Submission from Committee for the Advancement of Scientific Skepticism

at Centre for Inquiry Canada

As an organisation that promotes an evidence-based perspective on the world, CASS has several concerns regarding the regulation of homeopaths in Ontario and the commitment that the College of Homeopaths of Ontario has to protect the public from harm.  These concerns are focused on: (i) the concept of Standards of Practice, (ii) the titles used by homeopaths in Ontario, (iii) the treatment of chronic and acute illness, (iv) the role that homeopaths intend to play in the prevention of communicable diseases and the use of vaccines in their practices, and (v) the sale of prescribed products including all compounded formulae and devices by the prescribing homeopath or his or her business.

Standards of Practice

The criteria for the Standard of Practice as set out in Professional Misconduct Part I, Section 1 is a cause of concern for us. It is important when discussing Standards of Practice, to define the term “standards” as an average and agreed upon level or degree.  This becomes a problem when faced with two different conflicting standards of practice, namely “classical” and “contemporary” or “combination” homeopathy.  We are concerned that since the standard of care is so broad, being both “written and unwritten” as suggested in the explanation for this provision, that any care rendered by the homeopath and supported by another homeopath, regardless of the state of evidence of efficacy or safety of such practice, can be determined to be the standard of practice for the profession.

The efficacy of the modalities used by the homeopath should meet an “Objective Standard” as detailed in the explanation of Part I, Section 8.  This objective standard is one that exists, by definition, outside of the homeopathic doctrine.  CASS has examined many investigations into the efficacy of homeopathy and the consensus is that the modalities presented do not have sufficient evidence to support their use as treatment for any medical condition (for an example summary, see the report of the Science and Technology Committee of the U.K. House of Commons1).  We feel that the policy sets an, as of yet, unmet standard in the practice of homeopathy, and the council should consider this when setting out the scope of practice and the conditions for which the homeopath can prescribe treatment.

Use of Title “Doctor” and “Homeopathic Doctor” (HD)

In the Professional Misconduct policy, we support the inclusion of a passage specifically outlining the use of titles by homeopaths. It must be made clear to registrants (and enforced where necessary) that “Doctor” is a restricted title in Ontario and homeopaths must use the title “homeopath”.  We are concerned that despite this clear restriction there are many homeopaths in Ontario still using the restricted title “Doctor” or “Homeopathic Doctor”.  We have attached a recently confirmed list of those using either of these terms and expect this to be a tightly regulated policy when the College of Homeopaths of Ontario begins to accept registrants.

Claims to Treat Serious Chronic and Acute Illness

Many homeopaths make claims that overreach their abilities without any plausible evidence to support such claims.  These claims include - but are not limited to - being able to cure cancer, provide effective prophylaxis for malaria, and immunize against common childhood infections. These claims carry significant health risks when they lead patients to eschew effective conventional treatments. It is unethical for any medical practitioner to make misleading claims about the efficacy of any treatment, or to make any health claims that cannot be supported by rigorous scientific evidence. Genuine informed consent is not possible unless medical practitioners are entirely open and honest about the available evidence, or lack of it, for the treatments they propose.

The draft regulations do include some provisions that seem intended to address this issue. However, it is our view that these provisions do not go nearly far enough, and in any case, are, overall, far weaker than corresponding language in similar regulatory documents (e.g. those issued by the College of Physicians and Surgeons of British Columbia2).  Part 1, Section 25, of the proposed Professional Misconduct Regulations prohibits “Making a claim about a remedy, treatment, device or procedure other than a claim that can be supported as reasonable professional opinion.” This language is identical to the language governing physicians in Ontario (the Ontario Medicine Act, 19913).  However, in application to homeopaths, the language is questionable. Our concern is that “reasonable professional opinion” is ambiguous. If the standard were the same as that applied to physicians, the reasonable professional opinion would be based upon a standard of evidence that comes from empirical observation and that has been subject to rigorous scientific inquiry. A homeopath can have a reasonable professional opinion that is based upon an irrational medical paradigm, like vitalism, and provide support for a claim that is not otherwise supportable with objective scientific evidence.

Section 26, regarding advertising, compounds the problem of Section 25. While it is of course entirely correct to bar false or misleading advertising, this does not go far enough. Many doubtful claims cannot be demonstrated to be false, yet it would be entirely inappropriate for a medical practitioner to advertise services by making such claims. Medicine does not advance through the falsification of a claim but by the presentation of robust evidence supporting a claim. Therefore the standard should be that advertised claims must always be backed up by solid scientific evidence. Far more appropriate language is that proposed by the College of Chiropractors of Ontario, requiring advertising to be “accurate, factual, and contain information that is verifiable.“4

Vaccine Preventable Illness and Other Health Professionals

Section 50 of the proposed Professional Misconduct Regulations commendably requires homeopaths to attempt to collaborate with other relevant health care providers. However, this language fails to capture a serious failure of collaboration, which occurs when homeopaths actively disparage the treatment options provided by other medical practitioners. Of particular concern to us is the frequent promulgation of false and misleading information concerning vaccinations. Vaccinations are one of the most important and effective public health initiatives of modern times, responsible for saving millions of lives every year. Unfortunately, many alternative health practitioners, including a significant number of homeopaths, frequently spread scare stories about supposed risks of vaccination, and offer ineffective alternative treatments in their place5. Such misinformation, and the decline in vaccination rates it causes6, is one reason why, after years of decline, developed countries are now seeing renewed epidemics of infectious diseases - such as mumps and measles - that are entirely vaccine-controllable.

Regulated health professionals occupy a position of significant trust in our society, and patients rely on them for accurate, factual information regarding health matters. This trust often goes far beyond the professed areas of competence of the practitioner. For this reason, it is vital that homeopaths are tightly regulated regarding the claims that they may make concerning non-homeopathic treatment options, including vaccinations. Any such statements should be required to meet the same standards of accuracy and verifiability as should be required of the positive health claims made by homeopaths. Moreover, such claims should be prohibited where there is a reasonable likelihood that they will lead to unfounded fears or concerns regarding medical treatments. (Such may include true statements regarding known side effects of conventional treatments, without indicating the likelihood of such side effects, or the counterbalancing benefits expected.)

In addition to a requirement of accuracy, verifiability, and fairness in describing conventional medical treatments, we believe that the regulations must make abundantly clear the duty of homeopaths to refer patients to an appropriate physician or other medical practitioner whenever there is any risk to the life or health of the patient. This includes collaboration regarding routine and non-routine vaccination programs.

Sale of Homeopathic Prescriptions and Devices by Homeopath

It is unclear in Part II of the Professional Misconduct policy what the duties of the homeopath are regarding the sale of therapeutic substances and devices while protecting the patient’s economic status.  Part II, Section, 3 Paragraph ix covers the sale of any products and the necessity of the homeopath to inform the patient of the availability of such items by other sellers, but it fails to go as far as the College of Physicians and Surgeons of Ontario Policy 1-10 on Dispensing Drugs7 when speaking about the conflict of interest that will exist when making a profit on such drugs.  We ask that a provision such as that found in the Ontario Medicine Act 1991, Section 16(d) be added to ensure that it is a “conflict of interest for a physician (homeopath) to profit on the sale of a drug to a patient except in very limited circumstances,” (CPSO Policy 1-10).  Those circumstances are set out in the Medicine Act above and concern only emergent and life-threatening situations.

In the light of this legislation and policies, it is obvious that a conflict of interest occurs when a homeopath profits from the dispensation of homeopathic preparations and this should be considered professional misconduct.

Conclusion

  It is clear to us that the Transitional Council, in producing the codes of conduct for its registrants, must take a very close look at the evidence supporting the practice of homeopathy, and when dealing with serious or potentially serious illnesses, restrict any practice that would endanger the public through non-evidence-based interventions or advice to eschew standard mainstream medical care in favour of homeopathic care.  We believe that due to the rising interest in homeopathy in Ontario a regulatory college is required to ensure a defined standard of practice and we hope the Transitional Council will focus its efforts on protecting the public rather than protecting the profession.

References

  1 UK House of Commons Science and Technology Committee (2010) Evidence Check 2: Homeopathy, HC45.  http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf

2 College of Physicians and Surgeons of British Columbia (2009).  Resource Manual: Complementary and Alternative Therapies.
https://www.cpsbc.ca/files/u6/Complementary-and-Alternative-Therapies.pdf

3 Ontario Medicine Act (1991), Part 4, Section 15.
http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_940114_e.htm#BK1

4 College of Chiropractors of Ontario (2009) Proposed Regulation: Advertising.  http://www.cco.on.ca/site_documents/Proposed%20Advertising.pdf

5 Ernst, E. (1997) The attitude against immunisation within some branches of complementary medicine. European Journal of Paediatrics,  156: 513-515.
http://www.springerlink.com/content/daq9mb133a837qxt/

6 François, G., Duclos, P., Margolis, H., Lavanchy, D., Siegrist, C.-A., Meheus, A., Lambert, P.-H., Emiroğlu, N., Badur, S., Van Damme, P. (2005) Vaccine safety controversies and the future of vaccination programs. Pediatric Infectious Disease Journal, 24 (11): 953-961.
http://journals.lww.com/pidj/Abstract/2005/11000/Vaccine_Safety_Controversies_and_the_Future_of.3.aspx

7 College of Physicians and Surgeons (2010) Dispensing Drugs (Policy 1-10).  http://www.cpso.on.ca/uploadedFiles/policies/policies/policyitems/dispensing_drugs.pdf.

Homeopath Using Restricted Term (Last Checked Aug. 2011 – evidence upon request)

1. Public Health: Homeopathic practitioners are starting to call themselves doctors despite clear restrictions on the use of that title.  This may confuse the public when they are trying to chose the best health care for themselves and their family. What steps will you take to protect Ontarians/Islanders from fraudulent claims by homeopaths and other alternative medicine practitioners?

2. Scientific Integrity: Many government scientists in Canada have been reporting political interference in their job.  What are the risks of elected officials filtering the products of governmental research to suit political needs and how will you balance scientific information, including statistics, with politics and personal beliefs when making a decision?

3. Climate Change:The Earth’s climate is changing and there is concern about the potentially adverse effects of these changes on lives of Ontarians/Islanders. What is your position on the following measures that have been proposed to address global climate change-a cap-and-trade system, a carbon tax, increased fuel-economy standards, or research?  Are there other policies you would support?

4. Education: Critical thinking is an important skill for children to learn early if they are to become good citizens.  How will you support the teaching of critical thinking to young Ontarians/Islanders?

Questions 2 and 3 were produced with the help of sciencedebate.org. Due to varying ways we were able to contact the candidates we were unable to contact fully every party, save for the Green Party of Ontario, approximate representation is detailed before each major party.  We did not contact any other parties than those listed here. The following responses have been received to date: 

Liberal Party of Ontario 

About 1/3 to 1/2 of the LPO had email addresses with the remaining web forms or other formats for contact. A single response from Deb Matthews, London North Centre was received:

Thank you Michael,

I’ve passed on your e-mail.

As you are out of riding, you may also wish to contact the candidates in your riding.

To find your local candidates please visit:

http://wemakevotingeasy.ca/en/find-your-candidate.aspx?channel_id=&lang=en

Progressive Conservative Party of Ontario

Only a small number of PC candidates had email addresses. A single response from the PC party was received.  Not surprising, as we did not have the resources to fill in all of the web-form based contact tools provided by the PC party and after several hours work only managed to get through 1/3 of the PC candidates.  Rod Jackson - Barrie responded below:

 Thank you very much for your comments and inquiry.  Your e-mail has been received and will be replied to at the earliest possible moment.
Campaign time is extraordinarily busy and I apologize for any delay.  In the meantime, please see the attached document, Change Book, for more information about our intended policies.

I appreciate your interest and hope I can count on your support on October 6th!

New Democratic Party of Ontario 

We recheased approx. 80% of the NDP candidates in Ontario and received this one response: 

Adam DeVita - Richmond Hill 

1. The medical profession in Ontario is a self-regulating and enforcing body. From your question it seems that you are unhappy with the level of enforcement of the right to title. There is ambiguity between an MD and a PH.D as both have the use of the title. It would be best for the government to work with the profession on a solution.

2. Thank you for this question. This is critically important. In our over-partisan era where far too much heed is paid to vested interest this is a big problem. I recall a set of statistics reported by the previous PC government, claiming that a cretin percentage of welfare recipients now had jobs, therefore their reforms worked. Since it was a phone survey, they simply did not report the number of former welfare recipients who no longer had a phone, thus excluding those who lost at least their phone service as a result of their reforms and inflating the results. As a Professional Engineer, I am a scientist before I am a politician. If real data is contradicting theory, it must be viewed as an opportunity for learning. I enjoy mathematics and am happy to identify and question political arguments based on statistical trickery by spin doctors. One of the things that has attracted me to the NDP is consistent support for government scientists and support of ‘whistle blower’ protection. The NDP has been questioning the very economic policies that lead to the crash of 2008+ for many years, even if this position was unpopular. Last week I gave a speech to our local chamber of commerce arguing that studies from the USA in the late 1990s showed that the minimum wage workers spend the bulk of their income in the local economy. Raising minimum wage has been demonstrated to be good for the economy and create jobs. (See Dr. Ravi Bata’s book “Alan Greenspan’s Fraud” (2005) for the published data)

3. The NDP is supportive of a cap and trade. This technique worked well for sulfur emissions. We do not support a simple carbon tax. We do support increased fuel efficiency standards. We will improve the standards for buildings, appliances, and electric motors. We are offering a series of tax credits and supports to help people save power and reduce their cost of living without affecting their standard of living. We are also helping businesses that invest in their buildings. We plan on investing in renewable energy, and conservation where it is cost effective. Environmentally speaking, 1MW saved is better than 1MW generated. We will invest in transit to freeze fares, thus helping people choose transit as a more effective form of transportation. Our affordable housing strategy must also be considered as part of the fight against climate change, because the lack of affordable housing increases pressure to allow urban sprawl.

4. We will fund education so that students can focus on their studies and extra-curricular activities instead of fund-raising. Critical thinking skills are part of our education. If our education system has the proper resources, I would expect our Professional Teachers to succeed at their job. Further to that, the best thing an MPP can do is lead by example.

Green Party of Ontario.

The GPO was the quickest and most comprehensive response.  We had email addresses for all GPO candidates. It is important to mention that there is no formal relationship between the Green Party and CFI and our membership spans all parties.  Our former Executive Director Justin Trottier is currently running in Parkdale-Highpark and had no hand in the fashioning of the questions or their distribution.  The order of the responses is as they were received. 

Alex Brown- Burlington

Public Health:

The professional designation of Doctor needs to be protected in Ontario as you have said, as well as all of science based medicine. While there is some room for homeopathic medicines (read placebos) the use of the term doctor by someone who has not gone through the trials and tribulations of medical school should be fined under an escalating system for the use, and continued use of the protected title of Doctor

Scientific Integrity

To put it simply, what you are describing here is the foundation of Lysenkoism. This has the danger of litterally costing lives when scientists and doctors simply do not understand what they are doing because they are working towards funding for political overlords. I would strongly push for the changing of tort law to help limit just what powers elected officials have over the scientists working under them.

Climate Change:
Change in the Earth’s climate is a very real concern that we as a people need to address, though we have to be wary of band-aid solutions that promise a quick fix. Cap and trade has always seemed to me to be something akin to slight of hand, and while I do think a carbon tax is in many ways a good idea, we have to be careful on how we implement it. Research into new technologies is something that must be done, though if they’re technologies such as better fuel efficiency in internal combustion engines or into applications of helium-3, will depend on the quality of the research proposal and the current levels of funding.

Education:
Critical thinking is something that is often fostered by math and the sciences, to that end what I would support would be an increase into the level that science is currently taught to our students in the lower grades, and as such in the higher grades, as well I would support an increase to things such as province wide science fairs. Lastly I would support the addition of logic classes into the curricula, in the lower levels of schooling, so that students can actually understand much of the beauty of math. (If you haven’t guessed my major in university is Math/Comp sci, so I breath math and logic, and rather dislike what has been done to mathematics)

Frank DeJong - Davenport

1. The best way of guarding against fraudulant practicioners and their claims is to ensure that all practitioners are required to demonstrate a proven body of knowledge, and that they are governed by self-governing bodies like other professionals.

2. Agreed that this is a problem. There should be as much separation as possible between elected officials and research, stats, etc. Transparency in decisions, ombudspeople and open book policies will help.

3. The best approach is through a carbon tax as part of a revenue neutral shift off of other taxes. This market mechanism will drive efficiencies like fuel economy without government intervention.

4. Firstly, Ontario should abolish the Catholic school system and move to one school system. Ontario teachers should be assisted in learning how to teach higher order, open ended critical thinking at teacher’s colleges and through in-service training.

Chad Durocher - Windsor West Candidate

1. I believe that only a certified doctor can use the title.  It is fraudulent to mislabel or misdirect the public in such a way.  If a certified doctor also treats patients with homeopathic measures, the patient must be told the difference between the alternative medicine and the suggested prescription.

2. I believe that the scientific community needs to report to the governing body the results that they find the to be the most most accurate.  If you are referring to government money being spent to do special interest projects, they should be reported immediately.
If the research has been done properly, the results should be uniform and correct, with little ability to sway results.

3. I support a decentralized green energy grid (solar, wind, bio-mass, bio-gass…), research to develop better measures to create and conserve energy, and a carbon tax that has incentives to reduce pollution..

4. I believe we should fund one school board. A single school board that reaches out to the diverse french and english population of Ontario.  I personally dream of a day that every student has the chance to be educated in a secular environment. Scientific evidence shows that religious indoctrination is not needed for a student to mature intellectually and socially. In fact, I believe that religion separates and misleads our young. The children should be taught what the religions are and how they affect ours and other societies, much like greek and roman mythology.

James Mihaychuk - Ottawa South

1. With regard to homeopathy as I understand it, there is apparently no scientific evidence to support the practice. I am therefore opposed to what I believe to be false claims made by distributors of these products. With regard to “other practitioners” I find that your question is both ambiguous and biased in its formulation. Where any form of treatment is scientifically proven to be of benefit through peer-reviewed scientific research that observes academic, medical, and ethical standards, it should be considered for a role in the delivery of health care based on its efficacy alone. The specific type of practitioner delivering the service is an important but secondary concern.

2. The practice that you referred to must stop. Peer reviewed research reports of all kinds should not be filtered by other entities. The authors of such reports should be free to discuss their work as part of the necessary and normal exchange of scientific knowledge.

3. The Green Party of Ontario proposes to implement carbon pricing if elected. In addition, Green MPPs would implement significant energy conservation and retrofit efforts. We would invest in new programs to help implement new or upgraded community and shared power plants providing combined heat and power. We would provide ongoing stability to industry and consumers for micro-FIT renewable energy projects. We would stop the Liberal plan to add 45% more nuclear power by 2030. Instead we would develop capabilities to import hydoelectricity from neighbouring provinces that currently export mainly to the northern USA.

4. Through continued, stable support of a sustainable system of public schools and libraries. In particular, Greens would increase education around healthy food, local farms, and affordable and available suplies of food. In this way our schools will help our students understand the connections between their own health and costly and debilitating diseases such as diabetes, heart disease, strokes, and cancer.

Mark Daye - Toronto Centre

 1. I’m very concerned with the trend towards homeopathic practitioners calling themselves doctors. The residents of Ontario deserve the best health care the world has to offer and need clear and concise information. I believe we need to ensure that the current guidelines are strictly enforced so residents know exactly who they are dealing with and what type of assistance they are getting.

2. Scientific Integrity is of the utmost importance and the results of independent scientific research and verified statistics must be accepted regardless of one’s political, religious or other beliefs.

3. The Green Party has a plan to implement a BC style carbon tax system, which I fully support. It’s time to move taxation to the things that we don’t want in our society and reduce tax on things like personal income. I strongly support the research of new energy technology and disagree with the generous subsidies that are doled out to the dangerous nuclear and dirty oil industries.

4. Let’s begin by restructuring our educational funding and create one publicly funded bilingual secular school system that celebrates diversity and teaches science based theories.

Erik Coverdale - Ancaster-Dundas-Flamborough-Westdale

1. I am an Engineer by training but it is unlawful for me to call myself an Engineer until I get my P. Eng licence to practice. The same principle should apply to doctors. It is the Professional Engineers Act, R.S.O. 1990, that makes this law. I would pass a similar law to protect the public from individuals misrepresenting their education and skills.

2. Skewing the data to advance a political agenda is unethical and should be taken seriously. I would call on an official to resign who has obviously done this.

3. I support a carbon tax, increased fuel standards, research into alternatives, and moving to carbon free alternatives that are available today.

4. Excellent question. I think it should be an addition to the current curriculum. Example: students should hear 2 or more sides to an issue, and decide which is right using logical reasoning. This would help them understand there is much information out there that isnt credible or correct… and even credible information is sometimes wrong!

Erik Stark - Scarborough Southwest 

1. Good Science requires both skepticism and open-mindedness. We need to look at homeopathy and other alternative health systems in a clearly un-biased scientific light. We must recognize that so-called scientific studies frequently carry a bias dependent on who the sponsor is and where their interests lie. Whatever studies there are should be presented and interpreted by both promoters and detractors so the public can make up their own minds on what is the best course of action for themselves.

2. I can think of a couple of examples. Back when John Crosbie was the minister of fisheries, and even before that, it was not politicly acceptable to warn of the imminent colapse of the cod fisheries off Newfoundland. The fishing industry was too heavily invested in overfishing the stock. As a result we had a catastrophic decline and the industry colapsed. And there are a number of cases when scientists at Health Canada were pressured by business interests to approve drugs that we clearly a cause of concern, many of which are documented by Shiv Chopra in his book “Corrupt to the Core”. We clearly need strong legislation that will protect scientists, and allow them to report their findings directly to the public without political interference.

3. We strongly favour a revenue neutral carbon tax - we are the only party to do so. I recently read Dr. James Hansen’s book “Storms of my Grandchildren - the truth about the coming climate catastrophe and our last chance to save humanity”. There he effectively argues against cap and trade. Of course we also favour increased fuel-economy standards, more research and support for our scientific and educational institutions in their efforts to find solutions to this crisis.

4. You are absolutely right. I can’t claim to be an expert on educational methods, but I think reading Plato would be a good first step. Teaching Logic and subjecting the comments of our politicians to critical analysis should be part of our high school education system.

Trifon Haitas - Oak Ridges-Markham*

*the following answers were prefaced with the note: “Below you will find the answers to your 5 questions by Oak Ridges-Markham Green Party Candidate Trifon Haitas.” Question 3 was not responded to.,

1. Fraud is a very serious offense and even though I am supportive of alternative and or homeopathic practitioners, I do not and will not support fraudulent claims made by homeopathic practitioners and or any other recognized conventional doctors. Fraud is a crime and must be dealt with according to the laws set to protect our community.

2. There exists a very grave risk when elected officials filter research to suit political needs. I If elected as MPP in Oak Ridges-Markham, I would do everything within my power to ensure that scientific information, including statistics is made available to the the community whose tax dollars went in to fund the study. We as politicians can not and ought not to ever withhold any scientific data from the public because of our personal and or political affiliation.

4. I fully agree that critical thinking is a very important skill that ought to be taught in our schools and when called to do so, will fully support our educators when they promote this particular skill as part of their curriculum.

Tim Grant - Trinity-Spadina

Hi Michael.  Sorry.  As you can appreciate, I receive lots of similar emails both from local residents and from organizations.

When a letter writer does not even bother addressing an individual candidate, I hope you understand why - in the middle of a busy election campaign - I would choose not to take the time away from canvassing local residents to answer such questions.

Feel free to get back to me after October 6th.

All the best in your efforts,

Tim 

Patrick Main - Huron-Bruce

 I appreciate your letter, and I understand your concerns! The best answers that I can provide you with at this point are taken straight fro the Green Party platform. I myself am quite new to politics and am not able to provide you with detailed answers at this point, however I will be sure to pass these concerns along to other GPO candidates and discuss possible solutions.

My primary reason for getting involved with the Green Party, was that I felt that they were the only party that truly have the best intentions for the public. Since this is not a sector that I am particularly familiar with, I would really appreciate YOUR suggestions on how to protect Ontarians from said fraudulent claims.

We are proposing a shift in taxes as an attempt to address climate change. We’re in support of the taxation of waste and carbon. We are taking many steps towards learning how to live sustainably, and it’s largely outlined in the platform will link to this email response. Specifically, we want to work towards replacing coal plants with other forms of renewable energy that aren’t of detriment to the environment. The GPO wishes to prioritize energy efficiency and conservation.

In terms of education, I am a firm believer in training young people to be critical thinkers. One of the strengths of the Green Party of Ontario’s platform in the last election was its plank to merge the catholic and public school systems. This would provide children with a much needed sense of equality and acceptance from a young age.

This year, the GPO is focusing on developing youth employment opportunities by updating and strengthening our education system

a. Freeze tuition for the 2012-13 school year while maintaining university and college budgets; index tuition increases to the rate of inflation from 2013-15

b. Expand training and certification programs in job growth areas such as green buildings, biomedical technology, renewable energy and sustainable transportation.

c. Increase investments in apprenticeship, co-operative and mentorship programs

I am personally most passionate about supporting our small and local businesses, farmers and artisans to create a strong local economy, and that’s what I’ve been emphasizing in my personal platform. My political involvement is based solely out of a genuine care for the people in my community, and a desire to make improvement. I would love to discuss these issues with you in greater detail at some point. Don’t hesitate to call if you have any other questions for me, but it seems like I may have more for you! Hope you’re having a great weekend! Follow the link to the GPO platform.

http://itstimeforgreen.ca/jobs/index.html

Kevin Labonte - London North-Centre 

1. The Green Party has not addressed this issue in our platform, but I will strengthen the regulations on products and services that make health claims, and increase the penalties placed on those who make unfounded claims. Such policies and regulations will require input from a wide range of practices, from medical to legal, to ensure it is fair an accurate.

2. I am opposed to any political interference in Scientific reporting. Science deals in facts not opinions. When Politicians begin to change facts into opinions to suit a political agenda we do a disservice to the public we are sworn to serve. However, we are human, and we are prone to mistakes. We need to encourage politicians to embrace the words ” I was wrong” and ” I don’t know”
Although not in our platform, The Green Party will not censor any research we’ve commissioned, the scientific community will have the opportunity to review and critique such research.

3. The Green Party openly supports a Carbon Tax, It has been stated by James Hansen, Director, NASA Goddard Institute for Space Studies, to be an effective form of pricing to reduce our dependency on fossil fuel. And it has proven popular in British Columbia. (http://bigthink.com/ideas/17890) I am however opposed to Cap and Trade, as that system does not do enough to reduce pollution and only serves to generate profit.(http://www.nytimes.com/2009/12/07/opinion/07hansen.html?_r=1)

Clearly both systems are not the silver bullet answer we seek. We need to continue to invest heavily in fuel efficiency and renewable energy research. We also need to listen to the best advise our researchers and scientists provide. Our Party is committed to improving energy and fuel efficiency to help both our environment and consumers pocketbooks.

4. I believe we need to remove pseudoscience from our science curriculum, and emphasize the scientific method and critical analysis. In other classes we should encourage students to make and accept mistakes in the pursuit of the facts.   

Kyle Jones - Renfrew-Nipissing-Pembroke Candidate

1. I support the licensing of the regulation of health care providers whose practice can produce solid research and clinical trials that has been subject to scrutiny by the health care community.  It is my position that licensing a health care provider tells the public that they are in fact receiving legitimate care.  If the Homeopathy community is able to provide solid evidence of it’s legitimacy then I would be happy to support their regulation. 

2. I feel that all decisions made in policy development require unbiased and scientific evidence.  It is my intention to maintain an open mind and integrity through any decision making process.  I do however believe in democracy and will ultimately subside to the will of my constituents.

3. A greener Ontario is the fundamental basis for the Green Party platform.  I believe that through advancing our investment in green research and adopting a carbon tax we can create a healthier Ontario, and one that has 21st century sustainable jobs.  I also support investment in high speed rail and public transit systems to free Ontario from being forced to drive and waste its valuable time and money stuck in traffic .

4. I support some substantial changes to the current system of education, it is necessary to remain objective and free from prejudice when designing curriculum for the children of this province.  Critical thinking skills can be taught by offering students logical and scientific course content that include multiple viewpoints on subject matter.  In addition I would also support healthy breakfast programs and an increase in arts, home economics and life skills course options for students.

Robert Rose - Kitchener/Conestoga  

1. I will need to research these points further prior to making a statement.

2. The GPO will eliminate these back room type deals that ruin the publics view of politics in our country. 

3. I support a carbon tax if those funds are returned back to research new green vehicles.  Research the potential of making hybrid or fully electric vehicles the Ontario standard, starting with government vehicles and giving tax breaks to lower the cost of purchasing hybrids.  Retrofit buildings to be green.

4. Continue to offer full day kindergarten, french immersion and environment based classes.  Get children exercising more in a day and from grades 1-12.

Donna Cridland - Welland

1. The Green Party believes in a sustainable, public health care system that provides every Ontarian with access to the quality health care they require, when and where they need it. Health care patterns have shifted dramatically from the 1950s when our current system was designed. At that point, needs were primarily for acute care. 

Today, broader health needs include prevention, treatment and long-term management of chronic illnesses. In addition, new technologies, treatments and medications that were not foreseen by the original planners have been developed to diagnose and treat illnesses. 

In multi-disciplinary family care teams, all key primary care health professionals work together, on a 24/7 basis. Experts agree that collaboration with other health professionals - pharmacists, nurse practitioners, physiotherapists, ultrasound technicians, home care workers, dieticians, and specialists, is an effective way for doctors to work.  We also need to use each profession’s competencies to the maximum. Ontario’s regulation of health care professions hasn’t kept pace with the evolution in the education and training of health care professionals, nor with practices in other jurisdictions.

Using each of Ontario’s more than 100,000 health care providers’ abilities to the fullest would create more capacity and enhance access to health care services. Expanding each professions scope of practice to match proven competencies enables the same services to be delivered by the most cost effective provider, promotes patient choice and helps to address wait lists and the physician shortage. This would provide better value for money in the health care system.  This way, patients get timely access to the right treatment and diagnosis, when they need it. This helps us stay healthy and heal faster, and improves the sustainability and efficiency of our health care system  Amend profession-specific acts of regulated health care professions to allow members of those professions to practise to the full extent of their demonstrated competencies as verified by their respective regulatory bodies.

2. SThe Green Party will deliver a government that works for people  We need a new approach to government, one where you and your community-not political insiders-come first.  It’s time for a new political culture in Ontario.  Electing Green MPPs will bring a breath of fresh air to Queen’s Park by rejecting hyper-partisanship and short-term thinking focused on getting votes. Our Green MPPs will:

Ensure open, transparent and accountable
government

End backroom deals and no-bid
contracts

Open government consulting
contracts up to scrutiny by posting details of all public contracts online

Streamline freedom of
information requests

Ensure public officials are
held to the highest standards

3. The Greens will lower business and income taxes while balancing the budget with a price on carbon based on the popular and successful BC model.

A simple, straight forward price on carbon, modelled after the popular British Columbia system, is the most efficient and cost effective approach to reducing greenhouse gas emissions.  Putting a small price on carbon provides the market incentives to spur innovation and entrepreneurialism to prepare our businesses to compete in a world with carbon pricing.

Carbon pricing is widely regarded as the only way forward to reduce emissions and promote innovation in green technologies.  A simple price on carbon is easy to administer and can be implemented now, unlike cap and trade schemes that are complex, easily abused and require trading partners that simply do not exist today.

The consensus supporting a carbon tax is growing. The following individuals and organizations are only a few of the many that have spoken out in favour of carbon pricing: Canadian Council of Chief Executives, The Economist, and Dan Reicher, Director of Energy Initiatives, Google.org.

4. The Green Party of Ontario fully supports the implementation of a full-day Early Learning Program.  However, the method in which it is currently being rolled out is deeply troubling. 

The Liberals aim to justify this program using literacy and numeracy standardized testing. The Green Party believes this is the wrong approach. We support full-day programs that stimulate creativity and growth. These are things that standardized tests clearly cannot measure.

Patti Chmelyk - Brampton West 

1. Have you noticed that many of the Green Party candidates are scientists?  We believe in scientific evidence.  And I do not agree with the misuse of the title Doctor - just as I do not agree with the misuse of the title Engineer.  Misuse and/or abuse of these titles that may cause misunderstandings with the public must be addressed legally.  Certainly implementing a process and negotiation would be appropriate. 

2. I have personally been a loud voice for the scientific community and will continue to be.  I am shocked with the interferance of politicians in the area of scientific research and the reporting on such research.  The Green Party believes in evidence based governance.  I would personally be a strong provincial advocate to the Federal government to re-instate the long form census. 

3. Personally, I think a carbon tax, increased fuel economy standards and research are the ways to go.  A cap and trade system does not make any sense to me at all.  The Green Party is always open to looking at best-evidence solutions to all issues.

4. One of the most important ways of teaching critical thinking is to get children reading literature that addresses difficult situations that challenge the way things are.  The teaching of history, particularly the ideas that come out of historical conflicts and crises, would be a critical contribution to the nurturing of critical thinking.  Media studies and advertising would also be areas of study that should be thoroughly covered every year - getting more in depth as the children age.  Daily world, national, provincial and local current events should be discussed/covered in the classroom.  And, of course scientific study and the scientific method must be taught in ways that leave no room for misunderstanding.  Of course, there is still my own personal favourite method for raising (3 adult children) critically thinking adults - “Question authority - NOT your mother”

Edward Yaghledjian - Durham

I shall incorporate several answers in one response. The responsibility of government is to assess the logical reasoning from professionals. It is not the position of politicians to avert and dispose of information if it does not benefit special interest groups. Clear transparent mehodology is the first and key step to sound government reasoning and social welfare.
Government is elected to protect and lead the population not to make use of the masses.

The Green Party platform begins with transparent governments. The very position of the green party is to assess analyse then deliver verdict on any future steps with full backing from the public for they were made aware why decisions are made in the manner they were. We will not force upon specialists in their fields to alter data or mislead the public by eliminating certain data.

We will penalize those who would be the greatest polluters and reward and assist those who not only look to reduce but have established low pollution level. This creates a fair playing field.

Most important is the understanding that sound educated public makes educated choices, thus leaned individuals are encouraged to speak and educate all of us. 

W. Peter Randall - Hamilton East - Stoney Creek

Question 1 

Your Green MPPs will:
1. Make health promotion and illness prevention a top priority
a) Support the development of healthy, liveable, recreation-friendly communities
b) Ensure clean air, water and food by reducing pollution, improving water quality and sewage treatment, and by paying landowners for producing healthy environmental goods and services
c) Provide incentives for people to pursue healthy lifestyles and support school-based nutrition, outdoor education and athletic programs
2. Reform health care delivery to ensure all Ontarians have access to quality community health services
a) Re-prioritize funding to support doctors, nurse practitioners and other health professionals for family/community care clinics that are integrated with public health
b) Put communities back in charge of local health care decisions
c) Finally deliver on electronic health records by using best practises from other places
3. Honour our seniors by improving the care available to Ontario’s aging population
a) Ensure that seniors receive the continuum of care they need where they want it by improving home care, transitional care, assisted living and long-term care
b) Create case managers at the family clinic level to proactively coordinate the care seniors need
c) Support all long-term care facilities to provide services in compliance with provincial standards

All professions need an accredited body and all Ontarians need to be aware of the risks, the services and their level of expertise and training. Then as long as practicing under those guideline sit is okay. We have to chase down shysters and illegally practicing vendors ruthlessly and tirelessly but those operating under the associations guidelines and licenses are fine and they should serve their role. Let the buyer beware, how many thousands buy lottery tickets which are ea complete sham and waste??

You believe in a certain doctor then that can be the best thing as it is often in the mind and how you feel can be the key to recovery. To each his own.

Question 2

Yes statistics can be made to say anything you want them to say…a serious problem indeed. All studies nee to be independent transparent and without coercion.

Your Green MPPs will:
1. Ensure open, transparent and accountable government
a) End backroom deals and no-bid contracts
b) Open government consulting contracts up to scrutiny by posting details of all public contracts online
c) Streamline freedom of information requests
2. Remove barriers that prevent citizens from being heard
a) Implement a community engagement process and restore local decision making for energy projects
b) Ensure that residents have a say in community health care decisions
c) Give citizens a greater say in public consultations, including strengthening the Environmental Bill of Rights, reforming the Ontario Municipal Board and ending lawsuits that prevent citizen participation in planning decisions
3. Ensure public officials are held to the highest standards
a) Strengthen conflict of interest rules for provincial and municipal officials
b) Disclose public officials’ expenses in a timely way
c) Eliminate corporate and union donations to political parties
3. Climate Change:The Earth’s climate is changing and there is concern about the potentially adverse effects of these changes on lives of Ontarians. What is your position on the following measures that have been proposed to address global climate change-a cap-and-trade system, a carbon tax, increased fuel-economy standards, or research?  Are there other policies you would support?

Question 3 

Your Green MPPs will:

1. Prioritize energy efficiency and conservation to reduce Ontario’s energy consumption
a) Save you money and create jobs by reinstating and expanding the home energy savings program as part of a comprehensive Green Building Program
b) Capture waste heat from chimneys in large buildings and turn it into electrical energy by increasing generation targets for combined heat and power
c) Remove barriers so entrepreneurs can save us money with innovative technologies in conservation, efficiency and a new smart grid
2. Pursue a secure and financially responsible energy supply
a) Require local participation in energy projects; support micro-generation and community-based renewables that generate local benefits
b) Negotiate agreements to purchase inexpensive hydroelectricity from neighbouring provinces and increase hydro generation in Ontario
c) Protect our pocketbooks by opposing construction of new nuclear plants and prohibiting cost overruns for nuclear projects from being passed to rate-payers and tax-payers
3. Implement a sustainable transportation plan to reduce gridlock and lessen the impact of rising fuel prices
a) Promote efficient, liveable communities where streets and roads are safe for all users
b) Reduce commuting costs by supporting transit and affordable commuter benefits including incentives for ride-sharing, more high-occupancy vehicle lanes, and tax credits for public transit users
c) Increase incentives for low-emission, fuel-efficient and electric vehicles

Question 4

You Green MP’s will

Develop youth employment opportunities by updating and strengthening our education system
a) Freeze tuition for the 2012-13 school year while maintaining university and college budgets; index tuition increases to the rate of inflation from 2013-15
b) Expand training and certification programs in job growth areas such as green buildings, biomedical technology, renewable energy and sustainable transportation
c) Increase investments in apprenticeship, co-operative and mentorship programs

Steve Dyck - Guelph

1. We see peer-reviewed alternative medicine to be important, also health promotion. Your question refers to homeopathy in particular, and we would advocate for strong, reasonable guidelines to help guide the public and protect them from fraudulent claims.

2. Scientific integrity is of the upmost importance. We have seen the problems with ministers dismissing scientific evidence, and we would work to have some of the most informed MPPs. We have been calling for inquiries into questions that other politicians didn’t want to, for example, a full environmental review of the Mega-Quarry.

3. The Green Party believes that we need to factor in so-called “Natural Capital” into our financial system. The easiest way to do this is to provide market incentives to do such. Part of our Green-Tax Shift would resemble the carbon tax that has been very popular in B.C. We also advocate for more transparent and accurate energy pricing. We oppose removing any taxes from gasoline, oil, and electricity. By showing the true costs of electricity, we can encourage renewable energy (which is cheaper in many cases than traditional sources). Taxing waste, inefficiency and pollution will help create market forces towards cleaner energy technologies, create jobs, and position us on the world stage.

4. We need to help encourage our children to think clearly and critically. Part of this will be through transparency. It’s very difficult for children to understand what’s going on when they only see part of the issue. We also strongly oppose all attack and fear-based advertisements, which do nothing other than play to emotions instead of to issues that are important.

Josh Rachlis - Eglinton-Lawrence

Sorry for the delay in replying. I’m sure you know how busy
campaigning gets. But I want you to know that you have my full
support. The Green Party of Ontario is committed to science, reason
and fairness, and to health and the environment. I’ve had Laurie David
herself tweet to her followers that I will be leading a new green
revolution. So you don’t have to sell me on the reality of climate
change! :) Also, I studied psychology with famed skeptic James Alcock.
I’m committed to a school system uninfluenced by religion. And to show
you how much on your team I am, I’ve written a quick, fun little song
specifically in response to your question:

http://www.youtube.com/user/JoshRachlis?feature=mhee#p/a/u/0/AuSvwiJcwfs

I invite you to share it with your friends and colleagues who are also
concerned about this issue.

Also, you can:

Save a tree by sharing my musical, paperless flyer, which is a fun
song: http://bit.ly/DigitalFlyer
See my videos and Like my page at http://facebook.com/JoshRachlisGPO
Follow my tweets at http://www.twitter.com/joshrachlis
Watch my campaign and eco-comedy vids at http://www.youtube.com/joshrachlis
Get a sign for your lawn by emailing me back with a request

And you can check out some great eco press I’ve been getting this week:

http://www.thestar.com/news/article/1064116—the-candidate-with-the-singing-campaign-flyer

http://www.metronews.ca/toronto/local/article/987009—this-song-goes-out-to-all-his-constituents

http://toronto.ctv.ca/servlet/an/local/CTVNews/20111003/ontario-election-close-races-eglinton-lawrence-111003/20111004/?hub=TorontoNewHome

Brian Chamberlain - Richmond Hill

1. Support enforcing the use of the term “Doctor” for only licensed medical doctors and those with a doctorate degree.

2. I am a trained scientist first and foremost and will always defer to science.  We can choose our opinions, but not our facts.  Government meddling in science must be prevented.

3. I and the Green Party support a carbon tax and increased fuel-economy standards.

4. I’m not a specialist in education at the early levels.  I teach in college.  I do support teaching techniques that can be shown to develop critical thinking in youth. 

Scott Warner - Mississauga-Streetsville

1. We as a prty support a focus on prevention and reduced overhead burden in our healthcare system, me personally I make a clear distinction between professional healthcare services and providers and alternative medicine. I do not view the term alternative medicine as derogatory. 

2. Personally -politics must be reduced in our public science today - if they will not fullfill a role of healpful particpant then corporations must be brought into line witht he good of the public. I am interested in a purer science that we see today.

3. More science less politics . Carbon tax - yes, but not because of AGW, to incent the transition to non hydrocarbon based power and energy

4. Force each grade 5 class to attend a field trip to the perimieter Institute.

 Good morning, William.
I apologize for not getting a response back to you sooner.
 
I appreciate your thoughts regarding the Phiten products, and as such, have altered our product description on our website. I have also forwarded your comments on to our representative for the Phiten products and am interested to see what their company response will be.
 
Our online store’s function is to generate revenue to assist in DUC’s wetland conservation mission and we try to do our absolute best to raise money for our conservation efforts by offering fun, unique and interesting items for our members’ enjoyment. The titanium products, which we view quite simply as a fun camo accessory, were suggested to us by a Ducks supporter as a retail idea and we are pleased that they have been good sellers for us.
 
I thank you for sharing your comments and trust that this information will address your concerns. Thank you for your ongoing support of DUC and our wetland conservation mission. The valuable contributions and feedback received by supporters like you are the reason behind DUC’s success on the landscape.
 
 Much appreciated,
___________________________
Elizabeth Wilson
National Manager Retail Programs
Ducks Unlimited Canada
Phone: (204) 467-3251
Fax: (204) 467-7305
http://www.ducks.ca/
Canada’s Conservation Company

Success! The website description went from this:

“Phiten products work with your body’s energy system, helping to regulate and balance the flow of energy throughout your body. Proper energy balance helps to alleviate discomfort, speed recovery, and counteract fatigue. Tire less easily and recover faster from intense physical activity! “
 

....to this:

Phiten’s classic 22” Titanium Necklace in woodland green camo design is a great looking camo accessory! Phiten’s philosophy is health, energy and well-being and Phiten products are worn by elite and professional athletes all over the world. For more information on Phiten’s philosophy as to the benefits of their products, please visit their website at: www.phiten-canada.com

 Although not a complete win, I’ll take the little wins where I can get them. My response:

Hello Elizabeth,

Thank you for your thoughtful response, and I appreciate the welcome change in the product description on your website. As you might imagine, my preferred outcome would have been the complete removal of these products, but I am guessing that DUC has a few thousand of them in a warehouse that need to be sold; DUC is a business that raises money for ecology, and I understand and support that. I am delighted that DUC is no longer expressly repeating the preposterous medical claims of these products, and it is my hope that eventually, DUC will cease to offer them at all. As a scientist, it is a somewhat jolting experience to read an excellent article in the Conservator concerning the good, solid science that goes into the decision making process for DUC projects, and then see this ridiculous “magic jewelry” for sale on your website. It does DUC’s scientific credibility a disservice to associate with such foolish tripe. I would also hope that in the future, the product line for the Store is scrutinized more fully, to avoid any further involvement in these and other examples of pseudoscientific quackery, if you’ll pardon the expression. Any scientist on your Board worth his or her salt would be invaluable in this regard. 

I am equally delighted that you have forwarded my comments on to Phiten. If the representative has a rebuttal anchored in good, verified scientific evidence, I would be absolutely shocked.

As a grassroots supporter and promoter of scientific literacy, I am pleased with this outcome, and will report it as such on my blog. I think your decision is a step in the right direction for DUC, and I look forward to continuing my support of DUC in their admirable work of wetlands conservation.

Thank you again.

I think that went rather well. Science 1, Quackery 0.5

How to Become a Really Good Pain in the Ass is an incisive, engaging, and entertaining guide to critical thinking and its benefits. Its purpose is to provide readers with tools to allow them to question beliefs and assumptions held by those who claim to know what they’re talking about – from politicians and lawyers to bankers, doctors, the divinely inspired, and even your boss.

A really good pain in the ass is someone who is empowered with the ability to spot faulty reasoning and, by asking the right sorts of questions, hold people accountable not only for what they believe but how they behave.

Event Dates, Cities and Contacts

8/18/2011 | Vancouver, BC | Contact: Jamie Williams
jwilliams@cficanada.ca

8/19/2011 | Kelowna, BC | Contact: Loren Price
loren.m.price@gmail.com

8/21/2011 | Kamloops, BC | Contact: Bill Ligertwood
billligertwood@shaw.ca

8/23/2011 | Calgary, AB | Contact: Nate Phelps
nphelps@cficanada.ca

8/24/2011 | Edmonton, AB | Contact: Brent Kelly
brent.art.k@gmail.com

8/26/2011 | Saskatoon, SK | Contact: Kendra Getty
kendragetty@gmail.com

9/9/2011 | Toronto, ON | Contact: Derek Pert
dpert@cficanada.ca

TBA | Ottawa, ON | Seanna Watson
ottawa@cficanada.ca

TBA | Montreal, ON | Brahim Abdenbi
abrahim.montreal@gmail.com

Find your local CFI Canada branch details on this page. 

A nominal admission price will apply at the door.

Media are welcome to attend.

About Dr. Christopher DiCarlo

Voted TV Ontario’s Big Ideas Best Lecturer and Canadian Humanist of the Year by Humanist Canada in 2008, Dr. DiCarlo presents highly insightful and lively discussions. He is a past Visiting Research Scholar at Harvard University and the Peabody Museum of Archaeology and Ethnology. He has been invited to speak at numerous national and international conferences and has written many scholarly papers ranging from bioethics to cognitive evolution.

{link}

One of the stated aims of the updated policy is to respect patient autonomy, but patient choice has little meaning if it is not informed by expert medical advice based on sound scientific evidence. The policy is heavily slanted in favour of alternative medicine and the language used even suggests equivalence between conventional and non-conventional medicine. Given the woefully unscientific nature of most of these therapies we find the suggested equivalence completely misguided, and bordering on irresponsible. As well, the use of the pre-scientific word “allopathy,” also suggests undue influence over the CPSO of the alt-med community who have a vested interest in selling these treatments.

“The policy also moves toward muzzling doctors to keep them from expressing concern about these practices if such opinions are “non-clinical,” even if the alternative therapy is completely implausible,” said Iain Martel, a CASS member and lead author of CASS’s response, “and yet at the same time no such constraint is put on alternative practitioners to keep them from impugning conventional medicine and speaking out against successful, safe, and vital public health programs like vaccination.” What is even more striking is the contrast between the CPSO policy and the British Colombian version: the CPSBC considers it unethical for a physician to prescribe a non-conventional therapy if there is no good evidence of the therapy’s effectiveness.

With the large increase in public fascination with alternative medicine it is an imperative for Ontario physicians to educate their patients about the pros and cons of these treatments. If a non-conventional treatment is supported by evidence to the same standard as a treatment used in conventional medicine, then the non-conventional treatment may also be considered, but given the unscientific nature of most “alternative” modalities, this is not likely to happen. “Ontarians look to their physicians for sound advice, based on solid medical knowledge, but under this policy, they may instead be directed to such magical nonsense as reiki and homeopathy, or prescribed dangerous chelation therapy,” said Martel, “it’s a significant risk.”

For More Information Contact:

 Michael Kruse, Co-Chair and Spokesperson

Committee for the Advancement of Scientific Skepticism

cass@cficanada.ca 

CPSO’s draft policy can be found here: http://www.cpso.on.ca/uploadedFiles/policies/consultations/non-allopathic-consultation-draft.pdf

Please Comment on the Policy here:  http://www.cpso.on.ca/policies/consultations/default.aspx?id=4310

CASS’s full response to CPSO’s draft policy can be found below (updated August 15 2011):

Comments on “Non-Allopathic (Non-Conventional) Therapies in Medical Practice”

About the Committee for the Advancement of Scientific Skepticism (“CASS”)

The Committee for the Advancement of Scientific Skepticism (CASS) is a national body of the Centre for Inquiry (CFI).  The mandate of CASS is to critically examine scientific, technological and medical claims in public discourse. Working with our expert advisers, we address factual inaccuracies and misinformation in public debates by promoting evidence-based science. To achieve these ends, CASS works within the infrastructure of CFI to co-ordinate campaigns with them and other interested parties.

General response

CASS has reviewed the CPSO draft policy, “Non-Allopathic (Non-Conventional) Therapies in Medical Practice”, and has a number of serious concerns about the policy. We understand that the aim of the new policy is to balance respect for patient autonomy with the need to protect the public from harm. Unfortunately, the draft policy leans far too heavily in the direction of the former, and is not sufficiently focused on the latter. In doing so, the new policy is unduly slanted in favour of non-conventional therapies. The loaded terminology used, and the painstakingly neutral language employed in comparing conventional and non-conventional therapies, suggests a false equivalence between the two. Given the woefully unscientific nature of most non-conventional therapies, we find such neutrality completely unwarranted.

In a message in CPSO’s Dialogue, Dr. Lynne Thurling states, “The bottom line is that we believe that the tenets of good medical practice apply to allopathic and non-allopathic care equally.” Unfortunately, this sensible principle is too frequently ignored in the text of the draft policy, where loose standards of evidence would allow the recommendation of non-conventional treatments that would never make it through the rigorous approval processes of conventional medicine. Indeed, the notion that non-conventional therapies that have been shown to be safe and effective exist is almost an oxymoron; such therapies would simply be added to the roster of conventional medicine.

Patient autonomy is an important principle, but it must not be confused with the adage that “the customer is always right.” When it comes to healthcare, patient choice has little meaning if it is not informed by expert medical advice, based on sound scientific research. We believe that physicians have a duty to inform patients who may be considering non-conventional therapies that the vast majority of such therapies have either never been properly tested for safety or efficacy, or else have been tested and have failed. Neutrality here is not an appropriate stance.

We have detailed below the main concerns we have with the draft policy. Rather than suggesting revisions to the existing document, we direct your attention to the guidelines produced by the College of Physicians and Surgeons of British Columbia, available online at https://www.cpsbc.ca/files/u6/Complementary-and-Alternative-Therapies.pdf (and attached to this submission). These guidelines capture far more accurately, we believe, the appropriate stance to take toward these therapies. In particular, the BC guidelines clearly capture the essential point that non-conventional therapies are generally unproven, and that in such circumstances it is unethical for a physician to recommend or endorse such treatments.

Detailed response

1.       Title and Terminology

The first objection we have to the draft policy lies in its title. This title introduces the terminology, to be carried throughout the document, of “allopathic” and “non-allopathic” therapies. This terminology, while commonplace in certain parts of the alternative medicine community, is rarely used within the medical community – with good reason[1]. As the history of the term “allopathy” shows, the term sets up a false dichotomy of medical paradigms, incorrectly suggesting a genuine competition between theories. Its use has historically been derogatory, invoking a spurious criticism of conventional medicine. Furthermore, it distracts attention from the real distinction between conventional and non-conventional medicine: that conventional medicine is based on substantial clinical and scientific research, while non-conventional medicine is based largely on tradition and scientifically-flawed principles.

The term “allopathy” was coined in 1810 by Samuel Hahnemann, inventor of homeopathy. Hahnemann intended the term as a contrary to “homeopathy”. Homeopathy is defined as the treatment of like with like, i.e. a disease is to be treated with a remedy which causes the same symptoms as the disease itself.    This is seen in the etymology of the term, derived from the Greek “homeo” = same and “pathos” = suffering. Allopathy, by similar formulation (“allos” = “different”), refers to the treatment of disease by a remedy that causes the “opposite” symptoms. In Hahnemann’s time, allopathy thus referred to the medieval medical practice of attempting to balance the four “humours”. Modern medicine, of course, follows no such principle, which would rule such mainstream practices as vaccination and radiation therapy non-allopathic, by definition.

Although Hahnemann’s term has always been rejected by mainstream medicine, it has frequently been adopted by chiropractors, naturopaths, and other opponents of conventional medicine, as a pejorative term. In this usage, allopathic medicine is solely concerned with the suppression of symptoms, whereas non-allopathic medicine treats the underlying cause. The term is thus a rhetorical weapon, used to advance an ideological claim. Moreover, the claim bound up in the term is fundamentally wrong; indeed, it exactly reverses the real situation. Whereas conventional medicine is frequently directed at discovering and treating underlying causes of illness – such as antibiotics to eliminate the microbial causes of infectious diseases – few non-conventional practices even address the real causes of illness. Homeopathy itself is purely concerned with symptoms, as shown by the homeopathic method of “provings”. And many naturopaths and traditional chiropractors are driven to reject modern theories of disease, in order to adhere to their vitalistic ideologies.

Finally, the terms “allopathic” and “non-allopathic”, by falsely suggesting an ideological opposition between competing medical paradigms, disguise the real distinction between mainstream medicine and the scientifically-unproven “traditional” remedies that fall under the label “Alternative and Complementary Medicine.” This is the distinction, buried in the draft policy, between therapies that have been rigorously tested and shown to be effective, and therapies which have either not been properly tested, or which have been tested and shown to be ineffective. The draft policy does note, “The categorization of specific therapies as non-allopathic is fluid: as clinical evidence regarding efficacy is accumulated, certain non-allopathic therapies may gain broad acceptance and thus be accepted in allopathic medicine.” What this formulation leaves unmentioned is the key corollary: that existing “non-allopathic” therapies are those for which such clinical evidence does not exist, and for which such evidence, in the vast majority of cases, is never likely to exist. It is this distinction that should be front and centre, and driving the entire policy.

Setting aside the problematic terminology, CASS also found problems in the definitions offered in the draft policy. Whereas, conventional (“allopathic”) medicine is defined as:

“the type of treatment, diagnostic analysis and conceptualization of disease or ailment that is the primary focus of medical school curricula and which is generally provided in hospitals and specialty or primary care practice,”

non-conventional therapies simply “differ” from conventional medicine in

“diagnostic techniques, theories of illness and disease, and treatment paradigms.”

This doggedly neutral language suggests a determination on the authors’ part to reinforce the notion that these are equivalent, competing paradigms. However, it has already been seen that the real difference is between evidence-based and non-evidence-based approaches. Such neutrality is entirely unwarranted and it is dangerously misleading for the College to suggest otherwise.

Let us be clear what is being implied here: the definitions in the policy suggest that the difference between the theory that diseases such as measles, cholera, and smallpox are caused by germs, and the theory, still held by some chiropractors, that such diseases are caused by “subluxations” in the spine lies merely in the fact that the former theory is the one taught in medical schools. No mention is made of the fact that the reason why such “conceptualizations” of disease are taught in medical schools is that they have been validated beyond any reasonable scientific doubt by centuries of basic and applied scientific research. No mention, either, that the conceptualizations of disease found in many non-conventional therapies – especially those based on vitalistic notions – are based on archaic medical models that have been thoroughly refuted by modern science. It is highly irresponsible for a professional organization to pander to such pseudo-scientific views via the spurious equivalence implicit in these definitions.

2.       Standards of Evidence

Although the draft policy includes, commendably, language requiring objective justification for all diagnoses and treatments, this language is frequently couched in terms that provide far too much latitude; potentially leading to the recommendation of treatments that are, in all likelihood, ineffective. The policy should make clear that the vast majority of non-conventional treatments have not been adequately tested, and that very few of them would survive such testing. In light of the poor track record of such treatments, the default position should be that they are not to be recommended. Instead, the policy allows, in many cases, for a diagnosis or treatment to be offered on the basis of very slim evidence. For example:

a.       Diagnosis

On diagnosis, the draft policy states that:

“If physicians also form a non-allopathic diagnosis, such diagnosis must be objectively justifiable, based on the clinical assessment conducted and other relevant information available to the physician.”

The problem with this requirement is that, as we saw earlier, many, if not most, non-conventional therapies (and diagnoses) are based on medical theories that are not merely unproven, but patently false. A diagnosis that the flow of one’s qi is blocked presupposes that qi exists, that it can be blocked, and that this can cause the symptoms observed; all of which is scientifically preposterous. Yet a physician may well claim objective justification for such a diagnosis, if such is the diagnosis suggested by an “authoritative” reference on acupuncture. Physicians should never suggest diagnoses that are based on scientifically implausible medical theories, and the Policy should make this clear.

b.       Therapeutic Options

In the section on therapeutic options, the draft policy does require that there be a reasonable expectation of efficacy, and that this expectation “must be supported by sound evidence.” However, the draft policy goes on to suggest that this evidence can be very weak in many cases:

“The type of evidence required will depend on the nature of the therapeutic option in question, including, the risks posed to patients, and the cost of the therapy. Those options that pose greater risks than a comparable allopathic treatment or that will impose a financial burden, based on the patient’s socio-economic status, must be supported by evidence obtained through a randomized clinical trial that has been peer-reviewed.”

This suggests that the evidential standard is lower for therapies that are low-risk, even if they are probably less effective than a conventional, more rigorously tested therapy. Moreover, the standard even for risky or expensive non-conventional options is far lower than it might appear: a single clinical trial, even of high quality, is of limited evidential value in the absence of replication or other evidential sources. The proposed standard would allow for the cherry-picking of one favourable trial, perhaps in a sea of contrary evidence, to be counted as “sound evidence”.

The bottom line is that, in determining therapeutic options, the standards applied to non-conventional treatments should be every bit as high as those applied to conventional treatments. Those standards are far higher than suggested in the draft policy.

c.        Ineffective and Unproven Therapeutic Options

Two further points are in order regarding the draft policy’s discussion of ineffective treatments and of treatments for which the effectiveness or risks are unknown. Regarding the former, an appropriate mandate to never propose ineffective therapeutic options is hollowed out by narrowing the mandate to options that have been “proven” to be ineffective. In science, we are told, it is impossible to prove a negative, thus rendering this rule effectively empty. A more appropriate mandate would be that treatments which are probably ineffective should not be proposed.

Regarding the far broader category of treatments for which effectiveness and risk are unknown, the draft policy veers toward incoherence. Given that the vast majority of non-conventional treatments fall into this category (or the probably ineffective category), the expectation of caution and suggestion of clinical trials appears incongruous with the generally more permissive policy in the earlier paragraphs. Perhaps the caution suggested here is more appropriate: where risk and efficacy are unknown, the cautious and ethical approach must be to refrain from proposing such treatment.

3.       Additional Concerns

a.       Line 97-100, line 223-226:

“The College expects physicians to respect patients’ treatment goals and decisions, even those which physicians deem to be unfounded or unwise. In doing so, physicians should state their best professional opinion about the goal or decision, but must refrain from expressing non-clinical judgements.”

“Clinical concerns must always be highlighted, however physicians must refrain from expressing personal non-clinical judgements or comments about the therapeutic options, or the patient’s health care goals or preferences unless that input is specifically requested by the patient.”

In these passages, it is unclear which “non-clinical judgements” are being excluded. We are concerned that they may be interpreted as imposing tight limits on physicians’ ability to state their honest, scientifically- sound, objections to pseudo-scientific medical theories and ideas. While physicians should refrain from expressing personal judgements about their patients holding such views, it would be morally and intellectually dishonest for a physician to withhold a view as to the merits of such bankrupt theories as homeopathy, even when the expression of such a view goes beyond the strictly clinical realm.

The apparent attempt to prevent physicians from expressing legitimate scientific skepticism about non-conventional medical practices and theories is particularly troubling, given that their non-conventional counterparts feel no such compunction in spreading misinformation about legitimate medical practices such as vaccination, as well as in misrepresenting the scientific standing of dubious non-conventional practices. Any policy that stands in the way of correcting this torrent of misinformation does a great disservice to the important goal of public medical literacy and may facilitate harm to patients.

b.       Line 176-177:

“…have a demonstrable and reasonable connection, supported by sound clinical judgement, to the diagnosis reached;”

“diagnosis” here is ambiguous: since the draft policy allows for the formation of a “non-allopathic diagnosis”, this clause might be thought to refer to such diagnoses. This would be problematic: since a non-conventional diagnosis may well have little bearing on reality, having a treatment option that is demonstrably and reasonably connected to it is hardly comforting. “Diagnosis” should read “conventional medical diagnosis”.

c.        Line 247-249:

“Where physicians are unfamiliar with the non-allopathic therapy in question, they must indicate as much to the patient, and explain that they are consequently unable to comment on the matter.”

This requirement, while seemingly innocuous, would prohibit a physician from advising a patient that, since the vast majority of non-conventional therapies are without merit, it is highly likely that the unknown new therapy is similarly without merit. Moreover, where an unproven therapy obviously conflicts with established medical knowledge, even a physician unfamiliar with the therapy is in a position to offer dissuading advice. (The requirement to indicate the limits of the physician’s knowledge is, however, clearly appropriate.)

d.       Footnote 13:

“This may include directing patients to journal articles, scientific studies and/or websites or providing them with more general resources, such as the contact information of regulatory colleges which govern practitioners of the desired therapy.”

The regulatory colleges for non-conventional medical practices (as well as related websites) are, regrettably, very poor sources of reliable information, and would be a poor recommendation.

e.        Line 278-279:

“there is a reasonable expectation that the care provided will be clinically effective.”

The standard of “reasonable expectation” is clearly lower than the standard of “on the basis of evidence, and sound clinical judgement” from the prior clause. Since one of the primary dangers from the use of non-conventional medicine is the harm that may result from the use of ineffective therapies in place of effective conventional therapies, the standard of evidence required should be no lower for efficacy than it is for risk. Furthermore, the required evidence must indicate that the efficacy is at least that of conventional alternatives.

4.       Conclusion

Despite the advancement of science and the ability to verify the efficacy of clinical interventions, there remain a number of hold-outs from our pre-scientific ancestors that either have not been shown to work or have been shown not to work.  Homeopathy is an example of such a therapy that has not been sufficiently studied and, where sufficient studies exist, has been shown not to be effective[2].  Despite this lack of evidence for efficacy, the general public makes extensive use of “complementary and alternative therapies” either alongside or, more worryingly, in place of conventional, evidence-based treatments.  In 2006, a survey found that 76% of Canadians had used at least one alternative therapy in their lives and it was estimated that Canadians spent around $7.84 billion between the latter half of 2005 and first half of 2006 on alternative therapies ($174 per user)[3].

            Physicians in Ontario have an opportunity to promote the principle of evidence-based medicine and start to reverse this potentially dangerous trend.  This principle is espoused in many policies at the College. We ask that you re-focus on this principle and reconsider the slide toward an ad populi capitulation in your draft policy on non-conventional medicine.

Yesterday afternoon I joined Raheel Raza, Muslim Canadian journalist, author,  public speaker, media consultant, anti-racism activist, and interfaith coordinator, on Sun TV News’ The Source with Ezra Levant. Levant is a polarizing figure you either love or hate. He’s well known for his book Shakedown,  which documents the censorship crusade of many Human Rights Commissions in Canada.  But that wasn’t the theme of our conversation.

The topic was our shared concern for the mixing of religion and public education through the continued public funding of Catholic Schools coupled with the introduction of outside religious leaders into schools, such as through Imam-led prayers in school cafeterias or the distribution of Gideon bibles in classes.

I firmly believe educational world religion classes are vital for each student to understand the world they inhabit and should be accessible to all students, but draw the line when it comes to granting exclusive and privileged access to students or schools to religious authorities for non-educational purposes.

Earlier in the morning, motivated by the article Ontario couple childless while Quebec parents enjoy fully-funded IVF, Associate Pastor of Westminster Chapel Scott Mason and I debated the pros and cons of health care funding for in vitro fertilization (IVF) on the John Oakley Show on AM640.

My heart goes out to infertile couples that want nothing more than to bring life into the world, and should be given whatever tools are available to assist. Additionally, as is the case in Quebec, provincial funding for IVF would provide enhanced maternal health and possibly save money in the long run. By mandating that public clinics provide no more than a single embryo at a time, we can reduce multiple pregnancies that often lead to unfortunate and expensive complications.

“Our Philosophy

All our products reflect Phiten’s uncompromising search for health. Our aim is to provide health-promoting technologies and products. We will never offer an item that might have an ill effect on your health, no matter how convenient and useful it may be. That’s our philosophy.

After examining the meaning of health in this day and age, we directed our attention to the body’s natural healing power. Part of the body’s natural responses, it is often weakened by the fatigue and stress accumulated with the hectic pace of modern life. Your body’s energy system influences all of your body’s responses. Phiten products regulate and balance that flow of energy throughout your body. Proper energy balance helps to alleviate discomfort, speed recovery, and counteract fatigue by restoring the body’s natural healing powers.

Through dedicated research, we have developed a number of unique wellness technologies and products. Accordingly, we’ve won the trust of many consumers and increasing numbers of athletes use our products. We are building on this trust to offer new products, adapting and applying our technologies to a wider range of uses to support your health and well-being.

Phiten continues to take on new challenges in serving people around the world by creating more products that answer the desire to enhance and maintain health.”

http://www.phiten-canada.com/aboutus.asp

So we’re clearly in downtown Woo-ville. So I thought that I would chastise Ducks Unlimited Canada (DUC) for their poor choice of promotional merchandise. Here’s the emails:

(Me)

 Hello,

I have been a supporter for quite some time. I am proud to display Ducks artwork in my home, and to contribute to Ducks from time to time. I am pleased that Ducks follows a science-based approach to the biology and ecology of it’s projects. So you can imagine how disappointed I was when I noticed titanium necklaces in your Store. The description includes this doozy:

“Phiten products work with your body’s energy system, helping to regulate and balance the flow of energy throughout your body. Proper energy balance helps to alleviate discomfort, speed recovery, and counteract fatigue. Tire less easily and recover faster from intense physical activity! “

This is complete nonsense. It is a preposterous medical claim that is completely unsupported by medicine and science. Frankly, it is false advertising. I am sure that this is an oversight on your part, as it is totally contradictory to your fact-based approach to wetlands conservation. I would request that you remove these items from your catalog immediately, or at the very least, remove the description that suggests a quantifiable health benefit from this ridiculous voodoo jewelry.

Thank you for your prompt attention to this matter.

(Them)

William - I would thank you for your comments and refer you to the Phiten website and the product information.  Professional athletes and sportspeople wear them and we thought we would offer the camo versions and see if our membership was interested in such a product.   As it turned out they are and we have received nothing but positive feedback from our membership!
 
Again, Ducks Unlimited Canada does appreciate your comments and will forward your concerns on to management.
 
http://www.phiten-canada.com/
http://www.phitenusa.com/
 
Thank you for your support of DUC. If you have any further questions, or if you’d like more information, please feel free to contact me.
 
Regards
Lorna Baker
Retail Sales Coordinator
Event Merchandise
Ducks Unlimited Canada
1-800-665-3825
supportercare@ducks.ca
http://www.ducks.ca
 

(Me)

Hi Lorna,

Thank you for your prompt reply, but I think that you haven’t entirely understood my position, nor do you understand the Phiten products. They are quite simply, a scam. They are jewelry with no tangible health benefit. The action that they claim for their products is implausible to say the least. Have you stopped to consider how this mystical concoction infused into string might possibly affect the metabolism of lactic acid in the body? I’ll help you out-it doesn’t. There is no conceivable mechanism for this to work. Their website, if you read the fine print, says that their claims have not been evaluated by the USFDA. The endorsement of professional athletes means nothing. A slick website with a bunch of feel-good pseudo-scientific baloney means nothing. I’m quite sure that I could find a website that claims to know for sure that Elvis is alive and well, living in a flying saucer on the far side of the moon. I am equally certain that I could find some vacuous professional athlete who would buy that load of BS-hook, line and sinker.

I am a scientist. Like the scientific staff at DUC, I work in facts. DUC’s conservation work is based on facts, on accepted and verified principles of ecology and conservation biology. Not on the message from some dead ducks coming in through a crystal ball. Phiten products are a slap in the face of reason, critical thinking, and scientific literacy. The “studies” that they cite as proof have holes in the methodology big enough to drive trucks through. Most of it is a complete fabrication. They are completely contradictory to the excellent science-based work that DUC does. They are a shining example of ignorance, the power of the placebo response, and the gullibility of consumers.

Please put me in touch with your manager. Any organization that raises money through such blatantly false merchandising is one that I will not be associated with for very long.


Sincerely,