Does homeopathy have a place in therapy?

Given the current blog series I’m collaborating on regarding the potential harms of homeopathy, I thought it might be useful to stop for a moment and discuss its appropriate place in therapy. Do I believe that informed, consenting adults should be able to choose homeopathy as part of a treatment regime? Yes.

Are most people fully informed, and therefore able to give full consent? No, I don’t believe they are.

If people are making their treatment decisions based simply on assertions like “it’s safe” or “it’s gentle and natural” or (worst of all) “it works for me”, they are not fully informed. (To see why “it works for me” isn’t adequate, take a look at my post on anecdotes). This creates an ethical problem that should be insurmountable for any decent healthcare provider.

The evidence in favour of homeopathy simply does not reach the standard that we demand of conventional medicines. The evidence that it has the potential to cause harms (as we are showing with the Homeopathy Harms blog series) is very real.  Does a patient tend to feel better after seeing a homeopath?  Probably.  In these days of seven minute GP consultations the chance to sit down for an hour with someone who wants to listen, and dig deeper, and really *help* you is probably a really lovely thing.  Should we mistake that for thinking that homeopathy is a beneficial discipline? No.  Should we allow double standards by accepting lower quality evidence for homeopathy (or any complementary medicine) than we do for conventional medicine? No way.

But knowing all of this, knowing that the most “potent” homeopathic remedies have precisely no active ingredient, that there is no evidence of benefit beyond placebo effect, that at best they’ll derive no therapeutic effect and at worse they may experience serious side effects, should an adult be allowed to choose homeopathy for themselves? Sure.  Do many users of homeopathy meet these basic criteria for informed consent? I very much doubt it.

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Posted on March 26, 2013, in Evidence, Homeopathy Harms, Science communication, Skepticism and tagged , , , , , , , , . Bookmark the permalink. 5 Comments.

  1. Which asks the question, do homeopaths deliberately mislead prospective customers? The battle against homeopaths on wikipedia to clearly state that there is often no active material present demonstrates that at least some do so.

    • I like to believe that most of them believe in what they do, and don’t intentionally mislead. Of course the results are just as harmful, but I’d rather believe that at least there’s minimal malice or charlatanism involved.

  2. Another great blogpost, Nancy!

    I think there’s a really interesting question lurking here. We know that homeopathy works (when it works at all) via various kinds of placebo effects (and I’m using “placebo effects” in a pretty wide sense here). We also know that in some limited circumstances, a placebo may be the best intervention available for some patients. However, there are ethical problems with prescribing placebos: as you correctly identify, the question of “informed consent” is at the heart of those problems.

    The question that interests me is this: does homeopathy offer a potentially ethical way of prescribing placebos? I wrote a blogpost about this a little while ago:
    http://dianthus.co.uk/homoeopathy-is-it-all-bad

    The problem of informed consent is certainly a tricky one. But is it, as you claim, insurmountable? I’m not so sure. Maybe it is. But maybe there is a way round it. I’m not sure what that way would be, but I’m not sure I’m ready to conclude it doesn’t exist.

    There is some evidence that placebos can be effective even when patients are told they are placebos:

    http://www.plosone.org/article/info:doi/10.1371/journal.pone.0015591

    But I do have some problems with that study. Specifically, I have my doubts about how truly informed the “informed” consent was. Read the description of what patients were told in detail and you’ll see what I mean. I also covered this paper at the time on the Pod Delusion:

    http://poddelusion.co.uk/blog/2011/01/14/episode-67-14th-january-2010/

    But what I think is fascinating here is that, since I thought of all this 3 years ago, I have never even once come across a homeopath trying to make the case that homeopathy can be used ethically in this way.

  3. Reblogged this on paarsurrey and commented:
    Paarsurrey says:
    One should remember that Christian Friedrich Samuel Hahnemann (10 April 1755[1] – 2 July 1843) founder of Homeopathy was a German physician and was a qualified MD.

    Early life

    Christian Friedrich Samuel Hahnemann was born in Meissen, Saxony, near Dresden. His father, along with many other family members, was a painter and designer of porcelain, for which the town of Meissen is famous. [2]

    As a young man, Hahnemann became proficient in a number of languages, including English, French, Italian, Greek and Latin. He eventually made a living as a translator and teacher of languages, gaining further proficiency in “Arabic, Syriac, Chaldaic and Hebrew”.[3]

    Hahnemann studied medicine for two years at Leipzig. Citing Leipzig’s lack of clinical facilities, he moved to Vienna, where he studied for ten months.[4] After one term of further study, he graduated MD at the University of Erlangen on 10 August 1779, qualifying with honors. His poverty may have forced him to choose Erlangen, as the school’s fees were lower.[5]Hahnemann’s thesis was titled Conspectus adfectuum spasmodicorum aetiologicus et therapeuticus. [A Dissertation on the Causes and Treatment of Cramps][6][7]

    [edit]Medical practice
    In 1781, Hahnemann took a village doctor’s position in the copper-mining area of Mansfeld, Saxony.[8] He soon married Johanna Henriette Kuchler and would eventually have eleven children.[3] After abandoning medical practice, and while working as a translator of scientific and medical textbooks,[9] Hahnemann travelled around Saxony for many years, staying in many different towns and villages for varying lengths of time, never living far from the River Elbe and settling at different times in Dresden, Torgau, Leipzig and Köthen (Anhalt)[10] before finally moving to Paris in June 1835.[11]

    [edit]Creation of homeopathy
    Main article: Homeopathy

    Hahnemann was dissatisfied with the state of medicine in his time, and particularly objected to practices such as bloodletting. He claimed that the medicine he had been taught to practice sometimes did the patient more harm than good:

    My sense of duty would not easily allow me to treat the unknown pathological state of my suffering brethren with these unknown medicines. The thought of becoming in this way a murderer or malefactor towards the life of my fellow human beings was most terrible to me, so terrible and disturbing that I wholly gave up my practice in the first years of my married life and occupied myself solely with chemistry and writing.[3]
    After giving up his practice around 1784,

    http://en.wikipedia.org/wiki/Samuel_Hahnemann

    Surgery and pathological tests should be common to the GP and Homoeopathic practioners; the patients who have chronic diseases but not fatal ones, they can benefit from Homeophty, in my opinion.

    • He may have been a “qualified” MD, but he also lived 200 years ago. Our understanding of science and medicine has changed so radically since then, that to simply accept his assertions is nothing short of irresponsible and lazy.

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