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The Doctor Will Sue You Now
April 9, 2009 8:11 AM   Subscribe

"If you’re ever looking for a warning sign that you’re on the wrong side of an argument, suing Medecins Sans Frontieres is probably a pretty good clue." Science journalist and blogger Ben Goldacre has released the missing chapter of his book, Bad Science, telling the story of Matthias Rath, vitamins and the AIDS crisis in South Africa. [Previously. Also.]
posted by xchmp (40 comments total) 25 users marked this as a favorite

 
Damn, was just crafting a post for this very story.
posted by fatfrank at 8:14 AM on April 9, 2009


Rath is scum of the first order, one that nearly makes me wish the eternal damnation thing were true.
posted by fatfrank at 8:19 AM on April 9, 2009


Rath was the head of Cardiovascular Research at the Linus Pauling Institute

Well, it's an appropriate position for a "mega-dose of vitamins will cure anything" nutjob. It's a shame that Pauling tainted his legacy with that nonsense.
posted by Optimus Chyme at 8:21 AM on April 9, 2009


Thanks for this.
posted by OmieWise at 8:23 AM on April 9, 2009


"If you’re ever looking for a warning sign that you’re on the wrong side of an argument, suing Medecins Sans Frontieres is probably a pretty good clue."

Whatever. MSF once "borrowed" my car to get beer for a party. Of course, being MSF they didn't ask for permission and to make matters worse they totaled it. When I got upset, they were all like "man, why are you trying to impose your boundaries on us? What's ours is yours man. We're all like this big oneness." So I sued them.
posted by allen.spaulding at 8:33 AM on April 9, 2009 [5 favorites]


The alternative therapy movement as a whole has demonstrated itself to be so dangerously, systemically incapable of critical self-appraisal that it cannot step up even in a case like that of Rath: in that count I include tens of thousands of practitioners, writers, administrators and more.

This times a million. Even on MeFi we have people like Zambrano et al who work to deny children safe and effective medical treatment. It is despicable and disgusting; we should not give up any ground, and we should not treat them as anything other than dangerously mentally ill.
posted by Optimus Chyme at 8:33 AM on April 9, 2009 [1 favorite]


If there's ever any doubt that memes can be as virulent as influenza and as deadly as mortar fire, Roth's diseased ideas can stand as a gold plated shining example. If the spreading of toxic, faulty public health policy causing deaths in the hundreds of thousands could be compared to rounding up masses of people and shooting them in the back of the head, Roth's mugshot would appear next to those of a few other famous individuals.

What a disgusting creature.
posted by seanmpuckett at 8:41 AM on April 9, 2009 [2 favorites]


Wait, I thought the placebo effect was enough to make a lie a good thing.
posted by DU at 8:45 AM on April 9, 2009


As always with Goldacre's writing, it just infuriates me on so many levels (none of themhis, of course).

When the Health Minister, Tshabalala-Msimang said ‘It doesn’t necessarily mean that if I am taking antibiotics and I die, that I died of antibiotics’ it just highlights the problems that come up with AIDS medication, religious arguments, climate change, and numerous other stupid arguments: complete denial. And that cheap, petty denial, where there really isn't an argument given in it's defense, just stupid refutation.

People coming out with uneducated responses to reasoned arguments are probably the thing that angers me the most, particularly when tens of millions of lives are at stake! And this from someone who considers the world overpopulated...
posted by opsin at 8:55 AM on April 9, 2009 [1 favorite]


What a loathesome figure.

It's inhumane to wish cancer or AIDS on anybody, but I do wish that if Rath is confronted with the worst news, he resorts only to his own prescriptions.
posted by ardgedee at 8:58 AM on April 9, 2009 [4 favorites]


I had to look since other people claiming to defend us all from bad science are, well, I'm not linking but if you poke around the web you'll see what I mean.

So looking at Goldacre's site, there is one bit that kind of annoys me. He's on about clinical studies that are never published and saying that doctors need that information because there are LIVES IN THE BALLANCE!!!

I'm not an official spokescritter for Big Pharma or anything, but if we do a clinical study and then you never hear anything else about it, you can pretty much bet that the results were less than or equal to the current best standard of care. (This doesn't exactly apply to comparisons between two current standards or treatment, but I live in the world of novel molecules.)

If your doctor is having difficulty between two treatments, one of which was abandoned by a drug company, so he swiped a few vials out of their biohazard bin, then yes, your life may hang in the balance.
posted by Kid Charlemagne at 9:01 AM on April 9, 2009


Christ, what an asshole?

This is an appalling story. I don't know the background on this Rath dude, but he seems to be known to a lot of you. What's behind his vitamin proselytizing? Is he making money off of the manufacture/sale of the vitamins? (That's my first assumption.) Or is he one of those crunchy granola folks who has gone too far to the other side, and really believes that the ARV drugs are poison, that the only thing to treat disease is good, natural stuff from the earth?
posted by mudpuppie at 9:08 AM on April 9, 2009


Matthias Rath will go to the same disease-infested hell where Christine Maggiore, Jesse Helms, and the Pope are currently suffering.
posted by Nelson at 9:11 AM on April 9, 2009


Kind of reminds me of this scumbag. I remember his very first infomercials in the early nineties. My friends and I fell all over ourselves laughing at his ridiculous product: Mega Memory. One anecdote stood out for us to the extent that I still quote it to this day. He was speaking about someone who studied his system before interviewing at a legal firm. This fine fellow was able to remember the name of everyone he was introduced to. After he came back for a second interview and demonstrated his recall, they all nicknamed him "The Walking Genius." As opposed to what, Stephen Hawking? Walking Computer, that's dumb, but sure. But Walking Genius?

Of course, now Trudeau has moved on to bigger and bolder scams, like Natural Cures "They" Don't Want You To Know About. So he's moving up the scumbag ladder relatively quickly, and now he's getting the last laugh on me and my buddies. Still, I can't help but recall another of his infomercials for martial arts training; the commercial was filmed as a fake late-night talk show hosted by Danny Bonaduce. I'd provide a youtube link but I can't access from work -- but then again, you probably have better things to do with your life than watch old awful infomercials. At least, I hope so.
posted by Edgewise at 9:29 AM on April 9, 2009 [1 favorite]


If, as Rath states, HIV does not cause AIDS; and, as Rath states, he can cure AIDS with vitamins; why then not propose that Mr. Rath be inoculated with HIV? After all, he won't get sick from it, and if he did, he could cure himself. Propose this to him as the perfect marketing strategy - he will be living proof of his statements.

As for his motivations, I suspect money and racism. There may be a more complex psychological failure at work as well - he may have been a well meaning man who simply became angry and frustrated with the incredible bureaucracy that pervades the medical and scientific communities; and said to Hell with it, I'll just have them all go kill themselves, taking perverse glee in finding success by doing exactly what he knows is the wrong thing.
posted by Xoebe at 9:30 AM on April 9, 2009


... perhaps even to your own friends and neighbours, in whatever suburban idyll has become your home, the moral principle of abstinence from sex and drugs is more important than people dying of AIDS; and perhaps, then, they are no less irrational than Thabo Mbeki.
posted by mrgrimm at 9:32 AM on April 9, 2009 [1 favorite]


We've got a MSF world map hanging in our bathroom at work, it's at eye height so every time I take a pee I find myself looking at either central Africa or Iceland.
posted by Divine_Wino at 9:37 AM on April 9, 2009


This one country [South Africa] has 6.3 million people who are HIV positive, including 30 per cent of all pregnant women.

That is insane.
posted by Civil_Disobedient at 9:41 AM on April 9, 2009


The alternative therapy movement as a whole has demonstrated itself to be so dangerously, systemically incapable of critical self-appraisal that it cannot step up even in a case like that of Rath: in that count I include tens of thousands of practitioners, writers, administrators and more.

One point: there are some types of alternative therapies for some diseases that provide some better results for some individuals in some cases.

However, I'm talking more about cases like my own back trouble responding better to chiropractic treatment and massage than to physical therapy, or a friend's fibromylagia symptoms lessening because she made a change in her diet. "Megadoses of vitamins are the panacea to cure AIDS" is something else again.
posted by EmpressCallipygos at 9:48 AM on April 9, 2009


This was a great read, thanks. I hate to wishi ill on others, but someone should inject HIV into Rath's eyeballs.
posted by HumanComplex at 10:23 AM on April 9, 2009


I'm not an official spokescritter for Big Pharma or anything, but if we do a clinical study and then you never hear anything else about it, you can pretty much bet that the results were less than or equal to the current best standard of care.

The problem is - who keeps track of these trials? Is every GP poring through all of the journals, noting all the papers and tracing them back to the register of trials (if one happens to exist in your country) and working out which ones are missing? Probably not. If they don't know how many trials you ran, they can't tell how many they never saw results for, or why (adverse results, inconclusive results, bad methodology, unforseen circumstances etc). They just go by what they see published, which is not representative of the total body of data e.g. from a NEJM paper investigating SSRI trial reporting:

Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall


This kind of publication bias amounts to a distortion of the evidence, and needs to be addressed.
posted by Jakey at 10:44 AM on April 9, 2009 [9 favorites]


Hot damn what a scumbag.

You know those little moral dilemmas, like 'what would you do if you were transported back in time and were Hitler's barber?' Well, if your answer is "I'd slit the fucker's throat" I don't see how popping Rath would be in any way off-limits.

Just sayin'.
posted by Kadin2048 at 10:51 AM on April 9, 2009


[...]a friend's fibromylagia symptoms lessening because she made a change in her diet.

Eating a healthy diet is not alternative medicine.
posted by Optimus Chyme at 10:54 AM on April 9, 2009 [2 favorites]


"Even on MeFi we have people like Zambrano et al who work to deny children safe and effective medical treatment."

Wait, what? Was this in one of those vaccination threads?
posted by klangklangston at 12:06 PM on April 9, 2009


Wait, what? Was this in one of those vaccination threads?

More or less.
posted by Optimus Chyme at 12:13 PM on April 9, 2009


Rath is bad news, but what the Catholic Church is doing (and what the Bush administration did) with respect to helping maintain epidemic levels of HIV infection in Africa by eliminating condom distribution from known-working ABC programs is on a much greater and much worse scale.
posted by Blazecock Pileon at 12:15 PM on April 9, 2009


Eating a healthy diet is not alternative medicine.

No, but a gluten/yeast/sucrose/craptonofotherstuff-free diet may be, or at the very least it could be argued that comes damn close.
posted by EmpressCallipygos at 12:39 PM on April 9, 2009


Actually MSF has plenty of critics and one of the reasons includes letting Rwandans suffer because they didn't know if they were helping some of the Genociders in a camp.

MSF is also not about helping anyone in need. Sort of the anthises of the ICRC. Also they are pretty full of themselves and think it is their way or the high way.
posted by tarvuz at 12:56 PM on April 9, 2009


No, but a gluten/yeast/sucrose/craptonofotherstuff-free diet may be, or at the very least it could be argued that comes damn close.

A not-insignificant proportion of the world population has a genuine intolerance to gluten proteins, which otherwise damage the cells in the upper intestine, blocking nutrient absorption and causing malnutrition and its associated symptoms.

For those individuals, a gluten-free diet is hardly alternative medicine, but as much a necessity of life, as, for example, eliminating phenylalanine from the diet of those who suffer PKU.

Diet is more or less a demonstration of cause-and-effect. If your body can't metabolize something properly or safely, you shouldn't eat it. That's not alternative medicine, by any stretch.
posted by Blazecock Pileon at 1:05 PM on April 9, 2009 [2 favorites]


Diet is more or less a demonstration of cause-and-effect. If your body can't metabolize something properly or safely, you shouldn't eat it. That's not alternative medicine, by any stretch.

Oh, I agree. My point (which I didn't make clearly enough, my apologies) is that some "alternative medicine" is actually not that "alternative" depending on the individual, or the procedure being suggested.

"Not eating what's bad for you" is indeed a no-brainer, but there are some who would be of the opinion that "gluten-free-diet" is an alternative medicine (in my friend's case, it's not a matter of "she has a proven gluten allergy", it's a matter of, "she doesn't have a gluten allergy as such, but for some reason gluten is aggravating this condition which may be unrelated").

It's only when things get to the extreme panacea level that you got a problem. Vtamin C does help with some specific diseases, but it's not the wonderdrug for everything, that's all...
posted by EmpressCallipygos at 1:53 PM on April 9, 2009


Kid Charlemagne: "So looking at Goldacre's site, there is one bit that kind of annoys me. He's on about clinical studies that are never published and saying that doctors need that information because there are LIVES IN THE BALLANCE!!!

I'm not an official spokescritter for Big Pharma or anything, but if we do a clinical study and then you never hear anything else about it, you can pretty much bet that the results were less than or equal to the current best standard of care. (This doesn't exactly apply to comparisons between two current standards or treatment, but I live in the world of novel molecules.)
"

Although I'm not positive this is the same point Goldacre was making, the problem with studies that are not published is, e.g., that PharmaCo will fund a dozen studies -- 2 with negative results, 9 with mediocre results, and one with positive results -- then publish the one study with positive results and use it to convince doctors to prescribe their new (expensive) medicine.
posted by alexei at 2:40 PM on April 9, 2009


This guy is getting rich peddling vitamins to poor and helpless populations, convincing them not to take anti-HIV drugs when there are over a million AIDS orphans and 800 people die a day from Aids. 800 people a day! Is there any serial killer responsible for as many deaths than this guy?

I'd love to pull a scam on him. Have someone with strep throat cough on him. Then when he goes to get checked, switch the files on him and tell him he has AIDS. Then put him in a hospital bed and tell him not to worry, because the doctor is a fan and is going to follow his advice and make sure he gets the appropriate vitamin treatment. As his fever goes up and hs throat gets more and more painful, make sure to have a camera to record his panic and outrage.
posted by eye of newt at 2:52 PM on April 9, 2009 [2 favorites]


It's only when things get to the extreme panacea level that you got a problem. Vtamin C does help with some specific diseases, but it's not the wonderdrug for everything, that's all...

The problem (or at least a problem) is that alternative medicine often uses the language of science to lend itself authority without having any of the rigour or reliability of the real thing. The media loves this kind of stuff because, unlike most real science, it offers clear and confident messages and doesn't require the audience (or the journalists) to think very much.

The net effect is to poison the public understanding of what science is and why it's important. So science, in the public eye, becomes antioxidants keeping you young and vaccines causing autism. The heroes of science become the lone mavericks railing against the system, rather than the people who are less adept at self-publicity and much better at actually getting good work done. This is the media's fault at least as much as the alternative medicine practitioners. And at least the alternative medicine practitioners usually believe what they're saying. Mainstream media doesn't generally give a damn about the veracity of the things it says about medicine and science.

I don't think most reasonable people have a problem with someone experimenting with what they eat to find a diet that makes them feel better. The problem comes when, for example. nutritionists flaunting PhD's from highly suspect universities claim that chlorophyll oxygenates the blood. All the small lies don't seem all that harmful on their own open the door for things like Rath's vitamin panacea.
posted by xchmp at 3:41 PM on April 9, 2009 [9 favorites]


Apparently the Rath of Con can be beaten.
posted by inkyroom at 8:22 PM on April 9, 2009


The problem (or at least a problem) is that alternative medicine often uses the language of science to lend itself authority without having any of the rigour or reliability of the real thing. The media loves this kind of stuff because, unlike most real science, it offers clear and confident messages and doesn't require the audience (or the journalists) to think very much.

I think we may be on the same page, just different paragraphs. :-)

I just got a little paranoid when I saw what looked to me like a pig-pile on the entire scope of alternative medicine, and wanted to just add my meek little, "em, some things some people call 'alternative' are actually kind of okay...."
posted by EmpressCallipygos at 9:35 PM on April 9, 2009 [1 favorite]


"em, some things some people call 'alternative' are actually kind of okay...."

Hence perhaps the idea that there's no such thing as alternative medicine. Only medicine that has been shown to work, and medicine that hasn't.
posted by edd at 10:21 PM on April 9, 2009 [4 favorites]


Kid Charlemagne I'm not an official spokescritter for Big Pharma or anything, but if we do a clinical study and then you never hear anything else about it, you can pretty much bet that the results were less than or equal to the current best standard of care.


The problem is, I don't want the next researcher to have to bet, I want him to know. That only works if Big Pharma also publishes everything that fails, including why it fails. It is vitally important to not only know what works, but also what doesn't work.
posted by DreamerFi at 1:23 AM on April 10, 2009


This is a bit tangential but I found this book review from a couple of years ago very illuminating on the subject of why it is easy for some South Africans to believe conspiracy theories about HIV/Aids.

For example, for many years 'medical science' was used to argue crazy racist stuff, like Africans were biologically and morally inferior to whites, and that's why they contracted diseases (that were in fact being accelerated by poverty etc). While to a lot of people this might seem like ancient history, in a place like South Africa you can imagine it would not seem quite so long ago, and so it might be a little easier to be suspicious of western medicine.

I'm not saying (nor is the review, or the books being reviewed) that Rath is anything other than a scammer.
posted by 8k at 6:00 AM on April 10, 2009 [1 favorite]


Oh good. Thanks for posting this, xchmp.
posted by homunculus at 12:33 PM on April 10, 2009


I wish the re-release of the book was available in the U.S. The only copies Amazon has are from resellers who want almost $130 for a copy. Which...no. I really want to read it, but not at collector book prices.
posted by dejah420 at 2:45 PM on April 10, 2009


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