks. No – criticism stems from other ranks too – people who are interested in science, the use of logic, appropriate scepticism and the pursuit of honest and open scientific debate to solve problems in our society. 
Reading the article, I had a deep intuition (like many others) that DRG wasn`t being neutral - wasn`t being fair. In this sense, his article is the opposite of science. I feel that DRG`s articles are symbolic for the rising tide of an unholy alliance between pseudo-scepticism and science that has emerged in the academic and intellectual community. 
The value of true scepticism as a powerful tool for understanding the world is being debased by both sides: it is often conflated with cynicism by the `alternative movement camp` - thus grossly devaluing it, and it is apparently misappropriated by people who have not fully grasped the difference between biased (i.e. pseudo) scepticism and true scepticism. 
Two hallmarks of pseudo-sceptics are: 
  • Confusion between the need to think reductively and need to think objectively. Objectivity is the foundation of science – and thinking reductively is not necessarily always the most logical. 
  • Holding the default position that truth is equated with scientific evidence. But - the lack of evidence for something is not necessarily evidence against it

For example, this is true for health products that have not been tested by clinical trial. Often, even perfectly honest scientific research depends on grant money – and, rather logically, this money is provided much more readily by agencies with money - often, agencies of power and interest within our socio-economic and political structures. Understandably, there is no economic incentive for private companies to fund research for products that cannot be patented. Subsequently – if only by sheer economic force - natural substances and techniques (i.e. non-patentable) for cancer treatment may not have had the privilege of being tested to the same extent – they might not have had the benefit of scientific scrutiny.  
Interestingly, DRG seems to automatically dismiss claims or science articles which have not been peer-reviewed. Although peer-review is a valuable process at the core of science, an uncritical acceptance of peer-review is unhealthy, and certainly wouldn’t be adopted by a true sceptic. According to this article published in the Journal of the Royal Society of Medicine, there are plenty of reasons to sceptical about the peer-review process in science:
David Robert Grimes says `science doesn´t make value judgements` and, in a sense, he`s right. Scientists and academic institutions are often just the innocent bystanders – unsurprisingly at the mercy of economic forces. But what science is incentivised to study is an economic (and socio-cultural) value judgement, by those that pull the strings. Even when grant money has `no strings attached` - i.e. is neutral and independent and scientists are  free to study what they wish – scientists still chose to study what they value! This choice might be shaped by a desire to adhere to intellectual boundaries to gain the respect of academic and scientific peers. 
In this sense, science definitely is a value judgment. At all research levels of academic institution – PhD, post-doc, professorship – scientific research is rarely truly independent. 
If we commit to the notion that `the facts and truth about cancer` can only be gauged by scientific trial, then whoever funds research becomes the `keeper of the truth`. For this simple reason, we should be sceptical when clinical evidence is posited as a default requirement when trying to understand what is `true` for a complex health topic such as cancer - a topic guarded to academic discourse and driven by economic forces. 
For this reason, the notion that `evidence is the benchmark of scepticism` is, actually, logically unsound. It would even be logically dubious to say that `evidence is the benchmark of scientific scepticism` because - as we have seen – objective assertions cannot always be tested reductively, for complex socio-cultural reasons. In effect, I am saying that we need to reserve some scepticism for the nature of scepticism itself. 
Pseudo-scepticism is to scepticism what scientism is to science. The problem with pseudo-scepticism is not that it´s a weaker form of scepticism – the problem is that it`s not scepticism at all. 
Scepticism is an attitude that is a vital and intrinsic aspect of the scientific method. But it depends on logic and reason, not scientific training. To put it another way - being a sceptic makes you a good scientist - not the other way around. True sceptics are open-minded. 
I argue that the word `sceptic` or `sceptical` should be abolished, because it is being abused and is not helpful to scientific discourse. Certainly, in my opinion, articles by people like DRG don`t embody the true essence of the word. `Scepticism` has become an intellectual `crack cocaine` for some members of the scientific and intellectual community. The word `sceptic` should be replaced with `objective` or `logical` or `reasonable` - because this is, essentially, what scepticism is at it`s root.

PART 3 - David Robert Grimes' ideas on vegetarianism, organic food, GM / Monsanto, and water fluoridation

Meat Consumption and Vegetarian Debate
David Robert Grimes has said (publicly):
1.      In reply to suggestion that a vegetarian diet can provide all nutrients humans need: ``Hmm...  The evidence on that is still kinda ropey. We *ARE* omnivores, and meat large part of our diet``. 
2.      In reply to a request for a good argument that justifies meat consumption: `` Canine incisors and a good reason :o) Meat isn`t so much problem as massive population requiring HUGE amounts of it``. 
3.     In reply to suggestion that the global meat industry is akin to genocide: ``You`ve compared food product to genocide. If you had a point, you`ve smothered it with hyperbole``.

4.    On vegetarian`s moral sentiment: ``You`re not the arbiter of what is or isn`t moral – subjective value judgments don`t interest me much``.  
I feel that these comments are objectionable on these grounds: 
Saying that the fact that human beings are omnivorous (and it is a fact) means that meat is a ``large part of our diet`` is not logically coherent. This is analogous to stating that agnosticism is the only logical position to take on the question of the existence of God (a fact) without providing the absolutely vital logical auxiliary that this does not mean the existence is likely in a 50/50 sense. In a logical argument about God`s existence, the two points of agnosticism and probability are inseparable. In the vegetarian debate, the 2 points that we are omnivorous but we do not need to eat much meat are equally inseparable - especially given the ecological, socio-cultural, ethical, animal welfare and humanitarian consequences of meat consumption.  
In an earlier draft to this section, I took an in depth look at our two closest Ape cousins – the Bonobo, and the Common, Chimpanzee. It suffices to say that, according to the canine argument, Homo sapiens should eat a largely vegetarian diet – since Chimpanzees (and Bonobos in particular) eat, overall, a largely vegetarian diet and yet have much larger canines. Gorillas and Orang-utans – our other closest primate cousins – eat an almost exclusively vegetarian diet. And guess what – they have huge canines! Clearly, the canine argument doesn`t make sense. This is what a Gorilla skull looks like: (Source: Wikipedia). 

Evidence and counter-arguments can be avoided at one's own convenience, but this can lead to false assumptions which (in this case) can have negative consequences for animals and the environment. I suggest you watch the documentary `Earthlings` for a look at the plight of animals all across the world. Somehow in his public comments, DRG seems to transcend the need to consider not only the bigger picture, but also the bigger question. 

The fact that DRG labels animals – sentient and intelligent beings – as ‘food product’ speaks volumes. Truly, civilised generations in the future will come to look back on how animals were treated in the 20th and 21st centuries as a horrific episode in human history. And yes, as ethically debased as genocide. As Mahatma Gandhi said, the greatness of a nation and its moral progress can be judged by the way its animals are treated. 
Intellectual enlightenment really is a pauper’s game compared to the enlightenment of the heart.  
Albert Einstein understood the deeper question when he said: `Nothing will benefit human health and increase chances for survival of life on Earth as much as the evolution to a vegetarian diet`. Indeed, if you watch the discussion between Richard Dawkins and Peter Singer about animal welfare and vegetarianism they raise the novel idea that the adoption of vegetarianism is a hallmark of an evolving culture, both in a metaphoric and Darwinian sense. Here´s the discussion: 
Vegetarianism is one of the best ways to directly contribute to a more compassionate and sustainable planet. Richard Dawkins values the ideas behind vegetarianism. Einstein realised the value of vegetarianism. 

Organic food
David Robert Grimes has said (publicly): 
·         ``Indeed – naturalistic fallacy galore – organic food is never *healthier* and requires more intensive farming! ``

Organic food is always healthier. This is because our health and the health of the environment is inextricably linked. What is bad for the environment is bad for us. It really is as simple as that. 
Arguments for organic food generally fall into 2 categories: 
1.      Organic food is healthier because it contains more nutrients.
2.      Organic food is healthier because it contains fewer pesticides and synthetic chemicals. 
Even if point 1 is false, point 2 is correct – and has been proved by scientific analysis. 
Recently, scientists have attributed Bee Colony Collapse Disorder (CCD) to the use of Neonicotinoid pesticides
I feel that DRG uses the precautionary principle wrongly here. By saying organic food is `never healthier`, I am assuming that - unless he is ignorant of the pesticide argument for organic food – DRG is urging caution against the idea of organic food on the grounds of a lack of peer-reviewed evidence. Even if this were true (and it`s not), the precautionary principle is usually always adopted from the opposite direction by people with common sense – the way it is meant.  
In my opinion, the way DRG doesn`t seem to provide this broader context and relevance of organic food displays the irony of his thinking. Given the dire status of bee colonies (a critical pollinator for our food crops), - whether organic food is, or is not, more healthy for humans is a debate akin in relevance to rearranging the furniture on the Titanic.  

Monsanto and GM food
David Robert Grimes has said (publicly):
·        ``Oddly, Monsanto get a fairly bed rep based largely on misunderstanding of the tech. But I think GM is important``.
·        ‘’Rice is dreadful for micro-nutrients though; kills/blinds lots of children hence the golden rice GM project’’

DRG appears to believe that Monsanto has a bad reputation mainly because the public misunderstands the technology. This comment alludes to the fact that he is grotesquely ignorant (or in denial) of the real reasons for the ubiquitous and growing antagonism toward companies like Monsanto. Political allying, bullying of farmers, undermining of sovereignty over agriculture of people in developing countries (masquerading as `investment` in developing countries which is, quick frankly, total bullshit), ecological destruction – these are some of the reasons that companies like Monsanto are so hated around the world. 
Watch this BBC Hard Talk discussion between Stephen Sackur and Mike Mack, the CEO of Syngenta (one of the world`s big agribusinesses and a contemporary of Monsanto). In this interview, Mike Mack reveals that companies like his are still using Neonicotinoid pesticides even in light of evidence that such pesticides have been strongly linked to Colony Collapse Disorder. Here´s the interview: 
The truth is, the actions of `Big Agri` are no less deplorable than `Big Pharma`. 
Regarding the ‘Golden Rice’ project – even if we assume for a moment that the intention is entirely honourable (e.g. the project is publicly funded as claimed) – this still leaves us with a deeper question. Does providing a mono-crop get to the source of the problem? Undoubtedly, the answer is no. Ostensibly, the reason for the invention of ‘Golden Rice’ is to provide the vitamin A lacking in indigenous rice cultivars. But this nutritional deficiency could be met by other, more ‘grass-roots’ ways such as encouraging communities to grow and develop poly-cultural agricultural systems. The land is there, and communities could be given access to a rich seed diversity. Ultimately, technological endeavours like the ‘Golden Rice’ project try to solve complex socio-cultural and economic/political problems with quick techno-fixes instead of encouraging communities (and giving them the tools/knowledge) to reclaim sovereignty over their own lives. 
Yet again, David Robert Grimes seems to look at the symptoms rather than the cause.

Watch this interesting talk by Professor Brian Wynne where he mentions the reason GM is not just a scientific question.  

David Robert Grimes wrote an article on water fluoridation. Here it is:
Another poor article by David Robert Grimes. Whether or not fluoridated water is bad for you, his article does not even raise the relevant broader question. This question is, of course, why tooth decay is so prevalent in our society. Tooth decay is almost certainly linked to poor diet, poor lifestyle choices and poor dental hygiene.  
Tooth decay, left untreated, is dangerous to health. It can even be fatal. It is for this reason why, under natural conditions, tooth decay is relatively rare in nature. Tooth decay is relatively rare in nature. It`s rare, not because animals drink fluoridated water or because animals brush their teeth twice a day. It`s rare because animals under natural conditions do not lead unhealthy lifestyles and eat processed junk food. Yet again, by thinking reductively, David Robert Grimes has produced an article which is largely irrelevant. 
Also – his philanthropic claim for fluoridated water – that unfluoridated water would discriminate against poor people who don`t have money to buy toothbrushes and pay for dental care – is a truly erroneous comment. The deeper social problems have not been addressed and, regardless, fluoridated water provides relatively little preventative value. For example, governments around the developing world allow – even actively encourage – corporations like Coca Cola to sell their acidic sugar laden drink to people in the farthest most reaches of the planet. Travel through almost any developing country (and developed country, for that matter) and you will become aware of the epic scale of the real problem – junk food is everywhere. 
Except, that is, for Bolivia – which has taken steps to ban Coca Cola and McDonald`s.  
In face of this deeper problem, whether water should be fluoridated, or not, is such a ridiculous argument. Given it`s contextual irrelevance, what`s the point of it even being put in water in the first place? 
Even if fluoridated did have a substantial effect, a cogent argument could be given to show how such measures are actually counter-productive - the supposed benefit of fluoridation might allow people to avoid the deeper problem - that is, poor diet and lifestyle choices cause health problems. DRG`s article is symbolic for the problem with our governments and medical institutions – they address the symptoms but not the cause. 
As it is, the evidence for the substantial benefit of fluoridation is, at best, spurious. Mark Dissendorf of the Human Sciences Program at the National University of Australia says: ''Large temporal reduction in tooth decay, which cannot be attributed to fluoridation, have been observed in both un-fluoridated and fluoridated areas of at last eight developed countries over the past thirty years. It is now time for a scientific re-examination of the alleged enormous benefits of fluoridation.''

Furthermore, there is good evidence that an indirect result of fluoridating water is a negative synergistic effect with lead - such that people become more susceptible to the bad effects of lead in areas where water has been fluoridated. Here are the articles:

Also, there is an interesting discussion on the history of water fluoridation in the USA-

Readers interested in the fluoride debate might want to read these articles: 


Greg Strockbine said...

you lost me as soon as you quoted a Stanford professor who said be careful of the myth-busters. As soon as I read that, I gave up on your article.

It seems like that could also apply to the debunker, ie, be careful of the debunker who debunks the debunker (myth buster).


Wow... it's been over 2 years since I wrote this article, and I was glad to see that, finally, someone was ready to engage in this important topic... only to discover that the person didn't actually bother to engage at all with the scientific arguments I present in the article.

Firstly, there isn't any logic in your implicit assumption that the veracity of the entire article can be guessed from that opening quote - a quote, by the way, that simply invites the reader to think carefully about what's really going on in any media report. And, ironically, you seem to agree that the topic of debunking itself is open to scrutiny. Perhaps you had a pre-conceived notion about my article and simply found an excuse not to read it.

Secondly, it's a shame you didn't read it because this is a very important topic, and one which DRG lacks the relevant nuance to understand - thus muddling the topic and misleading his readers.

My position has become even more substantiated following the recent study in Nature magazine which concludes that 70-90% of cancers are triggered by environmental factors. This Nature study truly undermines DRG's article 'six stubborn myths about cancer'.

zetetic150 said...

Great job. Pseudoskeptiks are make the murky job of the monopolies. More about of pseudoskeptiks:



zetetic150 said...


Pseudoskeptiks make the murky job of the monopolies.

PD. Grimmes is the principal influence of Edzard Ernst and other pseudoskeptiks.


Thanks for your comment. Yes, it is patently true that Grimes is pseudo-skeptic in his approach to health issues - any person with a grasp of logic and reason would spot this very soon upon reading his articles.

As for Edzard Ernst, I am not so familiar with his work, but from what I have read I get the sense that he also wastes a lot of time on 'debunking' things rather than simply promulgating useful information. For example, there is now a vast body of evidence regarding the link between various foods/lifestyle choices and disease prevention... the question is, why do we never hear about POSITIVE studies from journalists like Grimes?

Thanks for the link, very interesting discussion about the nature of logic and skepticism.

zetetic150 said...

Check this about of Ernst:



Thanks, interesting articles. I am 100% for evidence-based health solutions - and so if alternative approaches to medicine have been disproved [[as opposed to unproved - a critical distinction]] it's fair enough that they should be dismissed.

HOWEVER - the proponents of integrated medicine (or simply good medicine) do NOT usually mention fringe alternative approaches to medicine. They are just usually so puzzled why the orthodoxy in medicine are so reluctant to give the title ''medicine'' to proven approaches to healthcare - even though they have a solid evidence base and are therefore clearly medicinal (such as nutritional interventions, yoga, meditation, orthomolecular medicine etc).

E.g. If you have type-2 diabetes, simple lifestyle changes such as good food and exercise will effectively CURE type-2 diabetes in most instances, and thus there is no need for Pharma drugs. Here, food = medicine.

This is the real question. People like Grimes and Ernst use 'quakery' as a Straw Man argument, which just leads to black and white thinking, thus stopping rational debate. It leads people to adopt the strategy ''well, if alternative medicine doesn't work, i will just go down the pharmaceutical route'' - without realising that there is a VAST middle ground.

Because people like Grimes write so un-intelligently on health matters, they just end of polarising the discussion without alluding to the middle ground, and thus just end up misleading people and clouding the debate.

josh gorsky said...

I came across this blog because I read another article by Grimes that was so condescending and manipulative, not to mention false, that I had to read more about him. Glad to see such a well thought out rebuttal to this shill Dr Grimes. Great job and informative!


Thanks Josh. Could I ask which article in particular by Dr. Grimes you read?

Needless to say, I agree that Grimes goes about promulgating science in the wrong way - e.g. often condescending and manipulative (intellectually, at least).

I also agree that Grimes often gets his logic wrong, i.e. he makes a lot of logical errors and/or often contradicts himself, and this is best seen when triangulating what he says on different topics.

A simple example is this - he has stated that homeopathy is 'useless' because it is just the placebo effect. In another article he states that the significantly negative effects of gluten in the diet are attributive to the NOCEBO effect. But both the placebo and nocebo effect rely on the same mechanism - the mind-body connection.

Thus, Grimes uses this phenomenon selectively and in a biased way to suit the argument he is trying to present - for homeopathy, the implicit argument is that the mind-body effect is weak; for gluten - that the mind-body effect is strong. It's a contradiction, and thus a logical flaw.

Anonymous said...

Has anyone ever found out who funds DRGs research. I can't seem to find details. It might be revealing.


Thanks for your question, Anonymous. 'I don't know' is the simple answer. Even if it's the case that DRG hasn't any financial conflicts of interest (and this probably is the case), there is the question of indirect, deeper and more entrenched conflicts of interest. For example, DRG's writings have the support of 'Sense About Science' - who receive funding from pharmaceutical companies. This represents an intellectual conflict of interest which Grimes has consistently failed to acknowledge. Furthermore, as mentioned in the Wikispooks article on David Robert Grimes (and I attach the link below) - he writes for corporate media outlets that themselves have powerful conflicts of interest. All in all, this means that, even if Grimes has no direct financial conflicts of interest, the fact that he is allowed to write such poorly reasoned, biased and falsely balanced articles is a reflection of broader and blatant conflicts of interest systemic within academia, science and medicine.