Lol.

@Oddthinking I find that a bit biased too strongly. For quite some treatments we do not 'know' whether they work or not, how dangerous they are. When in vitro looks good but previous trials in vivo were negative? Then we would end up with permanent dismissal even if later trials show a good effect? Because they were conducted by 'quacks', underfunded, too small, from a biased sourced, published in 'quacky journals'? Especially in medicine, our 'certainty' isn't that firm in the long run.

While I am certainly not convinced in any way that 'magic water' does any more good than just delicious hydrating water, all these water related treatments are still not studied 'through'. Scientific EBM is the standard to measure up. But there double blinded studies are seen as sufficient, when we in that case do 'know' that triple blinded is better. If those water treatments rely on perosnal contact and placebo, then that is in huge need of being studied further.

Magic pills do not work better than placebo? Well, a lot of surgical interventions way too many are at the exact same level. sciencebasedmedicine.org/…

'People are in danger' because magic pills don't work better than placebo and delay 'necessary treatments' (plus waste of money? The delay is not inherently tightly bound to the pills themselves. The 'necessary treatment too often not really that necessary or even advisable.

And no, not anything 'chemo for cancer' (where we read of good results from proper oncology on one side (which tends to neglect the failures in agony) & 'miracle cures' on the other (with similar neglect for negative outcomes).

Do I scorn the quacks that believe in their stuff? I do scorn more the quacks that do not trust their own methods and do it anyway. Those are hard to identify. Do I scorn those 'quacks' that end up harming their clients systematically? That's the point. Whether it is chiros doing stuff proven harmful and no good, or parametrised medicine subscribing Cerivastatin, offering dangerous lifestyle drugs like paracetamol.

What do we call people who design a drug trial in 2020 with a medicine we know by name from previous trials that has been stopped because of very low efficacy and big side-effects? Or the same org designing a trial employing a drug with a known dangerous side in a recommended dosage much too big?

In the latter case of chloroquine we still do not 'know' much. Except that the top advisor for that trial regime now claims to be an idiot as his 'error' should be apologised for 'I mixed up the substances in my head and anyway thought that nCov is a big threat so we needed a big hammer to flatten that curve'.

In that case we knew from vitro that it might work, and we knew from vivo that the substance itself has individualised narrow therapeutic windows. Stay within, fine, exceed that and trouble approaches fast. This is exactly what we discuss here: there were immediate warning voices in response to the proposed regimes.

In our context here: 'Did we know it wouldn't work?' or 'Did we know it was inherently dangerous if applied in that way'?

In my view: that it would be of any benefit would have surprised me, pleasantly. But we learn a lot all the time. Good. The proposed study design I judged as borderline insane.

You can come up with areas that haven't been investigated thoroughly, in which more research might be warranted. But when you get to 20C homeopathy, we can say it has been tested, there is no effect, there could be no effect. It is no longer ethical to invite cancer patients to spent their limited lives trying it.

If there are surgical treatments that don't operate better than placebo, we should STOP doing those surgeries, NOT use them to justify other ills.

> 'People are in danger' because magic pills don't work better than placebo and delay 'necessary treatments' (plus waste of money? The delay is not inherently tightly bound to the pills themselves. The 'necessary treatment too often not really that necessary or even advisable.

This reads as a weird excuse. If someone says "Look at Steve Jobs. He was sold fake medicine and avoided real treatment for so long, his cancer couldn't be cured." and you say "Ah, but what about when that isn't the case!" Errr... I am pointing to an evil here. Don't deflect.

@LаngLаngС That's a bold claim. Oncology has made huge progress in the past 50 years. Any treatments that are as bad as placebo should be removed. Treatments that offer only small improvements but have serious side-effects should be explained - and here we get to the discussion about doctors being more likely to choosing NOT to have such treatments, presumably because they are more informed.

@LаngLаngС Quacks who don't believe their stuff are, perhaps, more morally culpable, but that doesn't excuse the people who first do harm because they didn't bother to check.

@LаngLаngС I don't get your point. If you think I put medical doctors on a pedestal and say they can never do the wrong thing, of course not! But at least they have reporting systems and they try to improve. Can they get better? YES! And they do. Can their reporting systems get better? ALSO YES!

@LаngLаngС I don't know enough about the study design to comment here.

@Oddthinking That's actually one point example frequently raised when discussing with other skeptics or just people hating 'alternative medicine' and looking down on anything they judge as such. But I read the story around Jobs and his cancer as really more in favour of what I just presented. Ernst: "What can we learn from Steve Jobs about complementary and alternative therapies?"

Even if we had more info on the details of diagnosis, recommended treatment, chosen approaches, it is sstill a lot of uncertainty – in both directions. Success not guaranteed, neither failure. What's often heard is that "Jobs proves it". And from wll we know, that's not the case.

@Oddthinking My point is that we should not only put medical doctors under much more scrutiny and ask for improvements. That is quite difficult for both situations, when performing routine jobs and getting it wrong (whether for a a case or systematically), as well when decisions have to be made under stress and uncertainty.

But for lots of 'the other stuff' we must not only demand abut also allow scientific investigation. Your example of 'diluted info water' is one extreme that looks much easier than it is. We both think the theory behind it is irrational. But deducing from that that all clients that reported to 'feel better' or were better must be themselves just delusional about their own experience is not correct.

(Although, many in fact are delusional abut the whole thing, as I would conclude from most high level evidence trials that show an aggregate sum of a pittance in effectiveness)

@LаngLаngС That article says: We couldn't draw a conclusion from one anecdote. There was no information about whether the complementary results worked. Smart people, in desperate situations, turn to CAM. I didn't see anything that undermined my argument.

@LаngLаngС Saying "Well, this is the best treatment, and it still only has a 25% chance of succeeding" does not somehow forgive someone who says "Well, this treatment has never been tested, but hey crystals look pretty so it probably work.s"

@LаngLаngС I am NOT calling people who find they feel better after CAM delusional. I am not attacking them for not understanding that medical science is much much harder than post hoc ergo propter hoc. I am continuing to blame the practitioners.

@LаngLаngС It isn't about looking down on people who have been lied to. I have been lied to by pharmacists, have fallen for it. I was angry when I realised, and that is where the looking looking down part happens - looking down on the people who are either actively lying or are indifferent to the truth.