Edzard Ernst
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Edzard Ernst (born 30 January 1948) is a retired British-German academic physician and researcher specializing in the study of complementary and alternative medicine. He was Professor of Complementary Medicine at the
University of Exeter The University of Exeter is a research university in the West Country of England, with its main campus in Exeter, Devon. Its predecessor institutions, St Luke's College, Exeter School of Science, Exeter School of Art, and the Camborne School of ...
, the world's first such academic position in complementary and alternative medicine. Ernst served as chairman of
Physical Medicine and Rehabilitation Physical medicine and rehabilitation (PM&R), also known as physiatry, and outside the United States as physical and rehabilitation medicine (PRM), is a branch of medicine that aims to enhance and restore functional ability and quality of life ...
(PMR) at the
University of Vienna The University of Vienna (, ) is a public university, public research university in Vienna, Austria. Founded by Rudolf IV, Duke of Austria, Duke Rudolph IV in 1365, it is the oldest university in the German-speaking world and among the largest ...
, but left this position in 1993 to set up the department of Complementary Medicine at the University of Exeter in England. He became director of complementary medicine of the Peninsula Medical School (PMS) in 2002. Ernst was the first occupant of the Laing chair in Complementary Medicine, retiring in 2011. He was born and trained in Germany, where he began his medical career at a homeopathic hospital in
Munich Munich is the capital and most populous city of Bavaria, Germany. As of 30 November 2024, its population was 1,604,384, making it the third-largest city in Germany after Berlin and Hamburg. Munich is the largest city in Germany that is no ...
, and since 1999 has been a British citizen. Ernst is the founder of two
medical journal A medical journal is a peer-reviewed scientific journal that communicates medical information to physicians, other health professionals. Journals that cover many medical specialties are sometimes called general medical journals. History The first ...
s: '' Focus on Alternative and Complementary Therapies'' (of which he was editor-in-chief until it was discontinued in 2016) and ''
Perfusion Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ (anatomy), organ or a tissue (biology), tissue, usually referring to the delivery of blood to a capillary bed in tissue. Perfusion may also refer t ...
''. Ernst's writing appeared in a regular column in ''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in Manchester in 1821 as ''The Manchester Guardian'' and changed its name in 1959, followed by a move to London. Along with its sister paper, ''The Guardian Weekly'', ''The Guardi ...
'', where he reviewed news stories about complementary medicine from an
evidence-based medicine Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It means integrating individual clinical expertise with the best available exte ...
perspective. Since his research began on alternative modalities, Ernst has been seen as "the scourge of alternative medicine" for publishing critical research that exposes methods that lack documentation of efficacy. In 2015 he was awarded the John Maddox Prize, sponsored jointly by Sense about Science and ''
Nature Nature is an inherent character or constitution, particularly of the Ecosphere (planetary), ecosphere or the universe as a whole. In this general sense nature refers to the Scientific law, laws, elements and phenomenon, phenomena of the physic ...
'', for courage in standing up for science.


Early life

Ernst was born in
Wiesbaden Wiesbaden (; ) is the capital of the German state of Hesse, and the second-largest Hessian city after Frankfurt am Main. With around 283,000 inhabitants, it is List of cities in Germany by population, Germany's 24th-largest city. Wiesbaden form ...
, Germany, in 1948. As a child, his family doctor was a homeopath, and at the time he saw it as part of medicine. His father and grandfather were both physicians, and his mother was a laboratory assistant. Ernst originally wanted to be a musician, but his mother persuaded him that medicine might be a good "sideline" career for him to pursue.


Training and early career

Ernst qualified as a doctor in Germany in 1978 where he also completed his M.D. and Ph.D. theses. He has received training in
acupuncture Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientif ...
,
autogenic training Autogenic training is a relaxation technique first published by the German and Nazi psychiatrist Johannes Heinrich Schultz in 1932. The technique involves repetitions of a set of visualisations accompanied by vocal suggestions that induce a sta ...
,
herbalism Herbal medicine (also called herbalism, phytomedicine or phytotherapy) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. Scientific evidence for the effectiveness of many herbal treatments ...
, homoeopathy, massage therapy and spinal manipulation. He learned homeopathy, acupuncture and other modalities whilst at a homeopathic hospital in
Munich Munich is the capital and most populous city of Bavaria, Germany. As of 30 November 2024, its population was 1,604,384, making it the third-largest city in Germany after Berlin and Hamburg. Munich is the largest city in Germany that is no ...
, when he began his medical career. In 1988, he became Professor in Physical Medicine and Rehabilitation (PMR) at Hannover Medical School and in 1990 Head of the PMR Department at the University of Vienna.


Work in complementary medicine

The world's first professor of complementary medicine, Ernst researches complementary medicine with an emphasis on efficacy and safety. His research mainly surveys systematic reviews and
meta-analyses Meta-analysis is a method of synthesis of quantitative data from multiple independent studies addressing a common research question. An important part of this method involves computing a combined effect size across all of the studies. As such, th ...
of
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
s; the institute has not performed a clinical trial for some time due to budget constraints. He has over 700 papers published in scientific journals. He has said that about five percent of
alternative medicine Alternative medicine refers to practices that aim to achieve the healing effects of conventional medicine, but that typically lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness. Such practices are ...
is backed by evidence, with the remainder being either insufficiently studied or backed by evidence showing lack of efficacy. Ernst's department at Exeter defined complementary medicine as "diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine." Ernst asserts that complementary techniques are mostly practiced by qualified physicians in Germany and Austria whereas they are mainly practiced by others in the UK. He also argues that the term "complementary and alternative medicine" (CAM) is an almost nonsensical umbrella term and that distinctions between its modalities must be made. Since his research began on alternative modalities, Ernst has been seen as "the scourge of alternative medicine" for publishing critical research. In a 2008 publication in the '' British Journal of General Practice'', he listed treatments that "demonstrably generate more good than harm", identifying only
acupuncture Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientif ...
for
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...
and
osteoarthritis Osteoarthritis is a type of degenerative joint disease that results from breakdown of articular cartilage, joint cartilage and underlying bone. A form of arthritis, it is believed to be the fourth leading cause of disability in the world, affect ...
; aromatherapy as a palliative treatment for
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
; hypnosis for labour pain; massage,
music therapy Music therapy, an allied health profession, "is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music t ...
, relaxation therapy for
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
and
insomnia Insomnia, also known as sleeplessness, is a sleep disorder where people have difficulty sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low ene ...
; and some plant extracts such as St John's wort for depression; hawthorn for
congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically pr ...
; and
guar gum Guar gum, also called guaran, is a galactomannan polysaccharide extracted from guar beans that has thickening and stabilizing properties useful in food, feed, and industrial applications. The guar seeds are mechanically dehusked, hydrated, mi ...
for
diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
. Ernst presented at the first Global Congress on Scientific Thinking and Action, which took place on 17–20 March 2021. He spoke about the risks and dangers of alternative medicine, pointing to
homeopathy Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians, believe that a substance that ...
and
chiropractic Chiropractic () is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It is based on several pseudoscientific ideas. Many c ...
as the most problematic areas within alternative medicine at the time.


Smallwood Report

In 2005, a report by the economist Christopher Smallwood, personally commissioned by Prince Charles, claimed that complementary and alternative medicine was cost-effective and should be available in the
National Health Service The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
(NHS). Ernst was initially enlisted as a collaborator on the report, but asked for his name to be removed after a sight of the draft report convinced him that Smallwood had "written the conclusions before looking at the evidence". The report did not address whether CAM treatments were actually effective and Ernst described it as "complete misleading rubbish". Ernst was, in turn, criticised by ''
The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal, founded in England in 1823. It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication. The journal publishes ...
'' editor Richard Horton for disclosing contents of the report while it was still in draft form. In a 29 August 2005 letter to ''
The Times ''The Times'' is a British Newspaper#Daily, daily Newspaper#National, national newspaper based in London. It began in 1785 under the title ''The Daily Universal Register'', adopting its modern name on 1 January 1788. ''The Times'' and its si ...
'' Horton wrote: "Professor Ernst seems to have broken every professional code of scientific behaviour by disclosing correspondence referring to a document that is in the process of being reviewed and revised prior to publication. This breach of confidence is to be deplored." Prince Charles' private secretary, Sir Michael Peat, also filed a complaint regarding breached confidentiality with Exeter University. Although he was "cleared of wrongdoing",Jo Revill, health editor
"'Meddling' Prince nearly cost health don his job"
''
The Observer ''The Observer'' is a British newspaper published on Sundays. First published in 1791, it is the world's oldest Sunday newspaper. In 1993 it was acquired by Guardian Media Group Limited, and operated as a sister paper to ''The Guardian'' ...
'', 10 March 2007
Ernst has said that circumstances surrounding the ensuing university investigation led to his
retirement Retirement is the withdrawal from one's position or occupation or from one's active working life. A person may also semi-retire by reducing work hours or workload. Many people choose to retire when they are elderly or incapable of doing their j ...
. In the 1 January 2006 edition of the '' British Journal of General Practice'', Ernst gave a detailed criticism of the report.


''Trick or Treatment''

In 2008, Ernst and Simon Singh published '' Trick or Treatment? Alternative Medicine on Trial''. The authors challenged the Prince of Wales, to whom the book is (ironically) dedicated, and The Prince's Foundation for Integrated Health on alleged misrepresentation of "scientific evidence about therapies such as homeopathy, acupuncture and reflexology". They asserted that Britons spent £500 million each year on unproven or disproven alternative therapies. In a review of ''Trick or Treatment'' in the ''
New England Journal of Medicine ''The New England Journal of Medicine'' (''NEJM'') is a weekly medical journal published by the Massachusetts Medical Society. Founded in 1812, the journal is among the most prestigious peer-reviewed medical journals. Its 2023 impact factor was ...
'', Donald Marcus described Ernst as "one of the best qualified people to summarize the evidence on this topic." In 2008, Ernst sent an open letter urging the Royal Pharmaceutical Society of Great Britain to crack down on high street chemists that sell homeopathic remedies without warning that the remedies lack evidence for claimed biological effects. According to him, this disinformation would be a violation of their ethical code:
My plea is simply for honesty. Let people buy what they want, but tell them the truth about what they are buying. These treatments are biologically implausible and the clinical tests have shown they don't do anything at all in human beings. The argument that this information is not relevant or important for customers is quite simply ridiculous.
In a 2008 interview with '' Media Life Magazine'', when he and Simon Singh were asked this question—"What do you think the future is for alternative medicine?"—they replied:
For us, there is no such thing as alternative medicine. There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines. Hopefully, in the future, the good medicines will be embraced within conventional medicine and the bogus medicines will be abandoned.Heidi Dawley
Note to Prince Charles: 'You're wrong'. Book raises new doubts about alternative medicine.
'' Media Life Magazine'' Apr 21, 2008
In a 2009 article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the '' American Journal of Medicine'', Ernst and Michael Baum—writing to other physicians—offered strong criticism of homeopathy:
Homeopathy is among the worst examples of faith-based medicine. ... These axioms f homeopathyare not only out of line with scientific facts but also directly opposed to them. If homeopathy is correct, much of physics, chemistry, and pharmacology must be incorrect.... To have an open mind about homeopathy or similarly implausible forms of alternative medicine (e.g., Bach flower remedies, spiritual healing,
crystal therapy Crystal healing is a pseudoscientific alternative-medicine practice that uses semiprecious stones and crystals such as quartz, agate, amethyst or opal. Despite the common use of the term "crystal", many popular stones used in crystal healin ...
) is therefore not an option.


''More Harm Than Good?''

In 2018, Ernst and co-author Kevin Smith, a medical ethicist, published the book ''More Harm Than Good? The Moral Maze of Complementary and Alternative Medicine.'' In a review of the book for '' Skeptical Inquirer'',
Harriet Hall Harriet A. Hall (July 2, 1945 – January 11, 2023) was an American family medicine, family physician, U.S. Air Force flight surgeon, author, Science communication, science communicator, and scientific skepticism, skeptic. She wrote about alterna ...
called Ernst the "world's foremost expert on the claims and the evidence (or lack thereof) for Complementary and Alternative Medicine (CAM)." Hall said that Ernst and Smith direct their attention to the ethicists and the scientific community for this book with the goal "to inform, not to entertain. It is not an easy or 'fun' read, but it's an important one". Dougal Jeffries, writing for the '' British Journal of General Practice'', said the book was "replete with both theoretical and real-life examples and is thoroughly referenced, but is a rather turgid read. It clearly demonstrates the extraordinary capacity of intelligent beings, including both practitioners and patients, to hold to irrational beliefs in the face of contrary evidence, but the authors show little sympathy for this very human tendency."


Early retirement from Exeter

Ernst was accused by Prince Charles' private secretary of having breached a confidentiality agreement regarding the 2005 Smallwood report. After being subjected to a "very unpleasant" investigation by the
University of Exeter The University of Exeter is a research university in the West Country of England, with its main campus in Exeter, Devon. Its predecessor institutions, St Luke's College, Exeter School of Science, Exeter School of Art, and the Camborne School of ...
, the university "accepted his innocence but continued, in his view, to treat him as 'persona non grata'. All fundraising for his unit ceased, forcing him to use up its core funding and allow its 15 staff to drift away." Writing in 2022, after Charles' accession to the throne, Ernst said, "There never was a formal confidentiality agreement with signature etc. But I did feel bound to keep the contents of the Smallwood report confidential. The investigation by my University was not just 'very unpleasant', it was also far too long. It lasted 13 months! I had to take lawyers against my own University! In addition, it was unnecessary, not least because a University should simply establish the facts and, if reasonable, defend its professor from outside attacks. The facts could have been established over a cup of tea with the Vice Chancellor in less than half an hour. When my department had been destroyed in the process, I retired voluntarily and was subsequently re-employed for half a year to help find a successor. In retrospect, I see this move as a smart ploy by the University to keep me sweet and prevent me from going to the press. A successor was never hired; one good candidate was found but he was told that he had to find 100% of the funds to do the job. Nobody of high repute would have found this acceptable, and thus the only good candidate was not even tempted to accept the position." He retired in 2011, two years ahead of his official retirement. In July 2011, a
Reuters Reuters ( ) is a news agency owned by Thomson Reuters. It employs around 2,500 journalists and 600 photojournalists in about 200 locations worldwide writing in 16 languages. Reuters is one of the largest news agencies in the world. The agency ...
article described his "long-running dispute with the Prince about the merits of alternative therapies" and stated that he "accused Britain's heir-to-the-throne Prince Charles and other backers of alternative therapies on Monday of being ' snake-oil salesmen' who promote products with no scientific basis", and that the dispute "had cost him his job – a claim Prince Charles's office denied".Kate Kelland
Professor calls Prince Charles, others "snake-oil salesmen".
Reuters Reuters ( ) is a news agency owned by Thomson Reuters. It employs around 2,500 journalists and 600 photojournalists in about 200 locations worldwide writing in 16 languages. Reuters is one of the largest news agencies in the world. The agency ...
, 25 July 2011
According to Ernst, "The snake oil salesman story is an entirely separate issue", which "happened years later." He added, "It is true that Charles's office denied that Charles knew about his 1st private secretary writing to my Vice Chancellor asking him to investigate my alleged breach of confidence." Ernst claims that as Sir Michael Peat wrote his letter in his capacity as the Prince's private secretary, Ernst finds that "exceedingly hard to believe." Ernst's book, ''Charles, the Alternative Prince: An Unauthorised Biography'', was published in February 2022. It focuses on Charles's interest in alternative medicine, with a critical assessment of his views. In 2009, Ernst's name appeared on a list of supporters of
Republic A republic, based on the Latin phrase ''res publica'' ('public affair' or 'people's affair'), is a State (polity), state in which Power (social and political), political power rests with the public (people), typically through their Representat ...
– an organisation which campaigns for the abolition of the British monarchy. However, writing on his website in 2022, Ernst clarified his position: "Even though Charles did a sterling job in trying, I did not become a republican. I do have considerable doubts that Charles will be a good King (his reign might even be the end of the monarchy), and I did help the republican cause on several occasions but I never formally joined any such group (in general, I am not a joiner of parties, clubs or interest groups)."


Other work and recognition

In a May 1995 ''
Annals of Internal Medicine ''Annals of Internal Medicine'' is an academic medical journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world. ''Annals'' publishes content releva ...
'' publication, Ernst detailed the
Nazi Nazism (), formally named National Socialism (NS; , ), is the far-right politics, far-right Totalitarianism, totalitarian socio-political ideology and practices associated with Adolf Hitler and the Nazi Party (NSDAP) in Germany. During H ...
"cleansing" of the University of Vienna medical faculty that allowed the "medical atrocities" of Nazi human experimentation. In 2001, Ernst sat on the Scientific Committee on Herbal Medicinal Products of the Irish Medicines Board. In 2005, he was a member of the Medicines Commission of the British Medicines Control Agency (now part of the
Medicines and Healthcare products Regulatory Agency The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department of Health and Social Care in the United Kingdom which is responsible for ensuring that medicines and medical devices work and are accepta ...
) which determines which substances may be introduced and promoted as medicine. In 2008, he was an external examiner for several university medical schools in several countries. He is a Founding Member and on the Board of the Institute for Science in Medicine, formed in 2009.Institute for Science in Medicine
In February 2011, Ernst was elected as a Fellow of the
Committee for Skeptical Inquiry The Committee for Skeptical Inquiry (CSI), formerly known as the Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP), is a program within the U.S. non-profit organization Center for Inquiry (CFI), which seeks to " ...
. He was editor-in-chief of the journal '' Focus on Alternative and Complementary Therapies'' which he founded in 1995 and which was discontinued in 2016. In 2015, Ernst was one of two recipients of the John Maddox Prize, sponsored jointly by Sense about Science and ''
Nature Nature is an inherent character or constitution, particularly of the Ecosphere (planetary), ecosphere or the universe as a whole. In this general sense nature refers to the Scientific law, laws, elements and phenomenon, phenomena of the physic ...
'', for courage in standing up for science.


Books

* ''Homeopathy: A Critical Appraisal'' (with Eckhart G. Hahn). Butterworth-Heinemann 1998. , 240 pages * ''The Desktop Guide to Complementary and Alternative Medicine: An Evidence-based Approach''.
Elsevier Health Sciences Elsevier ( ) is a Dutch academic publishing company specializing in scientific, technical, and medical content. Its products include journals such as ''The Lancet'', '' Cell'', the ScienceDirect collection of electronic journals, '' Trends'', ...
2006, , 556 pages * ''Complementary Therapies for Pain Management''. ''An Evidence-Based Approach''. Elsevier Science 2007. , 349 pages * ''The Oxford Handbook of Complementary Medicine''. Oxford University Press 2008. , 448 pages * '' Trick or Treatment? Alternative Medicine on Trial'' (with Simon Singh). Transworld Publisher 2008. , 416 pages (The same book published in the US is called ''Trick or Treatment: The Undeniable Facts about Alternative Medicine''). * ''Healing, Hype, Or Harm?: Scientists Investigate Complementary Or Alternative Medicine''. (ed.) Imprint Academic 2008, , 120 pages * '' A Scientist in Wonderland: A Memoir of Searching for Truth and Finding Trouble''. Imprint Academic 2015. , 173 pages * ''Homeopathy - The Undiluted Facts : Including a Comprehensive A-Z Lexicon.'' Springer 2018. , 151 pages * ''More Harm than Good?: The Moral Maze of Complementary and Alternative Medicine'' with Kevin Smith. Springer 2018 , 223 pages * ''SCAM: So-Called Alternative Medicine''. (Societas) Imprint Academic 2018, , 225 pages * ''Don't Believe What You Think: Arguments for and against SCAM''. (Societas) Ingram Book Company 2020. , 261 pages * ''Chiropractic: Not All That It's Cracked Up to Be.'' Springer 2021. , 206 pages * ''Alternativmedizin - was hilft, was schadet: Die 20 besten, die 20 bedenklichsten Methoden''. Gräfe und Unzer 2021. , 224 pages * ''So-Called Alternative Medicine (SCAM) for Cancer.'' Springer 2021. , 232 pages * ''Charles, The Alternative Prince: An Unauthorised Biography''. Societas 2022. , 210 pages * ''Charles, The Alternative King: An Unauthorised Biography.'' Societas 2023. , 216 pages * ''Bizarre Medical Ideas: ... and the Strange Men Who Invented Them'', Springer 2024, , 255 pages


References


Further reading

*


External links


edzardernst.com
€“ Ernst's blog


Official FACT website at University of Exeter

Summary of the department's most important findings
e.g. Homeopathy does not work, St John's Wort does.
Google scholar:
List of publications

on Complementary and Alternative Medicine. Ernst testified and his department was visited.
Q&A with Ernst in The International Review of Patient Care
*
Biographical note on the authors
of ''The Desktop Guide to Complementary and Alternative Medicine. An evidence based approach.'' Elsevier Science 2006 {{DEFAULTSORT:Ernst, Edzard German rehabilitation physicians Alternative medicine researchers English sceptics German skeptics The Guardian journalists Academics of the University of Exeter Living people Transcendental Meditation researchers Critics of alternative medicine German emigrants to England Naturalised citizens of the United Kingdom 1948 births People from Wiesbaden Physicians from Hesse John Maddox Prize recipients