Patients have a right to choose unscientific treatments

Saturday 19 August 2000 00:00 BST
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The principle behind homeopathy is of course nonsense on stilts. More than that, it is nonsense on floating stilts. The idea that a medicine can be effective after it has been diluted so much that no molecules of it remain, only what alternative practitioners claim is a "molecular memory", is incredible.

The principle behind homeopathy is of course nonsense on stilts. More than that, it is nonsense on floating stilts. The idea that a medicine can be effective after it has been diluted so much that no molecules of it remain, only what alternative practitioners claim is a "molecular memory", is incredible.

The research published in the British Medical Journal this week that found that a homeopathic remedy was more effective than a placebo should therefore be treated with extreme scepticism. The sample was tiny, just 51 people, and the condition treated - nasal allergy - has variable symptoms that are experienced subjectively.

Logically, homeopathy cannot work, yet many people claim to have benefited from it and in some cases it can be available on the NHS. Should it be? Yes it should, for three simple reasons. Homeopathic medicine, by definition, can do no harm; it is cheap; and patients should have the right, within reason, to choose their treatment.

The argument of cost is not insignificant: anything which shifts the emphasis of the medical profession from the glamour of hi-tech intervention is to be welcomed.

But it is the argument of patient choice that is the most important. One of the weaknesses of health care in this country has been for a long time the excessive deference shown by patients to doctors. The more patients are involved in, informed of and understand their conditions and choice of treatments, the more effective the health service is likely to be.

The problem is that homeopathy is not the best advertisement for what is now called complementary medicine. Acupuncture is a better example: the process by which it works remains a mystery, but that it could have some effect is scientifically plausible. If homeopathy is available on the NHS, the case for acupuncture is stronger. More research into the efficacy and safety of herbal medicines and aromatherapy should be encouraged. It tends to be neglected because there are no profits in it for the drugs companies.

If we are to move towards a health service in which consumers are more assertive, more demanding of information, more sceptical that "doctor knows best", then the medical profession has to accept patients' right to choose complementary treatments. Some patients will be sceptical about scientific scepticism itself, but that is a small price to pay for the principle that people should be allowed to decide for themselves.

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