Ending the homeopathy delusion

When nuclear power was discovered, homeopaths claimed that it explains their trade

Police say the infant was receiving natural treatment when he was admitted to hospital
Police say the infant was receiving natural treatment when he was admitted to hospital

Homeopathy has attracted fierce dispute since its invention around 200 years ago. Initially, scientists merely laughed at the implausibility of its assumptions: like does not cure like, and endless dilution (homeopaths call them “potentisations”) does not render a medicine more effective. To understand this better, consider the current homeopathic “best seller”, oscillococcinum, which is “potentised” from duck liver and recommended for colds or flu. It is sold in the C200 potency meaning that one part of organ extract is diluted in 10 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 parts of diluent: this is much less than one duck molecule per universe.

But homeopaths claim that science merely fails to explain the mode of action of such remedies. Hahnemann, homeopathy’s inventor, thought they worked via some “vital force”. When nuclear power was discovered, homeopaths claimed that it explains homeopathy; when quantum physics came to the fore, they believed to have found the mechanism of action; when nanoparticles became fashionable, they said these were the clue. In truth, the mode of action of highly diluted homeopathic remedies is not just unexplained, but science can explain that no plausible mechanism can exist.

Homeopaths nevertheless love to argue that the proof of the pudding is in the eating: homeopathy works because many patients experience benefit from it. Today about 300 clinical studies testing homeopathy have been published. The totality of this evidence fails to confirm that homeopathy works better than a placebo; this has been confirmed by one top-level report after another (only cherry-picked, homeopathy-sponsored evaluations arrive at different conclusions). But what about the many patients who swear by homeopathy? The answer is surprisingly simple: they benefit from placebo-effects, from the empathetic encounter with a homeopath and from various other phenomena that are unrelated to the homeopathic remedy itself.

So, it’s a placebo. What is wrong with that? Surely the main thing is to help patients, and if the remedies achieve this aim, homeopathy must be alright. This notion sounds plausible enough but, on closer inspection, it is fallacious for a whole range of reasons. The most important one seems somewhat paradoxical: we do not need placebos for generating placebo-effects. If a clinician administers a truly effective treatment with compassion, time and empathy, his patient is also likely to benefit from a placebo-response. In addition, this patient will benefit from the specific effects of the clinician’s effective treatment. In other words, just giving a homeopathic placebo means withholding the most important element of the therapeutic response. In my book, this is unethical.

“At least homeopathy is safe – not like the dangerous chemicals of Big Pharma!”, the last defenders of homeopathy claim. But this is merely another fallacy. Firstly, most homeopathic remedies might be harmless, but the same cannot be said of all homeopaths. Some advocate their placebos even for serious conditions, and it is obvious that such advice can cause very serious harm indeed. Secondly, the value of a therapy is not determined just by its safety, but by its risk/benefit balance. Homeopathy has no benefit and some risks; therefore its risks/benefit balance can never be positive.

Yesterday, we learnt that the Government might black-list homeopathy on the NHS. In view of the evidence, this should happen rather sooner than later.

Professor Edzard Ernst was awarded the 2015 John Maddox Prize for standing up for science

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