Canadian physicians criticize naturopaths in wake of Ezekiel Stephan’s death

Should we trust naturopaths to regulate themselves?
Should we trust naturopaths to regulate themselves?

A group of Canadian physicians recently asked me to post an open letter they sent to the College of Naturopathic Doctors of Alberta concerning the conduct of naturopath Tracey Tannis in selling an herbal product to Ezekiel Stephan’s mother after she reported he might have meningitis. Ezekiel stopped breathing the day after this interaction and later died at an Alberta hospital. If you are unfamiliar with the story of Ezekiel’s demise and the criminal case against his parents, here is a recent summary. A verdict should come this week.

While much attention is on Ezekiel’s parents for not providing him with access to prudent medical care, their interaction with Tracey Tannis has shed light on the issue of licensing naturopaths and allowing them to self-regulate. (In five Canadian provinces, naturopaths are registered, a.k.a. licensed, by their own regulatory boards, called “colleges.”)

Naturopaths aggressively lobby government officials for licensure with broad scopes of medical privileges because it provides their profession with legitimacy. Naturopaths are then allowed to police themselves.

The letter posted below, signed by 43 Canadian physicians and surgeons, addresses multiple ethical and practical issues regarding the professional practices of licensed naturopaths. Most importantly the letter highlights the fact that naturopaths want all of the same rights and privileges of medical doctors without having to adhere to the same rules. In no jurisdiction where they are licensed are naturopaths bound to medical standards of care. They can essentially do whatever they want and likely get away with it. I agree with these concerned physicians. The regulation of naturopaths by naturopaths needs to end.

In response to the concerned physicians’ letter, the College of Naturopathic Doctors of Alberta (CNDA) said it has opened a formal investigation of Tracey Tannis. I suspect the CNDA will find no wrongdoing, not because Tannis sold an herbal product to Ezekiel’s mother who intended to use it to treat his meningitis. Rather, the CNDA will probably close the case because naturopaths were only licensed in Alberta months after Ezekiel died. Therefore, the college has no jurisdiction over Tannis’s actions at that time because she and other naturopaths in Alberta were not yet licensed.

Ezekiel died 18 March 2012. Ezekiel’s mother purchased the herbal product from Tannis at her naturopathic clinic (with Ezekiel in the car too stiff to sit in a car seat) on 17 March 2012. The CNDA’s authority came into force in August 2012.

This chronology means that Tannis could be considered an unlicensed and unlawful practitioner of medicine ahead of the CNDA’s forming. Therefore, Tannis’s actions might fall within the purview of the College of Physicians and Surgeons of Alberta, which is charged with protecting the public from unlicensed medical practitioners.

Interested parties may not have noticed this time when naturopaths were unregulated in Alberta because Tannis’s record on the CNDA website reports that she has been registered in Alberta since 2006. I checked the other four provincial naturopathic colleges for a record of Tannis’s 2006 registration (even under her maiden name “Pike”) but found none. If Tannis were practicing medicine before the CNDA was established, then the College of Physicians and Surgeons should promptly look into the matter.


Screenshot of Tracey Tannis’s record at the CNDA (24 April 2016).

Cases like that of Ezekiel Stephan bring a great deal of attention to naturopathic practices. Many people may be unaware that governments across North America have essentially endorsed a profession that is based on discredited ideas about health and medicine, full of anti-science rhetoric with many ineffective and dangerous practices to operate as a “distinct primary health care profession.”

Naturopaths are not doctors. They do not receive anything that resembles legitimate medical training. They should not be granted any sort of governmental legitimacy through licensure and self-regulation. The physicians who signed onto this letter below are deeply concerned, and you should be too.


If the PDF viewer doesn’t load, click here to see the physicians’ letter.


If you are interested in contacting the organizer of the open letter, write to [email protected].

91 Replies to “Canadian physicians criticize naturopaths in wake of Ezekiel Stephan’s death

  1. Hi Britt,

    with regard to education of naturopaths, maybe it would be beneficial to compare the education of naturopaths with that of MDs in Germany or Austria or other European countries. In Austria you have to do at least 5 years med-school plus four years residency at a hospital in order to get a license. I.o.w. they have to do 9 years training – at least. Plus, the acceptance rate to Med-school is 10%.

    1. I’ll put it on my list! 😉 I have enough post ideas for the next 10 years. And as my blog becomes more international, the ideas keep coming. Germany is on the list for sure since I know so many German medical students and doctors and since my program takes place within the medical school. Plus, Germany has interesting laws regarding what is allowed (homeopathy) and what is not (ozone) to contrast with North America.
      If, perhaps, you would like to write a guest post for me on this topic, I’d be happy to post it. Thanks, Thomas!

      1. I would love to read more about German alternative medicine, since ND’s clients are told, frequently, how ‘x’ is used all the time in Germany, implying of course that its cutting edge therapy, and is safe and effective.

        1. Yes. It is the “any alternative therapy that comes from Europe is effective, safe, and better than anything available in the US” fallacy. (I just made this up, but this seems to be a common misconception.)

          1. You may have just “made this up,” but I first heard an equivalent comment years ago from a friend who’s a true believer in CAM. Her comment: “Doctors in Europe are much ‘advanced’ than those in the United States.” I interpreted this to mean that European healthcare professionals are allowed to get away with more quackery, which she regarded as “cutting edge” medicine.

            1. That reminds me of an article from 9 years ago in the journal Clinical Governance by WR Smith titled, “Pseudo-evidence based medicine [PBM]: what it is, and what to do about it.” Smith concluded as follows: “PBM can be defined as the practice of medicine based on falsehoods that are disseminated as true evidence, then adopted by unwitting and well-intentioned practitioners of evidence-based medicine (EBM). PBM borders on being not only unethical, but also criminal. It may well result not only in inappropriate quality standards and processes of care, but also in harms to patients.”

                1. We see this again in the case at hand: the father claiming that olive root has potent antiviral and antifungal activity without establishing that the same activities are found in humans, or that the root has any benefit in the treatment of meningitis. I’ve lost count of the number of times that I explained to one marketer and alt-med proponent and another that just because a plant extract shows strong activity in a well, test tube, or Petri dish (in vitro), doesn’t mean that after ingestion and metabolism in a living organism (in vivo), the same effects will be found. Nor does it mean that the plant is safe for human consumption, even when it’s use in herbal or any cultural medicine is centuries old.

                  1. You know the most common place to find the claim that something from a natural source has “potent antiviral and antifungal activity”? In the science literature. Go to the Journal of Organic Chemistry, and read all the synthesis papers. Inevitably, it is the synthesis of something that was isolated from a natural source (marine sponges are very popular in this regard) that has shown activity against something.

                    The difference? These and their colleagues are the ones who are carrying the test to show that it doesn’t just happen in a “well, test tube, or Petri dish” and that it is safe.

                2. Off topic, but has anyone mentioned that the photo of you with hands raised looks so much like a Russian icon? It’s a great shot.

          2. The US naturopathic doctors I’m most familiat with have been so trained to believe that the medical establishment suppresses the truth, that virtually any study conducted somewhere other than in the US must be superior.
            When I read some of the history written up in Pizorno’s books, I was really struck by how much he nurtured his resentment that medicine wasn’t accepting of his quackery.–
            Naturopathic students are actually taught to feel persecuted. It sets a bad tone for patients.

            1. Big quackery is very profitable, as he knows full well. If you can instill zealotry, all the better.

            2. The US naturopathic doctors I’m most familiat with have been so trained to believe that the medical establishment suppresses the truth, that virtually any study conducted somewhere other than in the US must be superior.

              Yet, is was the US FDA that would not approve thalidomide…

        2. As an Austrian I think I can supply some Info. In Austria, Germany and Switzerland MDs have quite a leeway with regard to patient treatment b/c according to the law treatment is a civil contract. Therefore if a patient chooses a treatment despite knowing it will not work that is perfectly fine. Therefore MDs offer such things as homeopathy. In Austria, Switzerland and Germany we do NOT have NDs. In Austria any medical treatment has to be performed by a licensed MD. Something like an ND is illegal here. In Germany and Switzerland the Situation is different. There they have what is called a “Heilpraktiker” which can be roughly translated as Naturopath. These Naturopaths have no schooling requirements whatsoever but take an exam (which is a joke). They are allowed to practice within strict limitations, and can not prescribe anything. In practice, however, this is often different. In all three countries so-called alternative medicine, especially homeopathy is quite popular and some MDs practice it but only upon request of the patient. Homeopathic drugs are not permitted to claim effects that are not scientifically proven.

        3. As an Austrian I think I can supply some Info. In Austria, Germany and Switzerland MDs have quite a leeway with regard to patient treatment b/c according to the law treatment is a civil contract. Therefore if a patient chooses a treatment despite knowing it will not work that is perfectly fine. Therefore MDs offer such things as homeopathy. In Austria, Switzerland and Germany we do NOT have NDs. In Austria any medical treatment has to be performed by a licensed MD. Something like an ND is illegal here. In Germany and Switzerland the Situation is different. There they have what is called a “Heilpraktiker” which can be roughly translated as Naturopath. These Naturopaths have no schooling requirements whatsoever but take an exam (which is a joke). They are allowed to practice within strict limitations, and can not prescribe anything. In practice, however, this is often different. In all three countries so-called alternative medicine, especially homeopathy is quite popular and some MDs practice it but only upon request of the patient. Homeopathic drugs are not permitted to claim effects that are not scientifically proven.

  2. The Naturocrit Podcast and Blog:

    Ah, (some) MDs of Canada awaken from their Odinsleep and miss most of the juicy targets that are naturopathy’s weaknesses!

    The horses have already left the barn:

    the province gave absurdity the power of self-regulation.

    Absurdity has no problem with absurdity.

    -r.c.

    1. At only 43, the number of Canadian physicians and surgeons who have so far signed the petition does seem rather small; however, considering that the entire population of Canada is only around one-tenth that of the U.S., or about the same as that of California, the current number of signatories can hardly be called inconsequential. Had the public of Canada been sufficiently aware of the lack of evidence to support the various prescriptions of naturopaths and the relatively meager medical training they receive, self-regulation could not in good conscience ever have been allowed. The fact that naturopathics were allowed self-regulation is further testament to the ignorance and incompetence of those in the Canadian government responsible for the welfare of the public. The problem stems in large part from the practice of federal regulators in Canada to first look to the U.S. For example, when the US FDA continued to allow homeopathic preparations to be prescribed for the treatment of disease and to be sold as over-the-counter (OTC) medicines, the fix was in. Bafflegabbed by the regulations of the FDA, Canadian authorities—ever the ones to avoid upsetting the U.S.—effectively put diplomacy before the safety of the public.

      1. I agree with A LOT if not all of what you say.

        ‘And believe you me’, to borrow from the Scottish, the MDs have a heavy burden.

        Yet, in the land of actual professional ethics,

        ‘each must pay for their own actions no-matter…’

        OR their lack of inaction when they should have acted, demonstrated, shrieked from the towers…

        Because the stakes are so high.

        -r.c.

        1. Not that I put the blame on Canada’s busy physicians, but I take it that you mean their lack of action.

          1. I was reading about nosodes last week. Am I right that Health Canada put a strict warning on the label to the effect that nosodes are not vaccines and not an alternative to a vaccine, but nevertheless H.C. allows them to be sold?
            Does anyone know if the ones that are sold in the US carry the same or a similar warning? Also, are they considered prescription medicine? I want to include the info in a presentation I’m making next week.

            1. To my knowledge, unlike Canada where nosodes are allowed to be sold provided they bear a warning label, the FDA continues to allow the sale of any and all homeopathic preparations as drugs without any warning labels. To be authoritative in your presentation, you would be best to directly cite FDA regulations and Health Canada. Check their respective web sites or call them if you can’t locate the answers.

              1. thanks, will do. It is really really hard to get specific information out of the FDA re homeopathics–I will do my best before the presentation.
                I’d just like to make sure I’m on the right track about the labeling. Also, are nosodes truly homeopathicly prepared, or are they less dilute? If you or anyone else could point me to a pharmacy that distributes them, a simple phone call might give me enough info. to decide if this is worth pursueing.

                1. I’m not sure if this info will be helpful to you but even if they are required to have a warning, I’m not sure that naturopaths are disclosing it when administering. My niece was given a “homeopathic MMR vaccine” as her first dose when she was an infant. I’m not sure her parents understood it was not equivalent, but when they went to give her the second dose their MD realized she was not at all protected.

                  I’m an MD student in Canada, btw.

              2. thanks, will do. It is really really hard to get specific information out of the FDA re homeopathics–I will do my best before the presentation.
                I’d just like to make sure I’m on the right track about the labeling. Also, are nosodes truly homeopathicly prepared, or are they less dilute? If you or anyone else could point me to a pharmacy that distributes them, a simple phone call might give me enough info. to decide if this is worth pursueing.

      2. Agreed. A small number. But I think (hope) this is just the start.
        As one of the doctors put it to me in a email: the assumption is that the college (CNDA) will do their job appropriately and investigate any wrong doing. You don’t necessarily think to have to hold the college publicly accountable.
        This small group of physicians is just now realizing that NDs want all the privileges as medical doctors, but none of the same oversight. How else can you justify the CNDA allowing naturopaths in Alberta to inject ozone into patients?
        NDs get away with all sorts of nonsense. Alberta has a chance to stop naturopaths in their tracks. Let’s support their efforts!

        1. A lot of Canadian doctors like myself were not aware of the letter. I would happily add. G name to the list.

        2. Far more needs to be done to educate physicians and the public in Canada about the practices of naturopaths. Yet, even with a meager 43 physicians as signatories, the petition definitely has ‘legs’. Canada has around 77,000 physicians. In the U.S., the number of actively practicing physicians in 2013 was approximately 767,000, or 9.9 times as many. By direct extrapolation, had the same ratio of physicians signed a petition in the U.S., the number would be 428. Coincidentally, the ratio roughly reflects the difference in populations between the countries; Canada with approx. 35 million and the U.S. with 318 million people, or 9 times the number in Canada. Given the public interest in and mainstream media attention to incompetent physicians who have misdiagnosed patients in Canada, it’s a wonder that so little attention has been accorded the potential and real dangers of naturopathy; injecting ozone into people being only one case in point. Allowing anyone to administer acupuncture in the treatment of conditions for which the practice has not been shown effective in clinical trials is another. By extension, no one in Canada should be allowed to practice either so-called ayurvedic or traditional Chinese medicine without first having demonstrated that the products and practices are both safe and effective in well controlled clinical trials. Just because a practice is cultural doesn’t mean that it is either effective or harmless.

          1. Far more needs to be done to educate physicians and the public in Canada about the practices of naturopaths.

            I agree. Most people, I suspect, think that “naturopaths” are just doctors that use herbal drugs and TCM. Of course, it’s nothing of the sort.

            1. I believe your suspicion is correct. You have also very succinctly described the problem. However rare, there are naturopaths who admit to and lament their lack of medical knowledge, especially in the realm of pathology.

              1. However rare, there are naturopaths who admit to and lament their lack of medical knowledge, especially in the realm of pathology.

                Of course, you have to actually ask them in the first place. I don’t think they run around advertising that concern.

                Aside from Britt, of course. 🙂

                1. A Canadian naturopath voluntarily told me of his lack of knowledge. That may be because he knew of my background in research.

      3. I don’t think its a small thing when you can get 43 physicians involved enough to agree on something and put their names to a public document.

      4. I had no idea about the letter; if I’d known, I would have signed, as would have at least three other physicians in my office.

  3. Thank you for the article. Why did the parents take their child to the naturopath if all they wanted was a vial of medicine? If Ezekiel wasn’t even seen at the NDs office, then the trip was just a stressful experience for him, since I imagine that they tried and failed to get him in the car seat before settling on putting him on a flat surface to take him in the car. None of this makes any sense. They take their child in a car to get help for him, but then settle for a bottle of… not medicine? Did anyone at the naturopath office know that the kid was right outside, in the car? Don’t naturopaths pride themselves on taking lots of time to get to know their patients? Didn’t they have even a minute to look at this suffering little boy?

    1. It seems like every adult involved was totally blindsided by just how much trouble this child was in, despite the fact that his neck and body were so stiff that he could not sit in his car seat. When I first read that, it absolutely blew my mind. Strapping him to his mattress and putting him in the car? WTF? That’s not even a safe way to transport a healthy toddler in a car. Why not strapped to the roof, like Mitt Romney’s freaking dog? Seriously, how many more ways could the universe have shouted “This is an emergency! Call an ambulance!” at these people?

      1. I guess in this case it’s not an emergency until the kid stops breathing…

        How terribly sad.

  4. My US state’s regulators see Tannis’ actions as an example that shows she was doing exactly as she should have, sending the Stephans to the hospital. They think she’s demonstrated that she did know the limits to naturopathic medicine.

    Interesting that someone in a position of authority would have so clearly made up their mind before the trial was over….

    1. The question is, why would anyone dispense a product without knowing whether it was effective or harmful for a given condition?

      1. Certainly not a professional … plus a professional would not dispense a product without examining the patient first.

    2. Well, the problem is that Tannis did NOT do as she should have.

      First, she told the parents to give Echinacea which is clearly ineffective, thus leading the parents into the false thinking that their child receives treatment. The result is that the incentive to attend hospital drops.Please correct me if I am wrong, but if anything, an MD would have given a broad band antibiotics, just in case it is bacterial meningitis.

      Second, she should have told the patients personally and very clearly that bacterial meningitis is a definite possibility, that this disease can be deadly within hours, that natural remedies do not work and that the only option they have is to attend an ER *immediately* – as any MD would have done.

      1. You’ve put into words something I’ve struggled to express for several years–that allowing the unqualified to treat patients lowers motivation to seek and maintain a relationship with actual medical providers.

        I’ve heard far too many policy makers repeat the alt. med. jingle that their patients who are suspicious of wouldn’t have any medical care if not for them. They believe that giving clients the option to have both alternative and actual medical care will somehow sweeten the taste of real medicine.

        1. I think these are two different things. People wary of so-called conventional medicine will definitely prefer an ND and that may be better than nothing. However, the case reveals several weak points with NDs: First their lack of professionality and second the over-confidence that results from this. Additionally they are taught myths like the self healing force, mother nature did this and that for humans or that Naturopaths treat the person as a whole whereas medicine only quenches the symptoms (found in prominent textbooks of naturopathy). The problem is a psychological one. Once one gets *any* treatment, a layperson is prone to think the treatment works. This probability is much lower with an ND than with an MD.

        2. Additionally there is a a barrier that has to broken during emergencies, that is that laypersons realize very late how serious things really are. In German there is a wonderful poem that describes accurately what happens in such a situation, it is called Erlking by Johann Wolfgang Goethe:

          Who rides there so late through the night dark and drear?
          The father it is, with his infant so dear;
          He holdeth the boy tightly clasp’d in his arm,
          He holdeth him safely, he keepeth him warm.

          “My son, wherefore seek’st thou thy face thus to hide?”
          “Look, father, the Erl-King is close by our side!
          Dost see not the Erl-King, with crown and with train?”
          “My son, ’tis the mist rising over the plain.”

          “Oh, come, thou dear infant! oh come thou with me!
          For many a game I will play there with thee;
          On my strand, lovely flowers their blossoms unfold,
          My mother shall grace thee with garments of gold.”

          “My father, my father, and dost thou not hear
          The words that the Erl-King now breathes in mine ear?”
          “Be calm, dearest child, ’tis thy fancy deceives;
          ‘Tis the sad wind that sighs through the withering leaves.”

          “Wilt go, then, dear infant, wilt go with me there?
          My daughters shall tend thee with sisterly care;
          My daughters by night their glad festival keep,
          They’ll dance thee, and rock thee, and sing thee to sleep.”

          “My father, my father, and dost thou not see,
          How the Erl-King his daughters has brought here for me?”
          “My darling, my darling, I see it aright,
          ‘Tis the aged grey willows deceiving thy sight.”

          “I love thee, I’m charm’d by thy beauty, dear boy!
          And if thou’rt unwilling, then force I’ll employ.”
          “My father, my father, he seizes me fast,
          For sorely the Erl-King has hurt me at last.”

          The father now gallops, with terror half wild,
          He grasps in his arms the poor shuddering child;
          He reaches his courtyard with toil and with dread, –
          The child in his arms finds he motionless, dead.

      2. You’ve put into words something I’ve struggled to express for several years–that allowing the unqualified to treat patients lowers motivation to seek and maintain a relationship with actual medical providers.

        I’ve heard far too many policy makers repeat the alt. med. jingle that their patients who are suspicious of wouldn’t have any medical care if not for them. They believe that giving clients the option to have both alternative and actual medical care will somehow sweeten the taste of real medicine.

    3. Well, the problem is that Tannis did NOT do as she should have.

      First, she told the parents to give Echinacea which is clearly ineffective, thus leading the parents into the false thinking that their child receives treatment. The result is that the incentive to attend hospital drops.Please correct me if I am wrong, but if anything, an MD would have given a broad band antibiotics, just in case it is bacterial meningitis.

      Second, she should have told the patients personally and very clearly that bacterial meningitis is a definite possibility, that this disease can be deadly within hours, that natural remedies do not work and that the only option they have is to attend an ER *immediately* – as any MD would have done.

    4. Many commenters on this story have said the same thing – that the naturopath did the right thing, she told them to go to a doctor, she’s the good guy! Yes, she told them to go to a doctor, but only after “prescribing” a worthless remedy (ka-ching) without ever seeing the patient – a clear breach of ethics for an MD, who cannot prescribe anything for a patient without first examining that patient, and for very good reason.

  5. Thank you for writing this, and many thanks to those who signed the letter. Yes, naturopaths are not medical doctors, nor are they scientists. Their professed knowledge of biodiversity and natural products, as well as almost anything in biology, biochemistry, pharmacology, is concocted, with no foundation in fact and apparently no attempt to align their views with natural science (real natural science, not wishful nonsense). Their recognition, and the statements by the Alberta Health Minister at that time, may have belonged two centuries ago, but are a disservice to the public now.

    1. And by the way, the number of years that naturopathy students study homeopathy and imaginary components and treatments is irrelevant. Four years of nonsense is still nonsense, but nonsense empowered to mislead and harm.

      1. Agreed. Although I would argue it is not necessarily irrelevant.
        I think it is striking to know that I spent 3x as many hours time learning homeopathy compared to pharmacology.

        1. Had you spent so much time in the study of pharmacology, the lack of evidence in support of sundry treatments and prescriptions of naturopaths would have become apparent. But then, how would the school honestly answer the questions from more knowledgeable students and still promote naturopathy?

  6. Further details of the case, including recordings heard by the jury, reveal that the infant had never been taken to a physician and had not been vaccinated for bacterial meningitis, the disease that physicians have concluded was the cause of death. The father, who professed to be very knowledgeable of naturopathy, had never taken the infant to a physician beforehand and believe that obtaining medical attention from a physician at an earlier point in the case would have been without benefit. According to the CBC, with only an unconfirmed diagnosis of viral meningitis to go on, instead, he went online to visit medical and ‘natural websites’ [sic] that recommended ‘boosting the immune system’. He administered olive root extract, which he claimed to be a ‘very powerful’ antiviral and antifungal; “Total Reload”, a product he markets which contains vitamins, electrolytes, and amino acids; and “Blast”, a product “recommended” by naturopath Tracey Tannis (Pike). The mother described Blast as an “immune booster” containing ‘lots of homeopathics, natural antibiotics [sic] and an immune booster’. Rather than immediately taking the infant to a hospital, as the naturopath also recommended, the parents took the infant home because they saw signs of improvement. To the critical question of whether any one of the products were demonstrated to be safe and effective in the treatment of either viral or bacterial meningitis in human clinical trials, to my knowledge the answer is no.

    1. These details are hard to hear. It is so hard to imagine trusting a website over any medical physician, yet we know this happens daily. I am anxiously awaiting the verdict.

      1. Both medical and so-called “natural” web sites are rife with errors and misinformation on medicinal plants and various dietary supplements.

      2. The parents in this case trusted their own website — most of the quackeries tried on Ezekiel came from the family business.

    2. That is all pretty horrifying to read but is the vaccination for bacterial meningitis now part of standard childhood vaccine schedules? I remember getting it when I was a senior in high school, before going to college. But things could well have changed since then.

      Not that that has any bearing on the rest of it. One thing you can say–these people must really have been True Believers and not just snake oil salesmen if they trusted their products to treat their own child. Honest fools and now a child is dead.

      1. As far as I know, the vaccination for meningococcal disease is still given to adolescents (though Canada may have a different schedule), but meningitis can also be caused by HiB and pneumococcal bacteria, and there are infant vaccines for both of those.

      2. The Hib vaccine to protect against Hib meningitis, the most common meningitis in infants and young children pre-vaccine, is given to Canadian infants at 2,4, 6 and 18 months.

    1. Yes, I just read that. Guilty of “failure to provide the necessities of life”.

  7. In the latest report on the case from the CBC, the parents will serve a maximum of 5 years. Apparently, they believed so strongly in the meme of “boosting the immune system” that they avoided the common advice of seeking immediate treatment with conventional medicine. Had they studied conventional pharmacology, they would have known that the immune system is constantly self-balancing. When certain cells of the immune system are increased in activity, others are decreased. For that reason, the more appropriate, conventional scientific term is immunomodulation; not immunostimulation or immune boosters. Marketers of dietary supplements abhor the term immunomodulators because it reveals the fallacy they deem to promote in selling to an unsuspecting public for whom the term “boosting the immune” system is perceived as beneficial whereas immunomodulator would lead to questions. What immune cells are upregulated and which ones are down-regulated by a given product? In the case of malaria, for example, stimulating certain cells of the immune system would kill a person.

    1. The problem with “boosting” the immune system is that a “boosted” immune system easily gets out of control vz. autoimmune reactions or the dreaded cytokine storm.

    2. The problem with “boosting” the immune system is that a “boosted” immune system easily gets out of control vz. autoimmune reactions or the dreaded cytokine storm.

    3. “Boostung” (recte modulating) the immune system is a promising therapeutic approach in some scenarios (e.g. cancer). However, recommending such an approach in an acute infectious disease proves the lack of understanding how an immune system works. Immunomodulation is a long term training process process that takes days to weeks to be effective. Doing this during an acute infection is akin to recommending boot camp training for troops heavily under enemy fire.

      1. Yes, I agree. However, there are those who died from immunotherapeutic strategies in the treatment of cancer due to fever, such as in the example interleukin-2/lymphokine-activated killer cell therapy.

        1. As a cancer researcher I know that of course and it demonstrates the complexity of the immune system where a primarily beneficial process can get out of control with grave consequences.

  8. In the latest report on the case from the CBC, the parents will serve a maximum of 5 years. Apparently, they believed so strongly in the meme of “boosting the immune system” that they avoided the common advice of seeking immediate treatment with conventional medicine. Had they studied conventional pharmacology, they would have known that the immune system is constantly self-balancing. When certain cells of the immune system are increased in activity, others are decreased. For that reason, the more appropriate, conventional scientific term is immunomodulation; not immunostimulation or immune boosters. Marketers of dietary supplements abhor the term immunomodulators because it reveals the fallacy they deem to promote in selling to an unsuspecting public for whom the term “boosting the immune” system is perceived as beneficial whereas immunomodulator would lead to questions. What immune cells are upregulated and which ones are down-regulated by a given product? In the case of malaria, for example, stimulating certain cells of the immune system would kill a person.

  9. Since the verdict was handed down, insightful coverage of the case has followed:

    Steven Novella comments: “. . . how much blame does Canada have for licensing a profession of, essentially, fake medical providers? Governments that legitimize such professions are failing in their duty to their citizens in the same manner that the Stephans failed Ezekiel. Ezekiel’s death is therefore on the heads of the naturopathic profession and the Canadian government as well.”

    David Gorsky writes: “Naturopathy is quackery. No quackery is too quacky to be rejected by naturopaths, who embrace homeopathy, acupuncture, energy medicine, chelation therapy, intravenous vitamin C, applied kinesiology, and many more. The world view from which naturopathy springs, namely beliefs in vitalism and that nature is always better than “artificial” or “scientific” medicine (hint: it ain’t), is not unique to naturopaths. It’s the same world view that drives parents like David and Collet Stephan to treat their dying child with “natural” herbal remedies instead of taking their child to a real doctor before it was too late.”

  10. Modern medical science has many shortcomings, not the least of which is a tendency among specialists to myopia and a pervading view of the human system as only a series of isolated parts in an isolated machine (which it is not). As such, modern medicine is not very good at dealing with so-called ‘chronic’ or potentially terminal conditions (mental problems, pain management, skin problems, stress, cancers, degenerative illnesses, etc.).

    One area that modern medical science is EXTREMELY good at is in acute emergency situations. Break a leg, get stabbed by a knife, get a bacterial infection, and modern medicine is generally superb at getting you sorted. Oh, and with vaccines. Guess what, they work. In a way, so-called ‘naturopathic’ treatment is the opposite: having a natural, holistic approach to life and an awareness of the biochemical impact of stuff you consume is going to be beneficial over the long term, and may help defend against later ‘chronic’ conditions (good nutrition being the first ‘naturopathic’ treatment, right?). But find yourself with an acute medical emergency and naturopathic treatments are going to be TERRIBLE. There’s also nothing to compare with a well-trained immune system (i.e. a vaccine) to fight off many forms of pathogenic illness.

    There can be no doubt that many powerful compounds exist in ‘natural’ remedies (lets not forget that penicillin was discovered in naturally occurring mould)–but a big problem is that many (perhaps most?) ‘naturopathic’ practitioners don’t know what they’re doing in the first place (a rigorous, thorough and accountable eduction system is not in place, among other problems) and they are not competent to treat people.

    The story of Ezekiel Stephan is heartbreaking, and there is much vitriol against the parents and the ND. These are ignorant people who should at very least know that they don’t know any better. Wishful thinking, I guess. If they had known that they would have taken Ezekiel to the ER a hell of a lot sooner.

    1. These are ignorant people who should at very least know that they don’t know any better.

      Do not confuse denial with ignorance.

      Ignorance means “without knowledge”

      Is there a word that means “to deny knowledge”?

    2. Bullsh!t, mate. I am a General Practitioner (Family Doctor) and chronic conditions are our bread and butter. Where did you get the idea that modern medicine has a “pervading view of the human system as only a series of isolated parts in an isolated machine”? Which medical school did you go to that taught you that?

      The suggestion that fantasy and pseudomedicine are better at treating chronic and potentially terminal conditions (or anything, for that matter) is daft and dangerous.

      And by the way, statements to the effect of “Mainstream medicine is good for accidents and emergencies but outside of that they’re just pharma shills who want to keep you sick for fun and prizes” is a big red flag that the person who said it is pretty far down the rabbit hole of woo.

      1. “Mainstream medicine is good for accidents and emergencies”

        Translation: “Alt-med is no good for people who die before they’ve paid their bills.” Wonder what else it might be no good for.

      2. Agreed Emil Sinclair. I’ve received excellent care with my GPs over the years including recent psychiatric care. I chose to talk with my GP rather than visit an unknown psychiatrist. For me it’s important that I take an active part in my care and working with a good GP is the best way to do that. One’s GP has an overview of your health and coordinates between reports from various specialists. My Doctor’s Clinic works as a team and their MOAs are an important part of your care too.

  11. Modern medical science has many shortcomings, not the least of which is a tendency among specialists to myopia and a pervading view of the human system as only a series of isolated parts in an isolated machine (which it is not). As such, modern medicine is not very good at dealing with so-called ‘chronic’ or potentially terminal conditions (mental problems, pain management, skin problems, stress, cancers, degenerative illnesses, etc.).

    One area that modern medical science is EXTREMELY good at is in acute emergency situations. Break a leg, get stabbed by a knife, get a bacterial infection, and modern medicine is generally superb at getting you sorted. Oh, and with vaccines. Guess what, they work. In a way, so-called ‘naturopathic’ treatment is the opposite: having a natural, holistic approach to life and an awareness of the biochemical impact of stuff you consume is going to be beneficial over the long term, and may help defend against later ‘chronic’ conditions (good nutrition being the first ‘naturopathic’ treatment, right?). But find yourself with an acute medical emergency and naturopathic treatments are going to be TERRIBLE. There’s also nothing to compare with a well-trained immune system (i.e. a vaccine) to fight off many forms of pathogenic illness.

    There can be no doubt that many powerful compounds exist in ‘natural’ remedies (lets not forget that penicillin was discovered in naturally occurring mould)–but a big problem is that many (perhaps most?) ‘naturopathic’ practitioners don’t know what they’re doing in the first place (a rigorous, thorough and accountable eduction system is not in place, among other problems) and they are not competent to treat people.

    The story of Ezekiel Stephan is heartbreaking, and there is much vitriol against the parents and the ND. These are ignorant people who should at very least know that they don’t know any better. Wishful thinking, I guess. If they had known that they would have taken Ezekiel to the ER a hell of a lot sooner.

  12. Ezekiel’s father now insists the jurors were wrong in their verdict, that they were tricked by the prosecution, and as a result, anyone whose parenting is deemed unfit by the Canadian government will risk prosecution. In taking such a fanatical stance, he seems to be ignoring the fact that regardless of his particular case, laws to protect children from the harms of parental negligence were already in place.

    The CBC has since interviewed Canadian experts for their opinions on the case and the subject of so-called alternative medicine. Director of research at the University of Alberta’s Health Law and Science Policy Group, Tim Caulfield, commented: ’Studies have shown that some people are more likely to believe these kinds of things. They’re more likely to believe in the supernatural. They’re more likely to be religious and they’re more likely to buy the entire package of complimentary and alternative medicine.’

    Juliet Gauchon, a bioethicist at the University of Calgary, noted that ’There’s an element of irrationality in the rejection of physician advice. If physicians are telling people things they don’t want to hear, then it’s hard for the patient and the family to accept what they are being told’, adding ‘I wonder if it’s a distrust of people in authority in general.’

    At the University of Toronto, Dr. David Juurlink, a specialist in pharmacology and toxicology, was quoted by the CBC as follows: ‘What irritates me and most other science-minded people who care about public health is that the federal government effectively legitimizes this nonsense.’ He added that the approval of natural health products by Health Canada is misleading the public to believe that the products are endorsed: ‘An unwitting consumer might view that as evidence of effectiveness’. . . ‘It’s no such thing.’

    1. If only Ezekiel’s father had demonstrated the same level of concern for his desparately ill son. The unwavering enthusiasm with which the Stephans and fellow True Believers throw that poor child under the bus is truly a thing to behold. Just be sure to have a barf bag.

    2. This guy is really incredible. In Austria we had a similar case in the 90ties. Charge: Bodily harm due to negilgence. Fortunately this child did not die. If it would have died the charge would have been bodily harm due to negligence with fatal consequences, punishable with 1 to 15 years.

    3. anyone whose parenting is deemed unfit by the Canadian government will risk prosecution.

      Well, in the US, we do prosecute a lot of “unfit” parents. However, that usually requires extreme unfitness, particularly abuse. So unless you are doing things like abusing your child or killing them through negligence, you don’t have to worry about being prosecuted…

      Oh wait…

  13. Only duly qualified MDs should be Primary Care Physicians, never Naturopaths! Canada has become a hotbed of pseudoscience and woo, encouraged by Health Canada’s lax attitude to so called ‘natural remedies’, the efficacy of which is unproven. The public tend to think that a remedy works because it is approved for sale by Health Canada, this is absolutely not so. Very sad that a little boy died because of parental neglect and it appears perhaps mistakes by this naturopath.

  14. Britt, on one of your newest tweets you present a naturopathic cancer clinic based in Calgary. This presentations shows like nothing else what’s wrong with naturopaths. First, they say medicine focuses on “late stage curative care” instead of cancer prevention. This alone shows the lack of understanding how cancer really works. Cancer is a stochastic process liked to probabilities, environmental factors and genetic disposition only changes these probabilities. Therefore cancer prevention is (with exception of a few cancers) extremely difficult. Once one has developed cancer, preventative measures are more or less without effect. It is like trying to prevent a car crash that has already happened by driving slowly afterwards.

    However, it gets even better: Quote: “Dr. Quan’s cancer program involves finding the cause; is it a
    nutritional deficiency, toxic heavy metals, plastics, electro-smog,
    emotional issues, food allergies, infectious organism, dental, geopathic
    stress, or organ weakness? Dr. Quan will help find the answer. The
    program includes the use of intravenous therapies alongside
    detoxification and diet modification.”

    As stated previously, trying to cure cancer by removing real and perceived causative agents is like trying to repair a car that has been damaged in a speeding accident by driving only 10 mph. Both will not fly.

    Now come the really dangerous things:

    First, “Calgary Alternative Cancer Treatment” suggests that there is an alternative cancer treatment. Well, that does not fly either.

    Second: Quote: “The future of cancer care lies not in finding the best chemo, the right dose of radiation, or a new surgical technique, but in finding the right way to personalize treatment according to the individual imbalances in each person.” Sounds very feasible, doesn’t it ? It is worng. The future lies exactly in finding the best chemo which will be a personalized chemotherapy.

    Third: Quote: “Calgary’s Western Naturopathic cancer treatment has helped many individuals recover their health” The statistics would be interesting. I bet it is highly observer biased and therefore invalid.

    Fourth: Quote: “Dr. Quan is a student of Dr. Klinghardt, one of the leading natural medicine physicians in the world.” This adds authority and professionalism where there is none.

    In conclusion it can be said that, despite big advances in managing side effects, state-of-the-art cancer therapy is still dreaded by many patients and psychologically as well as physically not easy. Here we have a pseudo-authority “removing” the reasons for cancer, correcting underlying imbalancesand and offering some side-effect less treatments. Sounds like a reasonable alternative? For quite some laypersons definitely, but to an expert this approach is akin to trying to stop on ongoing attack of a sexual predator by psychoanalysis attempting to correct a childhood gone bad. It will not fly. Therefore naturopaths should not only be forbidden from practicing pediatrics, but to treat any kind of disease that requires treatment beyond administering over the counter drugs.

    1. Where does one even begin? He runs two clinics, both located inside Rexall drug stores. One of the largest drug store chains in Canada, Rexall retails homeopathic preparations, in addition to liquid extracts of plants which the company refers to as “naturopathic”. Since when were liquid extracts or tinctures in dropper bottles exclusive to naturopathy? In other words, if it’s popular, they could care less if what they sell is efficacious or not, as exemplified by the naturopathic practices located at the drug stores where ineffective, pseudo-scientific treatments are sold to unwitting cancer patients.

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