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Evaluate This: When Marketing Is Medicine

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[img]7|left|||no_popup[/img]It gets me every time. I look at the label of this or that nutriceutical product and find a claim related to improving bodily functions, only to then find the small print that says, “This product is not intended to diagnose or treat medical conditions.” Say what? Then comes the kicker in the fine print: “This product has not been evaluated by the FDA.” In other words, the only thing these nutriceutical products have going for them is a marketing campaign and a massive case of cognitive dissonance.

What’s worrying is that despite the fine print, these products are, indeed, intended to diagnose and treat medical conditions. (Of course, in the big picture the real intent is to treat wallets overstuffed with money.) Yet there it is, an admission that these products have not undergone any kind of scientific evaluation to confirm that a) it works as intended; and b) it is safe.

Part of the problem is a common reasoning error among lay people in regards to things like cause and effect in medicine. For example, Jack feels a cold coming on and takes Airborne. Maybe he gets the sniffles, a cough, fever, but two days later he feels good again. Naturally, when a friend feels a cold coming on, Jack recommends Airborne because it worked for him; it shortened the severity and duration of his cold. But did it? The problem with this sort of reasoning is the common one of confusing correlation with causation; two events occur at roughly the same time, and one is assumed to cause the other. This is precisely the sort of assumption that needs the rigours of the scientific methodology. In the case of Jack and airborne, we don’t know that the Airborne did anything to relieve that particular cold. Jack, unfortunately, cannot be his own control group. Maybe the Airborne did nothing and it was a mild cold virus. Maybe the Airborne made it worse, taking a minor case of the sniffles and prolonging it by a day. The question is, how does Jack know whether the Airborne was effective? The scientific method, through the use of such tools as the double-blind study, can handle questions of this nature. (We shouldn’t need science, however, to be skeptical when a product like Airborne proudly markets its creation by an elementary school teacher instead of, say, a medical doctor and scientist who is an expert in immunology, biochemistry, and other key disciplines.)

Science is especially critical when we consider treatments for cancer, weight-loss or other diseases and medical conditions – treatments that occur within the difficult dichotomy (http://www.csicop.org/) of conventional and alternative/complementary medicine. With all the quacks, “faith” healers, and genuinely well-intentioned but misguided folk out there, we are assaulted by a barrage of information and claims, filtered through our own biases and wishful thinking, that make us vulnerable to making bad decisions. The unfortunate case of 13-year-old Daniel Hauser, whose parents initially preferred alternative treatments to chemotherapy for their son’s cancer despite the fact that chemotherapy for Hodgkin’s lymphoma has an over 90 percent success rate, is but one example of the risks that come with misunderstanding science and medicine. Thankfully, Daniel’s situation seems to have a taken a turn for the better. However, this isn’t always the case. For example, with cancer being responsible for roughly 25 percent of deaths in the U.S., there is not a shortage of people looking to find a cure when diagnosed with one form of cancer or another. And there is no shortage of “cures” out there, either: CanCell, magnetic therapy, laetrile, Burzynski’s anti-neoplastron therapy, hydrazine sulfate, and others described at Quack Watch (http://www.quackwatch.com/). Illustrating the tragic consequences that come with indulging unproven treatments, we have:

“In December 2000, the Annals of Internal Medicine published a case report of a 55-year-old man with cancer of the sinus near his left cheekbone. Instead of undergoing recommended medical treatment, he obtained hydrazine sulfate through a Web site and, for four months, followed the regimen published on the kathykeeton.com Web site. Two weeks later, he was hospitalized with signs of kidney and liver failure. Despite intensive hospital care, he died within a week.”

We Need an Impartial FDA

In addressing these issues, there lies a vital argument for an entity such as the Food and Drug Administration – an impartial organization, answerable to the people (albeit indirectly; elected officials choose the FDA’s management), and tasked with submitting claims for cures and nutrition to the rigours of a scientific evaluation. Cueing up heroic theme music, one could even say the FDA has as a mission the protection of human health and well-being. And it’s a nice idea, except for the other part of the problem, namely, the question of whether an organization like the FDA truly is impartial. The Union for Concerned Scientists, for example, surveyed (http://www.ucsusa.org/scientific_integrity/) 5,918 FDA scientists and concluded that “The results paint a picture of a troubled agency: hundreds of scientists reported significant interference with the FDA's scientific work, compromising the agency's ability to fulfill its mission of protecting public health and safety.” The Wikipedia entry (http://en.wikipedia.org/) on the FDA lists other controversies.

The point isn’t that the FDA should be entirely rejected despite a clear need for reform. The argument is that ultimately, responsibility lies with us to be educated about science and to adopt an attitude of healthy skepticism that minimizes the chances of being deceived by dubious marketing.

Frédérik Sisa invites you to visit his blog.