MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The website of the HOMEOPATHY HUB gives us intriguing access to the brain of a homeopath. It tells us that “protecting patient choice is at the heart of everything we do. Homeopathy, which is the second largest system of medicine in the world, is a form of treatment which plays a vital role in the lives of hundreds of thousands of people across the UK. There is, however, a movement to try and withdraw homeopathy from the public and make homeopathic medicines difficult to secure. Our intention is to be a central “hub” for accurate information on current campaigns to retain access to homeopathy and details on how you can get involved and make your voice heard. Without public and patient support we will not be successful.”

Here are a few of the above statements that I find doubtful:

  • protecting patient choice – choice requires reliable information; as we will see, this is not provided here;
  • second largest system of medicine in the world – really?
  • plays a vital role – where is the evidence for that claim?
  • movement to try and withdraw homeopathy from the public and make homeopathic medicines difficult to secure – nobody works towards this aim, some people are trying to stop wasting public funds on useless therapies, but that’s quite different, I find;

The HOMEOPATHY HUB recently alerted its readers to the fact that the Charity Commission (CC) is currently conducting a public consultation on whether organisations promoting the use of complementary and alternative medicines (CAM) should have charitable status (https://www.gov.uk/government/consultations/consultation-on-complementary-and-alternative-medicines) and urged its readers to defend homeopathy by responding to the CC offering a “few helpful points” to raise. These 7 points give, I think, a good insight into the thinking of homeopaths. I therefore copy them here and add a few of my own comments below:

  1. there are many types of evidence that should be considered when evaluating the effectiveness of a therapy. These include scientific studies, patient feedback and the clinical experience of  doctors  who  have trained in a CAM discipline.  Within Homeopathy there is considerable evidence which can be found (https://www.hri-research.org)
  2. many conventional therapies and drugs  have inconclusive evidence or prove to be useful in only some cases, for example SSRIs (anti-depressants).  Inconsistent evidence is often the result  of the complexity of both  the medical  condition being treated and the therapy being used. It is not indicative of a therapy that doesn’t work
  3. removing all therapies or interventions that  have inconsistent or inconclusive evidence would seriously limit the  public and the medical profession’s  ability to help treat and ease patients suffering.
  4. all over the world there are doctors, nurses, midwives, vets  and other healthcare professional  who integrate  CAM therapies into their daily  practice because they see effectiveness. They would not use these therapies if they  did  not see their patients  benefitting from them.  For example in the UK, within the NHS hospital setting, outcome studies demonstrate effectiveness of homeopathy. (http://www.britishhomeopathic.org/evidence/results-from-the-homeopathic-hospitals/)
  5. practitioners of many CAM therapies belong to registering bodies which expect their members to comply to the highest professional standards in regards to training and practice
  6. In the UK the producers and suppliers of  CAM treatments (homeopathy, herbal medicine etc) are strictly regulated
  7. as well as  providing valuable information to the  growing  number of people seeking to use CAM as part of their healthcare, CAM charities frequently fund treatment for those people, particularly the elderly and those on a low income, whose health has benefitted from these therapies but who cannot  afford them. This meets the charity’s criterion of  providing a public benefit.

MY COMMENTS

  1. “Patient feedback and the clinical experience of  doctors” may be important but is not what can be considered evidence of therapeutic effectiveness.
  2. Yes, in medicine evidence is often inconsistent; this is why we need to rely on proper assessments of the totality of the reliable data. If that fails to be positive (as is the case for homeopathy and several other forms of alternative medicine), we are well advised not to employ the treatment in question in routine healthcare.
  3. Removing all treatments for which the best evidence fails to show effectiveness – such as homeopathy – would greatly improve healthcare and reduces cost. It is one of the aims of EBM and an ethical imperative.
  4. Yes, some healthcare professionals do use useless therapies. They urgently need to be educated in the principles of EBM. Outcome studies have normally no control groups and therefore are no adequate tools for testing the effectiveness of medical interventions.
  5. The highest professional standards in regards to training and practice of nonsense will still result in nonsense.
  6. The proper regulation of nonsense can only generate proper nonsense.
  7. Yes, CAM charities frequently fund bogus treatments; hopefully (and with the help of readers of this blog), the CC will put an end to this soon.

I think these 7 points by the HOMEOPATHY HUB are a very poor defence of homeopathy. In fact, they are so bad that it is not worth analysing more closely than I did above. Yet, they do provide us with an insight into the homeopathic mind-set and show how illogical, misguided and wrong the arguments of homeopathy enthusiasts really are.

I do encourage you to give your response to the CC – it wound be hard to use better arguments than the homeopaths!!!

82 Responses to Inside the brain of a homeopath

  • Same old same old, really. Bluster, obfuscate, misrepresent, launch a straw man or two, huff and puff and continue to be astonished that anyone could fail to appreciate the miraculous powers of shaken water dripped on sugar pills and allowed to evaporate.

  • Homeopathy, which is the second largest system of medicine in the world

    I’d love a homeopathy fan to point out a reliable source for that ‘fact’…

    • a reliably diluted fact perhaps?

    • I’ve been trying to trace this claim for the last week or so since my tweet about it went more viral than expected.

      The earliest reference I can find is from 1999.

      Link

      I can’t find anything from WHO to suggest where this might have come from.

      • I have a good candidate for its source. It is a WHO publication, but I would like some confirmation from a homeopathy fan first. If I don’t get anything, I’ll publish where I think it comes from. Can I email you about it to see if you confirm my suspicion?

  • “Homeopathy, which is the second largest system of medicine in the world”.

    We have multiple systems of medicine??! I want to try the fifth largest: please advise what that one might be.

  • Ah, the 4Homeopathy PR group. Their grasp on reality has always been questionable to say the least.

    One of the essential contradictions in their arguments is that the supply of the majority of homeopathic medicines is of questionable legality. It only happens because the MHRA do not regard homeopathic medicines as of any real interest (and possibly political interference has a role). It’s hardly strictly regulated. If it were, it would be very difficult for UK lay homeopathy to function at all.

    It’s not as if the UK trade bodies don’t know this and 4Homeopathy have strong links with them. The lessons of the 2012 consolidation of Medicines legislation seems to have been lost on them. They were made to look foolish and ineffectual.

    As for the trade bodies regulating their own members, it’s clear that they are spectacularly ineffective at this. The most visible manifestation are the large number of member websites that do not comply with ASA rules. Worse still, these websites often make claims for the treatment of conditions that would by any reasonable person be understood to be far beyond the competence of any lay homeopath to deal with. Offering a cure for autism is something I’ve seen a lot of recently.

  • Acleron, Alan Henness, Guy Chapman: comment on: https://health.spectator.co.uk/homeopathy-fans-are-angry-here-is-what-the-fuss-is-about/

    Do you do anything else apart from blogging day and night?

  • Please explain why the MHRA have little interest in homeopathic medicines? The MHRA are one of the most powerful organisations in the country who always act swiftly in any cases that affect public health.
    They must surely have assessed homeopathy as a low risk?

    • Homeopathic medicines in themselves are pretty safe, barring contamination and adulteration issues. The MHRA have been known to act when i) unregistered products have been placed in the retail pharmacy supply chain and ii) products have been associated with illegal and dangerous health claims. The UK homeopathy manufacturers have been told off by the MHRA more than once.

      It’s also the case that the MHRA defer to the Advertising Standards Authority (ASA) in dealing with misleading marketing claims, unless they are really bad. They also defer to Trading Standards if claims are made regarding the treatment of cancer.

      It is worth pointing out that there are very few votes in homeopathy. Only 1.3% of the UK population use it and it is unlikely that voting intentions will be decided on this issues. Some have speculated that there are political reasons why the law is not enforced.

      Recognition of homeopathic products as “medicine” was something foisted on the UK by the EU. Which itself is the result of lobbying by French and German manufacturers. It maybe that some within the MHRA don’t regard it as medicine and thus beneath their notice.

    • The MHRA might have assessed homeopathy as low risk: the salient question is what benefits does it bring? That there are occasional serious risks is indisputable, but are there any tangible, consistent benefits that can be attributed to homeopathy — with credible supportive evidence? In the absence of tangible benefits, the risk:benefit ratio is infinitely huge, and homeopathy is therefore best avoided.

      Besides, according to the OP, homeopathy is “the second largest system of medicine in the world”. Huh?! We need different systems of medicine like a moose needs a hatrack. Just one system based on sound science ought to be sufficient.

  • The point about failures of reality-based medicine is an obvious red herring.

    There is no charity whose aims include the promotion of SSRIs.

    The homeopathists unwittingly make my main point in response to the consultation: In fact, the promotion of any specific treatment should not be given charitable status. It creates an inherent conflict with the essential process of medical science, in finding and discarding treatments that do not work.

  • A list of anecdotes does not justify any risk Frank. Are Drs experiencing their patients being harmed by delaying treatments and throwing away their medication because of homeopathy? Please supply the evidence of harm by homeopathy- not a pile of unvalidated stories?

    As for 1.3% being users of homeopathy. It is likely that a lot more might believe it works or support the right for people to use it. There is the possibility of there being some who have sympathy for the homeopaths. If the survey had asked a different question about support or belief in homeopathy then the 1.3% could be higher.
    It will be necessary to prove to the CC that homeopathy manifests a risk and that is not in the public interest to have homeopathic charities. So where is the evidence to support this?

    • You are quite right about risk. I’d recommend reading Gerd Gigerenzer’s “Reckoning with Risk” to lay people.

      One of the big questions that’s never asked in surveys about use of homeopathy or CAM in general is whether users actually understand what it is? I do understand what homeopathy is, in all its various flavours, but on examination of many homeopaths’ websites, they tend to steer away from a clear explanation of it is.

      Personally, I think that asking the Charities Commission to deny charity status to CAM promoting charities is throwing the baby out with the bathwater. The onus should be on trustees to spend money responsibly.

      I’d not want to deny someone in a hospice CAM therapy but I would strongly object to claims for cure of terminal conditions.

      • UK HR’s altruism in respect of hospice patients is appreciated – but what is the purpose of the camistry (CAM therapy)?
        It won’t have any effect on the pathology, or the therapy would be ‘medicine’.
        The only effect will be that the therapy might make the patient ‘feel better’.

        The aim of making patients ‘feel better’ is laudable.
        Fooling them with fake preparations, misleading them with false stories, encouraging false hope is to be deprecated.
        Homeopaths should counsel and care for patients, but should no longer use homeopathically prepared remedies.
        If that means they have to be better counsellors, and not rely on ‘magic pills’, so be it.

        The conflation of the practitioner with the pillule, the style with the substance, therapist with the therapy, will confuse the charity commissioners.

        If only homeopaths would move on. Hahnemann did, when he gave up the misguided orthodox treatments of his day. Why cannot those interested in his methodology move on and acknowledge the ‘remedies’ play no part in achieving the results practitioners see, except as placebos. And patients must be told that is the case if they are not to be misled.

        The CC should not vicariously endorse practices of practitioners which lack integrity (or insight). They might be knowing frauds. How can anyone tell?

        • Dr Richard Rawlins,

          Please explain this:Dr. Rawlins

          It is nice to see that you are here. Please would you answer this question:

          Greg on Thursday 20 April 2017 at 07:43
          Is Dr. Richard Rawlins biased against homeopaths?

          Dr Rawlins, you have not replied to this topic from previous blog:

          Dr. Rawlins, the problem is that you don’t know for certain that homeopathic remedies do not have a medicinal effect. (See: Robert Mathie’s study)

          Therefore, if it is not certainly known that remedies are pure placebos, why should homeopaths state that they are?

          You have not addressed this:
          Greg on Thursday 13 April 2017 at 06:53

          Dr Rawlins, please go through these comments and explain:

          10 April

          Greg: After a lifetime of investigating homeopathy, Edzard should be able to provide a concise ‘head of argument’ for the case against homeopathy. Perhaps he could also try to do this in a dispassionate scientific manner to support his prosecutorial rhetoric: homeopaths are ignorant, corrupt, charlatans, frauds, quacks, criminals, ‘kill your entire family’ (see your listed article above).

          What if his case is wrong? Perhaps he would not feel any sense of shame for insulting so many people?

          Dr Rawlins: ‘Homeopaths are ignorant, corrupt, charlatans, frauds, quacks, criminals.’
          What evidence is there that they are not?

          Greg: Dr Rawlins, I would not have thought of you as the type of person to jump into this with your statement:
          ‘Homeopaths are ignorant, corrupt, charlatans, frauds, quacks, criminals.’
          What evidence is there that they are not?

          What if the model and method of ‘investigating’ homeopathy is wrong? I have stated several times on this site that I consider the method (RCT) and model allopathic/clinical homeopathy used in most of the investigations into homeopathy are likely to fail P=F.

          If someone devises a way to test homeopathy properly and evidence of efficacy is found, what will you say then?

          Greg: Crimen injuria is a crime under South African common law, defined to be the act of “unlawfully, intentionally and seriously impairing the dignity of another. (Wikipedia)

          Does this law apply in the UK?

          11 April
          Dr Rawlins:
          I made no allegations.
          I was quoting another post.
          That is why my comment was in quotation marks.
          I have no idea whether any homeopath is ignorant, corrupt, a quack, charlatan, fraud or criminal.
          Do you?
          How do we tell?

          We are dealing here with probabilities and likelihoods, That’s why a proper scientific approach is necessary.
          Which is more likely, that homeopaths are ignorant, quacks or frauds – or that they have discovered a quite remarkable phenomenon which requires all current knowledge of natural sciences to be set aside?
          Which do you think more likely?

          Dr Rawlins: No – nor in SA either.
          Folks in the categories we are considering here have no dignity which can be impaired.

          End of quotes

          The conflicting statements in the text are:

          I have no idea whether any homeopath is ignorant, corrupt, a quack, charlatan, fraud or criminal.
          Folks in the categories we are considering here have no dignity which can be impaired.
          What evidence is there that they are not?

          These statements appear inconsistent, please would you clarify, thank you.

          Reply

          • What is your qualification in homeopathy and analysis of clinical studies – if there are any ? Reply, Greg.

    • It will be necessary to prove to the CC that homeopathy manifests a risk and that is not in the public interest to have homeopathic charities.

      No, that isn’t how it works. See the Charity Commission’s guidance. It is up to the charity to demonstrate a public benefit. See in particular page 7, where it says, “Where it is not clear that a purpose is beneficial, the Commission meat need to ask for evidence of this. For example, the Commission may need to ask for evidence of … the healing benefits of a therapy provided under an advancement of health purpose.”

      • Sorry, there’s a typo there. That first sentence quoted from the Charity Commission document should read “…the Commission may need to ask for evidence of this.”

  • I do not feel I can answer the issues you (Greg) raise on this thread, but I note you say, “…if it is not certainly known that remedies are pure placebos, why should homeopaths state that they are?”

    Answer: It’s called honesty and intellectual integrity – and because that’s the way science works. It’s also a matter of probability. No ‘science’ is 100% accurate to the ‘n’th degree- but describes things as they are to the highest possible probability.
    As homeopathy is a faith (as far as I can tell), it cannot be subject to scientific analysis, but neither should public funds be spent on purchasing remedies, and even private patients should be given full information so that they can make wise choices.
    And until there is plausible evidence of effects on specific conditions, the domain represented by ‘homeopathy’ is not likely to meet the criteria required by the CC.
    Sorry.

    Why not move on?
    Best wishes.

  • Greg has asked “Is Dr. Richard Rawlins biased against homeopaths?”
    For clarification:

    Bias is defined as ‘Inclination or prejudice for or against one person or group, especially in a way considered to be unfair.’
    Dictionary definitions of ‘bias’ include the concept of what is ‘fair’ or ‘reasonable’.

    I am inclined against homeopaths (their philosophy and practice, not their persons), but only on the basis of reason, probability and intellectual integrity.
    How else are their implausible claims to be addressed, and gullible and vulnerable patients to be helped?

    • Reality is biased against homeopathy, just as it is biased against flat earth theory, alchemy and astrology.

      The problem is not reality, the problem is bullshit beliefs.

  • Do you therefore imply that your key statement below is supported by your statement: I am inclined against homeopaths (their philosophy and practice, not their persons), but only on the basis of reason, probability and intellectual integrity.

    Key statement
    Dr Rawlins: ‘Homeopaths are ignorant, corrupt, charlatans, frauds, quacks, criminals.’
    What evidence is there that they are not?

  • The ‘gullible and vulnerable patients’ Dr Rawlins mentions are fully aware of the nature of homeopathy. You would have to have lived in a cave as a hermit since 2006 to not have been made aware of the principles and dilutions involved.

    Some just believe in homeopathy like millions more believe in various religions that also might make no sense to Dr Rawlins ‘on the basis of reason, probability and intellectual integrity’.
    There comes a point of resistance where the % of people who believe that homeopathy works will not shrink despite the resources of the GTS, Sense about Science and the efforts of Edzard. In fact the targeting of homeopathy and CAM in this way using lawyers may even galvanise support from those who support freedom of choice.
    How ironic that the same sceptics who in the past quite rightly criticised missguided legal attacks on certain individuals who were just expressing their opinions are now apparently using law to attack the poorly funded CC to stop people expressing their opinions via a charity.
    I think that the CC will not want to go down a slippery slope of banning charities that represent the beliefs of minorities unless someone can prove harm.
    I predict that nothing will come of this.

    • Many consumers are NOT “fully aware of the nature of homeopathy”. Many confuse it with herbal medicine. And many believe it is effective, while the evidence fails to support this notion.

    • “In fact the targeting of homeopathy and CAM in this way using lawyers may even galvanise support from those who support freedom of choice.”

      I wonder if you support freedom of choice in other consumer areas? Do you not agree there should be regulations and enforcement preventing people from purchasing, for example, flammable children’s costumes and nightwear, or would the fact that lots of people appreciate the low prices of these products and have never had problems with them mean they should be free to continue to buy them?

      How about people who pass off phoney watches as genuine Rolex? Huge numbers of people will be unable to tell the difference: should they be allowed freedom of choice to buy these products, or would you value people who point out that they’re fakes and argue vociferously to have them taken off the market?

      You are plainly oblivious of the numbers of people who are ‘gullible and vulnerable’ about consumer issues in general, and you’re wrong when you say people are “fully aware of the nature of homeopathy”. Just read the comments of believers on this and other blogs that attempt to warn consumers about the Big Snakeoil industry, and you’ll start to realize that — by your criteria — there must be a helluva lot of folk living in caves as hermits.

      • Frank: Should people have the choice to believe in virgin births, ascending prophets and other miracles? Do you think that such beliefs are harmful and like homeopathy should be stopped because they restrict rationale thinking?
        Many give money to churches and religous charities which in turn encourage religion. Should these charities be stopped due to the lack of an evidence base for God or because of a risk of irrational thinking?
        Not everyone subscribes to living their life based on evidence based science and thinking in the way that you consider to be rational.
        Trying to make out that people are ‘gullible and vunerable’ is likely to enforce resistance.

        • @IsleofSkye

          I’d argue that religion blunts the cutting edge of reality, and it underpins many of the world’s current problems, and that religious beliefs seem very similar to beliefs in pseudo-medicine. But I didn’t say that “homeopathy should be stopped because [it restricts] rationale [sic] thinking”. I very clearly made the point that the selling of homeopathy to people who know nothing of biology or medicine and are in no position, from their knowledge or experience, to distinguish beliefs from reality, is a consumer issue.

          I’m not arguing for homeopathy to be stopped, merely that people who prescribe homeopathy or sell homeopathic products should be obliged to ensure their patients give their informed consent to the treatment, for good, consumer-protectionist reasons. ‘Informed’ includes advising a patient there is no evidence to show that homeopathic ‘medicines’ have any therapeutic benefit.

          Let’s drill down a little, because the spectrum from consumer products through altmed to religion is worth thinking about. The description I just gave: “people who know nothing of biology or medicine and are in no position, from their knowledge or experience” essentially describes someone who is gullible (i.e. easily persuaded to believe something; credulous). It also describes someone who is ignorant of biology or medicine. But the words ‘gullible’, ‘credulous’ and ‘ignorant’ have acquired pejorative overtones that blight their intrinsic meanings. Because I used ‘gullible’ you said that’s “likely to enforce resistance”. Would you have reacted the same way if I used only ‘vulnerable’? By the standards of today’s culture, ‘vulnerable’ tends to induce the opposite reaction: “OMG, we must protect vulnerable people at all costs!”.

          “Many give money to churches and religous charities which in turn encourage religion.” And the majority of such people regularly attend places of worship where they hear their beliefs discussed in great detail. If they don’t agree with the detail they can pick another religion (many people switch religions or become agnostics/atheists; it happens all the time).

          Most people who seek homeopathy are feeling poorly in some way and pick up the products over the counter at pharmacies without consulting the pharmacist for detailed explanation of their modus operandi. They know the pharmacist is a specialist in dispensing medicines, which provides reassurance that what a pharmacist supplies must do what it seems to say on the label. Those who consult a professional homeopath will get a reassuring consultation and a short lesson in homeopathic theory which they’re not usually in any position to mull over or dispute. This raises a fundamental problem in consumer protection terms.

          In my opinion, religion and altmed sit on different parts of the spectrum of life experiences. Both are in business to sell beliefs (and raise money in the process), but no religion claims to be based on science, whereas altmed mimics and parallels scientific medicine, which makes it hard for the layman (OK if I use that word? Not one of your pejoratives?) to distinguish something based in science and reality from something that’s purely a belief.

          When you complain my words are likely to enforce resistance you’re merely saying you’re going to stick your fingers in your ears harder, shout ‘la-la-la’ louder and never try to comprehend the reasoning of those you feel oppose your just beliefs. I have often tried honestly and hard to understand the arguments of those who favour CAM over real medicine, but the reasoning never comes based on credible, scientific evidence and, frankly, seems to originate in ignorance (with the literal meaning of that word and nothing pejorative implied).

        • Steve Tonkin (below) has said much the same as me in entirely different words.

    • The FTC staff report on Homeopathic Medicine and Advertising is worth reading. The consumer research section is the interesting part.

      https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-staff-report-homeopathic-medicine-advertising-workshop/p114505_otc_homeopathic_medicine_and_advertising_workshop_report.pdf

      Admittedly, the focus groups are small in size conducted in the US. It could be possible that the focus groups are unrepresentative of the overall US population and that British consumers are more informed. Even so, the confusion of between different categories is likely to exist to a degree in British consumers. Many UK lay homeopaths are very cagey about what they say about the nature of homeopathy in their advertising. True, increased scrutiny of marketing claims has resulted in a decline of claims for the efficacy of homeopathy in treating named conditions but not what is meant. Homeopathy is, in essence, a form of vitalism. It posits dis-ease is caused by mysterious, invisible, intangible spiritual forces and that they are cured by spiritual essences of materials acted on an invisible, intangible “vital force”. That may appeal to some but others will be incredulous on learning this.

      It’s worth pointing out that in the UK homeopathy had pretty much died out by the late 1960s. Its subsequent rise in popularity could be seen in the context of the growth of New Age thinking. Homeopathy could shrink back to a handful of practitioners again. Cultural shifts could do that. Campaigning is unlikely to do it on its own. Anti-homeopathy campaigning can re-inforce the Gallileo fallacy that many homeopaths and their supporters hold but increased awareness of the vitalistic nature of homeopathy is likely to result in a overall decrease in use by consumers.

      The problem with expressing an opinion is that free speech is necessarily limited. Advertising and promotion are not free speech – they are commercial speech – and consumer protection law exists. The State does have some duty in protecting the public from unscrupulous vendors.

      Freedom of choice needs to be balanced with public health considerations as well. Sweden, for example, forbids the use of CAM on children under 8 and pregnant women. Part of the reasoning for this is the matter of informed consent.

      Charitable status does confer a few benefits with regards to taxation, etc, but there are not-for-profit voluntary organisations that are not charities. Asking the Charities Commission to unrecognise certain CAM charities is not going to make the actual activities go away.

  • Dr Rawlins may be busy today so I will wait for him to reply. He mentioned: can we move on which is a gentlemanly gesture but he has not retracted his ad hominem statement and his position is at the heart of what this blog is about. Is homeopathy placebo and therefore bogus medicine?

    Dr Ernst is being naughty: ‘many believe it is effective, while the evidence fails to support this notion.’

    The FACT is that there is some RCT evidence that fails to support this notion, and there is some RCT evidence that supports this notion. There is also the contention that RCT’s are not suitable/have not been suitably designed to measure efficacy of individualised homeopathy.

    • “… he has not retracted his ad hominem statement…”
      HAVE YOU EVER RETRACTED ONE OF YOURS?
      “The FACT is that there is some RCT evidence that fails to support this notion, and there is some RCT evidence that supports this notion.”
      I HAD THOUGHT THAT IS CLEAR THAT I MEAN THE BEST AVAILABLE EVIDENCE. AND THAT FAILS…
      “There is also the contention that RCT’s are not suitable/have not been suitably designed to measure efficacy of individualised homeopathy.”
      THAT IS NOT A SERIOUS CONTENTION AT ALL. IT MERELY IS A PLEA FOR DOUBLE STANDARDS BY THOSE WHO NEED THEM IN ORDER FOR THEIR THERAPY NO TO BE DISCLOSED AS RUBBISH.

      • ‘Best available evidence’, in whose opinion Dr Ernst? I prefer the view of different sets of evidence.

        Let us see what Dr Rawlins reply is, shall we?

        • not a question of opinion; there are generally accepted criteria here

        • Greggyboy, we don’t care about your opinion. We have established that you do not have the competency to assess the validity of homeopathic studies. It is as simple as that.

        • Best available evidence according to the Swiss, British and Australian governments, the BMA, the Chief Medical Officer, the Chief Scientific Adviser, the National Institute for Clinical Excellence, the Royal Pharmaceutical Society – in fact pretty much every relevant body that has expressed an opinion other than those with a vested interest in SCAM.

    • What is “Greg” still doing here?
      We have long since confirmed that the fool is a mere troll with nothing to contribute to this blog and this situation has in no way improved.
      Its knowledge of its pet subject of homeopathy is negligible as demonstrated by its total inability to answer simple, pertinent questions. I cannot recall having seen one comment that indicated insight or understanding, even on a homeopath-level.
      It carries on about irrelevant issues usually based on its own misunderstanding and rants grandiosely about ad hominem attacks as if it were possible to ‘personally’ insult an non-credentialed, incognito internet troll.
      “Greg” keeps asking silly questions that have already been answered here ‘ad nauseam’ but never responds when asked, this is one of the hallmarks of internet trolls.
      Like this for example:

      Is homeopathy placebo and therefore bogus medicine?

      “Greg” brags about having read through 4 years worth of blog posts here on this blog but still did not manage to learn nything from it, least of all the plain and simple answer to its badly formulated query:
      No, Homeopathy is not ‘placebo’, it is a two centuries old failed attempt at making up a substitute for medieval sorcery that constituded “medicine” at that time. Its continued use under the pretense of medical services not only constitutes bogus medicine , it is plain and simple fraud!. Its purported effects may be called placebo effects as they can always be explained by other factors than the administration of pure (shaken) water or sugar pills.

      I will try to ignore this pestilent nuisance and I suggest others do the same.

    • Greg: No.
      Use of placebos is not ‘bogus medicine’.
      Medical ethics require that patients are fully informed of the nature of any treatment, medicine, remedy proposed – in order that they can make informed choices.
      Placebos have been shown to assist patients ‘feel better’ even when their nature has been declared.
      In some circumstances, that might be good medicine – however, as the effects are temporary, many doctors are very wary of using placebos and avoid their use.
      Context is all.

      • Dr Rawlins
        If use of placebos is not ‘bogus medicine’ then what is the justification for your statement:

        ‘Homeopaths are ignorant, corrupt, charlatans, frauds, quacks, criminals.’
        What evidence is there that they are not?’

        Thank you for providing clarification on the points discussed; this is the final and key point remaining.

        • Anonymous Greg, if you find it easier, let me rephrase my question without putting it as a statement (which was my initial stylistic preference):

          “What evidence is there that homeopaths are not ignorant (of scientific methodology); corrupt (associated with companies selling remedies of no proven value); charlatans (shouting out and promoting the benefits of their practices and pillules); frauds (obtaining money by false pretences), quacks, (professing knowledge of medical practices of which they have no proper understanding); criminals (acting contrary to the laws of the land in which they reside)?”

          • Dr Rawlins: what evidence do you have that homeopaths are 1.ignorant, 2.corrupt, 3.charlatans, 4.frauds, 5.quacks. 6. criminals.

            Please would you provide this evidence so that these people can be brought to justice, if you have concrete evidence of homeopaths that have committed offences then the law would expect you to report these offenses.

            2, 4, and 6 must be reported.

            Thank you.

          • You are wrong, of course. Many fraudulent claims are never reported. Others are handled outside the criminal justice system, including ASA rulings on misleading adverts.

          • Please read the question I posed:
            “What evidence is there that homeopaths are not ignorant (of scientific methodology); corrupt (associated with companies selling remedies of no proven value); charlatans (shouting out and promoting the benefits of their practices and pillules); frauds (obtaining money by false pretences), quacks, (professing knowledge of medical practices of which they have no proper understanding); criminals (acting contrary to the laws of the land in which they reside)?”

            The question has to be put that way because, when faced with implausible claims, it is for the proposer to justify claims – and the probability is that the practitioners fall into the categories I have described, rather than that of discoverers of a system of medicine which would require the abandonment of known scientific principles.
            That’s how science works.

  • …those who support freedom of choice.

    Really? Surely not that tired old canard again?

    Freedom of choice needs to be informed. It is frequently the case that the touts of pseudomedicine seem to go to enormous lengths to try to ensure that their marks are uninformed (or, in some cases, misinformed). There is also the question of who pays for individuals’ “freedom of choice”. If I decided that it was my freedom to choose a daily 100ml dose of Laphroaig Quarter-Cask because I believed it “worked for me” in warding off illness, would you support the notion that the NHS should provide that choice?

    There are other consequences: the “(pseudo)medical freedom of choice”-induced demise of the Amur tiger and poaching of rhinoceroses for their horns are both well known and well documented, but this is merely the tip of another iceberg. According to the Smithsonian, other animals that are endangered because their body-parts are used in pseudomedicine include water buffalo, the Chinese alligator, the Asian elephant, musk deer, the sun bear, Grevy’s zebra, wild banteng, and the hawksbill sea turtle.

    But, hey, so what? They must be sacrificed on the altar of “freedom of choice” in pseudomedicine.

    • Why restrict this to medicine? Why shouldn’t people have the freedom of choice to invest in pyramid schemes and Ponzi games if they believe in them?

      Why shouldn’t there be a charity to promote such schemes? It could highlight the marvellous rates of return they offer, and point out that many of Charles Ponzi’s investors were so satisfied with the results that they continued asking him to invest their money, and even sending him Christmas cards, while he was imprisoned as a result of his products being suppressed by Big Banka.

  • No I wouldn’t support Laphroaig on the NHS and I dont see the logic in connecting this with homeopathy on the NHS which does not involve overdosing patients with alcohol. Personally I am not bothered whether or not there is any homeopathy on the NHS. Those who want it can pay for it as far as I am concerned.
    Homeopathic charities do not take money from the NHS or taxpayer. They are supported by those into homeopathy.
    Neither do homeopathic beliefs impact on the demise of endangered animals. Irrational logic.
    No ones freedom of choice has to be informed with any evidence base when it comes to beliefs.
    If you dont want homeopathy in society you have to show that homeopathy is a danger to public health and that it is not in the public interest to allow it.
    You have no evidence to support this.
    Therefore as long as there is any tolerance in society you will meet resistance and fail.

  • NHS prescriptions Edzard have indeed fallen 95%. That is due to funding cuts and does not reflect popularity of Homeopathy and has nothing to do with this CC consultation.
    The CC is doing this consultation because they have been threatened with legal action by Lawyers paid for by the GTS and it is the cheapest option. Why don’t you ask them? The consultation is not as a result of any pressure from medical professionals, politicians or yourself. Well am I right?

    • “That is due to funding cuts…” and these cuts are due to rational voices finally being listened to.
      The CC is doing this consultation because they finally see that they have to listen to these voices – lawyers or no lawyers.
      …and no, you are not right.

    • IsleofSkye said:

      NHS prescriptions Edzard have indeed fallen 95%. That is due to funding cuts and does not reflect popularity of Homeopathy

      Oh? Why do you say that?

  • IsleofSkye actually brings up a good point I have wondered about for a while, but never wanted to derail any thread by asking. Since it seems to fits here, I’ll go ahead.

    Some of the most fervent support for homeopathy seems to come from India. I am aware that India has brilliant minds in science, working in all areas of medicine, research and healthcare. In fact the couple of generic prescriptions I take occasionally are made by a lab in India.

    So here’s the question: are any of the many legitimate, educated and rational scientists, doctors, researchers, etc. in India embarrassed by the prevalence and support of homeopathy in their own country? Do they ever speak out publicly, warm the public or condemn the sugar pills, or is it deemed too politically incorrect and culturally unacceptable to criticize homeopathy and risk offending so many people who believe in it?

    A second question that’s been rattling around in my brain: why is there no homeopathic birth control? What do homeopaths recommend/sell/use themselves if they don’t want to or can’t use a physical barrier method like a condom or IUD?

  • I wouldnt underestimate the threat of legal action Edzard on the poorly resourced CC.
    NHS prescriptions have fallen by 95% in 20 years due to funding cuts. How though can this be quantified to determine any fall in popularity of homeopathy.
    There have been funding cuts in lots of treatments like varicose vein surgery but this does not mean that there is a decline in the popularity of this surgery with patients.

    • As someone who has actually done varicose vein surgery, I must advise that few patients want it!
      There are much better methods now available, with surgery only being a last resort.
      Ask your doctor!

  • It seems that things have come ‘Full Circle’

    George on Saturday 07 September 2013 at 03:51
    Dr. Ernst….

    As an introduction — it is very easy to argue against a method, if you have decided that it is just placebo. Since Homeopathy is a placebo then all your arguments sound rational.

    Other researchers equally notable to you — pointing out their own work state that homeopathy is not an expensive placebo
    These are some examples
    http://www.ncbi.nlm.nih.gov/pubmed/12634583 , http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2967878-6/fulltext

    Are these researchers delusional and you are correct? Maybe, all their measurements are wrong and biased..who knows?

    Besides that :Your argument against the saying that “The saying assumes that the sole reason for the clinical outcome is the treatment. ” should also apply to the mainstream medicine. Following your mode of thinking there is no way to accumulate enough evidence to show that a medication really works since the therapeutic effect might be due to other reasons as you said– even if there are controlled studies—– all the effects you described would be a crucial factor.

    Now, regarding the anecdotal evidence is BY DEFINITION weaker than a control study but it has a value -especially if it attracts as large number of people who claim they feel better. All the mainstream doctors who prescribe different medications to patients are aware of that ; and we know what the pharmaceutical companies say about their products : that they work ONLY for 45 percent of the patients – even if they have obtained a license based on placebo control studies.

    Therefore – even a placebo control trial or better a meta analysis of the trials is theoretically preferable – the anecdotal evidence might be also valuable \
    ——Example :recent studies found that anti-depressants are not more effective than exercise or other approaches – almost a placebo. If placebo control trials were the golden standard then the patients should gradually stop taking them. But doctors publicly warned their patients that they should NOT stop taking their medication— based on their experience that they ….work.

    End of quote

    Is it any wonder that George (did you uncover who ‘he’ was?) gave up on Edzard Ernst?

    With the firing of FBI Director James Comey, perhaps Edzard and Bjorn will be too busy tracking the story that Edzard is tracking about Russian Influence in the United States Government/Presidential Elections to comment on this site for a while?

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