Monthly Archives: April 2013

Homeopathic Harms Vol 7.1: Professional Ethics

Here’s a teaser for the latest in our Homeopathic Harms series – head on over to A Healthy Dose of Skepticism to read the full post…

As you’ll know by now, I’m a pharmacist. And as such, I have to be registered with the General Pharmaceutical Council (GPhC) to practice in the UK. I’m therefore governed by the GPhC, and in particular their code of conduct, ethics and performance, which has seven main points:

  1. Make patients your first concern
  2. Use your professional judgement in the interests of patients and the public
  3. Show respect for others
  4. Encourage patients and the public to participate in decisions about their care
  5. Develop your professional knowledge and competence
  6. Be honest and trustworthy
  7. Take responsibility for your working practices.

If I-or any of my colleagues- were to act against this code of ethics, we could be held to account by our regulator and reprimanded accordingly. Other healthcare professionals- Doctors, nurses etc- all have similar codes of conduct produced by their regulatory bodies. They all have one thing in common- that the patient is central to everything you do, and if a member steps outside this code of conduct, there is a clear and organized route through which complaints or concerns can be raised. This is as it should be: healthcare professionals have the lives of patients in their hands, and need to be held to account if anything goes wrong. As I’ve written before in this series, homeopaths don’t have to register with a regulatory body and anyone can set themselves up as a homeopath with no training whatsoever. Whilst some ‘professional’ bodies exist in the UK, they have no regulatory powers so are unable to reprimand anyone if they receive a complaint.

Why vaccines *won’t* overwhelm your immune system

A very quick post today, but a topical one given the situation in Wales (and the UK in general) with regards to measles.  The latest press release from the Welsh NHS has said that there are now 765 known cases, and that over 70 of these people have been hospitalised.  That’s one in ten of the people affected who have ended up in hospital.

There has been (entirely reasonable) supposition in the press that the people affected are largely children who were not vaccinated with the MMR due to the completely false suggestion that the vaccine may cause autism or bowel disorders.  It is felt in some circles that the vaccine may somehow overwhelm a child’s immune system, and lead to illness.

Numerous studies have disproven ths link, and the original paper that suggested it has been withdrawn by the publisher.  The paper itself has been called not only wrong, but downright fraudulent.  Sadly this hasn’t been enough to undo the damage done by the original paper, and by the subsequent media storm that erupted around it.  Measles is not a trivial infection, and as the Welsh NHS press release rightly says, “it is just a matter of time before a child is left with serious and permanent complications such as eye disorders, deafness or brain damage, or dies.”

So in light of all that, I stumbled across this quote this morning in an article published at Medscape.  It’s a rather eloquent way of highlighting the scale of immune assault that we all face every single day, and how unlikely it is that any vaccine could pose a risk on these grounds:

In general, however, if you take a step back and look at this question, the notion that the number of immunologic components in vaccines could in some way weaken, overwhelm, or perturb the immune system is fanciful. When we are in the womb, we are in a sterile environment. When we leave the womb and enter the birth canal and the world very quickly, we are colonized with trillions of bacteria, to which we make an immune response. The total number of immunologic components in today’s vaccines is approximately 165. When you think about the number of antigens that you encounter (remembering that a single bacterium has 2000-6000 immunologic components) and that you are making grams of immunoglobulin every day, that the dust you inhale isn’t sterile, and the food and water that you eat and drink aren’t sterile…The notion that vaccines would somehow weaken or overwhelm the immune system is certainly not supported by what we know about immunology and microbiology.

To put it another way, one single bacterium has 12-36 times as many immunologic components as the average vaccine.  The average person has trillions of bacteria on and in their bodies (in fact in terms of cell numbers we’re more bacteria than we are human), so the addition of a few extra antigens in a vaccine is really a vanishingly tiny drop in a huge ocean.

While I’m not trying suggest that vaccines are risk-free (because that can’t be said of any medicine), the risk of being vaccinated is certainly much lower than the risk of complications from catching something like measles.

Postscript: Medscape have a second article about a recent study that found no link between childhood vaccination and autism; it’s worth a look if you have a login.

EDIT: thanks to Nico in the comments for pointing out a factual error.  I originally asserted that by weight a human being is more bacteria than human.  That is of course wrong (we’re 1-3% bacteria by weight).  We do however contain 10 times as many bacterial cells as our own cells.  Which is either quite wonderful or rather creepy, depending on how you look at it.

Homeopathic Harms Vol 6: Self-awareness & self-criticism

One of the most important mechanisms that people have for regulating their own behaviour is feedback from other people.  This happens from the day we’re born – babies learn that some behaviours earn a smile so they repeat them; toddlers learn that other behaviours get attention, so they repeat them.  As adults we do exactly the same thing – we learn behaviours that make us successful friends, partners or parents based on how people react to us.

This carries over into professional life too, and in some professions is even put into words as codes of conduct, or ethics.  We learn what is and is not acceptable by seeing how people respond to our actions.

Well, that’s a lovely little snippet about human behaviour, but what does it have to do with harm caused by homeopathy?  Sadly, lots.  Homeopaths style themselves as health professionals, meaning people trust and respect them.  In other health professions – let’s take conventional doctors as an example – if an individual gives poor advice or commits an act that’s seen as misconduct, there are mechanisms in place to deal with that.  They can be sanctioned or struck off, re-educated, suspended, and any number of other things.  Crucially, their peers support this process; if a doctor suspects misconduct by another they can act on it, formally or informally.  The same is true in other health professions – nurses, pharmacists, you name it.

So surely homeopaths do the same?  Well…no.

The Society of Homeopaths exists, and has a code of conduct and ethics.  However there’s no requirement whatsoever for a homeopath to be a member of the society, and I couldn’t find anything on their website about disciplinary processes or how to complain about a member. When asked to publicly condemn behaviour that is clearly unacceptable in individuals trusted to give health advice, the society has consistently failed to do so.

But the society doesn’t represent every homeopath, and in any case these are independent people – surely individuals have spoken out about poor behaviour among their peers?  I’d like to say yes, but again, the answer’s no.

When Anthony Pinkus was found by BBC reporters to be promoting homeopathic vaccines (after previously being investigated by the General Pharmaceutical Council for similar behaviour), his fellow pharmacists were outraged at what they saw as acts that put patients at risk and brought their profession into disrepute.  His fellow homeopaths?  Not a peep.

When various homeopaths were found to be promoting homeopathy for the treatment of rape, domestic violence and homosexuality, the general public were rightly angered at the outrageously offensive claims.  Their fellow homeopaths gave barely a whimper.

When Penelope Dingle died after suffering months of excruciating pain because her homeopath told her it was all in her head, the coroner’s report was damning.  The homeopathic community was oddly silent.

When homeopaths peddle their remedies to incredibly vulnerable people in Africa for the treatment and prevention of HIV and AIDS, their peers say nothing about it.  However Peter Chappell, a founder member of the Society of Homeopaths is all in favour, and in fact produces his own range of remedies, as well as others for  malaria, dengue fever, and goodness knows what else.

When Nelsons in London were found to have such poor manufacturing standards that there was broken glass present on their production line, and one in six vials of remedy actually had no homeopathic ingredient added, the Food and Drug Administration (the American drug regulator) pulled no punches in their report.  The UK homeopathic community, of which Nelsons is a part, said nothing.

There are doubtless many, many more examples just like these, but I think I’ve hammered the point home well enough.  And I am sure that some homeopaths who read this will be rather offended, because maybe they did oppose these things; but that’s not enough.  If homeopaths want to be seen as trustworthy providers of complementary therapies they need to change this pattern, they need to be vocal.  Where poor behaviour is evident, they need to shout first and loudest about it, like the pharmacists did with Anthony Pinkus. They need to scream from the rooftops that unethical advice, endangerment of people’s safety is against everything that they stand for, and that an individual who does those things doesn’t represent their community.  Even leaving aside the problems regarding lack of efficacy, how else can anyone ever trust that they can visit a homeopath and receive honest, ethical advice?

Homeopathic Harms vol 5: interactions

I might be a little quiet for the next wee while due to some unforeseen circumstances,  but to tide you over here’s the next installment in the Homeopathic Harms series by @SparkleWildfire – interactions.

In the next installment of our series on the harms of homeopathy, I want to talk about interactions. I’ve covered this a bit in the past, but let’s have a look at this area in a bit more detail.

We all hopefully know by now that homeopathic medicines pretty much have no trace of active ingredient in them by now. Do we need to worry about drug interactions with homeopathic remedies?

Can homeopathic medicines interact with conventional medicines?
The obvious answer is no. Magic Sugar Water Pills are highly unlikely to affect any conventional medicines. There’s a lack of actual evidence to prove this, but I think it’s pretty safe to rely on a theoretical basis here. So that’s great, right, blog post over and see you later. If only it were that simple.

Read the rest over at A Healthy Dose of Skepticism.