Legalized magic

There is a piece of legislation in Ontario whose mere existence has me baffled. Essentially, it allows people who perform acts of magic to give themselves a title and makes it illegal to give yourself that particular title without being licensed to do so. This is like my having the ability to call myself a frobshmirtzer because I can talk to invisible aliens from the planet Frob, but if you try to call yourself a frobshmirtzer, you will get fined. I don't have to prove or even demonstrate that I can talk to such aliens, or even that they exist. I can just say that modern science doesn't have the right tools to be able to detect these aliens but trust me, I can. The government has decided that someone calling themself a frobshmirtzer without having this ability is somehow against the public good, so they have outlawed it. Only in this case, the word isn't frobshmirtzer, it's "acupuncturist".

I did a fair bit of research for this article. I look around for studies that examined the effectiveness of acupuncture, and found many that showed that it was completely ineffective, or at least no more effective than placebo. There are special tools that can be used to simulate the needles without actually inserting them into the skin (amusingly called "sham acupuncture"), and there are studies that show that sham acupuncture is just as effective as "real" acupuncture. There are studies that show that inserting the needles into random places on the body, rather than the magic acupuncture points, is also just as effective. I did find a number of studies that showed it to be very effective in certain cases, but those studies were either done by or funded by agencies that were associated with holistic medicine and therefore had a vested interest in positive results. I'm afraid that a study showing how effective acupuncture is does not carry much weight with me if it was done by the Department of Holistic Wellness at a Chinese university.

But I have to be honest here. I also found a few studies that showed it to be effective without any obvious bias in the study or flaws in how it was done. Now, I'm not a trained scientist, so I can't always look at a study and see what was done wrong; it's possible that these studies had biases (obvious, unintentional, or well-hidden) in them or other problems that discount or completely invalidate the results. I don't know for sure, so I have to take them at face value. But whenever I hear about such a study on one of the several skeptical podcasts I listen to, the podcasters (who are trained scientists) point out the flaws in the study. Long story short: if there have been peer-reviewed clinical trials showing the effectiveness of acupuncture whose results have been analyzed and repeated by other researchers (none of whom have any conflicts of interest), mainstream science hasn't seen them.

Can I say with absolute certainty that acupuncture never works better than placebo? No, of course not. What I can say with absolute certainty is that nobody has ever given a scientifically plausible explanation of how it works that is consistent with what we know about the human body and doesn't resort to special pleadings about undetectable energy fields. At best it is an unproven and controversial practice. To me, it is appalling that there is an Ontario law that gives it credence and treats it like a perfectly valid and accepted form of medical treatment.

The legislation in question is called the Traditional Chinese Medicine Act, 2006. It's a fairly short act that essentially does the following:

• defines "traditional Chinese medicine" as "the assessment of body system disorders through traditional Chinese medicine techniques and treatment using traditional Chinese medicine therapies to promote, maintain or restore health."
• establishes a body called the "College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario"
• authorizes members of the College to perform acupuncture and to give "a traditional Chinese medicine diagnosis identifying a body system disorder as the cause of a person’s symptoms using traditional Chinese medicine techniques"
• states that only members of the College can call themselves "acupuncturist" or "traditional Chinese medicine practitioner" and lists the penalties

This act seems to be a work in progress – five years later, the College has not yet been created. The government has created The Transitional Council of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario, whose goal is to "develop regulations and establish the College". One thing I found amusing on their web site was that one of the standards they plan to create is to define "what are considered acts of professional misconduct". How do you define professional misconduct in an industry that is entirely based on fallacy?

I do not believe that all acupuncturists are charlatans, liars or cheats. I'm sure many of them, likely even the majority, honestly believe that what they are doing is effective. The placebo effect is very powerful, and confirmation bias is very difficult to see through. You likely know people, or perhaps you're one yourself, who have gone to a psychic and come away saying "wow, she really nailed it!" Then they can tell you ten facts the psychic said about that person that were exactly right. Did they mention, or do they even remember, the other thirty facts that she got wrong? "I'm hearing a name, a woman's name. Marcie? Marge? Margaret? Mary?"  "Yes, I have an Aunt Mary who died two years ago! Wow, it's amazing how she knew that!" She only got 25% of her guesses right and you think she did a great job. That's confirmation bias. It's highly possible that an acupuncturist will unintentionally take credit for those patients who seem to be positively affected by acupuncture, and dismiss those for whom acupuncture does not work as the anomalies, saying "well, it doesn't work for everyone".

I am angered by the fact that our government has wasted time and money discussing the "issue" of non-registered acupuncturists and coming up with a plan to register them. Acupuncturists make their living inserting needles into people's bodies and telling them it will heal them, when everything we know about medicine tells us that it can't work, and countless studies show that it doesn't. This practice, according to the Ontario government, is OK. But calling yourself an acupuncturist when you're not licenced to do so is illegal and you will be subject to a fine of up to $25,000 for a first offense. This is so ass-backwards that it makes my head spin.