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Hey, I recently encountered this article and it makes me uncomfortable for a number of reasons: https://www.wikihow.com/Administer-a-Coffee-Enema

(For those who don’t know, this is basically inserting hot coffee into the rectum).

There are people that do this, people that believe it works, but it doesn’t make it any less pseudoscientific. This procedure is considered by most medical authorities to be unproven, rash, and potentially dangerous.

This article was uploaded by WRM in 2011. I worry that allowing pseudoscientific articles like this one would be a bad precedent to set. We already have naturopathic expert reviewers which I think are bad enough, but this kind of alternative health is outright dangerous.

More information:

Coffee enemas can cause numerous side effects, including infections , sepsis (including campylobacter sepsis), severe electrolyte imbalance , colitis , proctocolitis , salmonella , brain abscess , and heart failure.

And to think that people are performing these procedures on children, not just themselves. I believe we have a social responsibility to exclude articles like this. To passively ignore them is rubber stamping their behavior.

Most articles in the Alternative Health category are not immediately dangerous, but believing that they work can be. Indeed, some people explore homeopathic treatments and refuse any conventional medical treatment when their children (or themselves) need immediate treatment. That’s utterly irresponsible, and we should either be including warnings that these articles are not medically sound and wikiHow doesn’t endorse their advice or exclude them entirely.


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WHAT? Why? Oh dear god, lets please place a warning as you mentioned, that these are not medical treatments! Ofcourse we have all sorts of topics covered in our proud how to guide. Like topics that may not be legal in some countries etc. However those topics are not lethal in nature nor do they pose a threat to life like How to lie, how to cheat, hack etc.The instructions placed in this article gives a clear message that this activity is legit (despite the warning placed in it already )- the star rating proves it furthermore! Im sorry to sound strange. The practice is abysmal if it is done on children and other people without their consent or without knowing all its side effects.

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The topic is obviously garbage from an efficacy standpoint, as are the colon cleanse genre, earthing content (which may all be deleted now), and others, which is a subject that has been discussed numerous times. The over the top descriptive language, from boiling only non chlorinated water (boiling regular, chlorinated water will remove the chlorine immediately) in ONLY a stainless steel pot (implying using even a pyrex glass pot could cause problems, what, cross contamination or chemical leaching???) to the exact 12 minute duration of the process would be laughable if someone thought such garbage were funny.  I would at least move the content to a less authoritative category under alternate health? and add warnings along the lines mentioned. My preference would be to let people looking for this kind of content find it somewhere else, but the as in the past, it seems that the argument is that if people want garbage, they are better off (somehow) finding it at wikiHow.

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Well, I really don’t know what to say, so as Sarah can be blunt at best of times it’s probably best that I don’t use the words that come to mind instead to say that the whole article is a load of codswallop and pseudo rubbish.  Thank goodness @ Lojjik spotted it.  I am very proud of my association with wikiHow and how everyone here strives to get the articles as accurate as possible and would be embarrassed if someone I knew found it and thought it I condoned it in some way.  I say ‘‘bin it’’ asap!

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NFD|dan.

Wikipedia mentions that several deaths have occurred as a result of this “treatment.” I can’t agree more than wikiHow should not harbor pseudoscientific articles like this, especially if they have potentially fatal side effects. 

The idea of a naturopathic “expert reviewer” makes me very uncomfortable, as most of these treatments are not rooted in science. For example, homeopathy has been proven time and time again to be a useless, completely ineffective quack treatment that is no more effective than placebo. Even most people who know anything about alternative medicine think it is laughable, unless they are trying to sell this snake oil.

In any case, this article needs to go. We should also make an effort to seek out other similarly dangerous articles and, at the very least, give them a once-over.

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I’ve never been a big fan of pseudoscience-based stuff; Dr. Oz makes me cringe. This topic in particular is a bit…errr…weird? But stepping back and looking at the bigger picture - saying we shouldn’t have anything that people do for their own bodies, that has potentially fatal side effects, and isn’t proven by science - is a huge move. That would mean deleting a lot of stuff that falls under alternative health and dieting.

I remember years ago when people wanted to delete @elocina ’s article about caffeine jello shots because lots of college students had been hospitalized and died from using them. We decided as a community to keep the article because we are not responsible for guarding people’s health and safety. We assume that our readers are adults who are capable of making their own decisions, and we try to inform them of the risks. We’ve kept controversial articles on how to smoke cigarettes and how to make yourself throw up, even though millions of people die from both of those activities, because we are not “big brother”. I still get harassed periodically, for several years now, on my talk page by people who accuse me of killing children for not personally deleting the smoking articles. We have always taken a very strong stance that just because we have instructions on how to do something, that does not mean that the entirety of the wikiHow community and project recommends everyone should do it. The information is there, the risks are outlined, the reader makes their own call.

I actually thought about starting an article about helminthic therapy recently. It’s where people ingest parasites to get rid of life-threatening allergies and/or autoimmune conditions. It’s not FDA approved and no one in the US is supposed to try it unless it is under a clinical trial. But try telling that to a mother whose child is suffering terribly from Crohn’s disease . A wiki is where people can share information like this. I’d be disappointed to know that we can’t let people talk about it because there are risks and the results aren’t proven through science yet. I mean, you’re drinking a vial of parasitic worms - that is pretty crazy! But people who have exhausted medically-proven options are often willing to take those kinds of risks.

As someone who cares for a family member with a chronic, incurable illness, and I don’t want to get into more detail out of respect for that person’s privacy - but if I want to seek out information on an alternative treatment for her that has its own risks, I’m a huge believer that that is MY decision to make, and I would rather really not have any website decide what I should and shouldn’t know about it because they feel they have a moral responsibility to protect me from the risks:confused:

I think you’re right @Lojjik in that there are people who use this information irresponsibly. And it’s scary. Like I remember stories of parents whose baby died from malnutrition because they wanted their child to be vegan. But I wouldn’t feel comfortable deleting an article about how to raise a vegan child just because the topic seems risky to me. There are also people who shun medical treatment in favor of faith and prayer, sadly more common than it should be, but that doesn’t mean that everyone who believes in the power of faith will go this route, or that we should delete articles like http://www.wikihow.com/Pray-to-God-for-a-Miracle .

I do think this article could benefit from a bold edit with stronger warnings at the beginning. But I don’t feel comfortable making decisions for people on what they should or should not do with their own bodies and deleting information based on that decision. I’ve started editing the article to address the risks more clearly while still respecting the readers’ right to choose whether to go forward with this. I placed an {{inuse}} template on it since it’s a work in progress but please feel free to help.

I’d also like to get more input from people who I know have been involved in discussions like this in the past, like @maluniu @flickety @ttrimm @jordan , because this seems like it would be a radical shift in how we interpret NFD|dan or might even warrant its own NFD reason.

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I think that’s a valid concern and you’re right that we’re not in a position to be telling people what they should or should not be doing. As far as science is concerned, it’s a black and white issue but it is a gray area when it comes to ethics.

In many cases, people do learn about alternative medicine through the internet. As a site that provides knowledge, it is vital to give people the knowledge they need and not just the knowledge they want to hear, and that would include serious visible warnings and disclaimers about the risks involved in alternative medicine (whether they want to acknowledge those grave risks exist or not). I wouldn’t have made this thread if I thought articles like these would be a one-time thing. I expect them to recur, especially as natural and alternative health movement groups spread (like anti-vaccination culture).

Inclusion of such information does make me worry about how we will be perceived (Google likes authoritative and well-sourced quality content, and it’s possible that making this content highly visible could be harmful to us).

If our policy is that we will maintain articles that pose serious grave risks of death, we need to consider what  {{nfd|dan}} should cover, because the difference is not clear.

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I picked up on something that @Krystle said about the idea of having a new nfd category for articles where alternative remedies may pose a serious risk to health.  I guess putting an accuracy template on such articles would alert the reader to possible dangers using methods that have possibly caused medical issues. 

I know many people believe in alternative remedies and some may work, but unlike clinical drugs that have been rigorously tested over years, alternative remedies have not been subjected to the same clinical trials.  I am all for trying alternative medicines but only if I know that it has been verified by qualified clinicians and not some snake oil salesman as @ Lojjik  said right at the start of this thread.           

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The problem with using {{accuracy}} is that the content can not be fixed, because fixing it would involve scrapping the article and writing one using science-based medicine. The methods as described are accurate for performing the steps, but not accurate as to what they’re meant to remedy.

These things need an attention-grabbing block of text that appears when you view them.

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I see what you are getting at regarding the {{accuracy}} template @Lojjik , I had not considered it in that context. 

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For a long time, I have felt that important content that does not fit neatly into logically ordered steps should be placed at the bottom of the introduction—after a paragraph break and in italics. In this case, I believe emboldened and italicized warnings are appropriate.

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The added warnings are a step in the right direction, but I still believe this is a topic we’re better off without. Here is a well written, well sourced article that outlines a lot of information regarding coffee enemas:  http://www.thepaleomom.com/2015/06/coffee-enemas-what-the-science-says-versus-what-youve-heard.html

The article mentions that there have been a number of studies and case reports published about coffee enemas, but that the studies fall into two categories: those that report severe complications, even when the enemas are done “correctly,” and those that report that the enemas don’t work as described or produce otherwise healthful results.

I think we have a responsibility not to provide moral or ethical filtering for our articles, but rather to provide information that is helpful, relevant, and accurate. If all the studies done on this particular topic point to a conclusion otherwise: that there are serious risks, and no benefits, how is the article helpful? It instructs the reader to do something that has been proven not to work and could harm them. If legitimate information were available that shows these therapies work, we could use them as sources. I can’t find anything other than “wellness blogs” that make wild claims without backing them up, other than giving peoples’ testimonials.

The helminthic therapy example would seem at first to be relevant, but I don’t think that it is. For one thing, the helminthic therapies that are being tested have actually been shown to be effective. Despite sounding “pretty crazy,” they have been shown to have relatively few side effects, and they are not life-threatening side effects, and they are mitigated by certain drugs administered at the same time. Some of the worms (helminths) have been classified by the FDA as medical devices, and although they cannot be purchased legally in the US, they are being actively studied for their benefits for specific conditions. The key difference here is that helminthic therapy is an experimental treatment, whereas coffee enemas are, without a doubt, pseudoscientific or prescientific in nature.

I have always been in support of keeping articles that teeter on moral or ethical ground, and I still feel that way. I don’t think we should delete every article in the alternative medicine and dieting categories, and to extrapolate this to that extreme is disingenuous. I do think that we should be able to look at the claims being made in an article, weigh the sources and veracity of those claims, determine that the specific article is not helpful and is in fact dangerous, and decide that we don’t want to host such content.

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There are various medias. One is the Internet which wikiHow uses. Anyone can make any form of audio or visual and either display or sell it. Movies have censor boards. Movies are big investments which give back millions. May be thats why it has censor board, also because movies have a big impact on people. Actors, musicians, scriptwriters everyone go by rules and keep the society in mind. What they make eventually becomes archives of what the society was, is and could be.

These days, when anyone has a health issue, they search online and then visit the doctor. Earlier there was and in the future will be discussions , about wikiHow’s reliability. People turn to wikiHow and find everything they need. However, they may feel shocked seeing that we have titles such as how to xyz - which may be morally wrong (which they do not want their child, or siblings to ever do) these may be the times when the same readers who read us may question wikiHow’s credibility.

Krystle, Jack et al ultimately are the decision makers, ofcourse after seeking the views of the community at large. If there was an artist making billions by selling paintings, if he is asked to tear down a sellable painting because it has a scene of someone being brutally murdered or raped, should he tear it down? He will not be willing mainly because his paintings are his babies and secondly it gives him money. But, if you are notable or sort after by masses you are obligated to serve the masses responsibly. No one will ask a child’s drawing book to be torn if it has a brutal depiction. No one cares. However, wikiHow has readership across the globe. It has readers and people turn to it so wikiHow has the responsibility to pick and show our content responsibly. What is responsibly then? An article on sex, hacking, stripping, faking something etc is what makes us a wide guide however when we take the liberty to stretch beyond and do just about anything good, evil, deceptive is when we are forgetting our social responsibility thus creating a doubt about our credibility.

Making an article such as this and placing warnings, will not have an effective impact on people to help them know that this is likely to have them killed the next morning. Ofcourse, those who participated in this thread are not those who need to hear a yes. They care for people and wikiHow just like it belongs to us and vice versa.

Ofcourse, deleting a how to guide from the huge resource of wikiHow or deleting many such articles will pain the makers and the nurturers of this site but what has to be done, has to be done because people read it. wikiHow is huge, not a random small journal. The bigger the name, the more the responsibilities. (Responsibility, not restrictions). For with bigger fame comes bigger responsibilities. I dont know if there is a censor board or an effective one which checks through what must and must not take the space on the internet media. If there was one, harmful content as this might have had a fair chance of being legally asked to be deleted because wikiHow is not small.

Beyond this, I had to say, if there was a wiki that made people aware of what not to do or blindly trust, topics like these, would be ones which would be written and presented with pictures not to do and why not to do them.

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I agree with @Isorhythmic and @Vishwavijay . 

I feel that the community has a responsibility to use good judgement by removing content from the wikiHow hosting platform that is dangerous to individuals or to society. That is the intent of the NFD|dan.

Further, I think that it is a mistake to use a one size fits all model to judge any of the articles. Each scientifically unproven or pseudoscience-based article is unique and must be judged individually on its merits and potential for harming those who follow the steps. That is why the community has administrators whose judgement is sound and balanced in control of the article deletion process.

I have added stronger warnings to the article here .

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@Isorhythmic I’m glad we agree not to throw the baby out with the bathwater. I feel a lot more comfortable talking about one article than a whole category. I like how you whittled it down to very specific criteria that does seem to apply exclusively to this article. Thank you for breaking it down. What separates this article from other dangerous activities with no clear benefits (other than just people enjoying it) like base jumping and smoking cigarettes is the plethora of shady ‘detox’ claims surrounding this particular practice. That gave me some ideas for editing the page in a way that gives us the opportunity to educate through debunking. Thanks again for a really thoughtful response.

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I have a very odd idea that may or may not help with this…

We could make a new template, called {{experimental}} or something of the like, which instead of being for editors, would be for readers to know that the subject is less than scientifically supported. For example:

“This article describes an experimental health treatment that is not backed up by significant research. Consult a doctor before making any serious changes to your diet or lifestyle.”

This would make it especially clear that while they are welcome to try this, they should not consider it a substitute for actual medicine, and should exercise good judgment. The template could sit either above or below the introduction.

Maybe that would help keep things clear?

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@MissLunaRose That’s a good idea. If we come across a lot more topics like these a template would be something to consider. We’d probably also want to draw some kind of line for determining whether something is scientifically supported, which might be tricky:slight_smile:

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Oh, I like that idea @MissLunaRose ! And @Krystle perhaps we could have a voting system like we do for nfds, whee certain users are eligible to vote on whether it should get tagged or not?

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^ I doubt that is nesscary, these type of article are rare.

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What does Wikihow inc.'s Mission State concerning this?