Consumer protection

From Wikipedia, the free encyclopedia

In regulatory jurisdictions that provide for it (comprising most or all developed countries with free market economies), consumer protection is a group of laws and organizations designed to ensure the rights of consumers as well as fair trade, competition and accurate information in the marketplace. The laws are designed to prevent the businesses that engage in fraud or specified unfair practices from gaining an advantage over competitors. They may also provide additional protection for those most vulnerable in society. Consumer protection laws are a form of government regulation that aim to protect the rights of consumers. For example, a government may require businesses to disclose detailed information about products—particularly in areas where safety or public health is an issue, such as food.

Consumer protection is linked to the idea of consumer rights and to the formation of consumer organizations, which help consumers make better choices in the marketplace and get help with consumer complaints. Other organizations that promote consumer protection include government organizations and self-regulating business organizations such as consumer protection agencies and organizations, ombudsmen, the Federal Trade Commission in America and Better Business Bureaus in America and Canada, England, etc.

A consumer is defined as someone who acquires goods or services for direct use or ownership rather than for resale or use in production and manufacturing.

Consumer interests can also be protected by promoting competition in the markets which directly and indirectly serve consumers, consistent with economic efficiency, but this topic is treated in competition law. Consumer protection can also be asserted via non-government organizations and individuals as consumer activism.

Consumer law

Consumer protection law or consumer law is considered as an area of law that regulates private law relationships between individual consumers and the businesses that sell those goods and services. Consumer protection covers a wide range of topics, including but not necessarily limited to product liability, privacy rights, unfair business practices, fraud, misrepresentation, and other consumer/business interactions. It's a way of preventing frauds and scams from service and sales contracts, eligible fraud, bill collector regulation, pricing, utility turnoffs, consolidation, personal loans that may lead to bankruptcy. 

The following lists consumer legislation at the nation-state level. In the EU member states Germany and the United Kingdom there is also the applicability of law at the EU level to be considered; this applies on the basis of subsidiarity.

Australia

In Australia, the corresponding agency is the Australian Competition and Consumer Commission or the individual State Consumer Affairs agencies. The Australian Securities and Investments Commission has responsibility for consumer protection regulation of financial services and products. However, in practice, it does so through privately run EDR schemes such as the Financial Ombudsman Service (Australia).

Brazil

In Brazil, consumer protection is regulated by the Consumer's Defense Code (Código de Defesa do Consumidor), as mandated by the 1988 Constitution of Brazil.

Germany

Germany, as a member state of the European Union, is bound by the consumer protection directives of the European Union; residents may be directly bound by EU regulations. A minister of the federal cabinet is responsible for consumer rights and protection (Verbraucherschutzminister). In the current cabinet of Angela Merkel, this is Katarina Barley. 

When issuing public warnings about products and services, the issuing authority has to take into account that this affects the supplier's constitutionally protected economic liberty, see Bundesverwaltungsgericht (Federal Administrative Court) Case 3 C 34.84, 71 BVerwGE 183).

India

See also: Consumer Protection Act of 1986 and National Consumer Disputes Redressal Commission

In India, consumer protection is specified in The Consumer Protection Act, 1986. Under this law, Separate Consumer Dispute Redress Forums have been set up throughout India in each and every district in which a consumer can file his complaint on a simple paper with nominal court fees and his complaint will be decided by the Presiding Officer of the District Level. The complaint can be filed by both the consumer of a goods as well as of the services. An appeal could be filed to the State Consumer Disputes Redress Commissions and after that to the National Consumer Disputes Redressal Commission (NCDRC). The procedures in these tribunals are relatively less formal and more people friendly and they also take less time to decide upon a consumer dispute when compared to the years long time taken by the traditional Indian judiciary. In recent years, many effective judgment have been passed by some state and National Consumer Forums. 

Indian Contract Act, 1872 lays down the conditions in which promises made by parties to a contract will be legally binding on each other. It also lays down the remedies available to aggregate party if the other party fails to honor his promise. 

The Sale of Goods Act of 1930 act provides some safeguards to buyers of goods if goods purchased do not fulfill the express or implied conditions and warranties.

The Agriculture Produce Act of 1937 act provides grade standards for agricultural commodities and live stock products.It specifies the conditions which govern the use of standards and lays down the procedure for grading, marking and packaging of agricultural produce.The quality mark provided under the act is known as AGMARK-Agricultural Marketing.

Nigeria

The Nigerian government has a duty to protect its people from any form of harm to human health through the use and purchase of items to meet daily needs. In light of this, the Nigerian Consumer Protection Council (CPC), whose aim is to protect and enhance consumers' interest through information, education, and enforcement of the rights of consumers was established by an Act of Parliament to promote and protect the interest of consumers over all products and services. In a nutshell, it is empowered to Eliminate hazardous & substandard goods from the market. Provide speedy redress to consumer complaints and petition arisen from fraud, unfair practice and exploitation of consumer.

On February 5, 2019, the President of Nigeria, Muhammadu Buhari, assented to the new Federal Competition and Consumer Protection Commission Bill, 2018. Thus, the bill became a law of the Federal Republic of Nigeria and binding on entities and organizations so specified in the Act. 

The long title of the Act reads: “This Act establishes the Federal Competition and Consumer Protection Commission and the Competition and Consumer Protection Tribunal for the promotion of competition in the Nigerian market at all levels by eliminating monopolies, prohibiting abuse of dominant market position and penalizing other restrictive trade and business practices.” 

The Act further repealed the hitherto Nigerian Consumer Protection Council Act and transferred it’s core mandate to the new Commission

Taiwan

Modern Taiwanese law has been heavily influenced by European civil law systems, particularly German and Swiss law. The Civil Code in Taiwan contains five books: General Principles, Obligations, Rights over Things, Family, and Succession. The second book of the Code, the Book of Obligations, provided the basis from which consumers could bring products liability actions prior to the enactment of the CPL.

The Consumer Protection Law (CPL) in Taiwan, as promulgated on January 11, 1994, and effective on January 13, 1993, specifically protects the interests and safety of customers using the products or services provided by business operators. The Consumer Protection Commission of Executive Yuan serves as an ombudsman supervising, coordinating, reporting any unsafe products/services and periodically reviewing the legislation.

According to the Pacific Rim Law & Policy Association and the American Chamber of Commerce, in a 1997 critical study, the law has been criticized by stating that "although many agree that the intent of the CPL is fair, the CPL's various problems, such as ambiguous terminology, favoritism towards consumer protection groups, and the compensation liability defense, must be addressed before the CPL becomes a truly effective piece of legislation that will protect consumers"

United Kingdom

The United Kingdom, as it is still a member state of the European Union, is bound by the consumer protection directives of the European Union;;;; residents may be directly bound by EU regulations. Specifics of the division of labour between the EU and the UK are detailed here. Domestic (UK) laws originated within the ambit of contract and tort but,, with the influence of EU law, it is emerging as an independent area of law. In many circumstances, where domestic law is in question, the matter is judicially treated as tort, contract, restitution or even criminal law. 

Consumer Protection issues are dealt with when complaints are made to the Director-General of Fair Trade. The Office of Fair Trading will then investigate, impose an injunction or take the matter to litigation. However, consumers cannot directly complain to the OFT. Complaints need to be made to the Citizens Advice Consumer Service (which has taken over from Consumer Direct) who will provide legal advice to complainants, or re-direct the individual complaint to Trading Standards for investigation. Due to restrictions within the Enterprise Act 2002, individual complainants are unable to be told whether their case is being investigated or not. In very rare cases, Consumer Direct may direct a very large number of complaints to the OFT to be considered as a systemic complaint. The OFT can also be engaged by consumer groups e.g. The Consumers Association or the statutory consumer protection body – Consumer Focus – via a super complaint. The OFT rarely prosecute companies, however, preferring a light touch regulation approach. Consumer complaints against companies are not published, but investigation work, undertakings, and enforcement are located at. Many of the consumer protection laws e.g. Distance Selling Regulations 2000 or Unfair Terms in Consumer Contracts Regulations 1999 (20 years ago) are actually UK implementations of EU directives. The OFT is one of the bodies responsible for enforcing these rules. It leads to a problem that these examples of legislation are clearly designed to deal with individual complaints but the OFT will only deal with systemic complaints and will ignore individual complainants redirecting them back to Consumer Direct.

The Office of Fair Trading also acts as the UK's official consumer and competition watchdog, with a remit to make markets work well for consumers, and at a local, municipal level by Trading Standards departments. General consumer advice can be obtained from the Citizens Advice Consumer Service or via a local branch of the Citizen's Advice Bureau. 

On the 3rd September, Conservative MEP Daniel Dalton proposed plans to the European Parliament's Internal Market and Consumer Protection Committee to introduce an App that would provide a single source of advice and dispute resolution. 

United States

Consumer protection laws often mandate the posting of notices, such as this one which appears in all automotive repair shops in California

In the United States a variety of laws at both the federal and state levels regulate consumer affairs. Among them are the federal Federal Food, Drug, and Cosmetic Act, Fair Debt Collection Practices Act, the Fair Credit Reporting Act, Truth in Lending Act, Fair Credit Billing Act, and the Gramm–Leach–Bliley Act. Federal consumer protection laws are mainly enforced by the Federal Trade Commission, the Consumer Financial Protection Bureau, the Food and Drug Administration, and the U.S. Department of Justice. 

At the state level, many states have adopted the Uniform Deceptive Trade Practices Act including, but not limited to, Delaware, Illinois, Maine, and Nebraska. The deceptive trade practices prohibited by the Uniform Act can be roughly subdivided into conduct involving either a) unfair or fraudulent business practice and b) untrue or misleading advertising. The Uniform Act contains a private remedy with attorneys fees for prevailing parties where the losing party "willfully engaged in the trade practice knowing it to be deceptive". Uniform Act §3(b). Missouri has a similar statute called the Merchandising Practices Act. This statute allows local prosecutors or the Attorney General to press charges against people who knowingly use deceptive business practices in a consumer transaction and authorizes consumers to hire a private attorney to bring an action seeking their actual damages, punitive damages, and attorney's fees.

Also, the majority of states have a Department of Consumer Affairs devoted to regulating certain industries and protecting consumers who use goods and services from those industries. For example, in California, the California Department of Consumer Affairs regulates about 2.3 million professionals in over 230 different professions, through its forty regulatory entities. In addition, California encourages its consumers to act as private attorneys general through the liberal provisions of its Consumers Legal Remedies Act.

California has the strongest consumer protection laws of any US state, partly because of rigorous advocacy and lobbying by groups such as Utility Consumers' Action Network, Consumer Federation of California, and Privacy Rights Clearinghouse. For example, California provides for "cooling off" periods giving consumers the right to cancel contracts within a certain time period for several specified types of transactions, such as home secured transactions, and warranty and repair services contracts.

Other states have been the leaders in specific aspects of consumer protection. For example, Florida, Delaware, and Minnesota have legislated requirements that contracts be written at reasonable readability levels as a large proportion of contracts cannot be understood by most consumers who sign them.

Constitutional laws

47 national constitutions currently in force include some sort of consumer right. The Constitute project lists the text of each of these provisions Kenya's provision, for example, suggests that citizens have the right to

1. goods and services of "reasonable quality."
2. information about the product, and
3. protection of their health and safety in the use of the product.

The Kenyan rule also stipulates that citizens would have legal recourse in the case of injury or product defects.

Laws

• Competition law

United Kingdom

• Consumer Protection (Distance Selling) Regulations 2000
• Consumer Rights Act 2015
• Electronic Commerce Regulations 2002
• Enterprise Act 2002
• General Product Safety Regulations 2005
• Sale and Supply of Goods to Consumers Regulations 2002/3045
• Supply of Goods (Implied Terms) Act 1973
• Supply of Goods and Services Act 1982
• Unfair Contract Terms Act 1977
• Unfair Terms in Consumer Contracts Regulations 1999

United States

• Consumer Product Safety Act – gives the Consumer Product Safety Commission the power to develop safety standards and pursue recalls for products
• Federal Trade Commission Act – created the Federal Trade Commission (FTC) to prevent unfair competition, deceptive acts, regulate trade, etc.

Privacy laws

• United States National Do Not Call Registry – allows US consumers to limit telemarketing calls they receive.

Food and drug

• Pure Food and Drug Act – led to the creation of the U.S. Food and Drug Administration (FDA) to regulate foods, drugs, and more.

Communications

• Communications Act of 1934 – created the Federal Communications Commission (FCC) to regulate all radio and interstate cable, phone, and satellite communications.

Banking

• Fair Credit Reporting Act (FRCA) – regulates the collection, dissemination, and use of consumer credit information
• Fair Debt Collection Practices Act (FDCPA) – eliminates abusive consumer practices, ensure fairness, etc.
• Truth in Lending Act (TILA) – requires clear disclosure of key terms of the lending arrangement and all costs.

Real estate

• Real Estate Settlement Procedures Act (RESPA) – prohibits kickbacks and requires lenders to provide a good faith estimate of costs

Health insurance

• Health Insurance Portability and Accountability Act (HIPAA) – provides consumer protection for health information

Digital media

• Digital Millennium Copyright Act – prohibits production or sale of devices or services intended to circumvent copyright measures.
• Digital Media Consumers' Rights Act (proposed) – would repeal the Digital Millennium Copyright Act

Australia

• The Australian Consumer Law
• Division 2 of Part 2 of the Australian Securities and Investments Commission Act 2001 in relation to financial services and products.

Quackwatch

From Wikipedia, the free encyclopedia

Quackwatch

Available in	English, French, Portuguese
Owner	The Quackwatch network of people
Editor	Stephen Barrett
Website	English: Quackwatch.org French: www.sceptiques.qc.ca/quackwatch/ Portuguese: quackwatch.haaan.com/index.html
Alexa rank	174,812 (US 04/2017)
Commercial	No
Registration	No
Launched	1996
Current status	Active
OCLC number	855159830

Quackwatch is a United States-based website, self-described as a "network of people" founded by Stephen Barrett, which aims to "combat health-related frauds, myths, fads, fallacies, and misconduct" and to focus on "quackery-related information that is difficult or impossible to get elsewhere". Since 1996 it has operated the alternative medicine watchdog website quackwatch.org, which advises the public on unproven or ineffective alternative medicine remedies. The site contains articles and other information criticizing many forms of alternative medicine.

Quackwatch cites peer-reviewed journal articles and has received several awards. The site has been developed with the assistance of a worldwide network of volunteers and expert advisors. It has received positive recognition and recommendations from mainstream organizations and sources. It has been recognized in the media, which cite quackwatch.org as a practical source for online consumer information. The success of Quackwatch has generated the creation of additional affiliated websites; as of 2013 there were 21 of them.

History

Barrett founded the Lehigh Valley Committee Against Health Fraud (LVCAHF) in 1969, and it was incorporated in the state of Pennsylvania in 1970. In 1996, the corporation began the website quackwatch.org, and the organization itself was renamed Quackwatch, Inc. in 1997. The Pennsylvania nonprofit corporation was dissolved after Barrett moved to North Carolina in 2008, but the network's activities continue. Quackwatch is closely affiliated with the National Council Against Health Fraud (NCAHF), of which it was a co-founder.

Mission and scope

Quackwatch is overseen by Barrett, its owner, with input from advisors and help from volunteers, including a number of medical professionals. In 2003, 150 scientific and technical advisors: 67 medical advisors, 12 dental advisors, 13 mental health advisors, 16 nutrition and food science advisors, 3 podiatry advisors, 8 veterinary advisors, and 33 other "scientific and technical advisors" were listed by Quackwatch. Since that time, many more have volunteered, but advisor names are no longer listed. The site has recruited volunteers to report on various topics of questionable health practice. Many credible professionals have agreed to be involved on the site in their fields of expertise.

Quackwatch describes its mission as follows:

... investigating questionable claims, answering inquiries about products and services, advising quackery victims, distributing reliable publications, debunking pseudoscientific claims, reporting illegal marketing, improving the quality of health information on the internet, assisting or generating consumer-protection lawsuits, and attacking misleading advertising on the internet.

Quackwatch states that there are no salaried employees, and a total cost of operating all of Quackwatch's sites is approximately $7,000 per year. It is funded mainly by small individual donations, commissions from sales on other sites to which they refer, profits from the sale of publications, and self-funding by Barrett. The stated income is also derived from usage of sponsored links. The site focuses on combating health-related frauds, myths, fads, and fallacies that are hard to find elsewhere.

Site content

The Quackwatch website contains essays and white papers, written by Barrett and other writers, intended for the non-specialist consumer. The articles discuss health-related products, treatments, enterprises, and providers that Quackwatch deems to be misleading, fraudulent, and/or ineffective. Also included are links to article sources and both internal and external resources for further study.

Related and subsidiary sites

The site is developed with the assistance from volunteers and expert advisors. Many of its articles cite peer-reviewed research and are footnoted with several links to references. The site's search engine helps retrieve specific articles. A review in Running & FitNews stated the site "also provides links to hundreds of trusted health sites." Naturowatch is a subsidiary site of Quackwatch which aims to provide information about naturopathy that is "difficult or impossible to find elsewhere", and thereby functions as a skeptical guide to the topic. The site is operated by Barrett and Kimball C. Atwood IV, an anesthesiologist by profession, who has become a vocal critic of alternative medicine.

The site is available in French and Portuguese, and formerly in German, as well as via several mirrors.

Influence

Some sources that mention Stephen Barrett's Quackwatch as a useful source for consumer information include website reviews, government agencies, various journals including an article in The Lancet and some libraries.

Mention in media, reviews, and journals

Quackwatch has been mentioned in the media, reviews and various journals, as well as receiving several awards and honors. It was reviewed in an article by the American Society of Consultant Pharmacists and by Clint Sprott, an emeritus professor of physics at the University of Wisconsin–Madison. The Journal of the American Medical Association mentioned Quackwatch as one of nine "select sites that provide reliable health information and resources" in 1998. It was also listed as one of three medical sites in U.S. News & World Report's "Best of the Web" in 1999. A website review by Forbes magazine stated:

Dr. Stephen Barrett, a psychiatrist, seeks to expose unproven medical treatments and possible unsafe practices through his homegrown but well-organized site. Mostly attacking alternative medicines, homeopathy and chiropractors, the tone here can be rather harsh. However, the lists of sources of health advice to avoid, including books, specific doctors and organizations, are great for the uninformed. Barrett received an FDA Commissioner's Special Citation Award for fighting nutrition quackery in 1984. BEST: Frequently updated, but also archives of relevant articles that date back at least four years. WORST: Lists some specific doctors and organizations without explaining the reason for their selection.

Citations by journalists

Quackwatch has also been cited or mentioned by journalists in reports on therapeutic touch, Vitamin O, Almon Glenn Braswell's baldness treatments, dietary supplements, Robert Barefoot's coral calcium claims, William C. Rader's "stem cell" therapy, noni juice, shark cartilage, and infomercials. The site's opinion on a US government report on complementary medicine was mentioned in a news report in the Journal of the National Cancer Institute. Sources that mention quackwatch.org as a resource for consumer information include the United States Department of Agriculture, the American Journal of Pharmaceutical Education, The Lancet, the Journal of Marketing Education, the Medical Journal of Australia, the Journal of the American Dietetic Association, the U.S. Department of Health & Human Services, the U.S. National Institutes of Health, the Skeptic's Dictionary, and the Diet Channel. Websites of libraries across the United States of America, include links to Quackwatch as a source for consumer information. In addition, several nutrition associations link to Quackwatch. An article in PC World listed it as one of three websites for finding the truth about Internet rumors, and WebMD listed it as one of eight organizations to contact with questions about a product. In a Washington Post review of alternative medicine websites, the introduction rated Quackwatch as offering "better truth-squadding than the Food and Drug Administration or the National Center for Complementary and Alternative Medicine."

American Cancer Society

The American Cancer Society lists Quackwatch as one of ten reputable sources of information about alternative and complementary therapies in their book Cancer Medicine, and includes it in a list of sources for information about alternative and complementary therapies in an article about on-line cancer information and support. In a long series of articles on various alternative medicine methods, it uses Quackwatch as a reference and includes criticisms of the methods.

Health On the Net Foundation (HONcode)

The Health On the Net Foundation, which confers the HONcode "Code of Conduct" certification to reliable sources of health information in cyberspace, directly recommends Quackwatch, and has stated about Quackwatch:

On the positive side, "four web sites stand out" from the rest for the exemplary quality of their information and treatments: quackwatch.org, ebandolier.com, cis.nci.nih.gov and rosenthal.hs.columbia.edu. Three sites, quackwatch.org, rosenthal.hs.columbia.edu/ and cis.nci.nih.gov are HONcode certified by the Health On the Net Foundation.

Their website also uses Quackwatch extensively as a recommended source on various health-related topics. It also advises Internet users to alert Quackwatch:

If you come across a healthcare Web site that you believe is either possibly or blatantly fraudulent and does NOT display the HONcode, please alert Quackwatch. Of course, if such a site DOES display the HONcode, alert us immediately.

Gold standard in 2007 feasibility study

In a 2007 feasibility study on a method for identifying web pages that make unproven claims, the authors wrote:

Our gold standard relied on selected unproven cancer treatments identified by experts at http://www.quackwatch.org. The website is maintained by a 36 year old nonprofit organization whose mission is to "combat health related frauds, myths, fads, fallacies, and misconduct." The group employs a 152 person scientific and technical advisory board composed of academic and private physicians, dentists, mental health advisors, registered dietitians, podiatrists, veterinarians, and other experts whom review health related claims. By using unproven treatments identified by an oversight organization, we capitalized on an existing high quality review.

Site reviews

The Good Web Guide said Quackwatch "is without doubt an important and useful information resource and injects a healthy dose of scepticism into reviewing popular health information". Cunningham and Marcason in the Journal of the American Dietetic Association described Quackwatch as "useful", while Wallace and Kimball, in the Medical Journal of Australia, described the site as "objective". The Rough Guide To The Internet writes "don't buy anything until you've looked it up on Quackwatch, a good place to separate the docs from the ducks."

Ned Vankevitch, associate professor of communications at Trinity Western University, places Barrett in a historical tradition of anti-quackery, embracing such figures as Morris Fishbein and Abraham Flexner, which has been part of American medical culture since the early-twentieth century. Acknowledging that Quackwatch's "exposé of dangerous and fraudulent health products represents an important social and ethical response to deception and exploitation", Vankevitch criticizes Barrett for attempting to limit "medical diversity", employing "denigrating terminology", categorizing all complementary and alternative medicine as a species of medical hucksterism, failing to condemn shortcomings within conventional biomedicine, and for promoting an exclusionary model of medical scientism and health that serves hegemonic interests and does not fully address patient needs.

Donna Ladd, a journalist with The Village Voice, says Barrett relies heavily on negative research in which alternative therapies are shown to not work. Barrett said to Ladd that most positive case studies are unreliable. Barrett says that "a lot of things don't need to be tested [because] they simply don't make any sense."

Waltraud Ernst, professor of the history of medicine at Oxford Brookes University, commenting on Vankevitch's observations, agrees that attempts to police the "medical cyber-market with a view to preventing fraudulent and potentially harmful practices may well be justified." She commends "Barrett's concern for unsubstantiated promotion and hype," and states that "Barrett's concern for fraudulent and potentially dangerous medical practices is important," but she sees Barrett's use of "an antiquarian term such as 'quack'" as part of a "dichotomising discourse that aims to discredit the "'old-fashioned', 'traditional', 'folksy' and heterodox by contrasting it with the 'modern', 'scientific' and orthodox." Ernst also interprets Barrett's attempt to "reject and label as 'quackery' each and every approach that is not part of science-based medicine" as one which minimizes the patient's role in the healing process and is inimical to medical pluralism.

A review paper in the Annals of Oncology identified Quackwatch as an outstanding complementary medicine information source for cancer patients.

Helen Pilcher writing for Nature News believes "Up to 55% of the Internet's 600 million users gather medical information from it. Patients with life-threatening diseases, such as cancer, often use the web to seek out alternative therapies, but with over half a million sites offering advice, the quality of that information varies greatly." Edzard Ernst says, "Good websites do exist, and the majority of those tested provided useful and reliable information. Two sites, Quackwatch and Bandolier, stood out for the quality of the information they provide.

The Handbook of Nutrition and Food explains "Maintaining adequate nutrition is important for general health of cancer patients, as it is with all patients, and diet plays a role in preventing certain cancers. However, no diet or dietary supplement product has been proven to improve the outcome of an established cancer. Detailed information on today's questionable cancer methods is available on the Quackwatch web site".

Steven L. Brown states "Dr. Stephen Barrett's website www.quackwatch.com provides excellent, detailed, well-researched, and documented information about alternative therapies that have been disproved."

Journalist John MacDonald, writing for the Khaleej Times, called Quackwatch "a voice of reason on everything from the efficacy of alternative medicine to the validity of advice from best-selling diet gurus, and the various forms of medical quackery being perpetrated on gullible consumers".

The 2009 Internet Directory advised that "Have you ever read a health article or had a friend suggest a remedy that sounded too good to be true? Then check it out on Quackwatch before you shell out any money or risk your health to try it. Here you will find a skeptical friend to help you sort out what's true from what is not when it comes to your physical well-being."

The book Chronic Pain For Dummies says "Although many reliable resources are on the Internet, including those we list in this chapter, sadly, far too many sites offer only incorrect and/or outdated information, and many are downright hoaxes designed to sell empty promises. Make sure you gather information only from reliable resources. Two good sites for checking out possible hoaxes are www.quackwatch.org and http://hoaxbusters.ciac.org."

The Arthritis Helpbook articulated that "One good source for information about questionable treatments is Quackwatch.org, a nonprofit corporation whose purpose is to combat health-related frauds, myths, and fallacies (www.quackwatch.org). They also have other sites that are accessible from Quackwatch."

Katherine Chauncey, in Low-Carb Dieting for Dummies, writes "The main purpose of Quackwatch (www.quackwatch.org) is to combat fraud, myths, fads, and fallacies in the health field. This is a hard-hitting site developed by Stephen Barrett, MD. Not only is quackery-related information targeted, but quack individuals are named. You'll find information here that you won't find anywhere else. One of the goals of the site is to improve the quality of information on the Internet. Just reviewing this site will show you how to recognize information that may be coming from dubious sources."

Writing in the trade-journal The Consultant Pharmacist, pharmacist Bao-Anh Nguyen-Khoa characterized Quackwatch as "relevant for both consumers and professionals". Nguyen-Khoa noted two Quackwatch articles to be of interest to consultant pharmacists - "Selling of Dubious Products" about pharmacists stocking and recommending dubious alternative products that they have a poor knowledge of but continued stocking them because of the higher profit margins, and "Misuse of Compounding" about some pharmacies compounding readily available commercial products from bulk instead of available prescriptions because the ingredients may be less expensive. Nguyen-Khoa remarked that the "site makes an effort to cross-reference keywords with other articles and link its citations to the Medline abstract from the National Library of Medicine". The site has received praise from reputable reviewers and rating services. As of 1999, steps were taken to correct the presence of so many articles written by Barrett which left one with a sense of a lack of fair balance in one author's condemnation of many dubious health therapies, as many reputable professionals have signed on to populate the site in their area of expertise. Nguyen-Khoa stated that the implementation of a peer review process would improve the site's legitimacy, which is a logical transition for a site that uses a lot of accepted medical literature as its foundation. The success of Quackwatch has generated other related sites. According to The Consultant Pharmacist, Barrett often "inserts his strong opinions directly into sections of an article already well supported by the literature. Although entertaining, this direct commentary may be viewed by some as less than professional medical writing and may be better reserved for its own section."

Dr. Thomas R. Eng, director of the U.S. Department of Health and Human Services Science Panel on Interactive Communication and Health stated in 1999 that while "the government doesn't endorse Web sites", ..."[Quackwatch] is the only site I know of right now looking at issues of fraud and health on the Internet."

The organization has often been challenged by supporters and practitioners of the various forms of alternative medicine that are criticized on the website.

Chelation therapy

From Wikipedia, the free encyclopedia

Chelation therapy
Two molecules of deferasirox, an orally administered chelator, binding iron. Deferasirox is used in the treatment of transfusional iron overload in people with thalassemia.

Chelation therapy is a medical procedure that involves the administration of chelating agents to remove heavy metals from the body. Chelation therapy has a long history of use in clinical toxicology and remains in use for some very specific medical treatments, although it is administered under very careful medical supervision due to various inherent risks.

Chelation therapy must be administered with care as it has a number of possible side effects, including death. In response to increasing use of chelation therapy as alternative medicine and in circumstances in which the therapy should not be used in conventional medicine, various health organizations have confirmed that medical evidence does not support the effectiveness of chelation therapy for any purpose other than the treatment of heavy metal poisoning. Over-the-counter chelation products are not approved for sale in the United States.

Medical uses

Chelation therapy is the preferred medical treatment for metal poisoning, including acute mercury, iron (including in cases of sickle-cell disease and thalassemia), arsenic, lead, uranium, plutonium and other forms of toxic metal poisoning. The chelating agent may be administered intravenously, intramuscularly, or orally, depending on the agent and the type of poisoning.

Chelating agents

There are a variety of common chelating agents with differing affinities for different metals, physical characteristics, and biological mechanism of action. For the most common forms of heavy metal intoxication – lead, arsenic, or mercury – a number of chelating agents are available. Dimercaptosuccinic acid (DMSA) has been recommended for the treatment of lead poisoning in children by poison control centers around the world. Other chelating agents, such as 2,3-dimercaptopropanesulfonic acid (DMPS) and alpha lipoic acid (ALA), are used in conventional and alternative medicine. Some common chelating agents are ethylenediaminetetraacetic acid (EDTA), 2,3-dimercaptopropanesulfonic acid (DMPS), and thiamine tetrahydrofurfuryl disulfide (TTFD). Calcium-disodium EDTA and DMSA are only approved for the removal of lead by the Food and Drug Administration while DMPS and TTFD are not approved by the FDA. These drugs bind to heavy metals in the body and prevent them from binding to other agents. They are then excreted from the body. The chelating process also removes vital nutrients such as vitamins C and E, therefore these must be supplemented.

The German Environmental Agency (Umweltbundesamt) listed DMSA and DMPS as the two most useful and safe chelating agents available.

Chelator	Used in
Dimercaprol	acute arsenic poisoning acute mercury poisoning lead poisoning (in addition to EDTA) Lewisite poisoning (for which it was developed as an antidote)
Dimercaptosuccinic acid	lead poisoning arsenic poisoning mercury poisoning
Dimercapto-propane sulfonate (DMPS)	severe acute arsenic poisoning severe acute mercury poisoning
Penicillamine	Mainly in: copper toxicity Occasionally adjunctive therapy in: gold toxicity arsenic poisoning lead poisoning rheumatoid arthritis
Ethylenediamine tetraacetic acid	lead poisoning
Deferoxamine and Deferasirox	acute iron poisoning iron overload

Side effects

When used properly in response to a diagnosis of harm from metal toxicity, side effects of chelation therapy include dehydration, low blood calcium, harm to kidneys, increased enzymes as would be detected in liver function tests, allergic reactions, and lowered levels of dietary elements. When administered inappropriately, there are the additional risks of hypocalcaemia (low calcium levels), neurodevelopmental disorders, and death.

History

Chelation therapy can be traced back to the early 1930s, when Ferdinand Munz, a German chemist working for I.G. Farben, first synthesized ethylenediaminetetraacetic acid (EDTA). Munz was looking for a replacement for citric acid as a water softener. Chelation therapy itself began during World War II when chemists at the University of Oxford searched for an antidote for lewisite, an arsenic-based chemical weapon. The chemists learned that EDTA was particularly effective in treating lead poisoning.

Following World War II, chelation therapy was used to treat workers who had painted United States naval vessels with lead-based paints. In the 1950s, Norman Clarke, Sr. was treating workers at a battery factory for lead poisoning when he noticed that some of his patients had improved angina pectoris following chelation therapy. Clarke subsequently administered chelation therapy to patients with angina pectoris and other occlusive vascular disease and published his findings in The American Journal of the Medical Sciences in December 1956. He hypothesized that "EDTA could dissolve disease-causing plaques in the coronary systems of human beings." In a series of 283 patients treated by Clarke et al. From 1956-1960, 87% showed improvement in their symptomatology. Other early medical investigators made similar observations of EDTA's role in the treatment of cardiovascular disease (Bechtel, 1956; Bessman, 1957; Perry, 1961; Szekely, 1963; Wenig, 1958: and Wilder, 1962).

In 1973, a group of practicing physicians created the Academy of Medical Preventics (now the American College for Advancement in Medicine). The academy trains and certifies physicians in the safe administration of chelation therapy. Members of the academy continued to use EDTA therapy for the treatment of vascular disease and developed safer administration protocols.

In the 1960s, BAL was modified into DMSA, a related dithiol with far fewer side effects. DMSA quickly replaced both BAL and EDTA as the primary treatment for lead, arsenic and mercury poisoning in the United States. Esters of DMSA have been developed which are reportedly more effective; for example, the monoisoamyl ester (MiADMSA) is reportedly more effective than DMSA at clearing mercury and cadmium. Research in the former Soviet Union led to the introduction of DMPS, another dithiol, as a mercury-chelating agent. The Soviets also introduced ALA, which is transformed by the body into the dithiol dihydrolipoic acid, a mercury- and arsenic-chelating agent. DMPS has experimental status in the United States, while ALA is a common nutritional supplement.

Since the 1970s, iron chelation therapy has been used as an alternative to regular phlebotomy to treat excess iron stores in people with haemochromatosis. Other chelating agents have been discovered. They all function by making several chemical bonds with metal ions, thus rendering them much less chemically reactive. The resulting complex is water-soluble, allowing it to enter the bloodstream and be excreted harmlessly.

Calcium-disodium EDTA chelation has been studied by the U.S. National Center for Complementary and Alternative Medicine for treating coronary disease. In 1998, the U.S. Federal Trade Commission (FTC) pursued the American College for Advancement in Medicine (ACAM), an organization that promotes "complementary, alternative and integrative medicine" over the claims made regarding the treatment of atherosclerosis in advertisements for EDTA chelation therapy. The FTC concluded that there was a lack of scientific studies to support these claims and that the statements by the ACAM were false. In 1999, the ACAM agreed to stop presenting chelation therapy as effective in treating heart disease, avoiding legal proceedings. In 2010 the U.S. Food and Drug Administration (FDA) warned companies who sold over-the-counter (OTC) chelation products and stated that such "products are unapproved drugs and devices and that it is a violation of federal law to make unproven claims about these products. There are no FDA-approved OTC chelation products."

Society and culture

In 1998, the U.S. Federal Trade Commission (FTC) charged that the web site of the American College for Advancement in Medicine (ACAM) and a brochure they published had made false or unsubstantiated claims. In December 1998, the FTC announced that it had secured a consent agreement barring ACAM from making unsubstantiated advertising claims that chelation therapy is effective against atherosclerosis or any other disease of the circulatory system.

In August 2005, doctor error led to the death of a five-year-old autistic boy who was undergoing chelation therapy. Others, including a three-year-old nonautistic girl and a nonautistic adult, have died while undergoing chelation therapy. These deaths were due to cardiac arrest caused by hypocalcemia during chelation therapy. In two of the cases hypocalcemia appears to have been caused by the administration of Na2EDTA (disodium EDTA) and in the third case the type of EDTA was unknown. Only the 3-year-old girl had found to have an elevated blood lead level and resulting low iron levels and anemia, which is the conventional medical cause for administration of chelation therapy. According to protocol, EDTA should not be used in the treatment of children. More than 30 deaths have been recorded in association with IV-administered disodium EDTA since the 1970s.

Use in alternative medicine

In alternative medicine, some practitioners claim chelation therapy can treat a variety of ailments, including heart disease and autism. The use of chelation therapy by alternative medicine practitioners for behavioral and other disorders is considered pseudoscientific; there is no proof that it is effective. In addition to being ineffective, chelation therapy prior to heavy metal testing can artificially raise urinary heavy metal concentrations (“provoked” urine testing) and lead to inappropriate and unnecessary treatment. The American College of Medical Toxicology and the American Academy of Clinical Toxicology warn the public that chelating drugs used in chelation therapy may have serious side effects, including liver and kidney damage, blood pressure changes, allergies and in some cases even death of the patient.

Cancer

The American Cancer Society says of chelation therapy: "Available scientific evidence does not support claims that it is effective for treating other conditions such as cancer. Chelation therapy can be toxic and has the potential to cause kidney damage, irregular heartbeat, and even death."

Cardiovascular disease

The U.S. National Center for Complementary and Alternative Medicine (NCCAM) conducted a trial on the chelation therapy's safety and efficacy for patients with coronary artery disease. NCCAM Director Stephen E. Straus cited the "widespread use of chelation therapy in lieu of established therapies, the lack of adequate prior research to verify its safety and effectiveness, and the overall impact of coronary artery disease" as factors motivating the trial. The study has been criticized by some who said it was unethical, unnecessary and dangerous, and that multiple studies conducted in prior to it demonstrated that the treatment provides no benefit.

According to the findings of a 1997 systematic review, EDTA chelation therapy is not effective as a treatment for coronary artery disease and this use is not approved in the United States by the US Food and Drug Administration (FDA). Several possible mechanisms for its efficacy have been proposed, though none have been scientifically validated. 

The American Heart Association stated in 1997 that there is "no scientific evidence to demonstrate any benefit from this form of therapy." The United States Food and Drug Administration (FDA), the National Institutes of Health (NIH) and the American College of Cardiology "all agree with the American Heart Association" that "there have been no adequate, controlled, published scientific studies using currently approved scientific methodology to support this therapy for cardiovascular disease." They speculate that any improvement among heart patients undergoing chelation therapy can be attributed to the placebo effect and generally recommended lifestyle changes such as "quitting smoking, losing weight, eating more fruits and vegetables, avoiding foods high in saturated fats and exercising regularly." They also are concerned that patients could put off proven treatments for heart disease like drugs or surgery.

A systematic review published in 2005 found that controlled scientific studies did not support chelation therapy for heart disease. It found that very small trials and uncontrolled descriptive studies have reported benefits while larger controlled studies have found results no better than placebo. 

In 2009, the Montana Board of Medical Examiners issued a position paper concluding that "chelation therapy has no proven efficacy in the treatment of cardiovascular disease, and in some patients could be injurious."

The final results of TACT were published in November 2012. The authors concluded that disodium EDTA chelation "modestly" reduced the risk of adverse cardiovascular outcomes among stable patients with a history of myocardial infarction. The study also showed a "marked" reduction in cardiovascular events in diabetic patients treated with EDTA chelation. An editorial published in the Journal of the American Medical Association said that "the study findings may provide novel hypotheses that merit further evaluation to help understand the pathophysiology of secondary prevention of vascular disease." Critics of the study characterized the study as showing no support for the use of chelation therapy in coronary heart disease, particularly the claims to reduce the need for coronary artery bypass grafting (CABG, pronounced "cabbage").

The US National Center for Complementary and Alternative Medicine began the Trial to Assess Chelation Therapy (TACT) in 2003. Patient enrollment was to be completed around July 2009 with final completion around July 2010, but enrollment in the trial was voluntarily suspended by organizers in September 2008 after the Office for Human Research Protections began investigating complaints such as inadequate informed consent. Additionally, the trial was criticized for lacking prior Phase I and II studies, and critics summarized previous controlled trials as having "found no evidence that chelation is superior to placebo for treatment of CAD or PVD." The same critics argued that methodological flaws and lack of prior probability made the trial "unethical, dangerous, pointless, and wasteful." The American College of Cardiology supported the trial and research to explore whether chelation therapy was effective in treating heart disease. Evidence of insurance fraud and other felony convictions among (chelation proponent) investigators further undermined the credibility of the trial.

Autism

Quackwatch says that autism is one of the conditions for which chelation therapy has been falsely promoted as effective, and practitioners falsify diagnoses of metal poisoning to "trick" parents into having their children undergo the risky process. As of 2008, up to 7% of children worldwide with autism had been subjected to chelation therapy. The death of two children in 2005 was caused by the administration of chelation treatments, according to the American Center for Disease Control. One of them was autistic. Parents either have a doctor use a treatment for lead poisoning, or buy unregulated supplements, in particular DMSA and lipoic acid. Aspies For Freedom, an autism rights organization, considers this use of chelation therapy unethical and potentially dangerous. There is little to no credible scientific research that supports the use of chelation therapy for the effective treatment of autism.