Over on Code for Life, Grant’s recently put up some posts concerning homeopathy (here & here, for example). He’s also suggested that homeopathic (& other) remedies should carry disclaimers to do with their active ingredients (or lack thereof) and what they can & can’t do.
Anyway, one of the common responses to articles critical of homeopathy & other ‘complementary & alternative medicines’** is that, even if they ‘work’ only via the placebo effect, at least they do no harm. I would argue that if the placebo effect masks an ongoing problem, then it is doing harm. And the same is true if patients are led to stop taking necessary medication. But – & I think more seriously – here’s an example where following a homeopathic prescription may do considerable damage: homeopathic vaccinations.
The article I’ve linked to (posted by Peter Bowditch of ratbags.com, for purposes of serious critiquing) makes the following claim:
Well, they’re pretty safe in making this claim for smallpox as that’s been eradicated in the wild, but the rest are still with us in various parts of the world. These are pretty extraordinary claims for products that, by their very nature, usually contain no molecules whatsoever of their supposed active ingredients. Most of the diseases on that list can be fatal if left untreated, & can leave survivors with ongoing physical problems. So you’d expect to see some decent evidence that homeopathic ‘vaccines’ actually perform as claimed – good, solid evidence-based data on patient outcomes. Not vague statements that lack names, dates & other data, which is all the article provides. Yet hard evidence appears to be lacking.
Take influenza, for example. Here’s an evidence review from our Ministry of Health – a meta-analysis of a number of studies examining claims for a homeopathic ‘remedy’ called oscillococcinum (made from the liver of a dead duck, by the way, although it’s so highly diluted that you would be hard-pressed to find any evidence at all of duck in your liquid or pills). Oscillococcinum is prescribed by many homeopaths as both a prophylactic & treatment for flu. The Ministry’s evidence summary examined data from a systematic review & a total of 7 clinical trials (representing 3459 patients). Three of the trials (2265 patients) found that the oscillococcinum preparation did not prevent the flu. The other 4 trials looked at its efficacy in treating flu – oscillococcinum shortened the length of the illness by about 6 hours. In other words, this particular homeopathic remedy didn’t do what was claimed for it; it acted as neither vaccine nor treatment. (There did appear to be some reduction in severity of flu symptoms, but as such data tend to be self-reported it’s hard to be sure how much represented actual effect of the preparation & how much reflected patient expectations that they’d get better.)
But that’s just the flu – what about the other claims made in that article? Since they’re extremely vague, & cite no evidence whatsoever in their support, it’s rather difficult to judge. But a scirus search for published data on the claimed efficacy of homeopathic treatment during a a supposed polio ‘epidemic’ in Buenos Aires turned up nothing. And frankly, if the stuff was that good I’d expect to see hard evidence of that fact. Given the potential severity of polio, I’m sure doctors around the globe would love to have an addition to the treatments available to them. But then, it seems that most individuals affected by polio don’t progress to the severe paralytic form of the disease – so many of those Buenos Aires patients claimed as success stories for the homeopathic ‘vaccine’ may in fact have had the less severe infection, easily confused with the flu. With no actual data in the article, how can we tell?
So it’s hard to see how the claims made in the article for homeopathy’s ability to prevent serious, potentially lethal, infectious diseases can be supported. What’s more, I wonder how those claims can sit with any code of conduct for homeopaths. After all, the Society of Homeopaths in the UK has a code of ehtics which clearly states that no advertising may be used which expressly or implicitly claims to cure named diseases. And another homeopathy site expressly states that TCAM practitioners are prohibited from… treating infectious, communicable diseases (which is pretty much everything on that list I cited). Where does the responsibility lie, if someone follows this advice, takes (for example) a malaria ‘vaccine‘, contracts the falciparum form of the disease, and dies?
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PS CAM isn’t really the right term. If a treatment works, can be shown to work in a reliable manner, produces positive outcomes that can be confirmed by other workers in the field – then it’s medicine. If it doesn’t – whatever it is, medicine it’s not.
And Ben Goldacre has an excellent article on the subject here.
Renee says:
I’ve been reading the full ‘Fact’ sheet you linked to – scary stuff. I’m currently reading through the ‘evidence’ from the Swinburne University trial from 2004, compiled by one homeopathic practitioner for his PhD. I got to the ‘Safety of Homeoprophylaxis’ section and was about to skip it as I know these ‘remedies’ are safe, being little more than sugar and water. But it actually made for quite interesting reading!
The whole thing read like some sort of mystic religious (what’s a polite word for it…) twaddle… e.g.
“…some homeopaths have expressed concerns over the years as to whether the long-term use of the remedies in my HP program is energetically safe. Many people who are not bound to the pharmaceutical paradigm understand that energy can produce real and tangible effects, and if misused can cause problems.”
The more I read about this ‘science’ the more incredulous I am that it is taken seriously by anyone.
Apologies for the overuse of inverted commas in this post. 🙂
Alison Campbell says:
I have to use ‘…’ when writing about this stuff – I don’t want people to think that I think that they’re real remedies etc! As for teaching it at University & dignifying the outcome with a BSc – as a number of universities in the UK do – that seriously concerns me.
Grant says:
Hi Renee,
You seem to be a regular commenter here! 🙂
There is an element of “mysticism” to homeopathy in that like other “remedies” derived from that time there is a concept of “vital forces” in them, which has long since been soundly disproven.
Matty Smith says:
It’s strange how powerless it feels outside the sciences sometimes. I figure I’ll join a skeptic’s group. Facebook has an impact, it reaches a lot of people. During the overdose I joined a languishing two-member anti-homeopathy group on facebook (http://www.facebook.com/#!/group.php?gid=435628195340&ref=ts) and it seems to be growing. Up to 70 members. But just search for homeopathy on there. The pro groups haves thousands and hundreds of members.
Depressing.
Grant says:
Matty,
All going well I hope to add a little more anti-homeopathy “noise” over the weekend. It the forecasted rains comes, it’ll be more likely! 🙂
Renee says:
I saw a thing about it on Close Up last night, and the skeptics came off better than the homeopaths, IMHO.
Grant – I’m a science novice but long-time sceptic, so Alison is ‘learnin’ me in the facts behind my scepticism! (She’s also my own personal Biology-Google :))
Alison Campbell says:
Oooh, you are too kind 🙂
alison says:
Further to the ‘but it does no harm’ idea: an item concerning a coronial hearing on the death from rectal cancer of Australian woman Penelope Dingle:
http://www.ratbags.com/rsoles/history/2012/04april.htm#7scrayen
Grant says:
Matty & Renee: Ha. My ideas of writing about homeopathy must have been overtaken by events “in the real world”. I can’t even remember what it was I meant to write about! (It might have been an idea I had to write an article “naming and shaming” establishment figures and organisations that had unthinkingly promoted homeopathy.)
Alison: There is a related side-story – the homeopath in question is (apparently) suing a blogger who wrote speaking out against what happened. I popped some links to this story in the comments of this post (sorry for the lazy link – I’m too busy to cut’n’paste all the links to bring them over here):
http://sciblogs.co.nz/code-for-life/2012/04/01/sunday-shorts-1st-april-2012-awards-bullet-proof-hard-drives-and-more/
Alison Campbell says:
Grant – yes, I’ve been reading about the very sad & extremely unpleasant (to put it mildly!) end to Penelope Dingle’s life, courtesy of people like Peter Bowditch. In the immortal words of the Tui billboards: “but it does not harm” – yeah right!
Grant says:
Just for other reader’s clarity it’s Alison’s *reading* of the case that is “courtesy of people like Peter Bowditch”, not “ the very sad & extremely unpleasant (to put it mildly!) end to Penelope Dingle’s life”. (The homeopath who treated her was Francine Scrayen.)
Also: ignore my link – use Alison’s!
I had meant to ask Alison to edit out my bit addressed to her – after I posted my comment I realised P.B. had already linked to it all. Should have expected that, really.