Posted by: Edzard Ernst25 August 2012
It was Andy Lewis, a fellow blogger, who first formulated a notion which he called ‘Ernst’s law’.
When I first saw it, I felt this was a bit silly. Then it made me chuckle, and eventually it got me thinking: could there be some truth in it, and if so, why?
As I understand it, the ‘law’ stipulates that if a scientist investigating alternative medicine is much liked by the majority of enthusiasts of alternative medicine, the scientist is not doing their job properly. In any other area of healthcare, such a ‘law’ would be paradoxical and absurd. Why then does it seem to make sense, at least to some degree, in alternative medicine?
The differences between any area of conventional and alternative medicine are diverse and profound.
Take neurology, for instance: here we have an organ-system, anatomy, physiology, pathophysiology, aetiology and nosology all related more or less specifically to this field and that are all based on sound knowledge and rigorous science, as well as substantial evidence. None of this knowledge, science and evidence is static, but each has evolved and can be predicted to do so in future. What we knew about any neurological phenomenon 50 years ago, for example, was dramatically different from what we know today. All of this scientific discovery links up with the knowledge gathered in other areas of medicine to generate a more or less complete bigger picture.
In alternative medicine or any single branch thereof, we have no specific organ-system, anatomy, physiology, pathophysiology, aetiology or nosology that is based on scientific discovery.
We also have few notions that are transferable from one branch of alternative medicine to another – on the contrary, the notions of homeopathy, for example, are in overt contradiction to those of acupuncture which, in turn, are out of sync with those of reflexology, aromatherapy and Reiki.
Instead, each branch of alternative medicine has its own axioms that are largely detached from reality or, indeed, from the axioms of other branches of alternative medicine.
In acupuncture, for instance, we have concepts such as yin and yang, life energies, meridians and acupuncture points, all of which fly in the face of science. Moreover, there is hardly any development these of concepts, which renders them akin to dogmas, and there is little evidence that the combination of all the branches of alternative medicine would add up to provide a sensible ‘bigger picture’.
If a scientist were to instill scientific, critical, progressive thought in a field like neurology, they would be greeted with open arms among many like-minded researchers who all pursue the aim of advancing their field and contributing to the knowledge base by overturning wrong assumptions and discovering new truths.
On the other hand, if researchers were to spend their time trying to back up dodgy concepts or bogus treatments, they would most likely not be appreciated by the majority of the experts working in this field.
By contrast, if someone wanted to evaluate homeopathy, acupuncture or other alternative therapies in a rigorous and critical fashion, they would inevitably discover that many of the concepts are highly questionable, based on wishful thinking or beliefs that are so strongly held that doubting them is tantamount to a sacrilege.
If this scientist nonetheless exposed these deficits to the world or conducted research that predictably fails to confirm what wishful thinkers had assumed, they would not make many friends among the proponents of alternative medicine.
If this scientist dedicated decades of hard work to these tasks, that person would become a thorn in the flesh of believers. Instead of welcoming the scientist with open arms, some disappointed enthusiasts of alternative treatments might even pay for defaming them.
On the other hand, if researchers merely tried to confirm the implausible assumptions of alternative medicine, they might well become the celebrated ‘heroes’ of this field.
This is the bizarre phenomenon that ‘Ernst’s law’ seems to capture quite well – and this is why I believe the ‘law’ is worth more than a laugh and a chuckle. In fact, ‘Ernst’s law’ might even describe the depressing reality of retrograde thinking in alternative medicine more accurately than most GPs care to admit.
What do my readers feel? Their comments following this blog may well confirm or refute my theory.
Professor Edzard Ernst is the emeritus professor of complementary medicine at the Peninsula Medical School, University of Exeter