Dr Alex McMahon argues homeopathy is flying in the face of science, spending precious resources, undermining the principles of the NHS, and doing more harm than good to those most in need.
Samuel Hahnemann, who invented homeopathy, probably meant well when he devised his idea for the ailments of humanity at the end of the 18th century. Most people have heard of the ‘like cures like’ idea, and may be sympathetic. Most people probably know that homeopaths dilute their treatments to such a degree that there is not a single molecule of the original material left: and then turned into pills. This is not ‘like cures like’. Hahnemann himself, if he was here to defend himself, may well argue that he was trying to be scientific and improve on dreadful treatments like bloodletting and purging that were common in his day. At the turn of the 19th century it may well have been a dangerous gamble to visit a physician: cure or kill.
Unfortunately Hahnemann extrapolated his theory from a single experiment. He fell prey to the logical fallacy known as ‘induction’. This problem was mainly mooted by David Hume around 1748. Although the lives of Hahnemann and Hume overlapped by around 20 years, this particular medical problem was only really solved in the 20th century by the devising of the Randomised Controlled Trial (see the James Lind library1 for the history of fair testing of treatments).
Homeopaths often justify dilution with the notion that it equates to greater potency of their treatment. In this case it would be dangerous to go for a swim in the sea. Sceptics often stage mass suicide attempts by overdosing on homeopathic medicines to mock this idea. On the plus side, homeopathic treatments will be entirely free from side-effects. Having said that, you would have to be wary of homeopathic plutonium, although diluted arsenic seems safe. 2
Homeopaths could easily test their treatments in Randomised Controlled Trials, which are occasional positive but mostly unconvincing due to a lack of vigour. 3 Unfortunately, although there are fortunes to be made in the High Street from untested homeopathic medicines, there is no motive to subject these treatments to formal testing as there is very little regulation. This is in sharp contrast to the punitive levels of regulation for pharmacologically active medicines. 4
But is any harm done by this inoffensive quackery? The NHS provides expensive homeopathic hospitals and prescriptions. This money could be better spent. We are also undermining medical research and science in people’s minds. Many people argue that it is only a placebo. Placebos are deception. It is not widely known that the so-called ‘placebo effect’ is hotly disputed 5 and is in fact a natural consequence of the phenomenon known as ‘regression to the mean’ where patients’ symptoms get better simply due to the passing of time. 6 By displacing real medicine and health care, the NHS has to pay twice due to any subsequent harm caused by the delay in treatment. There are dangerous parallels to the anti-vaccination movement in both the developed and developing worlds. Misplaced middle-class concerns with the scientific method ultimately undermine the concept of universalism and institutions that help the poor and those with the greatest need.
1 http://www.jameslindlibrary.org/
2 David Shaw. Homeopathy and medical ethics. Focus on Alternative and Complementary Therapies 2011; 16; 1: 17-21.
3 Shang A, Huwiler-Müntener K, Nartey L, Jüni P, Dörig S, Sterne JA, Pewsner D, Egger M. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.Lancet2005; 366:726-32.
4 McMahon AD, Conway DI, MacDonald TM, McInnes GT.The Unintended Consequences of Clinical Trials Regulations.PLoS Medicine 2009; 6; 11: e1000131.
5 Hróbjartsson A, Gøtzsche PC. Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment.Journal of Internal Medicine 2004; 256; 2:91-100.
6 Bland JM, Altman DG. Some examples of regression towards the mean. British Medical Journal 1994; 309: 780.
Dr Alex D McMahon is Reader in Epidemiology, University of Glasgow
From Healthier Scotland: the Journal
SHA and homeopathy