MD, PhD, MAE, FMedSci, FRCP, FRCPEd.

fallacy

People use unproven so-called alternative medicine (SCAM) even when evidence quite clearly indicates that the SCAM in question does not work.

Why?

Here are some of the factors that can play a role:

  1. The Placebo Effect Makes People Feel Better

SCAM “helps” even though it doesn’t work. The placebo effect is a real neurobiological phenomenon that can reduce pain, improve mood, decrease stress, and affect lots of other, mostly subjective endpoints. In some situations, placebos can be as effective as real treatments. This creates genuine subjective improvement that convinces many people the SCAM in question is effective.

  1. False Hope and the Need for Control

When conventional medicine offers little, people “grab at straws” because hope drives them. For seriously ill patients, suggesting unproven interventions can provide hope and a sense of control over their illness. The ritual involved in administering SCAM creates profound impact because people feel they’re getting the attention they crave.

  1. Confirmation Bias

People selectively gather evidence conforming to their beliefs, while neglecting contradictory evidence. If someone feels better after acupuncture, for instance, they attribute it to the treatment rather than natural recovery, placebo, the attention from the therapist, or simply the restful time spent on the treatment bench. Experience or stories from others bring helped by a treatment are not evidence, of course, but they can be very compelling.

  1. The “Expensive = Good” Heuristic

It feels reassuring to spend some money on one’s health. “If it’s expensive, it must be good!” Traveling abroad for exotic SCAMs creates hope through fundraising. And expectation boosts the placebo response.

  1. Anti-Science Beliefs Predict SCAM Use

Anti-science beliefs and conspiracy theories increase the willingness to take risks and try SCAM. People who are suspicious, untrusting, eccentric, and see the world as dangerous tend to see meaningful patterns where none exist. If you believe that Big Pharma is trying to kill you, you are likely to employ SCAM.

  1. Dissatisfaction with Conventional Medicine

It’s “frustrating and demoralising when medical therapies do not offer the benefits people need or expect”. When doctors can’t provide answers or effective treatments, people are likely to seek SCAM. Sadly, I have to admit that some conventional healthcare professionals can behave such that one simply cannot be surprised, if patients look elsewhere.

  1. Humans Are Wired to See Patterns

Humans evolved to quickly detect patterns and understand how events might be causally related. We seek explanations rather than seeing randomness, but this makes us prone to seeing connections where none exist. This cognitive vulnerability is why we mistake correlation for causation. We are easily fooled, and most easily by ourselves.

8. Misinformation

Over the years, I have come to realise that all of these factors – and many more – can play a role, but that none of them is as important as misinformation. SCAM has been in the limelight sice decades, and the public is bombarded with misleading information about SCAM. It comes from journaalists, book authors, influencers, marketeers, bloggers, social media, and many other sources. And it continuously brainwashes the public into believing that even the most deplorably useless SCAM is effective, safe, and supressed by the establishment. I sympathise with everyone who is being sent up the garden path in this way and thus may get deprived of his/her savings or – much worse – health.

 

Although so-called alternative medicine (SCAM) is widely used across the US population, population-level associations with mortality remain understudied. Therefore, this investigation examined associations between SCAM use patterns and all-cause mortality among US adults.
Data from the National Health Interview Survey (2007/2012, N=55,023) were linked to mortality through 2019 (5,530 deaths; 472,636.5 person-years). This analysis examined 21 specific SCAM modalities, SCAM usage intensity, recency of use, and theoretically and empirically derived domains using Cox proportional hazards models with hierarchical covariate adjustment, Benjamini-Hochberg false discovery rate correction, and exploratory subgroup analyses.
The results show that 43.2% of adults engaged in 1+ SCAM practice. After full adjustment and FDR correction, yoga (HR=0.73, 95% CI: 0.62-0.87) and Pilates (HR=0.64, 95% CI: 0.49-0.85) were associated with lower mortality. Each additional SCAM practice was associated with 6% lower mortality (HR=0.94, 95% CI: 0.92-0.96). Recent users had lower mortality than past-only users (HR=0.79 vs. 0.90), and multiple practice users showed the strongest association (HR=0.76, 95% CI: 0.68-0.86). Exploratory subgroup analyses revealed suggestive but largely non-robust patterns.
The authors concluded that most individual SCAM modalities showed null associations with mortality, but yoga and Pilates demonstrated inverse associations that persisted after adjustment and FDR correction, and broader measures of SCAM engagement consistently indicated lower mortality risk. Whether these associations reflect SCAM-specific benefits or general physical activity and health-conscious selection warrants further investigation.
This study might be used as a textbook example for an elementary lesson on: ‘CORRELAATION IS NOT CAUSATION’. It seems highly unlikely that any SCAM has sepcific effects on longevity. Any type of regular physical excercise might have an effect, but this would not be specific to yoga and pilates.
A likely explanation for some of the observed reults is that SCAM users are nore health concious. The authors of the paper are well aware of this confounder when they state that SCAM users “were younger, more educated, higher income, less likely to smoke, more physically active, and reported better self-rated health than non-users.”
My message to consumers: if you want to live a long life, forget about SCAM and adopt a healthy life-style.

This recent survey caught my attention; here is the abstract:

Homeopathy is one of the most widespread alternative methods of treatment in Bulgaria in the last 25-30 years. The aim of the research is to study and analyze the knowledge and attitudes of Bulgarians over the age of 18 regarding the application of homeopathy as a curative method in general medical practice. A cross-sectional survey among a sample of the general Bulgarian population was conducted during a 4-week period in April-May 2022. The data were collected using the Google Forms platform via an online questionnaire. A total of 508 completed responses were collected (women-450, men-58). The overwhelming number are familiar with homeopathy and have used it before for their own health problems (97% of women and 86% of men). A large number of those who have used homeopathy report an improvement in their health (88% of women and 74% of men). The majority of respondents believe that homeopathy is useful for health care (93% of women and 79% of men). Further representative studies are needed to determine the role of homeopathy as a complementary method in general medical practice.

So, the researchers collected 508 responses on Google Forms. This method does not allow calculating a response rate, i.e. a percentage of those who saw the questionnaire and decided to reply. It might well have been 1% or lower. Who can reasonably be assumed to have resopnded? My guess is that those with an interest in homeopathy did and those without it did not respond. Thus, we should not be surprised to see that 97% of women (~90% of the respondents were women) had used homeopathy, 88% reported improvements, 93% belilieve it to be useful for Health care. I have previously compared such SCAM surveys to someone studying our views about hamburgers by placing themselves outside McDonalds and interviewing customers about the subject.

What these figures do not tell us is that presumably ~90% of Bulgarians could not care less about homeopathy! Despite this rather obvious suspicion, the authors ignore the fatal flaw in their survey and state that “the prevailing opinion that homeopathy is beneficial to health care in general is noteworthy. In other studies it is found that patients expected their family physician to refer them to CAM, including homeopathy, to have updated knowledge about CAM, and to offer CAM treatment in the clinic based on appropriate training. It can be assumed that homeopathy could be part of an integrative approach in health care, given the increased number of people wishing to use it, as well as the large number of doctors who have completed a training course in homeopathy in Bulgaria.”

Of course, this would be trivial, if it were not rather typical for a large chunk of “research” getting published in the realm of so-called alternative medicine (SCAM). I did put research in ” “, because it is, in fact, not research as we know it. Too many SCAM “researchers” have settled for conducting pseudo-research, i.e. investigations, like the one above, which can only produce findings that favour SCAM in one way or another. As this sort of thing is happening a thousand times over every month, it gradually erodes science and creates a general (erroneous) feeling (not least on the political level) that SCAM must be good for our health, after all.

And why do SCAM researchers prefer pseudo-research to proper science?

In my view, the answer is clear: they have realised or feel instinctively that proper hypothesis-testing research would not generate the results they so ardently need in order to promote their creed/ideology/business.

As explained in my previous post, plausibility matters. The post was predominantly about biological plausibility – but things can be a little more complex, and it would be foolish to deny the fact that there are two kinds of plausibility; biological and clinical.

Biological plausibility concerns compatibility with established physiology, biochemistry, and pathology. It asks whether a credible pathway exists by which an assumed cause could produce an effect. And it takes into account current knowledge from biology and other natural sciences. Within the Bradford Hill framework, biological plausibility helps distinguish mere statistical associations from actual causes. For more details see my previous post.

Clinical plausibility, by contrast, is based on much softer criteria, such as clinical observation and real-world outcomes. Here, the core question is whether a claimed effect fits observed patient patterns, e.g.:

  • temporal relationships,
  • dose-response gradients,
  • reproducibility across cohorts,
  • alignment with known clinical phenotypes.

Supported by case series, observational studies, clinical trials, or epidemiological studies, an intervention can be clinically plausible long before its underlying biology is understood. This has historically been the case for many drugs; an apt example is aspirin which has been used clinically long before a biologically plausible mechanism was discovered..

The two forms of plausibility should be complementary. Ideally, a robust causal claim satisfies both mechanistic logic and clinical observation. Biological plausibility without clinical evidence remains speculative. Clinical plausibility without a known mechanism invites skepticism and further inquiry.

The deficit of biological plausibility is a major indictment of many forms of so-called alternative medicine (SCAM). They often offer no tenable mechanism and fail under rigorous testing. Conversely, demanding full mechanistic clarity before accepting consistent clinical data is likely to hinder progress in healthcare.

In relation to so-called alternative medicine (SCAM), the issue was summarised more than 20 years ago as follows:

In summary, the way to prove the efficacy of most CAM therapies is with well-designed RCTs, and there is no reason to believe that clinical trial designs cannot be developed that allow even complex CAM therapies to be evaluated. The procedures involved can be sophisticated, complex and expensive, however, and this confronts investigators with the challenge of identifying which of the myriad of existing and future CAM therapies merit the effort and expense of definitive RCT evaluation. The challenge should be met as it is in conventional drug discovery, through plausibility-building research. Whenever possible, efforts should be made to establish a credible mechanism of action for a candidate CAM therapy, because this will increase its biological plausibility and reduce the risk of false-negative RCT results. When biological plausibility is lacking, clinical plausibility alone must be the basis for determining whether or not to proceed to the costlier phase of definitive RCTs. The creation of a plausibility-building CAM research strategy will require thought, instruction, funding, and collaboration among conventional clinical investigators and CAM advocates. The advantages are many: fairness, low cost and the creation of rules of engagement for CAM evaluation that foster balanced partnerships between CAM advocates and mainstream clinical scientists.

Ultimately, in my view, not a dogmatic stance but a balanced integration of both biological and clinical plausibility should underpin rational decisions about which medical hypotheses to pursue, adopt, or discard.

Evidence‑based medicine (EBM) was developed to make clinical decisions more reliable by grounding them more solidly in good research. Thus, randomised clinical trials, systematic reviews, and meta-analysis became crucial for healthcare. That development brought undeniable progress, but it also created a problem: if we focus exclusively on such evidence, we might neglect an important question:

IS THE TREATMENT IN QUESTION BIOLOGICALLY PLAUSIBLE?

Put simply, EBM asks “Does it work in this study?” without first asking “Could it reasonably work at all?”

The neglect of biological plausibility can lead to wasted resources, misleading conclusions and, in some cases, the promotion of nonsense. The issue is, of course, particularly relevant in so-called alternative medicine (SCAM) known for its frequent lack of plausibility. A simple example might explain this more clearly: in homeopathy, we see an abundance of poor-quality studies with a positive result. This could easily lead to the overall impression that homeopathy works, while in fact it cannot reasonably work at all.

So, how can we reasonably take account of this complication? It turns out there are several options:

Option 1 Gatekeeping

One way to account for plausibility within EBM is to use it to decide what we test in the first place. Before launching an expensive clinical trial, we can ask for a clear explanation of how the proposed intervention might reasonably work. If no such rationale can be articulated without contradicting science, it is reasonable to conclude that the intervention lacks sufficient plausibility to justify the time, money and ethical burden involved in testing it on patients. In practice, this kind of gatekeeping often happens informally, but making it explicit and mandatory could help keep overtly implausible interventions from consuming scarce resources.

Option 2 Prior probability

Plausibility can also be integrated into how we interpret trial results. Some trialists treat a statistically significant result as an infallible signal that the therapy was effective. When a trial result is “statistically significant”, it means the data we observed would be unlikely if the treatment had no effect.  Prior probability is another way of expressing plausibility. If a hypothesis is highly plausible given existing scientific knowledge, a positive trial fits into a broader, coherent picture. If a hypothesis is highly implausible, a positive trial is more likely to be a false positive, an artefact of bias, chance, methodological flaws, or fraud. In other words, for low‑plausibility claims, we need stronger and more consistent evidence before accepting them as true. The less plausible a claim is, the more extraordinary the evidence must be.

Option 3 Guidelines

Guideline development offers another opportunity to embed plausibility into EBM. When expert panels prepare recommendations, they typically grade the strength of evidence according to study design, risk of bias, and consistency of results. They might also add a distinct step in which they rate the plausibility of the intervention. This rating could be justified explaining how well the intervention fits with established knowledge. Guideline writers could then let this plausibility rating influence the strength of their recommendations.

Health technology assessments have been moving in this direction for some time. It makes guideline documents more transparent: clinicians could see not only what the trials showed, but also how the intervention was judged to fit into or contradict broader scientific understanding.

Option 4 Causation

Finally, causation frameworks are being used to bring plausibility into EBM. When we decide whether an association is causal, we often rely on criteria such as consistency, temporality and strength of association. Biological plausibility is another of these criteria. Using it systematically means asking whether there is a logical pathway from intervention to outcome that passes through known mechanisms and observed effects. If such a pathway can be sketched in a way that accords with science, plausibility is high. If not, plausibility is low, and we should be more cautious about drawing causal conclusions from statistical associations alone.

EBM has revolutionized healthcare, but evaluating evidence in a vacuum can carry the risk of validating the absurd. To minimise this risk, we might consider integrating biological plausibility into EBM, a possibility that has long been discussed by many experts in the field. This approach is not a rejection of EBM, but a vital safeguard for it which ensures that the evidence aligns with and strengthened by fundamental science and existing knowledge. By demanding extraordinary evidence for extraordinary claims, medicine can better protect its resources, maintain intellectual integrity, and ensure that clinical practice rests on a foundation that is both statistically sound and scientifically reasonable.

 

The Church of Scientology has spent decades insisting that psychiatry is a terrorist conspiracy, antidepressants are a gateway to mass murder, and only its own “tech” can save humanity from the menace of Prozac and similar “poisons”. One might imagine this worldview would remain safely quarantined within L. Ron Hubbard’s realm of loons.

But then Robert F. Kennedy Jr. became Secretary of Health and Human Services!

By pure coincidence Kennedy’s “Make America Healthy Again” crusade, unveiled with the MAHA Action Plan to Curb Psychiatric Overprescribing, just happens to target the very same SSRIs that Scientology and its front group CCHR have been demonising for years. Antidepressants are singled out, deprescribing is framed as a patriotic duty, and psychotherapy and lifestyle tweaks are held up as the noble alternative to “overmedicalization.” The American Psychiatric Association calls SSRIs evidence‑based treatment; Kennedy, channelling his inner CCHR lawyer, suggests they’re harder to quit than heroin and may be helping to fuel mass violence.

Enter Wisner Baum, the mass‑tort firm whose senior partners have long, colourful histories with Scientology and its covert operations. This firm has spent years suing antidepressant manufacturers and other psychiatric technologies. And Kennedy has quietly pocketed over $850,000 in fees from them, while keeping a continuing financial interest as HHS Secretary. It is hard to imagine a neater arrangement: a Scientology‑linked law firm sues drug companies; a Scientology‑approved health secretary casts doubt on those same drugs from the cabinet; and fee income flows merrily along.

So, is Kennedy formally a Scientologist?

No, to the best of my knowledge, there is no evidence for that. But perhaps the label becomes somewhat unimportant, when the nation’s top health official is advancing policy that mirrors Scientology’s doctrine and staying financially intertwined with its legal defender. Whether or not he has taken the oath or not (and I am not saying he has), he seems to be doing the work of Xenu, the mysterious extraterrestrial ruler of a galactic confederacy.

An article entitled “Beyond the Appearance of Rigor: Trustworthiness, Integration, and Standardization in Traditional, Complementary, and Integrative Medicine” caught my eye. The name “Traditional, Complementary, and Integrative Medicine” is, I think, impressive as it demonstrates the seemingly infinite ability of SCAM-promoters to come up endlessly with new and ridiculous terms! Please allow me nonetheless to continue calling it so-called alternative medicine (SCAM).

The paper itself might be summarised as follows:

SCAMs struggles to fit into mainstream science. Trustworthiness isn’t just about flashy, individual study results; it requires a reliable system of transparent data and independent replication. However, forcing SCAM into mainstream healthcare via scientific scrutiny, standardisation and integration is a double-edged sword. It strips away the personalized, holistic essence of these therapies. Instead of abandoning science or changing the therapies, researchers need to use creative, flexible scientific methods that document the real-world complexity of SCAM without trying to force it into an artificial mold.

I have heard this argument often, particularly early on when I started applying science to SCAM. SCAM proponents were initially taken by the idea; later, when the results were often not what they expected, they were less impressed and argued that, because science failed to produce positive results, something must be wrong with it and in need of improvement. Specifically, the arguments were:

  • SCAM is individualised,
  • SCAM is holistic,
  • SCAM is complex,
  • SCAM is subtle,
  • SCAM depends on the skill of the practitioner.

And therefore, SCAM cannot be fitted into the straitjacket of science, particularly not in the one imposed by the randomised clinical trial.

It took many years to convince some SCAM proponents that these notions were erroneous, that science is not always perfect but that no better method for testing exists, that many mainstream interventions (e.g. physiotherapy, psychotherapy) are just as complex, holistic, etc. as is SCAM. Eventually the argument that SCAM defies scientific evaluation disappeared – not totally, but almost.

Now, 30 years later, it is back!

One cannot even blame the SCAM enthusiasts for reviving it. Thirty years of research and very little of SCAM has been proven to work – unless one gives SCAM a huge ‘benefit of the doubt’ and pretends poor science constitutes proof. Even the treatments that SCAM proponents celebrate as evidence-based fall apart once we scratch the surface and discover how poor and irreproducible the evidence mostly is.

Yes, I do sympathise with the frustration of SCAM proponents as they gradually realise all this. Many of them know only too well that their most solid evidence can be taken apart by any first-year medical student with rudimentary skills of critical evaluation. Many of them therefore have long moved away from hypothesis testing research and prefer the type of investigation that never generates a negative finding (e.g. surveys, qualitative studies, sociological approaches). Others, including the two authors of the above-mentioned paper, prefer to go full circle and revive the notions we dealt with decades ago claiming we need different standards for SCAM than for the rest of medicine.

Perhaps someone should tell them that double standards are never a good idea?

A recent paper published in the Lancet was entitled “Wellbeing for people and the planet: how to value everyone and everything on a thriving planet beyond 2030“. Here is its abstract:

Humanity is crossing multiple planetary boundaries while facing rising inequality, democratic fragility, and worsening mental health, exposing the incompatibility of unlimited gross domestic product-driven growth with a finite, socially interdependent planet. Only 17% of the Sustainable Development Goal targets are on track, indicating the need for a deeper transformation rather than faster implementation. Synthesising evidence across disciplines, we argue that human beings are evolutionarily wired for cooperation and relational wellbeing, and not perpetual consumption and status competition. This argument underpins a post-2030 shift in a global development paradigm that places multidimensional wellbeing, of people and the planet, at its core. We outline three mutually reinforcing systemic shifts: deliberative democracy that gives communities real power to shape collective futures; economic democracy that redirects finance, enterprise design, and fiscal policy towards equitable, regenerative outcomes; and transformed land and resource governance that recognises ecological limits and the rights of nature. By aligning institutions with the cooperative nature of humans and the Earth’s regenerative capacity, societies can achieve flourishing lives for all within planetary boundaries, offering a scientifically grounded agenda for the decades beyond 2030.

While reading the article, I asked myself: will our current leaders and governments accept shared limits, long time horizons, and fair trade-offs? In practice, men like Donald Trump or Vladimir Putin would probably view this framework through the lens of power, national and personal advantage, as well as political control, rather than collective wellbeing. In addition, sizable sections of the public might simply be too ignorant to comprehend the need for such a strategy. In other words, the proposal may sound morally strong but could be politically unrealistic.

If Trump or Putin were asked to follow the strategy, I fear that several objections would appear immediately.

  • First, they would reject the idea that planetary limits should constrain national ambition, especially as they seem to think that economic or military strength or even personal advantage matter more than global cooperation.
  • Second, they would treat wellbeing metrics as soft or ideological compared with jobs, growth, security, or sovereignty.
  • Third, they would use the language of wellbeing selectively, supporting parts that could further their agendas, while ignoring parts that require sacrifice, redistribution, or international restraint.

Of course, such caveats do not make the paper and its arguments wrong, but they suggest a significant gap between theory and practice. The altruistic strategy is strongest when actors are willing to cooperate and are able to think long term. I am afraid that it is weak in a world where leaders like Trump or Putin can gain by rejecting climate obligations, weakening institutions, or prioritising short-term national interest. In other words, the paper offers a vision for a better governing ethic, but it does not solve the problem of how to make uncooperative or authoritarian leaders comply.

So, my concern is not that the strategy is useless, but that it is unrealistic and far too dependent on political goodwill. A system that works only when leaders are already committed to fairness and restraint cannot be a robust system. What we also need, therefore, is a strategy by which we are able to get such leaders … improving the education of the general public might be a start.

In the US, the dismantling of public health is in full swing. That this development would sooner or later involve chiropractic had to be expected:

Thus, the recently launched MAHA Chiropractic Hub cannot come as a surprise. The new Hub is a national lobbying and promotional initiative designed to position chiropractic care as a drug-free, “prevention-first” solution to chronic disease and to reshape US healthcare policy in its favour. Launched as part of the broader “Make America Healthy Again” campaign, the Hub is a coordinated partnership between the MAHA Centre, MAHA Action, and various chiropractic associations, practitioners, and educators. The initiative promotes chiropractic as a root-cause fix for a broken system.

However, medical researchers and public health experts note that the broader claims of chiropractic, particularly those regarding “prevention-first” wellness and treating chronic non-musculoskeletal diseases, lack a credible evidence base. While an optimistic reading of the clinical evidence might support spinal manipulation for short-term relief of acute lower back pain, high-quality scientific data remains weak or non-existent for its efficacy in managing systemic health issues, preventing disease, or acting as a primary care substitute.

Operationally, the Hub seems to organize its strategy around 4 main pillars:

  • Public Relations & Branding: Launching a national media campaign to rebrand chiropractic as a credible, prevention-focused discipline, an effort critics argue pushes past the boundaries of evidence-based medicine.
  • Legislative Lobbying: Pressing for the Chiropractic Medicare Coverage Modernization Act and the full enforcement of Section 2706 of the Affordable Care Act to expand federal funding and reimbursement.
  • Military & Veterans Integration: Promoting chiropractic within Defense Health and Army medical structures for musculoskeletal injuries and pushing the Department of Veterans Affairs (VA) to expand access and reduce wait times.
  • Targeted Outreach: Explicitly marketing these non-drug, non-surgical options to vulnerable or specialized demographics, including children, military personnel, veterans, and seniors.

By targeting federal policy and public perception, the Hub seeks to institutionalise chiropractic care across major public health sectors. In the true MAHA tradition, skepticism from the medical and scientific communities regarding the effectiveness and safety of chiropractic is being ignored.

What is next?

You may well ask!

A homeopath to run the FDA, or the flat earth society taking over NASA?

Nothing can surprise me now!

Homeopaths tend to voice a standard set of arguments when confronted with irrefutable evidence against homeopathy. In the discussion sections of this blog, we heard them all:

  • “The negative trials are flawed designed.” They claim these trials were done by ungifted therapists or used the wrong remedies, wrong potencies, wrong dosing schedules, etc. Therefore, they do not reflect true homeopathic practice.
  • “Homeopathy is individualised, RCTs can’t capture it.” They argue that randomised clinical trials are inherently unsuitable because homeopathic treatment must be tailored to each patient, rendering RCTs “unfair” or even “unscientific.”
  • “Only a fraction of the evidence has been considered.” They assert that critics cherry-pick negative evidence and ignore positive small trials, case series, or observational data that they regard as equally valid.
  • “There is much positive evidence.” They point to older or methodologically weak positive studies and claim these outweigh or at least balance the otherwise negative body of evidence.
  • “Meta-analyses and systematic reviews are biased and/or politically motivated.” They allege that negative evaluations are driven by ideological hostility to homeopathy, Big Pharma influence, or institutional bias.
  • “Statistical significance is not the same as clinical reality.” They argue that  statistics miss “real-world” benefits observed in practice and that evidence-based medicine is too narrow.
  • “Evidence-based medicine overvalues RCTs and undervalues experience.” They insist that long clinical experience, case reports, patient testimonies, etc. should count as strong evidence and that their accumulated practice is itself proof of efficacy.
  • “Patient demand and satisfaction are evidence.” They use high patient satisfaction, repeat consultations, and word-of-mouth popularity as a proxy for effectiveness.
  • “Millions use it worldwide.” They argue that longstanding, global usage implies that it must work; otherwise it would have disappeared.
  • “Conventional medicine is not perfect either.” They respond to criticism by highlighting harms, errors, and historical reversals in conventional medicine, implying that science-based critics lack moral authority.
  • “If it were only placebo, it wouldn’t work on XY.” They claim efficacy in infants, animals, or unconscious patients as evidence that placebo cannot fully explain the effects.
  • “Mechanisms aren’t fully known, but that doesn’t matter.” They liken homeopathy to earlier medical advances whose mechanisms were unknown at the time (e.g. aspirin), arguing that lack of a plausible mechanism is not a valid reason to reject positive clinical observations.
  • “Physics and chemistry are incomplete; future science will explain it.” They invoke concepts like quantum physics, nanostructures, or complex systems to argue that current science is still too limited to explain homeopathy.
  • “Regulatory / institutional conspiracies.” They suggest that powerful pharmaceutical or medical lobbies seek to suppress homeopathy to protect their financial interests.
  • “Homeopathy is cheap and safe; risk–benefit favours it.” They argue that even if evidence is thin, the very low risk and low cost justify its use.
  • “The therapeutic encounter itself is part of the effect.” They turn criticisms about placebo and context effects into a strength: the long consultation, empathy, and attention are claimed to be legitimate and central components of homeopathy.
  • “Freedom of choice / patient autonomy.” They shift from scientific to ethical/political ground, insisting that patients should be free to choose homeopathy regardless of scientific consensus.
  • “Skeptics misunderstand what homeopathy really is.” They claim that people conflate homeopathy with herbalism, confuse potencies, or misunderstand Hahnemann’s principles, so their critiques do not address true homeopathy.
  • “Critics don’t see the individual ‘miracle’ cases.” They counter population-level data with vivid anecdotes of dramatic improvements which they regard as decisive.
  • “Negative evidence is ‘absence of evidence’, not ‘evidence of absence’.” They argue that failed trials or negative reviews merely show that efficacy hasn’t been proved yet, not that homeopathy does not work.
  • “Science evolves; today’s ‘overwhelming evidence’ may be overturned.” They claim that scientific consensus has been wrong before and that homeopathy will eventually be vindicated when paradigms shift.

In discussions with homeopaths, these points are repeated endlessly. One could easily get the impression of a broken record. All of the above arguments have in common that – even as some of then contain a kernel of truth – they are erroneous. In theory it could be easy to point this out to the stereotypical homeopathy promoter; in practice, however, it often is impossible, since the broken record continues turning senselessly.

 

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