Rose Shapiro is a British journalist who contributes regularly to several publications including the Guardian and the Independent. She is best known for her book ‘Suckers: How Alternative Medicine Makes Fools of Us All’.
Sadly I felt in a naive kind of way, if you show people the evidence, it will make people reconsider.
On becoming interested in science
I’ve always been interested in evidence, partly because I grew up in a household where my father, a scientist, a scientific psychologist, who was very committed to scientific method and used to very annoyingly say, when I was a young person and made my young person’s assertions about life, would say ‘I’d like to see the evidence’. And it drove me crazy, but it’s now my own response to any kind of claim, really, whether it comes from the orthodoxy or the alternative or the fringe.
On your area of expertise
Alternative medicine, and that’s what I’ve done recently is looking at its prevalence, who’s using it, and what claims are being made about it, and also in my book, um, I wrote a lot about the history of its development because I think that’s very revealing and its something that, the cause that I have is to disabuse people of the claims of alternative medicine if there’s no evidence for them.
On the history of alternative therapies
Um, well, there’s old pre-scientific medicine that we all know about leading up to the point where scientific medicine began in the 18th century, and so you could say that from before that point, we were all subject to what is now called alternative medicine, with ideas of the life force, balancing of the energies and all of that. But that is now very much the grounding of what alternative medicine is in the modern era. Um, different wings of it have their own histories, which are often far more recent than they appear to be because they’re always talking about ancient wisdom for instance, so, um, ear acupuncture, which sounds like a phrase of ancient Chinesey things was invented by a Frenchman in the 1950’s. Osteopathy at the end of the 19th century, Chiropractic ten years later by somebody who tried all sorts of other kinds of hucksterish things instead and that in itself is, I found it really interesting, and I think it shows what it’s about; its hucksters who invent things, mostly.
On the appeal of alternative therapies
I think there is, I think people find it personally empowering. I think they feel that they become, particularly the women who use it, it is predominantly middle age, middle class women like me who use it and they feel that they are in some ways getting a kind of control over their own lives and their families’ health, and they’re their own wise women of ancient history themselves. And it’s a very attractive, flattering kind of discourse that often happens where you get told when you’re a patient really how you’re pretty marvellous and this treatment’s going to kind of bring out your inner marvellousness which will then cure you and purify your blood or whatever it is, so it’s a, I can see its appeal.
On educating people to its ineffectiveness
Well, I think that’s quite difficult. Sadly I felt, in a naive kind of way, if you show people the evidence, if you show people history, if you show people the horror stories – because there are horror stories – it will make people reconsider. But I think there is a, quite a large group of people who whatever, whatever fact, you know, say ‘I know it’s true, I don’t want to know the evidence’. ‘Don’t confuse me with the facts’ is the cliche, you know, it’s what people tend to feel. But I think there’s another group who, it hasn’t really occurred to them that there could be anything to question here, and I think, and I certainly know that my book has done that for a lot of people who say ‘I’ve always been a bit doubtful’ but it was the book that really gave them the ammunition to drill down into all of this and think it through themselves, and that is the best way to do it.
In fact I only yesterday was talking to one of the other contributors here [at QED], talking about something called black salve which is a treatment for cancer, that’s a very corrosive material that people put on their skin that’s supposed to diagnose cancer and also treat it, and she was showing me photographic evidence of terrible burns on people’s faces, losing most of your nose to this black salve with no benefit in relation to the cancer. And those are hard cases and they are, I guess, overall in terms of the number of people who use alternative medicine, relatively rare, but there is no benefit that outweighs those risks. And, for instance I interviewed a woman who had a stroke following a chiropractic neck adjustment, and, you know, her life has completely changed; she’s lucky to be alive, cause people have died from that, but she cant really work effectively, her left side has been affected so she can’t write, she can’t do the handicraft that she used to be able to do and it’s hard for her to look after her child, you know, that is a life changing effect of a supposedly benign treatment.
I used to think that presenting what is known as the facts and the risks and the benefits would have a bigger effect than I think it actually has because of people’s commitments to this area, but I think the minute case by case, dealing with authorities, dealing with, say, the Advertising Standards Authority case by case, getting this out of mainstream acceptance by doing those small confrontations I think is very much worth doing. I think, over the years since I’ve been working in this area, I think it has changed considerably partly because, well, the rise in the skeptic movement has really really helped, but I think it’s become part of the mainstream to be more critical and specifically to be more critical of, say, homeopathy which now, you know, you can make jokes on homeopathy on the BBC on a comedy show which nobody would’ve done 15 years ago I don’t think. They wouldn’t have thought it was even interesting enough to make jokes about, which I think it is.
I myself took a Seven Seas, I made a complaint about a Seven Seas, I think it was an omega oil supplement and I can’t remember the wording but it was more than implying that it would help with your joints and mobilise your joints and I did make a complaint about that, because I wanted to try doing something in that, you know, rather than writing a book and what I thought was the big final thing of setting it all out, to do a small thing to see what that, what effect that had and they did uphold my complaint and they had to change their advert so I think we all should be doing that all the time. I think the Nightingale Collaboration is doing that in a very, very detailed and technical and confident way, I think is a fantastic resource.
On the placebo effect
I think probably homeopathy, just because of its, it being so prevalent. And also because at the core of it there is this sugar pill which is such a beautiful example of why, of the con of it all, that people take it and know that it’s a sugar pill but somehow all these other magical things are being laid upon it and still they take it, and accept it, so that was probably what got me going on it.
Well it appears to be, actually I think the placebo effect is a bit overrated or a bit talked up beyond its, its real power. But what does seem to be the case is, the more bells, whistles and kind of stuff happening, the better the placebo effect is; so for instance, um, acupuncture really delivers on that front because there’s quite a lot to say about it, a lot of things happen and there can be a bit of, there’s discomfort, there’s ritual, it’s loaded with meaning, and that appears to get a better result. I think in smaller ways there’s evidence that you can affect how people respond to different colour pills for instance by their associations with red or green or whatever. But I think even more interestingly that you can induce the placebo effect in an honest kind of way almost by saying to somebody ‘Here’s some pills that contain no active ingredient, people say they find them helpful, would you like to take them?’ And even that, when it’s honestly delivered, can have an effect, but in this sort of, you know, it doesn’t go that far, it’s not going to cure, um, cystitis I wouldn’t have thought.