MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Some doctors use homeopathy, and for proponents of homeopathy this has always been a strong argument for its effectiveness. They claim that someone who has studied medicine would not employ a therapy that does not work. I have long felt that this view is erroneous.

This article goes some way in finding out who is right. It was aimed at describing the use of homeopathy by physicians working in outpatient care, factors associated with prescribing homeopathy, and the therapeutic intentions and attitudes involved.

All physicians working in outpatient care in the Swiss Canton of Zurich in the year 2015 (n = 4072) were approached. Outcomes of the survey were:

  • association of prescribing homeopathy with medical specialties;
  • intentions behind prescriptions;
  • level of agreement with specific attitudes;
  • views towards homeopathy including explanatory models,
  • rating of homeopathy’s evidence base,
  • the endorsement of indications,
  • reimbursement of homeopathic treatment by statutory health insurance providers.

The participation rate was 38%, mean age 54 years, 61% male, and 40% specialised in general internal medicine. Homeopathy was prescribed at least once a year by 23% of the respondents. Medical specialisations associated with prescribing homeopathy were: no medical specialisation (OR 3.9; 95% CI 1.7-9.0), specialisation in paediatrics (OR 3.8 95% CI 1.8-8.0) and gynaecology/obstetrics (OR 3.1 95% CI 1.5-6.7).

Among prescribers, only 50% clearly intended to induce specific homeopathic effects, only 27% strongly adhered to homeopathic prescription doctrines, and only 23% thought there was scientific evidence to prove homeopathy’s effectiveness. Seeing homeopathy as a way to induce placebo effects had the strongest endorsement among prescribers and non-prescribers of homeopathy (63% and 74% endorsement respectively). Reimbursement of homeopathic remedies by statutory health insurance was rejected by 61% of all respondents

The authors concluded that medical specialties use homeopathy with significantly varying frequency and only half of the prescribers clearly intend to achieve specific effects. Moreover, the majority of prescribers acknowledge that effectiveness is unproven and give little importance to traditional principles behind homeopathy. Medical specialties and associated patient demands but also physicians’ openness towards placebo interventions may play a role in homeopathy prescriptions. Education should therefore address not only the evidence base of homeopathy, but also ethical dilemmas with placebo interventions.

These data suggest than many doctors use homeopathy as a placebo. And this is what I had always suspected. Certainly I did often employ it in this way when I still worked as a clinician. The logic of doing so is quite simple: there are many patients where, after running all necessary tests, you conclude that there is nothing wrong with them. You try your best to get the message across but it is not accepted by the patient who clearly wants to have a prescription for something. In the end, due to time pressure etc., you give up and prescribe a homeopathic remedy hoping that the placebo effect, regression towards the mean and the natural history of the condition will do the trick.

And often they do!

I do know that this is hardly good medicine and arguably even not entirely ethical, but it is the reality. If I found myself in the same situation again, I am not sure that I would not do something similar.

56 Responses to Many physicians using homeopathy employ it as a placebo

  • @ Professor Ernst

    Does your conclusion mean that you are slowly changing your mind since writing this?
    http://web.archive DOT org/web/20100103080345/http://www.arc.org.uk/news/arthritistoday/131_1.asp

    I know you’d like to have an institute of placebo research https://www.theguardian.com/science/2003/sep/25/scienceinterviews.health

  • In an article for USA Today, Roger McNamee wrote: “Facebook, Google and others exploit human nature, creating addictive behaviours that compel consumers to check for new messages, respond to notifications and seek validation from technologies whose only goal is to generate profits….Like gambling, nicotine, alcohol or heroin, Facebook and Google . . . produce short-term happiness with serious negative consequences in the long term. Users fail to recognise the warning signs of addiction.”

    Tristan Harris, 33, a former “design ethicist” at Google who studied behavioural psychology, has said tech companies use the same tactics as the gambling industry. Facebook, Instagram and Tinder give “intermittent rewards”, meaning that every time users open them there is a chance they will get a “like”, a message or a date — and a chance they will not.

    Could this be how homeopathic remedies work – by the experience of taking one providing a ‘hit’ of dopamine which is pleasurable – and addictive?
    It’s the experience which patients crave, not the actual physical remedy – which of course has no effect.

    Just as drug addicts are impervious to rational arguments against their habit, so patients craving homeopathic remedies are addicted, and need to be treated as such if they are to be weaned from their beliefs. Appeals to their wisdom will not work. They crave consolation, and orthodox doctors generally do not provide satisfaction.

    Placebos ‘work’, though IMHO it is unethical to use them without telling the patient that is the modus operandi of the treatment proposed.
    Have no fear, in many cases it’ll still ‘work’ (be reported by the patient as being of benefit).

  • This is absolutely brilliant and something I can well understand of why reputable Physicians prescribe homeopathic remedies. In my early days as a Physician we had different coloured ‘simple’ Linctuses for a variety of conditions. I always reminded myself to emphasise the effectiveness when writing by hand the prescription.

  • Yeah, the Dr. could have a supply of neutral pills and say ‘here, try these placebos, scientifically, they should have no effect, but many people feel relief after taking them.’ or something like that.

  • For me, this post beautifully answers my comment in the previous post, Aromatherapy: an ‘efficient’ therapy.

    Standing applause.

  • Prescribing a placebo violates the principle of informed consent. I’m assuming here that the doctor doesn’t tell the patient that the placebo is a placebo. In that case the doctor is lying to the patient, either explicitly (if they make a claim of efficacy) or by omission. Giving a patient water and telling them it is a drug is malpractice.

  • It is very hard to forge a bulletproof vest of relative indifference to modern facilities and the massive flow of information. One of the easiest and most accessible types of experience in today’s world is to have one’s beliefs reinforced, no matter how cranky… It takes a fair bit of education to develop resistance against irrationality, and another fair bit of education to develop resistance against peer and social pressure, e.g. to “fit in” somewhere.

    Belief systems are practically subtypes of addiction alright, so it is natural to expect withdrawal symptoms when shedding the light of logic. Take homeopathy believers as patient models for example… Placebo in this context is not a beneficial form of treatment because if one considers the entire timeline, the diffuse nonspecific effects are countered by the earlier immersion of the patient’s brain into a dark-age sanctuary in total isolation from critical thought. Sacrificing rationality for life, in return for a long-term subscription to random and spurious nonspecific, marginally beneficial effects is not a good deal to have made at any point in one’s life!

    So, the placebo effect in “true believers” must be measured in a correct context and from a more inclusive perspective. The benefits they get were paid for, quite expensively I must say, when they meticulously delved into the addiction, usually guided by others who, by perpetuating the nonsense, unavoidably assume full responsibility for degrading the believers’ quality of life in the very long run. True believers will be henceforth deprived of correct or reasonable decisions in many areas of life, especially healthcare, in the near or distant future, because they denounced rationality themselves, without even a warning of doing so. Homeopathy is such an addiction and it wouldn’t be so much of one if not for doctors who keep feeding it in the so highly respected doctor-patient context and setting. When homeopathy “junkies” go to doctors, it is of utter importance to not buy into their game, not even for easy money.

    In simple words, oftentimes, the placebo effect is a created need, a deep hole intentionally dug into one’s personality, to be filled very slowly in extremely small pulses, such is the nature of nonspecific effects, in return for money (such is the nature of addictions). And just to be clear, the hole is usually much larger than can be filled by placebo effects in one lifetime. To test for true addiction, inform the patients that this is just a placebo. If the effects are still elicited, it is almost definitive, they are either true believers, or true liars.

    As for non-true-believers, warning a patient that a prescription is only a placebo is ok as long as the placebo is not accompanied by a stupid elaborate cover story the patient might fall for, such as homeopathy. If it can simply be a sugar pill, all the better for the sugar industry:
    Dear patient, this is a sugar pill. If you take one before lunch and one before dinner, you may feel a bit better. If you take one before you sleep, you may sleep better. It doesn’t do anything special, but there are people that feel better after taking it. Or you can have a beer… Almost everybody feels better after a beer… Unless you mustn’t drink of course. Then you can have sex. Or a cup of tea, unless you are prone to nephrolithiasis… Then you can simply drink a cup of water. Or you can call me for compassion and some empathy.

    Now, why hide such a simple interaction behind a scenario as complex and self-interwoven as homeopathy? This directly puts the patient at the risk of buying into hocus pocus. Next thing you know, the patient starts visiting homeopaths et voila! A crank is born! It is a sad story and maybe a bit exaggerated in terms of chances and proclivity, but such is the nature of worst-case scenarios!

  • Dr Rawlins continues to wax lyrical about ‘informed consent’, and James seems to have once again fallen off his perch into the abyss.

    Dr Rawlins, why is it that this issue has to be discussed over and over again with you pretending that ‘informed consent’ is delivered to patients receiving medical treatment via a LEAFLET? Dr Rawlins, the infantile, demented, psychotic, elderly, uneducated, uninterested, naive trusting patients, and all the others… do they read and understand what is in the leaflets? There is an upper percentile of patients who drill their doctors for exact details of the proposed treatment and do their own research before going ahead or declining treatment but if you take your head out of the sand just this once: what is your estimate of the percentage of cases seen by doctors in general, or in your previous medical practice, that INFORMED consent was obtained prior to commencement of therapy?

    Read the article:https://smw.ch/article/doi/smw.2017.14505
    ‘All physicians working in outpatient care in the Swiss Canton of Zurich in the year 2015 (n = 4072) were approached.’
    ‘The participation rate was 38%, mean age 54 years, 61% male, and 40% specialised in general internal medicine.’

    James and Dr Rawlins: why would medical physicians prescribe homeopathy in the first place when they have have EVIDENCE BASED MEDICINE at their fingertips to dispense?

    In response to Dr Ernst’s conclusion: as a believer in the therapeutic effects of homeopathy, I would never prescribe plain sugar pills (sac lac) as the old school did.

    • Greg said:

      Dr Rawlins, the infantile, demented, psychotic, elderly, uneducated, uninterested, naive trusting patients, and all the others…

      Awww, bless. Is that your professional diagnosis?

  • Thank you Greg, but I am not clear why you are shouting ‘leaflet’. Consent forms are usually referred to as such.
    Consent can be obtained verbally, but if the practitioner were to be challenged (e.g. if complications arose), it is best to have written evidence. Invariably required for surgical interventions – so the answer is 100% – or certainly should be.

    No consent is perfect – but is the best we can do. Homeopaths don’t even get to first base, and assume their patients have consented. They do not check that their patients understand that the consensus of orthodox medical and scientific opinion is that homeopathic remedies are placebos.

    I do not know what the motivation is for registered practitioners to practise homeopathy. They might obtain vicarious thrills from the sense of power over gullible patients, they might be charlatans, or frauds. How do we know? Do you?

    • Richard Rawlins on Wednesday 13 September 2017 at 17:24
      Greg (who ever you are),
      Your numerated points are of course red herrings and can be ignored.

      Thank you for answering the question posed.

      With respect to the prescription of the drugs which GP’s prescribe :
      All come with detailed data sheets covering indications, doses, side effects etc.

      I should have thought my ‘issue’ was obvious:
      To ensure (in so far as is possible) that vulnerable and gullible patients are not taken advantage of.
      Do you heve an ‘issue’ with that?

      Richard Rawlins on Thursday 14 September 2017 at 12:56
      Please stick to the point.
      IMHO (and in due course I hope the GMC will agree) – doctors who want to prescribe HP preparations should tell patients what the consensus of scientific and medical opinion is, and why. Using a data sheet if they wish.
      But to prescribe HP products without properly informing patients is, IMHO, unethical.

      That’s it!

      Re Greg and informed consent:
      How doctors inform patients is up to them (as long as the GMC is happy that they do so).
      If data sheets are OK for pharmaceutical products, that’ll be fine for HP products.

      Has anyone got an example of a data sheet for a homeopathically prepared product?

      Richard Rawlins on Friday 15 September 2017 at 07:16
      Please do not be silly (is there a ‘remedy’ for that?).
      I have never suggested I ‘speak on behalf of patients’, homeopathic or otherwise.
      I am asking a question about how all patients are treated and cared for.
      I am not sure what a ‘homeopathic patient’ is and will resist attempts at satire.

      As for the ‘sides’ in this debate – are you (or anyone else posting here) seriously suggesting that patients should not be properly informed about treatements that are proposed?

      I have already indicated I will keep this blog informed about progress with the GMC.
      You could help.
      Did you, JK, ever received a data/information sheet from your homeopath informing you of the consensus of scientific and medical opinion about the HPP they were recommending?
      Thank you.

      Richard Rawlins on Wednesday 20 September 2017 at 08:38
      The reference to the GMC will include:
      “There is no evidence that registered medical practitioners who practice homeopathy comply with GMC guidance and provide patients with the information they will need to decide whether or not to accept recommendations to take homeopathically prepared products. Specifically, patients are not told (either verbally or by data sheet), that the consensus of conventional medical and scientific opinion is that such products are placebos, and have no ailment specific effect. Attempts have been made to identify relevant information/data sheets, to no avail.”

      OK?

      Please correct me if I am wrong.

      end of quotes

  • I understand that anything beyond a couple of sentences or paragraphs seems like an abyss to Greg. The answer you want Greg, that doctors prescribe homeopathy because it works, is not one you are going to get, of course. That half of them believe it works means that medicine is probably not their sport. However, maybe they want more money and more addicted clients.

    Consent forms are a must of course! There is no “leaflet”. Patients that go to the doctors to challenge their knowledge had better be prepared as to whose knowledge they are challenging. Is it the doctor’s, or is it the entire orthodox medical community’s? Then, they can do their own research and decline the treatment in favor of whichever unsupported nonsense they like.

    When you have patients addicted to homeopathy, however, it is well known that they don’t understand how homeopathy works but want it anyway, so they should still sign a consent form and get whatever they imagine they are getting. Or they should be sent to homeopathy addiction rehab… (primary school, that is…)

    • James: ‘when you have patients addicted to homeopathy’, goodness me. Do you not have patients in psychiatry addicted and totally controlled by their medications?

      There are many forms of addiction: drugs, alcohol, tobacco, gambling, sex, fitness fanatics, workaholics. A physician that exploits the addictions that their patients have are unethical, perhaps criminal, and should not be in practice.

      Now, please James, I would be take you more seriously if you did not ramble on so much.

      • No! Patients in psychiatry are typically not addicted to their medications. They are told to take them to keep their disorder under control and, quite often, they forget or don’t, which is why, also often, they have flares of aggravation. Homeopathy addicts mever forget to take their pills, actually, they often ignore more knowledgeable suggestions because they are brainwashed into believing medicine is a conspiracy to kill people, or stuff. They are constantly seeking their homeopathic products and care, no matter what.

        Physicians that keep prescribing homeopathic products with no effect to either please their patients or make money, or both, are also included in your list of potentially criminal behavior, though you missed the mention…

        And… No! Having patients addicted to any medication, drugs or anything is irrelevant in a discussion about homeopathy prescription prevalence and the consequent wrongdoing.

        • James, your comment makes more sense in this order:
          ‘Having patients addicted to any medication, drugs or anything is irrelevant in a discussion about homeopathy prescription prevalence and the consequent wrongdoing.’ ‘Patients in psychiatry are typically not addicted to their medications. They are told to take them to keep their disorder under control and, quite often, they forget or don’t, which is why, also often, they have flares of aggravation.’ So I understand why you would not want to have a discussion about psychiatry on an open forum such as this site. You and Dr Rawlins (Dr Rawlins’ GMC post was factually vacuous) rely mostly on your own authority, and philosophical speculation to attempt to persuade people to your view.

          Your statement regarding patients use of psychiatric medication is interesting to say the least:
          https://www.thefix.com/content/what-psychiatric-medication-addiction

          In regard to your statement on homeopathic patient’s addiction to homeopathic medicine:
          Homeopathy addicts mever forget to take their pills…

          There are > 100 million homeopathy users on the planet: do you have scientific data available to support your view regarding homeopathic patients use of of homeopathic medication or this your statement just another one of your philosophical speculations?

          • Greg said:

            There are > 100 million homeopathy users on the planet:

            That leaves about 7,500 million of the total of 7,600 million who are not users. What point were you trying to make?

          • Ummm, I see you have a thing for double standards. The most robust scientific evidence, taken as a whole and accounting for quality, show that homeopathy doesn’t have any specific effect. Yet you keep believing in it, based on numerous convenient anecdotes, which are the only positive clues available.

            If you are basing your belief in homeopathy on anecdotes, I really don’t see why it is a problem for you to believe my anecdotally based account that homeopathy lovers are really “in love” with their potions, and most will seek them and trust them no matter what any orthodox doctor of medicine may tell them.

            I don’t speculate that much, which should be made clear to you if you take into account the fact that the average occasional homeopathy user commenting in this blog always has something to say about avoiding medicine because it kills people etc. They trust their homeopathy thing far too much, unfortunately.

            Now, about that own authority thing, I can only say this is way beyond wrong as a comment. If you disagree with something, just say so and we’ll talk about that… Come to think of authorities, however, that homeopathy thing we were talking about…hmmm…

  • Humankind cannot bear too much reality.

    “I am very sorry to tell you that there is nothing that I can do to help you. Bear up to this truth.

    Or put your faith in something or other. Try these “pills”. Some people swear by them though there is nothing in them that could possibly be of the slightest benefit.”

    “Thank you doctor, I’ll try them.”

    So long as patients pay for placebos, fair enough, and crazy enough.

  • Greg comments:
    There are > 100 million homeopathy users on the planet: do you have scientific data available to support your view regarding homeopathic patients use of of homeopathic medication or this your statement just another one of your philosophical speculations?

    Alan Henness comments:
    That leaves about 7,500 million of the total of 7,600 million who are not users. What point were you trying to make?

    He fancies himself as an alternative medicine critic but, it seems, he can barely read.

    How awful about Alan.

    Good grief.

  • Many physicians using Paracetemol employ it as a placebo

    http://www.bmj.com/content/350/bmj.h1225

    “Conclusions Paracetemol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetemol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.”

    Prof. Ernst, considering that paracetemol for low back pain is no better than a placebo, and homeopathy is employed as a placebo, at least the side effects of homeopathy are negligible by comparison.
    Then one has to consider the ethics of prescribing a drug that can and does have significant toxic effects on the body, especially the liver.
    It is the most widely prescribed drug in New Zealand and is advertised as a treatment for back pain

    https://www.panadol.co.nz/?gclid=CjwKCAiAxarQBRAmEiwA6YcGKHvMY3HSH7jedDXqNch9GbA8QoDCIk0XnvBF6o5SAxaBef3YOt8FJxoC5OUQAvD_BwE

    perhaps you can comment on the ethics of this?

    Finally, if paracetemol does not work for back pain, then it will not work for any other pain of a biomechanical dysfunctional aetiology e.g. neck, elbow, hip etc. pain.
    Perhaps it would also be wise for you to comment on this anomaly?

    • Gibley: ‘Professor’ Ernst has stated that this blog focuses exclusively on ‘alternative medicine’. The reason that this is stated is so that critical examination of conventional medicine can be sidetracked using ‘logical defenses’ with tu quoque frequently cited.

      This is one of the most funny things about reading this blog, is that those that cite tu quoque (see James above using this defense against my comment in order not to get into a dirty discussion about psychiatry) seriously seem to believe that they are on the right side of the debate.

      Your comment is so good that it deserves a proper response from Dr. Ernst but I would not bet on that happening.

      • “Professor’ Ernst has stated that this blog focuses exclusively on ‘alternative medicine’. The reason that this is stated is so that critical examination of conventional medicine can be sidetracked using ‘logical defenses’ with tu quoque frequently cited.”
        NO, THE REASON IS THAT THIS IS WHERE MY EXPERTISE IS.

      • Dear Greg, what exactly are you expecting as a proper response? It is extremely clear that paracetamol is, in all likelihood, no better than placebo when used for low back pain, especially acute. Due to a relatively moderate risk of side effects, the risks typically do not outweigh the benefits, so it would be wiser to avoid prescribing paracetamol for low back pain, at least for middle-aged individuals. The “ethics” part is also quite simple and concise. Doctors should tell patients with low back pain that paracetamol probably won’t soothe their pain significantly, as per the most up-to-date evidence, and may also have side effects, especially in long-term use. As the relevant Cochrane Review states:

        About one in five people reported side effects, though few were serious, and there was no difference between intervention and control groups.

        Hopefully, we are done with that.

        Now, Greg, you really have a way of imagining things, such as logical defenses and stuff, where there simply aren’t any. The most funny thing about reading this blog at the moment is that you are using a tu quoque to say that psychiatry patients can also (latin: “quoque”) be considered as addicted to medications. Afterwards, neglecting the fact that you are using psychiatry as a bait to change the subject (unknowingly, maybe?), you go on to say that I use logical defenses to avoid talking about psychiatry, when, in fact, I never said anything about psychiatry in the first place.

        Now, let me put it in simple words for you…
        Greg says:

        James: ‘when you have patients addicted to homeopathy’, goodness me. Do you not have patients in psychiatry addicted and totally controlled by their medications?

        Can you see the “tu quoque” in that?

        The not-so-funny thing about the blog is that you write in pulses of meaning, with small sentences and highlighting and mentioning only what suits you from what others say to you. Your small replies, with small sentences and chopped off bits and pieces of diffuse meanings are quick-and-easy to read for the average reader, whereas the lengthier responses needed to explain your irrational line of argumentation are usually more boring to go through. The actual trouble is that any random reader checking on any excerpt of your verbal-volleyball interactions will subconsciously keep in mind your responses more than what others say to you. Proponents of alternative medicine in general, or homeopathy in particular (you know, the guys on your side of the debate) may find ample relief on their quests for self-righteous verification.

        Done with that too, hopefully.

        Now, your “tu quoque” abuse aside, let’s do something constructive for once; some team exercise.
        Gibley, Greg, repeat after me:
        Paracetamol being no better than placebo for acute (and possibly chronic) low back pain in middle-aged individuals does not mean homeopathy works.

        • No James, IT DOES NOT MEAN THAT HOMEOPATHY WORKS.

          It means that paracetamol is also dispensed as placebo, as are antibiotics and other medicines. Give the patients some drug and get them out the office.

          For a short while, I thought perhaps you may be Professor James Alcock but you demonstrated that you can’t possibly be a professor of psychiatry: you are too thick to be that.

          • Sure, you can create your world as you wish, Greg. I have taken the trouble of providing reasonable responses to you all too much. This wish of yours…not granted. I am sure you can have very interesting conversations about psychiatry, however, at a psychiatrist’s practice. There are plenty around.

            Let me remind fellows you and Gibley, that paracetamol is by definition not a placebo, because a placebo has by definition no side effects. Paracetamol is not employed as a placebo because it is not one. Gibley is comparing the two and suggests to use the one without side-effects, whereas this one also comes along with no effects at all. Why visit the doctor in the first place then?

            Paracetamol works well for a wide range of conditions, I don’t see how its effectiveness in acute low back pain should lead to a conclusion that it doesn’t work for any other pain of biomechanical dysfunctional etiology. I can understand, however, that brainwashed homeopathy users start seeing everything as subscribing to the law of similars. If it doesn’t work for this, it doesn’t work for similars… Alas, you cannot jump to such a conclusion. There are, simply, too many confounding factors in each condition. That’s why people study medicine for so long. There are mechanisms involved.

        • …does not mean homeopathy works.

          Nor does it mean that paracetamol doesn’t work very effectively to provide relief from other forms of pain (e.g. headaches, post-operative pain, pain from injuries, dental pain). So it doesn’t become relegated to alternative medicine status, as Gibley-squared suggests below, any more than acyclovir is an alternative medicine because it acts only against herpesvirus infections.

          In fact, the paracetamol story told in this thread once again highlights the difference between real and pseudo-medicine when it comes to evidence. Research of quality shows paracetamol has no effect beyond placebo in low-back pain (in middle aged people) so it will cease to be prescribed in this indication as the message spreads. Compare that situation with most of the species of pseudo-medicine. They start with a notion pulled out of thin air by an individual. That notion becomes a gospel, surrounded by various scriptures faithfully written by believers, never mind how absurd the notion may be. The notion typically expands its scope but is never retracted for particular indications in the absence of supportive evidence.

          • Paracetamol works when used correctly.

          • And, in the end, followers can’t even remember how and why they believed it in the first place. Law of similars, brainwashing… and that’s about it. It’s like they were born with the “software” installed… Unbelievable…

    • As James has pointed out, whether or not paracetemol works has no bearing whatsoever on whether or not homeopathy works. If paracetemol were a poison cooked up by Big Pharma to keep people sick, it would have no bearing on whether or not homeopathy works. If crushing paracetemol and snorting it gave patients the ability to fly, it would have no bearing on whether or not homeopathy works.
      If you have evidence that homeopathy works, that would be relevant. Arguments that ‘x doesn’t work either’ are pure whataboutism (what James more properly calls a tu quoque logical fallacy). It’s a great tactic to sidetrack an argument when you have no evidence for your position.

  • Looks like the Nightingale Collaboration is on the verge of closing down:
    http://companydb.uk/07406649-the-nightingale-collaboration-limited#.WgvbYIWa_9I

    Admits no education in homeopathy, seems to have difficulty reading, but spends a lot of time critiquing homeopathy.

    That’s what I call a real homeopathic critic!

  • Dr Ernst, you are a qualified medical doctor so you do have the expertise to respond to Gibley if you wanted to BUT YOU CHOOSE NOT TOO. I understand why though.

  • Prof Ernst, you have often said that once something is proven, “medically and scientifically”, it then moves from the “alternative” to the conventional.
    What about something that has been considered, in the past, to be a legitimate treatment modality i.e. paracetemol. that science now has shown to be no better than an placebo.
    Paracetemol has now become an “alternative” simply because science has proven that it does not work.
    Thus as a new member of the CAM forms of treatment, you are quite entitled to comment on it. In fact, you should now be an expert on this new alternative, proven to be placebo, method of treatment for low back pain. Paracetemol.

    • Paracetamol is a legitimate treatment modality and not a placebo. Science has shown that it doesn’t have much of an effect for something. There are many other “somethings” for which it has an effect. So, if you rephrase your comment, maybe you’ll get an answer.

      But if you correctly rephrase your comment and it reflects reality and the truth, there will be no question left. So, come to think of that, better keep up the misconstruing and misrepresenting… It’s almost the only way to ask questions in here!

      • It is being advertised for the use in treatment of conditions that science has shown that it does not work. It is no better than a placebo, and a toxic, dangerous one at that,

        https://www.panadol.co.nz/?gclid=CjwKCAiAxarQBRAmEiwA6YcGKHvMY3HSH7jedDXqNch9GbA8QoDCIk0XnvBF6o5SAxaBef3YOt8FJxoC5OUQAvD_BwE

        Where is the ethics of that?

        James, tell me about the “something’s”, maybe Bjorn can help. As I said before, if it does not work for low back pain of a biomechanical aetiology, then it is not going to work for any other condition of a similar nature.
        So why is it being advertised for the use in such conditions.

        • One Cochrane review states:

          This review provides high quality evidence that a single dose of either IV paracetamol or IV propacetamol provides around four hours of effective analgesia for about 36% of patients with acute postoperative pain.

          • James

            “….around four hours of effective analgesia for about 36% of patients with acute postoperative pain.”

            And the long term effect on liver?

            Paracetamol is used mostly on children during fever. WHO has put out an advise:
            http://www.who.int/bulletin/volumes/81/5/Russell0503.pdf

            “Few prospective human studies have documented whether anti pyretics have any clinically relevant adverse effects. Some animal studies have shown that fever helps survival during infection, and that anti pyresis increases mortality.”
            For four hours of relief from fever, a child is sacrificed. Great medicine.

            http://www.dailymail.co.uk/health/article-148442/Killed-paracetamol.html
            http://pediatrics.aappublications.org/content/108/4/1020#xref-ref-3-1
            https://www.nps.org.au/australian-prescriber/articles/paracetamol-use-in-children
            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658515/

          • I cannot decide where to begin with your comment fellow Iqbal… However, I think the series of illusions flooding your head is beginning to unveil.

            -Fever helps survival… You don’t even seem to understand the reasons fever develops but…
            Anyway, you think to yourself… so we need to help the fever evolve.

            -Homeopathic potions or pills help the fever evolve… this is why you think the fever rises. Of course, homeopathic water does nothing, and fever would rise anyway.
            And if this is not enough of a grandiose delusion, you think we are all here to attack homeopathy… as if there is anything to attack. And you equate fever with acute postoperative pain. And stuff…

            Why are you so concerned about the long-term effect of paracetamol on the liver Iqbal? What makes you think a fever would last a month or more? After fever is gone, you think people keep taking paracetamol? To study the long-term effects on their liver, apparently…

            If you think you are saying something new, ask yourself first, who on earth would advise long-term use of any drug without considering risks and benefits.

            Apart from that, you are using extreme cases to represent an average-case scenario. I will let anyone having been involved in strategic planning for any type of operation and in any field, comment on how far from reality your design is. Every person taking a dose of paracetamol costs a child its life… Great! This time, you really surpassed your previous performance!

            What is next on your rationale fellow Iqbal? Ban kitchen knives because people may suffer acute bleeding from improper use? Does the knife industry participate in some conspiracy to reduce the world population?

  • Considering that Professor Odds and Dr Rawlins are the only two credible commenters on Dr Ernst’s side, what I would like to see is their response to James’ statements:

    1. Homeopathy addicts mever forget to take their pills

    What evidence is there that homeopathy patients ‘mever’ forget to take their pills?

    2. No! Patients in psychiatry are typically not addicted to their medications. They are told to take them to keep their disorder under control and, quite often, they forget or don’t, which is why, also often, they have flares of aggravation.

    • You know, m is next to n, mever means next to never, your analytical skills preclude you from identifying humor, or typos for that matter.

      You will not see a response because they don’t have any obligation to respond to self-professed unknowns talking just about anything they fancy they know, with no credentials for support. It is a risk (and a very real one) of wasting their useful time. I understand these implications but you don’t seem to, and you behave here as if you are pulling strings of puppets. As long as we are both unidentified objects, identified people in here won’t, and shouldn’t, really, give much weight to our statements.

      But I am here to remind them that, thankfully, not everyone of an unknown identity comes here to force-feed alternative excrement and wacky argumentations. So, while they can’t always be bothered by the ramblings of someone that is completely unknown, this doesn’t mean that unknowns can get away with it. Some other unknown may help keep a balance.

      • James, it is noteworthy that you have not addressed the substance of your statements.

        Now, do ‘homeopathy patients mever forget to take their pills?

        How would you know this?

        If you are able to answer this question then maybe we can go to point 2. I would not bet on that either.

        • they say that, when a patient forgets to take a homeopathic remedy, she will suffer from an over-dose.

        • The substance of this comment is also your own self-professed expertise dear Greg. What do you suggest to people when they use it? What do experts teach? Should people skip doses or stick religiously to the treatment? How many doses have you ever missed? You can ask around homeopathy users. This is going to be the closest to reliable evidence you can ever get with homeopaths. You see, the horrible truth is that trying to get honest responses from homeopaths to gather such a kind of evidence can even cost you your job.

          In short, I am not avoiding anything. There is no such thing as “scientific evidence” for an unscientific field, so your persistent requests are invalid all along. But if you really want an answer, you can go ask a mirror… how faithfully do you stick to any remedy regimen?

  • Poor Alan, can’t he see that I am just trying to make sure that more readers click on it?

    The facts speak for themselves.

    How awful about Alan.

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