On April 26, David and Collet Stephan, the Alberta couple who treated their sick toddler with horseradish and onion smoothies for two weeks, were found guilty of failing to provide the necessaries of life to their 18-month-old son, a sentence that carries up to five years in jail. Ezekiel died of meningitis in 2012.
It's a tragic story, even more so because nobody doubts that David and Collet Stephan loved their son. Instead, they seem to have misguidedly believed that alternative therapies, including an echinacea tincture they bought at a naturopath's office, would help him get better. The boy eventually stopped breathing, and they phoned 911. He later died in hospital. (The parents testified that they thought Ezekiel had the flu, although a family friend and nurse had suggested he may have meningitis.)
Doctors, government, and the alternative medicine industry all have a duty to do better here. Horseradish and echinacea are no substitute for conventional, science-based medicine. Patients across Canada need better access to family doctors, and they need to know—without a doubt—when it's time to seek one out, and forego the naturopath.
"I hope this sends a strong message about the nature of [alternative] services," Tim Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta, who has been following the case, told Motherboard on Monday, shortly after the verdict. "And I hope it causes policymakers throughout Canada to rethink how they're positioning these therapies in our healthcare system."
Alternative therapies, including naturopaths' services, are popular. It's easy to see why: in Canada, which suffers from a longstanding doctor shortage, it can be difficult—if not impossible—to get a family doctor. Even when you do have one, that doctor is often rushed. By contrast, naturopaths sit with their patients for half an hour or longer, going over every little detail of their health. One of their most valuable services is "lifestyle counselling," simple diet and exercise advice, that doctors often don't have the time to do.
Naturopaths have been given the right to self-regulate in many parts of Canada, like Alberta, which gives them a veneer of professionalism. But the general public should be clear on this: plenty of their most popular services still have little or no science behind them. In a 2011 survey in Alberta, Caulfield found that homeopathy, detoxification, and hydrotherapy were among the most popular and advertised treatments offered by Alberta's naturopaths. "There is no scientific evidence to support those services at all," he said.
Detoxing, for one, has been debunked over and over again. But people keep paying for it.
The growing creep to pseudoscience, and a distrust of conventional medicine, is something we all need to address—Canada's doctors and policymakers included. A step in the right direction was former Health Minister Rona Ambrose's announcement, in 2015, that "nosodes" (homeopathic treatments) would be labelled clearly to show they are not vaccines. The College of Naturopaths of Ontario is in line with this advice.
But there's clearly still some confusion around alternative therapies. In November, another trial begins in Alberta, into the death of 7-year-old Ryan Lovett, whose mother treated his illness with "holistic" treatments. The Canadian Press found several cases dating back to the 1960s.
Since I first wrote about Ezekiel Stephan, I've heard from many naturopaths who point out that they're licensed professionals, working to protect their patients. I don't doubt that's true. But what needs to be made absolutely clear is that such treatments are not an alternative to conventional, science-based medicine. Naturopaths have an important role in this.
The Alberta naturopath whose office provided Ezekiel's parents with the tincture is now under investigation. As for David and Collet Stephan, observers seem to doubt that they'll be sentenced to a full five years in jail.
"Alternative practitioners shouldn't be your go-to primary care physician," Caulfield said. If an adult want to pay for a detox or some other alternative treatment, that's one thing. "We shouldn't be testing out our ideologies around healthcare on our children."