Homeopaths still pushing uphill

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I’ve received a comment on this earlier post, andI think it is worth sharing, front and centre.

It comes from a clearly disgruntled supporter of homeopathy (called Elaine), with the aim of urging some protest to the ‘unfair’ treatment meted out. Rather than have it languish in the comments to an old post, here it is with my comments (well, most of it – I’m certainly not going to put in the bits that encourage people to write in to the authorities).

Lets hear from the AHA about balanced journalism and interview some patients that have received benefits- be it placebo or otherwise. I’m all for skeptical criticism, but against witch hunts. The use of homeopathic caffeine in the TT story was certainly not a reasonable example of how homeopathic ND’s would use or prescribe that product.

The Australian Health Ethics Committee which is part of the National Health & Medical Research Council (NHMRC) has recently released a draft public statement on homeopathy stating that “it is unethical for health practitioners to treat patients using homeopathy, for the reason that homeopathy (as a medicine or procedure) has been shown not to be efficacious.” This statement was supported by only three references, one of which was the findings of the flawed UK Science & Technology report (1). The other two references being the American Medical Association 2006, report of the Council of ethical & Judicial Affairs (2) & the World Health Organisation 2009 report, safety issues in the preparation of homeopathic medicines (3). It is clearly evident that the NHMRC’s position statement is based on extremely scanty evidence & moreover it seems it has not done its own investigation, very disappointing considering this is Australia’s primary medical research body. Refer Consultation Draft attachment.

It’s so ironic that Elaine complains about the lack of evidence in the determination of the AHE, when the elephant in the room is the total and utter lack of evidence in support of any efficacy for homeopathy. Not only has homeopathy “been shown not to be efficacious“, but, it has also not been shown to be efficacious. Have you done your research? Try this Pubmed link for starters. Results are indistinguishable from placebo, and this is reinforced by systematic reviews of all the clinical evidence.

Chiding the NHMRC for not doing its homework is a bit rich. Systematic reviews of all the clinical evidence show that results are indistinguishable from placebo. Yes, the NHMRC is Australia’s primary research council, but, what is it you want them to research? Are you asking them to use science, to evaluate something that, in homeopathy’s own words, ‘can’t be assessed using standard science’?

The NHMRC did not consult with any homeopathic organisations before the release of its draft public statement. The Australian Homeopathic Association (AHA) (which represents most non-medical professional homeopaths), the Australian Medical Fellowship of Homeopathy (which represents medical doctors) & many independent homeopaths have recently lodged formal complaints with the NHMRC & presented an extensive evidence base to support ethical homeopathic practice.

You keep going on about an ‘extensive evidence base’. So publish it. Go on, I dare you. And I don’t want to hear about how satisfied your patients are. You raised the issue of efficacy as a therapy, and so it onus is on you to demonstrate it. Show me how it’s cured malaria, or HIV or cancer, or anything really, other than dehydration.

While the immediate aim of the NHMRC is to stop homeopathic health fund rebates no doubt its long-term goal is to create negative publicity & misinformation in the public arena which will in turn have a knock-on effect to undermine credibility & public confidence in homeopathy. This draft public statement was discovered accidently in mid May by a homeopathic colleague!! How ironic it is that a health ethics committee could have such unethical communication. The cut off date for submissions to the NHMRC has passed (July 1st 2011)

Now you’ve got the idea. Undermining credibility and public confidence in a scam is exactly the right thing to do. Please don’t bleat about ethics when you know that you’re motivated by self-interest, while the NHMRC is working on behalf of the community. The UK has recently woken up to homeopathy, and has ceased to fund treatments from the public purse. The 2009 British Commons committee found that: “the ultra-dilution notion “scientifically implausible” and that systematic reviews and analyses “conclusively demonstrate that homeopathic products perform no better than placebos.

Please make an official complaint & encourage anyone interested in pursuing justice, fairness and balanced medicine including homeopathy to do so also by emailing or writing to…

Justice would be to save the community billions of dollars which line the pockets of unscrupulous or deluded homeopaths. And ‘balanced medicine’??? What the hell is that? Medicine is either effective or not – balance is an irrelevant concept.

Medicine provides fairness in the following way: The opportunity exists for homeopathy to demonstrate its efficacy by conducting properly constructed (high quality) trials, followed by appropriate analysis, publication and then replication in subsequent studies. This approach removes the biases of the researchers, to provide a FAIR assessment of the therapy. Anything else is unacceptable.

Homeopathy has had 200 years or so to demonstrate efficacy, and it has yet to do so. I’m betting that it won’t be doing so anytime soon.

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11 thoughts on “Homeopaths still pushing uphill

    Blamer .. said:
    July 11, 2011 at 11:49 am

    I’m curious about attitudes towards the ethics of placebo treatments, in general.

    Ought it be permissible for a pharmacy to sell a substance X that works equally well to the most effective placebo treatment?

    Do advocates of science-based medicine have stronger objections to this than proponents of homeopathy?

      rationalbrain said:
      July 11, 2011 at 12:17 pm

      I think we need to sort out ethical issues from permissibility, if that is a word.

      Re your last question, I think SBM do have stronger objections, on the basis that placebo ‘treatments’ are over-rated, and in any case, you are in effect telling lies to patients. The real trouble with legitimising placebo treatment, is that it provides any relief only for general, non-specific ailments. Anything more substantial or serious will not be helped by placebo, at least not for long. The question is, is it ethical to in effect de-sensitise people to the use of placebo? Plenty has been written by practitioners of SBM, this for example, with a very apposite quote being:

      He has come to the dubious conclusion that CAM is worthwhile, even if just for the placebo effect. And therefore what? Does he think we should prescribe homeopathic potions to patients, even though they are just water? Does he think we should stick needles into non-existent acupuncture points, even though the evidence shows poking the skin with toothpicks is just as effective? Should insurance pay to have nurses wave their hands over patients prior to going into surgery in order to fluff up their “human energy field?”

      With respect to what is ‘permissible’, as opposed to ethical, clearly it’s not really possible to prevent the sale of water; however it should not be permissible to claim that the water makes you immortal (at least without evidence that proves it!).

    Blamer .. said:
    July 11, 2011 at 8:05 pm

    I share your concern about de-sensitising the public if folks are free to sell substance X (works fine, but no better than a placebo). It lowers the minimum acceptable standard that contemporary SBM is holding itself to in order to safeguard the public. And that happens regardless of whether substance X avoids specific health claims on its packaging (CAM) or not.

    Yes, telling lies to patients is exactly what concerns me. Even if we’re watering that down to merely leaving out part of the truth. Say, due to overlooking what SBM has discovered.

    I’ve used the term ‘permissible’ deliberately because it could be that selling substance X is neither ethically right nor wrong.

    Now imagine we were giving it away for free. How strongly do proponents of SBM and CAM feel now? (Hint: Are we willing to overlook the nocebo effect?)

      rationalbrain said:
      July 11, 2011 at 9:10 pm

      Giving it away makes no difference from an ethical standpoint. It’s not the monetary value that gives it legitimacy – it’s the white coat that hands it over, and which is the surrogate or representative of ‘science’. Instant legitimacy. That’s why I believe it’s wrong for pharmacies to be selling crap in their shops. It’s the argument from authority that deceives so many in society. It’s a bit depressing really, just like tonight’s Australian Story.

    Elaine said:
    July 12, 2011 at 11:23 am

    see mercola.com for a list of positive scientific references.
    I do not condone witch hunts.

    Elaine said:
    July 12, 2011 at 11:09 pm

    Firstly please consider this:
    http://news.techworld.com/personal-tech/3256631/dna-molecules-can-teleport-nobel-prize-winner-claims/

    I am not sure how Mercola’s list of references for homeopathy, nor the successful cases and interviews he has posted on his web site can be dismissed in one paragraph on the basis of your interpretation of his vaccine data (which is not entirely relevant to this discussion but I will post a link below to this as you incorrectly noted that he was discredited for this reason and inferred that he was against all vaccinations*)? Did you bother to read and review them? Please try to be fair and use your “rational brain” which must have a degree in quantum physics and a nobel prize supporting it to place your reasoning above others. Clearly you are claiming to be more intelligent than Luc Montagnier, listed above who supports homeopathy based on Quantum science.
    Contrary to your pre-judgement I am not a homeopath. I do freely discuss this though, as I have many clients who are homoeopaths. I simply do not support this shallow reporting or biased, faulty journalism. The arithmetic of dilutions was incorrect. There was no serious explanation of methodology, or mention of succussion or molecular imprinting as the basis for potentisation– we are talking about quantum physics, not chemistry. The “in house” jocularity was based on an incorrect assumption that homoeopathy is chemistry. There was very little time spent interviewing successful treatments of chronic disease (be it that ” 30% placebo cure”– which, btw is little understood and at times is as effective as any modern medicine!) If the production team was polite enough to obtain an interview with Brauer homoeopaths perhaps you might have not made these mistakes in production of the final sent to air edited version. The incorrect procedure for homeopathic caffeine indulgence was not representative of homeopathy. In short that show, and this forum, fails on many levels.
    The vortex of ignorance towards holistic medicine is great. Many people confuse even the basic terminology of holistic medicine with homoeopathy, this lack of understanding is not corrected with poor journalism.
    Fortunately the tide is turning and people are reclaiming their lives and questioning medical intervention when it is detrimental or not required, for example refusing to use antibiotics for viral infections and seeking zinc supplements, and non harmful homeopathy.

    Cochrane data clearly does not support a lot of “accepted” science, eg. many surgical procedures for instance. It is also surprising how little data other than level 4 EBM (evidence based medicine) is available for most of what we believe to be well thought out medical procedures. Level 4 EBM is little more than someone’s opinion! Many of the studies in biologically variable living beings do not fit in the Cochrane pool.

    Level 1: Consistent Randomised Controlled Clinical Trial, cohort study, all or none, clinical decision rule validated in different populations.

    Level 2: Consistent Retrospective Cohort, Exploratory Cohort, Ecological Study, Outcomes Research, case-control study; or extrapolations from level A studies.

    Level 3: Case-series study or extrapolations from level B studies.

    Level 4: Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles.

    By setting Homeopathy up as the “straw man” argument, journalists are missing the boat. I am interested in the results of all levels of EBM of any treatment; alternative or traditional, as evidence of proof that a treatment is effective for specific pathology. In the absence of level 1-3 EBM, which of course is often the case in traditional medicine, a rational explanation based on sound biochemical, physiological, quantum physics or anatomic principles will be helpful. In this case there are many instances where quantum physics provides an explanation (see Luc Montagnier above) for that otherwise beneficial “placebo” positive effect. Let us not rule out what we just don’t quite understand yet.

    Evidence Based Practice
    According to The Cochrane Collaboration web site, EBP as we know it today has its roots in the work of the British epidemiologist Archie Cochrane (1909-1988). The international EBP research center, the Cochrane Collaboration was named in his honor in 1993. The web site states that:

    Cochrane argued that as resources for health care are limited, they should be used effectively to provide care that has been shown, in valid evaluations, to result in desirable outcomes. He emphasized the importance of randomized controlled trials in providing reliable information on the effectiveness of medical interventions.
    RCT (Randomised Controlled studies) are often flawed for biological beings. Kaptchuk (2001, p108), an experienced Traditional Chinese Medicine practitioner and scholar who now works at Harvard Medical School observes “Ultimately, medicine, at its best, can never enumerate or know everything about a person. At best medicine is an art that resonates with an elusive truth.”
    Cochrane data, therefore is a tool for MBA’s and the health care industry.

    Please read this and then reply
    http://www.naturalnews.com/031073_science_tyranny.html

    It is hoped that your source and intent of producing such journalism is not to be a “science blogger-internet whore”. If you do have financial incentives for producing such poor journalism, please disclose them now.

    and lastly- dogs do not recognise the placebo effect, for yet another positive review of published RCT study on homeopathy see:
    http://veterinaryrecord.bmj.com/content/164/12/364.abstract
    ____________________________________________________
    Kaptchuk, T., (2001). OMD subjectivity and the placebo effect in medicine. Alternative Therapies, 7(5), 100-108

    * http://vaccines.mercola.com/

    http://emf.mercola.com/sites/emf/archive/2011/01/05/new-evidence-identifies-strong-cell-phone-cancer-link.aspx

    Elaine said:
    July 13, 2011 at 8:14 am

    Cochrane Database Syst Rev. 2009 Apr 15;(2):CD004845.
    Homeopathic medicines for adverse effects of cancer treatments.
    Kassab S, Cummings M, Berkovitz S, van Haselen R, Fisher P.
    Source

    Royal London Homoeopathic Hospital, 60 Great Ormond Street, London, UK, WC1N 3HR. sosie.kassab@uclh.nhs.uk

    This article referenced on pubmed- one click away on the pubmed link you provided lead to a positive review of homoeopathy.

    The Heel products from Baden Baden Germany have ample scientific support and are even prescribed by many doctors of traditional medicine, their advantage of NSAID’s (non steroidal antiinflammatory drugs such as aspirin) are that they are equally efficacious with no bad side effects (stomach ulcers, renal complications are common with NSAID’s useage).

      rationalbrain said:
      July 13, 2011 at 8:27 am

      Elaine
      I’ve looked at this article.
      The author’s conclusion is as follows:

      This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required

      My question is, by what measure is this a positive review????? The best you can say is that the homeopathic stuff didn’t cause adverse effects, but then, that’s what one would expect from drinking water.
      As I’ve said in other articles about bogus therapies (see Elmore), studies always seem to be ‘preliminary’ and ‘needing further research’. After 200 years, can we please have some definitive data using properly constituted trials.
      Elaine, it is no surprise that homeopathic hospitals are to be defunded in the UK. Why is it that the British government could find none of the evidence of which you speak?
      More on this in my response to your other comment.

    Response on homeopathy articles « rationalbrain said:
    July 13, 2011 at 10:56 am

    […] by rationalbrain on July 13, 2011 It seems at least one person is taking me to task over recent articles on homeopathy, and I welcome […]

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