5X5 Episode 81

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5X5 Episode 181
18th November 2009

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5X5 80 5X5 82
Skeptical Rogues
S: Steven Novella
B: Bob Novella
J: Jay Novella
E: Evan Bernstein
M: Mike Lacelle
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Voice-over: You're listening to the Skeptics' Guide 5x5, five minutes with five skeptics, with Steve, Jay, Rebecca, Bob and Evan.

S: This is the SGU 5X5 and tonight we're talking about naturopathy. Mike Lacalle's sitting in for Rebecca Watson tonight.

Naturopathy [Nature-opathy] or Naturopathy [Naturo-pathy] is a system of practice, of medical practice or healing practice, that's about 100 years old and is based primarily on the principle of using natural or non-invasive remedies in order to enhance the body's ability to heal itself. It really is a philosophical or philosophy-based medical practice. It's overtly not a science-based practice. It is still relatively on the fringe in that in at least most states in the United States, for example, it is not a licensed recognized medical profession, though it is licensed in some states. It has not gained widespread acceptance within the mainstream medical profession because of its use and endorsement of a host of unscientific modalities.

M: That's right. Naturopaths believe that the body heals itself if it's kept in a fully natural environment. They also believe we're a combination of a natural body, a soul and a nonphysical mind. And they use lots of words like balance and energy and harmony. Naturopathy is rooted in vitalism. Vitalism is the belief that we possess a kind of energy or force that gives us life.

S: But of course, you know, vitalism, which was a viable scientific notion 150-or-so-years ago, but it's gone the way of the aether and other unnecessary hypotheses within science. There essentially was nothing for the vitalistic force to do once we figured out how biology works essentially. So it lingers on only in these philosophy-based notions like naturopathy.

E: Yeah, modern day naturopathy can be traced back to Father Sebastian Kneipp from Germany, who opened a water cure center after becoming convinced that a fellow student had cured themselves of tuberculosis by bathing in the Danube river. And another person who was responsible for introducing naturopathy to the United States was Benedict Lust who took Kneipp's ideas, brought them to the United States and opened his own water cure institute in New York City. And he took the term naturopathy in 1902 and combined it with the use of massage and herbs, homeopathy, spinal manipulations and various other types of occult healing. Eventually he opened the American Institute of Naturopathy and that's how things got started here in America.

B: One common tactic used by naturopaths is to claim that their methods can be used to boost the immune system. They assume that many, if not all, diseases are caused by impaired immune responses. The fact is, many diseases - cancer among them - can ravage the body even with completely uncompromised immune systems. Add to that the absence of any scientific evidence that naturopathic treatments can enhance immune response and you have at best wishful thinking and at worse scam artists.

J: As of this recording, 15 states and the District of Columbia have licensing laws for naturopathic doctors. In these states, naturopathic doctors are required to graduate from a 4-year residential naturopathic medical school and pass extensive post-doctoral board examinations, which they call the NPLEX, in order to receive a license. These people also have to fulfill state mandated continuing education requirements. I believe that those are required annually.

S: The problem with the whole licensure thing, however, is as Edzard Ernst quite eloquently stated, even "the most meticulous regulation of nonsense must still result in nonsense." The problem is that in order to acquire licensure, naturopaths are not required to prove that anything they do is scientific, or that they have an appropriate evidence base for their treatments, or even that they adhere to any ethical standards. Essentially, they have to prove only that they are internally organized, that they track their members, that they make them take exams, that their paperwork is in order - logistical things like that. But nothing that really asks the question of "is the practice ethical and scientifically legitimate?" Jay, you mentioned that they have to pass exams, but actually they have been criticized for adjusting the scores of the exams so that all of the naturopaths who take the exams pass them. So essentially the exams are worthless because they just pass everybody.

Naturopaths will often make the claim that licensure is necessary in order to prevent bad naturopaths from practicing. They want to make sure that only the legitimate naturopaths can practice. And that's somehow going to protect the public. Unfortunately, there's no difference between a "good naturopath" and "bad naturopath" as there's no science base to anything that they do. They will frequently use practices that are not evidence- or science-based so without a science-based standard of care, what is the difference? That is really just a political ploy that they use in order to get licensure and to really inhibit competition. It's just one body of naturopaths trying to insulate themselves from competition, from other practitioners, but it is in no way protecting the public from unscientific or substandard care.

M: So naturopathy, from my observations, they're the jack-of-all-trades of quackery. I see dozens of receipts for naturopathy every day and I've seen everything from food allergy tests to prescribing homeopathic remedies to acupuncture, aligning of the crescent moon, whatever that is. I've seen receipts for drug prescriptions, certain, well, vitamin prescriptions, and I've also seen one or two receipts for minor surgeries.

S: That's right, and they, it's really a loose collection of anything that's been discarded by science-based medicine, or that is either disproven or is implausible and hasn't been studied. There really isn't any cohesive or coherent theme to the different modalities that they use. They sort of white-wash it all by saying "yeah, it's all natural," or "it's all supporting the body's own self-healing," but that's quite glib and superficial. When you really look at all the different things that they do, they don't really have anything to do with each other except that they're not legitimate scientific practices.

S: SGU 5x5 is a companion podcast to the Skeptics' Guide to the Universe, a weekly science podcast brought to you by the New England Skeptical Society in association with skepchick.org. For more information on this and other episodes, visit our website at www.theskepticsguide.org. Music is provided by Jake Wilson.

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