Challenging misleading healthcare claims.

Prof Edzard Ernst retires

In 1993, Sir Maurice Laing, a supporter of complementary therapies, founded the Complementary Medicine Research Group, now at the Peninsula Medical School at the Universities of Exeter and Plymouth.

Laing appointed Edzard Ernst, then chair of physical and rehabilitation medicine at the Medical Faculty of Vienna, to set it up and Ernst became the first occupant of the Laing chair in Complementary Medicine. In 2002, Ernst became its Director.

It is to the defining attributes of science and the scientific method that Laing wanted — and needed — Ernst to adhere.

In 2008, Ernst explained his attitude to alternative therapies:

For us [Ernst and Dr Simon Singh], there is no such thing as alternative medicine.

There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines.

Hopefully, in the future, the good medicines will be embraced within conventional medicine and the bogus medicines will be abandoned.

This was shortly after Enrst had been critical of misleading claims being made by Prince Charles' beloved, but now defunct, Foundation for Integrated Health. It was this that heralded the end of Ernst's career.

A few days ago, Prof Ernst announced his retirement as Director of the Complementary Medicine Research Group.

To better understand the situation and future plans, we asked Prof Ernst some questions and he was kind enough to answer:

 

What does the Complementary Medicine Research Group at the Peninsula Medical School do and why?

From the early beginnings in 1993 we had defined our aims as follows.

  • To conduct rigorous, interdisciplinary and international collaborative research into the efficacy, safety and costs of complementary medicine (CM)
  • To be neither promotional nor derogatory but struggle for objectivity.
  • To promote analytical thinking in this area
  • The overreaching aim of all of our research is to maximise the benefit and minimise the risk of CM for the patient.

I believe that, vis-à-vis the high levels of usage and the abundance of misinformation bombarding consumers on a daily basis, these aims are important.

 

What was the original vision of Sir Maurice Laing?

Sir Maurice Laing was a good and clever man. He wanted foremost rigorous research. I'm sure he would have wished our results to have been more often positive, but he told me repeatedly that it was more important to conduct good research to a standard that would be acceptable even to sceptics, than to bend over backwards in an attempt to generate positive findings.

 

What have been the Group's greatest achievements?

This is hard for me to say. There have been many. We published more than 1,000 papers in the peer-reviewed medicinal literature. Several independent reviews thus identified us as the most productive CM research group in the world. We also did a few books as a group; the most important two are The Desktop Guide to Complementary and Alternative Medicine. 2nd edition. Edinburgh: Elsevier Mosby. 2006 and Oxford Handbook of Complementary Medicine. Oxford: Oxford University Press; 2008.

We also created a journal, Focus on Alternative and Complementary Therapies. But these achievements are trivial compared to the fact that, I think, we changed the climate of CM research worldwide. When we started, there was hardly any critical thinking within CM at all. We have worked very hard to introduce this into CM through our articles, books, lectures, annual conferences, etc. I'm not saying that the field is known for its self-criticism. In fact, we are still the only centre that consistently does critical evaluations. But the principle has been established and will grow, I hope.

 

Why are you choosing to retire now as Director of the Group?

I am still two years before the official retirement age. Yet I am retiring because the £2 million donated by the Laing Foundation is running out. My University had signed a contract to match this sum, but fund raising was never successful. After Prince Charles complained to the Vice Chancellor about me five years ago, it stopped altogether. Instead of fulfilling their promise, the University told us that they will close us down in May 2011. It was only because I could persuade the new dean who started in September 2010 to reconsider that complete and final closure was averted. The 'deal' we struck was that I officially retire, then get re-hired half-time for a year to help find a successor and provide the continuity. Personally, I am over the moon with this solution. I have fought so many battles that the scars are beginning to show and I feel exhausted with all of this.

 

Why is it important that your Group continues its work?

We are the only group who is doing full-time CM research not for proving that this or that therapy is effective and safe but for testing whether that is the case. This is such an important difference! It is the difference between a scientist and a promoter. The latter we don't need in academia, promoters; they already populate every other strand of society.

 

I understand you'll be working part time for the next year to help find a successor. What qualities will you be looking for in your replacement?

I am looking for a person who is a good scientist with energy and enough courage to stand up against the often quite overpowering forces of quackery. The university wants someone who can bring in money — and that is, of course, equally important.

 

There has been a lot of speculation about the Group being closed down because of a lack of funding. How secure is its future?

Without money, it clearly will not work. The trouble is that it is relatively easy to get research funds if you have the reputation of being "sympathetic" to CM. If you are critical, it is much harder. But if you're not critical, you are not a scientist — and, in that case, it is better not to do the research in the first place.

 

There have been a lot of very personal attacks on your integrity, impartiality and your qualifications to comment on complementary medicine. Has this affected you personally or the work you are doing?

Yes, of course! Over the years I have become rather thick-skinned. But it affects me nevertheless. The best strategy, I find, is to see the funny side of it. Homeopaths attack me for not having qualifications in homeopathy. Think of it! If that's not really hilarious, I don't know what is.

 

What will you do when you fully retire?

Become really outspoken about quackery and charlatans. I look forward to that. Hopefully, UK libel law has changed by then.

 

This is an extract from a longer article written for Zeno's Blog: The end of an era.