Simon Singh
The BBC series Alternative Medicine was widely regarded as a great success: its first episode, broadcast in January, attracted 3.8 million viewers, making it BBC2's second most watched programme of the week. There were glowing reviews and high profile news stories about it.
But this week scientists involved in the series have complained that elements of the programmes were misleading, the production team was uninformed, and scientists were used as "marionettes".
Last month it was suggested the series had a misleading sequence in which acupuncture was used instead of a general anaesthetic during open heart surgery in China. It was claimed the narration underplayed the role of the powerful sedatives and large doses of local anaesthetic that were used during the surgery, and exaggerated the role of the acupuncture.
The scientists say the programme culminated in an experiment that left viewers with the false impression they had seen a major step forward in the understanding of acupuncture.
Presenter Kathy Sykes introduced the programme by saying: "In a groundbreaking experiment I will discover something truly astonishing about acupuncture." She went on: "It's hugely ambitious, because of course we've got to be scientific and rigorous and plan it really carefully, but if it does work we could find powerful evidence that acupuncture is having a real effect on the body."
The experiment showed images of the brains of patients undergoing superficial and deep needling. Sykes summarised the results: "Acupuncture was having a real effect on the brain and it was doing something completely unexpected. It was a result that surprised us all ... The bit of the brain that helps us decide whether something is painful, we think perhaps is being affected by acupuncture and so maybe that helps to explain why acupuncture can help with chronic pain." The experiment was reported with national newspaper headlines such as "Acupuncture does combat pain, study finds".
However, Professor George Lewith of Westminster University, the most experienced acupuncture researcher on the team devising the BBC experiment, criticises the way the experiment was presented: "The interpretation of the science in this particular programme was not good and was inappropriately sensationalised by the production team. I think all of us on the experiment felt like that."
Although sympathetic about some of the claims of acupuncturists, he contradicts the way the experiment was described: "The experiment was not groundbreaking, its results were sensationalised and there was insufficient time to analyse the data properly and so draw any sound conclusions. It was oversold and over-interpreted. We were encouraged to over-interpret, and proper scientific qualifications that might suggest alternative interpretations of the data appear to have been edited out of the programme. Because the BBC had funded the experiment, they wanted their money's worth - that's not a good basis for science."
The series claimed to maintain the highest standards, and was subtitled "The Evidence". But Edzard Ernst, professor of complementary medicine at Exeter University, was dismayed by the shortage of hard evidence. The main consultant for the series says: "The BBC decided to do disturbingly simple storylines with disturbingly happy endings. But none of these stories is as simple as they presented, nor do they have such happy endings. Even when the evidence was outright negative, they somehow bent over backwards to create another happy ending.
"I feel that they abused me in a way. It was as if they had instructions from higher up that this had to be a happy story about complementary medicine without any complexity, and they used me to give a veneer of respectability."
Rationality
Prof Ernst, an experienced TV consultant, was disappointed by several sections of the series. The low point for him came last November, when he complained three times about the programme on faith healing, which he felt was creating a false impression. Having been ignored, he wrote to Martin Wilson, the series producer: "With any other subject this would simply be a false impression and an orgy in pseudo science, but with healing this cuts much deeper. Here we are touching on a very fundamental issue of rationality. If your programme undermines rationality in that unfortunate way, it does an enormous disfavour far beyond healthcare and promotes US-style anti-science."
Having seen the finished programme, he wishes he had not had his name attached to it.
According to Prof Ernst, the fundamental problem was the production team's lack of expertise and unwillingness to listen: "I would have expected that journalists doing a medical programme would be able to deal with medical evidence. But they were at a complete loss to understand the difference between an anecdote and real evidence. You need somebody on the team who is a scientist, particularly in the area that the programme is about. Also, there is no point having expert advisers if nobody is going to take on board what they say."
Despite the criticisms, the BBC is understood to be considering commissioning a second series. A spokesman said yesterday: "We take these allegations very seriously and we strongly refute them. We used two scientific consultants for the series, Prof Ernst and Dr Jack Tinker, dean emeritus of the Royal Society of Medicine, both of whom signed off the programme scripts. It seems extremely unusual that Prof Ernst should make these comments so long after the series has aired."
The spokesman said Dr Tinker said he remained happy with the tone and content of the films, stating: "Fellow medics at the Royal Society, including one eminent professor, said it was the best medical series they had seen on television."
The BBC had consulted other medical experts to ensure the series' integrity: "There was no pressure from anyone to distort the evidence. The results of the acupuncture experiment were not sensationalised. It was Prof Lewith who, in the programme, described the results as 'quite special' and 'something unique to acupuncture'. The results were not edited to give a distorted picture, any reservations scientists did have were fairly reflected in the programme.
"The BBC's science unit has a strong track record of making accurate, distinctive and high quality programmes which are rigorously scrutinised before being aired, and this series is no exception. We stand by the series."
Professor David Colquhoun, a pharmacologist at University College London, says he has already detected signs that the series has had an impact on public attitudes to alternative medicine.
The series visited South Africa to show the use of the plant sutherlandia in treating Aids. Prof Colquhoun says: "Sutherlandia is a totally unverified treatment for Aids. The programme gave a positive impression of what sutherlandia can do, even though no clinical trials have been done yet. The comments made in the programme about Aids were irresponsible and potentially dangerous. Sadly, but predictably, the programme on herbalism has already been exploited by vendors of unproven treatments. While it is true that the programme did not actually assert that this herb cured Aids, it certainly left the impression that it was good stuff."
One company now promotes sutherlandia tablets thus: "In South Africa, BBC2 TV presenter Professor Kathy Sykes learnt of the herb sutherlandia, which is being touted as a new weapon in the fight against HIV and Aids ... It is with thanks to programmes such as Alternative Medicine, shown on BBC 2 on Tuesday 7th February, and the work carried out by Professor Kathy Sykes that medicinal herbs can receive the acknowledgement they truly deserve, and this knowledge be passed on to the general public."
Prof Ernst says: "I see the impact of the programmes on the public because a lot of them write to me and want to be operated on by acupuncture anaesthesia because they think it is a realistic possibility, which it is not."
· Simon Singh is a science writer, and directed and produced programmes such as Tomorrow's World and Horizon
