Why Caroline Lucas should drop her support for Homeopathy


10:05 am - August 1st 2010

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contribution by Adam Grace

Caroline Lucas, the member for Brighton and Hove and leader of the Green Party, has put her name to a Parliamentary Early Day Motion (EDM) which “expresses concern” about the following;

…. motions 301a-301f at this year’s British Medical Association’s (BMA) Annual Representative Meeting, which call for no further commissioning of, nor funding for, homeopathic remedies in the NHS.

Homeopathy is, to many minds, a perfect exercise in charlatanry. Despite the BMA voting last month “overwhelmingly” in favour of kicking the alleged charlatanry out of public health care, Caroline Lucas and her co-signatories are not happy, claiming that proper consultation did not take place.

This wrongly suggests that there is still a public debate to be had on alternative medicine.

Perhaps the debate will continue on in the private sphere for a tedious length of time until the last alleged charlatan dies out, but the public debate has been done, done again and paid for. It was investigated by the Parliamentary Commitee for Science and Technology, which published its findings in February of this year in a report which can be found here.

For the sake of brevity and kindness I’ll cut to the chase. The section entitled “The evidence check: NHS funding and provision” states the following;

11.  In our view, the systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos (Paragraph 70)
13.  We regret that advocates of homeopathy, including in their submissions to our inquiry, choose to rely on, and promulgate, selective approaches to the treatment of the evidence base as this risks confusing or misleading the public, the media and policy-makers. (Paragraph 73)

The reports ‘Conclusions and Recommendations’ section suggest the government “should stop allowing the funding of homeopathy on the NHS”.

So that should put an end to it, shouldn’t it? No, of course not. The findings of this committee have been perpetually ignored by Parliament as a whole, the NHS continues to pay lip service to medicine which could be described at best as pseudoscientific and at worst as robbery and quackery rolled into one.

The state shouldn’t be funding this, just like they shouldn’t fund the teaching of religious dogma alongside empirical science, as though they are both equally plausible concepts.

The reason I have focused on Caroline Lucas and her recently added signature, is that she is the leader of a party which in some respects recognises the insidiously dangerous nature of the enemies of science more than any other.

Climate change deniers largely cling on to conspiracy and half baked, disproved scientific theory in order to further their own agenda or private interests. The amount of damage that these deniers will do to humanity probably won’t ever be quantifiable but it’s safe to say that the Caroline Lucas has some measure of it.

The Green Party’s first ever MP has been incredibly refreshing in very many different respects. She speaks earnestly, advocating passionately for party and constituency interests. She has spoken very impressively about the dumping of toxic waste by Trafigura and has recently tabled her own EDM calling for justice for Ian Tomlinson.

It might also be fair to say that her position on homeopathy may be some way informed by divides within her party, although their position on the place of alternative medicine within the NHS is that “any medicine or treatment available on the NHS should be backed up by scientific evidence.”

Their manifesto is slightly more watered down however (perhaps reflecting party splits) with the removal of that dirty word ‘evidence’. It pledges “[to] make available on the NHS complementary medicines that are cost-effective and have been shown to work.”

If Caroline Lucas and her Green Party continue with a policy of making room in the NHS for pseudoscience, they create a giant contradiction with their largest policy of environmental protection which relies so much on the unimpeachability of scientific rigour.


A longer version is at Ideas on Toast. Adam Grace is also on Twitter.

More coverage
DavBlog: Greens and Science
Chris Meredith: The agony of choice

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Reader comments


“If Caroline Lucas and her Green Party continue with a policy of making room in the NHS for pseudoscience, they create a giant contradiction with their largest policy of environmental protection which relies so much on the unimpeachability of scientific rigour.”

This is exactly the kind of thing that gives the Green party a bad name, and makes it easier for people to dismiss tham and/or not see them as a “serious” political presence, merely a bunch of socks and sandal wearing knit your own yoghurt pot loonies.

Homeopathy has no place as part of public health care, any more than crysals, aura readings and clearing out your chakras…!

I don’t support homeopathy but I support Caroline Lucas’ position which is mis-characterised and simplified here.

I’m also not sure why people object so strongly to the placebo effect wrt alternative medicine as if it isn’t a factor in all treatments.

I know I said I don’t support homeopathy but if I ever tire of rushed 10 minute consultations with doctors who don’t listen to me or treat me as a human being, and who prescribe needless drugs that don’t seem to have any effect then I like the idea of being able to choose a homeopath who will at least give me more time of day and treat me with respect. All the better if they are in the NHS and will alert me to something that could be serious and require conventional treatment.

@2 John

That isn’t really an argument for supporting continued NHS funding for unscientific treatments; at best it’s an argument for giving NHS doctors more resources to spend more time in cobsultations to give people better service.

I don’t buy the “they might alert you to something proper medicine can actually help with” either. If people are so convinced of the benefits of alternative therapies, let them pay for them from their own resources: the NHS shouldn’t be funding a genteel form of going to see a witch doctor.

Placebo effect it may be, but homeopathy is still bollocks. It is a complete con and to support it, as Galen 10 says, discredits the other stances the Greens choose to make regarding science. You cannot have a pick’n’mix attitude to evidence, choosing the bits you like and ignoring inconvenient ones.

Looking at Green Party online forums I can see why Caroline Lucas has done this. There is a strong romantic element in the Greens with all sorts of whacky shibboleths. Its a great pity because it shows how the party has not grown up yet. Perhaps it never will.

The Greens claim to be anti-capitalist. To support the kind of ruthless, dishonest alternative big-business represented by the CAM brigade is another sign of hypocrisy.

Aye, agree with this… there is rumoured to be a placebo affect associated with people of faith and acts of prayer but we’d not want want the NHS funding religious groups now, would we? This kind of new-age mysticism bullshit should be kicked into the long grass, and shame on Caroline Lucas for supporting it (and tainting the Greens by proxy).

There’s an easy solution here that respects the beliefs of homeopaths. Simply lend them all the funding they require – then take it all back and tell them to give their bank accounts a good shake. Their bank accounts should have a perfect memory of the funding, letting them carry on with their “treatments”.

Job done!

The Green Party needs to drop its support for homeopathy which, as Adam’s article suggests, “could be described at best as pseudoscientific and at worst as robbery and quackery rolled into one”.

What I find troubling with the article, however, is how quickly it switches from a perfectly sensible criticism of homeopathy into a dismissal of all “alternative medicine”. To characterise all healing practices that do not currently fall under the umbrella of conventional western medicine as equally ineffective places one on very shaky ground indeed (particularly with respect to herbalism and certain non-western traditional treatments).

I have no vested interest in any alternative therapies, nor am I going to defend any particular one (though, anecdotally, acupuncture completely sorted out my back when I hurt it). All I will say is that dismissing everything we’ve yet to admit into our narrow vision of medicine as being no better than homeopathy (which is complete claptrap) is a dangerously reactionary position.

I agree the Green Party should stop supporting homeopathy. Unfortunately the typical Green supporter has also long been the typical target of the propaganda of the homeopathy industry. They have successfully portrayed themselves to many Green supporters as saintly providers of organic eco-healing being persecuted by the faceless medical industry, which is hellbent on feeding people chemical remedies tested on animals.

“a party which in some respects recognises the insidiously dangerous nature of the enemies of science more than any other.”

Not really – it was only up until last year that their manifesto fully supported homeopathy and was against stem cell research:

http://liberalconspiracy.org/2009/06/09/is-the-green-party-anti-science/

@JimBliss

I’m all for evidence based policy.

If something is tested and shown to work then it becomes conventional medicine and is incorporated into conventional medical practice. I don’t see any problem with any forms of alternative medicine, no matter how outlandish, being scientifically tested and if shown to work, accepted by the NHS as an effective treatment.

The problem is, treatments have been tested, public money has funded a report that concluded that they don’t work beyond being a placebo. Parliament then decided to roundly ignore the reports findings and allow the tax payer to continue to fund NHS homeopathy, despite them already having paid for a report which says it’s a load of rubbish. It’s an odd contradiction.

Who was it who said “Alternative medicine that works is called ‘medicine’.” ?

@Adam Grace (#10) & Mr S Pill (#11)

I agree completely that the public funding of homeopathy is absurd. The problem I had was with the (apparent) dismissal of everything that currently falls under the heading of “alternative medicine”. A vast array of modern, “conventional” treatments began life as folk remedies. Many of the drugs we use successfully today are, though subsequently synthesised) based on active ingredients found in roots, herbs or flowers.

So I think it’s dangerous to use the phrase “alternative medicine” almost interchangeably with “homeopathy”, as it promotes an attitude that is in danger of preventing further treatments from making the journey from “alternative” to “conventional”.

Personally, I’m immensely reassured to learn that the Greens support Homeopathy. It would have upset my assessment of the Greens to discover that they didn’t.

@blanco

I was referring specifically to how much their environmental policies rely on people putting their trust into the rigorous testing that scientific theory is subject to.

Policies that support homeopathy almost serve to suggest that science is ‘just another opinion’. It’s that exact kind of argument which is so damaging to environmental protection campaigns.

15. Roger Mexico

The trouble is that NHS Homeopathy, like it or not, is almost the perfect way to manage and maximise the placebo effect.

Patients are referred to conventionally trained doctors who can and should spot anything serious and get it treated properly (and can be jumped on by the GMC if not). Water is about as harmless as you can get. Side effects, though possible – the power of the mind works both ways – tend to be a lot less; unlike say antidepressants. And as discussed above it’s got to be cheaper than throwing pharmaceuticals down people’s throats.

There is after all a difference between “not working” and “not working better than placebo”

Like it or not doctors have to deal with a lot of situations where there’s not much they can do: self-limiting conditions, the worried well, vague aches and pains investigated to death, conditions best left alone despite patient demands. If they can say “Go and see Dr Woo the Homeopath – he’s had some success with problems like these”, at worst they’re getting a medical second opinion. At best the placebo effect works its magic charm and the patient feels better.

And it also gives those, who want to take part in magical mystery tours, a safer way of doing that than wandering off to the wilder shores of woo. Somehow I doubt the official opinion of the NHS, its bigwigs or for that matter Parliament will influence many patients either way.
The only thing that will stop Boots (and the rest of the Laura Ashley wing of Big Pharma) selling the stuff is if the customers stop buying. You can’t ban it without making Tate and Lyle the biggest drug dealer in the country and they’ll just change the wording to “traditionally used to treat ..” or some such.

It may disturb some people’s sense of medical ethics, but given that the most basic ethical rule is “do no harm”, I can’t see how the current use of homeopathy on the NHS fails that.

Finally I do worry a bit if the attack on homeopathy is becoming a bit of a distraction. It’s not just the butterflies-on-wheels aspect; dealing with Big Pharma with all its power and slipperiness requires endless energy, patience, courage, research, incredulity etc. For some, it may be easier just to burn down the ramshackle summerhouse in the grounds, rather than scale the castle walls.

“Like it or not doctors have to deal with a lot of situations where there’s not much they can do: self-limiting conditions, the worried well, vague aches and pains investigated to death, conditions best left alone despite patient demands.”

As for applying “scientific methods” in the practice of medicine, NHS clinicians would earn more respect if they honed their diagnostic and prescribing skills:

“At least 100 patients are dying or suffering serious harm each year after healthcare workers give them the wrong medication. The number of alerts relating to errors or ‘near-misses’ in the supply or prescription of medicines has more than doubled in two years, the National Patient Safety Agency said.

“More than 86,000 incidents regarding medication were reported in 2007, compared with 64,678 in 2006 and 36,335 in 2005. The figures, for England and Wales, show that in 96 per cent of cases the incidents caused ‘no or low harm’, but at least 100 were known to have resulted in serious harm or death.”
http://www.timesonline.co.uk/tol/life_and_style/health/article6820090.ece

@Roger Mexico

Thanks for that v. thoughtful post.

I wouldn’t say that the natural corollarly of opposing homeopathy is supporting ‘Big Pharma’.

I’d say there is a place for placebo in the NHS. The problem that I have is with the near instituionalisation of treatments that have no scientific basis, and with how they are allowed to stand as an equally legitimate alternative to real medicine.

The NHS website says;…..
“Despite the lack of clinical evidence, homeopathy remains a popular complementary therapy and it is available on the NHS.”

It’s almost as if the lack of clinical evidence is just a side issue and that science isn’t a necessary basis for the practice of medicine. There may be a place for placebos in the NHS, but the umbrella of homeopathy allows for state funding of all manner of unregulated, unsubstantiated nonsense. There is also a notable lack of regulation for homeopaths in contrast to conventional practitioners. The NHS site also says.

“Unlike doctors, nurses, and other conventional healthcare professionals, homeopaths do not have to be registered with a regulatory body. The ‘Complementary and Natural Healthcare Council’ is a voluntary organisation which practitioners can register with, but they do not have to.”

The fact that homoepathy has literally nothing in it renders it one of the best ‘alternative medicines’ available. At least it can only kill you by omission, and not harm you by some rather toxin found in herbal or Chinese medicine.

‘rather’ should have been ‘random’

Arguments that NHS-funded homeopathy is harmless miss the point that the NHS has finite resources. Money for woo is money that could have been spent making really sick people better.

Doctors don’t need homeopathy to manage the placebo effect. Experienced GPs often have a range of strategies that work using the patient’s mind to make them feel better. Of course, if the patient pops into a wellness salon on the way home the manipulative bastards there will convince a vulnerable person that they have been lied to for the benefit of Big Pharma and need a range of expensive CAM treatments.

Real is scientific homeopathy. It cures even when Conventional Allopathic Medicine (CAM) fails. Nano doses of evidence-based modern homeopathy medicine brings big results for everyone

@18: ” At least it can only kill you by omission, and not harm you by some rather toxin found in herbal or Chinese medicine.”

Quite so – and not just Chinese medicine, believe me.

I was eventually taken off a widely prescribed drug, originally prescribed by my GP, by a hospital consultant after it emerged – from the FDA in America – that the drug was associated with higher risk of cardiac failure. As I’ve learned from friends and acquaintances of similar vintage years, the like of this is not an unusual experience.

These days, I take care to check out FDA warnings whenever NHS healthcare professionals mention a promising new treatment. In recent months, I’ve turned down one as a result.

More news from the archives:

“Accidents, errors and mishaps in hospital affect as many as one in 10 in-patients, claim researchers. The report in the journal Quality and Safety in Health Care said up to half of these were preventable.

“Checks on 1,000 cases in just one hospital found examples of fatal surgical errors, infections and drug complications.”
http://news.bbc.co.uk/1/hi/health/7116711.stm

@BobB

How do you logically go from being concerned about incompetent medical professionals, and wrongly prescribed (but proven to work) medication to a support for medical treatments that are not scientifically substantiated?

You may have good reason not to trust conventional medicine but the fact that it’s harmless is not reason enough to put your trust in homeopathy.

“How do you logically go from being concerned about incompetent medical professionals, and wrongly prescribed (but proven to work) medication to a support for medical treatments that are not scientifically substantiated?”

Let’s be clear, I’ve no regard for homeopathy, which I regard as just another medical con – something I’ve known for getting on 50 years, since being married to a pharmacologist, who recently retired from a senior academic post abroad.

You may have good reason not to trust conventional medicine but the fact that it’s harmless is not reason enough to put your trust in homeopathy.

It is if there is nothing much wrong with you. If not: http://www.youtube.com/watch?v=HMGIbOGu8q0

Until antibiotics were discovered in 1928, there was little effective medication – vaccination against smallpox (1795), digitalis (a heart stimulant derived from foxgloves, a traditional remedy), aspirin (a wonder drug derived from traditional medicines), and antiseptics and anaesthetics for surgery.

“Greek archaeologists have uncovered a rare find, the skeletal remains of a young woman who appears to have undergone brain surgery – nearly 1,800 years ago. The bones, which date from the third century, were found in one of more than 1,000 graves excavated in an ancient cemetery near the city of Veria in Greece.”
http://www.independent.co.uk/news/world/europe/skeleton-reveals-ancient-greek-brain-surgery-795739.html

Tsk, just cut the homeopathy budget by 60 dilutions and everyone will get better anyway….isn’t that how it works? Less is more?

28. Roger Mexico

@Adam Grace (1.01)

My understanding is that those who administer homeopathy under the NHS are all conventionally trained as well, and presumably use (and are obliged to use) conventional treatments where appropriate.

Of course you can’t regulate it outside the NHS – that’s one of my arguments. I don’t agree with those who say there should even be any government regulation: it would be like herding smoke and it would be impossible to censure those staying outside such regulation if they were careful about how they worded their claims. Of course homeopathic professionals can (and do) set up their own bodies. I suspect membership acts as some guarantee of sincerity if nothing else.

As far as cost goes – well sugar and water don’t cost much. The allocated time of the professionals involved would be, as so often, the main cost. If homeopaths offer more time to patients, it’s difficult to argue that they should forced to offer the same bad practices the rest of us get.

I should have been clearer; I didn’t mean to suggest that supporting homeopathy or Big Pharma are the only alternatives. Indeed by remark about the “Laura Ashley wing” was meant to suggest their often both run by the same companies. It’s just that homeopathy is such an easy target for anyone with even a little scientific understanding; while problems with the pharmaceutical industry are more subtle and much harder to tackle effectively.

As for the Government supporting professions with with no evidence-based backing, well maybe we should start first with the management consultants … and the economists …and the policy advisers … and …

29. Roger Mexico

@Tim Worstall

Suddenly Osbourn’s budget all makes sense!

@Bob B

I’m not sure what point you’re trying to make.

The problem isn’t homeopathy in itself, the problem is public money being spent on treatment that has no proven working effect. You are right that the practitioners of conventional medicine don’t always get it right, many modern drugs turn out to be dangerous etc. But that is a problem with the way drugs are tested and the way the performance of health workers is managed. The problem isn’t with the underlying scientfic method used to find the cures or to train the doctors, a method which is largely ignored by homeopathy yet crucial when trying to discover what treatments actually work.

Recap:

“Bloodletting (or blood-letting) is the withdrawal of often considerable quantities of blood from a patient to cure or prevent illness and disease. It was the most common medical practice performed by doctors from antiquity up to the late 19th century, a time span of almost 2,000 years.”
http://en.wikipedia.org/wiki/Bloodletting

That. too. has a contemporary fiscal resonance.

“I’m not sure what point you’re trying to make.”

The news is that I’m making several points:

– I’ve no regard for homeopathy, for which there is no under-pinning scientific justification, hence my absence of surprise on learning that the Greens support homeopathy

– on the documented evidence of escalating diagnostic and treatment errors in the NHS, I’ve not much confidence in mainstream medical practice either: IMO it’s advisable to check out FDA warnings on new treatments

– these sentiments are not logically inconsistent

Of two incompatible propositions, both can’t be simulataneously correct but both can be wrong.

@Roger Mexico

“it’s difficult to argue that they should forced to offer the same bad practices the rest of us get.”

I’d argue if they want to personally fund the time of the homeopath and the likely ineffective treatment that goes along with it then that’s entirely their right, but in an NHS that is under a huge and constant amount of strain it would be prudent to direct money towards improving the ‘bad practises’ you mention rather than offering false alternatives.

Yes, Homeopathy is an easy target I agree, which is why it’s strange that otherwise sensible politicians like Caroline Lucas choose to take it’s side. I certainly agree though, that rejection of homeopathy shouldn’t come hand in hand with an unquestioning attitude to pharmaceuticals.

“As for the Government supporting professions with with no evidence-based backing, well maybe we should start first with the management consultants … and the economists …and the policy advisers … and …”

Advisers, consultants and the like are paid to offer a professional opinion based on the facts available, much like doctors. The government wouldn’t say “we’ll pay for these professional policy advisers and consultants, but for the sake of providing alternative opinions we’ll also pay for a troupe of laymen with no basis to offer a professional opinion.”

Anyway, thanks for your excellent comments.

@11 S Pill

Dara O’Briain in “Talks Funny”?

“Science knows it doesn’t know everything; otherwise, it’d stop. But just because science doesn’t know everything doesn’t mean you can fill in the gaps with whatever fairy tale most appeals to you.”
“Right now I would take homeopaths and I’d put them in a big sack with psychics, astrologers and priests. And I’d close the top of the sack with string, and I’d hit them all with sticks”
” ‘Herbal medicine has been around for thousands of years’ Yes, and then we tested it and the stuff that worked became MEDICINE”

The argument about “finite resources” in the NHS is false logic. We have placebo in conventional medicine but it is far more expensive. Patients who hold the ahistoric belief that conventional medicine is scientific get better quicker from a viral infection when taking red colored antibiotic tablets rather than white ones, or none at all. 100 years ago mercury was similarly effective. Give those who need comfort and empathy sugar water, save public resources and stick it in the eye for the big pharmas.

Shock as sky is blue?

@33

Could be that one, yeah… I was thinking it was David Mitchell for some reason though? Anyway, the point stands 😉

“- I’ve no regard for homeopathy, for which there is no under-pinning scientific justification, hence my absence of surprise on learning that the Greens support homeopathy

– on the documented evidence of escalating diagnostic and treatment errors in the NHS, I’ve not much confidence in mainstream medical practice either: IMO it’s advisable to check out FDA warnings on new treatments

– these sentiments are not logically inconsistent

Of two incompatible propositions, both can’t be simulataneously correct but both can be wrong.”

If I misunderstood your position, I apologise. I think we largely agree. I wasn’t really trying to make a case for an unquestioning warm embrace of current medical practices rather just a case for the value of the science that underpins conventional medicine.

Your lack of confidence in homeopathy and conventional medicine in both cases seem to translate directly to a concern that science isn’t applied correctly, or at all in homeopathy’s case.

The examples that you’ve provided of conventional medicine ‘going wrong’ are likely to have happened due to scienctific methods being wrongly applied or compromised, either by incompetent doctors or careless pharmaceutical companies for reasons of profit. That is a seperate but valid debate on how far medical standards are compromised to serve other interests.

This all just further demonstrates the values of the correct application of science. In conventional medicine science is largely applied correctly,, where it is not there is an anomaly. Homeopathy doesn’t apply science at all though, which gives it a systemic problem.

@john
“The argument about “finite resources” in the NHS is false logic. We have placebo in conventional medicine but it is far more expensive.”
_______

Placebos work, and are employed in conventional medicine by GPs because of their propensity to work. A homeopathic treatment may work as a placebo, it might not, but it’s not required to actually be proved effective before we’re issued the bill for it.

“The examples that you’ve provided of conventional medicine ‘going wrong’ are likely to have happened due to scienctific methods being wrongly applied or compromised, either by incompetent doctors or careless pharmaceutical companies for reasons of profit.”

Agreed. It could prove an intersting but challenging research project to see if there are any systematic causes of errors in mainstream medical practice.

From experience, I sense that part of it is a tendency of clinicians to impose stereotypes. This may be unavaoidable given the sheer complexity of human physiology and the increasing treatments available as the pharmas strive for profitable blockbusters – which is why so little commerical effort is put into preventing and treating malaria, a disease largely confined to poor countries.

This explains why we have the inceasingly narrow specialisms.in medical practice, which raises questions about the good sense of vesting almost all treatment commissioning decisions with GPs, who don’t have the time and energy to keep up with all the research and treatments coming out across medicine.

I’ve sometimes found it difficult to engage in meaningful dialogue with healthcare workers – who tend to simply ignor what I’ve said if it doesn’t fit with their preconceived picture. Friends and acquaintances confirm an impression that the prospect of individual variations in the side-effects of drugs tends to get overlooked or played down – which is why I think it’s a good idea to check out the FDA on treatments.

41. Roger Mexico

@Adam Grice (#32)

It’s my fault for being over-cryptic again. My comment on the additional time that homeopathic NHS practitioners give their patients (which may of course be partly responsible for their results) was meant to be contrasted with the derisory times the rest of the NHS is meant to use. No doubt these will reduce further as “reforms” replace more GPs with with private health centres etc.

I just think people should be given decent consultation time whatever the circumstances. Maybe the example of the homeopaths will shame the rest of the NHS into it. Suggesting extra time should be payed for isn’t my preferred solution.

The comment about management consultants was mainly a joke, of course. It’s true, though, that the work of these “professionals” is rarely subject to the same scrutiny for effectiveness that we now expect in most branches of medicine. (There’s an interesting discussion about how to test educational procedures on Bad Science at the moment).

And of course I’m not suggesting that “laymen” should be used in the NHS supply of homeopathy – quite the opposite. Though how you distinguish between the layfolk and the professional (or should we say “priesthood”) in management consultancy, economics etc, is another issue.

Politicians such as Caroline Lucas (and those in all other parties) who support the use of homeopathy in the NHS are presumably doing so because there is popular demand for it. patient choice is wildly over-hyped, but this is oddly one of the few areas where it is meaningful. I know many doctors feel morally conflicted in this area – that they are being dishonest with patients by implication (no body’s advocating direct lying I think).

You admit (#38) that placebos “work”. In that case you can’t pick and choose which placebos are valid and which aren’t – that’s the whole point of placebos! (That’s not to say the way in which they are presented to the patient for optimum effectiveness can’t be investigated scientifically).

I hope I’ve been a bit clearer this time. Thank you for an interesting discussion.

Good post. If the lib-dems do collapse and I need to start voting green, I at least want them to be vaguely rooted in science.

But why does homeopathy get proper-nouned? 🙁

@ Roger Mexico

“My comment on the additional time that homeopathic NHS practitioners give their patients (which may of course be partly responsible for their results) was meant to be contrasted with the derisory times the rest of the NHS is meant to use. No doubt these will reduce further as “reforms” replace more GPs with with private health centres etc.”

I agree that wherever necessary, meetings with consultants should be made as long as they need to be. I’ve not seen the evidence that suggests that people are being rushed in and out of consultant’s offices on the NHS, whereas they’re getting more time with homeopaths.
_________

“And of course I’m not suggesting that “laymen” should be used in the NHS supply of homeopathy – quite the opposite. Though how you distinguish between the layfolk and the professional (or should we say “priesthood”) in management consultancy, economics etc, is another issue.”

My argument was that homeopaths, partly due to the lack of regulation they are subject to and partly due to the lack of science inherent in their methods, are medical laymen when compared to conventional practicioners.
_________

“You admit (#38) that placebos “work”. In that case you can’t pick and choose which placebos are valid and which aren’t – that’s the whole point of placebos! (That’s not to say the way in which they are presented to the patient for optimum effectiveness can’t be investigated scientifically).”

Placebos work. But not all homeopathic treatments work even as a placebo. Some homeopathic remedies will have a placebo effect (which is very often the upper limit of their usefulness) but not all. These remedies are not subject to the same degree of testing that conventional placebo treatments withstand. Where a convincing case can be made for the effectiveness of a homeopathic remedy (as a placebo or otherwise) it should be made available as part of a conventional course of treatment.

“Where a convincing case can be made for the effectiveness of a homeopathic remedy (as a placebo …..) it should be made available as part of a conventional course of treatment.”

The “or otherwise” I entirely agree with. When a homeopathic (or any other treatment) can be proven to work it just becomes medicine and thus should be provided.

But the point about placebos is that it doesn’t matter what the treatment is: it’s that treatment is being given which causes the effect, not what the treatment is.

So no, if homeopathy works only as a placebo then we don’t prescribe homeopathic mdeicines. We prescribe a sugar pill.

“The “or otherwise” I entirely agree with. When a homeopathic (or any other treatment) can be proven to work it just becomes medicine and thus should be provided.

But the point about placebos is that it doesn’t matter what the treatment is: it’s that treatment is being given which causes the effect, not what the treatment is.”

You’re right of course, I mistyped the sentence. Think I’d meant to say “Where a convincing case can’t be made for the effectiveness of a homeopathic remedy (as a placebo or otherwise) it shouldn’t be made available as part of a conventional course of treatment.”

#39 Adam & #44 Tim. You are both only half right because you overlook that most drugs prescibed and taken have a placebo effect (and not just the sugar pills that the doctors occassionally dish out). What I was trying to emphasise is that your faith in “scientific” medicine is misplaced and will be looked back on in 100 years with the horror that we look back on the “scientific” treatments of yesterday.

@Jim bliss

What I find troubling with the article, however, is how quickly it switches from a perfectly sensible criticism of homeopathy into a dismissal of all “alternative medicine”. To characterise all healing practices that do not currently fall under the umbrella of conventional western medicine as equally ineffective places one on very shaky ground indeed (particularly with respect to herbalism and certain non-western traditional treatments).

Thanks Jim, that is exactly how I felt about this article. This point rather undermines an otherwise well reasoned article, as it appears to be a rather lame and unconvincing attempt at tarring all forms of non-conventional medical practice with the same brush.

48. TuringMachine

@47 – so which non – conventional or alternative medical practice would you say are supported by substantial bodies of evidence?

How about this claim?

“Numerous drugs have entered the international pharmacopoeia via the study of ethnopharmacology and traditional medicine.”
http://www.scitopics.com/Drug_Discovery_and_Development_Traditional_Medicine_and_Ethnopharmacology_Perspectives.html

50. TuringMachine

@49 erm yeah, how about it?

“@49 erm yeah, how about it?”

Numerous drug therapies in regular use have derived from traditional medicines – digitalis, aspirin, curare, quinine etc.

By press reports, in the 1990s several of the big pharmas sponsored or financed global searches to find effective traditional medicines.

“The Journal of Ethnopharmacology published by Elsevier is dedicated to the exchange of information about peoples’ uses of plants, fungi and other natural products and is the official journal of the Society.”
http://www.ethnopharmacology.org/ISE_journal.htm

@John

It’s not a blind faith in ‘scientific medicine’. Rather, it’s putting trust in the endless peer reviewing that scientific theories are subject to. Skepticism is a deeply ingrained part of the process of coming to a scientific conlusion and so faith in the process of reaching that conclusion is not a traditional position of ‘faith’. The doubt is worked into the process so laymen such as myself don’t need to give it much consideration.
_____________

@Graham,
If by ‘non-conventional’ medical practice you mean practice that is not substantiated by scientifc theory, then yes I am tarring it with the same “not to be tax funded” brush. I’m not trying to dismiss ‘a priori’, any type of non-conventional medicine, but neither should they be accepted ‘a priori’ just because they provide an alternative to conventional medicine. Science is the standard that any form of medical practice should be held up to.

53. TuringMachine

Right Bob. So what point are you making?

“Right Bob. So what point are you making?”

There are many, documented examples of traditional or alternative medicines which have been adopted into mainstream medicine so it’s unwise to dismiss enbloc alternative or complementary therapies. But it’s wise to also look not only at the evidence for effectiveness but evidence relating to unwanted side-effects, impurities and toxins.

None of this should be construed as support for Homeopathy. One of the problems is that all tend to get lumped together and endorsed for what amount to sentimental reasons or rampant commercialism rather than the results of scientific investigations.

55. TuringMachine

@54 – I don’t think the link you supplied supports your argument. Can you give an example of a “complementary” or “alternative” treatment or therapy which has been shown (and by this I mean through a rigorous process of testing and statistical analysis) to be effective?

56. TuringMachine

@52 – exactly.

I liked your article, by the way.

“I don’t think the link you supplied supports your argument. Can you give an example of a “complementary” or “alternative” treatment or therapy which has been shown (and by this I mean through a rigorous process of testing and statistical analysis) to be effective?”

As previously mentioned digitalis, aspirin, curare and quinine all derived from traditional medicines. There are probably many more examples. You can doubtless manage to do your own google searches for the respective histories and endorsements by drug regulators. From experience, much of the relating research and medical textbook literature is subject to online subscription barriers.

Good, sensible article Adam.

One cannot understand how the Greens can support this. After all, think of all the wasteful “manufacturing” and distributing costs which must go into creating a product which has no active ingredients at all.

Indeed, it is almost a parody of the industrial process. If environmentalists really want to endorse a placebo, surely there is one which is not so resource- and packaging-intensive?

Surely?

59. TuringMachine

So Bob, can you actually give a single example of an “alternative” or “complementary” treatment that has been proved to be effective? I’m guessing from your responses so far that the answer is “no” but maybe it would help if I provide a few examples:

Acupuncture
Reflexology
Aromatherapy
Hopi ear candles
Reiki
Large doses of fish oil
Anything suggested by Gillian McKeith or, to use her full academic title, Gillian McKeith

do you think that any of the above work?

By the way, I know where aspirin and quinine come from, but I don’t see how their origins support “complementary” or “alternative” treatments.

“So Bob, can you actually give a single example of an “alternative” or “complementary” treatment that has been proved to be effective?”

You plainly have special needs comprehension difficulties.

I’ve already mentioned that digitalis, aspirin, curare and quinine all derived from traditional medicines and were absorbed into mainstream medicine. A google search will support this. This academic journal shows a continuing professional interest in information about traditional, ethnic medicines:

“The Journal of Ethnopharmacology published by Elsevier is dedicated to the exchange of information about peoples’ uses of plants, fungi and other natural products and is the official journal of the Society.”
http://www.ethnopharmacology.org/ISE_journal.htm

At no place have I suugested a blanket endorsement of all “alternative” or “complementary” treatments, only that the big pharmas did finance global trawls in the 1990s of traditional ethnic remedies so it would be unwise to dismiss all of them regardless.

61. TuringMachine

Well Bob, since you have chosen to resort to insults, I shall reciprocate. You’re obviously not intellectually equipped to:

a. understand my question, since you haven’t provided any examples of “alternative” or complementary” treatments which work.

b. understand what the words complementary and alternative actually mean. Yes, I know you provided examples including aspirin and quinine but they were neither complementary nor alternative to anything, where they? They aren’t exactly current examples either, now are they? The google search that you keep recommending will support these assertions. I would also recommend a search of an english dictionary which will help you pin down (you may need the help of someone not as intellectually challenged as yourself for this one) the meanings of the words complementary and alternative.

c. recognise that a link to an article about lots of drugs containing chemical compounds derived from/patterned on compounds present in plants or that some of the plants’ properties were recognised by people before they came to the attention of scientists doesn’t actually support the case for “alternative” or “complementary” treatments. Particularly when said article is in a rather dodgy looking journal.

So Bob, to summarise:

a. you haven’t provided any examples/evidence of “complementary” or “alternative” treatments which work despite being asked several times to do so

b. instead you’ve waffled on about aspirin and quinine and provided a link to an article that doesn’t support anything you’ve said

c. you have attempted to use sarcasm only to have it backfire on you

and, finally

d. you’ve made yourself look an even bigger twat than you usually do

62. Roger Mexico

@Adam Grace

Sorry it’s me again. To respond to your three points at #43:

With regard to appointment lengths, I was thinking more of GPs than consultants – there’s certainly a lot of unhappiness about the short times GPs are supposed to have per appointment. All I suggested was it seems strange to complain that homeopaths are doing the right thing and therefore should be stopped because GPs aren’t allowed to.
__________________

You’re missing my point about NHS homeopathy (that’s my fault for trying to get more digs in at management consultants). Its practitioners are not lay people; they are conventionally trained and qualified and know the science even if they also believe in some extra woo.

There is something called the Faculty of Homeopathy which provides the extra training, but they only accept qualified doctors, nurses, vets etc (or the equivalent students). So the homeopaths you get on the NHS are not “laymen compared to conventional practitioners”. They are those practitioners. Incidentally most seem to be GPs so I assume most of their time is spent dealing conventional medicine as well.
__________________

I think you misunderstand about placebos. In a sense they don’t exist – anything not physically harmful could be a placebo in particular circumstances. And come to think of it practically anything can be an effective drug: water would be far from a placebo if you were dying of thirst; sugar pills useful if a diabetic with low blood sugar.

So you can’t really talk about a placebo like a conventional drug – it’s the effect that’s important and that will vary with what I called its “presentation”: the appearance of the drug; the way it is given; the instructions; literally dozens of variables. Everything in fact except its composition.

Purely by historic chance, we have in NHS homeopathy a way of using the placebo effect in an effective, safe and cheap way. It would seem foolish to get rid of it.

“d. you’ve made yourself look an even bigger twat than you usually do”

That about says it all regarding your competence.

I’ve repeatedly given irrefutable examples of traditional medicines which have been absorbed into mainstream medicine and explicitly denied that I’m giving blanket endorsement to all alternative or complementary medicine – but then I’m not not dismissing all of it together either. I’m arguing for an eclectic, scientific approach, dumbo, which is the intelligent, constructive course to take.

The seriousness with which the big phamas took up a search for traditional ethnic medicines and treatments is undeniable. The publication of a regular academic journal focused on ethnic medicine is the evidence.

@Roger

“All I suggested was it seems strange to complain that homeopaths are doing the right thing and therefore should be stopped because GPs aren’t allowed to.”

I suppose you’d need to establish a) that GPs are under pressure to spend less time on appointments and that b) longer appointments are actually necessary and prove helpful to the succesful treatment of a patient above and beyond a shorter appointment.

Regardless, I’m not arguing that homeopaths should be stopped in the NHS because they are “doing the right thing” (if longer appointments really are the right thing for both the NHS and the patient). The value of science is reason enough without even delving into the practical concerns.
_______

I accept your point about homeopaths also being conventional practitioners and therefore not lay people, it was an ill-thought out comparison. Although any supposed scientist who adds a layer of “extra woo” to their medical education is seriously asking for their judgement to be called into question.
_______

“Purely by historic chance, we have in NHS homeopathy a way of using the placebo effect in an effective, safe and cheap way. It would seem foolish to get rid of it.”

The problem with this is that NHS homeopathy isn’t streamlined to provide an evidence based distribution of placebos where necessary. Lot’s of homeopaths believe, without any reasonable basis, that their methods offer far more to a patient than a placebo.
As you say, it’s purely by chance that we have homeopathy. If it’s methods hadn’t graduated through history to the modern day, would we really have a gap in our health care system that required a mess of new-agists and faith healers to fill? No I daresay we might have found a different more evidence based approach to distributing placebos.

While you say it’s cheap, millions are spent on placebo drugs which are conventially prescribed without a homeopath ever being involved. There’s a lot more to the set up of homeopathy than the placebo effect, there is an unruly, unscientific and difficult to regulate culture that goes along with the clinical benefits of homeopathy as a placebo, it’s that culture which I wouldn’t want my tax pennies spent on.

@64: I suppose you’d need to establish a) that GPs are under pressure to spend less time on appointments and that b) longer appointments are actually necessary and prove helpful to the succesful treatment of a patient above and beyond a shorter appointment.”

Try this:

“GPs want to spend more time with sicker patients while those with minor ailments see a nurse, ring a helpline or go online for a video consultation.

“The Royal College of GPs (RCGP) is calling for appointments for standard patients to be increased from 10 to 15 minutes so doctors can spend more time with the growing number of people with long-term conditions such as diabetes, cancer and obesity.”
http://www.guardian.co.uk/society/2010/mar/23/gps-consultations-ill-patients

The predictable outcome of the 10 minute appointment regime is that GPs just hand out pills.

“Britons are increasingly turning to prescription drugs to cure every ailment, a new study found. The average number of prescriptions dispensed per person rose from eight a year to more than 16 over the past two decades, according to the paper, titled A Pill for Every Ill.”
http://www.independent.co.uk/life-style/health-and-families/health-news/britain-turning-to-prescription-drugs-1930212.html

66. Roger Mexico

@TuringMachine

The history of medicine is full of folk remedies that later turned out to be useful and they were often seen as “alternative” to the current medical orthodoxy; so i think you should lay off Bob B a bit. You certainly can’t demand the name of something that’s simultaneously part of modern and alternative medicine! Once it becomes the first, it stops being the second.

Of course it’s this very history which makes medical researchers today aware of how different traditions may feed into modern medicine. That doesn’t mean most long-standing “alternatives” are effective – they’re usually not accepted for good reasons. Nor, more interestingly, when elements of alternative medicine make it into science, are they usually adopted unchanged. Nobody takes willow tree bark for headaches, even if, when people did, they were probably better off than those following the conventional medicine of the day.

To pick an example that Bob B could have used: twenty years ago the use of leeches was highly “alternative”. In the last decade it has become widespread. But the use today is not quite the most usual historic use. I suspect if the indications that there may be something in acupuncture turn out to be true, the uses and the techniques won’t have much to do with ancient Chinese wisdom.

This explains my limited advocacy of NHS homeopathy, because of its formalisation of the placebo effect. (Neat circle back to original topic eh?)

@65s

Getting too off topic now perhaps. The argument put to me was that homeopaths were being punished for ‘doing the right thing’ in spending more time with their patients than other doctors. Regardless of whether or not it’s true that GPs need more time with patients, this is a false dichotomy. The reason given by most doctors that oppose homeopathy is it’s lack of scientific worth, not because they need more time for appointments.

While we are at it, a greatly neglected topic is the persistence of huge price differentials in mainstream OTC pharmaceuticals for common ailments.

An outstanding example is Loaratadine, a non-drowsy oral medication for sufferers of hay fever and insect bites in seasonal demand, which is widely marketed under a variety of brand names I dare not mention here:
http://en.wikipedia.org/wiki/Loratadine

Frankly, the scale of the price differentials is truly scandalous and can only persist because of widespread buyer ignorance.

69. Shatterface

Rather than cutting funding for homeopathy entirely we should simply *dilute* the money to point where it is virtually indetectable – say 0.000000000000001p.

If there’s anything in homeopathy at all this trace element of funding will be all they need.

#66 Roger, “formalisation of the placebo effect” indeed. The problem with opponents of homeopathy here seems to be that they don’t understand what the placebo effect is.

#67 Adam, doctors need to spend more time with “serious” illnesses that respond well to their treatments not with patients suffering from vague symptoms who would benefit more from a homeopath listening seriously to them, manipulating their arms and then giving them sincere reassurances and a ritual medical regime to follow at home. The casualness with which “scientific” medicine treats such patients is the reverse placebo effect which “homeopathy on the NHS” removes.

71. Roger Mexico

Some round-up points:

I agree we need more investigation into homeopathy. Not more versus placebo; we know what the answer is there. But to see how best it is delivered and what it can tell us about how medicine works (conventional and alternative). And if the practitioners happen to believe there’s something extra there – maybe that’s one of the reasons for success. That’s one of the reasons we have double blind experiments, after all.

As for cost, no figures I can find put homeopathy’s cost to the NHS that high compared to total budget. I suspect spending on antibiotics prescribed for viruses, or any one of list of drugs known to have no significant effect, would each dwarf the bill for NHS Homeopathy. If we’re driving down costs, there are other priorities.

The “unruly, unscientific and difficult to regulate culture that goes along with the clinical benefits of homeopathy”, that Adam rightly denounces, takes place outside the NHS (and is impossible to stop). Some claim that homeopathy on the NHS somehow validates the other stuff. A short overview of the alternative medicine scene will show these treatments manage to thrive by without any validation by anyone. If anything the NHS side of things may keep other homeopaths more honest.

Three more general thoughts:

I think the more strident, anti-alternative rhetoric of many people in such debates can be counter-productive. I understand the frustration, but it alienates those who may believe even a bit in such things; and worse it gives the impression of close-minded arrogance (unintended I’m sure and of course the opposite of the scientific method). The last thing we need is to encourage a Good v Evil narrative – especially if we put the majority on the other side.

The coming years will see attempts to change the NHS often on ideological grounds. We need to be directing our desire for evidence-based policy towards that, not skirmishes over small matters. Of course the privateers will be only too willing to offer “alternative services”. There’s money in it.

Does the body rule the mind or does the mind rule the body? I don’t know sang the Smiths. We still don’t, but the effects of how remedies are “presented” can be important and needs to be looked at. Medicine has always been a bit fuzzy round the edges and, as I pointed out at #66, has imported “fringe” treatments before – usually transformed. We do need to keep open minds, remembering that what we learn may not what we have been taught.

Funny how Global Warming is treated on Conservative Home in the same way that Homeopathy is treated on Liberal Conspiracy.

Disregard that whole pesky science thing and the two angry mobs do tend to resemble one another.

73. John Sullivan

So, she should drop her support for homoepathy even if she believes in it, because its politically opportunistic to do so? Argue that she’s wrong by all means.

Studies in support of Homeopathy published in reputed journals

1. Scientific World Journal
http://www.ncbi.nlm.nih.gov/pubmed/17982565

2. Lancet
http://www.ncbi.nlm.nih.gov/pubmed/9310601

3. Neuro Psycho Pharmacology
http://www.nature.com/npp/journal/v27/n2/abs/1395862a.html // Bacopa Monnieri for memory

@”Dr.” Nancy Malik

What are you a “doctor” of? Mumbo-jumbo?

It’s no surpise that Lucas supports homeopathy, given the Greens’ anti-science positions on so much else (GM crops, nuclear power, etc): what is more worrying is that three leading Labour left-wingers, McDonnell, Corbyn and Simpson supported a very similar EDM earlier this year:

http://edmi.parliament.uk/EDMi/EDMDetails.aspx?EDMID=40517

Perhaps the criticism they recieved back in February is the reason they haven’t supported this latest defence of charlatanry and mumbo-jumbo.


Reactions: Twitter, blogs
  1. Liberal Conspiracy

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  28. David Ritter

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  31. Adam

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  32. Niall Millar

    Why Caroline Lucas should drop her support for Homeopathy http://bit.ly/cwowTt (via @libcon) yes. V disappointing but not surprising.

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    I urge @carolinelucas to read this, if she hasn't already… http://bit.ly/cNMELG

  83. gwyn bailey

    Support Caroline Lucas, ignore: http://bit.ly/cpmsR2 . My take: http://rephidimstreet.blogspot.com/2010/07/homeopathy.html

  84. Anthony Steele

    @octoberclub – Why single out @CarolineLucas for her support for Homeopathy http://bit.ly/cNMELG

  85. Kristofer Keane

    RT @libcon Why Caroline Lucas should drop her support for Homeopathy http://bit.ly/cpmsR2

  86. Criticism not crucifixion – an Lefty’s apology | from the road to damascus

    […] I found it slightly odd when, one week ago, a plethora of angry lefties, tweeting, retweeting and blogging, forced the spotlight on Caroline’s first mistake (a […]

  87. Criticism not crucifixion – a Lefty’s apology | from the road to damascus

    […] I found it slightly odd when, one week ago, a plethora of angry lefties, tweeting, retweeting and blogging, forced the spotlight on Caroline’s first mistake (a […]

  88. Why we chose to criticise Caroline Lucas over Homeopathy | Liberal Conspiracy

    […] August 12, 2010 at 6:37 pm A couple of weeks ago we published a blog post by Adam Grace titled: Why Caroline Lucas should drop her support for Homeopathy. It generated huge interest and got us some criticism from lefty […]

  89. Making bogus research claims, the homeopathic way | Liberal Conspiracy

    […] 15, 2010 at 10:00 am With homeopathy rearing up its ugly head in the wake of Adam Grace’s well-founded criticisms of Caroline Lucas, I think its time for something a little different here on LC – a bit of […]

  90. Duncan Bruce

    Here is just one reason why Caroline Lucas is most definitely NOT brilliant >> http://t.co/UQhv65MM

  91. Malcolm Powers

    "@duncanqbruce: Here is just one reason why Caroline Lucas is most definitely NOT brilliant >> http://t.co/7M1aWzD2" absolutely!





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