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Trick or Treatment?: Alternative Medicine on Trial | 
 enlarge | Authors: Simon Singh, Edzard Ernst
Publisher: Bantam Press
Category: Book
List Price: £16.99
Buy New: £9.00
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Rating:  18 reviews
Sales Rank: 3831
Media: Hardcover
Pages: 352
Shipping Weight (lbs): 1.3
Dimensions (in): 9.3 x 6 x 1.5
ISBN: 0593061292
EAN: 9780593061299
ASIN: 0593061292
Publication Date: April 21, 2008
Availability: Usually dispatched within 1-2 business days
Condition: Brand New, UK Based & In Excellent Condition!
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| Customer Reviews: Read 13 more reviews...
 Uncomplimentary medicine August 19, 2008
Eric Reeder
2 out of 6 found this review helpful
The book is impeccably constructed and written with wonderful fluency - I would expect nothing less from somebody with Singh's skills and experience. The authors weave together lots of little stories, biographies, and anecdotes into a very palatable confection. This is all about 'evidence-based' medicine and how it shines its light over our culture. By the final page this apparent objectivity reveals itself as the belief that 'the concept of an alternative type of medicine is a throwback to the Dark Ages' and 'the public is being misled again and again'.
Written by such highly qualified men, it is all highly plausible, and if I hadn't been selectively using aspects of what I prefer to call 'complementary medicine' since the late 1970's I would probably accept it. My problem with the book is that it simply doesn't accord with my experience.
I cannot be an apologist for the whole field - there are some pretty stupid people in the world, some of them unfortunately do work in complementary medicine, and the neophilia of the media has done more harm than good - but the therapists I have used have been professional, knowledgeable, fairly priced and highly effective. Nor would I devalue the orthodox medical paradigm - I am deeply grateful for some of he spectacular benign effects of modern medicine as well as the kindness of GP's. But Ernst and Singh seem to misrepresent what is happening in the world by perceiving it through a highly limited filter and then being suspiciously selective in their tale-telling. They rely on the apparent finality of new statistical methods and the convenience of attributing pretty much everyting else to the placebo effect to give weight to their argument, and conveniently miss out any accurate statisitics on just how satisfied most the clients of this 40 billion pound worldwide phenomenon really are, or why they really use such therapies.
Most conveniently they do not address the complex issue of people in an affluent post-modern society being free to make choices when orthodox medicine fails them in some way. Iatrogenic illness, the painful side-effects of superficially effective drugs, the fact that most treatment for chronic illness is palliative at best, and so on, are far more potent incentives for people to look for alternatives than Ernst and Singh care to admit. If, like me, they then find that a few sessions with a good osteopath are much cheaper than a lifetime on painkillers they may use that method again. The authors seem fairly sniffy about the potential synergistic benefits to health of time, kindness, informal counselling added to technique - but that is exactly why many of us choose to go back. The authors claim that orthodox medicine is just as 'holistic' - it could be, but it rarely is.
I would take issue with many other things in the book as well. In their campaign of reductionism they do not acknowledge that many therapies are believed to work on similar principles and use similar models. It may all be 'biologically implausible', but then why have these 'energetic' models emerged independently in several continents at many different times, and why have they become a common vocabulary for so many millions of people just as science has?
I have no doubt that the negative tales the authors tell are true, but selectivity in support of a particular polemic is nothing like the whole truth. Either I am inordinately gullible, unbelievable suggestible, or the therapies that I chose to use offer something that isn't yet easily measured by orthodox methods and means that my visits to the doctor are incredibly rare.
I may heartily disagree with much in this book, but it has at least helped me to understand how frustrating non-orthodox medicine can appear to be to those who see modern science as the final frontier. For that, and the great story-telling I thank the authors most sincerely.
 A healthy dose of sense and reason August 7, 2008
tayloran9 (London UK)
2 out of 3 found this review helpful
I find it perplexing the way some people simply assume to be correct what others tell them with no deeper inquisitiveness or afterthought. We know we cannot simply trust anyone otherwise we run the risk of being duped as we see from various successful scams.
What is more perplexing is how intelligent people can simply assume to be correct what their own gut feelings tell them or be tricked into actually believing they've experienced things that they haven't. I remember a study done a while ago where a group of random people took part in a psychological experiment. These people were shown a photo taken from their early childhood and asked to remember and describe the scene in it. The only problem was, some of the pictures had been cleverly doctored to show events that never actually took place, such as a hot air balloon ride! Many in the group, as you'd expect, drew blanks and were confused and could not recall the balloon ride. However, astonishingly, many of the participants after a while actually `recalled' this fake event and even `remembered' how elated they felt up there in the sky and how cold it was! (For those interested, it was the Wade et al 2002 study; link here: h--p://www.thepsychologist.org.uk/archive/archive_home.cfm?volumeID=21&editionID=162&ArticleID=1375)
We know we can't unquestioningly rely on strangers but worryingly, it seems not all of us can 100% rely on our own feelings! So then how do we find truth? Perhaps one way is to rely on the testimonials or opinions of the people around us. But is this totally wise, especially when we see that many people are not reliable sources of information? For me, this is where the scientific method of testing and evidence steps in and proves its absolute authority. Surely this is the best method we have of discovering what the truth is in any given situation; surely nothing can beat evidence derived from proper tests.
Trick or Treatment is about proving that the vast majority of alternative medicine doesn't work but it is also a celebration of the scientific method in the context of medicine. It begins fascinatingly by recalling various important historical moments when the scientific method first began to be used and how it then revealed such hugely important secrets that had eluded mankind for so long, particularly in the field of healthcare.
These introductions serve a very useful purpose, because the crux of the book is based on the results of many high quality scientific trials that render most alternative medicine completely ineffective or even dangerous. However, there are still many out there who, for some reason, don't accept the authority of the clinical trial / scientific method and these first few chapters provide an excellent case for counteracting this mistrust.
The rest of the chapters are devoted to one of the main types of CAM and begin by providing a detailed description and background to it. Then the authors bring in the mighty weight of a vast range of quality evidence (meaning evidence from the types of trials that eliminate all possibility of bias or erroneous results) to finally blow up any doubt in the rational mind that much of this stuff is childish nonsense and simply doesn't work.
As you'd expect, there's also a lot of fascinating information and evidence about the placebo effect and whether it is morally acceptable to sell it, and why, despite lack of evidence for and concrete evidence against, people continue to waste vast amounts of time and money on CAM and continue to steadfastly believe in it.
The book came out at a similar time to one by Rose Sharp, Suckers - How Alternative Medicine Makes Fools of us All. It treads much the same ground but is an excellent companion piece to Trick or Treatment, as both books often both elaborate on details the other one glides over. However, Trick or Treatment is better for focusing on the available evidence and therefore acts as a great reference book.
Also, to the authors' credit, they don't back away from including the results of various high profile trials that bizarrely seemed to acknowledge the efficacy of some of the main types of CAM, For instance, the WHO trials that seemed to support homeopathy and a certain BBC documentary that seemed to show somebody undergoing major heart surgery without any anaesthetic, only acupuncture (shame on you BBC!). This may be quite disheartening for the rationalist as he/she reads through this but order is soon restored once we read that such trials or PR stunts were riddled with bias or faked and that meta-analysis in fact shows the opposite.
Trick or Treatment is an important book and it's hard to believe that millions of westerners still buy into much of this nonsense. The book won't change people's minds overnight; many will still cling to their anti-Big Pharma stance, egocentric fashionista lifestyle or desire for more mystery in the world. But for those of us who place more importance in what's actually true and don't want to be a dupe, this book is invaluable as well as a fascinating read.
made my mum give up her Arnica 30C globules! August 3, 2008
Dr. C. Becker (Edinburgh, Scotland)
6 out of 7 found this review helpful
I have been meaning to write a review of Trick or Treatment for some months now and had a lot of sophisticated ideas how to phrase it. In the meantime, I had sent my mother a "care package", with dried cranberries, organic Earl Grey tea and a copy of Trick or Treatment. She called me last weekend and said:
"This book is so full of suspense and so extraordinarily well written. I understand what you mean now. I guess I will have to give up my beloved Arnica globules then. It *does* make sense that they cannot work if there is nothing in them. To bad that the German version does not come out until next year, I have some friends who should read this book."
There, that sums it up: Singh and Ernst obviously struck the right tone and paced the book appropriately for the educated user of "alternative medicine" to follow and accept the conclusions of many careful trials. That is excellent, because I myself somehow never muster the patience to go through the details, why this or that "alternative" is not even worth trying.
The only point that I found irritating (and so did my mum) is the sparseness of literature. Few sources are cited and they only refer to the chapter rather than a specific statement. This is something that would be worth amending in future printings and/or in other language additions. I want all necessary references in the book I am reading and don't want to be refered to another book of the author for background.
A must read for:
Any person in the medical field, so they understand who and what contributes to healing (the colour of the pill often as much as the ingredient).
Anyone with a longer lasting medical condition (since they are the prime "target" for most of the CAM methods and practitioners).
Any parent (most CAM products are essentially "Wellness" and parents should realize that they can generate "Wellness" for their child without the stringent rules of homeopathy, or the potentially dangerous upper spine manipulations of a chiropractor).
Medical Myth Buster June 8, 2008
Loretta J. Marron (Australia)
10 out of 12 found this review helpful
This book should be compulsory reading for every medical student, doctor and the worried well. It is easy to read and it explains both the history and research now available for many traditional and some very creative placebo treatments and products.
I recommend this book to anyone with an open mind to science and medical research.
MOSTLY TRICK, NOT MUCH TREATMENT May 28, 2008
JMWiesner (Woodbridge, Suffolk)
12 out of 18 found this review helpful
This is a book that should make us all sit up and listen. Trick or Treatment is dedicated - with a well-savoured irony, I suspect - to the Prince of Wales.
Most of the previous publications on alternative and complimentary medicine that I have read, seem to be based on opinion and/or anecdotal evidence. 'Trick or Treatment' is quite different. Edzard Ernst, one of the two authors, is the first Professor of Alternative and Alternative Medicine in the world. Under his leadership the faculty at Exeter University has carried out extensive and definitive research, on a large scale, to test the efficacy of a range of alternative and complimentary treatments including, amongst others, homeopathy and acupuncture. Both Professor Ernst and his co-author Simon Singh are adamant that neither of them had any previous bias, no vested interests were involved, and no assumptions were made in advance. The aim was solely to find out through exhaustive and objective research, whether the claims of success made by alternative medical practitioners are soundly based on hard scientific evidence.
The results of Ernst's research at Exeter are clear. And what results! The book provides conclusive proof that most alternative 'medicines' and practices are, with some exceptions, worse than useless, other than having a placebo effect; in some instances they can actually cause harm. As the authors remark, they mostly "relieve nothing more than cash from the patients pocket". Some herbal remedies are proven to have beneficial properties. For those of us who love the stuff but suffer from "Go away, you reek of Garlic", we can now (genuinely and righteously) counter with " but I HAVE to take it, it's for my heart, you see".
Perhaps the most surprising result from Exeter is the one that deals with the most widely used and, up to now, perhaps the most respected of all the alternative practices eg. Homeopathy. The authors give hard evidence that homeopathy has little or no efficacy; in most cases the claims of success are apparently false, either by design or more probably through self-delusion.
For those who have so strongly advocated the inclusion of certain alternative and complimentary treatments within the NHS. here is a book that provides judgements and decisions that are founded on reason, and informed by evidence. It would be nothing short of a travesty if substantial funds were diverted from effective and conventional treatment on the NHS, in order to support unsubstantiated and unproven alternatives. If supporters of Complimentary and Alternative medicine, can counter the conclusions reached in Trick or Treatment with sound evidence-based research of their own, let us hear it loud and clear.
In general this book is written with a clarity and precision that makes it easy for the average person to grasp the whole research process. It is not only a fascinating read the first time round, but the information within makes it a book you will want to refer back to, time and time again.
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