Last week, an editorial in the National Post by Tim Caulfield ruffled a few homeopathic feathers. In it, Caulfield argues that when provinces grant regulatory status to alternative practitioners like naturopathy, they are legitimizing rank quackery. This is the case because naturopathy relies heavily on homeopathy, which Caulfield correctly describes as “bogus”.
Canadian supporters of homeopathy are feeling the heat. Karen Wehrstein, homeopath and Executive Director of the Canadian Consumers Centre for Homeopathy responded to Caulfield’s criticism, defending homeopathy as a legitimate practice. The result is underwhelming, relying largely on appeals to its apparent popularity, and simple insistence that the science is actually coming in in favour of the homeopathic approach.
Even so, her claims require scrutiny. She begins her defense of homeopathy by describing how popular it is:
Homeopathy is so well trusted that 300 million patients in more than 80 nations use it. In countries such as the U.K., Brazil, parts of India, Mexico and Cuba, homeopathy is integrated into the health system and covered by public health insurance. In Europe, three out of four people are familiar with it. In Cuba, mass dosing of preventive homeopathic medicines is now used routinely by the public health system for epidemic control. One of the world’s most popular over-the-counter flu medicines — Oscillococcinum — is a homeopathic remedy … Homeopathy is now a regulated health profession in Ontario, and homeopathic medicines are classified by Health Canada.
Wehrstein provides no reference to back up her claim that over 300 million people use homeopathy worldwide. Other proponents claim a much lower number. Even if her number is accurate, simple use does not imply efficacy, which she well knows. Further, use does not equate to trust (belief in efficacy). Some people may be genuinely unaware of what they are using, some people may confuse homeopathy with herbal remedies, and some people may not have access to real medicine.
What about all these countries that integrate homeopathy into their publicly funded healthcare systems? Indeed, you would think that if the evidence was that impressive for homeopathy, more than a small handful of countries would endorse it. Instead, what you see is critical rejection of homeopathy. Wehrstein specifically mentions the UK as an example of a country that endorses and pays for homeopathy as part of its national health plan. This is misleading. In 2009, the UK’s parliamentary Science and Technology Committee specifically reviewed the scientific evidence that supported government policy and found the following.
The Government’s position on homeopathy is confused. On the one hand, it accepts that homeopathy is a placebo treatment. This is an evidence-based view. On the other hand, it funds homeopathy on the NHS without taking a view on the ethics of providing placebo treatments. We argue that this undermines the relationship between NHS doctors and their patients, reduces real patient choice and puts patients’ health at risk. The Government should stop allowing the funding of homeopathy on the NHS. We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals—hospitals that specialise in the administration of placebos—should not continue, and NHS doctors should not refer patients to homeopaths.
The UK doesn’t endorse homeopathy as effective and it does not fund homeopathy because it’s effective. Proponents in the UK had every opportunity to present the best scientific evidence it had to support homeopathic principles and products. They failed. Similarly should a similar inquiry ever be conducted in Canada to examine the evidence in support of the regulation of naturopaths, homeopaths and homeopathic remedies, ruling governments would be in a position to have to explain why they directly and indirectly legitimize witch doctors and magical potions as medicine. I long for the day. Ironically, part of Caulfield’s argument is that by regulating this nonsense, these problematic practices are legitimized. How does Ms. Wehrstein defend the legitimacy of homeopathy? By citing government regulation. Point to Caulfield.
A massive study showing that homeopathy is more cost-effective than any other forms of medicine, traditional or alternative, was commissioned by the government of Switzerland and published in 2011.
How did the Swiss government come to such a different conclusion than their UK counterparts? They basically relied on a report largely written by homeopaths using a manipulated standard of evidence. So much for the Swiss.
There are, in fact, many promising studies on homeopathy, across a broad number of fields. Of the meta-analyses — studies measuring the number and results of existing studies — that have been published, the majority show findings promising enough to recommend further research in the field.
It is routine for homeopaths to assert that there is good evidence that homeopathy works and more is coming in every day, but this is a weaker assertion by Wehrstein. Really? Of all the published studies the best homeopathy can do is show promise? This is hardly good enough if it were true, but it turns out that it is not.
Homeopaths in the UK attempted to convince the Science and Technology Committee much the same thing the Wehrstein is trying to convince us of here – that most of the available meta analyses show that homeopathy is effective. However, it turns out that of the 5 cited by British homeopaths (and I think it’s fair to assume that Wehrstein includes these in her majority), 2 were outdated, 1 was a republication of one of the outdated reviews that was actually less than positive, 1 though initially positive was re-analysed 6 separate times with negative results and the last was completely negative. In other words, the reviews do not show that homeopathy works, nor do they show that homeopathy is somehow “promising”. For more information, see page 18 of the Committee report.
The largest single study of homeopathy ever published was conducted under the auspices of the Cuban Ministry of Health in 2007. The populations of the three provinces of Cuba most threatened by the hurricane-triggered disease leptospirosis — a total of 2.3 million people — were all given two doses of a preventative homeopathic medicine in advance of the time of worst danger. The result: “The homeoprophylactic approach was associated with a large reduction of disease incidence and control of the epidemic.”
Wehrstein fails to mention why this study is rejected as evidence for homeopathy’s efficacy yet presents it as if its definitive. It isn’t. The provinces that were treated with the homeopathic vaccine were experiencing a spike in infection prior to the intervention. With no control for this, the authors cannot conclude that homeopathy caused a decline in infection. In fact, randomization within the treatment area was possible, but somehow not thought of by the homeopaths running the study. For me the real nail in the coffin for this paper is the fact that despite such success in getting 96% of the treatment region covered, rates of infection were subsequently no better than in 2004, without homeopathy. In other words, homeopathy probably didn’t work. For an excellent takedown and discussion of other irregularities and curiosities in this study, please click here.
There is no magic or witchcraft in homeopathy. Anyone of any (or no) religious or spiritual tradition can practise it with training, and the patient does not have to believe in it for it to work (else it wouldn’t affect infants, animals and microbes). In homeopathy, positive results require the use of standard and repeatable procedures based on consistent principles, which are the core of the curricula of homeopathic colleges.
It’s also true that anyone can practice reading goat entrails to play the stock market with a little training (and for a fee) at any reputable Entrail Reading College. Can you imagine the visceral chaos if the curricula were not standardized?
More seriously, standardized, repeatable procedures and consistent principles are great and desirable, but unless the principles have objective and demonstrable merit, everything you do based on them is empty, meaningless ritual. A little like making a magic potion.
Homeopathy’s big stumbling block to acceptance is that its medicines are diluted so much that people outside of the field can’t understand how they can possibly have an effect. There are, however many scientists who do have that expertise. So many, that there is an entire journal devoted to the field, the International Journal of High Dilution Research. And they seem to be getting intriguingly close to providing definitive answers.
It’s typical for homeopaths to claim that skeptics are not able to understand how homeopathy works because they’re not experts in homeopathy. However, skeptics understand just how dilute most remedies on the market are and it requires no real expertise to understand that homeopathy cannot work. Even the most scientifically illiterate person (who isn’t a homeopath) is likely to call BS when they hear that the smaller the dose, the stronger the medicine. But apparently us common folks are really the stupid ones, since there are “many” illustrious scientists who are homeopathy experts. So many that they got together to found an academic journal that no one has ever heard of.
Opponents of homeopathy claim that homeopathic medicines are “just plain water” with no medicinal properties. But increasing numbers of scientific findings are making it harder to maintain such as stance. One study has found that solutions prepared in the traditional homeopathic way — through repeated dilutions by mechanical shaking — have properties unlike plain water, with elements of the dissolved material. Another study suggests the solutions have an affect on living cells in vitro. Yet another study shows that solutions can be distinguished from each other, using the right equipment to determine their contents. And emerging research suggests that homeopathic solutions actually contain nanoparticles of the original dissolved material.
Once again, we are told that the science in favour of homeopathy is coming in, but we can’t evaluate any of it because Ms. Wehrstein failed to provide appropriate references for her claims. This is extremely odd, since she was able to link to other studies. I find it difficult to believe that this was an oversight.
It’s not quacks or junk scientists researching high dilutions. Dr. Luc Montagnier, Nobel laureate and co-discoverer of the human immunodeficiency virus, presented at a national American homeopathic conference last year, discussing his work on the ability of DNA in high dilutions to emit electromagnetic waves.
It is not unknown for smart people to believe in dumb things. In fact, there’s a depressingly long list of Nobel laureates in science and MD’s that believe in dumb things. With respect to Dr. Montagnier himself, he apparently hasn’t been able to convince any of his scientific colleagues that homeopathy has any merit, which is probably why he is currently presenting at pseudoscientific conferences. Dr. Montagnier may be a Nobel laureate but that does not make him a credible authority on homeopathy, in fact he can be a Nobel laureate, a quack and a junk scientist, all at the same time.
Karen Wehrstein’s best defence of homeopathy consisted of appealing to its popularity, selectively citing studies and meta-analyses that she surely knows have been heavily critiqued for their lack of merit, appealing to the authority of a nobel prize winner as if he’s infallible and finally playing the “keep an open mind” card – as if the rest of us are doing science wrong. As proponents of pseudoscientific medicine strive for legitimacy they ironically bring down upon themselves the kind of scrutiny that will, given enough time, result in the exposure of these practices as quackery. They can’t claim to be scientifically grounded and then insist that the standard by which everything else in science is judged is inappropriate for them. Nor can they continue to expect that regulators, patients and consumers should be content to simply wait until they can produce the required science to back their claims, while they carry on business as usual without regard to the consequences. Proof, or stop peddling water and sugar as if it’s medicine.
I can’t end this post without mentioning that apparently Ms. Wehrstein is under the impression that opponents of homeopathy are really attacking it because they are anti-woman. Really, she actually thinks this idea has merit. This is where homeopathy advocates are at, charging that criticism of homeopathy is motivated by misogyny. They are so arrogant they can’t even entertain the possibility that they are wrong.