Edzard Ernest and the Prince: Trafficking in Denouncing Complementary and Alternative Medicine

Photo of Edzard ErnestThree colleagues independently sent notes sharing that Edzard Ernst, MD is in the news again. The anti-CAM author grabbed headlines with old news about what he presents as a vendetta to “silence” him that Prince Charles had against him. This headline-grabbing gambit for Ernst’s newest book, A Scientist in Wonderland appears to be working. The book reportedly details, in a chapter entitled “Off with His Head,” Ernst’s perspective on the 2007-2011 dispute. According to The Guardian, the battle erupted after Ernst was given the opportunity to review a draft form of a planned government document on complementary and alternative medicine. Ernst violated professional confidentiality by disclosing the contents. The article links Ernst’s trials to the fact that he “was himself strongly criticised for disclosing the report’s contents before they had been fully reviewed and published.”

The article notes that Prince Charles has been a strong supporter of the potential value of complementary and alternative medicine in assisting people to health and in potentially lowering health costs. A particularly acrimonious theme in the dispute has been the Prince’s support for, and Ernst’s antagonism toward, homeopathy. Following the hoopla over the report, Ernst was sanctioned. Funds subsequently dried up for Ernst’s department at the University of Exeter which at one time included a group of 20 co-workers. He eventually retired to a countryside retreat where he continues to write.

Comment: When colleagues shared this news with me, I wondered about the ethics of writing anything. Why give Ernst and his polarizing more visibility? I have chosen to do so to raise this general question: what do we do with professionals from any perspective who polarize the evidence discussion in integrative health? Ernst kept himself and his work visible and supported, at least until recently, through an oeuvre that hardly admits to the value in integrative practices and practitioners. Meantime, the likes of the conservative accrediting agency for health care organizations, The Joint Commission, has re-shaped guidelines based on evidence. A RAND Corporation researcher marches our 28 high quality studies and concludes that it’s time to stop arguing that we have no data on cost-effectiveness. Mirror imagine to Ernst is the medical doctor author who traffics in over-claims about petri-dish studies of natural agents as though they were large human trials while lambasting shortcomings and biases in pharmaceutical trials.

A colleague Ben Kilgler, MD, MPH, and I recently suggested some ways out of this polarization in Finding a Common Language: Resolving the Town and Gown Tension in Moving Toward Evidence-Informed Practice.  In short, we urge evidence-based humility on all sides. Ernst shows little humility regarding how little high-level evidence we actually have on interventions of any kind. “Silencing” and “vendetta” are claims from an individual who silences a good deal of research in his personal vendetta against entire complementary and integrative fields and disciplines. Ernst’s protest rings hollow. Still, his book might be a stimulating – as in infuriating – read. Anyone need an ire injection?

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