Mike's Media Diary
July 18th, 2010

Der große Schüttelfrust (Der Spiegel, Nr. 28, 12.7. 2010, S. 58-67)

Posted in Der Spiegel by mike

Der SPIEGEL-Redakteur Markus Grill (42) und seine Kollegin Veronika Hackenbroch (40) befassen sich in ihrer Titelstory “Homöopathie. Die große Illusion” auf zehn Seiten mit der populären Paradeform einer sanften Medizin.

Leider haben sie im Untertitel das Fragezeichen vergessen.

Das fehlende Fragezeichen

Der gesamte Textumfang beträgt 34955 Zeichen. Da sollte man meinen, dass das Fehlen dieses einen Zeichens doch keinen wirksamen Unterschied macht.

Aber es ist wie bei der Homöopathie. Kleine Ursachen können große Folgen haben.

Eine Krankheit der Profession

Mit Fragezeichen wäre aus dem journalistischen Virusträger ein medizintherapeutischer Heilungstext geworden.

So aber wird das spannende Titelthema von der Krankheit des professionalisierten Skeptizismus befallen.

Skeptiker und andere Menschen

Skeptiker sind Menschen, die meinen, dass der Zweifel ein Selbstzweck sei und nichts, das ihm nicht systematisch unterzogen wurde, Anspruch auf Gültigkeit habe.

Die englische Sprache stellt der skeptischen Grundhaltung eine Weltsicht gegenüber, die als “open minded” bezeichnet wird.

Chronisch-misstrauisch

Dementsprechend unterscheiden wir im Deutschen aufgeschlossene Menschen von skeptisch-verschlossenen bzw. chronisch-misstrauischen Zeitgenossen.

JournalistInnen gehören häufig (aber zum Glück nicht immer) zum letztgenannten Typus.

Der Fall Grill

Nehmen wir den Fall des SPIEGEL-Redakteurs Markus Grill. Er ist 42 Jahre alt und “Vater zweier Söhne” (Der Spiegel, Nr. 28, “Hausmitteilung”, S. 5).

Weiter erfahren wir über ihn, dass er “im Freundeskreis schon oft den Ratschlag bekommen hat: Leiden die Kinder unter irgendeinem Wehwechen, helfen kleine homöopathische Kugeln, die Globuli” (Der Spiegel, Nr. 28, S. 5).

Nicht nur Vater

Aber Grill ist nicht nur Vater. Er zählt auch zu “den besten investigativen Journalisten Deutschlands” (Sonia Mikich).

Seine  Spezialität ist die Enthüllung von Skandalen in der Pharmabranche. Dafür hat er dieses Jahr den Journalistenpreis des Deutschen Netzwerks Evidenzbasierte Medizin erhalten.

Wie die Pillen produziert werden

Deshalb hat er den Globuli-Ratschlag seiner Freunde auch nicht einfach ausprobiert, sondern erst mal eine professionelle Hintergrundrecherche gestartet:

“Grill ließ sich in Karlsruhe in den Gebäuden der Deutschen Homöopathischen Union (DHU) zeigen, wie die Wunderpillen produziert werden” (Der Spiegel, Nr. 28, S. 5).

Grills Schüttelfrust

Dieser Besuch wurde zum Auslöser von Grills “Schüttelfrust”. Womit wir wieder beim fehlenden Fragezeichen sind.

Denn die in Handarbeit durch Schütteln eines Glaskolbens erzeugten Verdünnungsgrade können in der Homöopathie Dimensionen (“D”) erreichen, im Vergleich zu denen das fehlende Fragezeichen im Cover-Untertitel “Homöopathie. Die große Illusion” als grob stofflich erscheinen mag.

Homöopathische Verdünnungsgrade

“So kommt bereits bei D9 etwa ein Tropfen Wirkstoff auf den Inhalt eines Tanklasters. D23 entspricht bereits einem Tropfen Wirkstoff im gesamten Mittelmeer. Und D78 bedeutet, dass wenige Wirkstoffmoleküle auf alle Moleküle des Universums kommen” (Der Spiegel, Nr. 28, S. 64).

“Daneben stellt die DHU auch Potenzen wie D200 und D1000 her.” (Der Spiegel, Nr. 28, S. 64)

Keine Belege

Doch damit nicht genug.

“Je länger sich Grill und seine Kollegin mit der vermeintlichen Wundermedizin beschäftigten, desto größer wurde ihre Skepsis. Sie fanden weltweit keine überzeugenden Belege für die Wirksamkeit homöopathischer Zuckerkügelchen.” (Der Spiegel, Nr. 28, S. 5).

Placebos

Das Fazit der Spiegelredakteure lautet daher, dass es sich bei homöopathischen Medikamenten um “Placebos” handelt.

Diese sollen einer “larvierten Form von Psychotherapie” (Der Spiegel, Nr. 28, S. 66) den Anschein einer medizinischen Behandlung verleihen.

Am Zweifel zweifeln

Skeptiker haben ein Grundproblem. Ihnen fällt es schwer, am Zweifel zu zweifeln.

Skepsis macht in bestimmten Kontexten durchaus Sinn. Aber nicht in allen.

Wer das einsieht, ist fähig, am Zweifel zu zweifeln, d.h. diesen nicht als Lebenshaltung zu verabsolutieren, sondern intelligent, situativ und wohldosiert einzusetzen.

Wer heilt, hat Recht!

Der geheilte Skeptiker wird zum Pragmatisten.

Samuel Hahnemann (1755-1843), der Begründer der Homöopathie, hat den Grundsatz einer pragmatisch orientierten Arztpraxis einmal wie folgt formuliert: “Wer heilt, hat Recht!”

Heilungsorientierter Pragmatismus

Auch bei den LeserInnen des SPIEGEL ist der in diesem Zitat zum Ausdruck kommende heilungsorientierte Pragmatismus weit verbreitet.

So schreibt Peter Kuhn aus Genf in seinem Leserbrief: “Wenn der Patient sagt, es gehe ihm besser, dann kommt auch ein negativer Objektivierungsbeweis dagegen nicht auf” (Der Spiegel, Nr. 29, 19.7.2010, S.9).

Nicht ‘nur’, sondern ‘aha’

Und Dirk Houben aus Wuppertal geht noch einen Schritt weiter, wenn er formuliert:

“Ob nun in der Homöopathie, in der Psychotherapie oder der Schulmedizin, der Placeboeffekt läuft immer wacker mit, er wäre bei kluger Betrachtung aber nicht ein ‘Nur’, sondern vielmehr ein ‘Aha’” (Der Spiegel, Nr. 29, S. 9).

Medizinische Maschinerie

Was Houben meint, hat der in Seattle praktizierende Freiburger Komplementärmediziner Dietrich Klinghardt mit Blick auf die Schulmedizin einmal wie folgt auf den Begriff gebracht:

“Der Hauptgrund, warum die Schulmedizin überhaupt so oft wirkt, liegt im Placeboeffekt, der ausgelöst wird durch die ungeheuer eindrucksvolle medizinische Maschinerie” (Dietrich Klinghardt, Lehrbuch der Psychokinesiologie, S. 33).

Farbige Pillen und weiße Kittel

Insofern kann man sagen, dass die meisten Skeptikerargumente, die sich in dem Spiegel-Artikel von Grill und Hackenbroch finden, Argumente sind, die sich auch auf die Schulmedizin anwenden lassen.

Denn: “‘Rituale’ wie Blutdruckmessen, ‘Symbole’ wie farbige Pillen, weiße Kittel und die ehrliche und liebevolle Bemühung des Arztes tun ihre Wirkung” (Klinghardt, ebd., S. 33).

Verantwortung in Medizin und Naturwissenschaft

Und das ist auch gut so. Denn in der Medizin geht es um Heilung und nicht um die Verabsolutierung des Zweifels.

Das gilt übrigens auch für eine verantwortungsvolle Form von Naturwissenschaft.

Revolution statt Blockade

Sie nimmt die Erfahrungen ernst, die ÄrztInnen und PatientInnen machen und blockiert mit ihren alten Wissensbeständen nicht den Fortschritt der Forschung.

Denn das, was wir heute zwar erfahren, aber noch nicht erklären können, markiert den Raum, in dem sich sich zukünftige wissenschaftliche Revolutionen ereignen.

Mike Sandbothe

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97 comments

  1. xconroy says:

    So sehr ich die Kritik an einer Verabsolutierung der Skepsis unterstütze (weil “Skepsis” in manchen Bereichen einen quasi-religiösen Status einnimmt, man denke nur an die unsägliche Klimadebatte), so fragwürdig finde ich es, hier 1.) einen Kontext zu proklamieren, in dem Skepsis *nicht* Sinn macht und 2.) den Satz “wer heilt hat recht” überzustrapazieren. Zu 1.): ein Kontext, in dem Skepsis unangebracht ist, wäre für mich zb. der einer persönlichen Beziehung. Klar kann ich mir rational einreden, daß alles Mögliche dafür spricht, daß sie nicht lange hält – ich lasse mich aber trotzdem darauf ein, weil meine Emotionen stärker als meine Skepsis sind.
    Aber genau dies sollte in einem Kontext wissenschaftlicher Auseinandersetzung eben *nicht* so sein – da sollte jede Position bis auf die Grundmauern auseinandergenommen werden können und sich äußerst skeptischer Nachbohrungen unterziehen müssen. Das gilt in Fällen von “Frontstellungen” wie der Klima- oder eben Homöopathiedebatte natürlich für beide Seiten, und wenn das nicht stattfindet, entsteht eben die erwähnte Verabsolutierung der Skepsis und eine beidseitige ideologische Verhärtung, die eine nüchterne Wahrheitsfindung sehr erschwert.

    Zu 2.): wer so argumentiert, macht es sich mmn etwas zu einfach hier. Womit ist gesagt, daß eine Zustandsverbesserung kausal auf bestimmte zugeschriebene Eigenschaften des Medikaments zurückzuführen ist und *nicht* auf einen eh stattfindenden natürlichen Heilungsprozess oder eben auf einen Placebo-Effekt (den, wie ganz richtig gesagt wird, auch schulmedizinische Methoden auslösen können und dessen reale Heilfähigkeit wohl größer ist, als man allgemein annimmt)? Bestätigende Leserbriefe unterstützen da eher nicht die Annahme der stattgefundenen chemisch induzierten Heilung, sondern lediglich der *Beobachtung* einer Heilung in zeitlichem Zusammenhang mit Einnahme des Medikaments (dazu käme noch der ebenso bekannte Spruch “die Dosis macht`s”, von dem aus gesehen extreme Verdünnungen und deren Wirkung eben nicht mehr so dolle aussehen. Aber das würde jetzt zu weit führen).

    So sieht angewandte Skepsis aus ;-) (die Kritik am überheblichen Tonfall des SPIEGELS teile ich ja übrigens, aber das bezieht sich auf nahezu alle Artikel, darum lese ich dieses Dingens seit Jahren kaum noch).

    July 18th, 2010 at 19:02

  2. mike says:

    Vielen Dank für das Feedback. Ad 1: Die philosophische Skepsis geht davon aus, dass es letztlich keine Grundmauer gibt, die wir nicht untergraben könnten. Darin unterscheiden sich Skeptiker von Realisten und Antirealisten, die beide meinen, intersubjektiv verbindliche Wahrheitsbedingungen formulieren zu können. Insofern ist ein Mensch im Verständnis der Skepsis selbst darauf angewiesen, irgendwo mit dem Zweifel aufzuhören. Liebe ist ein Beispiel. Sie könnte nicht entstehen und sich entwickeln, wenn wir daran ständig zweifeln wollten. Das gleiche gilt für die Selbstheilung unseres Körpers. Ad 2: Homöopathische Medikamente dienen (wie die Psychotherapie) dazu, die Selbstheilungskräfte des Körpers zu stärken. Es ist die Aufgabe der Medizin, diesen Prozess zu unterstützen. Er ist komplex und naturwissenschaftlich bis heute nicht in allen Details verstanden. Allopathische und homöopathische Medikamente spielen dabei eine unterschiedliche Rolle. Bei den allopathischen Medikamenten und chirurgischen Eingriffen sind die Kausalzusammenhänge mit Blick auf das jeweilige Symptom häufig einigermaßen darstellbar. Die Selbstheilung wird dabei als Hintergrundgeschehen vorausgesetzt und nicht direkt in den Blick genommen bzw. häufig sogar negativ beeinflußt (Bsp. Antibiotika). Das ist bei homöopathischen Interventionen anders. Sie zielen direkt auf die Stärkung der Selbstheilung. Diese aber ist kein einfacher monokausal zu beschreibender Prozess, sondern ein komplexes Geschehen, das wir bisher primär über seinen Erfolg bewerten. Aber auch hier gibt es Fortschritte in der quantenphysikalisch und biophotonentheoretisch orientierten naturwissenschaftlichen Forschung, die nicht auf einfache Kausalzusammenhänge zielt, sondern auf interaktive Rückkopplungsschleifen und nichtlineare Wirkungszusammenhänge.

    July 18th, 2010 at 20:30

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