Alternative medicine is riddled with a multitude of serious ethical problems. In our recent book, we made an attempt to look at them systematically and critically (I am not aware of anyone having done this before). Essentially, we arrive at the conclusion that, for many types of alternative medicine, it is not possible to practise them according to fundamental demands of healthcare.
Homeopathy is one of them. I recently had a look at the CODE OF ETHICS of the UK Society of Homeopaths (last updated 2015). There I almost instantly stumbled over perhaps the most significant hurdle of practising homeopathy ethically. Here is what the SoH demands of its members:
1) To ensure that the patient is always able to make informed choices with regard to their healthcare, registered and student clinical members must give full and clear information about their services when commencing homeopathic treatment. This will include written information about the nature of the treatment, charges, availability for advice, confidentiality and security of records.
2) To ensure that the patient or their authorised representative is able to give valid consent with regard to healthcare, registered and student clinical members must give clear and sufficient information about the nature of homeopathic treatment, its scope and its limitations, before treatment begins and as appropriate during treatment…
The SoH is absolutely correct, full, sufficient and clear information before commencing treatment and consent to that treatment are two preconditions for any type of healthcare. However, the SoH is a bit shy about explaining what ‘full information’ must entail. As I have mentioned before, full and sufficient information must include:
- the diagnosis,
- its natural history,
- the most effective treatment options available,
- the proposed therapy,
- its effectiveness,
- its risks,
- its cost,
- a rough treatment plan.
So, let’s imagine a patient who suffers from stomach pains consulting his homeopath. Following the above 8 points, here is what she would need to tell him:
- I don’t know what your diagnosis is; I am not medically trained.
- I therefore can tell you nothing about its natural history.
- And nothing about the most effective treatment for your condition.
- I nevertheless propose to treat you with a homeopathic remedy.
- There is no good evidence that it will work beyond a placebo effect.
- The remedy is harmless, but not giving you an effective treatment might, of course, cause considerable harm.
- The cost of the consultation is £80, and the remedy will cost you around £15.
- I suggest you come again in a week or two; perhaps we need quite a few consultations altogether.
After hearing this, almost any patient would get up, thank the homeopath for the full information and look for a clinician who is able to offer an effective therapy. In other words, the SoH is inhibiting its members from practising homeopathy (alright, they don’t spell it out in such clear terms, but that is what full and sufficient information amounts to).
Why do they do that?
Because they have to!
Not supplying full and sufficient information would simply be unethical. And unethical healthcare cannot be tolerated.